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Barberá-Riera M, Barneo-Muñoz M, Gascó-Laborda JC, Bellido Blasco J, Porru S, Alfaro C, Esteve Cano V, Carrasco P, Rebagliato M, de Llanos R, Delgado-Saborit JM. Detection of SARS-CoV-2 in aerosols in long term care facilities and other indoor spaces with known COVID-19 outbreaks. ENVIRONMENTAL RESEARCH 2024; 242:117730. [PMID: 38000631 DOI: 10.1016/j.envres.2023.117730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Coronavirus outbreaks are likely to occur in crowded and congregate indoor spaces, and their effects are most severe in vulnerable long term care facilities (LTCFs) residents. Public health officers benefit from tools that allow them to control COVID-19 outbreaks in vulnerable settings such as LTCFs, but which could be translated in the future to control other known and future virus outbreaks. This study aims to develop and test a methodology based on detection of SARS-CoV-2 in aerosol samples collected with personal pumps that could be easily implemented by public health officers. The proposed methodology was used to investigate the levels of SARS-CoV-2 in aerosol in indoor settings, mainly focusing on LTCFs, suffering COVID-19 outbreaks, or in the presence of known COVID-19 cases, and targeting the initial days after diagnosis. Aerosol samples (N = 18) were collected between November 2020 and March 2022 in Castelló (Spain) from LTCFs, merchant ships and a private home with recently infected COVID-19 cases. Sampling was performed for 24-h, onto 47 mm polytetrafluoroethylene (PTFE) and quartz filters, connected to personal pumps at 2 and 4 L/min respectively. RNA from filters was extracted and SARS-CoV-2 was determined by detection of regions N1 and N2 of the nucleocapsid gene alongside the E gene using RT-PCR technique. SARS-CoV-2 genetic material was detected in 87.5% samples. Concentrations ranged ND-19,525 gc/m3 (gene E). No genetic traces were detected in rooms from contacts that were isolated as a preventative measure. Very high levels were also measured at locations with poor ventilation. Aerosol measurement conducted with the proposed methodology provided useful information to public health officers and contributed to manage and control 12 different COVID-19 outbreaks. SARS-CoV-2 was detected in aerosol samples collected during outbreaks in congregate spaces. Indoor aerosol sampling is a useful tool in the early detection and management of COVID-19 outbreaks and supports epidemiological investigations.
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Affiliation(s)
- M Barberá-Riera
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - M Barneo-Muñoz
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - J C Gascó-Laborda
- Epidemiology Division, Public Health Center, Castelló de la Plana, Spain
| | - J Bellido Blasco
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology Division, Public Health Center, Castelló de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - S Porru
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - C Alfaro
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - V Esteve Cano
- Department of Inorganic and Organic Chemistry, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain
| | - P Carrasco
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - M Rebagliato
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - R de Llanos
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain.
| | - J M Delgado-Saborit
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Avenida de Vicent Sos Baynat s/n, 12071, Castellón de la Plana, Spain; Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region, FISABIO-Public Health, FISABIO-Universitat Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain.
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2
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Shankar SN, Vass WB, Lednicky JA, Logan T, Messcher RL, Eiguren-Fernandez A, Amanatidis S, Sabo-Attwood T, Wu CY. The BioCascade-VIVAS system for collection and delivery of virus-laden size-fractionated airborne particles. JOURNAL OF AEROSOL SCIENCE 2024; 175:106263. [PMID: 38680161 PMCID: PMC11044810 DOI: 10.1016/j.jaerosci.2023.106263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
The size of virus-laden particles determines whether aerosol or droplet transmission is dominant in the airborne transmission of pathogens. Determining dominant transmission pathways is critical to implementing effective exposure risk mitigation strategies. The aerobiology discipline greatly needs an air sampling system that can collect virus-laden airborne particles, separate them by particle diameter, and deliver them directly onto host cells without inactivating virus or killing cells. We report the use of a testing system that combines a BioAerosol Nebulizing Generator (BANG) to aerosolize Human coronavirus (HCoV)-OC43 (OC43) and an integrated air sampling system comprised of a BioCascade impactor (BC) and Viable Virus Aerosol Sampler (VIVAS), together referred to as BC-VIVAS, to deliver the aerosolized virus directly onto Vero E6 cells. Particles were collected into four stages according to their aerodynamic diameter (Stage 1: >9.43 μm, Stage 2: 3.81-9.43 μm, Stage 3: 1.41-3.81 μm and Stage 4: <1.41 μm). OC43 was detected by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) analyses of samples from all BC-VIVAS stages. The calculated OC43 genome equivalent counts per cm3 of air ranged from 0.34±0.09 to 70.28±12.56, with the highest concentrations in stage 3 (1.41-3.81 μm) and stage 4 (<1.41 μm). Virus-induced cytopathic effects appeared only in cells exposed to particles collected in stages 3 and 4, demonstrating the presence of viable OC43 in particles <3.81 μm. This study demonstrates the dual utility of the BC-VIVAS as particle size-fractionating air sampler and a direct exposure system for aerosolized viruses. Such utility may help minimize conventional post-collection sample processing time required to assess the viability of airborne viruses and increase the understanding about transmission pathways for airborne pathogens.
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Affiliation(s)
- Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL 32611, USA
| | - William B. Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL 32611, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Tracey Logan
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Rebeccah L. Messcher
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | | | | | - Tara Sabo-Attwood
- Department of Environmental and Global Health, University of Florida, Gainesville, FL 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL 32611, USA
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, FL 33146, USA
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3
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Vass WB, Shankar SN, Lednicky JA, Yang Y, Manzanas C, Zhang Y, Boyette J, Chen J, Chen Y, Shirkhani A, Washeem M, Fan ZH, Eiguren-Fernandez A, Jutla A, Wu CY. Detection and isolation of infectious SARS-CoV-2 omicron subvariants collected from residential settings. AEROSOL SCIENCE AND TECHNOLOGY : THE JOURNAL OF THE AMERICAN ASSOCIATION FOR AEROSOL RESEARCH 2023; 57:1142-1153. [PMID: 38143528 PMCID: PMC10735208 DOI: 10.1080/02786826.2023.2251537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/17/2023] [Indexed: 12/26/2023]
Abstract
Airborne transmission of infectious (viable) SARS-CoV-2 is increasingly accepted as the primary manner by which the virus is spread from person to person. Risk of exposure to airborne virus is higher in enclosed and poorly ventilated spaces. We present a study focused on air sampling within residences occupied by individuals with COVID-19. Air samplers (BioSpot-VIVAS, VIVAS, and BC-251) were positioned in primary- and secondary-occupancy regions in seven homes. Swab samples were collected from high-touch surfaces. Isolation of SARS-CoV-2 was attempted for samples with virus detectable by RT-qPCR. Viable virus was quantified by plaque assay, and complete virus genome sequences were obtained for selected samples from each sampling day. SARS-CoV-2 was detected in 24 of 125 samples (19.2%) by RT-qPCR and isolated from 14 (11.2%) in cell cultures. It was detected in 80.9% (17/21) and cultured from 61.9% (13/21) of air samples collected using water condensation samplers, compared to swab samples which had a RT-qPCR detection rate of 10.5% (4/38) and virus isolation rate of 2.63% (1/38). No statistically significant differences existed in the likelihood of virus detection by RT-qPCR or amount of infectious virus in the air between areas of primary and secondary occupancy within residences. Our work provides information about the presence of SARS-CoV-2 in the air within homes of individuals with COVID-19. Information herein can help individuals make informed decisions about personal exposure risks when sharing indoor spaces with infected individuals isolating at home and further inform health departments and the public about SARS-CoV-2 exposure risks within residences.
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Affiliation(s)
- William B. Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Yang Yang
- Department of Statistics, University of Georgia, Athens, Georgia, USA
| | - Carlos Manzanas
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, Florida, USA
| | - Yuetong Zhang
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Jessica Boyette
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Jiayi Chen
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Yuqiao Chen
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Amin Shirkhani
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Mo Washeem
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Z. Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, Florida, USA
- Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | | | - Antarpreet Jutla
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
| | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, Florida, USA
- Department of Chemical, Environmental, and Materials Engineering, University of Miami, Coral Gables, Florida, USA
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Li H, Nannu Shankar S, Witanachchi CT, Lednicky JA, Loeb JC, Alam MM, Fan ZH, Lauzardo M, Mohamed K, Eiguren-Fernandez A, Wu CY. Lack of SARS-CoV-2 in environmental samples collected from September 2020-February 2021 in a university that followed CDC reopening guidance. HYGIENE AND ENVIRONMENTAL HEALTH ADVANCES 2023; 7:100061. [PMID: 37305381 PMCID: PMC10198740 DOI: 10.1016/j.heha.2023.100061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 04/27/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023]
Abstract
This study aimed to provide environmental surveillance data for evaluating the risk of acquiring SARS-CoV-2 in public areas with high foot traffic in a university. Air and surface samples were collected at a university that had the second highest number of COVID-19 cases among public higher education institutions in the U.S. during Fall 2020. A total of 60 samples were collected in 16 sampling events performed during Fall 2020 and Spring 2021. Nearly 9800 students traversed the sites during the study period. SARS-CoV-2 was not detected in any air or surface samples. The university followed CDC guidance, including COVID-19 testing, case investigations, and contact tracing. Students, faculty, and staff were asked to maintain physical distancing and wear face coverings. Although COVID-19 cases were relatively high at the university, the possibility of acquiring SARS-CoV-2 infections at the sites tested was low.
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Affiliation(s)
- Hongwan Li
- Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, USA
- Department of Environmental Engineering Sciences, University of Florida, USA
| | | | | | - John A Lednicky
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Julia C Loeb
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Md Mahbubul Alam
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | - Michael Lauzardo
- Emerging Pathogens Institute, University of Florida, USA
- Department of Medicine, University of Florida, USA
| | - Karim Mohamed
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, USA
- Department of Chemical, Environmental and Materials Engineering, University of Miami, USA
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5
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Martínez-Espinosa E, Carvajal-Mariscal I. Virus-laden droplet nuclei in vortical structures associated with recirculation zones in indoor environments: A possible airborne transmission of SARS-CoV-2. ENVIRONMENTAL ADVANCES 2023; 12:100376. [PMID: 37193349 PMCID: PMC10163794 DOI: 10.1016/j.envadv.2023.100376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023]
Abstract
Droplet nuclei dispersion patterns in indoor environments are reviewed from a physics view to explore the possibility of airborne transmission of SARS-CoV-2. This review analyzes works on particle dispersion patterns and their concentration in vortical structures in different indoor environments. Numerical simulations and experiments reveal the formation of the buildings' recirculation zones and vortex flow regions by flow separation, airflow interaction around objects, internal dispersion of airflow, or thermal plume. These vortical structures showed high particle concentration because particles are trapped for long periods. Then a hypothesis is proposed to explain why some medical studies detect the presence of SARS-CoV-2 and others do not detect the virus. The hypothesis proposes that airborne transmission is possible if virus-laden droplet nuclei are trapped in vortical structures associated with recirculation zones. This hypothesis is reinforced by a numerical study in a restaurant that presented possible evidence of airborne transmission by a large recirculating air zone. Furthermore, a medical study in a hospital is discussed from a physical view for identifying the formation of recirculation zones and their relation with positive tests for viruses. The observations show air sampling site located in this vortical structure is positive for the SARS-CoV-2 RNA. Therefore, the formation of vortical structures associated with recirculation zones should be avoided to minimize the possibility of airborne transmission. This work tries to understand the complex phenomenon of airborne transmission as a way in the prevention of transmission of infectious diseases.
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Affiliation(s)
- E Martínez-Espinosa
- Industrial and Environmental Processes Department, Instituto de Ingeniería, UNAM, Ciudad Universitaria, Mexico City 04510, México
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Tedeschini E, Pasqualini S, Emiliani C, Marini E, Valecchi A, Laoreti C, Ministrini S, Camilloni B, Castronari R, Patoia L, Merante F, Baglioni S, De Robertis E, Pirro M, Mencacci A, Pasqualini L. Monitoring of indoor bioaerosol for the detection of SARS-CoV-2 in different hospital settings. Front Public Health 2023; 11:1169073. [PMID: 37151587 PMCID: PMC10157290 DOI: 10.3389/fpubh.2023.1169073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Background Spore Trap is an environmental detection technology, already used in the field of allergology to monitor the presence and composition of potentially inspirable airborne micronic bioparticulate. This device is potentially suitable for environmental monitoring of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in hospital, as well as in other high-risk closed environments. The aim of the present study is to investigate the accuracy of the Spore Trap system in detecting SARS-CoV-2 in indoor bioaerosol of hospital rooms. Methods The Spore Trap was placed in hospital rooms hosting patients with documented SARS-CoV-2 infection (n = 36) or, as a negative control, in rooms where patients with documented negativity to a Real-Time Polymerase Chain Reaction molecular test for SARS-CoV-2 were admitted (n = 10). The monitoring of the bioaerosol was carried on for 24 h. Collected samples were analyzed by real-time polymerase chain reaction. Results The estimated sensitivity of the Spore Trap device for detecting SARS-CoV-2 in an indoor environment is 69.4% (95% C.I. 54.3-84.4%), with a specificity of 100%. Conclusion The Spore Trap technology is effective in detecting airborne SARS-CoV-2 virus with excellent specificity and high sensitivity, when compared to previous reports. The SARS-CoV-2 pandemic scenario has suggested that indoor air quality control will be a priority in future public health management and will certainly need to include an environmental bio-investigation protocol.
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Affiliation(s)
- Emma Tedeschini
- Dipartimento di Scienze Agrarie, Alimentari e Ambientali, Università degli Studi di Perugia, Perugia, Italy
| | - Stefania Pasqualini
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Carla Emiliani
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Ettore Marini
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Alessandro Valecchi
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Chiara Laoreti
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Stefano Ministrini
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
- *Correspondence: Stefano Ministrini
| | - Barbara Camilloni
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Roberto Castronari
- Dipartimento di Medicina e Chirurgia, Università degli Studi di Perugia, Perugia, Italy
| | - Lucio Patoia
- Ospedale S.G. Battista – Azienda Unità Sanitaria Umbria 2, Foligno, Italy
| | - Francesco Merante
- Ospedale S.G. Battista – Azienda Unità Sanitaria Umbria 2, Foligno, Italy
| | - Stefano Baglioni
- S.C. Pneumologia, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera di Perugia, Perugia, Italy
| | - Edoardo De Robertis
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Matteo Pirro
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Antonella Mencacci
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
| | - Leonella Pasqualini
- Dipartimento di Chimica, Biologia e Biotecnologie, Università degli Studi di Perugia, Perugia, Italy
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Zahedi A, Seif F, Golshan M, Khammar A, Rezaei Kahkha MR. Air Surveillance for Viral Contamination with SARS-CoV-2 RNA at a Healthcare Facility. FOOD AND ENVIRONMENTAL VIROLOGY 2022; 14:374-383. [PMID: 35610444 PMCID: PMC9129059 DOI: 10.1007/s12560-022-09524-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 05/10/2022] [Indexed: 05/13/2023]
Abstract
The transmission pathway of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 also called COVID-19 disease) in indoor environments are the main area of contention between health systems and scientists. In this context, little has been investigated about the collection of airborne viral shedding. Here, we collected air samples from 24 locations inside the sole COVID-19 patient care center in Zabol, Iran, for screening SARS-CoV-2 RNA from March to May 2021. Locations included the ICU, COVID-19 wards (CWs) rooms, corridors, nearby nurses' stations, and toilets. We identified the SARS-CoV-2 RNA in breathing zone of CW, in room air, with the positivity rate of 2.5% at a concentration of 17 × 103 virus genome copies/m3 air. It also investigates the relationship between local climate conditions [i.e., temperature and relative humidity] and COVID-19 transmission with the evolution of daily official data on the number of new cases, hospitalizations, and deaths. Current data explained that the difference of temperature and humidity may affect the behavior of virus along with other factors, i.e., population density, individual viral shedding, and infectious dose of SARS-CoV-2 (both indoor and outdoor). Our data support the potential SARS-CoV-2 airborne transmission indoors suggesting the specific safety assessment of building to improve ventilation solutions besides proper using face masks and extensive public health interventions.
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Affiliation(s)
- Amir Zahedi
- Department of Environmental Health Engineering, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Faezeh Seif
- Department of Basic Sciences, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Masoumeh Golshan
- Department of Environmental Health Engineering, Faculty of Health, Zabol University of Medical Sciences, Zabol, Iran.
| | - Alireza Khammar
- Department of Occupational Health, Faculty of Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mohammad Reza Rezaei Kahkha
- Department of Environmental Health Engineering, Faculty of Health, Zabol University of Medical Sciences, Zabol, Iran
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8
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Vass WB, Lednicky JA, Shankar SN, Fan ZH, Eiguren-Fernandez A, Wu CY. Viable SARS-CoV-2 Delta variant detected in aerosols in a residential setting with a self-isolating college student with COVID-19. JOURNAL OF AEROSOL SCIENCE 2022; 165:106038. [PMID: 35774447 PMCID: PMC9217630 DOI: 10.1016/j.jaerosci.2022.106038] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 05/08/2023]
Abstract
The B.1.617.2 (Delta) variant of SARS-CoV-2 emerged in India in October of 2020 and spread widely to over 145 countries, comprising over 99% of genome sequence-confirmed virus in COVID-19 cases of the United States (US) by September 2021. The rise in COVID-19 cases due to the Delta variant coincided with a return to in-person school attendance, straining COVID-19 mitigation plans implemented by educational institutions. Some plans required sick students to self-isolate off-campus, resulting in an unintended consequence: exposure of co-inhabitants of dwellings used by the sick person during isolation. We assessed air and surface samples collected from the bedroom of a self-isolating university student with mild COVID-19 for the presence of SARS-CoV-2. That virus' RNA was detected by real-time reverse-transcription quantitative polymerase chain reaction (rRT-qPCR) in air samples from both an isolation bedroom and a distal, non-isolation room of the same dwelling. SARS-CoV-2 was detected and viable virus was isolated in cell cultures from aerosol samples as well as from the surface of a mobile phone. Genomic sequencing revealed that the virus was a Delta variant SARS-CoV-2 strain. Taken together, the results of this work confirm the presence of viable SARS-CoV-2 within a residential living space of a person with COVID-19 and show potential for transportation of virus-laden aerosols beyond a designated isolation suite to other areas of a single-family home.
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Affiliation(s)
- William B Vass
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - John A Lednicky
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, 32611, USA
- Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, Gainesville, FL, USA
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9
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Lohse ZM, Shapiro JJ, Lednicky JA, Cash MN, Jun I, Mavian CN, Tagliamonte MS, Saleem C, Yang Y, Nelson EJ, Salemi M, Ryan KA, Morris JG. Persistence of Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variant in Children and Utility of Rapid Antigen Testing as an Indicator of Culturable Virus. Clin Infect Dis 2022; 76:e491-e494. [PMID: 36029095 PMCID: PMC9907546 DOI: 10.1093/cid/ciac693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
We screened 65 longitudinally collected nasal swab samples from 31 children aged 0-16 years who were positive for severe acute respiratory syndrome coronavirus 2 Omicron BA.1. By day 7 after onset of symptoms, 48% of children remained positive by rapid antigen test. In a sample subset, we found 100% correlation between antigen test results and virus culture.
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Affiliation(s)
- Zoe M Lohse
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Jerne J Shapiro
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - John A Lednicky
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Melanie N Cash
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Inyoung Jun
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Epidemiology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Carla N Mavian
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Massimiliano S Tagliamonte
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Cyrus Saleem
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Yang Yang
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Eric J Nelson
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Marco Salemi
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Kathleen A Ryan
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA,Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - J Glenn Morris
- Correspondence: J. G. Morris, Emerging Pathogens Institute, University of Florida, 2055 Mowry Rd., Gainesville, FL, 32610-0009 ()
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10
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SARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings. Nat Commun 2022; 13:4717. [PMID: 35953484 PMCID: PMC9366802 DOI: 10.1038/s41467-022-32406-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 07/26/2022] [Indexed: 11/09/2022] Open
Abstract
Two years after the emergence of SARS-CoV-2, there is still a need for better ways to assess the risk of transmission in congregate spaces. We deployed active air samplers to monitor the presence of SARS-CoV-2 in real-world settings across communities in the Upper Midwestern states of Wisconsin and Minnesota. Over 29 weeks, we collected 527 air samples from 15 congregate settings. We detected 106 samples that were positive for SARS-CoV-2 viral RNA, demonstrating that SARS-CoV-2 can be detected in continuous air samples collected from a variety of real-world settings. We expanded the utility of air surveillance to test for 40 other respiratory pathogens. Surveillance data revealed differences in timing and location of SARS-CoV-2 and influenza A virus detection. In addition, we obtained SARS-CoV-2 genome sequences from air samples to identify variant lineages. Collectively, this shows air sampling is a scalable, high throughput surveillance tool that could be used in conjunction with other methods for detecting respiratory pathogens in congregate settings.
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11
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Silva PG, Branco PTBS, Soares RRG, Mesquita JR, Sousa SIV. SARS-CoV-2 air sampling: A systematic review on the methodologies for detection and infectivity. INDOOR AIR 2022; 32:e13083. [PMID: 36040285 PMCID: PMC9538005 DOI: 10.1111/ina.13083] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
This systematic review aims to present an overview of the current aerosol sampling methods (and equipment) being used to investigate the presence of SARS-CoV-2 in the air, along with the main parameters reported in the studies that are essential to analyze the advantages and disadvantages of each method and perspectives for future research regarding this mode of transmission. A systematic literature review was performed on PubMed/MEDLINE, Web of Science, and Scopus to assess the current air sampling methodologies being applied to SARS-CoV-2. Most of the studies took place in indoor environments and healthcare settings and included air and environmental sampling. The collection mechanisms used were impinger, cyclone, impactor, filters, water-based condensation, and passive sampling. Most of the reviewed studies used RT-PCR to test the presence of SARS-CoV-2 RNA in the collected samples. SARS-CoV-2 RNA was detected with all collection mechanisms. From the studies detecting the presence of SARS-CoV-2 RNA, fourteen assessed infectivity. Five studies detected viable viruses using impactor, water-based condensation, and cyclone collection mechanisms. There is a need for a standardized protocol for sampling SARS-CoV-2 in air, which should also account for other influencing parameters, including air exchange ratio in the room sampled, relative humidity, temperature, and lighting conditions.
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Affiliation(s)
- Priscilla G Silva
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Pedro T B S Branco
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
| | - Ruben R G Soares
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, Solna, Sweden
- Division of Nanobiotechnology, Department of Protein Science, Science for Life Laboratory, KTH Royal Institute of Technology, Solna, Sweden
| | - João R Mesquita
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Epidemiology Research Unit (EPI Unit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Sofia I V Sousa
- LEPABE - Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, Porto, Portugal
- ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Porto, Portugal
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12
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Jefferson T, Heneghan CJ, Spencer E, Brassey J, Plüddemann A, Onakpoya I, Evans D, Conly J. A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses. Viruses 2022; 14:1605. [PMID: 35893670 PMCID: PMC9332164 DOI: 10.3390/v14081605] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 01/03/2023] Open
Abstract
Systematic reviews of 591 primary studies of the modes of transmission for SARS-CoV-2 show significant methodological shortcomings and heterogeneity in the design, conduct, testing, and reporting of SARS-CoV-2 transmission. While this is partly understandable at the outset of a pandemic, evidence rules of proof for assessing the transmission of this virus are needed for present and future pandemics of viral respiratory pathogens. We review the history of causality assessment related to microbial etiologies with a focus on respiratory viruses and suggest a hierarchy of evidence to integrate clinical, epidemiologic, molecular, and laboratory perspectives on transmission. The hierarchy, if applied to future studies, should narrow the uncertainty over the twin concepts of causality and transmission of human respiratory viruses. We attempt to address the translational gap between the current research evidence and the assessment of causality in the transmission of respiratory viruses with a focus on SARS-CoV-2. Experimentation, consistency, and independent replication of research alongside our proposed framework provide a chain of evidence that can reduce the uncertainty over the transmission of respiratory viruses and increase the level of confidence in specific modes of transmission, informing the measures that should be undertaken to prevent transmission.
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Affiliation(s)
- Tom Jefferson
- Department for Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UK;
| | - Carl J. Heneghan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (C.J.H.); (E.S.); (A.P.)
| | - Elizabeth Spencer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (C.J.H.); (E.S.); (A.P.)
| | - Jon Brassey
- Trip Database Ltd., Little Maristowe, Glasllwch Lane, Newport NP20 3PS, UK;
| | - Annette Plüddemann
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG, UK; (C.J.H.); (E.S.); (A.P.)
| | - Igho Onakpoya
- Department for Continuing Education, University of Oxford, Rewley House, 1 Wellington Square, Oxford OX1 2JA, UK;
| | - David Evans
- Li Ka Shing Institute of Virology, Department of Medical Microbiology & Immunology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - John Conly
- Centre for Antimicrobial Resistance, Alberta Health Services, Alberta Precision Laboratories, University of Calgary, Calgary, AB T2N 4N1, Canada;
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13
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Baselga M, Uranga-Murillo I, de Miguel D, Arias M, Sebastián V, Pardo J, Arruebo M. Silver Nanoparticles–Polyethyleneimine-Based Coatings with Antiviral Activity against SARS-CoV-2: A New Method to Functionalize Filtration Media. MATERIALS 2022; 15:ma15144742. [PMID: 35888208 PMCID: PMC9318907 DOI: 10.3390/ma15144742] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 02/06/2023]
Abstract
The use of face masks and air purification systems has been key to curbing the transmission of SARS-CoV-2 aerosols in the context of the current COVID-19 pandemic. However, some masks or air conditioning filtration systems are designed to remove large airborne particles or bacteria from the air, being limited their effectiveness against SARS-CoV-2. Continuous research has been aimed at improving the performance of filter materials through nanotechnology. This article presents a new low-cost method based on electrostatic forces and coordination complex formation to generate antiviral coatings on filter materials using silver nanoparticles and polyethyleneimine. Initially, the AgNPs synthesis procedure was optimized until reaching a particle size of 6.2 ± 2.6 nm, promoting a fast ionic silver release due to its reduced size, obtaining a stable colloid over time and having reduced size polydispersity. The stability of the binding of the AgNPs to the fibers was corroborated using polypropylene, polyester-viscose, and polypropylene-glass spunbond mats as substrates, obtaining very low amounts of detached AgNPs in all cases. Under simulated operational conditions, a material loss less than 1% of nanostructured silver was measured. SEM micrographs demonstrated high silver distribution homogeneity on the polymer fibers. The antiviral coatings were tested against SARS-CoV-2, obtaining inactivation yields greater than 99.9%. We believe our results will be beneficial in the fight against the current COVID-19 pandemic and in controlling other infectious airborne pathogens.
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Affiliation(s)
- Marta Baselga
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (I.U.-M.); (D.d.M.); (M.A.); (V.S.); (J.P.); (M.A.)
- Correspondence:
| | - Iratxe Uranga-Murillo
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (I.U.-M.); (D.d.M.); (M.A.); (V.S.); (J.P.); (M.A.)
- Department of Microbiology, Pediatrics, Radiology and Public Health, Facultad de Medicina, University of Zaragoza, 50009 Zaragoza, Spain
- Networking Research Center on Infectious Diseases, CIBERINFEC, 28029 Madrid, Spain
| | - Diego de Miguel
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (I.U.-M.); (D.d.M.); (M.A.); (V.S.); (J.P.); (M.A.)
- Department of Microbiology, Pediatrics, Radiology and Public Health, Facultad de Medicina, University of Zaragoza, 50009 Zaragoza, Spain
| | - Maykel Arias
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (I.U.-M.); (D.d.M.); (M.A.); (V.S.); (J.P.); (M.A.)
- Department of Microbiology, Pediatrics, Radiology and Public Health, Facultad de Medicina, University of Zaragoza, 50009 Zaragoza, Spain
- Networking Research Center on Infectious Diseases, CIBERINFEC, 28029 Madrid, Spain
| | - Victor Sebastián
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (I.U.-M.); (D.d.M.); (M.A.); (V.S.); (J.P.); (M.A.)
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Department of Chemical Engineering, Campus Río Ebro–Edificio I+D, University of Zaragoza, 50018 Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain
| | - Julián Pardo
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (I.U.-M.); (D.d.M.); (M.A.); (V.S.); (J.P.); (M.A.)
- Department of Microbiology, Pediatrics, Radiology and Public Health, Facultad de Medicina, University of Zaragoza, 50009 Zaragoza, Spain
- Networking Research Center on Infectious Diseases, CIBERINFEC, 28029 Madrid, Spain
| | - Manuel Arruebo
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (I.U.-M.); (D.d.M.); (M.A.); (V.S.); (J.P.); (M.A.)
- Instituto de Nanociencia y Materiales de Aragón (INMA), CSIC-Universidad de Zaragoza, 50009 Zaragoza, Spain
- Department of Chemical Engineering, Campus Río Ebro–Edificio I+D, University of Zaragoza, 50018 Zaragoza, Spain
- Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain
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14
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Tao Y, Zhang X, Qiu G, Spillmann M, Ji Z, Wang J. SARS-CoV-2 and other airborne respiratory viruses in outdoor aerosols in three Swiss cities before and during the first wave of the COVID-19 pandemic. ENVIRONMENT INTERNATIONAL 2022; 164:107266. [PMID: 35512527 PMCID: PMC9060371 DOI: 10.1016/j.envint.2022.107266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 05/02/2023]
Abstract
Caused by the SARS-CoV-2 virus, Coronavirus disease 2019 (COVID-19) has been affecting the world since the end of 2019. While virus-laden particles have been commonly detected and studied in the aerosol samples from indoor healthcare settings, studies are scarce on air surveillance of the virus in outdoor non-healthcare environments, including the correlations between SARS-CoV-2 and other respiratory viruses, between viruses and environmental factors, and between viruses and human behavior changes due to the public health measures against COVID-19. Therefore, in this study, we collected airborne particulate matter (PM) samples from November 2019 to April 2020 in Bern, Lugano, and Zurich. Among 14 detected viruses, influenza A, HCoV-NL63, HCoV-HKU1, and HCoV-229E were abundant in air. SARS-CoV-2 and enterovirus were moderately common, while the remaining viruses occurred only in low concentrations. SARS-CoV-2 was detected in PM10 (PM below 10 µm) samples of Bern and Zurich, and PM2.5 (PM below 2.5 µm) samples of Bern which exhibited a concentration positively correlated with the local COVID-19 case number. The concentration was also correlated with the concentration of enterovirus which raised the concern of coinfection. The estimated COVID-19 infection risks of an hour exposure at these two sites were generally low but still cannot be neglected. Our study demonstrated the potential functionality of outdoor air surveillance of airborne respiratory viruses, especially at transportation hubs and traffic arteries.
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Affiliation(s)
- Yile Tao
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Xiaole Zhang
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Guangyu Qiu
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Martin Spillmann
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland
| | - Zheng Ji
- School of Geography and Tourism, Shaanxi Normal University, Xi'an 710119, China
| | - Jing Wang
- Institute of Environmental Engineering, ETH Zurich, Zurich 8093, Switzerland; Laboratory for Advanced Analytical Technologies, Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf 8600, Switzerland.
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15
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Baselga M, Güemes A, Alba JJ, Schuhmacher AJ. SARS-CoV-2 Droplet and Airborne Transmission Heterogeneity. J Clin Med 2022; 11:2607. [PMID: 35566733 PMCID: PMC9099777 DOI: 10.3390/jcm11092607] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 04/21/2022] [Accepted: 05/03/2022] [Indexed: 12/13/2022] Open
Abstract
The spread dynamics of the SARS-CoV-2 virus have not yet been fully understood after two years of the pandemic. The virus's global spread represented a unique scenario for advancing infectious disease research. Consequently, mechanistic epidemiological theories were quickly dismissed, and more attention was paid to other approaches that considered heterogeneity in the spread. One of the most critical advances in aerial pathogens transmission was the global acceptance of the airborne model, where the airway is presented as the epicenter of the spread of the disease. Although the aerodynamics and persistence of the SARS-CoV-2 virus in the air have been extensively studied, the actual probability of contagion is still unknown. In this work, the individual heterogeneity in the transmission of 22 patients infected with COVID-19 was analyzed by close contact (cough samples) and air (environmental samples). Viral RNA was detected in 2/19 cough samples from patient subgroups, with a mean Ct (Cycle Threshold in Quantitative Polymerase Chain Reaction analysis) of 25.7 ± 7.0. Nevertheless, viral RNA was only detected in air samples from 1/8 patients, with an average Ct of 25.0 ± 4.0. Viral load in cough samples ranged from 7.3 × 105 to 8.7 × 108 copies/mL among patients, while concentrations between 1.1-4.8 copies/m3 were found in air, consistent with other reports in the literature. In patients undergoing follow-up, no viral load was found (neither in coughs nor in the air) after the third day of symptoms, which could help define quarantine periods in infected individuals. In addition, it was found that the patient's Ct should not be considered an indicator of infectiousness, since it could not be correlated with the viral load disseminated. The results of this work are in line with proposed hypotheses of superspreaders, which can attribute part of the heterogeneity of the spread to the oversized emission of a small percentage of infected people.
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Affiliation(s)
- Marta Baselga
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
| | - Antonio Güemes
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Surgery, University of Zaragoza, 50009 Zaragoza, Spain
| | - Juan J. Alba
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Department of Mechanical Engineering, University of Zaragoza, 50018 Zaragoza, Spain
| | - Alberto J. Schuhmacher
- Institute for Health Research Aragon (IIS Aragón), 50009 Zaragoza, Spain; (M.B.); (A.G.); (J.J.A.)
- Fundación Agencia Aragonesa para la Investigación y el Desarrollo (ARAID), 50018 Zaragoza, Spain
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16
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Horve PF, Dietz LG, Bowles G, MacCrone G, Olsen-Martinez A, Northcutt D, Moore V, Barnatan L, Parhizkar H, Van Den Wymelenberg KG. Longitudinal analysis of built environment and aerosol contamination associated with isolated COVID-19 positive individuals. Sci Rep 2022; 12:7395. [PMID: 35513399 PMCID: PMC9070971 DOI: 10.1038/s41598-022-11303-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/12/2022] [Indexed: 12/13/2022] Open
Abstract
The indoor environment is the primary location for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), largely driven by respiratory particle accumulation in the air and increased connectivity between the individuals occupying indoor spaces. In this study, we aimed to track a cohort of subjects as they occupied a COVID-19 isolation dormitory to better understand the impact of subject and environmental viral load over time, symptoms, and room ventilation on the detectable viral load within a single room. We find that subject samples demonstrate a decrease in overall viral load over time, symptoms significantly impact environmental viral load, and we provide the first real-world evidence for decreased aerosol SARS-CoV-2 load with increasing ventilation, both from mechanical and window sources. These results may guide environmental viral surveillance strategies and be used to better control the spread of SARS-CoV-2 within built environments and better protect those caring for individuals with COVID-19.
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Affiliation(s)
- Patrick F Horve
- Institute of Molecular Biology, University of Oregon, Eugene, OR, 97403, USA.,Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Leslie G Dietz
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Garis Bowles
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Georgia MacCrone
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | | | - Dale Northcutt
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA.,Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, 97403, USA
| | - Vincent Moore
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Liliana Barnatan
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA
| | - Hooman Parhizkar
- Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, 97403, USA.,Institute for Health and the Built Environment, University of Oregon, Portland, OR, 97209, USA
| | - Kevin G Van Den Wymelenberg
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, 97403, USA. .,Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, 97403, USA. .,Institute for Health and the Built Environment, University of Oregon, Portland, OR, 97209, USA.
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17
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Styczynski A, Hemlock C, Hoque KI, Verma R, LeBoa C, Bhuiyan MOF, Nag A, Harun MGD, Amin MB, Andrews JR. Assessing impact of ventilation on airborne transmission of SARS-CoV-2: a cross-sectional analysis of naturally ventilated healthcare settings in Bangladesh. BMJ Open 2022; 12:e055206. [PMID: 35428628 PMCID: PMC9013789 DOI: 10.1136/bmjopen-2021-055206] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/18/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To evaluate the risk of exposure to SARS-CoV-2 in naturally ventilated hospital settings by measuring parameters of ventilation and comparing these findings with results of bioaerosol sampling. STUDY DESIGN Cross-sectional study. STUDY SETTING AND STUDY SAMPLE The study sample included nine hospitals in Dhaka, Bangladesh. Ventilation characteristics and air samples were collected from 86 healthcare spaces during October 2020 to February 2021. PRIMARY OUTCOME Risk of cumulative SARS-CoV-2 infection by type of healthcare area. SECONDARY OUTCOMES Ventilation rates by healthcare space; risk of airborne detection of SARS-CoV-2 across healthcare spaces; impact of room characteristics on absolute ventilation; SARS-CoV-2 detection by naturally ventilated versus mechanically ventilated spaces. RESULTS The majority (78.7%) of naturally ventilated patient care rooms had ventilation rates that fell short of the recommended ventilation rate of 60 L/s/p. Using a modified Wells-Riley equation and local COVID-19 case numbers, we found that over a 40-hour exposure period, outpatient departments posed the highest median risk for infection (7.7%). SARS-CoV-2 RNA was most frequently detected in air samples from non-COVID wards (50.0%) followed by outpatient departments (42.9%). Naturally ventilated spaces (22.6%) had higher rates of SARS-CoV-2 detection compared with mechanically ventilated spaces (8.3%), though the difference was not statistically significant (p=0.128). In multivariable linear regression with calculated elasticity, open door area and cross-ventilation were found to have a significant impact on ventilation. CONCLUSION Our findings provide evidence that naturally ventilated healthcare settings may pose a high risk for exposure to SARS-CoV-2, particularly among non-COVID-designated spaces, but improving parameters of ventilation can mitigate this risk.
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Affiliation(s)
- Ashley Styczynski
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Caitlin Hemlock
- Division of Epidemiology and Biostatistics, University of California Berkeley, Berkeley, California, USA
| | - Kazi Injamamul Hoque
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Renu Verma
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Chris LeBoa
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Md Omar Faruk Bhuiyan
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Auddithio Nag
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Md Golam Dostogir Harun
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammed Badrul Amin
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Jason R Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA
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18
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Myers NT, Laumbach RJ, Black KG, Ohman‐Strickland P, Alimokhtari S, Legard A, De Resende A, Calderón L, Lu FT, Mainelis G, Kipen HM. Portable air cleaners and residential exposure to SARS-CoV-2 aerosols: A real-world study. INDOOR AIR 2022; 32:e13029. [PMID: 35481935 PMCID: PMC9111720 DOI: 10.1111/ina.13029] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/22/2022] [Accepted: 04/02/2022] [Indexed: 05/04/2023]
Abstract
Individuals with COVID-19 who do not require hospitalization are instructed to self-isolate in their residences. Due to high secondary infection rates in household members, there is a need to understand airborne transmission of SARS-CoV-2 within residences. We report the first naturalistic intervention study suggesting a reduction of such transmission risk using portable air cleaners (PACs) with HEPA filters. Seventeen individuals with newly diagnosed COVID-19 infection completed this single-blind, crossover, randomized study. Total and size-fractionated aerosol samples were collected simultaneously in the self-isolation room with the PAC (primary) and another room (secondary) for two consecutive 24-h periods, one period with HEPA filtration and the other with the filter removed (sham). Seven out of sixteen (44%) air samples in primary rooms were positive for SARS-CoV-2 RNA during the sham period. With the PAC operated at its lowest setting (clean air delivery rate [CADR] = 263 cfm) to minimize noise, positive aerosol samples decreased to four out of sixteen residences (25%; p = 0.229). A slight decrease in positive aerosol samples was also observed in the secondary room. As the world confronts both new variants and limited vaccination rates, our study supports this practical intervention to reduce the presence of viral aerosols in a real-world setting.
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Affiliation(s)
- Nirmala T. Myers
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Robert J. Laumbach
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
| | - Kathleen G. Black
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Pamela Ohman‐Strickland
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Biostatistics and EpidemiologyRutgers School of Public HealthRutgers UniversityPiscatawayNew JerseyUSA
| | - Shahnaz Alimokhtari
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Alicia Legard
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Adriana De Resende
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Leonardo Calderón
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Frederic T. Lu
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Gediminas Mainelis
- Department of Environmental SciencesRutgers UniversityNew BrunswickNew JerseyUSA
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
| | - Howard M. Kipen
- Rutgers Environmental and Occupational Health Sciences InstituteRutgers UniversityPiscatawayNew JerseyUSA
- Department of Environmental and Occupational Health and JusticeRutgers UniversityPiscatawayNew JerseyUSA
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19
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Ramuta MD, Newman CM, Brakefield SF, Stauss MR, Wiseman RW, Kita-Yarbro A, O'Connor EJ, Dahal N, Lim A, Poulsen KP, Safdar N, Marx JA, Accola MA, Rehrauer WM, Zimmer JA, Khubbar M, Beversdorf LJ, Boehm EC, Castañeda D, Rushford C, Gregory DA, Yao JD, Bhattacharyya S, Johnson MC, Aliota MT, Friedrich TC, O'Connor DH, O'Connor SL. SARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022. [PMID: 35378751 PMCID: PMC8978944 DOI: 10.1101/2022.03.29.22272716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Two years after the emergence of SARS-CoV-2, there is still a need for better ways to assess the risk of transmission in congregate spaces. We deployed active air samplers to monitor the presence of SARS-CoV-2 in real-world settings across communities in the Upper Midwestern states of Wisconsin and Minnesota. Over 29 weeks, we collected 527 air samples from 15 congregate settings and detected 106 SARS-CoV-2 positive samples, demonstrating SARS-CoV-2 can be detected in air collected from daily and weekly sampling intervals. We expanded the utility of air surveillance to test for 40 other respiratory pathogens. Surveillance data revealed differences in timing and location of SARS-CoV-2 and influenza A virus detection in the community. In addition, we obtained SARS-CoV-2 genome sequences from air samples to identify variant lineages. Collectively, this shows air surveillance is a scalable, cost-effective, and high throughput alternative to individual testing for detecting respiratory pathogens in congregate settings.
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20
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Viral load of SARS-CoV-2 in droplets and bioaerosols directly captured during breathing, speaking and coughing. Sci Rep 2022; 12:3484. [PMID: 35241703 PMCID: PMC8894466 DOI: 10.1038/s41598-022-07301-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/16/2022] [Indexed: 02/08/2023] Open
Abstract
Determining the viral load and infectivity of SARS-CoV-2 in macroscopic respiratory droplets, bioaerosols, and other bodily fluids and secretions is important for identifying transmission modes, assessing risks and informing public health guidelines. Here we show that viral load of SARS-CoV-2 Ribonucleic Acid (RNA) in participants’ naso-pharyngeal (NP) swabs positively correlated with RNA viral load they emitted in both droplets >10 \documentclass[12pt]{minimal}
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\begin{document}$$\upmu \hbox {m}$$\end{document}μm and bioaerosols <10 \documentclass[12pt]{minimal}
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\begin{document}$$\upmu \hbox {m}$$\end{document}μm directly captured during the combined expiratory activities of breathing, speaking and coughing using a standardized protocol, although the NP swabs had \documentclass[12pt]{minimal}
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\begin{document}$$\approx$$\end{document}≈ 10\documentclass[12pt]{minimal}
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\begin{document}$$^3\times$$\end{document}3× more RNA on average. By identifying highly-infectious individuals (maximum of 18,000 PFU/mL in NP), we retrieved higher numbers of SARS-CoV-2 RNA gene copies in bioaerosol samples (maximum of 4.8\documentclass[12pt]{minimal}
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\begin{document}$${\times }10^{5}$$\end{document}×105 gene copies/mL and minimum cycle threshold of 26.2) relative to other studies. However, all attempts to identify infectious virus in size-segregated droplets and bioaerosols were negative by plaque assay (0 of 58). This outcome is partly attributed to the insufficient amount of viral material in each sample (as indicated by SARS-CoV-2 gene copies) or may indicate no infectious virus was present in such samples, although other possible factors are identified.
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21
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Dinoi A, Feltracco M, Chirizzi D, Trabucco S, Conte M, Gregoris E, Barbaro E, La Bella G, Ciccarese G, Belosi F, La Salandra G, Gambaro A, Contini D. A review on measurements of SARS-CoV-2 genetic material in air in outdoor and indoor environments: Implication for airborne transmission. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 809:151137. [PMID: 34699823 PMCID: PMC8539199 DOI: 10.1016/j.scitotenv.2021.151137] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 05/03/2023]
Abstract
Airborne transmission of SARS-CoV-2 has been object of debate in the scientific community since the beginning of COVID-19 pandemic. This mechanism of transmission could arise from virus-laden aerosol released by infected individuals and it is influenced by several factors. Among these, the concentration and size distribution of virus-laden particles play an important role. The knowledge regarding aerosol transmission increases as new evidence is collected in different studies, even if it is not yet available a standard protocol regarding air sampling and analysis, which can create difficulties in the interpretation and application of results. This work reports a systematic review of current knowledge gained by 73 published papers on experimental determination of SARS-CoV-2 RNA in air comparing different environments: outdoors, indoor hospitals and healthcare settings, and public community indoors. Selected papers furnished 77 datasets: outdoor studies (9/77, 11.7%) and indoor studies (68/77. 88.3%). The indoor datasets in hospitals were the vast majority (58/68, 85.3%), and the remaining (10/68, 14.7%) were classified as community indoors. The fraction of studies having positive samples, as well as positivity rates (i.e. ratios between positive and total samples) are significantly larger in hospitals compared to the other typologies of sites. Contamination of surfaces was more frequent (in indoor datasets) compared to contamination of air samples; however, the average positivity rate was lower compared to that of air. Concentrations of SARS-CoV-2 RNA in air were highly variables and, on average, lower in outdoors compared to indoors. Among indoors, concentrations in community indoors appear to be lower than those in hospitals and healthcare settings.
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Affiliation(s)
- Adelaide Dinoi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy
| | - Matteo Feltracco
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniela Chirizzi
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Sara Trabucco
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Marianna Conte
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy; Laboratory for Observations and Analyses of Earth and Climate, Agenzia Nazionale per le Nuove Tecnologie, l'Energia e lo Sviluppo Economico Sostenibile (ENEA), 00123 Rome, Italy
| | - Elena Gregoris
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Elena Barbaro
- Istituto di Scienze Polari (ISP-CNR), Via Torino 155, Venice, Mestre, Italy; Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Gianfranco La Bella
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Giuseppina Ciccarese
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Franco Belosi
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Via Gobetti 101, Bologna, Italy
| | - Giovanna La Salandra
- Istituto Zooprofilattico Sperimentale della Puglia e della Basilicata (IZSPB), Via Manfredonia 20, Foggia, Italy
| | - Andrea Gambaro
- Dipartimento di Scienze Ambientali, Informatica e Statistica, Università Ca' Foscari di Venezia, Via Torino 155, Venezia, Mestre, Italy
| | - Daniele Contini
- Istituto di Scienze dell'Atmosfera e del Clima (ISAC-CNR), Str. Prv. Lecce-Monteroni km 1.2, Lecce, Italy.
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22
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Tharak A, Kopperi H, Hemalatha M, Kiran U, C. G. G, Moharir S, Mishra RK, Mohan SV. Longitudinal and Long-Term Wastewater Surveillance for COVID-19: Infection Dynamics and Zoning of Urban Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052697. [PMID: 35270390 PMCID: PMC8910010 DOI: 10.3390/ijerph19052697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023]
Abstract
Wastewater-based epidemiology (WBE) is emerging as a potential approach to study the infection dynamics of SARS-CoV-2 at a community level. Periodic sewage surveillance can act as an indicative tool to predict the early surge of pandemic within the community and understand the dynamics of infection and, thereby, facilitates for proper healthcare management. In this study, we performed a long-term epidemiological surveillance to assess the SARS-CoV-2 spread in domestic sewage over one year (July 2020 to August 2021) by adopting longitudinal sampling to represent a selected community (~2.5 lakhs population). Results indicated temporal dynamics in the viral load. A consistent amount of viral load was observed during the months from July 2020 to November 2020, suggesting a higher spread of the viral infection among the community, followed by a decrease in the subsequent two months (December 2020 and January 2021). A marginal increase was observed during February 2021, hinting at the onset of the second wave (from March 2021) that reached it speak in April 2021. Dynamics of the community infection rates were calculated based on the viral gene copies to assess the severity of COVID-19 spread. With the ability to predict the infection spread, longitudinal WBE studies also offer the prospect of zoning specific areas based on the infection rates. Zoning of the selected community based on the infection rates assists health management to plan and manage the infection in an effective way. WBE promotes clinical inspection with simultaneous disease detection and management, in addition to an advance warning signal to anticipate outbreaks, with respect to the slated community/zones, to tackle, prepare for and manage the pandemic.
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Affiliation(s)
- Athmakuri Tharak
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India; (A.T.); (H.K.); (M.H.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India;
| | - Harishankar Kopperi
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India; (A.T.); (H.K.); (M.H.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India;
| | - Manupati Hemalatha
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India; (A.T.); (H.K.); (M.H.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India;
| | - Uday Kiran
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India;
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad 500007, India; (G.C.G.); (S.M.)
| | - Gokulan C. G.
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad 500007, India; (G.C.G.); (S.M.)
| | - Shivranjani Moharir
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad 500007, India; (G.C.G.); (S.M.)
| | - Rakesh K. Mishra
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India;
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad 500007, India; (G.C.G.); (S.M.)
- Correspondence: (R.K.M.); (S.V.M.)
| | - S. Venkata Mohan
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India; (A.T.); (H.K.); (M.H.)
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India;
- Correspondence: (R.K.M.); (S.V.M.)
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23
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24
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Breshears LE, Nguyen BT, Mata Robles S, Wu L, Yoon JY. Biosensor detection of airborne respiratory viruses such as SARS-CoV-2. SLAS Technol 2022; 27:4-17. [PMID: 35058206 PMCID: PMC8720388 DOI: 10.1016/j.slast.2021.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Airborne SARS-CoV-2 transmission represents a significant route for possible human infection that is not yet fully understood. Viruses in droplets and aerosols are difficult to detect because they are typically present in low amounts. In addition, the current techniques used, such as RT-PCR and virus culturing, require large amounts of time to get results. Biosensor technology can provide rapid, handheld, and point-of-care systems that can identify virus presence quickly and accurately. This paper reviews the background of airborne virus transmission and the characteristics of SARS-CoV-2, its relative risk for transmission even at distances greater than the currently suggested 6 feet (or 2 m) physical distancing. Publications on biosensor technology that may be applied to the detection of airborne SARS-CoV-2 and other respiratory viruses are also summarized. Based on the current research we believe that there is a pressing need for continued research into handheld and rapid methods for sensitive collection and detection of airborne viruses. We propose a paper-based microfluidic chip and immunofluorescence assay as one method that could be investigated as a low-cost and portable option.
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Affiliation(s)
- Lane E Breshears
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Brandon T Nguyen
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Samantha Mata Robles
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Lillian Wu
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States
| | - Jeong-Yeol Yoon
- Department of Biomedical Engineering, The University of Arizona, Tucson, AZ 85721, United States.
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25
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Wilson AM, Sleeth DK, Schaefer C, Jones RM. Transmission of Respiratory Viral Diseases to Health Care Workers: COVID-19 as an Example. Annu Rev Public Health 2022; 43:311-330. [DOI: 10.1146/annurev-publhealth-052120-110009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Health care workers (HCWs) can acquire infectious diseases, including coronavirus disease 2019 (COVID-19), from patients. Herein, COVID-19 is used with the source–pathway–receptor framework as an example to assess evidence for the role of aerosol transmission and indirect contact transmission of viral respiratory infectious diseases. Evidence for both routes is strong for COVID-19 and other respiratory viruses, but aerosol transmission is likely dominant for COVID-19. Key knowledge gaps about transmission processes and control strategies include the distribution of viable virus among respiratory aerosols of different sizes, the mechanisms and efficiency by which virus deposited on the facial mucous membrane moves to infection sites inside the body, and the performance of source controls such as face coverings and aerosol containment devices. To ensure that HCWs are adequately protected from infection, guidelines and regulations must be updated to reflect the evidence that respiratory viruses are transmitted via aerosols. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Amanda M. Wilson
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA
| | - Darrah K. Sleeth
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
| | - Camie Schaefer
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
| | - Rachael M. Jones
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA;, ,
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26
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da Silva PG, Gonçalves J, Lopes AIB, Esteves NA, Bamba GEE, Nascimento MSJ, Branco PTBS, Soares RRG, Sousa SIV, Mesquita JR. Evidence of Air and Surface Contamination with SARS-CoV-2 in a Major Hospital in Portugal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010525. [PMID: 35010785 PMCID: PMC8744945 DOI: 10.3390/ijerph19010525] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 02/06/2023]
Abstract
As the third wave of the COVID-19 pandemic hit Portugal, it forced the country to reintroduce lockdown measures due to hospitals reaching their full capacities. Under these circumstances, environmental contamination by SARS-CoV-2 in different areas of one of Portugal's major Hospitals was assessed between 21 January and 11 February 2021. Air samples (n = 44) were collected from eleven different areas of the Hospital (four COVID-19 and seven non-COVID-19 areas) using Coriolis® μ and Coriolis® Compact cyclone air sampling devices. Surface sampling was also performed (n = 17) on four areas (one COVID-19 and three non-COVID-19 areas). RNA extraction followed by a one-step RT-qPCR adapted for quantitative purposes were performed. Of the 44 air samples, two were positive for SARS-CoV-2 RNA (6575 copies/m3 and 6662.5 copies/m3, respectively). Of the 17 surface samples, three were positive for SARS-CoV-2 RNA (200.6 copies/cm2, 179.2 copies/cm2, and 201.7 copies/cm2, respectively). SARS-CoV-2 environmental contamination was found both in air and on surfaces in both COVID-19 and non-COVID-19 areas. Moreover, our results suggest that longer collection sessions are needed to detect point contaminations. This reinforces the need to remain cautious at all times, not only when in close contact with infected individuals. Hand hygiene and other standard transmission-prevention guidelines should be continuously followed to avoid nosocomial COVID-19.
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Affiliation(s)
- Priscilla Gomes da Silva
- ICBAS–School of Medicine and Biomedical Sciences, Porto University, 4050-313 Porto, Portugal;
- Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- LEPABE–Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (P.T.B.S.B.); (S.I.V.S.)
| | - José Gonçalves
- Institute of Sustainable Processes, University of Valladolid, 47011 Valladolid, Spain;
- Department of Chemical Engineering, University of Valladolid, 47011 Valladolid, Spain
| | - Ariana Isabel Brito Lopes
- Unidade Local de Saúde do Alto Minho E.P.E., 4904-858 Viana do Castelo, Portugal; (A.I.B.L.); (N.A.E.); (G.E.E.B.)
| | - Nury Alves Esteves
- Unidade Local de Saúde do Alto Minho E.P.E., 4904-858 Viana do Castelo, Portugal; (A.I.B.L.); (N.A.E.); (G.E.E.B.)
| | - Gustavo Emanuel Enes Bamba
- Unidade Local de Saúde do Alto Minho E.P.E., 4904-858 Viana do Castelo, Portugal; (A.I.B.L.); (N.A.E.); (G.E.E.B.)
| | | | - Pedro T. B. S. Branco
- LEPABE–Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (P.T.B.S.B.); (S.I.V.S.)
| | - Ruben R. G. Soares
- Department of Biochemistry and Biophysics, Science for Life Laboratory, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Sofia I. V. Sousa
- LEPABE–Laboratory for Process Engineering, Environment, Biotechnology and Energy, Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal; (P.T.B.S.B.); (S.I.V.S.)
| | - João R. Mesquita
- ICBAS–School of Medicine and Biomedical Sciences, Porto University, 4050-313 Porto, Portugal;
- Epidemiology Research Unit (EPIunit), Institute of Public Health, University of Porto, 4050-600 Porto, Portugal
- Correspondence:
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27
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Ang AXY, Luhung I, Ahidjo BA, Drautz‐Moses DI, Tambyah PA, Mok CK, Lau KJX, Tham SM, Chu JJH, Allen DM, Schuster SC. Airborne SARS-CoV-2 surveillance in hospital environment using high-flowrate air samplers and its comparison to surface sampling. INDOOR AIR 2022; 32:e12930. [PMID: 34519380 PMCID: PMC8653264 DOI: 10.1111/ina.12930] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/15/2021] [Accepted: 09/02/2021] [Indexed: 05/18/2023]
Abstract
Reliable methods to detect the presence of SARS-CoV-2 at venues where people gather are essential for epidemiological surveillance to guide public policy. Communal screening of air in a highly crowded space has the potential to provide early warning on the presence and potential transmission of SARS-CoV-2 as suggested by studies early in the epidemic. As hospitals and public facilities apply varying degrees of restrictions and regulations, it is important to provide multiple methodological options to enable environmental SARS-CoV-2 surveillance under different conditions. This study assessed the feasibility of using high-flowrate air samplers combined with RNA extraction kit designed for environmental sample to perform airborne SARS-CoV-2 surveillance in hospital setting, tested by RT-qPCR. The success rate of the air samples in detecting SARS-CoV-2 was then compared with surface swab samples collected in the same proximity. Additionally, positive RT-qPCR samples underwent viral culture to assess the viability of the sampled SARS-CoV-2. The study was performed in inpatient ward environments of a quaternary care university teaching hospital in Singapore housing active COVID-19 patients within the period of February to May 2020. Two types of wards were tested, naturally ventilated open-cohort ward and mechanically ventilated isolation ward. Distances between the site of air sampling and the patient cluster in the investigated wards were also recorded. No successful detection of airborne SARS-CoV-2 was recorded when 50 L/min air samplers were used. Upon increasing the sampling flowrate to 150 L/min, our results showed a high success rate in detecting the presence of SARS-CoV-2 from the air samples (72%) compared to the surface swab samples (9.6%). The positive detection rate of the air samples along with the corresponding viral load could be associated with the distance between sampling site and patient. The furthest distance from patient with PCR-positive air samples was 5.5 m. The airborne SARS-CoV-2 detection was comparable between the two types of wards with 60%-87.5% success rate. High prevalence of the virus was found in toilet areas, both on surfaces and in air. Finally, no successful culture attempt was recorded from the environmental air or surface samples.
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Affiliation(s)
- Alicia XY Ang
- Department of MedicineDivision of Infectious DiseasesNational University HospitalSingaporeSingapore
| | - Irvan Luhung
- Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological UniversitySingaporeSingapore
| | - Bintou A. Ahidjo
- Department of Microbiology and ImmunologyNational University of SingaporeSingaporeSingapore
- BSL3 Core FacilityYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Daniela I. Drautz‐Moses
- Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological UniversitySingaporeSingapore
| | - Paul A. Tambyah
- Department of MedicineDivision of Infectious DiseasesNational University HospitalSingaporeSingapore
- Department of MedicineInfectious Disease Translational Research ProgrammeYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Chee Keng Mok
- Department of Microbiology and ImmunologyNational University of SingaporeSingaporeSingapore
- BSL3 Core FacilityYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Kenny JX Lau
- Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological UniversitySingaporeSingapore
| | - Sai Meng Tham
- Department of MedicineDivision of Infectious DiseasesNational University HospitalSingaporeSingapore
| | - Justin Jang Hann Chu
- Department of Microbiology and ImmunologyNational University of SingaporeSingaporeSingapore
- BSL3 Core FacilityYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
- Department of MedicineInfectious Disease Translational Research ProgrammeYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - David M. Allen
- Department of MedicineDivision of Infectious DiseasesNational University HospitalSingaporeSingapore
- Department of MedicineInfectious Disease Translational Research ProgrammeYong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
| | - Stephan C. Schuster
- Singapore Centre for Environmental Life Sciences EngineeringNanyang Technological UniversitySingaporeSingapore
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Ribaric NL, Vincent C, Jonitz G, Hellinger A, Ribaric G. Hidden hazards of SARS-CoV-2 transmission in hospitals: A systematic review. INDOOR AIR 2022; 32:e12968. [PMID: 34862811 DOI: 10.1111/ina.12968] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/17/2021] [Accepted: 11/19/2021] [Indexed: 05/04/2023]
Abstract
Despite their considerable prevalence, dynamics of hospital-associated COVID-19 are still not well understood. We assessed the nature and extent of air- and surface-borne SARS-CoV-2 contamination in hospitals to identify hazards of viral dispersal and enable more precise targeting of infection prevention and control. PubMed, ScienceDirect, Web of Science, Medrxiv, and Biorxiv were searched for relevant articles until June 1, 2021. In total, 51 observational cross-sectional studies comprising 6258 samples were included. SARS-CoV-2 RNA was detected in one in six air and surface samples throughout the hospital and up to 7.62 m away from the nearest patients. The highest detection rates and viral concentrations were reported from patient areas. The most frequently and heavily contaminated types of surfaces comprised air outlets and hospital floors. Viable virus was recovered from the air and fomites. Among size-fractionated air samples, only fine aerosols contained viable virus. Aerosol-generating procedures significantly increased (ORair = 2.56 (1.46-4.51); ORsurface = 1.95 (1.27-2.99)), whereas patient masking significantly decreased air- and surface-borne SARS-CoV-2 contamination (ORair = 0.41 (0.25-0.70); ORsurface = 0.45 (0.34-0.61)). The nature and extent of hospital contamination indicate that SARS-CoV-2 is likely dispersed conjointly through several transmission routes, including short- and long-range aerosol, droplet, and fomite transmission.
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Affiliation(s)
- Noach Leon Ribaric
- Faculty of Medicine, University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
| | - Charles Vincent
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Günther Jonitz
- German Medical Association, Berlin, Germany
- State Chamber of Physicians Berlin, Berlin, Germany
| | - Achim Hellinger
- Department of General, Visceral, Endocrine and Oncologic Surgery, Fulda Hospital, University Medicine Marburg Campus Fulda, Fulda, Germany
| | - Goran Ribaric
- Johnson & Johnson Institute, Norderstedt, Germany
- MedTech Europe, Antimicrobial Resistance (AMR) and Healthcare Associated Infections (HAI) Sector Group, Brussels, Belgium
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29
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Nannu Shankar S, Witanachchi CT, Morea AF, Lednicky JA, Loeb JC, Alam MM, Fan ZH, Eiguren-Fernandez A, Wu CY. SARS-CoV-2 in residential rooms of two self-isolating persons with COVID-19. JOURNAL OF AEROSOL SCIENCE 2022; 159:105870. [PMID: 34483358 PMCID: PMC8401278 DOI: 10.1016/j.jaerosci.2021.105870] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/21/2021] [Accepted: 08/23/2021] [Indexed: 05/16/2023]
Abstract
Individuals with COVID-19 are advised to self-isolate at their residences unless they require hospitalization. Persons sharing a dwelling with someone who has COVID-19 have a substantial risk of being exposed to the virus. However, environmental monitoring for the detection of virus in such settings is limited. We present a pilot study on environmental sampling for SARS-CoV-2 virions in the residential rooms of two volunteers with COVID-19 who self-quarantined. Apart from standard surface swab sampling, based on availability, four air samplers positioned 0.3-2.2 m from the volunteers were used: a VIable Virus Aerosol Sampler (VIVAS), an inline air sampler that traps particles on polytetrafluoroethylene (PTFE) filters, a NIOSH 2-stage cyclone sampler (BC-251), and a Sioutas personal cascade impactor sampler (PCIS). The latter two selectively collect particles of specific size ranges. SARS-CoV-2 RNA was detected by real-time Reverse-Transcription quantitative Polymerase Chain Reaction (rRT-qPCR) analyses of particles in one air sample from the room of volunteer A and in various air and surface samples from that of volunteer B. The one positive sample collected by the NIOSH sampler from volunteer A's room had a quantitation cycle (Cq) of 38.21 for the N-gene, indicating a low amount of airborne virus [5.69E-02 SARS-CoV-2 genome equivalents (GE)/cm3 of air]. In contrast, air samples and surface samples collected off the mobile phone in volunteer B's room yielded Cq values ranging from 14.58 to 24.73 and 21.01 to 24.74, respectively, on the first day of sampling, indicating that this volunteer was actively shedding relatively high amounts of SARS-CoV-2 at that time. The SARS-CoV-2 GE/cm3 of air for the air samples collected by the PCIS was in the range 6.84E+04 to 3.04E+05 using the LED-N primer system, the highest being from the stage 4 filter, and similarly, ranged from 2.54E+03 to 1.68E+05 GE/cm3 in air collected by the NIOSH sampler. Attempts to isolate the virus in cell culture from the samples from volunteer B's room with the aforementioned Cq values were unsuccessful due to out-competition by a co-infecting Human adenovirus B3 (HAdVB3) that killed the Vero E6 cell cultures within 4 days of their inoculation, although Cq values of 34.56-37.32 were measured upon rRT-qPCR analyses of vRNA purified from the cell culture medium. The size distribution of SARS-CoV-2-laden aerosol particles collected from the air of volunteer B's room was >0.25 μm and >0.1 μm as recorded by the PCIS and the NIOSH sampler, respectively, suggesting a risk of aerosol transmission since these particles can remain suspended in air for an extended time and travel over long distances. The detection of virus in surface samples also underscores the potential for fomite transmission of SARS-CoV-2 in indoor settings.
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Affiliation(s)
- Sripriya Nannu Shankar
- Department of Environmental Engineering Sciences, College of Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Chiran T Witanachchi
- Department of Environmental Engineering Sciences, College of Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - Alyssa F Morea
- Department of Environmental Engineering Sciences, College of Engineering, University of Florida, Gainesville, FL, 32611, USA
| | - John A Lednicky
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32610, USA
| | - Julia C Loeb
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32610, USA
| | - Md Mahbubul Alam
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32610, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, FL, 32610, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, Gainesville, FL, 32611, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, 32611, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, College of Engineering, University of Florida, Gainesville, FL, 32611, USA
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30
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Li H, Shankar SN, Witanachchi CT, Lednicky JA, Loeb JC, Alam MM, Fan ZH, Mohamed K, Boyette JA, Eiguren-Fernandez A, Wu CY. Environmental Surveillance for SARS-CoV-2 in Two Restaurants from a Mid-scale City that Followed U.S. CDC Reopening Guidance. AEROSOL AND AIR QUALITY RESEARCH 2022; 22:210304. [PMID: 35024044 PMCID: PMC8752097 DOI: 10.4209/aaqr.210304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Since mask use and physical distancing are difficult to maintain when people dine indoors, restaurants are perceived as high risk for acquiring COVID-19. The air and environmental surfaces in two restaurants in a mid-scale city located in north central Florida that followed the Centers for Disease Control and Prevention (CDC) reopening guidance were sampled three times from July 2020 to February 2021. Sixteen air samples were collected for 2 hours using air samplers, and 20 surface samples by using moistened swabs. The samples were analyzed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for the presence of SARS-CoV-2 genomic RNA. A total of ~550 patrons dined in the restaurants during our samplings. SARS-CoV-2 genomic RNA was not detected in any of the air samples. One of the 20 surface samples (5%) was positive. That sample had been collected from a plastic tablecloth immediately after guests left the restaurant. Virus was not isolated in cell cultures inoculated with aliquots of the RT-PCR-positive sample. The likelihood that patrons and staff acquire SARS-CoV-2 infections may be low in restaurants in a mid-scale city that adopt CDC restaurant reopening guidelines, such as operation at 50% capacity so that tables can be spaced at least 6 feet apart, establishment of adequate mechanical ventilation, use of a face covering except while eating or drinking, and implementation of disinfection measures.
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Affiliation(s)
- Hongwan Li
- Department of Environmental Engineering Sciences, University of Florida, USA
| | | | | | - John A. Lednicky
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Julia C. Loeb
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Md. Mahbubul Alam
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Z. Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | - Karim Mohamed
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | - Jessica A. Boyette
- Department of Environmental Engineering Sciences, University of Florida, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, USA
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31
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Singer BC, Zhao H, Preble CV, Delp WW, Pantelic J, Sohn MD, Kirchstetter TW. Measured influence of overhead HVAC on exposure to airborne contaminants from simulated speaking in a meeting and a classroom. INDOOR AIR 2022; 32:e12917. [PMID: 34477251 DOI: 10.1111/ina.12917] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/08/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
Tracer gas experiments were conducted in a 158 m3 room with overhead supply diffusers to study dispersion of contaminants from simulated speaking in physically distanced meeting and classroom configurations. The room was contained within a 237 m3 cell with open plenum return to the HVAC system. Heated manikins at desks and a researcher operating the tracer release apparatus presented 8-9 thermal plumes. Experiments were conducted under conditions of no forced air and neutral, cooled, or heated air supplied at 980-1100 cmh, and with/out 20% outdoor air. CO2 was released at the head of one manikin in each experiment to simulate small (<5 µm diameter) respiratory aerosols. The metric of exposure relative to perfectly mixed (ERM) is introduced to quantify impacts, based on measurements at manikin heads and at three heights in the center and corners of the room. Chilled or neutral supply air provided good mixing with ERMs close to one. Thermal stratification during heating produced higher ERMs at most manikins: 25% were ≥2.5 and the highest were >5× perfectly mixed conditions. Operation of two within-zone air cleaners together moving ≥400 cmh vertically in the room provided enough mixing to mitigate elevated exposure variations.
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Affiliation(s)
- Brett C Singer
- Indoor Environment Group, Energy Analysis and Environmental Impacts Division, Building Technologies and Urban Systems Division, Energy Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Haoran Zhao
- Indoor Environment Group, Energy Analysis and Environmental Impacts Division, Building Technologies and Urban Systems Division, Energy Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Chelsea V Preble
- Indoor Environment Group, Energy Analysis and Environmental Impacts Division, Building Technologies and Urban Systems Division, Energy Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, California, USA
- Department of Civil & Environmental Engineering, University of California, Berkeley, California, USA
| | - William W Delp
- Indoor Environment Group, Energy Analysis and Environmental Impacts Division, Building Technologies and Urban Systems Division, Energy Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Jovan Pantelic
- Indoor Environment Group, Energy Analysis and Environmental Impacts Division, Building Technologies and Urban Systems Division, Energy Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, California, USA
- Center for the Built Environment, University of California, Berkeley, California, USA
| | - Michael D Sohn
- Indoor Environment Group, Energy Analysis and Environmental Impacts Division, Building Technologies and Urban Systems Division, Energy Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Thomas W Kirchstetter
- Indoor Environment Group, Energy Analysis and Environmental Impacts Division, Building Technologies and Urban Systems Division, Energy Technologies Area, Lawrence Berkeley National Laboratory, Berkeley, California, USA
- Department of Civil & Environmental Engineering, University of California, Berkeley, California, USA
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32
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Bueno de Mesquita PJ, Delp WW, Chan WR, Bahnfleth WP, Singer BC. Control of airborne infectious disease in buildings: Evidence and research priorities. INDOOR AIR 2022; 32:e12965. [PMID: 34816493 DOI: 10.1111/ina.12965] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/07/2021] [Accepted: 11/11/2021] [Indexed: 06/13/2023]
Abstract
The evolution of SARS-CoV-2 virus has resulted in variants likely to be more readily transmitted through respiratory aerosols, underscoring the increased potential for indoor environmental controls to mitigate risk. Use of tight-fitting face masks to trap infectious aerosol in exhaled breath and reduce inhalation exposure to contaminated air is of critical importance for disease control. Administrative controls including the regulation of occupancy and interpersonal spacing are also important, while presenting social and economic challenges. Indoor engineering controls including ventilation, exhaust, air flow control, filtration, and disinfection by germicidal ultraviolet irradiation can reduce reliance on stringent occupancy restrictions. However, the effects of controls-individually and in combination-on reducing infectious aerosol transfer indoors remain to be clearly characterized to the extent needed to support widespread implementation by building operators. We review aerobiologic and epidemiologic evidence of indoor environmental controls against transmission and present a quantitative aerosol transfer scenario illustrating relative differences in exposure at close-interactive, room, and building scales. We identify an overarching need for investment to implement building controls and evaluate their effectiveness on infection in well-characterized and real-world settings, supported by specific, methodological advances. Improved understanding of engineering control effectiveness guides implementation at scale while considering occupant comfort, operational challenges, and energy costs.
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Affiliation(s)
| | - William W Delp
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - Wanyu R Chan
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, California, USA
| | - William P Bahnfleth
- Department of Architectural Engineering, Pennsylvania State University, State College, Pennsylvania, USA
| | - Brett C Singer
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, California, USA
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33
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Horve PF, Dietz L, Northcutt D, Stenson J, Van Den Wymelenberg K. Evaluation of a bioaerosol sampler for indoor environmental surveillance of Severe Acute Respiratory Syndrome Coronavirus 2. PLoS One 2021; 16:e0257689. [PMID: 34780482 PMCID: PMC8592464 DOI: 10.1371/journal.pone.0257689] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/07/2021] [Indexed: 12/23/2022] Open
Abstract
The worldwide spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has ubiquitously impacted many aspects of life. As vaccines continue to be manufactured and administered, limiting the spread of SARS-CoV-2 will rely more heavily on the early identification of contagious individuals occupying reopened and increasingly populated indoor environments. In this study, we investigated the utility of an impaction-based bioaerosol sampling system with multiple nucleic acid collection media. Heat-inactivated SARS-CoV-2 was utilized to perform bench-scale, short-range aerosol, and room-scale aerosol experiments. Through bench-scale experiments, AerosolSense Capture Media (ACM) and nylon flocked swabs were identified as the highest utility media. In room-scale aerosol experiments, consistent detection of aerosol SARS-CoV-2 was achieved at an estimated aerosol concentration equal to or greater than 0.089 genome copies per liter of room air (gc/L) when air was sampled for eight hours or more at less than one air change per hour (ACH). Shorter sampling periods (75 minutes) yielded consistent detection at ~31.8 gc/L of room air and intermittent detection down to ~0.318 gc/L at (at both 1 and 6 ACH). These results support further exploration in real-world testing scenarios and suggest the utility of indoor aerosol surveillance as an effective risk mitigation strategy in occupied buildings.
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Affiliation(s)
- Patrick Finn Horve
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, United States of America
| | - Leslie Dietz
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, United States of America
| | - Dale Northcutt
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, United States of America
- Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, United States of America
| | - Jason Stenson
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, United States of America
- Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, United States of America
| | - Kevin Van Den Wymelenberg
- Biology and the Built Environment Center, University of Oregon, Eugene, OR, United States of America
- Energy Studies in Buildings Laboratory, University of Oregon, Eugene, OR, United States of America
- Institute for Health and the Built Environment, University of Oregon, Portland, OR, United States of America
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34
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Li H, Shankar SN, Witanachchi CT, Lednicky JA, Loeb JC, Alam MM, Fan ZH, Mohamed K, Eiguren-Fernandez A, Wu CY. Environmental Surveillance and Transmission Risk Assessments for SARS-CoV-2 in a Fitness Center. AEROSOL AND AIR QUALITY RESEARCH 2021; 21:210106. [PMID: 35047025 PMCID: PMC8765736 DOI: 10.4209/aaqr.210106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Fitness centers are considered high risk for SARS-CoV-2 transmission due to their high human occupancy and the type of activity taking place in them, especially when individuals pre-symptomatic or asymptomatic for COVID-19 exercise in the facilities. In this study, air (N=21) and surface (N=8) samples were collected at a fitness center through five sampling events from August to November 2020 after the reopening restrictions were lifted in Florida. The total attendance was ~2500 patrons during our air and environmental sampling work. Air samples were collected using stationary and personal bioaerosol samplers. Moistened flocked nylon swabs were used to collect samples from high-touch surfaces. We did not detect SARS-CoV-2 by rRT-PCR analyses in any air or surface sample. A simplified infection risk model based on the Wells-Riley equation predicts that the probability of infection in this fitness center was 1.77% following its ventilation system upgrades based on CDC guidelines, and that risk was further reduced to 0.89% when patrons used face masks. Our model also predicts that a combination of high ventilation, minimal air recirculation, air filtration, and UV sterilization of recirculated air reduced the infection risk up to 94% compared to poorly ventilated facilities. Amongst these measures, high ventilation with outdoor air is most critical in reducing the airborne transmission of SARS-CoV-2. For buildings that cannot avoid air recirculation due to energy costs, the use of high filtration and/or air disinfection devices are alternatives to reducing the probability of acquiring SARS-CoV-2 through inhalation exposure. In contrast to the perceived ranking of high risk, the infection risk in fitness centers that follow CDC reopening guidance, including implementation of engineering and administrative controls, and use of personal protective equipment, can be low, and these facilities can offer a relatively safe venue for patrons to exercise.
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Affiliation(s)
- Hongwan Li
- Department of Environmental Engineering Sciences, University of Florida, USA
| | | | | | - John A Lednicky
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Julia C Loeb
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Md Mahbubul Alam
- Department of Environmental and Global Health, University of Florida, USA
- Emerging Pathogens Institute, University of Florida, USA
| | - Z Hugh Fan
- Department of Mechanical & Aerospace Engineering, University of Florida, USA
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | - Karim Mohamed
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, USA
| | | | - Chang-Yu Wu
- Department of Environmental Engineering Sciences, University of Florida, USA
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35
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Cherrie JW, Cherrie MPC, Smith A, Holmes D, Semple S, Steinle S, Macdonald E, Moore G, Loh M. Contamination of Air and Surfaces in Workplaces with SARS-CoV-2 Virus: A Systematic Review. Ann Work Expo Health 2021; 65:879-892. [PMID: 34329379 PMCID: PMC8385829 DOI: 10.1093/annweh/wxab026] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES This systematic review aimed to evaluate the evidence for air and surface contamination of workplace environments with SARS-CoV-2 RNA and the quality of the methods used to identify actions necessary to improve the quality of the data. METHODS We searched Web of Science and Google Scholar until 24 December 2020 for relevant articles and extracted data on methodology and results. RESULTS The vast majority of data come from healthcare settings, with typically around 6% of samples having detectable concentrations of SARS-CoV-2 RNA and almost none of the samples collected had viable virus. There were a wide variety of methods used to measure airborne virus, although surface sampling was generally undertaken using nylon flocked swabs. Overall, the quality of the measurements was poor. Only a small number of studies reported the airborne concentration of SARS-CoV-2 virus RNA, mostly just reporting the detectable concentration values without reference to the detection limit. Imputing the geometric mean air concentration assuming the limit of detection was the lowest reported value, suggests typical concentrations in healthcare settings may be around 0.01 SARS-CoV-2 virus RNA copies m-3. Data on surface virus loading per unit area were mostly unavailable. CONCLUSIONS The reliability of the reported data is uncertain. The methods used for measuring SARS-CoV-2 and other respiratory viruses in work environments should be standardized to facilitate more consistent interpretation of contamination and to help reliably estimate worker exposure.
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Affiliation(s)
- John W Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
- Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Riccarton, Edinburgh, UK
| | - Mark P C Cherrie
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
- University of Edinburgh, School of Geosciences, Edinburgh, UK
| | - Alice Smith
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - David Holmes
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - Sean Semple
- University of Stirling, Institute for Social Marketing and Health, Stirling, UK
| | - Susanne Steinle
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
| | - Ewan Macdonald
- University of Glasgow, Institute of Health and Wellbeing, Glasgow, UK
| | - Ginny Moore
- National Infection Service, Public Health England, Porton Down, Salisbury, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North, Edinburgh, UK
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36
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Oeschger TM, McCloskey DS, Buchmann RM, Choubal AM, Boza JM, Mehta S, Erickson D. Early Warning Diagnostics for Emerging Infectious Diseases in Developing into Late-Stage Pandemics. Acc Chem Res 2021; 54:3656-3666. [PMID: 34524795 DOI: 10.1021/acs.accounts.1c00383] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The spread of infectious diseases due to travel and trade can be seen throughout history, whether from early settlers or traveling businessmen. Increased globalization has allowed infectious diseases to quickly spread to different parts of the world and cause widespread infection. Posthoc analysis of more recent outbreaks-SARS, MERS, swine flu, and COVID-19-has demonstrated that the causative viruses were circulating through populations for days or weeks before they were first detected, allowing disease to spread before quarantines, contact tracing, and travel restrictions could be implemented. Earlier detection of future novel pathogens could decrease the time before countermeasures are enacted. In this Account, we examined a variety of novel technologies from the past 10 years that may allow for earlier detection of infectious diseases. We have arranged these technologies chronologically from pre-human predictive technologies to population-level screening tools. The earliest detection methods utilize artificial intelligence to analyze factors such as climate variation and zoonotic spillover as well as specific species and geographies to identify where the infection risk is high. Artificial intelligence can also be used to monitor health records, social media, and various publicly available data to identify disease outbreaks faster than traditional epidemiology. Secondary to predictive measures is monitoring infection in specific sentinel animal species, where domestic animals or wildlife are indicators of potential disease hotspots. These hotspots inform public health officials about geographic areas where infection risk in humans is high. Further along the timeline, once the disease has begun to infect humans, wastewater epidemiology can be used for unbiased sampling of large populations. This method has already been shown to precede spikes in COVID-19 diagnoses by 1 to 2 weeks. As total infections increase in humans, bioaerosol sampling in high-traffic areas can be used for disease monitoring, such as within an airport. Finally, as disease spreads more quickly between humans, rapid diagnostic technologies such as lateral flow assays and nucleic acid amplification become very important. Minimally invasive point-of-care methods can allow for quick adoption and use within a population. These individual diagnostic methods then transfer to higher-throughput methods for more intensive population screening as an infection spreads. There are many promising early warning technologies being developed. However, no single technology listed herein will prevent every future outbreak. A combination of technologies from across our infection timeline would offer the most benefit in preventing future widespread disease outbreaks and pandemics.
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Affiliation(s)
| | | | | | | | | | - Saurabh Mehta
- Department of Population Health Sciences, Weill Cornell Medicine, New York, New York 10065, United States
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Sanchez-Galan JE, Ureña G, Escovar LF, Fabrega-Duque JR, Coles A, Kurt Z. Challenges to detect SARS-CoV-2 on environmental media, the need and strategies to implement the detection methodologies in wastewaters. JOURNAL OF ENVIRONMENTAL CHEMICAL ENGINEERING 2021; 9:105881. [PMID: 34221893 PMCID: PMC8239206 DOI: 10.1016/j.jece.2021.105881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/15/2021] [Accepted: 06/13/2021] [Indexed: 06/13/2023]
Abstract
Understanding risks, putting in place preventative methods to seamlessly continue daily activities are essential tools to fight a pandemic. All social, commercial and leisure activities have an impact on the environmental media. Therefore, to accurately predict the fate and behavior of viruses in the environment, it is necessary to understand and analyze available detection methods, possible transmission pathways and preventative techniques. The aim of this review is to critically analyze and summarize the research done regarding SARS-COV-2 virus detection, focusing on sampling and laboratory detection methods in environmental media. Special attention will be given to wastewater and sewage sludge. This review has summarized the survival of the virus on surfaces to estimate the risk carried by different environmental media (water, wastewater, air and soil) in order to explain which communities are under higher risk. The critical analysis concludes that the detection of SARS-CoV-2 with current technologies and sampling strategies would reveal the presence of the virus. This information could be used to design systematic sampling points throughout the sewage systems when available, taking into account peak flows and more importantly economic factors on when to sample. Such approaches will provide clues for potential future viral outbreak, saving financial resources by reducing testing necessities for viral detection, hence contributing for more appropriate confinement policies by governments and could be further used to define more precisely post-pandemic or additional waves measures if/ when needed.
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Affiliation(s)
- Javier E Sanchez-Galan
- Facultad de Ingeniería de Sistemas Computacionales (FISC), Universidad Tecnológica de Panamá, Panama
- Grupo de Investigación en Biotecnología, Bioinformática y Biología de Sistemas (GIBBS), Universidad Tecnológica de Panamá, Panama
- Institute of Scientific Research and High Technology Services, Panama City, Panama
| | - Grimaldo Ureña
- Grupo de Investigación en Biotecnología, Bioinformática y Biología de Sistemas (GIBBS), Universidad Tecnológica de Panamá, Panama
- Theoretical Evolutionary Genetics Laboratory, University of Houston, Houston, TX, USA
| | | | - Jose R Fabrega-Duque
- Centro de Investigaciones Hidráulicas e Hidrotécnicas (CIHH), Universidad Tecnologica de Panama, Panama
| | - Alexander Coles
- Centro de Investigaciones Hidráulicas e Hidrotécnicas (CIHH), Universidad Tecnologica de Panama, Panama
| | - Zohre Kurt
- Grupo de Investigación en Biotecnología, Bioinformática y Biología de Sistemas (GIBBS), Universidad Tecnológica de Panamá, Panama
- Urban Risk Center, Florida State University-Panama, Panama
- Institute of Scientific Research and High Technology Services, Panama City, Panama
- Department of Environmental Engineering, Middle East Technical University, Ankara, Turkey
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Lee BU. Why Does the SARS-CoV-2 Delta VOC Spread So Rapidly? Universal Conditions for the Rapid Spread of Respiratory Viruses, Minimum Viral Loads for Viral Aerosol Generation, Effects of Vaccination on Viral Aerosol Generation, and Viral Aerosol Clouds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9804. [PMID: 34574724 PMCID: PMC8470664 DOI: 10.3390/ijerph18189804] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/16/2022]
Abstract
This study analyzes the reasons the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant of concern (VOC) spreads so rapidly. Novel topics such as universal conditions for the rapid spread of respiratory viruses, minimum viral loads for viral aerosol generation, effects of vaccination on viral aerosol generation, and viral aerosol clouds were studied. The analyses were based on experimental results and analytic model studies. Four universal conditions, namely asymptomatic host, high viral load, stability of viruses in air, and binding affinity of viruses to human cells, need to be satisfied for the rapid spread of respiratory viruses. SARS-CoV-2 and its variants such as the Alpha VOC and Delta VOC satisfy the four fundamental conditions. In addition, there is an original principle of aerosol generation of respiratory viruses. Assuming that the aerosol-droplet cutoff particle diameter for distinguishing potential aerosols from earthbound respiratory particles is 100 μm, the minimum viral load required in respiratory fluids to generate viral aerosols is ~106 copies mL-1, which is within the range of the reported viral loads in the Alpha VOC cases and the Delta VOC cases. The daily average viral loads of the Delta VOC in hosts have been reported to be between ~109 copies mL-1 and ~1010 copies mL-1 during the four days after symptom onset in 1848 cases of the Delta VOC infection. Owing to the high viral load, the SARS-CoV-2 Delta VOC has the potential to effectively spread through aerosols. COVID-19 vaccination can decrease aerosol transmission of the SARS-CoV-2 Alpha VOC by reducing the viral load. The viral load can explain the conundrum of viral aerosol spreading. The SARS-CoV-2 Delta VOC aerosol clouds have been assumed to be formed in restricted environments, resulting in a massive numbers of infected people in a very short period with a high spreading speed. Strong control methods against bioaerosols should be considered in this SARS-CoV-2 Delta VOC pandemic. Large-scale environmental monitoring campaigns of SARS-CoV-2 Delta VOC aerosols in public places in many countries are necessary, and these activities could contribute to controlling the coronavirus disease pandemic.
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Affiliation(s)
- Byung Uk Lee
- Aerosol and Bioengineering Laboratory, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul 05029, Korea
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Baboli Z, Neisi N, Babaei AA, Ahmadi M, Sorooshian A, Birgani YT, Goudarzi G. On the airborne transmission of SARS-CoV-2 and relationship with indoor conditions at a hospital. ATMOSPHERIC ENVIRONMENT (OXFORD, ENGLAND : 1994) 2021; 261:118563. [PMID: 34177342 PMCID: PMC8215890 DOI: 10.1016/j.atmosenv.2021.118563] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 05/06/2023]
Abstract
The limited knowledge about the mechanism of SARS-CoV-2 transmission is a current challenge on a global scale. Among possible transmission routes, air transfer of the virus is thought to be prominent. To investigate this further, measurements were conducted at Razi hospital in Ahvaz, Iran, which was selected to treat COVID-19 severe cases in the Khuzestan province. Passive and active sampling methods were employed and compared with regard to their efficiency for collection of airborne SARS-COV-2 virus particles. Fifty one indoor air samples were collected in two areas, with distances of less than or equal to 1 m (patient room) and more than 3 m away (hallway and nurse station) from patient beds. A simulation method was used to obtain the virus load released by a regularly breathing or coughing individual including a range of microdroplet emissions. Using real-time reverse transcription polymerase chain reaction (RT-PCR), 11.76% (N = 6) of all indoor air samples (N = 51) collected in the COVID-19 ward tested positive for SARS-CoV-2 virus, including 4 cases in patient rooms and 2 cases in the hallway. Also, 5 of the 6 positive cases were confirmed using active sampling methods with only 1 based on passive sampling. The results support airborne transmission of SARS-CoV-2 bioaerosols in indoor air. Multivariate analysis showed that among 15 parameters studied, the highest correlations with PCR results were obtained for temperature, relative humidity, PM levels, and presence of an air cleaner.
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Affiliation(s)
- Zeynab Baboli
- Student Research Committee, Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Niloofar Neisi
- Clinical Sciences Research Institute, Alimentary Tract Research Center, Department of Medical Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Akbar Babaei
- Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Ahmadi
- Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Armin Sorooshian
- Department of Chemical and Environmental Engineering, University of Arizona, Tucson, AZ, USA
- Department of Hydrology and Atmospheric Sciences, University of Arizona, Tucson, AZ, USA
| | - Yaser Tahmasebi Birgani
- Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Environmental Health Engineering, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Maison DP, Ching LL, Cleveland SB, Tseng AC, Nakano E, Shikuma CM, Nerurkar VR. Algorithm for the Quantitation of Variants of Concern for Rationally Designed Vaccines Based on the Isolation of SARS-CoV-2 Hawai'i Lineage B.1.243. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2021.08.18.455536. [PMID: 34751271 PMCID: PMC8575142 DOI: 10.1101/2021.08.18.455536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
SARS-CoV-2 worldwide emergence and evolution has resulted in variants containing mutations resulting in immune evasive epitopes that decrease vaccine efficacy. We acquired clinical samples, analyzed SARS-CoV-2 genomes, used the most worldwide emerged spike mutations from Variants of Concern/Interest, and developed an algorithm for monitoring the SARS-CoV-2 vaccine platform. The algorithm partitions logarithmic-transformed prevalence data monthly and Pearson's correlation determines exponential emergence. The SARS-CoV-2 genome evaluation indicated 49 mutations. Nine of the ten most worldwide prevalent (>70%) spike protein changes have r- values >0.9. The tenth, D614G, has a prevalence >99% and r -value of 0.67. The resulting algorithm is based on the patterns these ten substitutions elucidated. The strong positive correlation of the emerged spike protein changes and algorithmic predictive value can be harnessed in designing vaccines with relevant immunogenic epitopes. SARS-CoV-2 is predicted to remain endemic and continues to evolve, so must SARS-CoV-2 monitoring and next-generation vaccine design.
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Bak A, Mugglestone MA, Ratnaraja NV, Wilson JA, Rivett L, Stoneham SM, Bostock J, Moses SE, Price JR, Weinbren M, Loveday HP, Islam J, Wilson APR. SARS-CoV-2 routes of transmission and recommendations for preventing acquisition: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance. J Hosp Infect 2021; 114:79-103. [PMID: 33940093 PMCID: PMC8087584 DOI: 10.1016/j.jhin.2021.04.027] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 02/06/2023]
Affiliation(s)
- A Bak
- Healthcare Infection Society, UK.
| | | | - N V Ratnaraja
- British Infection Association, UK; University Hospitals Coventry & Warwickshire NHS Trust, UK
| | - J A Wilson
- Infection Prevention Society, UK; Richard Wells Research Centre, University of West London, UK
| | - L Rivett
- Healthcare Infection Society, UK; Cambridge University NHS Hospitals Foundation Trust, UK
| | - S M Stoneham
- Healthcare Infection Society, UK; Brighton and Sussex University Hospitals NHS Trust, UK
| | | | - S E Moses
- British Infection Association, UK; Royal College of Pathologists, UK; East Kent Hospitals University NHS Foundation Trust, UK
| | - J R Price
- Healthcare Infection Society, UK; Imperial College Healthcare NHS Trust, UK
| | - M Weinbren
- Healthcare Infection Society, UK; Sherwood Forest Hospitals NHS Foundation Trust, UK
| | - H P Loveday
- Infection Prevention Society, UK; Richard Wells Research Centre, University of West London, UK
| | - J Islam
- Healthcare Infection Society, UK; Brighton and Sussex University Hospitals NHS Trust, UK
| | - A P R Wilson
- Healthcare Infection Society, UK; University College London Hospitals NHS Foundation Trust, UK
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Kopperi H, Tharak A, Hemalatha M, Kiran U, Gokulan CG, Mishra RK, Mohan SV. Defining the methodological approach for wastewater-based epidemiological studies-Surveillance of SARS-CoV-2. ENVIRONMENTAL TECHNOLOGY & INNOVATION 2021; 23:101696. [PMID: 34250217 PMCID: PMC8253532 DOI: 10.1016/j.eti.2021.101696] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/10/2021] [Accepted: 06/13/2021] [Indexed: 05/24/2023]
Abstract
Since COVID-19 outbreak, wastewater-based epidemiology (WBE) studies as surveillance system is becoming an emerging interest due to its functional advantage as a tool for early warning signal and to catalyze effective disease management strategies based on the community diagnosis. An attempt was made in this study to define and establish a methodological approach for conducting WBE studies in the framework of identifying/selection of surveillance sites, standardizing sampling policy, designing sampling protocols to improve sensitivity, adopting safety protocol, and interpreting the data. Data from hourly sampling indicated a peak in the viral RNA during the morning hours (6-9 am) when the all the domestic activities are maximum. The daily sampling and processing revealed the dynamic nature of infection spread among the population. The two sampling methods viz. grab, and composite showed a good correlation. Overall, this study establishes a structured protocol for performing WBE studies that could provide useful insights on the spread of the pandemic at a given point of time. Moreover, this framework could be extrapolated to monitor several other clinically relevant diseases. Following these guidelines, it is possible to achieve measurable and reliable SARS-CoV-2 RNA concentrations in wastewater infrastructure and therefore, provides a methodological basis for the establishment of a national surveillance system.
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Affiliation(s)
- Harishankar Kopperi
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Athmakuri Tharak
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India
| | - Manupati Hemalatha
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - Uday Kiran
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
| | - C G Gokulan
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad 500007, India
| | - Rakesh K Mishra
- CSIR-Centre for Cellular and Molecular Biology (CSIR-CCMB), Hyderabad 500007, India
| | - S Venkata Mohan
- Bioengineering and Environmental Sciences Lab, Department of Energy and Environmental Engineering (DEEE), CSIR-Indian Institute of Chemical Technology (CSIR-IICT), Hyderabad 500007, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad 201002, India
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Borges JT, Nakada LYK, Maniero MG, Guimarães JR. SARS-CoV-2: a systematic review of indoor air sampling for virus detection. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:40460-40473. [PMID: 33630259 PMCID: PMC7905194 DOI: 10.1007/s11356-021-13001-w] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/12/2021] [Indexed: 05/03/2023]
Abstract
In a post-pandemic scenario, indoor air monitoring may be required seeking to safeguard public health, and therefore well-defined methods, protocols, and equipment play an important role. Considering the COVID-19 pandemic, this manuscript presents a literature review on indoor air sampling methods to detect viruses, especially SARS-CoV-2. The review was conducted using the following online databases: Web of Science, Science Direct, and PubMed, and the Boolean operators "AND" and "OR" to combine the following keywords: air sampler, coronavirus, COVID-19, indoor, and SARS-CoV-2. This review included 25 published papers reporting sampling and detection methods for SARS-CoV-2 in indoor environments. Most of the papers focused on sampling and analysis of viruses in aerosols present in contaminated areas and potential transmission to adjacent areas. Negative results were found in 10 studies, while 15 papers showed positive results in at least one sample. Overall, papers report several sampling devices and methods for SARS-CoV-2 detection, using different approaches for distance, height from the floor, flow rates, and sampled air volumes. Regarding the efficacy of each mechanism as measured by the percentage of investigations with positive samples, the literature review indicates that solid impactors are more effective than liquid impactors, or filters, and the combination of various methods may be recommended. As a final remark, determining the sampling method is not a trivial task, as the samplers and the environment influence the presence and viability of viruses in the samples, and thus a case-by-case assessment is required for the selection of sampling systems.
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Affiliation(s)
- João Tito Borges
- Department of Infrastructure and Environment, School of Civil Engineering, Architecture and Urban Design, University of Campinas (InfrA, FEC, UNICAMP), Rua Saturnino de Brito, 224, Cidade Universitária, Campinas, SP, 13083889, Brazil
| | - Liane Yuri Kondo Nakada
- Department of Infrastructure and Environment, School of Civil Engineering, Architecture and Urban Design, University of Campinas (InfrA, FEC, UNICAMP), Rua Saturnino de Brito, 224, Cidade Universitária, Campinas, SP, 13083889, Brazil
| | - Milena Guedes Maniero
- Department of Infrastructure and Environment, School of Civil Engineering, Architecture and Urban Design, University of Campinas (InfrA, FEC, UNICAMP), Rua Saturnino de Brito, 224, Cidade Universitária, Campinas, SP, 13083889, Brazil
| | - José Roberto Guimarães
- Department of Infrastructure and Environment, School of Civil Engineering, Architecture and Urban Design, University of Campinas (InfrA, FEC, UNICAMP), Rua Saturnino de Brito, 224, Cidade Universitária, Campinas, SP, 13083889, Brazil.
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Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis 2021; 21:710. [PMID: 34315427 PMCID: PMC8314268 DOI: 10.1186/s12879-021-06357-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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Affiliation(s)
- Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Isaac I Bogoch
- Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
| | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Karina Escandón
- Department of Anthropology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Saskia V Popescu
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Jason Kindrachuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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Darvishi V, Darvishi S, Bahrami-Bavani M, Navidbakhsh M, Asiaei S. Centrifugal isolation of SARS-CoV-2: numerical simulation for purification of hospitals' air. Biomech Model Mechanobiol 2021; 20:1809-1817. [PMID: 34138382 PMCID: PMC8210528 DOI: 10.1007/s10237-021-01477-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/07/2021] [Indexed: 01/03/2023]
Abstract
Coronavirus and its spread all over the world have been the most challenging crisis in 2020. Hospitals are categorized among the most vulnerable centers due to their presumably highest traffic of this virus. In this study, centrifugal isolation of coronavirus is successfully deployed for purifying hospitals’ air using air conditioners and ducts, suggesting an efficient setup. Numerical simulations have been used to testify the proposed setup due to the complexities of using experimental investigation such as high cost and clinical hazards of the airborne SARS-CoV-2 in the air. Results show that a 20-cm pipe with an inlet velocity of 4 m/s constitutes the best choice for the separation and purification of air from the virus. The proposed scalable method also efficiently separates larger particles, but it can separate smaller particles too. Numerical results also suggest installing the air purifying system on the floor of the hospitals’ room for maximum efficiency.
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Affiliation(s)
- Vahid Darvishi
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, 16846, Tehran, Iran.,Sensors and Integrated Bio-Microfluidics/MEMS Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, 16846-13114, Narmak, Tehran, Iran
| | - Saeed Darvishi
- Mechanical Engineering Department, Babol Noshirvani University of Technology, 47148-71167, Babol, Iran
| | | | - Mahdi Navidbakhsh
- Tissue Engineering and Biological Systems Research Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, 16846, Tehran, Iran.
| | - Sasan Asiaei
- Sensors and Integrated Bio-Microfluidics/MEMS Laboratory, School of Mechanical Engineering, Iran University of Science and Technology, 16846-13114, Narmak, Tehran, Iran.
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Ram K, Thakur RC, Singh DK, Kawamura K, Shimouchi A, Sekine Y, Nishimura H, Singh SK, Pavuluri CM, Singh RS, Tripathi SN. Why airborne transmission hasn't been conclusive in case of COVID-19? An atmospheric science perspective. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145525. [PMID: 33940729 PMCID: PMC7984961 DOI: 10.1016/j.scitotenv.2021.145525] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/15/2021] [Accepted: 01/26/2021] [Indexed: 05/06/2023]
Abstract
Airborne transmission is one of the routes for the spread of COVID-19 which is caused by inhalation of smaller droplets1 containing SARS-CoV-2 (i.e., either virus-laden particulate matter: PM and/or droplet nuclei) in an indoor environment. Notably, a significant fraction of the small droplets, along with respiratory droplets, is produced by both symptomatic and asymptomatic individuals during expiratory events such as breathing, sneezing, coughing and speaking. When these small droplets are exposed to the ambient environment, they may interact with PM and may remain suspended in the atmosphere even for several hours. Therefore, it is important to know the fate of these droplets and processes (e.g., physical and chemical) in the atmosphere to better understand airborne transmission. Therefore, we reviewed existing literature focussed on the transmission of SARS-CoV-2 in the spread of COVID-19 and present an environmental perspective on why airborne transmission hasn't been very conclusive so far. In addition, we discuss various environmental factors (e.g., temperature, humidity, etc.) and sampling difficulties, which affect the conclusions of the studies focussed on airborne transmission. One of the reasons for reduced emphasis on airborne transmission could be that the smaller droplets have less number of viruses as compared to larger droplets. Further, smaller droplets can evaporate faster, exposing SARS-CoV-2 within the small droplets to the environment, whose viability may further reduce. For example, these small droplets containing SARS-CoV-2 might also physically combine with or attach to pre-existing PM so that their behaviour and fate may be governed by PM composition. Thus, the measurement of their infectivity and viability is highly uncertain due to a lack of robust sampling system to separately collect virions in the atmosphere. We believe that the present review will help to minimize the gap in our understanding of the current pandemic and develop a robust epidemiological method for mortality assessment.
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Affiliation(s)
- Kirpa Ram
- Institute of Environment and Sustainable Development, Banaras Hindu University, Varanasi 221005, India.
| | - Roseline C Thakur
- Institute for Atmospheric and Earth System Research (INAR)/Physics, Faculty of Science, University of Helsinki, 00014 Helsinki, Finland.
| | - Dharmendra Kumar Singh
- French National Centre for Scientific Research (CNRS)/IRCE Lyon, 2 avenue Albert Einstein, Villeurbanne 69100, France.
| | - Kimitaka Kawamura
- Chubu Institute for Advanced Studies, Chubu University, Kasugai 487-8501, Japan.
| | - Akito Shimouchi
- School of Life and Health Sciences, Chubu University, Kasugai 487-8501, Japan.
| | - Yoshika Sekine
- Department of Chemistry, Tokai University, Hiratsuka, Kanagawa 25901292, Japan.
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center, Sendai, Japan.
| | - Sunit K Singh
- Laboratory of Molecular Virology & Immunology, Molecular Biology Unit, Faculty of Medicine, Institute of Medical Sciences (IMS), Banaras Hindu University (BHU), Varanasi 221005, India.
| | - Chandra Mouli Pavuluri
- Institute of Surface-Earth System Science, School of Earth System Science, Tianjin University, Tianjin 300072, China.
| | - R S Singh
- Department of Chemical Engineering, IIT (BHU), Varanasi 221005, Uttar Pradesh, India.
| | - S N Tripathi
- Department of Civil Engineering, Centre for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India.
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47
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Gregson FKA, Watson NA, Orton CM, Haddrell AE, McCarthy LP, Finnie TJR, Gent N, Donaldson GC, Shah PL, Calder JD, Bzdek BR, Costello D, Reid JP. Comparing aerosol concentrations and particle size distributions generated by singing, speaking and breathing. AEROSOL SCIENCE AND TECHNOLOGY 2021. [PMID: 0 DOI: 10.1080/02786826.2021.1883544] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Affiliation(s)
| | - Natalie A. Watson
- Department of Ear, Nose and Throat Surgery, Lewisham and Greenwich NHS Trust, London, United Kingdom
| | - Christopher M. Orton
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom
- Department of Respiratory Medicine, Chelsea & Westminster Hospital, London, United Kingdom
- National Heart and Lung Institute, Guy Scadding Building, Imperial College London, London, United Kingdom
| | | | | | - Thomas J. R. Finnie
- Emergency Response Department Science and Technology (ERD S&T), Health Protection Directorate, Public Health England, Salisbury, Wiltshire, United Kingdom
| | - Nick Gent
- Emergency Response Department Science and Technology (ERD S&T), Health Protection Directorate, Public Health England, Salisbury, Wiltshire, United Kingdom
| | - Gavin. C. Donaldson
- National Heart and Lung Institute, Guy Scadding Building, Imperial College London, London, United Kingdom
| | - Pallav L. Shah
- Department of Respiratory Medicine, Royal Brompton Hospital, London, United Kingdom
- Department of Respiratory Medicine, Chelsea & Westminster Hospital, London, United Kingdom
- National Heart and Lung Institute, Guy Scadding Building, Imperial College London, London, United Kingdom
| | - James D. Calder
- Department of Bioengineering, Imperial College London, United Kingdom
- Fortius Clinic, London, UK
| | - Bryan R. Bzdek
- School of Chemistry, University of Bristol, Bristol, United Kingdom
| | - Declan Costello
- Ear, Nose and Throat Department, Wexham Park Hospital, United Kingdom
| | - Jonathan P. Reid
- School of Chemistry, University of Bristol, Bristol, United Kingdom
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48
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Cheng Y, Ma N, Witt C, Rapp S, Wild PS, Andreae MO, Pöschl U, Su H. Face masks effectively limit the probability of SARS-CoV-2 transmission. Science 2021; 372:eabg6296. [PMID: 34016743 PMCID: PMC8168616 DOI: 10.1126/science.abg6296] [Citation(s) in RCA: 143] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/17/2021] [Indexed: 12/11/2022]
Abstract
Airborne transmission by droplets and aerosols is important for the spread of viruses. Face masks are a well-established preventive measure, but their effectiveness for mitigating SARS-CoV-2 transmission is still under debate. We show that variations in mask efficacy can be explained by different regimes of virus abundance and related to population-average infection probability and reproduction number. For SARS-CoV-2, the viral load of infectious individuals can vary by orders of magnitude. We find that most environments and contacts are under conditions of low virus abundance (virus-limited) where surgical masks are effective at preventing virus spread. More advanced masks and other protective equipment are required in potentially virus-rich indoor environments including medical centers and hospitals. Masks are particularly effective in combination with other preventive measures like ventilation and distancing.
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Affiliation(s)
- Yafang Cheng
- Max Planck Institute for Chemistry, 55128 Mainz, Germany.
| | - Nan Ma
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China
| | - Christian Witt
- Department of Outpatient Pneumology and Institute of Physiology, Charité Universitätsmedizin Berlin, Campus Charité Mitte, 10117 Berlin, Germany
| | - Steffen Rapp
- University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Philipp S Wild
- University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Meinrat O Andreae
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA 92093, USA
- Department of Geology and Geophysics, King Saud University, 11451 Riyadh, Saudi Arabia
| | - Ulrich Pöschl
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
| | - Hang Su
- State Environmental Protection Key Laboratory of Formation and Prevention of Urban Air Pollution Complex, Shanghai Academy of Environmental Sciences, Shanghai 200233, China.
- Max Planck Institute for Chemistry, 55128 Mainz, Germany
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49
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Morel B, Barbera P, Czech L, Bettisworth B, Hübner L, Lutteropp S, Serdari D, Kostaki EG, Mamais I, Kozlov AM, Pavlidis P, Paraskevis D, Stamatakis A. Phylogenetic Analysis of SARS-CoV-2 Data Is Difficult. Mol Biol Evol 2021; 38:1777-1791. [PMID: 33316067 PMCID: PMC7798910 DOI: 10.1093/molbev/msaa314] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Numerous studies covering some aspects of SARS-CoV-2 data analyses are being published on a daily basis, including a regularly updated phylogeny on nextstrain.org. Here, we review the difficulties of inferring reliable phylogenies by example of a data snapshot comprising a quality-filtered subset of 8,736 out of all 16,453 virus sequences available on May 5, 2020 from gisaid.org. We find that it is difficult to infer a reliable phylogeny on these data due to the large number of sequences in conjunction with the low number of mutations. We further find that rooting the inferred phylogeny with some degree of confidence either via the bat and pangolin outgroups or by applying novel computational methods on the ingroup phylogeny does not appear to be credible. Finally, an automatic classification of the current sequences into subclasses using the mPTP tool for molecular species delimitation is also, as might be expected, not possible, as the sequences are too closely related. We conclude that, although the application of phylogenetic methods to disentangle the evolution and spread of COVID-19 provides some insight, results of phylogenetic analyses, in particular those conducted under the default settings of current phylogenetic inference tools, as well as downstream analyses on the inferred phylogenies, should be considered and interpreted with extreme caution.
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Affiliation(s)
- Benoit Morel
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
| | - Pierre Barbera
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
| | - Lucas Czech
- Department of Plant Biology, Carnegie Institution for Science, Stanford, CA, USA
| | - Ben Bettisworth
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
| | - Lukas Hübner
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
- Institute for Theoretical Informatics, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sarah Lutteropp
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
| | - Dora Serdari
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
| | - Evangelia-Georgia Kostaki
- Department of Hygiene Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Mamais
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Alexey M Kozlov
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
| | - Pavlos Pavlidis
- Institute of Computer Science, Foundation for Research and Technology-Hellas, Crete, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Stamatakis
- Computational Molecular Evolution Group, Heidelberg Institute for Theoretical Studies, Heidelberg, Germany
- Institute for Theoretical Informatics, Karlsruhe Institute of Technology, Karlsruhe, Germany
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50
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Robie ER, Abdelgadir A, Binder RA, Gray GC. Live SARS-CoV-2 is difficult to detect in patient aerosols. Influenza Other Respir Viruses 2021; 15:554-557. [PMID: 33939268 PMCID: PMC8189214 DOI: 10.1111/irv.12860] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2021] [Indexed: 01/12/2023] Open
Affiliation(s)
- Emily R Robie
- Division of Infectious Diseases, School of Medicine, Duke University, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Anfal Abdelgadir
- Division of Infectious Diseases, School of Medicine, Duke University, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Raquel A Binder
- Division of Infectious Diseases, School of Medicine, Duke University, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Gregory C Gray
- Division of Infectious Diseases, School of Medicine, Duke University, Durham, NC, USA.,Duke Global Health Institute, Duke University, Durham, NC, USA.,Global Health Research Center, Duke Kunshan University, Kunshan, China.,Program in Emerging Infectious Diseases, Duke-NUS Medical School, Singapore, Singapore
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