Probable Evidence of Aerosol Transmission of SARS-COV-2 in a COVID-19 Outbreak of a High-Rise Building

Although it is well established that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted through aerosols, the mode of long-range aerosol transmission in high-rise buildings remains unclear. In this study, we analyzed an outbreak of coronavirus disease 2019 (COVID-19) that occurred in a high-rise building in China. Our objective was to investigate the plausibility of aerosol transmission of SARS-CoV-2 by testing relevant environmental variables and measuring the dispersion of a tracer gas in the drainage system of the building. The outbreak involved 7 infected families, of which 6 were from vertically aligned flats on different floors. Environmen ìtal data revealed that 3 families' bathrooms were contaminated by SARS-CoV-2. In our tracer experiment, we injected tracer gas (CO2) into the dry floor drains and into water-filled toilets in the index case' s bathroom. Our findings showed that the gas could travel through vertical pipes by the dry floor drains, but not through the water of the toilets. This indicates that dry floor drains might facilitate the transmission of viral aerosols through the sewage system. On the basis of circumstantial evidence, long-range aerosol transmission may have contributed to the community outbreak of COVID-19 in this high-rise building. The vertical transmission of diseases through aerosols in high-rise buildings demands urgent attention.