SARS-CoV-2 Transmission and the Risk of Aerosol-Generating Procedures

Patients who are not in significant respiratory failure may also require aerosol-generating procedures, such as chest physiotherapy or pulmonary function tests, for management of other conditions. Preventing healthcare-associated transmission of infection requires understanding both how SARS-CoV-2 is spread, as well as the specific risks associated with commonly-used respiratory procedures. This document summaries current understanding of these issues. Determining viral transmission dynamics is complex and difficult to investigate experimentally. Previous research on coronaviruses, including the viruses that cause Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome, suggest that contact and droplet transmission are very likely, and that aerosol transmission may also be possible. Early research on SARS-CoV-2 has shown that the virus can remain infectious on certain surfaces for up to 72 hours and in aerosols for up to 3 hours. Aerosol generating procedures are those that have the potential to generate aerosols and droplets that can spread respiratory pathogens.