At the request of scientists: WHO recognized another transmission route for coronavirus

World Health Organization has expanded its coronavirus guide adding information about the possibility of aerosol transmission of the virus, in which the infection can spread through tiny droplets that remain in the air, writes NBC News.

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The update appeared on Thursday, July 9th, after open letter signed by more than 200 scientists, made the agency recognize the potential role that tiny droplets (or aerosols) play in the airborne transmission of the virus among people in crowded rooms.

“Outbreaks of COVID-19 have been reported in some indoor settings, such as restaurants, nightclubs, places of worship or offices where people may be shouting, talking or singing,” the WHO said in an updated review of the data. “In these outbreaks, aerosol transmission of the virus cannot be ruled out, especially in crowded and poorly ventilated spaces where infected people spend a lot of time near others.”

The agency said additional research is needed "to urgently investigate such cases and assess their relevance to the transmission of COVID-19."

In the expanded guidance, WHO notes that aerosols are only a small part of how the coronavirus spreads, and close contact with an infected person is still the most common mode of transmission.

“You can apply all of these definitions, but we've always been concerned about the spread of the virus when people are in small spaces for long periods of time,” said Cindy Prince, an epidemiologist at the University of Florida in Gainesville.

For respiratory diseases such as COVID-19, the medical community names two main routes of transmission: airborne and aerosol. In airborne transmission, virus particles can fly out of the mouth or nose when a person speaks, coughs or sneezes. Drops can spread up to 6 feet (about 2 meters) from an infected person, but then quickly fall to the ground or to other surfaces.

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With aerosol transmission, as opposed to airborne transmission, the virus particles are much smaller and linger in the air much longer. They are able to travel significantly greater distances than the 6 feet considered a safe distance between people. The smallest particles are able to move away from an infected person by “floating” in air currents. Measles, chicken pox and tuberculosis are diseases that can be transmitted by aerosol transmission.

When Dr. Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, was asked about aerosol spread of the coronavirus, he responded: “There is no convincing evidence that this type of transmission occurs. But we can’t completely rule it out.”

Although the airborne and aerosol types of transmission are different from each other, they are not mutually exclusive, said Dr. Isaac Bogoch, an infectious disease specialist, assistant professor of medicine at the University of Toronto.

“We often think of these clinical definitions as disparate, but that's not entirely accurate,” says Bogoch. “When we think about COVID-19, some aerosol transmission is likely, but it's safe to say that the majority of transmission is airborne.”

Gogh pointed to hospital protocols as a key indicator that aerosol transmission can be rare. In treating patients with coronavirus, most hospitals in the fight against infection adhered to guidelines designed for airborne droplets, and not to more stringent procedures to protect against aerosol transmitted infections.

According to Bogokh, if COVID-19 were indeed transmitted predominantly by aerosol, then the incidence rate among health workers would be much higher.

“Our personal protective equipment - masks, gowns, gloves and eye protection - are chosen as precautions against airborne transmission, and in the vast majority of cases, when we have access to these things and use them correctly, we do not contract this infection. “- he argued.

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Dr. Carlos del Rio, Executive Assistant to the Dean of the Emory University School of Medicine in Atlanta, believes that aerosol transmission is likely to be a risk under certain conditions, but WHO updates do not provide radically different recommendations compared to existing ones.

“If I'm in a crowded small room with a group of infected people, there's bound to be aerosol transmission there. But if I'm in a large room or outside and someone is walking nearby, I'm not too worried about aerosol transmission,” he added.

According to Prince, the updated information should reinforce the existing recommendations of public health officials, such as the practice of social distance and avoiding crowded rooms.

Del Rio is sure: even if you don’t need to wear masks, people should wear them in public places.

“Everyone is required to wear a mask,” he insists. “We need to make people aware that there are no other options.”

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