The Investigation of Particulate Respiratory Matter to Inform Guidance for the Safe Distancing of Performers in a COVID-19 Pandemic (PERFORM-2)

已知感染SARS-CoV-2的个体在人类呼气事件期间释放的呼吸颗粒跨越宽的尺寸范围，从大的宏观液滴到小的气溶胶颗粒。虽然这些飞沫（直径>5微米）和气溶胶（<5微米）是直接、间接和空气传播病毒的方式，但在说话、唱歌、演奏乐器和锻炼等活动中呼出的浓度和通量很难量化，在某些情况下仍然完全未知。由于缺乏对重新开始活动的风险评估至关重要的数据，导致采取了严重限制业余和专业领域歌唱、音乐表演和体育运动的预防措施。在与一群专业音乐家进行初步工作的基础上，我们将对歌手的气溶胶和液滴排放进行全面分析，涵盖广泛的流派，以及木管乐器和铜管乐器。在骨科手术室这个“零气溶胶”背景的环境中工作，我们将扩大我们的研究范围，量化业余音乐家和运动个人呼出的可吸入颗粒物，严格探索大液滴传播的距离和气溶胶通量，重点关注超级发射器，并与言语和语言治疗师合作，了解治疗期间使用气溶胶发生程序的风险。在一系列场地类型（从现代礼堂到历史悠久的教堂）中，我们将测量气溶胶扩散和清除的动态，为气溶胶扩散的计算流体动力学模型和暴露风险评估提供信息。

Respiratory particles emitted during human exhalatory events by an individual infected with SARS-CoV-2 are known to span a wide size range, from large macroscopic droplets to small aerosol particles. Although these droplets (>5 micrometres diameter) and aerosols (<5 micrometres) are responsible for direct, indirect and airborne modes of viral transmission, the concentrations and fluxes expired during activities such as speaking, singing, playing musical instruments and exercising, are poorly quantified and, in some cases, remain completely unknown. An absence of data, essential to inform assessments of risk in restarting activities, has led to precautionary measures that severely restrict singing, musical performance and sport, across both the amateur and professional domains. Building on preliminary work with a cohort of professional musicians, we will provide a comprehensive analysis of aerosol and droplet emissions from singers covering a broad range of genres, as well as woodwind and brass instruments. Working in an orthopaedic operating theatre, an environment of "zero aerosol" background, we will extend our study to quantify respirable particles exhaled by amateur musicians and individuals undertaking exercise, explore rigorously the distance of large droplet transmission and aerosol flux, focusing on super-emitters, and work with speech and language therapists to understand the risks of aerosol generating procedures used during therapy. In a range of venue types (from a modern auditorium to an historic church), we will measure the dynamics of aerosol dispersion and clearance, informing computational fluid dynamics models of aerosol spread and assessments of exposure risk.