A paradigm shift to align transmission routes with mechanisms
Abstract
Current infection-control guidelines subscribe to a contact/droplet/airborne paradigm that is based on outdated understanding. Here, we propose to modify and align existing guidelines with a more accurate description of the different transmission routes. This will improve the effectiveness of control measures as more transmissible variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerge.
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The first and main method is airborne transmission through inhalation of viruses in microscopic respiratory particles of 100 μm or less suspended in air, known as aerosols, and it can occur near-field and far-field.
“The first and main method is airborne transmission, which occurs through the inhalation of viruses carried in microscopic respiratory particles (≤100 μm in diameter) suspended in the air, known as aerosols.117 This transmission can occur both in the near-field (within the vicinity of the infection source) and in the far-field (greater distances from the infection source).”
From The Lancet Commission on lessons for the future from the COVID-19 pandemic (2022) · cites this paper as [117]
Numerous publications have attempted to overturn mistaken ideas about transmission routes for respiratory infectious diseases and have initiated a paradigm shift towards more accurate definitions.
“Numerous publications have attempted to overturn mistaken ideas about transmission routes for respiratory infectious diseases,117, 137, 138, 139, 140, 141, 142, 143 and have initiated a paradigm shift towards more accurate definitions.117”
From The Lancet Commission on lessons for the future from the COVID-19 pandemic (2022) · cites this paper as [117]
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- Authors
- Marr, L. C., & Tang, J. W.
- Affiliations
- Virginia Tech (US)
- University of Leicester (GB)
- Corresponding author
- Marr, Linsey C
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-08-20
- Volume
- 73
- Issue
- 10
- Pages
- 1747-1749
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W3193912241
- Cited by
- 53
- References
- 28
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 9 · 2023: 18 · 2022: 11 · 2021: 1
- FWCI
- 6.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- VTechWorks (Virginia Tech) (submittedVersion, public-domain)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- SARS-CoV-2, transmission routes, infection control guidelines, contact transmission, droplet transmission, airborne transmission, variant emergence, transmission mechanism, COVID-19 pandemic
- MeSH terms
- COVID-19, SARS-CoV-2, Aerosols, Humans, Infection Control
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