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      Combining Phi6 as a surrogate virus and computational large‐eddy simulations to study airborne transmission of SARS‐CoV‐2 in a restaurant

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          Abstract

          COVID‐19 has highlighted the need for indoor risk‐reduction strategies. Our aim is to provide information about the virus dispersion and attempts to reduce the infection risk. Indoor transmission was studied simulating a dining situation in a restaurant. Aerosolized Phi6 viruses were detected with several methods. The aerosol dispersion was modeled by using the Large‐Eddy Simulation (LES) technique. Three risk‐reduction strategies were studied: (1) augmenting ventilation with air purifiers, (2) spatial partitioning with dividers, and (3) combination of 1 and 2. In all simulations infectious viruses were detected throughout the space proving the existence long‐distance aerosol transmission indoors. Experimental cumulative virus numbers and LES dispersion results were qualitatively similar. The LES results were further utilized to derive the evolution of infection probability. Air purifiers augmenting the effective ventilation rate by 65% reduced the spatially averaged infection probability by 30%–32%. This relative reduction manifests with approximately 15 min lag as aerosol dispersion only gradually reaches the purifier units. Both viral findings and LES results confirm that spatial partitioning has a negligible effect on the mean infection‐probability indoors, but may affect the local levels adversely. Exploitation of high‐resolution LES jointly with microbiological measurements enables an informative interpretation of the experimental results and facilitates a more complete risk assessment.

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          A Novel Coronavirus from Patients with Pneumonia in China, 2019

          Summary In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)
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            Temporal dynamics in viral shedding and transmissibility of COVID-19

            We report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector-infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% (95% confidence interval, 25-69%) of secondary cases were infected during the index cases' presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home. Disease control measures should be adjusted to account for probable substantial presymptomatic transmission.
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              Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

              Summary Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. Methods We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047. Findings Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; p interaction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; p interaction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. Interpretation The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance. Funding World Health Organization.
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                Author and article information

                Contributors
                antti.hellsten@fmi.fi
                nina.atanasova@helsinki.fi
                Journal
                Indoor Air
                Indoor Air
                10.1111/(ISSN)1600-0668
                INA
                Indoor Air
                John Wiley and Sons Inc. (Hoboken )
                0905-6947
                1600-0668
                27 November 2022
                November 2022
                : 32
                : 11 ( doiID: 10.1111/ina.v32.11 )
                : e13165
                Affiliations
                [ 1 ] Department of Otorhinolaryngology and Phoniatrics – Head and Neck Surgery Helsinki University Hospital Helsinki Finland
                [ 2 ] Faculty of Medicine University of Helsinki Helsinki Finland
                [ 3 ] Finnish Meteorological Institute Helsinki Finland
                [ 4 ] Faculty of Biological and Environmental Sciences University of Helsinki Helsinki Finland
                [ 5 ] Faculty of Biological and Environmental Sciences University of Helsinki Lahti Finland
                [ 6 ] Finnish Institute of Occupational Health Helsinki Finland
                [ 7 ] Faculty of Veterinary Medicine, Food Hygiene and Environmental Health University of Helsinki Helsinki Finland
                [ 8 ] Department of Virology, Faculty of Medicine University of Helsinki Helsinki Finland
                [ 9 ] Department of Veterinary Biosciences, Faculty of Veterinary Medicine University of Helsinki Helsinki Finland
                Author notes
                [*] [* ] Correspondence

                Nina Atanasova, Faculty of Biological and Environmental Sciences, University of Helsinki and Finnish Meteorological Institute, P.O. Box 56, Helsinki FI‐00014, Finland.

                Email: nina.atanasova@ 123456helsinki.fi

                Antti Hellsten, Finnish Meteorological Institute, P.O. Box 503, Helsinki FI‐00014, Finland.

                Email: antti.hellsten@ 123456fmi.fi

                Author information
                https://orcid.org/0000-0002-0344-5078
                https://orcid.org/0000-0002-6927-825X
                https://orcid.org/0000-0003-3270-5972
                https://orcid.org/0000-0002-8570-1134
                https://orcid.org/0000-0003-0473-3327
                https://orcid.org/0000-0001-7938-071X
                https://orcid.org/0000-0002-0841-5353
                https://orcid.org/0000-0003-0209-5501
                https://orcid.org/0000-0003-1617-1181
                https://orcid.org/0000-0001-5343-0870
                https://orcid.org/0000-0002-2448-0841
                https://orcid.org/0000-0002-2344-2755
                https://orcid.org/0000-0002-7448-7144
                https://orcid.org/0000-0002-2548-1459
                https://orcid.org/0000-0003-1120-7405
                Article
                INA13165 INA-22-06-311.R1
                10.1111/ina.13165
                10100099
                36437671
                63b192ce-5833-4fea-8203-96097ec07d76
                © 2022 The Authors. Indoor Air published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 September 2022
                : 17 June 2022
                : 08 October 2022
                Page count
                Figures: 13, Tables: 10, Pages: 25, Words: 12709
                Funding
                Funded by: Academy of Finland , doi 10.13039/501100002341;
                Award ID: 335681
                Award ID: 309570
                Funded by: Business Finland , doi 10.13039/501100014438;
                Award ID: 40988/31/2020
                Funded by: Scientific Advisory Board for Defense, MATINE, Finland
                Award ID: VN/627/2020‐PLM‐9
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                November 2022
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.7 mode:remove_FC converted:13.04.2023

                Health & Social care
                aerosol transmission,air purifiers,covid‐19,infection‐probability,infective viruses,space dividers

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