Of all the mysteries that remain about COVID-19, how exactly it spreads is arguably the most contentious. Both the Centers for Disease Control and Prevention and the World Health Organization assert that it’s transmitted mainly through large respiratory droplets, and rarely via surfaces (which were initially of major concern). But this week, in a letter to WHO, 239 scientists and environmental experts expressed concern about another, more elusive route of transmission: tiny particles in the air.
The letter, obtained by the Washington Post, urged the organization to take airborne transmission seriously. “There is significant potential for inhalation exposure to viruses in microscopic respiratory droplets (microdroplets) at short to medium distances (up to several meters, or room-scale), and we are advocating for the use of preventive measures to mitigate this route of airborne transmission,” the letter reads.
It goes on to outline evidence of other viruses, including MERS and influenza, spreading through the air, and to recommend precautions to mitigate this risk, including more ventilation in buildings, “airborne infection controls” such as germicidal ultraviolet lights and avoiding overcrowding in indoor spaces. The WHO responded to the letter on Tuesday by acknowledging that evidence of airborne transmission is “emerging.”
While the environmental experts who supported the letter are pushing for structural changes like filters and UV lights, epidemiologists tell Yahoo Life that the letter highlights the danger the virus poses indoors — and adds further urgency to the need for the U.S. to adopt widespread mask mandates.
Dr. Eric Feigl-Ding, an epidemiologist from Harvard University who was one of the first to blow the whistle on the pandemic potential of COVID-19, has a unique way of visualizing it. “A virus transmission is kind of like secondhand smoke — it’s secondhand breathing from someone else,” says Feigl-Ding. “There is no such thing as a smoke-free part of a restaurant. Given what we know about secondhand smoke, the smoke will go everywhere, therefore it hurts the waitresses and bartenders and people who work there who don’t want to smoke but they’re kind of stuck with the occupational hazard of it.”
Thus far, the evidence on whether the coronavirus is spread through microdroplets is still unclear. But Feigl-Ding — who is also a senior fellow at the Federation of American Scientists — says there is enough evidence of masks providing some protection against microdroplets to require them everywhere. Given the rising resistance to wearing masks and the public outbursts against them, he believes the U.S. should be ramping up its efforts to mandate masks — perhaps through creative measures.
“This study highlights the importance of masks … and it shows that masks are really effective, even cloth masks,” says Feigl-Ding. “People are protesting mask mandates, but we need them because people are not wearing them. I think we have to think through the policies — should the mask enforcement be like a civilian speeding ticket?”
Feigl-Ding worries that holding individuals responsible, however, may not be the smartest way, and suggests that perhaps businesses should be required to enforce mask mandates instead. “It’s like, don’t sell cigarettes or alcohol to underage minors, and if you do, then you’re going to lose your liquor license,” he says. “I think businesses might be more palatable.”
Also in favor of a mask mandate is Dr. William Schaffner, an infectious disease expert at Vanderbilt University. “You know, if we all wore masks, we wouldn’t have to worry about airborne [transmission] either,” he says. “They prevent two things: the start of the airborne transmission — because they hold things in — and No. 2, they provide you some protection for the airborne transmission coming into you.”
Schaffner says masks should be a regular part of everyone’s routine. “If I had a magic wand, I’d have everybody in the United States wearing a mask today … as long as you’re close to people,” he says. “Of course, if you’re far away from people, if you’re walking down the sidewalk and nobody else is around, or you’re out jogging and nobody else is around, then you don’t have to wear a mask. But if you’re interacting with people in any way, you should be wearing a mask.”
Like Feigl-Ding, Schaffner thinks mask mandates may be the only way to ensure that they’re worn. “I’ve come reluctantly to the notion that we have to oblige people,” says Schaffner. “We have to require them to wear a mask. Otherwise, a very substantial portion of the population either is unaware or doesn’t care.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.
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