Catch Me if You Can: Reducing Infectious Disease Through Better Indoor Air Quality and Biosurveillance

Infectious disease transmission continues to be an unmet challenge. This is in part due to the air that circulates within our indoor environments, which can contain a myriad of potentially pathogenic bacteria, fungi, mold, and viruses as well as various allergens. This issue was highlighted during the COVID-19 pandemic, due to the highly infectious nature of SARS-CoV-2 and the public measures taken to limit airborne transmission of the pathogen through quarantining, social distancing, and maskwearing. The broad disruption in normal activities and interactions within these indoor environments prompted rethinking how indoor air quality can be improved to further mitigate infectious disease transmission. There is opportunity to accomplish health security and biosurveillance for protecting critical building infrastructures by incorporating existing and new measures for detection and control of microbial burden. Integrating central building controls and systems for heating, ventilation, and air conditioning with ongoing detection of environmental flora and microbes can help identify emerging pathogens and endemic biothreats such as SARS-CoV-2 and Legionella, respectively. This effort, however, will require (1) synergistic funding from 1 or more government agencies and multiple commercial entities to maintain habitable indoor environments and (2) environmental factors on infectious disease emergence and transmission to improve health outcomes and overall national security. In this commentary, we illustrate the importance of indoor air quality through case studies of infectious pathogens, their interaction with indoor environments, and measures to curtail the airborne transmission of respiratory disease.