Although airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been recognized, the condition of ventilation for its occurrence is still being debated. We analyzed a coronavirus disease 2019 (COVID-19) outbreak involving three families in a restaurant in Guangzhou, China, assessed the possibility of airborne transmission, and characterized the associated environmental conditions. We collected epidemiological data, obtained a full video recording and seating records from the restaurant, and measured the dispersion of a warm tracer gas as a surrogate for exhaled droplets from the index case. Computer simulations were performed to simulate the spread of fine exhaled droplets. We compared the in-room location of subsequently infected cases and spread of the simulated virus-laden aerosol tracer. The ventilation rate was measured using the tracer gas concentration decay method. This outbreak involved ten infected persons in three families (A, B, C). All ten persons ate lunch at three neighboring tables at the same restaurant on January 24, 2020. None of the restaurant staff or the 68 patrons at the other 15 tables became infected. During this occasion, the measured ventilation rate was 0.9 L/s per person. No close contact or fomite contact was identified, aside from back-to-back sitting in some cases. Analysis of the airflow dynamics indicates that the infection distribution is consistent with a spread pattern representative of long-range transmission of exhaled virus-laden aerosols. Airborne transmission of the SARS-CoV-2 virus is possible in crowded space with a ventilation rate of 1 L/s per person.

words)Main text (3456 words) AbstractBackground: The role of aerosols in the transmission of SARS-CoV-2 remains debated. We analysed an outbreak involving three non-associated families in Restaurant X in Guangzhou, China, and assessed the possibility of aerosol transmission of SARS-CoV-2 and characterize the associated environmental conditions. : medRxiv preprint 2 Methods: We collected epidemiological data, obtained a video record and a patron seatingarrangement from the restaurant, and measured the dispersion of a warm tracer gas as a surrogate for exhaled droplets from the suspected index patient. Computer simulations were performed to simulate the spread of fine exhaled droplets. We compared the in-room location of subsequently infected cases and spread of the simulated virus-laden aerosol tracer. The ventilation rate was measured using the tracer decay method.Results: Three families (A, B, C), 10 members of which were subsequently found to have been infected with SARS-CoV-2 at this time, or previously, ate lunch at Restaurant X on Chinese New Year's Eve (January 24, 2020) at three neighboring tables. Subsequently, three members of family B and two members of family C became infected with SARS-CoV-2, whereas none of the waiters or 68 patrons at the remaining 15 tables became infected. During this occasion, the ventilation rate was 0.75-1.04 L/s per person. No close contact or fomite contact was observed, aside from back-to-back sitting by some patrons. Our results show that the infection distribution is consistent with a spread pattern representative of exhaled virus-laden aerosols.Conclusions: Aerosol transmission of SARS-CoV-2 due to poor ventilation may explain the community spread of COVID-19.

The presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in fecal material has raised the possibility of viral transmission via a fecal–oral route. This study investigated whether SARS-CoV-2 transmission via fecal aerosols in the drainage pipe system may have been the cause of COVID-19 infection in a cluster of 3 families living in a high-rise building in China.

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Vascular endothelial growth factor (VEGF; also called vascular permeability factor) is a secreted mitogen with distinct target cell specificity for vascular endothelial cells. Hypoxia upregulates VEGF expression, making it a likely mediator of the angiogenesis that occurs in poorly perfused tissues. The purpose of this study was to determine whether VEGF gene expression is upregulated in chronically stimulated skeletal muscles, where hypoxia is thought to trigger the growth of blood vessels. The right anterior tibialis and extensor digitorum longus muscles of 12 rats were stimulated electrically (10 Hz, 300 microseconds pulses) for up to 21 days by way of the peroneal motor nerve. The contralateral muscles served as control. Northern analysis showed that VEGF mRNA levels increased by approximately sixfold after 4 days of stimulation and then decreased gradually over the next several days. VEGF mRNA levels were still elevated by two- to threefold after 21 days of stimulation. Higher VEGF mRNA levels in the early stages of muscle stimulation and gradually decreasing levels in later stages are consistent with a metabolic hypothesis in which tissue oxygenation controls VEGF expression. These studies support the hypothesis that VEGF has a physiological role in promoting angiogenesis in stimulated skeletal muscle.

a b s t r a c tBy performing unsteady CFD simulations using RNG ke 3 model and dynamic mesh technique, this paper investigates how the walking motion of health care worker (HCW) influences gaseous dispersion in a sixbed isolation room with nine downward supplies and six ceiling-level or floor-level exhausts. The flow near and behind HCW is easily affected by HCW motion. The flow disturbance induced by HCW walking with swinging arms and legs is a mixing process. The walking HCW displaces air in front of it and carries air in the wake forwardly, meanwhile pressure difference drives air from two lateral sides into the wake. HCW motion (0e5.4 s) indeed induces a little gaseous dispersion, but the residual flow disturbance after HCW stops (5.4 se25.4 s) induces more gaseous agent spread and it requires more than 30e60 s to approximately recover to the initial state after HCW stops.Although HCW motion indeed affects airborne transmission, but its effect is less important than ventilation design. No matter with or without HCW motion, the ceiling-level exhausts perform much better in controlling airborne transmission than the floor-level exhausts with the same air change rate (12.9 ACH). Smaller air change rate of 6 ACH experiences higher concentration and more gaseous spread than 12.9 ACH. In contrast to the realistic human walking, the simplified motion of a rectangular block produces stronger flow disturbance. Finally surface heating of HCW produces a stronger thermal body plume and enhances turbulence near HCW, thus slightly strengthens airborne transmission.

J o u r n a l P r e -p r o o f  RH=95% induces less droplets suspended in air and more deposition fraction(85%-100%). Wet air, sitting at nonadjacent seats, supply to bus backward reduce infection risk. AbstractDroplet dispersion carrying viruses/bacteria in enclosed/crowded buses may induce transmissions of respiratory infectious diseases, but the influencing mechanisms have been rarely investigated. By conducting high-resolution CFD simulations, this paper investigates the evaporation and transport of solid-liquid mixed droplets (initial diameter 10μm and 50μm, solid to liquid ratio is 1:9) exhaled in a coach bus with 14 thermal manikins. Five air-conditioning supply directions and ambient relative humidity (RH=35% and 95%) are considered. Results show that ventilation effectiveness, RH and initial droplet size significantly influence droplet transmissions in coach bus. 50μm droplets tend to evaporate completely within 1.8s and 7s as RH=35% and 95% respectively, while 0.2s or less for 10μm droplets. Thus 10μm droplets diffuse farther with wider range than 50μm droplets which tend to deposit more on surfaces. Droplet dispersion pattern differs due to various interactions of gravity, ventilation flows and the upward thermal body plume. The fractions of droplets suspended in air, deposited on wall surfaces are quantified. This study implies high RH, backward supply direction and passengers sitting at nonadjacent seats can effectively reduce infection risk of droplet transmission in buses. Besides taking masks, regular cleaning is also recommended since 85%-100% of droplets deposit on object surfaces.J o u r n a l P r e -p r o o f

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