WHO finally properly recognizes airborne nature of SARS-CoV-2
Over the past four years, COVID-19 has spread around the world killing millions of people. It is still evolving with different variants emerging at different times in different countries.
The virus that causes COVID-19 disease, SARS-CoV-2, may be with us for decades or even permanently as it evolves with all the serious ramifications to health and to the economy. Politicians, public health officials, and the public have become dangerously numb to hearing about COVID-19 and the lessons we should be heeding about how to mitigate transmission. Still it is very important to review and document all the evidence and evolving science about COVID-19 so that we might do a better job when confronted with this type of health crisis in the future.
Just this week there has been an important development regarding the understanding of the transmission of COVID-19. Only now, years after the emergence of COVID-19, has the UN’s World Health Organization (WHO) finally released a technical document that it describes as the “first step” toward better preventing transmission “through the air” of “infectious respiratory particles.” The pathogens covered include COVID-19, influenza, measles, tuberculosis, MERS, and SARS. This document could be most useful for addressing future pandemic threats or future situations of bioterrorism.
It is incredible that it has taken this long, and tremendously upsetting as I reflect back to 2020 and 2021 when my concerns about the potential for spread through the air of COVID-19 were not taken seriously and public health guidance failed to address this type of transmission, especially for vulnerable people in long-term care and congregate care settings.
This matter is a central thread of my account of the COVID-19 pandemic, as related in the book A Physician in the Political Arena -- viewed online or downloaded here.
In spring 2020, the WHO declared that COVID-19 was not airborne and insisted this was fact. WHO spokespeople said it was spread by droplets that drop. Just keep six feet apart we were all told. Public Health officials in Ontario and Canada followed suit, failing to think critically and failing to understand the dynamic interaction of the virus, the people affected, and the physical space.
The WHO’s news release from April 18, 2024, attempts to explain the challenge of addressing a lack of common terminology to describe transmission of pathogens. It suggests that the gaps in common understanding hampered efforts to curb the transmission of COVID-19. I find this to be a flimsy and, frankly, an unacceptable excuse for what occurred in 2020 and the period of time since.
The WHO’s failure to identify and communicate accurately the method of transmission of COVID-19 especially in the early days of the pandemic had extremely serious consequences, especially for those over 80 years of age at greatest risk of death from contracting SARS-CoV-2. It is hard to fathom that this failure could simply have resulted from confusion over terminology.
On page 32 of the WHO document, “Global technical consultation report on proposed terminology for pathogens that transmit through the air,” under the heading “Areas of non-consensus and concern regarding consequences,” it is revealed that “legal, logistic, operational and financial consequences that have global implications with regards to equity and access” were part of WHO considerations. Seriously, it is difficult to imagine how any credible scientific and health related group could have denied identifying spread through the air because of equity. How inequitable it is to deny the potential for airborne spread in the case of the very elderly who are most at risk because of their age.
Even if you only have time to read the news release and not the technical document itself, it is worth a read for anyone wishing to understand how terribly and tragically wrong public health experts were about the mechanism of transmission of SARS-CoV-2 during most of the COVID-19 pandemic emergency.
Gone are the terms “droplet” and “aerosol”. Now the infectious pathogens will be referred to as “infectious respiratory particles” or “IRPs”. The descriptor “through the air” will be used to refer to infectious disease such as COVID-19 that have a main mode of transmission as through the air or suspended in the air.
The term “airborne” will be nuanced in the context of respiratory pathogens that can travel in the air or be suspended in the air from a variety of actions as simple as speaking or singing, laughing or coughing…or breathing.
“The agreed terminology for pathogens that transmit through the air will help set a new path for research agendas and implementation of public health interventions to identify, communicate and respond to existing and new pathogens,” Dr Jeremy Farrar, WHO Chief Scientist said in the news release.
If only there was more concern for getting the transmission right from the beginning. Lives and livelihoods depend on it.
Dr. Merrilee Fullerton is the former Ontario Minister of Long-Term Care. This piece was originally published on her substack.