SARS-CoV-2 viral particles can travel large distances, detected at up to 4 meters, and remaining in air up to 3 hours after aerosolisation, although with uncertain infective viability.

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• Prateek Bahl, Con Doolan, Charitha de Silva, Abrar Ahmad Chughtai, Lydia Bourouiba, and C Raina MacIntyre.
• School of Mechanical and Manufacturing Engineering, UNSW Sydney, NSW, Australia.
• J. Infect. Dis. 2020 Apr 16.

AbstractCases of COVID-19 have been reported in over 200 countries. Thousands of health workers have been infected and outbreaks have occurred in hospitals, aged care facilities and prisons. World Health Organization (WHO) has issued guidelines for contact and droplet precautions for Healthcare Workers (HCWs) caring for suspected COVID-19 patients, whilst the US Centre for Disease Control (CDC) has recommended airborne precautions. The 1 - 2 m (≈3 - 6 ft) rule of spatial separation is central to droplet precautions and assumes large droplets do not travel further than 2 m (≈6 ft). We aimed to review the evidence for horizontal distance travelled by droplets and the guidelines issued by the World Health Organization (WHO), US Center for Diseases Control (CDC) and European Centre for Disease Prevention and Control (ECDC) on respiratory protection for COVID-19. We found that the evidence base for current guidelines is sparse, and the available data do not support the 1 - 2 m (≈3 - 6 ft) rule of spatial separation. Of ten studies on horizontal droplet distance, eight showed droplets travel more than 2 m (≈6 ft), in some cases more than 8 meters (≈26 ft). Several studies of SARS-CoV-2 support aerosol transmission and one study documented virus at a distance of 4 meters (≈13 ft) from the patient. Moreover, evidence suggests infections cannot neatly be separated into the dichotomy of droplet versus airborne transmission routes. Available studies also show that SARS-CoV-2 can be detected in the air, 3 hours after aeroslisation. The weight of combined evidence supports airborne precautions for the occupational health and safety of health workers treating patients with COVID-19.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.

This article appears in the collections: Does face mask use reduce COVID transmission? and Anaesthesiology, Personal Protective Equipment (PPE) and COVID.

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