New Delhi, Apr 16: There is consistent, strong evidence to prove that the SARS-CoV-2 virus, behind the COVID-19 pandemic, is predominantly transmitted through the air, according to a new assessment published on Friday in The Lancet journal.
The analysis by six experts from the UK, the US and Canada says public health measures that fail to treat the virus as predominantly airborne leave people unprotected and allow the virus to spread.
Although some studies in the past have suggested that COVID-19 may spread through air, overall scientific literature on the subject has been inconclusive.
In July last year, over 200 scientists from 32 nations wrote to the WHO, saying there is evidence that the coronavirus is airborne, and even smaller particles can infect people.
"The evidence supporting airborne transmission is overwhelming, and evidence supporting large droplet transmission is almost non-existent," said Jose-Luis Jimenez, from the University of Colorado Boulder in the US.
"It is urgent that the World Health Organization and other public health agencies adapt their description of transmission to the scientific evidence so that the focus of mitigation is put on reducing airborne transmission," Jimenez said.
The team, led by researchers at the University of Oxford in the UK, reviewed published research and identified 10 lines of evidence to support the predominance of the airborne route.
The researchers highlighted the super-spreader events such as last year's Skagit Choir outbreak in the US, in which 53 people became infected from a single infected case.
Studies have confirmed these events cannot be adequately explained by close contact or touching shared surfaces or objects, the researchers said in their assesment.
They noted that transmission rates of SARS-CoV-2 are much higher indoors than outdoors, and transmission is greatly reduced by indoor ventilation.
The team cited previous studies estimating that silent -- asymptomatic or presymptomatic -- transmission of SARS-CoV-2 from people who are not coughing or sneezing accounts for at least 40 per cent of all transmission.
This silent transmission is a key way COVID-19 has spread around the world, "supporting a predominantly airborne mode of transmission," according to the assessment.
The researchers also highlighted work demonstrating long-range transmission of the virus between people in adjacent rooms in hotels, who were never in each other's presence.
On the contrary, the team found little to no evidence that the virus spreads easily via large droplets, which fall quickly through the air and contaminate surfaces.
"We were able to identify and interpret highly complex and specialist papers on the dynamics of fluid flows and the isolation of live virus," said study lead author Trish Greenhalgh.
"While some individual papers were assessed as weak, overall the evidence base for airborne transmission is extensive and robust," Greenhalgh added.
He noted that there should be no further delay in implementing measures around the world to protect against such transmission.
The assessment has serious implications for public health measures designed to mitigate the pandemic, the researchers said.
They said "droplet measures" such as handwashing and surface cleaning, while important, should be given less emphasis than airborne measures, which deal with inhalation of infectious particles suspended in the air.
According to the researchers, if an infectious virus is primarily airborne, someone can potentially be infected when they inhale aerosols produced when an infected person exhales, speaks, shouts, sings, or sneezes.
They noted that some airborne control measures include ventilation, air filtration, reducing crowding and the amount of time people spend indoors.
Wearing masks whenever indoors, attention to mask quality and fit, and higher-grade PPE for healthcare and other staff when working in contact with potentially infectious people are some of the other control measures, according to the researchers.
"It is quite surprising that anyone is still questioning whether airborne transmission is the predominant transmission pathway for this virus or not," said study co-author Professor Kimberly Prather, from the University of California San Diego, US.
"Only by including inhalation of aerosols at both close and long range can we explain the many indoor outbreaks that have occurred around the globe. Once we acknowledge this virus is airborne, we know how to fix it, Prather said.
The researchers added that there are many examples of places that have fared much better by acknowledging this virus is airborne from the start, adding the world needs to follow their lead as soon as possible.
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New Delhi, May 16: The Centre directed Uttar Pradesh and Bihar on Sunday to prevent dumping of dead bodies in the Ganga and its tributaries, and focus on their safe disposal and a dignified cremation after corpses were seen floating in these rivers following a spurt in the number of coronavirus cases.
At a review meeting conducted on May 15-16, the Centre said dumping of dead bodies and partially burnt or decomposed corpses in the Ganga and its tributaries has recently been reported, which is "most undesirable and alarming".
"Namami Gange directs states to prevent dumping of dead bodies in the Ganga and focus on their safe disposal and providing support for ensuring dignified cremation," the Jal Shakti Ministry said.
The state pollution control boards were directed to monitor the water quality more frequently in consultations with the health departments.
The Central Pollution Control Board (CPCB) was assigned the task of overall monitoring, providing guidance to the state pollution control boards and taking up advanced analysis in the matter.
Support for cremation needs to be given top priority. Effective implementation of the government orders needs to be ensured. No loss of time should take place in implementation, the ministry said.
An advisory was issued by Rajiv Ranjan Mishra, Director General, National Mission for Clean Ganga, to the district magistrates, who are also the chairpersons of the district Ganga committees, on May 11.
This was followed up by a letter the next day to the chief secretaries to prevent the dumping of dead bodies in the river and ensure enforcement of the government guidelines on the cremation of COVID-19 victims.
The letter also advised the states to provide financial assistance as well as regulate the rates for the cremation or burial process.
On May 15, the steps taken in this regard in Uttar Pradesh and Bihar were reviewed at a meeting chaired Pankaj Kumar, Secretary, Ministry of Jal Shakti, and further action points were decided.
Highlighting the instructions already given, Kumar had called for expeditious action and underscored the need to give equal attention to such incidents in urban and rural areas along the Ganga and other rivers.
"Stopping of dumping of dead bodies as well as their safe disposal and protection of water quality have to be ensured on a war footing. After knowing the progress from the states, the CWC (Central Water Commission), the CPCB and the state pollution control boards would also be giving their feedback and action plans," he had said.
Mishra stated that the situation is being monitored and follow-up action is being taken in several districts such as Unnao, Kanpur rural, Ghazipur and Balia in Uttar Pradesh and Buxar and Saran in Bihar.
However, some cases have also been reported from other districts. He asked the state missions to keep an eye on the situation.
Mishra emphasised the need to strengthen enforcement, maintain vigil and take proactive action to facilitate and support the families for the cremation of the bodies and asked the state missions to specifically report on this.
"If needed, the project directors can assess and also give support to the district Ganga committees for this out of the NMCG funds available with them, while keeping the NMCG informed," he said.
Rajnish Dubey, Additional Chief Secretary, Urban Development, and Anurag Shrivastav, Principal Secretary, Jal Shakti and Project Director, State Ganga Mission, represented Uttar Pradesh in the meeting.
Shrivastava said all the district magistrates have been alerted about the issue and patrolling is being carried out to prevent dumping of dead bodies in the Ganga.
He also informed that 13 crematoria under Namami Gange, in addition to the existing ones, have been made available for the cremation of dead bodies.
It was informed that orders have been issued for financial support for cremations in urban areas. Dubey said similar orders for a financial support of Rs 5,000 have been issued by the Panchayati Raj department for rural areas and the SDRF and other forces have also been asked to carry out patrolling.
Anand Kishore, Principal Secretary, Urban Development and Project Director, State Ganga Mission, Government of Bihar, informed that it has been decided that the cremation or burial expenses of those dying due to COVID-19 will be borne by the state government.
He added that even if the deceased did not have a COVID-positive report but showed symptoms of the disease, the family will be offered this support.
He also said patrolling is being done to prevent further dumping of dead bodies in the river, especially in districts like Buxar and Saran (Chhapra).
CWC Chairman S K Halder informed that they are monitoring the flow and the water quality of the river through their stations and will further increase the frequency.
CPCB Member Secretary Prashant Gargava said the board has forewarned all water monitoring stations along the Ganga and her tributaries. The periodicity of testing the water quality has also been increased.
Debashree Mukherjee, Additional Secretary with the Jal Shakti Ministry, stated that besides an urgent assessment of the risks to the riverside communities by the pollution control boards, there is a need to raise awareness on the dos and don'ts as regards the use of river water and to prevent such incidents of dumping of bodies in the river.