Probable aerosol transmission of SARS-CoV-2 in a poorly ventilated courtroom

There is increasing evidence of SARS-CoV-2 transmission via aerosol; the number of cases of transmission via this route reported in the literature remains however limited. This study examines a case of clustering that occurred in a courtroom, in which 5 of the 10 participants were tested positive within days of the hearing. Ventilation loss rates and dispersion of fine aerosols were measured through CO2 injections and lactose aerosol generation. Emission rate and influencing parameters were then computed using a well-mixed dispersion model. The emission rate from the index case was estimated at 130 quanta h(-1) (interquartile (97-155 quanta h(-1)). Measured lactose concentrations in the room were found relatively homogenous (n = 8, mean 336 mu g m(-3), SD = 39 mu g m(-3)). Air renewal was found to play an important role for event durations greater than 0.5 h and loss rate below 2-3 h(-1). The estimated emission rate suggests a high viral load in the index case and/or a high SARS-CoV-2 infection coefficient. High probabilities of infection in similar indoor situations are related to unfavorable conditions of ventilation, emission rate, and event durations. Source emission control appears essential to reduce aerosolized infection in events lasting longer than 0.5 h.

Automated summary

This study investigated a case of COVID-19 clustering in a courtroom, finding a high emission rate and the importance of air renewal for event durations longer than 0.5 hours and loss rates below 2-3 h-1.