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COVID-19 Are the droplets somewhat airborne? Conflicting reports

Posted

Has 2 years experience.

There are conflicting reports. The CDC doesn't say it's airborne yet there was some Chinese research that says it is.
Bill DiBlasio in his latest update said that if someone infected is in a room and leaves the virus is not going to be in the air.
But I noticed how he said an hour. What about 2 minutes? What about 10 minutes.
Can the droplets be semi-airborne.
Somebody gets on a small elevator whose infected and is coughing. Then they leave.
A minute later you walk in and there's no one in there. Could you get it from the air?
It seems to be unknown. Yes most of those cough droplets fell to the floor (or wall)
but are there some tinier ones still in the air for a minuter or two?

NRSKarenRN, BSN, RN

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

CDC COVID 19: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings

Quote

Mode of transmission: Early reports suggest person-to-person transmission most commonly happens during close exposure to a person infected with COVID-19, primarily via respiratory droplets produced when the infected person coughs or sneezes. Droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the lungs of those within close proximity. The contribution of small respirable particles, sometimes called aerosols or droplet nuclei, to close proximity transmission is currently uncertain. However, airborne transmission from person-to-person over long distances is unlikely

https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Finfection-control.html

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

There's been no reason to believe that COVID-19 spreads through airborne transmission rather than droplet, and while this variant is new, the coronavirus itself is not and it's transmission characteristics are already fairly well understood. "Airborne" transmission refers to pathogens where it can remain in the air in a viable form for many hours to even days.

Coronavirus can spread through the air, potentially farther than the typical 6 feet of droplet transmission given the right circumstances of droplet formation and airflow, but that is significantly different than airborne transmission.

Some confusion seems to come from the CDCs recommendation to incorporate some aspects of airborne precautions due since basic droplet precautions don't actually comprehensively stop the transmission of droplet pathogens, they're just mostly effective, and given the impact of this particular pathogen there's sufficient reason try and close the gaps that droplet precautions leave.

While it's certainly important to protect against the spread of person-to-person transmission through the air, I think the focus on that lets people forget that transmission through surface vectors is probably far more common in the community.

Edited by MunoRN

Since we're not testing everyone... does administering a nebulizer treatment in the clinic cause airborne transmission? Should one be wearing a N95 mask when entering the room?

Closed Account 12345

Has 14 years experience.

I read something posted online by a pediatrician last night that said the airborne half life is 2.7 hours.

Now, I have no idea of his source or if it's accurate.

Something else I read from some govt source that I don't remember said likely airborne, but not to the extent of TB or varicella.

I do know this though. If there wasn't a degree of suspected airborne transmission, hospitals wouldn't be requiring N95 masks at $10 or more a pop to care for COVID-19 patients.

kbrn2002, ADN, RN

Specializes in Geriatrics, Dialysis. Has 19 years experience.

I haven't read the research yet but it was reported yesterday an MIT study showed the virus can travel 27 feet and remain airborne for several hours.

CampyCamp, RN

Has 18 years experience.

On 3/16/2020 at 12:40 PM, 2BS Nurse said:

Since we're not testing everyone... does administering a nebulizer treatment in the clinic cause airborne transmission? Should one be wearing a N95 mask when entering the

Nebs are not an aerosolizing procedure.

FLOATnureCO

Has 3 years experience.

5 hours ago, CampyCamp said:

Nebs are not an aerosolizing procedure.

At our hospital they are considered aerosolizing and require an n95.

Swellz

Specializes in oncology, MS/tele/stepdown. Has 6 years experience.

18 minutes ago, FLOATnureCO said:

At our hospital they are considered aerosolizing and require an n95.

Same with mine. I don't really know what to think anymore. I'm just following policy and hoping for the best.

NurseJamillah, BSN, RN

Specializes in Med-Surg. Has 3 years experience.

The WHO considers nebulizer treatment to be aerosol-generating.

From the WHO:

"In the context of COVID-19, airborne transmission may be possible in specific circumstances and settings in which procedures or support treatments that generate aerosols are performed; I.e., endotracheal intubation, bronchoscopy, open suctioning, administration of nebulized treatment, manual ventilation before intubation, turning the patient to the prone position, disconnecting the patient from the ventilator, non-invasive positive-pressure ventilation, tracheostomy, and cardiopulmonary resuscitation."

https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations

And the CDC has a broader umbrella, referring to suggested uses for N95 as those "procedures that generate aerosols or during which respiratory secretions are likely to be poorly controlled". They also list it under a description of procedures "likely to generate higher concentrations of respiratory secretions or aerosols":

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

Edited by NurseJamillah
Typos and added 2nd link

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

7 hours ago, kbrn2002 said:

I haven't read the research yet but it was reported yesterday an MIT study showed the virus can travel 27 feet and remain airborne for several hours.

I saw that repeated in various new stories today as well, but it should be noted that the study didn't actually find that it can remain in the air for several hours, they postulated that with small enough droplets (droplets too small to keep a virus viable) and with the right airflow a near evaporated droplet could remain in the air for several hours.

I think people put too much faith in the "6 feet" distance, there's never been any evidence that droplets aerosolized by a cough, sneeze, talking, or breathing are limited to 6 feet of flight, it's dependent on the size of the droplets and airflow characteristics. Although aerosolized droplets at least don't have the travelling capabilities of true airborne particles, which can land on a surface and then easily become suspended in the air again when brushed up into the air by walking, setting something on a surface, etc.

MunoRN, RN

Specializes in Critical Care. Has 10 years experience.

6 hours ago, CampyCamp said:

Nebs are not an aerosolizing procedure.

There's no definitive list of "aerosol generating procedures" because there's no evidence to support the definition, none, zilch, nada. It makes more sense to consider potential sources of aerosolized droplets as a whole and refer to them as potential aerosol generating events, which includes coughing, sneezing, talking, and even just breathing. There's no basis for utilizing a different level of protection for any of these procedures than for a patient not undergoing these procedures, but is breathing, talking, coughing, etc.

I wouldn't listen to Mayor Bill. He's the genius who was telling everyone to go to concerts and theaters and parades and festivals on March 13.

On 4/2/2020 at 5:20 PM, bossfrog said:

I wouldn't listen to Mayor Bill. He's the genius who was telling everyone to go to concerts and theaters and parades and festivals on March 13.

Didn't he admit his error in thinking?