SARS-Cov-2: The Relevance and Prevention of Aerosol Transmission

van der Valk, Johanna P.M.; in ’t Veen, Johannes C.C.M.

Coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has claimed many victims worldwide due to its high virulence and contagiousness. The person-to-person transmission of SARS-Cov-2 when in close contact is facilitated by respiratory droplets containing the virus particles, and by skin contact with contaminated surfaces. However, the large number of COVID-19 infections cannot be explained only by droplet deposition or contact contamination. It seems very plausible that aerosols are important in transmitting SARS-Cov-2. It has been demonstrated that SARS-CoV-2 remains viable in aerosols for hours, facilitating rapid distribution of the virus over great distances. Aerosols may, therefore, also be responsible for so-called super-spreader events. Indirect evidence points to a correlation between ventilation and the transmission and spread of SARS-Cov-2, supporting ventilation as an important factor in preventing airborne transmission. Further actions to avoid transmission of COVID-19 include social distancing, hygiene measures, and barrier measures, such as face-coverings. Professional masks offer better protection than cloth masks. These protection measures are especially relevant to health care workers, when performing endotracheal intubation, but the risk from non-invasive ventilation and nebulizing treatment seems to be moderate.