How does she get COVID-19 ?
Text updated on 2020-04-29
The virus comes out where it entered (secretions from the mouth and nose) and arrives very quickly on the hands.
The coronavirus SARS-CoV-2 (agent of the infection leading to the disease COVID-19) is transmitted:
- by droplets (>5μm) and aerosols(sputters) when coughing, sneezing, but also when speaking, singing, and screaming and through the eyes;
- by direct contact between people: handshake, hugging, kissing because we generally accompany these gestures with words;
- perhaps through the stool, which contains viral particles that can become suspended and enter the lungs.
Secondarily through indirect contact, via objects that have been contaminated by an infected person. For example, by opening a door handle covered with viral particles (because an infected person had previously used the handle after touching their face) and then touching his/her face with one's hand.
To lead to an infection, viral particles must enter through one of our mucous membranes (nose, mouth, eyes). The virus cannot infect us simply by passing through the skin of our hands, even if we have a small cut on the skin.
Absorption of a single viral particle is not enough to trigger an infection. It is not yet known how many absorbed viral particles are needed to cause an infection. But coronavirus can be detected for several days on surfaces, especially metal or plastic, surgical masks, or glass/ceramic (see questions below).
The risk of contamination does not disappear when you return home, quite the contrary.
There is considerable evidence to suggest that the SARS-CoV-2 virus is airborne.Morawska, L., & Cao, J. (2020). Airborne transmission of SARS-CoV-2: the world should face the reality. Environment International, 105730.
It is difficult to obtain irrefutable quantitative data on the COVID-19 transmission of aerosols in the air.Lewis, D. (2020). Is the coronavirus airborne? Experts can't agree. Nature 580, 175.
The 60 members of a choir gathered in a room to sing for 2.5 hours on March 10, 2020 in Washington State, USA. They kept a safe distance, used hydro-alcoholic solutions, but did not put on masks. Three weeks later, 45 of them tested positive for COVID-19.Los Angeles Times article of March 29, 2020.
In a windowless, air-conditioned restaurant on the 5th floor, a COVID-19 asymptomatic person contaminated at least two other people more than 2 meters away, who were eating at two adjacent tables.Lu, J., Gu, J., Li, K., Xu, C., Su, W., Lai, Z., ... & Yang, Z. (2020). COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020. Emerging Infectious Diseases, 26(7).
Using a laser beam, researchers have observed that saying the words "Stay Healthy" generates thousands of droplets of saliva that are otherwise invisible to the naked eye. A homemade wet cloth mask significantly reduces droplet excretion.Anfinrud, P., Bax, C. E., Stadnytskyi, V., & Bax, A. (2020). Could SARS-CoV-2 be transmitted via speech droplets?. medRxiv.
In Japan, many cases of "cluster" contamination have occurred in closed places: a sports hall, restaurant boat, hospital, festival where there were tents with minimal ventilation for eating.Nishiura, H., Oshitani, H., Kobayashi, T., Saito, T., Sunagawa, T., Matsui, T., ... & Suzuki, M. (2020). Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19). medRxiv.
The analysis of 318 cases where one person contaminated at least 2 other people in China (for a total of 1,245 people tested COVID+) reveals that the majority of the contaminations took place in a closed space, mainly in the home and on transportation, but also in restaurants, and that only one contamination took place following an open-air discussion with a person returning from Wuhan.Qian, H., Miao, T., Li, L. I. U., Zheng, X., Luo, D., & Li, Y. (2020). Indoor transmission of SARS-CoV-2. medRxiv.
This article describes non-contact cases of contamination: a person crossing the corridor in front of an open patient door (several times), and 4 technicians at the Wuhan hospital who did not come into contact with confirmed cases.Wang, J., & Du, G. (2020). COVID-19 may transmit through aerosol. Irish Journal of Medical Science (1971-), 1-2.