Claims coronavirus can spread through the air

Matt Woodley

10/02/2020 4:07:48 PM

A senior Chinese official has said the virus can infect people via airborne transmission, but an Australian expert says more evidence is needed.

Virologist Assoc Prof Ian Mackay would not be surprised if coronavirus could be transmitted by an airborne route, he said there is ‘zero public-reviewed experimental evidence’ to support the claim.

According to a report in local news site China Daily, the deputy head of the Shanghai Civil Affairs Bureau, Zeng Qun, revealed the potentially troubling development over the weekend at a media briefing concerning government efforts to contain the virus’ spread.
Mr Qun said transmission routes of the coronavirus included direct transmission, contact transmission and aerosol transmission.
‘Aerosol transmission refers to the mixing of the virus with droplets in the air to form aerosols, which causes infection after inhalation, according to medical experts,’ he said.
‘As such, we have called on the public to raise their awareness of the prevention and control of the disease caused by family gatherings.’
While Associate Professor Ian Mackay, a virologist at the Australian Infectious Diseases Research Centre, told newsGP he would not be surprised if coronavirus could be transmitted by an airborne route, he said there is ‘zero public-reviewed experimental evidence’ to support the claim.
‘That evidence would need to show that infectious virus in suitable quantities to start an infection in a susceptible host, is present in the airborne gel-like “droplet nuclei” captured from the air,’ he said.
‘At the moment this is just a pronouncement without supporting evidence. We have to be careful because we have seen numerous false starts and wild claims around this virus, which have all lacked any evidence, quality expert review, or slow and careful consideration before publication or any expertise associated with their original analysis.’
Meanwhile, doctors in New South Wales have reportedly made a ‘research breakthrough’, according to the state’s Health Minister Brad Hazzard. Minister Hazzard said extensive testing on an isolated patient at Westmead Hospital has allowed scientists to isolate the virus and study eight variants, producing two full genome sequences in the process.
Professor Dominic Dwyer, from NSW Health Pathology, said the successful research confirms the tests are working well.
‘We can also make a contribution in terms of understanding how the virus is changing around the world and how similar it is to other viruses around the world, and so we put our genetic sequences up on the WHO [World Health Organization] site for people to compare,’ he said.
‘Also, by having an isolate we help other laboratories in NSW and elsewhere to develop the right sorts of tests; and we can potentially help vaccine manufacturers.’
Associate Professor Mackay said confirmation of airborne transmission would not likely alter current efforts to contain the virus, but may affect frontline healthcare workers such as GPs.
‘If scientifically confirmed – which has proven historically difficult for other respiratory viruses, I might add – this could impact which items of personal protective equipment healthcare workers don when collecting samples and in dealings with and care of symptomatic patients,’ he said.
‘It may also impact on certain mathematical models that seek to measure the spread of the virus and construct scenarios for planning purposes. It will perhaps change our thoughts around social distancing; as in, well people staying clear of sick people.
‘It’s unfortunate that science has taken this long to get to this point to answer this particular question for this virus … the virus has been very fast-moving and so has the knowledge landscape, which puts a lot of pressure on health to stay up-to-date.’
While there are still questions regarding the manner in which the virus spreads, a new report published in the Journal of the American Medical Association details symptoms and clinical characteristics of the virus.
The single-centre case series involved 138 coronavirus patients who had been hospitalised in Zhongnan Hospital at Wuhan University. It found common symptoms included fever (99%), fatigue (70%) and dry cough (60%), with less common symptoms being headache, dizziness, abdominal pain, diarrhoea, nausea, and vomiting.
Forty of the cases were healthcare workers.
Global coronavirus deaths rose to more than 900 over the weekend – eclipsing the total number of fatalities in the 2002–03 SARS outbreak – but a decline in the number of new cases has led some experts to predict the spread of the virus may be slowing.
However, with the number of cases now topping 40,000, WHO Director-General Dr Tedros Adhanom Ghebreyesus warned ‘we may only be seeing the tip of the iceberg’ with regards to the spread of the coronavirus.
‘There’ve been some concerning instances of onward [coronavirus] spread from people with no travel history to [China],’ Dr Ghebreyesus tweeted.
‘Spread outside China appears to be slow now, but could accelerate. Containment remains our objective, but all countries must use the window of opportunity created by the containment strategy to prepare for the virus’s possible arrival.
‘In an evolving public health emergency, all countries must step up efforts to prepare for [coronavirus’] possible arrival and do their utmost to contain it should it arrive. This means lab capacity for rapid diagnosis, contact tracing and other tools in the public health arsenal.’
Australia had 15 confirmed cases of the virus at the time of publication.
The RACGP has more information on coronavirus available on its website.
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Dr Peter James Strickland   11/02/2020 12:41:36 PM

Of course this virus spreads via droplets in the air from coughing. --how can any expert query that? Whether it goes from one person to another it has to come out of the patient some way ---it is not spread via blood or other secretions, and it is logically spread via droplets directly from one patient's lungs to another person's lungs directly, OR via hands to mouth via droplets that have come from a patient's lungs (or hands). With so many deaths and cases now it appears logical to me that this is spread MAINLY via droplets from patients from coughing , and from the lungs. Otherwise, why are millions of people wandering around with masks on if this is not considered to be the spread source? I think the 'experts' need to get real on this matter, and into a pragmatic world away from mathematical modelling.

A.Prof Christopher David Hogan   11/02/2020 12:51:51 PM

In the early stages of such new infections there will be always be a lot of confusion & mixed messages
The best we can do is be patient, careful & circumspect.
It is the strength of General Practice that we are used to dealing with uncertainty & the disagreement of experts
It certainly is confronting when all the theoretical planning we have done to combat novel infections suddenly becomes horrifyingly real
Without a rapid diagnostic test , vaccine or treatment we must look to the past to preserve our future . It has happened before