EB: We know COVID-19 is a coronavirus, and we know that most coronavirus illnesses (like the common cold) are easy to transmit. We are still not sure of the exact transmission of the disease, but we tend to have a posture of use of respirators with most novel infections in order to best protect our healthcare workers.
When we talk about worker protection, we talk about something called the “Hierarchy of Controls.” PPE is at the very bottom.
We can remove hazards or things that are difficult to clean. We can replace hazards like glass bottles for blood cultures with plastic ones. We can put our patients in Airborne Infection Isolation Rooms (AIIR). We can arrange our cares differently. We can ask a patient to put a mask on when we enter the room to care for them. We need to be mindful of our safety as we work to care for patients with COVID-19. Be especially attentive of actions that might generate aerosols or air movement.
TT: Here is an analogy to help explain the difference between droplet and airborne. When you sneeze, you feel and see visible droplets of fluid. Your droplets can land anywhere. On the other hand, it is difficult to see aerosolized/airborne particles. An example of this is when you use hairspray. Although you are done with using hairspray, you can still smell it because some of the hairspray remains floating in the air.
We don’t fully understand the true transmission of COVID-19. Some suggest the transmission lies between droplet and airborne transmission. The science of transmission is still evolving. We must be patient in giving leading epidemiologists and researchers all over the world time to study the exact transmission of COVID-19. What we do know is COVID-19 is a novel coronavirus, and most coronaviruses are not airborne.
I want to add to Dr. Beam’s statement and reinforce what I posted earlier. In Dr. Beam’s Hierarchy of Controls, PPE is at the bottom. The general public thinks that PPE is the best way to protect from COVID-19. This is not true. As I have stated previously, PPEs do not protect you from a specific disease. The FDA has made a claim that PPEs are supposed to serve as non-disease specific barriers to fluids, solids, and airborne particles. The most effective ways to respond to COVID-19 is to eliminate or substitute hazards or advise people to do social distancing to keep them from being exposed to the hazard.