The world needs to reconsider the Olympic Games planned for this summer, experts warned last night amid concerns that “close airborne transmission” will fuel a further wave of the COVID-19 pandemic.
The BMJ cites one expert calling for postponement of the games in Tokyo as it reports analysis of the sources of infection.
Tackling the issue of close airborne transmission is essential for reducing the spread of COVID-19 because it is the primary route for the virus, respiratory experts write in the journal.
In an editorial in the latest edition of The BMJ they argue it is now apparent that SARS-CoV-2 is most likely to be transmitted when people are at close range through inhalation, rather than via contact with surfaces or longer range airborne routes, although it is possible to develop COVID-19 through these routes.
The experts from the universities of Leicester, Edinburgh Napier and Hong Kong, Virginia Tech, and NHS Lanarkshire, Edinburgh say the COVID-19 pandemic has contributed to the redefinition of airborne transmission of viruses.
They write a person breathing in particles, regardless of their size or name, are breathing in aerosols, and while this can happen at long range, it is more likely to happen when being close to someone because the aerosols between two people.
Wearing masks, being physically distanced and reducing indoor occupancy all help to lessen the usual routes of transmission, but the addition of ventilation is also important because the tiniest suspended particles can remain in the air for hours and these are an important route of transmission.
It is, they say, important for air to be replaced or cleaned, through opening windows, installing or upgrading heating, ventilation, and using air conditioning systems.
Good-fitting, high-quality masks with high filtration are also imperative to ensure effective protection against inhaled aerosols.
They maintain that improving indoor air quality through better ventilation will bring other benefits, such as reduced sick leave for other respiratory viruses and other environmentally related complaints, including allergies and sick building syndrome.
And they argue that the cost of upgrading ventilation systems would be offset less absenteeism with its impact on productivity.
“COVID-19 may well become seasonal, and we will have to live with it as we do with influenza,” they write. “So, governments and health leaders should heed the science and focus their efforts on airborne transmission.
“Safer indoor environments are required, not only to protect unvaccinated people and those for whom vaccines fail, but also to deter vaccine resistant variants or novel airborne threats that may appear at any time.
“Improving indoor ventilation and air quality, particularly in healthcare, work, and educational environments, will help all of us to stay safe, now and in the future.”
The call was backed today by the British Medical Association.
Its chair Dr Chaand Nagpaul said: “There has been much discussion by the Government and in the media about ‘hands, face and space’ but much less about the critical importance of fresh air and throughflow in buildings and on public transport. As restrictions are eased, and there is greater mixing between people in enclosed spaces, it is vital that measures are taken to ensure adequate ventilation.
“This should include explicit specifications on ventilation requirements in public and work settings, including in the hospitality sector such as restaurants, bars and pubs. Investment will also be needed to make sure our hospitals, clinics and GP surgeries are ventilated correctly and that our NHS workers and patients are kept as safe as possible.
“A failure to ensure adequate levels of ventilation in indoor areas runs the serious risk of a rebound increase in COVID-19 infections.”
Writing in the journal, Kazuki Shimizu, of the London School of Economics, say that “huge uncertainty” remains about the course of the pandemic.
The games risk important variants of concern to Japan, he writes, stating: “Japan must develop and implement a clear strategy to eliminate community transmission within its borders, as Australia did before the Australian Open tennis tournament.”
Tang J, Marr L, Li Y et al. COVID-19 has redefined airborne transmission. BMJ 15 April 2021
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