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Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19.
Antimicrob Resist Infect Control. 2020 07 06; 9(1):100.AR

Abstract

OBJECTIVES

To determine the risk of SARS-CoV-2 transmission by aerosols, to provide evidence on the rational use of masks, and to discuss additional measures important for the protection of healthcare workers from COVID-19.

METHODS

Literature review and expert opinion.

SHORT CONCLUSION

SARS-CoV-2, the pathogen causing COVID-19, is considered to be transmitted via droplets rather than aerosols, but droplets with strong directional airflow support may spread further than 2 m. High rates of COVID-19 infections in healthcare-workers (HCWs) have been reported from several countries. Respirators such as filtering face piece (FFP) 2 masks were designed to protect HCWs, while surgical masks were originally intended to protect patients (e.g., during surgery). Nevertheless, high quality standard surgical masks (type II/IIR according to European Norm EN 14683) appear to be as effective as FFP2 masks in preventing droplet-associated viral infections of HCWs as reported from influenza or SARS. So far, no head-to-head trials with these masks have been published for COVID-19. Neither mask type completely prevents transmission, which may be due to inappropriate handling and alternative transmission pathways. Therefore, compliance with a bundle of infection control measures including thorough hand hygiene is key. During high-risk procedures, both droplets and aerosols may be produced, reason why respirators are indicated for these interventions.

Authors+Show Affiliations

Department of Infectious, Diseases and Hospital Hygiene, Freiburgstrasse, 3010, Bern, Switzerland. rami.sommerstein@insel.ch. Swissnoso, the National Center for Infection Control, Bern, Switzerland. rami.sommerstein@insel.ch.Department of Infectious Diseases and Hospital Hygiene, Aarau Cantonal Hospital, Aarau, Switzerland.Swissnoso, the National Center for Infection Control, Bern, Switzerland. Department of Infectious Diseases, Thurgau Cantonal Hospital, Thurgau, Switzerland.Infection Control Programme and Division of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.Department of Infectious, Diseases and Hospital Hygiene, Freiburgstrasse, 3010, Bern, Switzerland. Swissnoso, the National Center for Infection Control, Bern, Switzerland.Swissnoso, the National Center for Infection Control, Bern, Switzerland. Infection Control Programme, EOC Hospitals, Ticino, Switzerland.Swissnoso, the National Center for Infection Control, Bern, Switzerland. Service of Infectious Diseases, Central Institute, Valais Hospitals, Sion, Switzerland.Swissnoso, the National Center for Infection Control, Bern, Switzerland. Infection Control Programme and Division of Infectious Diseases, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.Swissnoso, the National Center for Infection Control, Bern, Switzerland. Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.Swissnoso, the National Center for Infection Control, Bern, Switzerland. Department of Infectious Diseases, University Hospital Basel, Basel, Switzerland.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

32631450

Citation

Sommerstein, Rami, et al. "Risk of SARS-CoV-2 Transmission By Aerosols, the Rational Use of Masks, and Protection of Healthcare Workers From COVID-19." Antimicrobial Resistance and Infection Control, vol. 9, no. 1, 2020, p. 100.
Sommerstein R, Fux CA, Vuichard-Gysin D, et al. Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. Antimicrob Resist Infect Control. 2020;9(1):100.
Sommerstein, R., Fux, C. A., Vuichard-Gysin, D., Abbas, M., Marschall, J., Balmelli, C., Troillet, N., Harbarth, S., Schlegel, M., & Widmer, A. (2020). Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. Antimicrobial Resistance and Infection Control, 9(1), 100. https://doi.org/10.1186/s13756-020-00763-0
Sommerstein R, et al. Risk of SARS-CoV-2 Transmission By Aerosols, the Rational Use of Masks, and Protection of Healthcare Workers From COVID-19. Antimicrob Resist Infect Control. 2020 07 6;9(1):100. PubMed PMID: 32631450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. AU - Sommerstein,Rami, AU - Fux,Christoph Andreas, AU - Vuichard-Gysin,Danielle, AU - Abbas,Mohamed, AU - Marschall,Jonas, AU - Balmelli,Carlo, AU - Troillet,Nicolas, AU - Harbarth,Stephan, AU - Schlegel,Matthias, AU - Widmer,Andreas, AU - ,, Y1 - 2020/07/06/ PY - 2020/05/18/received PY - 2020/06/23/accepted PY - 2020/7/8/entrez PY - 2020/7/8/pubmed PY - 2020/7/16/medline KW - Aerosol KW - COVID-19 KW - Droplet KW - Infection control KW - Mask KW - SARS-CoV-2 KW - Transmission SP - 100 EP - 100 JF - Antimicrobial resistance and infection control JO - Antimicrob Resist Infect Control VL - 9 IS - 1 N2 - OBJECTIVES: To determine the risk of SARS-CoV-2 transmission by aerosols, to provide evidence on the rational use of masks, and to discuss additional measures important for the protection of healthcare workers from COVID-19. METHODS: Literature review and expert opinion. SHORT CONCLUSION: SARS-CoV-2, the pathogen causing COVID-19, is considered to be transmitted via droplets rather than aerosols, but droplets with strong directional airflow support may spread further than 2 m. High rates of COVID-19 infections in healthcare-workers (HCWs) have been reported from several countries. Respirators such as filtering face piece (FFP) 2 masks were designed to protect HCWs, while surgical masks were originally intended to protect patients (e.g., during surgery). Nevertheless, high quality standard surgical masks (type II/IIR according to European Norm EN 14683) appear to be as effective as FFP2 masks in preventing droplet-associated viral infections of HCWs as reported from influenza or SARS. So far, no head-to-head trials with these masks have been published for COVID-19. Neither mask type completely prevents transmission, which may be due to inappropriate handling and alternative transmission pathways. Therefore, compliance with a bundle of infection control measures including thorough hand hygiene is key. During high-risk procedures, both droplets and aerosols may be produced, reason why respirators are indicated for these interventions. SN - 2047-2994 UR - https://www.unboundmedicine.com/medline/citation/32631450/Risk_of_SARS_CoV_2_transmission_by_aerosols_the_rational_use_of_masks_and_protection_of_healthcare_workers_from_COVID_19_ L2 - https://aricjournal.biomedcentral.com/articles/10.1186/s13756-020-00763-0 DB - PRIME DP - Unbound Medicine ER -