Are they of relevance for transmission of SARS-CoV-2?

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Are they of relevance for transmission of SARS-CoV-2?

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New evidence suggests that many of the currently defined aerosol generation methods (AGPs) are unlikely to play a significant role in the generation of infectious aerosol that poses a risk to hospital staff. In a commentary article published in The Lancet Respiratory Medicine, a Bristol University research team discusses AGPs and the transmission of SARS-CoV-2 in healthcare.

The current UK Infection Control Guidelines for Hospitals are based on the premise that aerosols are only produced by specific medical procedures known as aerosol generation processes (AGPs).

The commentary article suggests that it is becoming increasingly clear that the transmission of SARS-CoV-2 via aerosol is possible and could represent a significant route of transmission. However, there is evidence that many of the currently defined AGPs are unlikely to play a significant role in the generation of infectious aerosol that poses a risk to personnel.

Further research is ongoing to measure other AGPs in a variety of clinical settings. However, based on previous research, it is likely that a cough patient with acute COVID-19 will generate more infectious aerosol than many AGPs. This seems to be supported by the epidemiological evidence pointing to an increased risk of infection for the ward medical staff (who care for patients with difficulty breathing and coughing in patients with COVID-19) compared to the ICU staff – although there are some caveats in the interpretation of these Data such as B. Patient mix, among others.

In light of these findings, researchers propose an end to the term aerosol generation processes and should instead focus on the risk that is apparent at first glance: close, physical exposure to people suspected of having COVID-19 over a long period of time or from who are known to have COVID-19 Ventilation remains poor.

Nick Maskell, Professor of Respiratory Medicine at the Academic Respiratory Unit and Bristol Medical School: Translational Health Sciences (DBS) said, "We suggest that clinicians follow an evidence-based framework that considers the main sources of risk, with an emphasis on physical exposure to patients Suspected or confirmed COVID-19 as a critical component.

"Additional factors known to be relevant to virus transmission, such as ventilation, proximity, and duration of exposure to patients, should be included in the risk assessment while taking into account the changing epidemiology of the infection with setting."

"Aerosol generation processes: are they relevant for the transmission of SARS-CoV-2?" By Fergus Hamilton, David Arnold, Bryan R. Bzdek, James Dodd, the AERATOR Group, Jonathan Reid and Nick Maskell is published in The Lancet Respiratory Medicine.

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More information:
Fergus Hamilton et al. Aerosol Generation Techniques: Are They Relevant to SARS-CoV-2 Transmission ?, The Lancet Respiratory Medicine (2021). DOI: 10.1016 / S2213-2600 (21) 00216-2

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Bristol University

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