Is the Coronavirus Getting Better at Airborne Transmission?
Newer variants of the coronavirus like Alpha and Delta are highly contagious, infecting far more people than the original virus. Two new studies offer a possible explanation: The virus is evolving to spread more efficiently through air.
The realization that the coronavirus is airborne indoors transformed efforts to contain the pandemic last year, igniting fiery debates about masks, social distancing and ventilation in public spaces.
Most researchers now agree that the coronavirus is mostly transmitted through large droplets that quickly sink to the floor and through much smaller ones, called aerosols, that can float over longer distances indoors and settle directly into the lungs, where the virus is most harmful.
The new studies don’t fundamentally change that view. But the findings signal the need for better masks in some situations, and indicate that the virus is changing in ways that make it more formidable.
“This is not an Armageddon scenario,” said Vincent Munster, a virologist at the National Institute of Allergy and Infectious Diseases, who led one of the new studies. “It is like a modification of the virus to more efficient transmission, which is something I think we all kind of expected, and we now see it happening in real time.”
Dr. Munster’s team showed that small aerosols traveled much longer distances than larger droplets and the Alpha variant was much more likely to cause new infections via aerosol transmission. The second study found that people infected with Alpha exhaled about 43 times more virus into tiny aerosols than those infected with older variants.
The studies compared the Alpha variant with the original virus or other older variants. But the results may also explain why the Delta variant is so contagious — and why it displaced all other versions of the virus.
“It really indicates that the virus is evolving to become more efficient at transmitting through the air,” said Linsey Marr, an expert in airborne viruses at Virginia Tech who was not involved in either study. “I wouldn’t be surprised if, with Delta, that factor were even higher.”
The ultratransmissibility of the variants may come down to a mix of factors. It may be that lower doses of the variants are required for infection, or that the variants replicate faster, or that more of the variant virus is exhaled into aerosols — or all three.
The Alpha variant proved to be twice as transmissible as the original virus, and the Delta variant has mutations that turbocharged its contagiousness even more. As the virus continues to change, newer variants may turn out to be even more transmissible, experts said.
But the tools at our disposal all still work well to halt the spread. Even loosefitting cloth and surgical masks block about half of the fine aerosols containing virus, according to the study of people infected with variants, published this month in the journal Clinical Infectious Diseases.
Still, at least in some crowded spaces, people may want to consider switching to more protective masks, said Don Milton, an aerosol expert at the University of Maryland who led the research.
“Given that it seems to be evolving towards generating aerosols better, then we need better containment and better personal protection,” Dr. Milton said of the virus. “We are recommending people move to tighter-fitting masks.”
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To compare how different variants spread through the air, his team asked participants with mild or asymptomatic infections to recite the alphabet, sing “Happy Birthday” loudly or shout out the University of Maryland slogan, “Go Terps!”
People infected with the Alpha variant had copious amounts of virus in their nose and throat, much more than those infected with the original virus. But even after adjusting for that difference, those infected with the variant released about 18 times as much virus into the smallest aerosols.
But the researchers examined only four people infected with Alpha, and 45 with older variants. That could skew the observed differences between the variants, said Seema Lakdawala, a respiratory virus expert at the University of Pittsburgh, who was not involved in either new study.
Infected people can pass the virus along to many, many others — or to none at all. How much virus they expel may depend on where in the respiratory tract it is replicating, the nature of the mucus in its environment, and what other microbes it may hitch a ride with.
The State of Vaccine Mandates in the U.S.
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- Vaccine rules. On Aug. 23, the F.D.A. granted full approval to Pfizer-BioNTech’s coronavirus vaccine for people 16 and up, paving the way for mandates in both the public and private sectors. Such mandates are legally allowed and have been upheld in court challenges.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. California became the first state to issue a vaccine mandate for all educators and has announced plans to add the Covid-19 vaccine as a requirement to attend school as early as next fall. Los Angeles already has a vaccine mandate for students 12 and older who are attending class in person starting Nov. 21. New York City has introduced a vaccine mandate for teachers and staff, but it has yet to take effect because of legal challenges. On Sept. 27, a federal appeals panel reversed a decision that temporarily paused that mandate.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get vaccinated. Mandates for health care workers in California and New York State appear to have compelled thousands of holdouts to receive shots.
- New York City. Proof of vaccination is required of workers and customers for indoor dining, gyms, performances and other indoor situations. City education staff and hospital workers must also get a vaccine.
- At the federal level. On Sept. 9, President Biden announced a vaccine mandate for the vast majority of federal workers. This mandate will apply to employees of the executive branch, including the White House and all federal agencies and members of the armed services.
- In the private sector. Mr. Biden has mandated that all companies with more than 100 workers require vaccination or weekly testing, helping propel new corporate vaccination policies. Some companies, like United Airlines and Tyson Foods, had mandates in place before Mr. Biden’s announcement.
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