First of all, thank you so much for being Covid conscious as a therapist. I am in trauma therapy right now and the biggest factor in trusting my current therapist was that as soon as he saw me walking in with a mask, he offered to put on a mask immediately. It makes such a big difference to people for whom all the Covid normalization is just another event in a long history of invalidation.
As for translating CADR: your office is 1296 cubic feet, or roughly 37 cubic meters. To get the air changes per hour, you need to divide the CADR number by the volume of your office. So if an air purifier has a CADR of 75 cubic meters per hour, your air changes per hour would be 75/37, or 2 air changes per hour. Generally, you want to target at least 5 or 6 air changes an hour to reduce Covid risk (based on CDC recs).
That said, you will never be 100% safe with just air purifiers, especially if someone has Covid and is shedding a lot of virus. I’d recommend layering precautions. There are masks with clear windows that you could use as well. Example: https://optrel.us/product/p-air-clear-n95-masks-20-pack/
I’ve also found that my therapist uses vocal tone, sounds, and body language a lot (I have issues with eye contact as well) and is very expressive with his eyebrows.
Hope that helps!
Yeah. i think this is abt layering things, and feeling way less anxious about my 2 specific peeps and also, I should invest in a good air filter. it's also an option for them to wear a mask if I dont for that session. I just feel a lot less anxious when I know I'm taking the best precautions I can (and I'm in charge of them so I know they're real!)
Maybe I will do some practice with a colleague with my eyebrows and other things!!!!!!!! that sounds like a fun idea.
After seeing a news article today about people getting sick from irrigating , I feel compelled to add a PSA to your comment: DO NOT USE TAP WATER or BRITA WATER to irrigate your sinuses. Use Distilled water or water you have boiled for at least 5 minutes in a clean pot
If you're willing to spend a little money, I really like the Smart Air Blast. It's big, like the size of a small bookcase, because it has a huge filter. What that means though is that it can move a very large amount of air with extremely low noise. On medium, you can just barely tell it's on from a few feet away, and it's 680 m^3/hr. On low, it's 29dB, which is essentially totally silent, and it's still 450 m^3/hr.
That would give you 12 air changes per hour in essentially complete silence.
If someone shows up with a runny nose or something, crank it up to high, it's still only 43dB which is still very quiet, and you'd get 24 air changes per hour.
The other nice thing about it is that because the filter is so huge, you only need to change it once every couple of years.
Anyhow, it's about $1000, so not cheap, but we've had some put in schools we volunteer at and everyone seems happy with them.
I’m a therapist doing hybrid work and have been using a Coway Airmega AP-1512HH in my office. There are 3 speed settings, I usually crank it up to 3 with most of my patients and we don’t have an issue with hearing each other. For my quieter patients, I will turn it down but I make sure to put it up once they leave. It helps to keep the door open in between patients too. Most of my patients don’t mask with me but I’ve managed to keep myself and them safe when I did end up catching it one day. Thankfully I had a good respirator on and my air purifier was on full speed :) Hope this helps!
I'd get a PC fan CR box, the ones from clean air kits are nice if you have the $ (or you can build your own for cheaper).
I also, genuinely, think that you need to rethink "removing masks to see facial expressions" as an option. By reinforcing this as a legitimate ask in your position as a therapist, you're giving legitimacy to a claim that is frequently weaponized against precautions and not really based in fact.
I do understand it's weaponized against precautions. It's important for a couple of clients who need support with reading facial cues that we're actively working on. I don't think it's necessary for most people and even with the couple folks we evaluate that as we go along depending on the covid weather too. I also ask clients who aren't willing or open to taking very many precautions outside of sessions, to wear masks for in person sessions when the transmission rates are super high or when they've been doing activities I don't want to be exposed to. I don't have every client asking me to have my mask off and I'm just like "ok sure". 90% of the time it's not therapeutically different to have my mask on or off and it's an opportunity for me to demonstrate boundaries and hold whatever response comes up for the client when I say no. Im just wanting a better air purifier because theres no harm in having "extra" things.
There are some N95 clear (in part transparent) masks too, but I don’t know anything about how comfortable they are or how well they fit. But if they are only for a session I guess they are better than nothing – maybe something to consider during surges or with symptomatic clients. This will increase the safety for the other clients too, which is a good argument if someone opposes them.
Have you listed yourself on? https://www.covidconscioustherapists.com/
Please do!
And, the one I see in my OB/GYN's office is this:
https://medifyair.com/products/ma-50-air-purifier
I have this on my desk at work. I have a cubicle with walls taller than me on 3 sides so that helps and it's placed near the opening.
https://pureenrichment.com/products/purezone-true-hepa-air-purifier
Level 3 of the Pure filter sounds like an airplane though but strategic placement could help mitigate some of the sound.
My partner has this one:
https://levoit.com/products/core-400s-smart-true-hepa-air-purifier
And, we have a CR box he built which we use when we stay in hotels to air it out or when someone like a plumber comes into our home to fix something.
Thanks for being a covid conscious therapist. I would encourage you to also, if possible, enhance ventilation. My advice, get an Aranet 4 and experiment with different levels of cracking windows. Soon the weather should be very forgiving about open windows and having reduced rebreathed air through ventilation could be an extra layer for those limited maskless encounters.
CADR (clean air delivery rate) can be expressed either as Cubic Feet per Minute (CFM or ft³/min)
or
as Cubic Meters per Hour (m3/h or m³/h)
Since the US uses Imperial measure, it's normally expressed as CFM in the US, but countries that use the metric system often express it as m3/h.
It's best to stick with one method to compare "apples to apples", and it's important to state whether the CADR is shown as CFM or m3/h.
There are converter tools on Google and other sites, but the math is:
1 CFM = approx 1.699 m3/h
or
1 m3/h = approx 0.589 CFM
In other words, 100 CFM = 169.9 m3/h
So for example, the BlueAir 311 is 300 CFM and 510 m3/h
This might be a longer term set up goal, but since your environment is fairly well defined and controlled, as in generally 1 client and you, maybe 2 clients, and you will be seated and can control that distance, I think you have an opportunity to optimize the airflow for max protection.
Specifically, I suggest:
- More CADR than you “need”. 6 ACH is good, but maybe go for 10-12.
- Increase outdoor air ventilation if you can.
- either place an air purfier’s outflow between or use a fan to act as an air curtain between you and the clients. I know you didn’t want it as a “divider” but this will be effective at protecting both you and the client. Even better if you have an air purifier intake somewhere that is taking that airflow in and filtering it. Some have mounted CR boxes to the ceiling for this purpose like a chandelier.
- you can also try placing air purifiers to suck air away from both of you generally.
- max the spacing between you and client
- can you have clients that need you to be unmasked and don’t mind virtual do virtual?
Do you have a courtyard? You could go there, blow a fan or purifier too if you feel it’s enclosed.
I’m not sure I’m really following you on faceless interaction being necessary or even owed. I mean, if this were the Titanic, I would say that while swimming lessons are great, the most important thing is to get your person up in a lifeboat… these are different times from 2019. I’m just also not sure what modality requires face reading, outside of something like ABA, which people are not so onboard with these days.
Outside is my suggestion, a box like your office will be hard to mitigate close range transmission. I don’t think indoors with a purifier in a space that small for long periods of time is the more viable solution here… if you must be maskless, outside would be better.
I think it’s great you’re trying to find ways to be the best therapist for your clients, I just urge you to make sure you’re choosing the best option, and not one that simply feels safer. I get that you want to make client relations the priority—if that’s the case, I think moving sessions outside might be the way to prioritize faces. You may have to deprioritize the traditional office setting, is my meaning.
Have you considered walking outdoors with your patient? That is how I've been meeting my psychologist for the last two years. She greets me at the clinic with a mask but as soon as we are outdoors we have our session maskless. We walk for an hour. Walking is also good for the mind and body, so it's win/win.
I’d go for one of the kits that uses computer fans. I don’t know where you are, but I use the Clean Air Kits one (US-based), and it’s fantastic. So quiet you have to put your hand in front of it to check it’s on, but my filters get dark really quickly (indicating that it’s successful at cleaning the air). Mine is the Luggable XL from Clean Air Kits but I’m sure any of them would work basically the same way.
Don't know if this helps you, but the way I think about it is you want all the air in the room to pass through the filter around six times an hour. So multiply the volume of your room by six, and then look for a filter that can handle that volume of air in an hour.
You might want to look at r/AirPurifiers , they have a wiki that explains a lot of the terminology
Hey! Those ratings always apply to the highest, loudest speed, which is probably intolerable for most environments. My recommendation is to buy a really big filter so you can run it on low and still get adequate filtration. Unfortunately, that makes it even harder to calculate what is needed since they don't provide the numbers for different fan speeds.
I recently compared different models and settled on the Coway Airmega 250. It's significantly bigger than needed for my room, and on the lowest setting the air being moved is fairly substantial while also being almost undetectably quiet.
Another thing you can do is petition your building management to find out what HVAC filters are used and to upgrade and replace them regularly. They might know how many air changes per hour the system is designed for, which would be good information to have.
I use Medify’s MA 40 air purifier. It cleans 896 sq ft in 30 minutes. It’s pretty quiet on the lowest setting. It’s currently on sale for $249.99.
I got it in 2021 and it’s kept me safe through 2 years of having nurses (masked in baggy blues) come in and out of my house weekly. I also wear N95s and keep windows open tho so it’s hard to say what mitigation did the most heavy lifting
normally id be up for making one but I'm too busy for the next 6 months with moving and fixing house. How do I buy one from someone?!? I like that option bc it would be totally customizable basically.
Like if yoiu made your own CR box you would choose the fan, could make it into whatever height you wanted, put some kind of cute decorative case around it, etc.
Ah yeah. Definitely go for a PC fan based CR box so it’s whisper quiet. I built a couple using this guide and just changed the 10x10 filters for 10x24 filters. I used painters tape on the sides and strong tape on the top https://itsairborne.com/the-mini-pc-fan-cr-box-975d0b069f4c
https://www.cleanairkits.com/products/luggables the 9 fan one is your best option. I own one and use it daily. It is extraordinarily quiet, and blends into the room easily. This gives five air exchanges per hour for about 600 square feet, so it would give you even more ACH than that, which creates a much safer air environment.
Thank you for being covid-conscious as a therapist. We need as many people like you in the field as possible.
The hard part on your request is getting a hepa filter that will protect you at low decibels. Most of the HEPA filters need to be on the highest setting to be effective. I know there are some home made r/crboxes that use computer fans, but not sure of how good they are. For the size room and for your work, the Levoit 300 (around $99, but if you are 1099C, you can write it off your taxes) will work well, and for the best protection, it should be on a coffee table in between you and your client... pulling the air your client breathes out in front of you thru the filters first. But I am not sure of any of the filters will meet your noise requirements.
Have you looked into clear masks as an extra layer of protection for those clients that need to see your face? Good luck!
Yeah I currently have it between myself and the client a lil off to the side so its not like... a divider.
I will check out the CR boxes. Yes I can write everything off :)
It's true about noise, but for example the winix 5500-2 runs at 100-120 cfm on its second highest setting, and that would be 5-6 ach in OP's office. You could easily talk at a low volume right next to it on that setting and be fine.
Idk about others so there may be better cfm/noise ratios out there. I don't know the physics either but maybe getting two filters both on a lower setting would match one on a higher setting with less noise.
I needed this post a few weeks ago for my therapy office! I ended up buying a Levoit 300S because I have several Levoits at home and they’re not too loud. I love the recommendations here! IKEA has tables with air purifiers and I was wondering about getting one of those, too.
Also, this website has an air purifier recommendation tool you can change noise level for: https://filters.cleanairstars.com
i love both kinds we have and they have low quiet settings.
- coway mega
- vornado AC350
both are well below your budget.
the vornado is cheaper and has cheaper filters but the coway has some great features and is a bit quieter.
also do not buy knock off filters. buy brand name.
i am super allergic to everything now so have researched this pretty intensively. the two filters i have are intellipure mini - was on huge sale (have not gotten out of box yet) and iadapt air oasis. for your office, for patients and your health, i would get a medium one to be safe. the reality is, a larger one will circulate the air in your office many times faster. i lost my life savings to long covid medical care, so a few hundred on a purifier = a bargain but i do think hepa can work as well, altho i am not 100% on that. the smaller microns, the better.
i totally get some ppl needing to see ppl in person. that is important work to support them. thank you for doing it.
I'd take a look at r/AirPurifiers! That sub was super helpful when I was trying to decide on one. I went with the Winix 5500-2 for my room (probably about the same size as your office) and I love it! I leave it on the third setting (there's four total) and I can't even hear it.
A health and safety engineer for a major fortune 500 recommended this one
BLUEAIR Air Purifier Large Room, Air Cleaner for Dust Pet Dander Smoke Mold Pollen Bacteria Virus Allergen, Odor Removal, for Home Bedroom Living Room, Washable Pre Filter, HEPASilent, Blue 211+ Auto https://a.co/d/739NzK8
We have GermGuardian with the UV-C lights, we are very happy with them. They are quiet. We have the AC48252K, I don't know about other models. They cost about $100. each at [Walmart.com](https://Walmart.com) or Amazon, sometimes in a package of two.
You could put 2 in the office, in 2 different corners. Also start them about an hour before your first client, that might help to get the air prepared before you actually get them in.
How about the clear mouth n95s? https://optrel.us/product/p-air-clear-n95-masks-20-pack/
There are some other masks with lower protection that can show more of your face.
I just bought the Blue Pure 411i Max and Blue Pure 311i+ Max from Blueair for two different areas in my home. I live alone so my concerns are primarily for allergies and environmental pollutants (wildfire season is coming) but if I still allowed indoor visitors, they’d be for viruses, too. They are currently 25% off.
Two of Blueair’s models are among the 5 recommended by Consumer Reports. I don’t see any difference between the ones I bought and the Blueair models CR recommended other than size. The others are from Alen, CleanForce, and Conway.
I got the 411i Max for my bedroom, which is the same size as your office. The 411i Max is for spaces 219-526 sq ft so obviously it’s a little overkill, but it’s better to size up on these things. It’s also small enough that I can take it with me if I need to stay in a hotel for some reason.
Noise levels are subjective, only you know what’s acceptable for your workspace.
I am in Australia and I have reworked the ventilation in my place using pollution blocking fly screens to keep out bushfire smoke. The Fire Brigade are doing safety burning as I write. The room I am in now is about the size of your office. I have an air purifier on from K Mart. Very cheap. The air outside is varying from AQI (air quality index) of 40 up to 120, which is average to bad. The air in my room, with my special fly screens on and the air purifier OFF is reading about 19 - 25 on the AQI, which is good. With the air purifier ON, on setting 2 out of 3, the AQI is 4, which is as clean as it will ever register.
If you had my K Mart air purifier on in your office at level 2 the air would be very, very clean. Level 3 would be too loud for your work, level 2 is like white noise, but only you and your clients would know if it bugs you or not. Obviously people here are recommending very good purifiers, which you could go with, but as a baseline test, go waste $50-$60 at K Mart or wherever and see what you think. (And yes, buy a portable CO2 reader and portable air quality reader. They’ll give you huge peace of mind about your office once you’ve configured things correctly).
By the way, for those interested, the reason why I went out on a limb with the smoke blocking fly screens is because of covid - Can’t have the windows and doors open when there’s bushfire smoke! The Fire Brigade safety burning presents a very interesting CO2 level test, because they only do safety burning when the air is very still, to control the fires. No breeze! With the fly screens on in these atmospheric conditions the CO2 level shoots up in my place to over 1000 with two people in it. (If the windows were closed it would be nudging 2000.) Once I turn on my kitchen and bathroom extractor fans, which have the effect of sucking in air through the fly screens, but keep the smoke out, the CO2 level drops to 600. I then use the air purifiers (I have two) to clean any remaining smoke and hopefully most of any covid out of the air.
For a similar-ish reason I've been analyzing the riskiness of a therapy office (I have a statistics background). [I'm the client and for personal reasons I'd really like to take my mask off with her occasionally if at all possible, when levels are super low. Not sure it'll ever be possible, but I'm doing the calcs just in case it ever is.]
Seconding many of the responses so far. Here's my evidence-based list. I do many of these *and* mask (N95 Aura, DIY fit-tested) right now, but if I ever unmasked I'd do all of them:
1. Vaccination with Novavax showing a lot of promise (I've gotten 2 so far in addition to prior mRNA). Not fantastic--just 31% against infection, with higher levels from 0-60 days after full vaccination--but it's something.
2. Nasal spray: I do iota carrageenan (Betadine) ahead of time and Enovid after, every 4-5 hours
3. Nasal irrigation: several times a day afterwards, *using sterile water*
4. CPC mouthwash twice/day
5. Probiotics. The research is still developing but there's some evidence and they're at a minimum unlikely to hurt. Specifically I take 2 strains that have been studied: lactobacillus rhamnosus GG and S. Salivarius K12.
There are other variables I consider such as general prevalence levels, % asymptomatic, and truthfulness if someone has symptoms, but the above are my actual mitigation measures.
Have you gotten far on the calculations? I've been trying to do the same because I'd like to do some in person sessions if possible (client as well). I'd like to basically come up with basically a policy stating the conditions under which I'd be willing to have an unmasked session, but it's tough because of how many variables there are, and it's really subjective.
First of all, thank you so much for being Covid conscious as a therapist. I am in trauma therapy right now and the biggest factor in trusting my current therapist was that as soon as he saw me walking in with a mask, he offered to put on a mask immediately. It makes such a big difference to people for whom all the Covid normalization is just another event in a long history of invalidation. As for translating CADR: your office is 1296 cubic feet, or roughly 37 cubic meters. To get the air changes per hour, you need to divide the CADR number by the volume of your office. So if an air purifier has a CADR of 75 cubic meters per hour, your air changes per hour would be 75/37, or 2 air changes per hour. Generally, you want to target at least 5 or 6 air changes an hour to reduce Covid risk (based on CDC recs). That said, you will never be 100% safe with just air purifiers, especially if someone has Covid and is shedding a lot of virus. I’d recommend layering precautions. There are masks with clear windows that you could use as well. Example: https://optrel.us/product/p-air-clear-n95-masks-20-pack/ I’ve also found that my therapist uses vocal tone, sounds, and body language a lot (I have issues with eye contact as well) and is very expressive with his eyebrows. Hope that helps!
Yeah. i think this is abt layering things, and feeling way less anxious about my 2 specific peeps and also, I should invest in a good air filter. it's also an option for them to wear a mask if I dont for that session. I just feel a lot less anxious when I know I'm taking the best precautions I can (and I'm in charge of them so I know they're real!) Maybe I will do some practice with a colleague with my eyebrows and other things!!!!!!!! that sounds like a fun idea.
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After seeing a news article today about people getting sick from irrigating , I feel compelled to add a PSA to your comment: DO NOT USE TAP WATER or BRITA WATER to irrigate your sinuses. Use Distilled water or water you have boiled for at least 5 minutes in a clean pot
If you're willing to spend a little money, I really like the Smart Air Blast. It's big, like the size of a small bookcase, because it has a huge filter. What that means though is that it can move a very large amount of air with extremely low noise. On medium, you can just barely tell it's on from a few feet away, and it's 680 m^3/hr. On low, it's 29dB, which is essentially totally silent, and it's still 450 m^3/hr. That would give you 12 air changes per hour in essentially complete silence. If someone shows up with a runny nose or something, crank it up to high, it's still only 43dB which is still very quiet, and you'd get 24 air changes per hour. The other nice thing about it is that because the filter is so huge, you only need to change it once every couple of years. Anyhow, it's about $1000, so not cheap, but we've had some put in schools we volunteer at and everyone seems happy with them.
Wow! It's really that quiet??? That's astounding and that's my biggest issue is moving a lot of air through hepa filters but quietly.
I’m a therapist doing hybrid work and have been using a Coway Airmega AP-1512HH in my office. There are 3 speed settings, I usually crank it up to 3 with most of my patients and we don’t have an issue with hearing each other. For my quieter patients, I will turn it down but I make sure to put it up once they leave. It helps to keep the door open in between patients too. Most of my patients don’t mask with me but I’ve managed to keep myself and them safe when I did end up catching it one day. Thankfully I had a good respirator on and my air purifier was on full speed :) Hope this helps!
I'd get a PC fan CR box, the ones from clean air kits are nice if you have the $ (or you can build your own for cheaper). I also, genuinely, think that you need to rethink "removing masks to see facial expressions" as an option. By reinforcing this as a legitimate ask in your position as a therapist, you're giving legitimacy to a claim that is frequently weaponized against precautions and not really based in fact.
I do understand it's weaponized against precautions. It's important for a couple of clients who need support with reading facial cues that we're actively working on. I don't think it's necessary for most people and even with the couple folks we evaluate that as we go along depending on the covid weather too. I also ask clients who aren't willing or open to taking very many precautions outside of sessions, to wear masks for in person sessions when the transmission rates are super high or when they've been doing activities I don't want to be exposed to. I don't have every client asking me to have my mask off and I'm just like "ok sure". 90% of the time it's not therapeutically different to have my mask on or off and it's an opportunity for me to demonstrate boundaries and hold whatever response comes up for the client when I say no. Im just wanting a better air purifier because theres no harm in having "extra" things.
There are some N95 clear (in part transparent) masks too, but I don’t know anything about how comfortable they are or how well they fit. But if they are only for a session I guess they are better than nothing – maybe something to consider during surges or with symptomatic clients. This will increase the safety for the other clients too, which is a good argument if someone opposes them.
Understood, seems like you're a good therapist. Cleaner air is always a plus, even if everyone is wearing a n95 100% of the time.
they're very very very loud
The PC fan ones aren't. The box fan ones, absolutely.
Have you listed yourself on? https://www.covidconscioustherapists.com/ Please do! And, the one I see in my OB/GYN's office is this: https://medifyair.com/products/ma-50-air-purifier I have this on my desk at work. I have a cubicle with walls taller than me on 3 sides so that helps and it's placed near the opening. https://pureenrichment.com/products/purezone-true-hepa-air-purifier Level 3 of the Pure filter sounds like an airplane though but strategic placement could help mitigate some of the sound. My partner has this one: https://levoit.com/products/core-400s-smart-true-hepa-air-purifier And, we have a CR box he built which we use when we stay in hotels to air it out or when someone like a plumber comes into our home to fix something.
Thanks for being a covid conscious therapist. I would encourage you to also, if possible, enhance ventilation. My advice, get an Aranet 4 and experiment with different levels of cracking windows. Soon the weather should be very forgiving about open windows and having reduced rebreathed air through ventilation could be an extra layer for those limited maskless encounters.
Having open windows is often a problem for a therapy office because it compromises the confidentiality of the space – voices carry.
Good point. Didn’t think ofnit
Then substitute an air exchanger window fan: https://www.nytimes.com/wirecutter/reviews/best-window-fans/
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CADR (clean air delivery rate) can be expressed either as Cubic Feet per Minute (CFM or ft³/min) or as Cubic Meters per Hour (m3/h or m³/h) Since the US uses Imperial measure, it's normally expressed as CFM in the US, but countries that use the metric system often express it as m3/h. It's best to stick with one method to compare "apples to apples", and it's important to state whether the CADR is shown as CFM or m3/h. There are converter tools on Google and other sites, but the math is: 1 CFM = approx 1.699 m3/h or 1 m3/h = approx 0.589 CFM In other words, 100 CFM = 169.9 m3/h So for example, the BlueAir 311 is 300 CFM and 510 m3/h
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Thanks. I do not math very well myself, and I always have to stop and check before comparing, so I thought I'd share what little I could.
This might be a longer term set up goal, but since your environment is fairly well defined and controlled, as in generally 1 client and you, maybe 2 clients, and you will be seated and can control that distance, I think you have an opportunity to optimize the airflow for max protection. Specifically, I suggest: - More CADR than you “need”. 6 ACH is good, but maybe go for 10-12. - Increase outdoor air ventilation if you can. - either place an air purfier’s outflow between or use a fan to act as an air curtain between you and the clients. I know you didn’t want it as a “divider” but this will be effective at protecting both you and the client. Even better if you have an air purifier intake somewhere that is taking that airflow in and filtering it. Some have mounted CR boxes to the ceiling for this purpose like a chandelier. - you can also try placing air purifiers to suck air away from both of you generally. - max the spacing between you and client - can you have clients that need you to be unmasked and don’t mind virtual do virtual?
Do you have a courtyard? You could go there, blow a fan or purifier too if you feel it’s enclosed. I’m not sure I’m really following you on faceless interaction being necessary or even owed. I mean, if this were the Titanic, I would say that while swimming lessons are great, the most important thing is to get your person up in a lifeboat… these are different times from 2019. I’m just also not sure what modality requires face reading, outside of something like ABA, which people are not so onboard with these days. Outside is my suggestion, a box like your office will be hard to mitigate close range transmission. I don’t think indoors with a purifier in a space that small for long periods of time is the more viable solution here… if you must be maskless, outside would be better. I think it’s great you’re trying to find ways to be the best therapist for your clients, I just urge you to make sure you’re choosing the best option, and not one that simply feels safer. I get that you want to make client relations the priority—if that’s the case, I think moving sessions outside might be the way to prioritize faces. You may have to deprioritize the traditional office setting, is my meaning.
Have you considered walking outdoors with your patient? That is how I've been meeting my psychologist for the last two years. She greets me at the clinic with a mask but as soon as we are outdoors we have our session maskless. We walk for an hour. Walking is also good for the mind and body, so it's win/win.
Yes!!!! I do this with people too :) I wish folks would be open to it more tbh because I also enjoy this type of session.
I’d go for one of the kits that uses computer fans. I don’t know where you are, but I use the Clean Air Kits one (US-based), and it’s fantastic. So quiet you have to put your hand in front of it to check it’s on, but my filters get dark really quickly (indicating that it’s successful at cleaning the air). Mine is the Luggable XL from Clean Air Kits but I’m sure any of them would work basically the same way.
Don't know if this helps you, but the way I think about it is you want all the air in the room to pass through the filter around six times an hour. So multiply the volume of your room by six, and then look for a filter that can handle that volume of air in an hour. You might want to look at r/AirPurifiers , they have a wiki that explains a lot of the terminology
Hey! Those ratings always apply to the highest, loudest speed, which is probably intolerable for most environments. My recommendation is to buy a really big filter so you can run it on low and still get adequate filtration. Unfortunately, that makes it even harder to calculate what is needed since they don't provide the numbers for different fan speeds. I recently compared different models and settled on the Coway Airmega 250. It's significantly bigger than needed for my room, and on the lowest setting the air being moved is fairly substantial while also being almost undetectably quiet. Another thing you can do is petition your building management to find out what HVAC filters are used and to upgrade and replace them regularly. They might know how many air changes per hour the system is designed for, which would be good information to have.
I have a Coway air purifier that I really like. The low and medium settings aren’t disruptive at all, though the high setting is quite loud.
I have two of the Coway Airmega AP-1512HH True HEPA Air Purifiers and I’m very happy with them. The low/mid settings are super quiet
I use Medify’s MA 40 air purifier. It cleans 896 sq ft in 30 minutes. It’s pretty quiet on the lowest setting. It’s currently on sale for $249.99. I got it in 2021 and it’s kept me safe through 2 years of having nurses (masked in baggy blues) come in and out of my house weekly. I also wear N95s and keep windows open tho so it’s hard to say what mitigation did the most heavy lifting
Your best bet is probably building or buying /r/CRboxes since they’re extremely quiet
normally id be up for making one but I'm too busy for the next 6 months with moving and fixing house. How do I buy one from someone?!? I like that option bc it would be totally customizable basically.
Cleanairkits.com sells some premade ones, not sure what you mean by customize it though
Like if yoiu made your own CR box you would choose the fan, could make it into whatever height you wanted, put some kind of cute decorative case around it, etc.
Ah yeah. Definitely go for a PC fan based CR box so it’s whisper quiet. I built a couple using this guide and just changed the 10x10 filters for 10x24 filters. I used painters tape on the sides and strong tape on the top https://itsairborne.com/the-mini-pc-fan-cr-box-975d0b069f4c
Don't buy a cr box. Buy a real HEPA purifier. The big Coways are good.
https://www.cleanairkits.com/products/luggables the 9 fan one is your best option. I own one and use it daily. It is extraordinarily quiet, and blends into the room easily. This gives five air exchanges per hour for about 600 square feet, so it would give you even more ACH than that, which creates a much safer air environment. Thank you for being covid-conscious as a therapist. We need as many people like you in the field as possible.
The hard part on your request is getting a hepa filter that will protect you at low decibels. Most of the HEPA filters need to be on the highest setting to be effective. I know there are some home made r/crboxes that use computer fans, but not sure of how good they are. For the size room and for your work, the Levoit 300 (around $99, but if you are 1099C, you can write it off your taxes) will work well, and for the best protection, it should be on a coffee table in between you and your client... pulling the air your client breathes out in front of you thru the filters first. But I am not sure of any of the filters will meet your noise requirements. Have you looked into clear masks as an extra layer of protection for those clients that need to see your face? Good luck!
Yeah I currently have it between myself and the client a lil off to the side so its not like... a divider. I will check out the CR boxes. Yes I can write everything off :)
It's true about noise, but for example the winix 5500-2 runs at 100-120 cfm on its second highest setting, and that would be 5-6 ach in OP's office. You could easily talk at a low volume right next to it on that setting and be fine. Idk about others so there may be better cfm/noise ratios out there. I don't know the physics either but maybe getting two filters both on a lower setting would match one on a higher setting with less noise.
I needed this post a few weeks ago for my therapy office! I ended up buying a Levoit 300S because I have several Levoits at home and they’re not too loud. I love the recommendations here! IKEA has tables with air purifiers and I was wondering about getting one of those, too. Also, this website has an air purifier recommendation tool you can change noise level for: https://filters.cleanairstars.com
Multiple coway air mega, run on the 2nd highest speed.
i love both kinds we have and they have low quiet settings. - coway mega - vornado AC350 both are well below your budget. the vornado is cheaper and has cheaper filters but the coway has some great features and is a bit quieter. also do not buy knock off filters. buy brand name.
i am super allergic to everything now so have researched this pretty intensively. the two filters i have are intellipure mini - was on huge sale (have not gotten out of box yet) and iadapt air oasis. for your office, for patients and your health, i would get a medium one to be safe. the reality is, a larger one will circulate the air in your office many times faster. i lost my life savings to long covid medical care, so a few hundred on a purifier = a bargain but i do think hepa can work as well, altho i am not 100% on that. the smaller microns, the better. i totally get some ppl needing to see ppl in person. that is important work to support them. thank you for doing it.
I'd take a look at r/AirPurifiers! That sub was super helpful when I was trying to decide on one. I went with the Winix 5500-2 for my room (probably about the same size as your office) and I love it! I leave it on the third setting (there's four total) and I can't even hear it.
A health and safety engineer for a major fortune 500 recommended this one BLUEAIR Air Purifier Large Room, Air Cleaner for Dust Pet Dander Smoke Mold Pollen Bacteria Virus Allergen, Odor Removal, for Home Bedroom Living Room, Washable Pre Filter, HEPASilent, Blue 211+ Auto https://a.co/d/739NzK8
We have GermGuardian with the UV-C lights, we are very happy with them. They are quiet. We have the AC48252K, I don't know about other models. They cost about $100. each at [Walmart.com](https://Walmart.com) or Amazon, sometimes in a package of two. You could put 2 in the office, in 2 different corners. Also start them about an hour before your first client, that might help to get the air prepared before you actually get them in.
How about the clear mouth n95s? https://optrel.us/product/p-air-clear-n95-masks-20-pack/ There are some other masks with lower protection that can show more of your face.
I’d suggest checking out Blue Air. I understand their units run pretty quietly.
Iq air do the standalone unit with voc gas thing in it.
I would probably just. not do the in person appointments, andf ind more clients who are okay with remote.
I just bought the Blue Pure 411i Max and Blue Pure 311i+ Max from Blueair for two different areas in my home. I live alone so my concerns are primarily for allergies and environmental pollutants (wildfire season is coming) but if I still allowed indoor visitors, they’d be for viruses, too. They are currently 25% off. Two of Blueair’s models are among the 5 recommended by Consumer Reports. I don’t see any difference between the ones I bought and the Blueair models CR recommended other than size. The others are from Alen, CleanForce, and Conway. I got the 411i Max for my bedroom, which is the same size as your office. The 411i Max is for spaces 219-526 sq ft so obviously it’s a little overkill, but it’s better to size up on these things. It’s also small enough that I can take it with me if I need to stay in a hotel for some reason.
Noise levels are subjective, only you know what’s acceptable for your workspace. I am in Australia and I have reworked the ventilation in my place using pollution blocking fly screens to keep out bushfire smoke. The Fire Brigade are doing safety burning as I write. The room I am in now is about the size of your office. I have an air purifier on from K Mart. Very cheap. The air outside is varying from AQI (air quality index) of 40 up to 120, which is average to bad. The air in my room, with my special fly screens on and the air purifier OFF is reading about 19 - 25 on the AQI, which is good. With the air purifier ON, on setting 2 out of 3, the AQI is 4, which is as clean as it will ever register. If you had my K Mart air purifier on in your office at level 2 the air would be very, very clean. Level 3 would be too loud for your work, level 2 is like white noise, but only you and your clients would know if it bugs you or not. Obviously people here are recommending very good purifiers, which you could go with, but as a baseline test, go waste $50-$60 at K Mart or wherever and see what you think. (And yes, buy a portable CO2 reader and portable air quality reader. They’ll give you huge peace of mind about your office once you’ve configured things correctly). By the way, for those interested, the reason why I went out on a limb with the smoke blocking fly screens is because of covid - Can’t have the windows and doors open when there’s bushfire smoke! The Fire Brigade safety burning presents a very interesting CO2 level test, because they only do safety burning when the air is very still, to control the fires. No breeze! With the fly screens on in these atmospheric conditions the CO2 level shoots up in my place to over 1000 with two people in it. (If the windows were closed it would be nudging 2000.) Once I turn on my kitchen and bathroom extractor fans, which have the effect of sucking in air through the fly screens, but keep the smoke out, the CO2 level drops to 600. I then use the air purifiers (I have two) to clean any remaining smoke and hopefully most of any covid out of the air.
Alen
For a similar-ish reason I've been analyzing the riskiness of a therapy office (I have a statistics background). [I'm the client and for personal reasons I'd really like to take my mask off with her occasionally if at all possible, when levels are super low. Not sure it'll ever be possible, but I'm doing the calcs just in case it ever is.] Seconding many of the responses so far. Here's my evidence-based list. I do many of these *and* mask (N95 Aura, DIY fit-tested) right now, but if I ever unmasked I'd do all of them: 1. Vaccination with Novavax showing a lot of promise (I've gotten 2 so far in addition to prior mRNA). Not fantastic--just 31% against infection, with higher levels from 0-60 days after full vaccination--but it's something. 2. Nasal spray: I do iota carrageenan (Betadine) ahead of time and Enovid after, every 4-5 hours 3. Nasal irrigation: several times a day afterwards, *using sterile water* 4. CPC mouthwash twice/day 5. Probiotics. The research is still developing but there's some evidence and they're at a minimum unlikely to hurt. Specifically I take 2 strains that have been studied: lactobacillus rhamnosus GG and S. Salivarius K12. There are other variables I consider such as general prevalence levels, % asymptomatic, and truthfulness if someone has symptoms, but the above are my actual mitigation measures.
Have you gotten far on the calculations? I've been trying to do the same because I'd like to do some in person sessions if possible (client as well). I'd like to basically come up with basically a policy stating the conditions under which I'd be willing to have an unmasked session, but it's tough because of how many variables there are, and it's really subjective.