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Airborne or Droplet Precautions for Health Workers Treating Coronavirus Disease 2019?
Bahl, Prateek; Doolan, Con; de Silva, Charitha; Chughtai, Abrar Ahmad; Bourouiba, Lydia; MacIntyre, C Raina.
  • Bahl P; School of Mechanical and Manufacturing Engineering, UNSW Sydney, New South Wales, Australia.
  • Doolan C; School of Mechanical and Manufacturing Engineering, UNSW Sydney, New South Wales, Australia.
  • de Silva C; School of Mechanical and Manufacturing Engineering, UNSW Sydney, New South Wales, Australia.
  • Chughtai AA; School of Public Health and Community Medicine, UNSW Sydney, New South Wales, Australia.
  • Bourouiba L; The Fluid Dynamics of Disease Transmission Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
  • MacIntyre CR; The Kirby Institute, UNSW Sydney, New South Wales, Australia.
J Infect Dis ; 225(9): 1561-1568, 2022 05 04.
Article in English | MEDLINE | ID: covidwho-1890948
ABSTRACT
Cases of coronavirus disease 2019 (COVID-19) have been reported in more than 200 countries. Thousands of health workers have been infected, and outbreaks have occurred in hospitals, aged care facilities, and prisons. The World Health Organization (WHO) has issued guidelines for contact and droplet precautions for healthcare workers caring for suspected COVID-19 patients, whereas the US Centers for Disease Control and Prevention (CDC) has initially recommended airborne precautions. The 1- to 2-meter (≈3-6 feet) rule of spatial separation is central to droplet precautions and assumes that large droplets do not travel further than 2 meters (≈6 feet). We aimed to review the evidence for horizontal distance traveled by droplets and the guidelines issued by the WHO, CDC, and European Centre for Disease Prevention and Control 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- to 2-meter (≈3-6 feet) rule of spatial separation. Of 10 studies on horizontal droplet distance, 8 showed droplets travel more than 2 meters (≈6 feet), in some cases up to 8 meters (≈26 feet). Several studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) support aerosol transmission, and 1 study documented virus at a distance of 4 meters (≈13 feet) from the patient. Moreover, evidence suggests that 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, and remain viable 3 hours after aerosolization. The weight of combined evidence supports airborne precautions for the occupational health and safety of health workers treating patients with COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study Limits: Aged / Humans Language: English Journal: J Infect Dis Year: 2022 Document Type: Article Affiliation country: Infdis

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Observational study Limits: Aged / Humans Language: English Journal: J Infect Dis Year: 2022 Document Type: Article Affiliation country: Infdis