Tags

Type your tag names separated by a space and hit enter

SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles.
Clin Microbiol Rev. 2020 12 16; 34(1)CM

Abstract

Since the beginning of the COVID-19 pandemic, there has been intense debate over SARS-CoV-2's mode of transmission and appropriate personal protective equipment for health care workers in low-risk settings. The objective of this review is to identify and appraise the available evidence (clinical trials and laboratory studies on masks and respirators, epidemiological studies, and air sampling studies), clarify key concepts and necessary conditions for airborne transmission, and shed light on knowledge gaps in the field. We find that, except for aerosol-generating procedures, the overall data in support of airborne transmission-taken in its traditional definition (long-distance and respirable aerosols)-are weak, based predominantly on indirect and experimental rather than clinical or epidemiological evidence. Consequently, we propose a revised and broader definition of "airborne," going beyond the current droplet and aerosol dichotomy and involving short-range inhalable particles, supported by data targeting the nose as the main viral receptor site. This new model better explains clinical observations, especially in the context of close and prolonged contacts between health care workers and patients, and reconciles seemingly contradictory data in the SARS-CoV-2 literature. The model also carries important implications for personal protective equipment and environmental controls, such as ventilation, in health care settings. However, further studies, especially clinical trials, are needed to complete the picture.

Authors+Show Affiliations

Department of General Medicine, CIUSSS Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada sophie.zhang.ccsmtl@ssss.gouv.qc.ca caroline.duchaine@bcm.ulaval.ca. CHSLD Bruchési and CHSLD Jean De La Lande, Montreal, Canada. GMF-U Faubourgs, Montreal, Canada. Centre de Recherche et d'Aide aux Narcomanes, Montreal, Canada.Department of Biochemistry, Microbiology, and Bioinformatics, Université Laval, Quebec City, Canada sophie.zhang.ccsmtl@ssss.gouv.qc.ca caroline.duchaine@bcm.ulaval.ca. Quebec Heart and Lung Institute-Université Laval (CRIUCPQ), Quebec City, Canada.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33115724

Citation

Zhang, X Sophie, and Caroline Duchaine. "SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles." Clinical Microbiology Reviews, vol. 34, no. 1, 2020.
Zhang XS, Duchaine C. SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles. Clin Microbiol Rev. 2020;34(1).
Zhang, X. S., & Duchaine, C. (2020). SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles. Clinical Microbiology Reviews, 34(1). https://doi.org/10.1128/CMR.00184-20
Zhang XS, Duchaine C. SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles. Clin Microbiol Rev. 2020 12 16;34(1) PubMed PMID: 33115724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles. AU - Zhang,X Sophie, AU - Duchaine,Caroline, Y1 - 2020/10/28/ PY - 2020/10/29/entrez PY - 2020/10/30/pubmed PY - 2020/11/11/medline KW - COVID-19 KW - SARS-CoV-2 KW - bioaerosols KW - infection prevention KW - inhalable aerosols KW - low-risk settings KW - personal protective equipment KW - respiratory protection KW - ventilation JF - Clinical microbiology reviews JO - Clin Microbiol Rev VL - 34 IS - 1 N2 - Since the beginning of the COVID-19 pandemic, there has been intense debate over SARS-CoV-2's mode of transmission and appropriate personal protective equipment for health care workers in low-risk settings. The objective of this review is to identify and appraise the available evidence (clinical trials and laboratory studies on masks and respirators, epidemiological studies, and air sampling studies), clarify key concepts and necessary conditions for airborne transmission, and shed light on knowledge gaps in the field. We find that, except for aerosol-generating procedures, the overall data in support of airborne transmission-taken in its traditional definition (long-distance and respirable aerosols)-are weak, based predominantly on indirect and experimental rather than clinical or epidemiological evidence. Consequently, we propose a revised and broader definition of "airborne," going beyond the current droplet and aerosol dichotomy and involving short-range inhalable particles, supported by data targeting the nose as the main viral receptor site. This new model better explains clinical observations, especially in the context of close and prolonged contacts between health care workers and patients, and reconciles seemingly contradictory data in the SARS-CoV-2 literature. The model also carries important implications for personal protective equipment and environmental controls, such as ventilation, in health care settings. However, further studies, especially clinical trials, are needed to complete the picture. SN - 1098-6618 UR - https://www.unboundmedicine.com/medline/citation/33115724/SARS_CoV_2_and_Health_Care_Worker_Protection_in_Low_Risk_Settings:_a_Review_of_Modes_of_Transmission_and_a_Novel_Airborne_Model_Involving_Inhalable_Particles_ L2 - http://cmr.asm.org/cgi/pmidlookup?view=long&pmid=33115724 DB - PRIME DP - Unbound Medicine ER -