It Is Time to Address Airborne Transmission of Coronavirus Disease 2019 (COVID-19)

Studies by the signatories and other scientists have demonstrated beyond any reasonable doubt that viruses are released during exhalation, talking, and coughing in microdroplets small enough to remain aloft in air and pose a risk of exposure at distances beyond 1 to 2 m from an infected individual (see e.g. [1-4]). For example, at typical indoor air velocities [5], a 5 μm droplet will travel tens of meters, much greater than the scale of a typical room, while settling from a height of 1.5 m to the floor. Several retrospective studies conducted after the SARS-CoV-1 epidemic demonstrated that airborne transmission was the most likely mechanism explaining the spatial pattern of infections e.g. [6]. Retrospective analysis has shown the same for SARS-CoV-2 [7-10]. In particular, a study in their review of records from a Chinese restaurant, observed no evidence of direct or indirect contact between the three parties [10]. In their review of video records from the restaurant, they observed no evidence of direct or indirect contact between the three parties. Many studies conducted on the spread of other viruses, including respiratory syncytial virus (RSV) [11], Middle
East Respiratory Syndrome coronavirus (MERS-CoV) [8], and influenza [2,4], show that viable airborne viruses can be exhaled [2] and/or detected in the indoor environment of infected patients [11-12]. This poses the risk that people sharing such environments can potentially inhale these viruses, resulting in infection and disease. There is every reason to expect that SARS-CoV-2 behaves
similarly, and that transmission via airborne microdroplets [10,13] is an important pathway. Viral RNA associated with droplets smaller than 5 μm has been detected in air [14], and the virus has been shown to maintain infectivity in droplets of this size [9]. Other viruses have been shown to
survive equally well, if not better, in aerosols compared to droplets on a surface [15].