ReviewIndoor air2022
What were the historical reasons for the resistance to recognizing airborne transmission during the COVID-19 pandemic?
Review in Indoor air, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Masks and respirators for prevention of respiratory infections: a state of the science review.Clinical microbiology reviews · 2024Pooled it
- Pooled it
- Is There an Optimal Wavelength for Germicidal Ultraviolet Air Disinfection?Environmental science & technology · 2026Article
- Walking for Health: Franz Tappeiner (1816-1902), Meran, and the Origins of Public Health-Oriented Physical Activity.International journal of environmental research and public health · 2026Article
- Review
- Size distribution and viral RNA load of influenza virus-laden airborne particles emitted from pigs over the course of an H1N1 infection.Scientific reports · 2025Article
- Three things we can do now to reduce the risk of avian influenza spillovers.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
- 2024 Year in Review: Fugitive Aerosols-Keeping the Air Clear for Patients and Staff.Respiratory care · 2025Review
- Aerosol Dispersion and Efficacy of Protective Strategies During Dental Procedures.International dental journal · 2025Article
- The attributes of public health leadership.European journal of public health · 2025Article
- Reflections From the Pandemic: Is Connectivism the Panacea for Clinicians?Journal of medical Internet research · 2024Article
- Bioaerosols and Airborne Transmission in the Dental Clinic.International dental journal · 2024Review
- Carl Flügge, one of the last holistic hygienists and discoverer of droplet transmission of infectious diseases.Medical microbiology and immunology · 2024Article
- Review
- Effects of 222 nm Germicidal Ultraviolet Light on Aerosol and VOC Formation from Limonene.ACS ES&T air · 2024Article
- Exploring the Interplay of Food Security, Safety, and Psychological Wellness in the COVID-19 Era: Managing Strategies for Resilience and Adaptation.Foods (Basel, Switzerland) · 2024Review
- The airborne transmission of viruses causes tight transmission bottlenecks.Nature communications · 2024Article
- The time has come to protect healthcare workers and patients from aerosol transmissible disease.Frontiers in public health · 2024Article
- Imprint of ancestral and modern threats in human mind - experience of fear, disgust, and anger.Frontiers in psychology · 2024Article
- "Backlash!"? A qualitative exploration of hospice palliative care staff's ongoing experiences of "living with covid".Palliative care and social practice · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
Abstract
The question of whether SARS-CoV-2 is mainly transmitted by droplets or aerosols has been highly controversial. We sought to explain this controversy through a historical analysis of transmission research in other diseases. For most of human history, the dominant paradigm was that many diseases were carried by the air, often over long distances and in a phantasmagorical way. This miasmatic paradigm was challenged in the mid to late 19th century with the rise of germ theory, and as diseases such as cholera, puerperal fever, and malaria were found to actually transmit in other ways. Motivated by his views on the importance of contact/droplet infection, and the resistance he encountered from the remaining influence of miasma theory, prominent public health official Charles Chapin in 1910 helped initiate a successful paradigm shift, deeming airborne transmission most unlikely. This new paradigm became dominant. However, the lack of understanding of aerosols led to systematic errors in the interpretation of research evidence on transmission pathways. For the next five decades, airborne transmission was considered of negligible or minor importance for all major respiratory diseases, until a demonstration of airborne transmission of tuberculosis (which had been mistakenly thought to be transmitted by droplets) in 1962. The contact/droplet paradigm remained dominant, and only a few diseases were widely accepted as airborne before COVID-19: those that were clearly transmitted to people not in the same room. The acceleration of interdisciplinary research inspired by the COVID-19 pandemic has shown that airborne transmission is a major mode of transmission for this disease, and is likely to be significant for many respiratory infectious diseases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.