We Have the Tools. Why Aren’t We Using Them?

If you’ve ever lived in – or even visited – a century-old apartment building, you know that at this time of year they can be unbearably hot. The radiators in those old buildings kick off an impressive amount of heat.

The best relief is often to throw open a window or two.

And that makes sense.

Because it’s the precise use case those old steam radiators were designed for.

At the turn of the century, when those buildings were new, the 1918 pandemic raged. A new “Fresh Air Movement” took hold. Scientists didn’t have vaccines – or many treatments – for the flu, but they believed that breathing fresh, rather than “stale,” air was beneficial. (They were still working out why, exactly, that was.)

Of course, in hindsight we know they were right.

Although at the time it was more educated theory than scientific fact, the New York City Board of Health ordered that some windows stay open – even on the coldest day of the year.

So, building engineers designed heating systems that could keep buildings comfortable on the coldest day of the year with all the windows open.

This was over 100 years ago, now.

Such a simple fix, opening windows.

That fix – that public policy – led to a massive change in building design. It meant a little discomfort for some. A little extra expense, perhaps. But that didn’t stop the order from being made.

New York isn’t the only city to have created a situation that required creative engineering solutions. After repeated outbreaks of cholera and typhoid, the city of Chicago planned a state of the art sewer system that would finally solve the city’s well-known wastewater problems.

It would be buried under the existing streets and topped with 4-14 feet of earth – enough to raise the grade of the city and keep the streets from flooding with wastewater.

That was ambitious enough on its own.

But there was more: the construction meant that entire blocks of Chicago would end up 4-14 feet below street level.

Faced with that conundrum, Chicagoans developed an audacious solution: raising – yes, physically lifting – buildings to the required level.

“Raising buildings to grade” became an actual occupation. It was quite a production to lift a multi-story stone building; hundreds of men would surround it, each with their own jack. On an engineer’s order, they would raise their jacks in unison, turning the screws a quarter inch at at time.

It would take them about five days to raise a building four feet.

Reporters recounted with pride that not a pane of glass would shatter in the process, and nary a crack in the masonry would be found. Stores in buildings that were being lifted continued to operate throughout the process (and were actually busier). People just went about their day, walking about a building that was being lifted a centimeter at a time.

As you can imagine, this was not an inexpensive project. Raising just one city block would cost over $550,000 in today’s dollars.

And that is how the city of Chicago lifted itself out of the mud and built the sewer infrastructure to keep wastewater from continuing to flood the city.

Oh – and did I mention that this all happened in 1855?

There are plenty more historical examples of cities acting boldly in service of public health. In 1908 – when diarrhea was the third leading cause of death nationally – Jersey City, New Jersey became the first city to routinely chlorinate drinking water. (It was quite controversial at the time.)

Other U.S. cities followed soon after, leading to a 66% decrease in the crude death rate from infectious diseases, before the first use of penicillin. See https://www.cdc.gov/healthywater/drinking/history.html

All this to say…

One hundred years ago, leaders demanded improved ventilation as a matter of public health. Engineers found a way to keep people comfortable.

One hundred and sixty eight years ago, leaders demanded improved sanitation. Engineers found a way to literally lift a city out of the mud.

Now we’re well into the 2000s, heading into the third year of an airborne pandemic. We have far more technology, expertise, knowledge, and manpower than 1850’s Chicago, 1900’s Jersey City, or 1920’s New York. We have myriad options of air cleaners and masks of all sorts.

The engineers have done their jobs.

The leaders haven’t.

I read these stories of 1850s Chicago and marvel at the vision and guts that plan took. I’m inspired by their imagination. I can’t help but smile when reading the reporters’ words, just dripping with pride.

Look at what we’ve done, they say. Look at what our city is capable of!

And then I come back to today … and I’m just sad.

When ARPA funds were announced I dreamed that local governments would use the funds to create safe spaces for everyone, and to encourage businesses to do the same.

After all, it’s as simple as using cheap and portable HEPA filters and/or adjusting the filters used in furnaces and air conditioners.

It’s as simple as requiring carbon dioxide monitors in public spaces, and setting safe limits on air flow that are monitored by health inspectors. After all, health inspectors inspect restaurant kitchens to ensure they’re clean enough that eating there won’t make you sick. Why wouldn’t we ask them to make sure the air in the restaurant is clean enough that breathing there won’t make you sick?

It’s as straightforward as revising building codes to prioritize ventilation and air cleaning, providing incentives for businesses, working with schools… And yes – providing and wearing effective masks.

I am perplexed as to why our leaders aren’t willing to use the tools and resources that are right in front of us – each of which has a huge return on investment in the form of increased productivity, fewer days missed due to illnesses (including, but not limited to, COVID) or allergies, and fewer people literally dying from airborne illnesses.

And cleaning the air – using any of the already-available technologies – would level the playing field, making inside spaces safer for the tens of millions of people who aren’t able to throw caution to the wind.

We are not being asked to lift our houses 10 feet.

We’re not even being asked to reconfigure entire heating systems.

We’re just being asked to plug in a HEPA filter.

Chicago’s city planners in 1855 were visionaries. New York’s Department of Public Health was stoic and ahead of its time – ordering the kind of ventilation that we need today, but without the benefit of today’s science.

We lack leaders of both stripes.

We lack visionaries who see this potential to create a healthier, more equitable, safer society. And we lack firm, confident public health experts who won’t back down.

When I began talking with political folks and policy wonks about the exciting possibilities for public health regulations and equitable, truly accessible public spaces I was met with “You know that’s just not possible.”


After all we have been through, and the massive amount of pain and suffering that can be resolved with a simple few policy changes, I cannot stand meek, meager excuses from people whose campaign slogans profess them to be fighters for equity, and justice, and working people.

Being a leader requires conviction, imagination, and fortitude. It requires the confidence and moral clarity to stand firm on matters of life and death, even when doing so is politically difficult.

It requires putting community first – before political careers and personal projects.

Unfortunately, there are plenty of “public servants” who are more focused on politics than their constituents, and who spend more time manufacturing a glossy version of themselves for the history books than doing real work.

And I’m here to tell them they are wasting a once-in-a-generation political opportunity. If their goal is to cement their legacy – to accomplish change that’s equitable, noble, and memorable – you can’t do much better than cleaning the air.

It’s as audacious as lifting a city – but far, far easier.

After all, we’ve got the tools.

We just have to use them.

Let’s get to work.

Actions for the Week of December 27, 2022

First, if you have a leadership position of any kind – including as a business owner, manager, or building operator – use your position to advocate for clean air in the workplace. It’s as simple as bringing in a HEPA filter and plugging it in or providing high-quality N-95 masks for everyone – but especially for public-facing employees. It’s truly to your personal benefit and will go a long way toward making your space safer for everyone.

Second, if you are an elected official, I am more than happy to share a policy document that I created specifically for local governments. There are many ways we can make life better for your constituents. Shoot me an email at hello@smalldeedsdone.com.

Third, it’s going to be another quiet week, with the new Congress beginning January 3. So rather than calling your elected officials, I’m going to encourage you to follow some excellent COVID policy advocates. While their advocacy centers on Long COVID, their reach is broader than that:

Long Covid Justice has a strategy circle of the following organizations:

Body PoliticThrough a global network of COVID-19 patients, chronic illness allies, and health and disability advocates, Body Politic breaks down barriers to patient-driven whole-person care and well-being, particularly for historically marginalized communities by facilitating peer-support, cultivating patient-led research and public education, and leading community-based advocacy. To learn more about the Body Politic Covid-19 Patient Support group, click here

The Covid-19 Longhauler Advocacy Project (C19LAP): The Covid-19 Longhauler Advocacy Project’s mission is to advance the understanding of Long COVID and expedite solutions and assistance for Longhaulers through advocacy, education research & support. C19LAP hosts and moderates a private Facebook support group for Covid-19 long-haulers and caregivers, and is a major leader in Long COVID advocacy. Follow on Twitter here: @C19LH_Advocacy

Marked by Covid: Marked By Covid is a national, grassroots, non-partisan nonprofit that promotes accountability, recognition, justice, and a pandemic-free future. Marked by COVID is led by people directly harmed by the pandemic. They promote accountability, equity, and justice; amplify the voices of those most impacted; and support survivors and bereaved.

#MEAction: A significant percentage of Long Haulers meet parts of the definition of ME/CFS (myalgic encephalomyelitis, previously known as chronic fatigue syndrome). #MEAction fights for recognition, education and research so that, one day, all people with ME/CFS will have support and access to compassionate and effective care. Check out #MEAction’s support groups here.

Patient-Led Research Collaborative (PLRC): The Patient-Led Research Collaborative facilitates patient-led and patient-involved research into Long Covid and associated conditions while following rigorous research methodology, and advocating for policies that enable patients, particularly the most marginalized, to access care and live with dignity. PLRC grounds their work in the principles of disability justice and participatory research methods, and in the knowledge that those who experience an illness are best able to identify research questions and solutions.

Strategies for High ImpactStrategies for High Impact (S4HI) builds the power of chronically-ill and disabled people – including people living with HIV, Long COVID, ME/CFS and other complex chronic conditions – and the capacities of our groups and networks. S4HI provides comprehensive organizational, coalition and network support, from coaching and facilitation, to strategic planning, interim staffing, and resource mobilization. S4HI also shifts narratives through strategic communications and content creation, and plans and executes powerful campaigns for change. S4HI manages the Network for Long COVID Justice and has worked with the AIDS Vaccine Advocacy Coalition, HIV Racial Justice NowPositive Women’s Network – USA, Sero Project, The Reunion Project, and The U.S. Caucus of People Living with HIV, among other partners.

Okay, friend. That’s a wrap for 2022.
I’ll see you on the other side of the New Year.


P.S.: Why don’t you make someone’s day and send this pep talk to a friend or two? I bet they need it.

If you’d like to sign up to get this pep talk and action list in your in-box each week, you can do that here. Welcome, friend!

P.P.S.: If you want to help support this work you can do so via Patreon at
https://www.patreon.com/smalldeedsdone or via paypal at https://www.paypal.me/smalldeeds
My deepest gratitude in advance.

Thank you for reading. Thank you for writing. I read and respond to every email! We’re in this together. Don’t you forget it.

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