Airborne infections related to virus aerosol contamination at indoor cultural venues: Recommendations on how to minimize

Abstract

Background: The COVID-19 pandemic has resulted in many live events being canceled or held without spectator participation. As a result, a series of investigations were carried out and strategies developed to determine the requirements under which cultural activities can be maintained. This work summarizes published studies and provides recommendations for performing cultural events under pandemic conditions.

Methods: The available literature search was evaluated in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The results were combined with findings, guidelines, and regulations for conducting courses in other indoor environments under pandemic conditions, for example, school classrooms. Recommendations were derived, the consideration of which can enable the continuation of cultural events.

Results: The published studies can only take into account the previous conditions of the pandemic situation with the known virus mutations. However, the number of experimental investigations including analytical and medical proof of infections, surveys, and simulations is comparatively small. This is due to the complexity of the events as well as the priority and urgency of the school issue. Cultural events take place under very different conditions. It is therefore practically impossible to predict the risk of infection for a specific situation with many potential virus spreaders attending or to derive general rules that go beyond the known measures of vaccination, testing, masks, and distance.

Conclusion: Cultural events can be held under pandemic conditions provided certain requirements are met. Most study results agree on this. Any recommendations on hygiene, safety, and ventilation measures in cultural facilities under pandemic conditions can reduce the risk of infection but cannot completely eliminate it. It is also of considerable importance that visitors protect themselves individually and act responsibly.

Keywords: public events; safety measures; ventilation.

FIGURE 1

Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) flow diagram according to Ref. [7] for a systematic review that included searches of different databases. GS, GoogleScholar; WoS, Web of Science

FIGURE 2

Time required for the diameter of pure water particles to decrease by 50% through evaporation at 20°C and various relative humidities. For comparison, the time required for a not shrinking particle to sink by 1 m in still air is also plotted (black curve).

FIGURE 3

Dynamics of visitors during a cultural event

FIGURE 4

Different types of air supply and air distribution during a cultural event. (a) Simple ventilation by fans; (b) ventilation system with inlet and outlet in the ceiling area; (c) individual ventilation directly at the seat and outlet in the ceiling area. The green and red arrows indicate air inlet and outlet, respectively.

FIGURE 5

Absolute risk of infection AR_inf according to the Wells–Riley equation in dependence of the air exchange rate. The calculation was carried out with Equation (1) for different quanta, see text for parameters and colors of the curves.