Why the WHO took two years to say COVID is airborne

5 月 5, 2022World News

Public-health advice on COVID-19 in early 2020 focused on sanitizing surfaces more than protecting against airborne transmission. Credit: Ozan Kose/AFP/Getty

As 2021 drew to a close, the highly contagious Omicron variant of the pandemic virus was racing around the globe, forcing governments to take drastic actions once again. The Netherlands ordered most businesses to close on 19 December, Ireland set curfews and many countries imposed travel bans in the hope of taming the tsunami of COVID-19 cases filling hospitals. Amid the wave of desperate news around the year-end holidays, one group of researchers hailed a development that had seemed as though it might never arrive. On 23 December, the World Health Organization (WHO) uttered the one word it had previously seemed incapable of applying to the virus SARS-CoV-2: ‘airborne’.

On its website, a page titled ‘Coronavirus disease (COVID-19): How is it transmitted?’ was quietly edited to state that a person can be infected “when infectious particles that pass through the air are inhaled at short range”, a process otherwise known as “short-range aerosol or short-range airborne transmission”. The website says that transmission can occur through “long-range airborne transmission” in poorly ventilated or crowded indoor settings “because aerosols can remain suspended in the air or travel farther than conversational distance”.

“It was a relief to see them finally use the word ‘airborne’, and to say clearly that airborne transmission and aerosol transmission are synonyms,” says aerosol chemist Jose-Luis Jimenez at the University of Colorado Boulder.

The seemingly uncontroversial statement marked a clear shift for the Switzerland-based WHO, which had tweeted categorically early in the pandemic, “FACT: #COVID19 is NOT airborne,” casting the negative in capital letters as if to remove any doubt. At that time, the agency maintained that the virus spreads mainly through droplets produced when a person coughs, sneezes or speaks, an assumption based on decades-old infection-control teachings about how respiratory viruses generally pass from one person to another. The guidance recommended distancing of more than one metre — within which these droplets were thought to fall to the ground — along with hand washing and surface disinfection to stop transfer of droplets to the eyes, nose and mouth.

It took until 20 October 2020 for the agency to acknowledge that aerosols — tiny specks of fluid — can transmit the virus, but the WHO said this was a concern only in specific settings, such as indoor, crowded and inadequately ventilated spaces. Over the next six months, the agency gradually altered its advice to say that aerosols could carry the virus for more than a metre and remain in the air (see ‘Changing views of how COVID spreads’).

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