Experimental aerosol survival of SARS-CoV-2 in artificial saliva and tissue culture media at medium and high humidity

Smither, Sophie J.; Eastaugh, Lin; Findlay, James S.; Lever, Mark S.

doi:10.1080/22221751.2020.1777906

Cited by 179 publications

(214 citation statements)

References 14 publications

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“…These results showed that the stability of SARS-CoV-2 was similar to that of SARS-CoV-1. Smither et al reported that SARS-CoV-2 is more stable at a medium RH of 40–60% (decay rate, 0.91%/min) compared with a higher RH of 68–88% (decay rate, 1.59%/min) in tissue culture media (TCM), whereas the converse was observed in artificial saliva, with a decay rate of 2.27% per minute at a medium RH and 0.40% per minute at a higher RH [ 29 ]. The results of the half-life obtained with TCM at a medium RH were similar to those described above [ 28 ].…”

Section: Environmental Factors Involved In Sars-cov-2 Inside Buildingmentioning

confidence: 99%

Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control

Azuma

Yanagi

Kagi

et al. 2020

Environ Health Prev Med

178

157

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a new zoonotic agent that emerged in December 2019, causes coronavirus disease 2019 (COVID-19). This infection can be spread by asymptomatic, presymptomatic, and symptomatic carriers. SARS-CoV-2 spreads primarily via respiratory droplets during close person-to-person contact in a closed space, especially a building. This article summarizes the environmental factors involved in SARS-CoV-2 transmission, including a strategy to prevent SARS-CoV-2 transmission in a building environment. SARS-CoV-2 can persist on surfaces of fomites for at least 3 days depending on the conditions. If SARS-CoV-2 is aerosolized intentionally, it is stable for at least several hours. SARS-CoV-2 is inactivated rapidly on surfaces with sunlight. Close-contact aerosol transmission through smaller aerosolized particles is likely to be combined with respiratory droplets and contact transmission in a confined, crowded, and poorly ventilated indoor environment, as suggested by some cluster cases. Although evidence of the effect of aerosol transmission is limited and uncertainty remains, adequate preventive measures to control indoor environmental quality are required, based on a precautionary approach, because COVID-19 has caused serious global damages to public health, community, and the social economy. The expert panel for COVID-19 in Japan has focused on the “3 Cs,” namely, “closed spaces with poor ventilation,” “crowded spaces with many people,” and “close contact.” In addition, the Ministry of Health, Labour and Welfare of Japan has been recommending adequate ventilation in all closed spaces in accordance with the existing standards of the Law for Maintenance of Sanitation in Buildings as one of the initial political actions to prevent the spread of COVID-19. However, specific standards for indoor environmental quality control have not been recommended and many scientific uncertainties remain regarding the infection dynamics and mode of SARS-CoV-2 transmission in closed indoor spaces. Further research and evaluation are required regarding the effect and role of indoor environmental quality control, especially ventilation.

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Section: Environmental Factors Involved In Sars-cov-2 Inside Buildingmentioning

confidence: 99%

Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control

Azuma

Yanagi

Kagi

et al. 2020

Environ Health Prev Med

178

157

View full text Add to dashboard Cite

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“…25 Experiments with aerosolised SARS-CoV-2 in artificial saliva have shown it to be twice as stable as influenza at medium humidity (40%-60%), and to have longer viability in high humidity (68%-88%) compared with lower humidities. 26 Interventions clinicians can undertake personally include self-distancing (eg, from a coughing patient) and careful doffing of personal protective equipment. Consideration should also be given to continuous masking by staff and patients.…”

Section: Discussionmentioning

confidence: 99%

Classification of aerosol-generating procedures: a rapid systematic review

et al. 2020

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In the context of covid-19, aerosol generating procedures have been highlighted as requiring a higher grade of personal protective equipment. We investigated how official guidance documents and academic publications have classified procedures in terms of whether or not they are aerosol-generating. We performed a rapid systematic review using preferred reporting items for systematic reviews and meta-analyses standards. Guidelines, policy documents and academic papers published in english or french offering guidance on aerosol-generating procedures were eligible. We systematically searched two medical databases (medline, cochrane central) and one public search engine (google) in march and april 2020. Data on how each procedure was classified by each source were extracted. We determined the level of agreement across different guidelines for each procedure group, in terms of its classification as aerosol generating, possibly aerosol-generating, or nonaerosol-generating. 128 documents met our inclusion criteria; they contained 1248 mentions of procedures that we categorised into 39 procedure groups. Procedures classified as aerosol-generating or possibly aerosol-generating by ≥90% of documents included autopsy, surgery/postmortem procedures with high-speed devices, intubation and extubation procedures, bronchoscopy, sputum induction, manual ventilation, airway suctioning, cardiopulmonary resuscitation, tracheostomy and tracheostomy procedures, non-invasive ventilation, high-flow oxygen therapy, breaking closed ventilation systems, nebulised or aerosol therapy, and high frequency oscillatory ventilation. Disagreements existed between sources on some procedure groups, including oral and dental procedures, upper gastrointestinal endoscopy, thoracic surgery and procedures, and nasopharyngeal and oropharyngeal swabbing. There is sufficient evidence of agreement across different international guidelines to classify certain procedure groups as aerosol generating. However, some clinically relevant procedures received surprisingly little mention in our source documents. To reduce dissent on the remainder, we recommend that (a) clinicians define procedures more clearly and specifically, breaking them down into their constituent components where possible; (b) researchers undertake further studies of aerosolisation during these procedures; and (c) guideline-making and policy-making bodies address a wider range of procedures.

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“…Experimental evidence on the airborne survival of SARS-CoV-2 was recently obtained by van Doremalen et al [53] and Smither et al [54] on different virus variants. van Doremalen et al [53] performed a bench-scale study in which both SARS-CoV-1 and SARS-CoV-2 were aerosolized, then the infectious viruses were quantified (TCID 50 / mL ).…”

Section: Survival Experimentsmentioning

confidence: 94%

“…Twelve papers performed experiments with coronaviruses at lab-scale with different aims: to evaluate performance of sampling methods [44][45][46][47][48] and to address the survival of coronavirus in experimental aerosolization scenarios [44,[49][50][51][52][53][54], also considering UV susceptibility [55].…”

Section: In Vitro Studies On Coronavirusmentioning

confidence: 99%

“…The majority of authors used human coronaviruses [44,45,49,[51][52][53][54], while the other studies considered surrogates, namely two animal coronaviruses, transmissible gastroenteritis virus (TGEV) [47,48] and murine hepatitis virus (MHV) [55], and the phage phi 6 [46,50]. Only two studies used the SARS-CoV-2, which requires strict safety containment and procedures (Biosafety Level 3).…”

Section: In Vitro Studies On Coronavirusmentioning

confidence: 99%

See 1 more Smart Citation

Covid-19 Airborne Transmission and Its Prevention: Waiting for Evidence or Applying the Precautionary Principle?

2020

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Besides the predominant ways of transmission of SARS-CoV-2 (namely, contacts and large droplets) the airborne one is increasingly taken into consideration as a result of latest research findings. Nevertheless, this possibility has been already suggested by previous studies on other coronaviruses including SARS-CoV and MERS-CoV. To describe the state of the art of coronaviruses and airborne transmission, a systematic review was carried out using the PRISMA methodology. Overall, 64 papers were selected and classified into three main groups: laboratory experiments (12 papers), air monitoring (22) and epidemiological and airflow model studies (30). The airborne transmission of SARS-CoV-2 is suggested by the studies of the three groups, but none has yet obtained complete evidence. The sampling and detection methods have not been validated, therefore monitoring results are affected by a possible underestimation. Then, epidemiological investigations only hypothesize the airborne transmission as a possible explanation for some illness cases, but without estimating its attributable risk. Nevertheless, while waiting for more evidence, it is urgent to base advice on preventive measures, such as the use of masks, safe distancing and air ventilation, on the precautionary principle.

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Experimental aerosol survival of SARS-CoV-2 in artificial saliva and tissue culture media at medium and high humidity

Cited by 179 publications

References 14 publications

Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control

Environmental factors involved in SARS-CoV-2 transmission: effect and role of indoor environmental quality in the strategy for COVID-19 infection control

Classification of aerosol-generating procedures: a rapid systematic review

Covid-19 Airborne Transmission and Its Prevention: Waiting for Evidence or Applying the Precautionary Principle?

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