Alicia Ault
April 04, 2020

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An expert committee has concluded that the novel coronavirus is aerosolized
through talking or exhalation, but it’s not yet clear if the viral particles are
viable and emitted in doses sufficient to cause infection.
“While the current SARS-CoV-2 specific research is limited, the results of
News > Medscape Medical News Coronavirus Is Aerosolized Through
Talking, Exhalation, New Report Says Alicia Ault April 04, 2020

Coronavirus Is Aerosolized Through Talking, Exhalation
“…available studies are consistent with aerosolization of virus from normal
breathing,” wrote Harvey Fineberg, MD, PhD, chair of the National Academies
Standing Committee on Emerging Infectious Diseases and 21st Century
Health Threats, in a rapid expert consultation issued April 2. Although aerosolization            could be considered a third potential route of transmission — along with large                 droplets emitted from sneezing or coughing and the transfer of viral particles after touching a contaminated surface — the relative contribution of each mode is uncertain, Fineberg told Medscape Medical News.

Information from Industry Hypothetical case study: Young woman with key symptoms Hypothetical case study: Young woman with key symptoms of narcolepsy of narcolepsy.         See video US-NDS-0371(1) It’s also still unclear what it takes to cause infection through aerosolization, he said.

“The best approach without that clear description is all three are possible and we have to guard against all three,” he said. Asked if there is any risk to operating on the assumption that the novel coronavirus can be transmitted through aerosols, Fineberg said, “I see no downside at this time at all.”

But, he said, that assumption does not change what he thinks are the best
precautions in healthcare facilities, which include handwashing and wearing
of personal protective equipment (PPE). Although N95 masks provide the
greatest measure of protection, it’s not realistic to expect that they can be
worn by all personnel, said Fineberg.

“This is a question of prioritization, of risk, and of availability,” he said. In
addition, N95s are difficult to wear for extended periods of time and may not
be necessary in every circumstance, said Fineberg, citing a gradient of risk.

The committee looked into the issue of aerosolization at the request of the
White House Office of Science and Technology Policy (OSTP), Fineberg said.
The report cited several studies it said supported the idea that SARS-CoV-2 is
airborne. One study (still in preprint and not yet peer reviewed) by Joshua
Santarpia, PhD, and colleagues at the University of Nebraska in Omaha, has
gotten a lot of attention. The researchers collected air and surface samples
from 11 rooms of patients with COVID-19, and found viral RNA in the air both
inside and outside the rooms and on ventilation grates.

Another study in preprint looking at hospitals and public areas in Wuhan
found that the highest concentrations of virus were in toilet facilities and in
PPE removal rooms. Doffing of the PPE may potentially have aerosolized the
virus, the researchers hypothesized.

Differential Diagnosis of Tardive Dyskinesia Differential Diagnosis of Tardive Dyskinesia Check your knowledge with this Fast Five quiz. Begin quiz now Fineberg and colleagues, however, approached the finding with caution, stating that “it may be difficult to re-suspend particles of a respirable size.” More likely, “fomites could be transmitted to hands, mouth, nose, or eyes
without requiring direct respiration into the lungs,” they write.

The report did not cite a recent overview in the Journal of the American
Medical Association by Lydia Bourouiba, PhD, of the Massachusetts Institute
of Technology in Cambridge. The report noted that recent research has found
that “exhalations, sneezes, and coughs not only consist of mucosalivary
droplets following short-range semiballistic emission trajectories but,
importantly, are primarily made of a multiphase turbulent gas (a puff) cloud
that entrains ambient air and traps and carries within it clusters of droplets
with a continuum of droplet sizes.”

She said that the lifetime of a droplet could be extended “from a fraction of a
second to minutes,” and that the cloud carrying viral particles could travel as
Coronavirus Is Aerosolized Through Talking, Exhalation.

The World Health Organization (W.H.O.) still contends (in a report dated March
29) that current evidence shows that “COVID-19 virus is primarily transmitted
between people through respiratory droplets and contact routes,” and that it
can only become airborne during procedures or treatments that generate
aerosols.

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Medscape Medical News © 2020
Citation: “Coronavirus Is Aerosolized Through Talking, Exhalation”, New Report Says        Medscape – Apr 04, 2020.

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