PDF(Pubmed)
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.
摘要：
SARS-CoV-2是否主要通过液滴或气溶胶传播的问题一直存在很大争议。我们试图通过对其他疾病传播研究的历史分析来解释这一争议。在人类历史的大部分时间里，主要的范例是许多疾病是由空气携带的，经常在很长的距离和幻想的方式。19世纪中后期，随着细菌理论的兴起，这种扭曲的范式受到了挑战，作为霍乱等疾病，产褥热,发现疟疾实际上是以其他方式传播的。出于他对接触/飞沫感染重要性的看法，以及他从miasma理论的剩余影响中遇到的阻力，著名的公共卫生官员CharlesChapin在1910年帮助发起了成功的范式转变，认为空中传播是最不可能的。这种新范式成为主导。然而,缺乏对气溶胶的理解导致了对传播途径研究证据解释的系统误差。在接下来的五十年里，空气传播被认为对所有主要呼吸系统疾病都具有微不足道或次要的重要性，直到1962年证明了结核病的空气传播（被错误地认为是通过液滴传播）。接触/液滴范式仍然占主导地位，在COVID-19之前，只有少数疾病被广泛接受为空气传播：那些明显传播给不在同一个房间的人的疾病。受COVID-19大流行的启发，跨学科研究的加速表明，空气传播是这种疾病的主要传播方式，并且可能对许多呼吸道传染病具有重要意义。
