Methods of transmission of infection with coronavirus 2

Mohamed Ibrahim Bassyouni
2020 / 5 / 26



The virus can transmit respiratory infections through droplets of different sizes if the diameter of their particles increases between 5 and 10 ãíßÑm. These particles are referred to as respiratory droplets. If its diameter is equal to 5 æãÊÑÇÊm´-or-less, it is referred to as the droplet cores. According to the available current evidence, infection with the virus that causes Covid-19 is transmitted mainly from person to person through respiratory and contact drops. In an analysis of a total of 75 465 cases of Covid-19 disease in China, no air transmission was reported.
The infection is transmitted by droplets when a person contacts someone with respiratory symptoms (such as coughing´-or-sneezing) close contact (within a distance of one meter), which makes this person at risk of exposing his mucous membranes (mouth and nose)´-or-conjunctiva (eye) to potential respiratory droplets To be contagious. The infection may also be transmitted by contaminated devices found in the immediate environment surrounding the infected person. Therefore, infection with the virus that causes Covid-19 disease can be transmitted either through -dir-ect contact with infected persons´-or-in-dir-ect contact with surfaces in the immediate surrounding environment´-or-tools used on the infected person (such as a stethoscope´-or-thermometer).
Air transmission differs from droplet transmission because air infection indicates the presence of microbes within the droplet cores that are generally particles equal to 5 micrometres in diameter´-or-less and can be kept in the air for long periods of time and transferred from person to person at distances greater than one meter.
In the context of Covid-19 disease, air infection may be possible in certain circumstances and contexts in which supportive procedures´-or-treatments are applied to the spray, i.e. endotracheal intubation, bronchoscopy, open sucking, administration of a spray and manual ventilation before intubation, placing the patient in the prone position and separating the patient from the respiratory system Artificial and non-invasive ventilation with positive pressure, endotracheal gland and CPR.
There is some evidence that Covid-19 infection may lead to an intestinal infection and is present in the stool. However, there is so far only one study in which the virus that causes Covid-19 has been cultured by taking it from a single stool sample. 9 No transmission of this virus has been reported to the mouth until now.

Effects of recent findings on the detection of the virus causing Covid-19 disease in air samples
So far, some scientific publications have reported preliminary evidence of the possibility of detection of the virus causing Covid-19 in the air, and thus some media organizations have reported an air transmission. Care must be taken in interpreting these preliminary results.
In a recent article in the New England Journal of Medicine, the sustainability of the virus causing Covid-19 disease was assessed. As part of this pilot study, the spray was generated using a triple jet collision sprayer and inserted into the Goldberg cylinder under controlled laboratory conditions. This high-powered machine does not embody the normal conditions of human cough. Moreover, the presence of the Covid-19 virus in spray particles over a period of three hours does not reflect the clinical context in which the procedures generating the spray are followed. Accordingly, the issue was related to conducting a spray generator in an experimental framework.
There was information reported by facilities that hosted patients with Covid-19 disease, who showed symptoms of the disease and did not detect the presence of the RNA of the virus that causes Covid-19 in air samples. The organization is aware of other studies that have evaluated the presence of virus RNA in air samples but have not yet been published in specialized journals. It should be noted that detection of the presence of virus RNA in environmental samples on the basis of assays of polymerase chain reaction does not mean that the virus is viable and transmissible. Further studies are necessary to determine the possibility of detection of the virus causing Covid-19 disease in air samples taken from patient rooms where no supportive procedures´-or-treatments are applied to the atomizer. As new evidence emerges in this regard, it is important to determine whether the virus whose presence is detected is viable and what its potential role is in transmission.
Conclusions
Based on the available evidence, including the latest publications mentioned above, the organization continues to recommend that people caring for patients with Covid-19 disease take precautions to prevent droplets and avoid contact. WHO also continues to recommend precautionary measures to avoid airborne infection in the conditions and contexts in which supportive spray-generating procedures and procedures are applied, as assessed in the risk. These recommendations are consistent with other national and international guidelines, including the guidelines issued by the European Society of Intensive Care Medicine and the Society for Critical Care Medicine and guidelines currently in use in Australia, Canada and the United Kingdom. At the same time, other countries and organizations, including the United States Centers for Disease Control and Prevention and the European Center for Disease Control and Prevention, recommend that precautionary measures be taken to avoid airborne infection in any situation involving care for people with Covid-19 disease, and considers the use of medical masks as an acceptable option In the event of a lack of respiratory masks of the type N95, FFP2´-or-FFP3.18-19
The organization s current recommendations stress the importance of using all personal protective equipment in a rational and appropriate manner and not-limit-ing the use of masks, which requires health care workers to adhere to strict and sound behavior, especially in relation to procedures for removing personal protection equipment and rules of hand hygiene. The organization also recommends that staff be trained on these recommendations and that personal protective equipment and other supplies and equipment be procured and adequately provided. Finally, the organization continues to stress the paramount importance attached to regular hand washing, adherence to due ethics when coughing´-or-sneezing, cleaning and sterilizing the environment, and the importance of maintaining a safe distance from others and avoiding close contact with people with fever´-or-showing respiratory symptoms, without taking appropriate protections.
The organization is carefully monitoring emerging evidence on this critical topic and will this scientific summary as more information becomes available.




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