Importance of non-pharmaceutical interventions in lowering the viral inoculum to reduce susceptibility to infection by SARS-CoV-2 and potentially disease severity.

Journal Article (Journal Article;Review)

Adherence to non-pharmaceutical interventions to prevent the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been highly variable across settings, particularly in the USA. In this Personal View, we review data supporting the importance of the viral inoculum (the dose of viral particles from an infected source over time) in increasing the probability of infection in respiratory, gastrointestinal, and sexually transmitted viral infections in humans. We also review the available evidence linking the relationship of the viral inoculum to disease severity. Non-pharmaceutical interventions might reduce the susceptibility to SARS-CoV-2 infection by reducing the viral inoculum when there is exposure to an infectious source. Data from physical sciences research suggest that masks protect the wearer by filtering virus from external sources, and others by reducing expulsion of virus by the wearer. Social distancing, handwashing, and improved ventilation also reduce the exposure amount of viral particles from an infectious source. Maintaining and increasing non-pharmaceutical interventions can help to quell SARS-CoV-2 as we enter the second year of the pandemic. Finally, we argue that even as safe and effective vaccines are being rolled out, non-pharmaceutical interventions will continue to play an essential role in suppressing SARS-CoV-2 transmission until equitable and widespread vaccine administration has been completed.

Full Text

Duke Authors

Cited Authors

  • Spinelli, MA; Glidden, DV; Gennatas, ED; Bielecki, M; Beyrer, C; Rutherford, G; Chambers, H; Goosby, E; Gandhi, M

Published Date

  • September 2021

Published In

Volume / Issue

  • 21 / 9

Start / End Page

  • e296 - e301

PubMed ID

  • 33631099

Pubmed Central ID

  • PMC7906703

Electronic International Standard Serial Number (EISSN)

  • 1474-4457

Digital Object Identifier (DOI)

  • 10.1016/S1473-3099(20)30982-8


  • eng

Conference Location

  • United States