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Higher viral load and infectivity increase risk of aerosol transmission for Delta and Omicron variants of SARS-CoV-2.
Riediker, Michael; Briceno-Ayala, Leonardo; Ichihara, Gaku; Albani, Daniele; Poffet, Deyan; Tsai, Dai-Hua; Iff, Samuel; Monn, Christian.
Afiliación
  • Riediker M; Swiss Centre for Occupational and Environmental Health, Winterthur, Switzerland.
  • Briceno-Ayala L; Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, Bogota, Colombia.
  • Ichihara G; Tokyo University of Science, Faculty of Pharmaceutical Sciences, Health Management Center, Chiba, Japan.
  • Albani D; Repubblica e Cantone Ticino, Dipartimento del territorio, Camorino, Switzerland.
  • Poffet D; Centre for Primary Care and Public Health (Unisanté), Department of Occupational and Environmental Health, Lausanne, Switzerland.
  • Tsai DH; Swiss Centre for Occupational and Environmental Health, Winterthur, Switzerland.
  • Iff S; State Secretariat for Economic Affairs (SECO), Working Conditions Section, Bern, Switzerland.
  • Monn C; State Secretariat for Economic Affairs (SECO), Working Conditions Section, Bern, Switzerland.
Swiss Med Wkly ; 152: w30133, 2022 01 03.
Article en En | MEDLINE | ID: mdl-35019196
BACKGROUND: Airborne transmission of SARS-CoV-2 is an important route of infection. For the wildtype (WT) only a small proportion of those infected emitted large quantities of the virus. The currently prevalent variants of concern, Delta (B1.617.2) and Omicron (B.1.1.529), are characterized by higher viral loads and a lower minimal infective dose compared to the WT. We aimed to describe the resulting distribution of airborne viral emissions and to reassess the risk estimates for public settings given the higher viral load and infectivity. METHOD: We reran the Monte Carlo modelling to estimate viral emissions in the fine aerosol size range using available viral load data. We also updated our tool to simulate indoor airborne transmission of SARS-CoV-2 by including a CO2 calculator and recirculating air cleaning devices. We also assessed the consequences of the lower critical dose on the infection risk in public settings with different protection strategies. RESULTS: Our modelling suggests that a much larger proportion of individuals infected with the new variants are high, very high or super-emitters of airborne viruses: for the WT, one in 1,000 infected was a super-emitter; for Delta one in 30; and for Omicron one in 20 or one in 10, depending on the viral load estimate used. Testing of the effectiveness of protective strategies in view of the lower critical dose suggests that surgical masks are no longer sufficient in most public settings, while correctly fitted FFP2 respirators still provide sufficient protection, except in high aerosol producing situations such as singing or shouting. DISCUSSION: From an aerosol transmission perspective, the shift towards a larger proportion of very high emitting individuals, together with the strongly reduced critical dose, seem to be two important drivers of the aerosol risk, and are likely contributing to the observed rapid spread of the Delta and Omicron variants of concern. Reducing contacts, always wearing well-fitted FFP2 respirators when indoors, using ventilation and other methods to reduce airborne virus concentrations, and avoiding situations with loud voices seem critical to limiting these latest waves of the COVID-19 pandemic.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pandemias / COVID-19 Tipo de estudio: Etiology_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Swiss Med Wkly Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pandemias / COVID-19 Tipo de estudio: Etiology_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Swiss Med Wkly Asunto de la revista: MEDICINA Año: 2022 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza