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New study on airborne COVID-19 spread warrants  tighter protocols

CNN Philippines — A report recently published by the medical journal Lancet that revealed COVID-19 transmission is predominantly airborne warrants stricter safety protocols in the Philippines’ public transport system and in enclosed office spaces, an expert said Monday.

Dr. Rontgene Solante, head of the Adult Infectious Diseases and Tropical Medicine department of San Lazaro Hospital, said in an interview with CNN Philippines’ The Source that tighter health protocols need to be implemented, including six feet of physical distancing, proper ventilation in enclosed spaces, and wearing of face masks with better filtration to protect people from airborne transmission.

Solante noted that a COVID-19 droplet transmission usually reaches a person within a 3-foot distance either through inhalation or by touching a surface. But an aerosolized COVID-19 droplet is a smaller particle that can stay in the air for up to three hours in an enclosed space and reach someone within 6 to 8-foot distance.

An aerosolized droplet can stay in the air longer than the [ordinary COVID-19] droplet and can reach longer than 3 feet — like 6 ft to 8 ft especially in a closed space without ventilation because of their ability to be airborne. The danger is that, the longer (it is) in the air, you have a higher risk of getting it,” he said.

This can be alarming especially in public places,” Solante added. “If you’re in a public and in an enclosed space, you’re only wearing a face mask and you’re not practicing 6-foot distancing, that’s the danger of airborne transmission.”

For offices and enclosed spaces, Solante suggested putting up a source of good ventilation and a larger space for physical distancing. Windows may be opened or negative pressure machines that lessen the density of airborne particles may also be installed. For high-risk areas such as elevators, talking must be discouraged.

Solante noted that common modes of transport like the Light and Metro Railway Transit should consider modifying health protocols among passengers, apart from imposing the use of face masks and face shields.

“They should modify now to have proper ventilation and limit the number of people per area. Passengers must not be allowed to talk and use their cellphones so there would be no aerosolization of COVID-19 particles,” he added.

The government must also reinforce guidelines among people and stress potential risks of staying in enclosed spaces.

“It’s just a matter of reinforcing it again and at the same time, strictly implementing the adequate and proper ventilation in an enclosed space. The danger of airborne is not much with open space,” he said. “It’s really in an enclosed space and you have more people inside, you cannot practice a safe distance, a lot of people talking, people not practicing social distancing — these factors can increase the rate of transmission.”

Experts from the UK, the US, and Canada said in The Lancet report that there must be an urgent modification of health protocols after listing ten streams of evidence why COVID-19 is transmitted “primarily by the airborne route.”

Some of the findings noted that there is higher transmission of COVID-19 indoors than outdoors and there is limited evidence to support other dominant modes of transmission, including respiratory droplets. The paper also said COVID-19 spread from infected but asymptomatic people, or those not coughing or sneezing, account for up to 59% of all transmission globally.