Amid increasing cases of health workers getting infected with Covid-19, a first of its kind study has dwelled in detail about various sizes of virus-containing droplets present in sneezes and coughs and their locations in the respiratory systems even as it suggested a string of protective measures to prevent the contagion transmission in various settings to protect the corona warriors.
The study "Coughs and Sneezes: Their Role in Transmission of Respiratory Viral Infections, Including SARS-CoV-2," is published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.
Rajiv Dhand, professor and chair, Department of Medicine and associate dean of clinical affairs, University of Tennessee Graduate School of Medicine, along with Jie Li, associate professor, Department of Cardiopulmonary Services, Division of Respiratory Care, Rush University Medical Center, said that "The apprehension about the use of aerosolized therapies in Covid-19patients relates to their potential to spread infectious aerosols.”
Airborne particles may be produced by various aerosol generating procedures (AGPs), such as suctioning or tracheal intubation, as well as by aerosol generators, especially jet nebulizers.
"AGPs such as intubation, bronchoscopy, physiotherapy and suctioning generate potential infectious bioaerosols by provoking coughs and are associated with increased infection rates among employees working in health care," stated the authors.
In contrast, AGPs such as oxygen therapy, use of humidified high-flow nasal cannula, non-invasive ventilation and manual ventilation via mask are less about 'generating' bio-aerosols and more about 'dispersing' aerosols further away from the patient, said the researchers.
Drs. Dhand and Li also noted that aerosols produced by medical aerosol generators do not contain pathogens unless the aerosol device is contaminated.
The authors have made various recommendations for reducing the transmission of respiratory tract infections, which are consistent with guidelines from the Centers for Disease Control and Prevention.
Over 1 lakh health-care workers worldwide are believed to have been infected with Covid-19, and possibly twice that, amid reports of continuing shortages of protective equipment, the International Council of Nurses (ICN) had said in April. The number has just surged in the following months.
Recommendations for corona warriors to keep the Virus at bay
- Avoid procedures that irritate airways and provoke violent coughing and try to reduce exposure to infectious aerosol.
- If possible, health care providers should stay six feet away from infected patients, especially when the patient is coughing or sneezing.
- When using a mechanical ventilator, institute barriers to filter the virus or reduce virus dispersion by placing a filter at the exhalation port of the ventilator or connecting a filter to the oxygen mask.
- For spontaneously breathing patients, placing a surgical mask on the patient's face or using tissue to cover his or her mouth, especially during coughing, sneezing or talking, may reduce the dispersion distance or viral load.
- Provide Personnel Protection Equipments (PPEs) to health care providers.
- While, ideally, infected patients should be in single rooms to prevent droplet dispersion, it is acceptable for two patients with the same infection that is spread by respiratory droplets to be in the same room.