Practical Indicators for Risk of Airborne Transmission in Shared Indoor Environments and Their Application to COVID-19 Outbreaks
Zhe Peng, A.L. Pineda Rojas, Emilio Kropff, William P. Bahnfleth, Giorgio Buonanno, Stephanie J. Dancer, Jarek Kurnitski, Yichen Li, Marcel Loomans, Linsey C. Marr, Lídia Morawska, William W. Nazaroff, Catherine J. Noakes, Xavier Querol, Chandra Sekhar, Raymond Tellier, Trisha Greenhalgh, Lydia Bourouiba, Atze Boerstra, Julian W. Tang, Shelly L. Miller, J. L. Jiménez
Abstract
). They combine the key factors that control airborne disease transmission indoors: virus-containing aerosol generation rate, breathing flow rate, masking and its quality, ventilation and aerosol-removal rates, number of occupants, and duration of exposure. COVID-19 outbreaks show a clear trend that is consistent with airborne infection and enable recommendations to minimize transmission risk. Transmission in typical prepandemic indoor spaces is highly sensitive to mitigation efforts. Previous outbreaks of measles, influenza, and tuberculosis were also assessed. Measles outbreaks occur at much lower risk parameter values than COVID-19, while tuberculosis outbreaks are observed at higher risk parameter values. Because both diseases are accepted as airborne, the fact that COVID-19 is less contagious than measles does not rule out airborne transmission. It is important that future outbreak reports include information on masking, ventilation and aerosol-removal rates, number of occupants, and duration of exposure, to investigate airborne transmission.