In a new study from the National University of Singapore, researchers found fine aerosols emitted during talking and singing may play a crucial role in COVID-19 transmission.
They found that fine aerosols (less than 5 micrometers, or μm) generated from these two types of activities contain more viral particles than coarse aerosols (more than 5 μm).
The fine respiratory aerosols may play a significant role in SARS-CoV-2 transmission, especially in an indoor environment.
The coronavirus disease 2019 (COVID-19) has been thought to spread primarily when an infected person coughs or sneezes, but little is known about its transmissibility through activities such as breathing, talking and singing.
In the study, the team tested 22 COVID-19 positive patients. The participants had to perform three separate expiratory activities on the same day.
These activities involved 30 minutes of breathing, 15 minutes of talking in the form of reading aloud passages from a children’s book, and 15 minutes of singing different songs, with rest between activities.
The participants had to carry out these three activities using specially designed exhalation collection equipment.
Aerosols were collected in two size fractions, namely coarse (more than 5 μm) and fine (less or equal to 5 μm).
The team found that COVID-19 patients who are early in the course of illness are likely to shed detectable levels of SARS-CoV-2 RNA in respiratory aerosols.
However, person-to-person variation in virus emission was high. Some patients surprisingly released more virus from talking than singing.
The result provides direct measurements to show that besides respiratory droplets, virus particles emitted in exhaled breath and vocalization activities are likely important for transmitting SARS-CoV-2.
The findings suggest that exposure to fine-particle aerosols needs to be mitigated, especially in indoor environments where airborne transmission of SARS-CoV-2 is most likely to occur. Reducing exposure to fine respiratory aerosols can be achieved through many ways, such as universal masking, physical distancing, increased room ventilation, more efficient filtration and air-cleaning technologies.
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The study is published in Clinical Infectious Diseases. One author of the study is Associate Professor Tham Kwok Wai.
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