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What is the evidence for physical distancing in covid-19?

August 28, 2020

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3223

  1. Nicholas R Jones, 1 clinical researcher,  
  2. Zeshan U Qureshi, clinical academic,2,  
  3. Robert J Temple, medical student3,  
  4. Jessica P J Larwood, medical student4,  
  5. Trisha Greenhalgh, professor1,  
  6. Lydia Bourouiba, professor5

Rigid safe distancing rules are an oversimplification based on outdated science and experiences of past viruses, argue Nicholas R Jones and colleagues

Physical distancing is an important part of measures to control covid-19, but exactly how far away and for how long contact is safe in different contexts is unclear. Rules that stipulate a single specific physical distance (1 or 2 metres) between individuals to reduce transmission of SARS-CoV-2, the virus causing covid-19, are based on an outdated, dichotomous notion of respiratory droplet size. This overlooks the physics of respiratory emissions, where droplets of all sizes are trapped and moved by the exhaled moist and hot turbulent gas cloud that keeps them concentrated as it carries them over metres in a few seconds.12 After the cloud slows sufficiently, ventilation, specific patterns of airflow, and type of activity become important. Viral load of the emitter, duration of exposure, and susceptibility of an individual to infection are also important.

Instead of single, fixed physical distance rules, we propose graded recommendations that better reflect the multiple factors that combine to determine risk. This would provide greater protection in the highest risk settings but also greater freedom in lower risk settings, potentially enabling a return towards normality in some aspects of social and economic life.

https://www.bmj.com/content/370/bmj.m3223

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