Intranasal or airborne transmission-mediated delivery of an attenuated SARS-CoV-2 protects Syrian hamsters against new variants.

Detection of secretory antibodies in the airway is highly desirable when evaluating mucosal protection by vaccines against a respiratory virus, such as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We show that intranasal delivery of an attenuated SARS-CoV-2 (Nsp1-K164A/H165A) induces both mucosal and systemic IgA and IgG in male Syrian hamsters. Interestingly, either direct intranasal immunization or airborne transmission-mediated delivery of Nsp1-K164A/H165A in Syrian hamsters offers protection against heterologous challenge with variants of concern (VOCs) including Delta, Omicron BA.1, BA.2.12.1 and BA.5. Vaccinated animals show significant reduction in both tissue viral loads and lung inflammation. Similarly attenuated viruses bearing BA.1 and BA.5 spike boost variant-specific neutralizing antibodies in male mice that were first vaccinated with modified vaccinia virus Ankara vectors (MVA) expressing full-length WA1/2020 Spike protein. Together, these results demonstrate that our attenuated virus may be a promising nasal vaccine candidate for boosting mucosal immunity against future SARS-CoV-2 VOCs.

Cepharanthine Dry Powder Inhaler for the Treatment of Acute Lung Injury.

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) induces a severe cytokine storm that may cause acute lung injury/acute respiratory distress syndrome (ALI/ARDS) with high clinical morbidity and mortality in infected individuals. Cepharanthine (CEP) is a bisbenzylisoquinoline alkaloid isolated and extracted from Stephania cepharantha Hayata. It exhibits various pharmacological effects, including antioxidant, anti-inflammatory, immunomodulatory, anti-tumor, and antiviral activities. The low oral bioavailability of CEP can be attributed to its poor water solubility. In this study, we utilized the freeze-drying method to prepare dry powder inhalers (DPI) for the treatment of acute lung injury (ALI) in rats via pulmonary administration. According to the powder properties study, the aerodynamic median diameter (Da) of the DPIs was 3.2 µm, and the in vitro lung deposition rate was 30.26; thus, meeting the Chinese Pharmacopoeia standard for pulmonary inhalation administration. We established an ALI rat model by intratracheal injection of hydrochloric acid (1.2 mL/kg, pH = 1.25). At 1 h after the model's establishment, CEP dry powder inhalers (CEP DPIs) (30 mg/kg) were sprayed into the lungs of rats with ALI via the trachea. Compared with the model group, the treatment group exhibited a reduced pulmonary edema and hemorrhage, and significantly reduced content of inflammatory factors (TNF-α, IL-6 and total protein) in their lungs (p < 0.01), indicating that the main mechanism of CEP underlying the treatment of ALI is anti-inflammation. Overall, the dry powder inhaler can deliver the drug directly to the site of the disease, increasing the intrapulmonary utilization of CEP and improving its efficacy, making it a promising inhalable formulation for the treatment of ALI.

[Changes in Secondary Inorganic Ions in PM2.5 at Different Pollution Stages Before and After COVID-19 Control].

To investigate the change characteristics of secondary inorganic ions in PM2.5 at different pollution stages before and after COVID-19, the online monitoring of winter meteorological and atmospheric pollutant concentrations in Zhengzhou from December 15, 2019 to February 15, 2020 was conducted using a high-resolution (1 h) online instrument. This study analyzed the causes of the haze process of COVID-19, the diurnal variation characteristics of air pollutants, and the distribution characteristics of air pollutants at different stages of haze.The results showed that Zhengzhou was mainly controlled by the high-pressure ridge during the haze process, and the weather situation was stable, which was conducive to the accumulation of air pollutants. SNA was the main component of water-soluble ions, accounting for more than 90%. Home isolation measures during COVID-19 had different impacts on the distribution characteristics of air pollutants in different haze stages. After COVID-19, the concentration of PM2.5 in the clean, occurrence, and dissipation stages increased compared with that before COVID-19 but significantly decreased in the development stage. The home isolation policy significantly reduced the high value of PM2.5. The concentrations of NO2, SO2, NH3, and CO were the highest in the haze development stage, showing a trend of first increasing and then decreasing. The concentration of O3 was lowest in the pre-COVID-19 development stage but highest in the post-COVID-19 development stage. The linear correlation between[NH4+]/[SO42-] and[NO3-]/[SO42-] at different time periods before and after COVID-19 was strong, indicating that the home isolation policy of COVID-19 did not change the generation mode of NO3-, and the corresponding reaction was always the main generation mode of NO3-. The correlation between[excess-NH4+] and[NO3-] was high in different periods before COVID-19, and NO3- generation was related to the increase in NH3 or NH4+ in the process of PM2.5 pollution in Zhengzhou.

The role of the oral cavity in SARS-CoV-2- and other viral infections.

OBJECTIVE: This study aims to review the role of the oral cavity in SARS-CoV-2- and other viral upper respiratory tract infections. MATERIAL AND METHODS: Data reviewed in the text have been researched online and also reflect personal expertise. RESULTS: Numerous respiratory and other viruses replicate in the oral cavity and are transmitted via aerosols (< 5 µm) and droplets (> 5 µm). SARS-CoV-2 replication has been documented in the upper airways as well as in oral mucosa and salivary glands. These sites are also virus reservoirs that can infect other organs, e.g., the lungs and gastrointestinal tract, as well as other individuals. Laboratory diagnosis of viruses in the oral cavity and upper airways focuses on real-time PCR; antigen tests are less sensitive. For screening and monitoring infections, nasopharyngeal and oral swabs are tested; saliva is a good and more comfortable alternative. Physical means like social distancing or masks have been proven successful to reduce the risk of infection. Both wet-lab and clinical studies confirm that mouth rinses are effective against SARS-CoV-2 and other viruses. Antiviral mouth rinses can inactivate all viruses that replicate in the oral cavity. CONCLUSIONS: The oral cavity plays an important role in viral infections of the upper respiratory tract: it serves as a portal of entry, a site of replication, and a source of infection by droplets and aerosols. Physical means but also antiviral mouth rinses can help reduce the spread of viruses and contribute to infection control.

Chargeability study of disinfectants and the optimization of design parameters of a handheld electrostatic disinfection device for small scale applications.

Apart from aerosols, contaminated surfaces with SARS-CoV-2 virus are the significant carriers of virus transmission. The disinfection and sanitization of the indoor and outdoor places are one among the powerful and effective strategies to avoid the surface-to-human transmission of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) through frequent touch and physical contact. Electrostatic spraying is one of the effective and efficient methods to apply the liquid-based sprays on surfaces to be disinfected or sanitized. This technique covers the directly exposed and obscured surfaces uniformly and reaches to hidden areas of the target. In this paper, the design and performance parameters of a motorized pressure-nozzle based handheld electrostatic disinfection device were optimized and the chargeability of ethanol (C2H5OH), formaldehyde (CH2O), glutaraldehyde (C5H8O2), hydrogen peroxide (H2O2), phenol (C6H5OH) and sodium hypochlorite (NaClO) has been critically investigated. The chargeability indicator for disinfectants was presented in terms of the charge-to-mass ratio. The significant value of the charge-to-mass ratio of 1.82 mC/kg was achieved at an applied voltage of 2.0 kV, the liquid flow rate and pressure of 28 ml/min and 5 MPa, respectively. The experimental results are well aligned to the proposed theoretical context.

3D modelling and simulation of the impact of wearing a mask on the dispersion of particles carrying the SARS-CoV-2 virus in a railway transport coach.

Even though the Covid-19 pandemic seems to be stagnating or decreasing across the world, a resurgence of the disease or the occurrence of other epidemics caused by the aerial dissemination of pathogenic biological agents cannot be ruled out. These agents, in particular the virions of the Covid-19 disease, are found in the particles originating from the sputum of infected symptomatic or asymptomatic people. In previous research, we made use of a three-dimensional Computational Fluid Dynamics (CFD) model to simulate particle transport and dispersion in ventilated semi-confined spaces. By way of illustration, we considered a commuter train coach in which an infected passenger emitted droplets (1 and 10 µm) and drops (100 and 1000 µm) while breathing and coughing. Using an Eulerian approach and a Lagrangian approach, we modelled the dispersion of the particles in the turbulent flow generated by the ventilation of the coach. The simulations returned similar results from both approaches and clearly demonstrated the very distinct aerodynamics of the aerosol of airborne droplets and, at the other end of the spectrum, of drops falling or behaving like projectiles depending on their initial velocity. That numerical study considered passengers without protective masks. In this new phase of research, we first used literature data to develop a model of a typical surgical mask for use on a digital manikin representing a human. Next, we resumed the twin experiment of the railway coach, but this time, the passengers (including the infected one) were provided with surgical masks. We compared the spatial and temporal distributions of the particles depending on whether the spreader passenger wore a mask at all, and whether the mask was perfectly fitted (without leaks) or worn loosely (with leaks). Beyond demonstrating the obvious value of wearing a mask in limiting the dissemination of particles, our model and our simulations allow a quantification of the ratio of particles suspended in the coach depending on whether the infected passenger wears a mask or not. Moreover, the calculations carried out constitute only one illustrative application among many others, not only in public transport, but in any other public or private ventilated space on the basis of the same physical models and digital twins of the places considered. CFD therefore makes it possible to estimate the criticality of the occupation of places by people with or without a mask and to recommend measures in order to limit aerial contamination by any kind of airborne pathogen, such as the virions of Covid-19.

The size distribution of SARS-CoV-2 genetic material in airborne particles sampled in hospital and home care environments occupied by COVID-19 positive subjects.

Characterizing the size distribution of airborne particles carrying SARS-CoV-2 virus is essential for understanding and predicting airborne transmission and spreading of COVID-19 disease in hospitals as well as public and home indoor settings. Nonetheless, few data are currently available on virus-laden particle size distribution. Thus, the aim of this study is reporting the total concentrations and size distributions of SARS-CoV-2- genetic material in airborne particles sampled in hospital and home environments. A nanoMOUDI R122 cascade impactor (TSI, USA) was used to collect size-segregated aerosol down to the sub-micron range in home and in three different hospital environments in presence of infected patients in order to provide the concentration of airborne SARS-CoV-2 genetic material for each particle size range at different sampling locations. Providing one of the largest datasets of detailed size-fractionated airborne SARS-CoV-2 RNA to date, we found that 45.2 % of the total sub- and super-micrometric fractions were positive for SARS-CoV-2 with its genetic material being present in 17.7 % of sub-micrometric (0.18-1 µm) and 81.9 % of super-micrometric (>1 µm) fractions. The highest concentration of SARS-CoV-2 genetic material in total suspended particles (5.6 ± 3.4 RNA copies m-3) was detected in the room occupied with patients with more severe COVID-19 symptoms collected during the patients' high flow nasal oxygen therapy. The highest concentration at certain particle size fraction strongly depends on the sampling environment. However, the contribution of SARS-CoV-2 genetic material was in favour of super-micrometric compared to sub-micrometric particle size range. The evaluation of the individual risk of infection was carried out on the basis of the obtained data considering a hypothetical exposure scenario. The obtained results indicate the necessity of the protective masks in presence of infected subjects, especially while staying for longer period of time in the hospital environments.

Evaluation and uncertainty analysis of Himawari-8 hourly aerosol product version 3.1 and its influence on surface solar radiation before and during the COVID-19 outbreak.

The hourly Himawari-8 version 3.1 (V31) aerosol product has been released and incorporates an updated Level 2 algorithm that uses forecast data as an a priori estimate. However, there has not been a thorough evaluation of V31 data across a full-disk scan, and V31 has yet to be applied in the analysis of its influence on surface solar radiation (SSR). This study firstly investigates the accuracy of V31 aerosol products, which includes three categories of aerosol optical depth (AOD) (AODMean, AODPure, and AODMerged) as well as the corresponding Ångström exponent (AE), using ground-based measurements from the AERONET and SKYNET. Results indicate that V31 AOD products are more consistent with ground-based measurements compared to previous products (V30). The highest correlation and lowest error were seen in the AODMerged, with a correlation coefficient of 0.8335 and minimal root mean square error of 0.1919. In contrast, the AEMerged shows a larger discrepancy with measurements unlike the AEMean and AEPure. Error analysis reveals that V31 AODMerged has generally stable accuracy across various ground types and geometrical observation angles, however, there are higher uncertainties in areas with high aerosol loading, particularly for fine aerosols. The temporal analysis shows that V31 AODMerged performs better compared to V30, particularly in the afternoon. Finally, the impacts of aerosols on SSR based on the V31 AODMerged are investigated through the development of a sophisticated SSR estimation algorithm in the clear sky. Results demonstrate that the estimated SSR is significant consistency with those of well-known CERES products, with preservation of 20 times higher spatial resolution. The spatial analysis reveals a significant reduction of AOD in the North China Plain before and during the COVID-19 outbreak, resulting in an average 24.57 W m-2 variation of the surface shortwave radiative forcing in clear sky daytime.

Different approaches to explore the impact of COVID-19 lockdowns on carbonaceous aerosols at a European rural background site.

To prevent the fast spread of COVID-19, worldwide restrictions have been put in place, leading to a reduction in emissions from most anthropogenic sources. In this study, the impact of COVID-19 lockdowns on elemental (EC) and organic (OC) carbon was explored at a European rural background site combining different approaches: - "Horizontal approach (HA)" consists of comparing concentrations of pollutants measured at 4 m a.g.l. during pre-COVID period (2017-2019) to those measured during COVID period (2020-2021); - "Vertical approach (VA)" consists of inspecting the relationship between OC and EC measured at 4 m and those on top (230 m) of a 250 m-tall tower in Czech Republic. The HA showed that the lockdowns did not systematically result in lower concentrations of both carbonaceous fractions unlike NO2 (25 to 36 % lower) and SO2 (10 to 45 % lower). EC was generally lower during the lockdowns (up to 35 %), likely attributed to the traffic restrictions whereas increased OC (up to 50 %) could be attributed to enhanced emissions from the domestic heating and biomass burning during this stay-home period, but also to the enhanced concentration of SOC (up to 98 %). EC and OC were generally higher at 4 m suggesting a greater influence of local sources near the surface. Interestingly, the VA revealed a significantly enhanced correlation between EC and OC measured at 4 m and those at 230 m (R values up to 0.88 and 0.70 during lockdown 1 and 2, respectively), suggesting a stronger influence of aged and long distance transported aerosols during the lockdowns. This study reveals that lockdowns did not necessarily affect aerosol absolute concentrations but it certainly influenced their vertical distribution. Therefore, analyzing the vertical distribution can allow a better characterization of aerosol properties and sources at rural background sites, especially during a period of significantly reduced human activities.

Characteristics and sources of carbonaceous aerosols in a semi-arid city: Quantifying anthropogenic and meteorological impacts.

Carbonaceous aerosols have great adverse impacts on air quality, human health, and climate. However, there is a limited understanding of carbonaceous aerosols in semi-arid areas. The correlation between carbonaceous aerosols and control measures is still unclear owing to the insufficient information regarding meteorological contribution. To reveal the complex relationship between control measures and carbonaceous aerosols, offline and online observations of carbonaceous aerosols were conducted from October 8, 2019 to October 7, 2020 in Hohhot, a semi-arid city. The characteristics and sources of carbonaceous aerosols and impacts of anthropogenic emissions and meteorological conditions were studied. The annual mean concentrations (± standard deviation) of fine particulate matter (PM2.5), organic carbon (OC), and elemental carbon (EC) were 42.81 (±40.13), 7.57 (±6.43), and 2.25 (±1.39) µg m-3, respectively. The highest PM2.5 and carbonaceous aerosol concentrations were observed in winter, whereas the lowest was observed in summer. The result indicated that coal combustion for heating had a critical role in air quality degradation in Hohhot. A boost regression tree model was applied to quantify the impacts of anthropogenic emissions and meteorological conditions on carbonaceous aerosols. The results suggested that the anthropogenic contributions of PM2.5, OC, and EC during the COVID-19 lockdown period were 53.0, 15.0, and 2.36 µg m-3, respectively, while the meteorological contributions were 5.38, 2.49, and -0.62 µg m-3, respectively. Secondary formation caused by unfavorable meteorological conditions offset the emission reduction during the COVID-19 lockdown period. Coal combustion (46.4% for OC and 35.4% for EC) and vehicular emissions (32.0% for OC and 50.4% for EC) were the predominant contributors of carbonaceous aerosols. The result indicated that Hohhot must regulate coal use and vehicle emissions to reduce carbonaceous aerosol pollution. This study provides new insights and a comprehensive understanding of the complex relationships between control strategies, meteorological conditions, and air quality.

Changes in air pollution, land surface temperature, and urban heat islands during the COVID-19 lockdown in three Chinese urban agglomerations.

COVID-19 has notably impacted the world economy and human activities. However, the strict urban lockdown policies implemented in various countries appear to have positively affected pollution and the thermal environment. In this study, Moderate Resolution Imaging Spectroradiometer (MODIS) land surface temperature (LST) and aerosol optical depth (AOD) data were selected, combined with Sentinel-5P images and meteorological elements, to analyze the changes and associations among air pollution, LST, and urban heat islands (UHIs) in three urban agglomerations in mainland China during the COVID-19 lockdown. The results showed that during the COVID-19 lockdown period (February 2020), the levels of the AOD and atmospheric pollutants (fine particles (PM2.5), NO2, and CO) significantly decreased. Among them, PM2.5 and NO2 decreased the most in all urban agglomerations, by >14 %. Notably, the continued improvement in air pollution attributed to China's strict control policies could lead to overestimation of the enhanced air quality during the lockdown. The surface temperature in all three urban agglomerations increased by >1 °C during the lockdown, which was mainly due to climate factors, but we also showed that the lockdown constrained positive LST anomalies. The decrease in the nighttime urban heat island intensity (UHIInight) in the three urban agglomerations was greater than that in the daytime quantity by >25 %. The reduction in surface UHIs at night was mainly due to the reduced human activities and air pollutant emissions. Although strict restrictions on human activities positively affected air pollution and UHIs, these changes were quickly reverted when lockdown policies were relaxed. Moreover, small-scale lockdowns contributed little to environmental improvement. Our results have implications for assessing the environmental benefits of city-scale lockdowns.

SARS-CoV-2 transmission with and without mask wearing or air cleaners in schools in Switzerland: A modeling study of epidemiological, environmental, and molecular data.

BACKGROUND: Growing evidence suggests an important contribution of airborne transmission to the overall spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), in particular via smaller particles called aerosols. However, the contribution of school children to SARS-CoV-2 transmission remains uncertain. The aim of this study was to assess transmission of airborne respiratory infections and the association with infection control measures in schools using a multiple-measurement approach. METHODS AND FINDINGS: We collected epidemiological (cases of Coronavirus Disease 2019 (COVID-19)), environmental (CO2, aerosol and particle concentrations), and molecular data (bioaerosol and saliva samples) over 7 weeks from January to March 2022 (Omicron wave) in 2 secondary schools (n = 90, average 18 students/classroom) in Switzerland. We analyzed changes in environmental and molecular characteristics between different study conditions (no intervention, mask wearing, air cleaners). Analyses of environmental changes were adjusted for different ventilation, the number of students in class, school and weekday effects. We modeled disease transmission using a semi-mechanistic Bayesian hierarchical model, adjusting for absent students and community transmission. Molecular analysis of saliva (21/262 positive) and airborne samples (10/130) detected SARS-CoV-2 throughout the study (weekly average viral concentration 0.6 copies/L) and occasionally other respiratory viruses. Overall daily average CO2 levels were 1,064 ± 232 ppm (± standard deviation). Daily average aerosol number concentrations without interventions were 177 ± 109 1/cm3 and decreased by 69% (95% CrI 42% to 86%) with mask mandates and 39% (95% CrI 4% to 69%) with air cleaners. Compared to no intervention, the transmission risk was lower with mask mandates (adjusted odds ratio 0.19, 95% CrI 0.09 to 0.38) and comparable with air cleaners (1.00, 95% CrI 0.15 to 6.51). Study limitations include possible confounding by period as the number of susceptible students declined over time. Furthermore, airborne detection of pathogens document exposure but not necessarily transmission. CONCLUSIONS: Molecular detection of airborne and human SARS-CoV-2 indicated sustained transmission in schools. Mask mandates were associated with greater reductions in aerosol concentrations than air cleaners and with lower transmission. Our multiple-measurement approach could be used to continuously monitor transmission risk of respiratory infections and the effectiveness of infection control measures in schools and other congregate settings.

Decay rate estimation of respiratory viruses in aerosols and on surfaces under different environmental conditions.

Majority of the viral outbreaks are super-spreading events established within 2-10 h, dependent on a critical time interval for successful transmission between humans, which is governed by the decay rates of viruses. To evaluate the decay rates of respiratory viruses over a short span, we calculated their decay rate values for various surfaces and aerosols. We applied Bayesian regression and ridge regression and determined the best estimation for respiratory viruses, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), severe acute respiratory syndrome coronavirus (SARS-CoV), middle east respiratory syndrome coronavirus (MERS-CoV), influenza viruses, and respiratory syncytial virus (RSV); the decay rate values in aerosols for these viruses were 4.83 ± 5.70, 0.40 ± 0.24, 0.11 ± 0.04, 2.43 ± 5.94, and 1.00 ± 0.50 h-1, respectively. The highest decay rate values for each virus type differed according to the surface type. According to the model performance criteria, the Bayesian regression model was better for SARS-CoV-2 and influenza viruses, whereas ridge regression was better for SARS-CoV and MERS-CoV. A simulation using a better estimation will help us find effective non-pharmaceutical interventions to control virus transmissions.

SARS-CoV2 in public spaces in West London, UK during COVID-19 pandemic.

BACKGROUND: Spread of SARS-CoV2 by aerosol is considered an important mode of transmission over distances >2 m, particularly indoors. OBJECTIVES: We determined whether SARS-CoV2 could be detected in the air of enclosed/semi-enclosed public spaces. METHODS AND ANALYSIS: Between March 2021 and December 2021 during the easing of COVID-19 pandemic restrictions after a period of lockdown, we used total suspended and size-segregated particulate matter (PM) samplers for the detection of SARS-CoV2 in hospitals wards and waiting areas, on public transport, in a university campus and in a primary school in West London. RESULTS: We collected 207 samples, of which 20 (9.7%) were positive for SARS-CoV2 using quantitative PCR. Positive samples were collected from hospital patient waiting areas, from hospital wards treating patients with COVID-19 using stationary samplers and from train carriages in London underground using personal samplers. Mean virus concentrations varied between 429 500 copies/m3 in the hospital emergency waiting area and the more frequent 164 000 copies/m3 found in other areas. There were more frequent positive samples from PM samplers in the PM2.5 fractions compared with PM10 and PM1. Culture on Vero cells of all collected samples gave negative results. CONCLUSION: During a period of partial opening during the COVID-19 pandemic in London, we detected SARS-CoV2 RNA in the air of hospital waiting areas and wards and of London Underground train carriage. More research is needed to determine the transmission potential of SARS-CoV2 detected in the air.

Mitigation of COVID-19 During Dental Treatment in a State Prison System.

In congregate living settings when active coronavirus disease 2019 (COVID-19) transmission is present, limiting the scope of dental care to urgent and emergent treatment minimizes exposure risk for patients and staff. Engineering controls to mitigate aerosol production during dental procedures, including enhanced high-volume evacuation, high-efficiency particulate absorbing air filtration, and the use of a dental dam provide additional protection for dental providers and staff. Properly fitted N-95 respirators are of particular importance to limit COVID-19 transmission when SARS-CoV-2 containing aerosols may be present. When patients are known to be COVID-19 positive, the use of powered air-purifying respirators is appropriate. Further protection against the spread of disease among patients and staff may be provided by point-of-care testing for patients prior to dental procedures during outbreaks.

Lung aerosol particle emission increases with age at rest and during exercise.

Airborne respiratory aerosol particle transmission of pathogens such as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), influenza, or rhinoviruses plays a major role in the spread of infectious diseases. The infection risk is increased during indoor exercise, as aerosol particle emission can increase by more than 100-fold from rest to maximal exercise. Earlier studies have investigated the effect of factors such as age, sex, and body mass index (BMI), but only at rest and without taking ventilation into account. Here, we report that during both rest and exercise, subjects aged 60 to 76 y emit on average more than twice as many aerosol particles per minute than subjects aged 20 to 39 y. In terms of volume, older subjects emit on average five times as much dry volume (i.e., the residue of dried aerosol particles) than younger subjects. There was no statistically significant effect of sex or BMI within the test group. Together, this suggests that aging of the lung and respiratory tract is associated with an increased generation of aerosol particles irrespective of ventilation. Our findings demonstrate that age and exercise increase aerosol particle emission. In contrast, sex or BMI only have minor effects.

Aerosol in the oral health-care setting: a misty topic.

Studies have shown that mouth and respiratory tract microorganisms can be transported in aerosol and spatter. Due to aerosol-generating procedures, there are potentially various infection risks for patients and those working in health care, especially in oral health care. Dental aerosol can contaminate not only the mucous membranes of the oral health-care professional's mouth, respiratory passages, and eyes but also exposed surfaces and materials in the environment. As such, preventing disease transmission within oral health-care offices is important issue. Since the start of the COVID-19 pandemic, an innumerable amount of (mis)information and advice on how to stay safe and prevent the spread of coronavirus has been published. What preventive measures can and have been taken to counteract this, and what have we learned during the pandemic? This review summarizes relevant literature that has addressed the presence and dispersal of aerosol and spatter as a concern in health care. It includes the sources of dental aerosol, their potential health threats, and strategies for controlling and mitigating their impact. It shows that further research is needed to better understand the potential health risks of dental aerosol and to develop effective strategies for mitigating them. CLINICAL RELEVANCE: Using personal protective equipment, high-volume evacuation systems and pre-procedural antimicrobial agents can help to reduce the potential for infection in oral health-care settings and protect the well-being of oral health-care workers and their patients.

SARS-CoV-2 transmission modes: Why and how contamination occurs around shared meals and drinks?

In spite of prevention measures enacted all over the world to control the COVID-19 pandemic outbreak, including mask wearing, social distancing, hand hygiene, vaccination, and other precautions, the SARS-CoV-2 virus continues to spread globally at an unabated rate of about 1 million cases per day. The specificities of superspreading events as well as evidence of human-to-human, human-to-animal and animal-to-human transmission, indoors or outdoors, raise questions about a possibly neglected viral transmission route. In addition to inhaled aerosols, which are already recognized as key contributors to transmission, the oral route represents a strong candidate, in particular when meals and drinks are shared. In this review, we intend to discuss that significant quantities of virus dispersed by large droplets during discussions at festive gatherings could explain group contamination either directly or indirectly after deposition on surfaces, food, drinks, cutlery, and several other soiled vectors. We suggest that hand hygiene and sanitary practices around objects brought to the mouth and food also need to be taken into account in order to curb transmission.

CO2 concentration as an indicator of indoor ventilation performance to control airborne transmission of SARS-CoV-2.

BACKGROUND: The Wells-Riley equation has been extensively used to quantify the infection risk of airborne transmission indoors. This equation is difficult to apply to actual conditions because it requires measurement of the outdoor air supply rate, which vary with time and are difficult to quantify. The method of determining the fraction of inhaled air that has been exhaled previously by someone in a building using a CO2 concentration measurement can solve the limitations of the existing method. Using this method, the indoor CO2 concentration threshold can be determined to keep the risk of infection below certain conditions. METHODS: Based on the calculation of the rebreathed fraction, an appropriate mean indoor CO2 concentration and required air exchange rate to control SARS-CoV-2 airborne transmission was calculated. The number of indoor occupants, ventilation rate, and the deposition and inactivation rates of the virus-laden aerosols were considered. The application of the proposed indoor CO2 concentration-based infection rate control was investigated through case studies in school classrooms and restaurants. RESULTS: In a typical school classroom environment with 20-25 occupants and an exposure time of 6-8 h, the average indoor CO2 concentration should be kept below 700 ppm to control the risk of airborne infection indoors. The ASHRAE recommended ventilation rate is sufficient when wearing a mask in classrooms. For a typical restaurant with 50-100 occupants and an exposure time of 2-3 h, the average indoor CO2 concentration should be kept below about 900 ppm. Residence time in the restaurant had a significant effect on the acceptable CO2 concentration. CONCLUSION: Given the conditions of the occupancy environment, it is possible to determine an indoor CO2 concentration threshold, and keeping the CO2 concentration lower than a certain threshold could help reduce the risk of COVID-19 infection.