Volume 5, no. 2, e00245-20, 2020, https://doi.org/10.1128/mSystems.00245-20. After original publication of this article, the following changes were made. Page 5, first paragraph, line 18: HEPA filters are rated to remove at least 99.97% of particles down to 0.3 μm (51). Most residential and commercial buildings utilize MERV-5 to MERV-11, and in critical health care settings, MERV-12 or higher and HEPA filters are used. MERV-13 filters have the potential to remove microbes and other particles ranging from 0.3 to 10.0 μm. Most viruses, including CoVs, range from 0.004 to 1.0 μm, limiting the effectiveness of these filtration techniques against pathogens such as SARS-CoV-2 (52). Furthermore, no filter system is perfect. Recently,.... was changed to HEPA filters are rated to remove at least 99.97% of particles at 0.3 μm in size, representing the most penetrating particle size (51). Most residential and commercial buildings utilize MERV-5 to MERV-11, and in critical health care settings, MERV-13 or higher and HEPA filters are used. MERV-13 filters have the potential to remove microbes and other particles ranging from 0.3 to 10.0 μm. Most viruses, including CoVs, range from 0.004 to 1.0 μm (52). However, viruses are rarely observed as individual particles, but instead are expelled from the body already combined with water, proteins, salts, and other components as large droplets and aerosols. Thus far, SARS-CoV-2 has been observed in aerosolized particles in a spectrum of sizes including 0.25 to 0.5 μm (96), necessitating high efficiency filtration techniques to reduce the transmission potential of pathogens such as SARS-CoV-2. However,.... Page 6, third paragraph, second sentence: Even though viral particles are too small to be contained by even the best HEPA and MERV filters, ventilation precautions can be taken to ensure the minimization of SARS-CoV-2 spread. was changed to Viruses are frequently found associated with larger particles (e.g., complexes with water, proteins, salts, etc.) in a range of sizes. Even though some of these particles have been identified in sizes that could potentially penetrate high efficiency filters, ventilation and filtration remain important in reducing the transmission potential of SARS-CoV-2. Page 10, Acknowledgments, first sentence: “We thank Jason Stenson and Cassandra Moseley for comments on the manuscript” was changed to “We thank Jason Stenson, Richard Corsi, Cassandra Moseley, and Linsey Marr for comments on the manuscript.

Aerosol transmission has played a significant role in the transmission of COVID-19 disease worldwide. We developed a COVID-19 aerosol transmission risk estimation model to better understand how key parameters associated with indoor spaces and infector emissions affect inhaled deposited dose of aerosol particles that convey the SARS-CoV-2 virus. The model calculates the concentration of size-resolved, virus-laden aerosol particles in well-mixed indoor air challenged by emissions from an index case(s). The model uses a mechanistic approach, accounting for particle emission dynamics, particle deposition to indoor surfaces, ventilation rate, and single-zone filtration. The novelty of this model relates to the concept of "inhaled & deposited dose" in the respiratory system of receptors linked to a dose-response curve for human coronavirus HCoV-229E. We estimated the volume of inhaled & deposited dose of particles in the 0.5-4 μm range expressed in picoliters (pL) in a well-documented COVID-19 outbreak in restaurant X in Guangzhou China. We anchored the attack rate with the dose-response curve of HCoV-229E which provides a preliminary estimate of the average SARS-CoV-2 dose per person, expressed in plaque forming units (PFUs). For a reasonable emission scenario, we estimate approximately three PFU per pL deposited, yielding roughly 10 PFUs deposited in the respiratory system of those infected in restaurant X. To explore the model's utility, we tested it with four COVID-19 outbreaks. The risk estimates from the model fit reasonably well with the reported number of confirmed cases given available metadata from the outbreaks and uncertainties associated with model assumptions.

Background

Several studies suggest that far-field transmission (>6 ft) explains a significant number of COVID-19 superspreading outbreaks.

Objective

Therefore, quantifying the ratio of near- and far-field exposure to emissions from a source is key to better understanding human-to-human airborne infectious disease transmission and associated risks.

Methods

In this study, we used an environmentally-controlled chamber to measure volatile organic compounds (VOCs) released from a healthy participant who consumed breath mints, which contained unique tracer compounds. Tracer measurements were made at 0.76 m (2.5 ft), 1.52 m (5 ft), 2.28 m (7.5 ft) from the participant, as well as in the exhaust plenum of the chamber.

Results

We observed that 0.76 m (2.5 ft) trials had ~36-44% higher concentrations than other distances during the first 20 minutes of experiments, highlighting the importance of the near-field exposure relative to the far-field before virus-laden respiratory aerosol plumes are continuously mixed into the far-field. However, for the conditions studied, the concentrations of human-sourced tracers after 20 minutes and approaching the end of the 60-minute trials at 0.76 m, 1.52 m, and 2.28 m were only ~18%, ~11%, and ~7.5% higher than volume-averaged concentrations, respectively.

Significance

This study suggests that for rooms with similar airflow parameters disease transmission risk is dominated by near-field exposures for shorter event durations (e.g., initial 20-25-minutes of event) whereas far-field exposures are critical throughout the entire event and are increasingly more important for longer event durations.

Impact statement

We offer a novel methodology for studying the fate and transport of airborne bioaerosols in indoor spaces using VOCs as unique proxies for bioaerosols. We provide evidence that real-time measurement of VOCs can be applied in settings with human subjects to estimate the concentration of bioaerosol at different distances from the emitter. We also improve upon the conventional assumption that a well-mixed room exhibits instantaneous and perfect mixing by addressing spatial distances and mixing over time. We quantitatively assessed the exposure levels to breath tracers at alternate distances and provided more insights into the changes on "near-field to far-field" ratios over time. This method can be used in future to estimate the benefits of alternate environmental conditions and occupant behaviors.

With the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that results in coronavirus disease 2019 (COVID-19), corporate entities, federal, state, county, and city governments, universities, school districts, places of worship, prisons, health care facilities, assisted living organizations, daycares, homeowners, and other building owners and occupants have an opportunity to reduce the potential for transmission through built environment (BE)-mediated pathways. Over the last decade, substantial research into the presence, abundance, diversity, function, and transmission of microbes in the BE has taken place and revealed common pathogen exchange pathways and mechanisms. In this paper, we synthesize this microbiology of the BE research and the known information about SARS-CoV-2 to provide actionable and achievable guidance to BE decision makers, building operators, and all indoor occupants attempting to minimize infectious disease transmission through environmentally mediated pathways. We believe this information is useful to corporate and public administrators and individuals responsible for building operations and environmental services in their decision-making process about the degree and duration of social-distancing measures during viral epidemics and pandemics.