Surgical Mask Partition Reduces the Risk of Noncontact Transmission in a Golden Syrian Hamster Model for Coronavirus Disease 2019 (COVID-19)

Abstract

Background Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is believed to be mostly transmitted by medium-to-large sized respiratory droplets although airborne transmission is theoretically possible in healthcare settings involving aerosol-generating procedures. Exposure to respiratory droplets can theoretically be reduced by surgical mask usage. However, there is a lack of experimental evidence supporting surgical mask usage for prevention of COVID-19. Methods We used a well-established golden Syrian hamster SARS-CoV-2 model. We placed SARS-CoV-2-challenged index hamsters and naïve hamsters into closed system units each comprising two different cages separated by a polyvinyl chloride air porous partition with unidirectional airflow within the isolator. The effect of a surgical mask partition placed in between the cages was investigated. Besides clinical scoring, hamster specimens were tested for viral load, histopathology, and viral nucleocapsid antigen expression. Results Non-contact transmission was found in 66.7% (10/15) of exposed naïve hamsters. Surgical mask partition for challenged index or naïve hamsters significantly reduced transmission to 25% (6/24, P=0.018). Surgical mask partition for challenged index hamsters significantly reduced transmission to only 16.7% (2/12, P=0.019) of exposed naïve hamsters. Unlike the severe COVID-19 manifestations of challenged hamsters, infected naïve hamsters had lower clinical scores, milder histopathological changes, and lower viral nucleocapsid antigen expression in respiratory tract tissues. Conclusions SARS-CoV-2 could be transmitted by respiratory droplets or airborne droplet nuclei in the hamster model. Such transmission could be reduced by surgical mask usage, especially when masks were worn by infected individuals.

Host and viral determinants for efficient SARS-CoV-2 infection of the human lung

“…RNA extraction and qRT-PCR were performed as we previously described 50,51 . Cell lysates and tissue samples were lysed by RLT buffer (Qiagen) and extracted with the RNeasy Mini kit (74106, Qiagen).…”

Characterization of cells susceptible to SARS-COV-2 and methods for detection of neutralizing antibody by focus forming assay

“…Further studies are warranted to determine what factors are necessary and sufficient for viral egress and could therefore serve as potential therapeutic targets. Multiple groups have demonstrated success using golden Syrian hamsters to model SARS-CoV-2 infection, pathogenesis, and possibly transmission[35,[52][53][54], which may reflect differing susceptibility of hamster cell types based on anatomical location of the isolated cells.…”

Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

“…We strongly recommend that cancer patients and HCWs wear a surgical mask to prevent SARS-CoV-2 transmission and infection (AII t ). 57 , 58 , 59 , 60 If caring for COVID-19 patients, we strongly recommend that HCWs wear FFP2/N95 respirators (AII t ) and personal protective equipment including gloves, gowns and eye protection such as goggles or face shields (AII r ). 22 , 61 , 62 , 63 , 64 Patients with COVID-19 are strongly recommended to wear a surgical mask or FFP2/N95 respirator without exhalation valve (AII t ) taking into account the protective equipment of their surroundings.…”

“… 22 , 61 , 62 , 63 , 64 Patients with COVID-19 are strongly recommended to wear a surgical mask or FFP2/N95 respirator without exhalation valve (AII t ) taking into account the protective equipment of their surroundings. 22 , 57 , 58 …”