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SARS-CoV-2 Aerosol Transmission Indoors: A Closer Look at Viral Load, Infectivity, the Effectiveness of Preventive Measures and a Simple Approach for Practical Recommendations

Author

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  • Martin Kriegel

    (Hermann-Rietschel-Institut, Technical University of Berlin, 10623 Berlin, Germany)

  • Anne Hartmann

    (Hermann-Rietschel-Institut, Technical University of Berlin, 10623 Berlin, Germany)

  • Udo Buchholz

    (Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany)

  • Janna Seifried

    (Department for Infectious Disease Epidemiology, Robert Koch Institute, 13353 Berlin, Germany)

  • Sigrid Baumgarte

    (Local Health Authority “Hamburg-Nord”, 20249 Hamburg, Germany)

  • Petra Gastmeier

    (Institute for Hygiene and Environmental Medicine, Charité-University Medicine Berlin, 12203 Berlin, Germany)

Abstract

There is uncertainty about the viral loads of infectious individuals required to transmit COVID-19 via aerosol. In addition, there is a lack of both quantification of the influencing parameters on airborne transmission and simple-to-use models for assessing the risk of infection in practice, which furthermore quantify the influence of non-medical preventive measures. In this study, a dose–response model was adopted to analyze 25 documented outbreaks at infection rates of 4–100%. We show that infection was only possible if the viral load was higher than 10 8 viral copies/mL. Based on mathematical simplifications of our approach to predict the probable situational attack rate (PARs) of a group of persons in a room, and valid assumptions, we provide simplified equations to calculate, among others, the maximum possible number of persons and the person-related virus-free air supply flow necessary to keep the number of newly infected persons to less than one. A comparison of different preventive measures revealed that testing contributes the most to the joint protective effect, besides wearing masks and increasing ventilation. In addition, we conclude that absolute volume flow rate or person-related volume flow rate are more intuitive parameters for evaluating ventilation for infection prevention than air exchange rate.

Suggested Citation

  • Martin Kriegel & Anne Hartmann & Udo Buchholz & Janna Seifried & Sigrid Baumgarte & Petra Gastmeier, 2021. "SARS-CoV-2 Aerosol Transmission Indoors: A Closer Look at Viral Load, Infectivity, the Effectiveness of Preventive Measures and a Simple Approach for Practical Recommendations," IJERPH, MDPI, vol. 19(1), pages 1-31, December.
    • Handle: RePEc:gam:jijerp:v:19:y:2021:i:1:p:220-:d:711283
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    References listed on IDEAS

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    1. Roman Wölfel & Victor M. Corman & Wolfgang Guggemos & Michael Seilmaier & Sabine Zange & Marcel A. Müller & Daniela Niemeyer & Terry C. Jones & Patrick Vollmar & Camilla Rothe & Michael Hoelscher & To, 2020. "Author Correction: Virological assessment of hospitalized patients with COVID-2019," Nature, Nature, vol. 588(7839), pages 35-35, December.
    2. Jos Lelieveld & Frank Helleis & Stephan Borrmann & Yafang Cheng & Frank Drewnick & Gerald Haug & Thomas Klimach & Jean Sciare & Hang Su & Ulrich Pöschl, 2020. "Model Calculations of Aerosol Transmission and Infection Risk of COVID-19 in Indoor Environments," IJERPH, MDPI, vol. 17(21), pages 1-18, November.
    3. Roman Wölfel & Victor M. Corman & Wolfgang Guggemos & Michael Seilmaier & Sabine Zange & Marcel A. Müller & Daniela Niemeyer & Terry C. Jones & Patrick Vollmar & Camilla Rothe & Michael Hoelscher & To, 2020. "Virological assessment of hospitalized patients with COVID-2019," Nature, Nature, vol. 581(7809), pages 465-469, May.
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    Cited by:

    1. Sandra N. Jendrossek & Lukas A. Jurk & Kirsten Remmers & Yunus E. Cetin & Wolfgang Sunder & Martin Kriegel & Petra Gastmeier, 2023. "The Influence of Ventilation Measures on the Airborne Risk of Infection in Schools: A Scoping Review," IJERPH, MDPI, vol. 20(4), pages 1-21, February.
    2. Birte Knobling & Gefion Franke & Lisa Beike & Timo Dickhuth & Johannes K. Knobloch, 2022. "Reading the Score of the Air—Change in Airborne Microbial Load in Contrast to Particulate Matter during Music Making," IJERPH, MDPI, vol. 19(16), pages 1-13, August.

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