Outbreak Investigation of Airborne Transmission of Omicron (B.1.1.529) - Sars-Cov-2 Variant of Concern in a Restaurant: Implication for Enhancement of Indoor Ventilation

31 Pages Posted: 16 Feb 2022

See all articles by Vincent Chi-Chung Cheng

Vincent Chi-Chung Cheng

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

David Christopher Lung

affiliation not provided to SSRN

Shuk-Ching Wong

The University of Hong Kong - Queen Mary Hospital

Albert Ka-Wing Au

affiliation not provided to SSRN

Qun Wang

The University of Hong Kong

Hong Chen

affiliation not provided to SSRN

Li Xin

The University of Hong Kong - Department of Microbiology

Allen Wing-Ho Chu

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Jonathan Daniel Ip

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Wan-Mui Chan

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Hoi-Wah Tsoi

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Herman Tse

affiliation not provided to SSRN

Ken Ho-Leung Ng

affiliation not provided to SSRN

Mike YE Kwan

Princess Margaret Hospital - Department of Paediatric and Adolescent Medicine

Shuk-Kwan Chuang

affiliation not provided to SSRN

Kelvin Kai-Wang To

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Yuguo Li

The University of Hong Kong - Department of Mechanical Engineering

Kwok-Yung Yuen

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases

Abstract

Airborne transmission of SARS-CoV-2 has been increasingly recognized in the outbreak of COVID-19, especially during the emergence of Omicron variant. We conducted an investigation of a restaurant outbreak due to Omicron variant. Besides the epidemiological and phylogenetic analysis, the secondary attack rates of customers of restaurant-related COVID-19 before (outbreak R1) and after enhancement of indoor ventilation (outbreak R2) were compared. On 27th December 2021, an index case attended a restaurant R2 for 98 minutes. Except for 1 sitting in the same table, six other secondary cases sat in 3 corners at 3 different zones, where designated staff served customers at different zone. The median exposure time was 34 minutes (range:19-98 minutes). All 7 secondary cases were phylogenetically related to the index. Smoke test demonstrated the direction of airflow which explained the distribution of secondary cases. Compared with an earlier COVID-19 outbreak in another restaurant R1 (19th February 2021), just preceding the mandatory requirement of enhancement of indoor ventilation, the secondary attack rates among customers in R2 was significantly lower than that in R1 (3.4%,7/207 vs 28.9%,22/76,p<0.001). Enhancement of indoor ventilation with installation of air purifier and upper-room ultraviolet-C germicidal irradiation could minimize the risk of SARS-CoV-2 transmission in the restaurant.

Keywords: Outbreak investigation, airborne transmission, Omicron, restaurant, indoor ventilation

Suggested Citation

Cheng, Vincent Chi-Chung and Lung, David Christopher and Wong, Shuk-Ching and Au, Albert Ka-Wing and Wang, Qun and Chen, Hong and Xin, Li and Chu, Allen Wing-Ho and Ip, Jonathan Daniel and Chan, Wan-Mui and Tsoi, Hoi-Wah and Tse, Herman and Ng, Ken Ho-Leung and Kwan, Mike YE and Chuang, Shuk-Kwan and To, Kelvin Kai-Wang and Li, Yuguo and Yuen, Kwok-Yung, Outbreak Investigation of Airborne Transmission of Omicron (B.1.1.529) - Sars-Cov-2 Variant of Concern in a Restaurant: Implication for Enhancement of Indoor Ventilation. Available at SSRN: https://ssrn.com/abstract=4011840 or http://dx.doi.org/10.2139/ssrn.4011840

Vincent Chi-Chung Cheng (Contact Author)

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

David Christopher Lung

affiliation not provided to SSRN ( email )

No Address Available

Shuk-Ching Wong

The University of Hong Kong - Queen Mary Hospital ( email )

Hong Kong
China

Albert Ka-Wing Au

affiliation not provided to SSRN ( email )

No Address Available

Qun Wang

The University of Hong Kong ( email )

Pokfulam Road
Hong Kong, HK
China

Hong Chen

affiliation not provided to SSRN ( email )

No Address Available

Li Xin

The University of Hong Kong - Department of Microbiology ( email )

Allen Wing-Ho Chu

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Jonathan Daniel Ip

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Wan-Mui Chan

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Hoi-Wah Tsoi

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Herman Tse

affiliation not provided to SSRN ( email )

No Address Available

Ken Ho-Leung Ng

affiliation not provided to SSRN ( email )

No Address Available

Mike YE Kwan

Princess Margaret Hospital - Department of Paediatric and Adolescent Medicine ( email )

China

Shuk-Kwan Chuang

affiliation not provided to SSRN ( email )

No Address Available

Kelvin Kai-Wang To

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

Yuguo Li

The University of Hong Kong - Department of Mechanical Engineering

China

Kwok-Yung Yuen

The University of Hong Kong - State Key Laboratory of Emerging Infectious Diseases ( email )

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