Cited by 245Infection Control and VentilationCOVID-19 epidemiological studiesCOVID-19 impact on air quality

Mechanistic transmission modeling of COVID-19 on the Diamond Princess cruise ship demonstrates the importance of aerosol transmission

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Azimi, Parham, Keshavarz, Zahra, Cedeno Laurent, Jose Guillermo, Stephens, Brent, Allen, Joseph G.·2021·Proceedings of the National Academy of Sciences

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Abstract

Significance: We find that airborne transmission likely accounted for >50% of disease transmission on the Diamond Princess cruise ship, which includes inhalation of aerosols during close contact as well as longer range. These findings underscore the importance of implementing public health measures that target the control of inhalation of aerosols in addition to ongoing measures targeting control of large-droplet and fomite transmission, not only aboard cruise ships but in other indoor environments as well. Guidance from health organizations should include a greater emphasis on controls for reducing spread by airborne transmission. Last, although our work is based on a cruise ship outbreak of COVID-19, the model approach can be applied to other indoor environments and other infectious diseases.

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Crossref · 10.1073/pnas.2015482118

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  • Laboratory, field, modelling, and case studies have shown that airborne transmission through inhalation of virus-laden aerosol is important, if not dominant, for COVID-19.

    “Laboratory, field, modelling, and case studies have shown that airborne transmission through the inhalation of a virus-laden aerosol is important, if not dominant, for COVID-19.119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130, 131, 132”
  • Building-level strategies are key to reducing the spread of airborne infectious diseases.

    “showing that building-level strategies are key to reducing the spread of airborne infectious diseases.40, 127, 401, 402, 403”

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Authors
Azimi, P., Keshavarz, Z., Cedeno Laurent, J. G., Stephens, B., & Allen, J. G.
Affiliations
  • Harvard University (US)
  • Environmental Health Department, Harvard T.H. Chan School of Public Health, Boston, MA 02115;
  • Illinois Institute of Technology (US)
Corresponding author
  • Azimi, Parham
  • Allen, Joseph G.
Venue
Proceedings of the National Academy of Sciences
Published
2021-02-03
Volume
118
Issue
8
ISSN
  • 0027-8424 (ISSN-L)
  • 1091-6490
OpenAlex
W3126546596
Cited by
245
References
46
Citations by year
2026: 12 · 2025: 31 · 2024: 32 · 2023: 38 · 2022: 72 · 2021: 52 · 2020: 7
FWCI
31.49
Type
journal article
Language
en
Open access
Locations
  • Proceedings of the National Academy of Sciences (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
  • Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
  • Physical Sciences › Environmental Science › Global and Planetary Change › COVID-19 impact on air quality
Keywords
COVID-19 pandemic, airborne transmission, respiratory droplets, fomite transmission, long-range transmission, cruise ships, transmission modelling, ventilation, air recirculation
MeSH terms
COVID-19, SARS-CoV-2, Aerosols, Disease Outbreaks, Humans, Models, Theoretical, Quarantine, Ships

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