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Preventing Covid airborne transmission should be prioritised, say experts

by Beth Gault
16 April 2021

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Attempts to reduce the spread of Covid-19 should focus on preventing close airborne transmission of the virus, according to an editorial in the British Medical Journal (BMJ).

Covid-19 is most likely to transmit between people at close range through inhalation, rather than contact with surfaces or longer airborne routes, respiratory experts have said.

The editorial, which is not peer reviewed, said the preventative steps of wearing masks, keeping distance and reducing indoor occupancy all help to reduce transmission.

However, the authors, including consultant virologist Dr Julian Tang, argued that emphasis should also be put on increased ventilation due to suspended particles that can remain in the air for hours.

They suggested measures should be undertaken to increase ventilation in populated settings, including healthcare, such as opening windows, and installing or upgrading heating, ventilation and air conditioning systems.

The editorial states: ‘Covid-19 may well become seasonal, and we will have to live with it as we do with influenza. 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 BMA welcomed the publication of the editorial and recommended that monitoring equipment is installed widely in clinical and non-clinical areas.

Dr Chaand Nagpaul, BMA chair of council, 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.

‘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.’

He added: ‘For healthcare workers specifically, masks with high filtration efficiency and a good fit, are vital. We have repeatedly called for high grade masks for healthcare staff, including wider use of FFP2/3 masks, and have raised this at the highest level in Government. Too many doctors continue to report being equipped with ill-fitting and inadequate PPE.’

It follows calls from the BMA in January to update PPE guidance to recommend the wider use of FFP3 respirators in general practice.