Managing infectious aerosols to counter engineered pandemics: Current recommendations and future research

In the increasingly likely event of an engineered-virus outbreak or pandemic of catastrophic potential, managing infectious aerosols to reduce transmission will be crucial. Now is the time to start preparing our buildings, public opinion, and regulatory environments for the infectious aerosol management interventions necessary to protect the public. But which interventions should governments and institutions invest in the most? We review the leading candidate methods for infectious aerosol management and discuss their respective advantages, disadvantages, and suitable settings. There is strong emerging evidence that two recently explored technologies, direct exposure to far-ultraviolet-C (UVC) light and triethylene glycol, are particularly efficacious and safe, but there remain open questions about the long-term safety and efficacy of these interventions. In the meantime, we recommend other interventions-especially upper-room UVC and in-room air cleaners-for settings where most occupants regularly spend more than a small fraction of their day. We conclude by listing research questions about these interventions that still need to be researched in social science, product development, medicine, engineering, economics, and ethics.