A quantitative analysis of the viral transmission risk in public spaces al- lows us to identify the dominant mechanisms that a proactive public health policy can act upon to reduce risk, and to evaluate the reduction of risk that can be obtained. The contribution of public spaces to the propa- gation of SARS-CoV-2 can be reduced to a level necessary for a declining epidemic, i.e. an overall reproduction rate below one. Here, we revisit the quantitative assessment of indoor and outdoor transmission risk. We show that the long-range aerosol transmission is controlled by the flow rate of fresh air and by the mask filtering quality, and is quantitatively re- lated to the CO2 concentration, regardless the room volume and the num- ber of people. The short-range airborne transmission is investigated ex- perimentally using dedicated dispersion experiments performed in two shopping malls. Exhaled aerosols are dispersed by turbulent draughts in a cone, leading to a concentration inversely proportional to the squared dis- tance and to the flow velocity. We show that the average infection dose, called the viral quantum, can be determined from epidemiological data in a manner consistent with biological experimental data. Practical implications. The results provide quantitative guidance useful for making rational public health policy decisions to prevent the dominant routes of viral transmission through reinforced ventilation, air purification, mechanical dispersion using fans, and incentivizing the wear- ing of correctly fitted, quality facial masks (surgical masks, possibly cov- ered by another fabric mask, or non-medical FFP2 masks). Taken to- gether, such measures significantly reduce the airborne transmission risk of SARS-CoV-2.
Preventive measures to reduce infection are needed to combat the COVID-19 pandemic and prepare for a possible endemic phase. Current prophylactic vaccines are highly effective to prevent disease but lose their ability to reduce viral transmission as viral evolution leads to increasing immune escape. Long term proactive public health policies must therefore complement vaccination with available nonpharmaceutical interventions (NPI) aiming to reduce the viral transmission risk in public spaces. Here, we revisit the quantitative assessment of airborne transmission risk, considering asymptotic limits that considerably simplify its expression. We show that the aerosol transmission risk is the product of three factors: a biological factor that depends on the viral strain, a hydrodynamical factor defined as the ratio of concentration in viral particles between inhaled and exhaled air, and a face mask filtering factor. The short range contribution to the risk, both present indoors and outdoors, is related to the turbulent dispersion of exhaled aerosols by air drafts and by convection (indoor), or by the wind (outdoors). We show experimentally that airborne droplets and CO2 molecules present the same dispersion. As a consequence, the dilution factor, and therefore the risk, can be measured quantitatively using the CO2 concentration, regardless of the room volume, the flow rate of fresh air and the occupancy. We show that the dispersion cone leads to a concentration in viral particles, and therefore a short range transmission risk, inversely proportional to the squared distance to an infected person and to the flow velocity. The aerosolization criterion derived as an intermediate result, which compares the Stokes relaxation time to the Lagrangian time scale, may find application for a broad class of aerosol-borne pathogens and pollutants.
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