Infectious SARS-CoV-2 is emitted in aerosols

Respiratory viruses such as SARS-CoV-2 are transmitted in respiratory droplets and aerosols, which are released during talking, breathing, coughing, and sneezing. Non-contact transmission of SARS-CoV-2 has been demonstrated, suggesting transmission in aerosols. Here we demonstrate that golden Syrian hamsters emit infectious SARS-CoV-2 in aerosols, prior to and concurrent with the onset of mild clinical signs of disease. The average emission rate is 25 infectious virions/hour on days 1 and 2 post-inoculation, with average viral RNA levels 200-fold higher than infectious virus in aerosols. Female hamsters have delayed kinetics of viral shedding in aerosols compared to male hamsters, with peak viral emission for females on dpi 2 and for males on dpi 1. The majority of virus is contained within aerosols <8 {micro}m in size. Thus, we provide direct evidence that, in hamsters, SARS-CoV-2 is an airborne virus.

Indicators for Risk of Airborne Transmission in Shared Indoor Environments and their application to COVID-19 Outbreaks

Some infectious diseases, including COVID-19, can be transmitted via aerosols that are emitted by an infectious person and inhaled by susceptible individuals. Most airborne transmission occurs at close proximity and is effectively reduced by physical distancing, but as time indoors increases, infections occur in those sharing room air despite maintaining distancing. There have been calls for quantified models to estimate the absolute and relative contribution of these different factors to infection risk. We propose two indicators of infection risk for this situation, i.e., relative risk parameter (Hr) and risk parameter (H). They combine the key factors that control airborne disease transmission indoors: virus-containing aerosol generation rate, breathing flow rate, masking and its quality, ventilation and particulate air cleaning rates, number of occupants, and duration of exposure. COVID-19 outbreaks show a clear trend in relation to these factors that is consistent with airborne infection The observed trends of outbreak size (attack rate) vs. H (Hr) allow us to recommend values of these parameters to minimize COVID-19 indoor infection risk. Transmission in typical pre-pandemic indoor spaces is highly sensitive to mitigation efforts. Previous outbreaks of measles, flu, and tuberculosis were assessed along with recently reported COVID-19 outbreaks. Measles outbreaks occur at much lower risk parameter values than COVID-19, while tuberculosis outbreaks are observed at much higher risk parameter values. Since both diseases are accepted as airborne, the fact that COVID-19 is less contagious than measles does not rule out airborne transmission. It is important that future outbreak reports include information on the nature and type of masking, ventilation and particulate-air cleaning rates, number of occupants, and duration of exposure, to allow us to understand the circumstances conducive to airborne transmission of different diseases. SynopsisWe propose two infection risk indicators for indoor spaces and apply them to COVID-19 outbreaks analysis and mitigation.

Relative humidity predicts day-to-day variations in COVID-19 cases in the city of Buenos Aires

Possible links between the transmission of COVID-19 and meteorology have been investigated by comparing positive cases across geographical regions or seasons. Little is known, however, about the degree to which environmental conditions modulate the daily dynamics of COVID-19 spread at a given location. One reason for this is that individual waves of the disease are typically too abrupt, making it hard to isolate the contribution of meteorological cycles. To overcome this shortage, we here present a case study of the first wave of the outbreak in the city of Buenos Aires, which had a slow evolution of the case load extending along most of 2020. We found that humidity plays a prominent role in modulating the variation of COVID-19 positive cases through a negative-slope linear relationship, with an optimal lag of 9 days between the meteorological observation and the positive case report. This relationship is specific to winter months, when relative humidity predicts up to half of the variance in positive cases. Our results provide a tool to anticipate local surges in COVID-19 cases after events of low humidity. More generally, they add to accumulating evidence pointing to dry air as a facilitator of COVID-19 transmission.

The effect of temperature and humidity on the stability of SARS-CoV-2 and other enveloped viruses

Environmental conditions affect virus inactivation rate and transmission potential. Understanding those effects is critical for anticipating and mitigating epidemic spread. Ambient temperature and humidity strongly affect the inactivation rate of enveloped viruses, but a mechanistic, quantitative theory of those effects has been elusive. We measure the stability of the enveloped respiratory virus SARS-CoV-2 on an inert surface at nine temperature and humidity conditions and develop a mechanistic model to explain and predict how temperature and humidity alter virus inactivation. We find SARS-CoV-2 survives longest at low temperatures and extreme relative humidities; median estimated virus half-life is over 24 hours at 10 {degrees}C and 40 % RH, but approximately 1.5 hours at 27 {degrees}C and 65 % RH. Our mechanistic model uses simple chemistry to explain the increase in virus inactivation rate with increased temperature and the U-shaped dependence of inactivation rate on relative humidity. The model accurately predicts quantitative measurements from existing studies of five different human coronaviruses (including SARS-CoV-2), suggesting that shared mechanisms may determine environmental stability for many enveloped viruses. Our results indicate scenarios of particular transmission risk, point to pandemic mitigation strategies, and open new frontiers in the mechanistic study of virus transmission.

Transmission of SARS-CoV-2 by inhalation of respiratory aerosol in the Skagit Valley Chorale superspreading event

During the 2020 COVID-19 pandemic, an outbreak occurred following attendance of a symptomatic index case at a regular weekly rehearsal on 10 March of the Skagit Valley Chorale (SVC). After that rehearsal, 53 members of the SVC among 61 in attendance were confirmed or strongly suspected to have contracted COVID-19 and two died. Transmission by the airborne route is likely. It is vital to identify features of cases such as this so as to better understand the factors that promote superspreading events. Based on a conditional assumption that transmission during this outbreak was by inhalation of respiratory aerosol, we use the available evidence to infer the emission rate of airborne infectious quanta from the primary source. We also explore how the risk of infection would vary with several influential factors: the rates of removal of respiratory aerosol by ventilation; deposition onto surfaces; and viral decay. The results indicate an emission rate of the order of a thousand quanta per hour (mean [interquartile range] for this event = 970 [680-1190] quanta per hour) and demonstrate that the risk of infection is modulated by ventilation conditions, occupant density, and duration of shared presence with an infectious individual. Practical ImplicationsO_LIDuring respiratory disease pandemics, group singing indoors should be discouraged or at a minimum carefully managed as singing can generate large amounts of airborne virus (quanta) if any of the singers is infected. C_LIO_LIVentilation requirements for spaces that are used for singing (e.g., buildings for religious services and rehearsal/performance) should be reconsidered in light of the potential for airborne transmission of infectious diseases. C_LIO_LIMeetings of choirs and other kinds of singing groups during pandemics should only be in spaces that are equipped with a warning system of insufficient ventilation which may be detected with CO2 "traffic light" monitors. C_LIO_LISystems that combine the functions heating and ventilation (or cooling and ventilation) should be provided with a disclaimer saying "do not shut this system off when people are using the room; turning off the system will also shut down fresh air supply, which can lead to the spread of airborne infections." C_LI