An estimation of airborne SARS-CoV-2 infection transmission risk in New York City nail salons

Although airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from person-to-person over long distances is currently thought to be unlikely, the current epidemiological evidence suggests that airborne SARS-CoV-2 infection transmission in confined, indoor spaces is plausible, particularly when outdoor airflow rates are low and when face masks are not utilized. We sought to model airborne infection transmission risk assuming five realistic exposure scenarios using previously estimated outdoor airflow rates for 12 New York City nail salons, a published quanta generation rate specific to SARS-CoV-2, as well as the Wells-Riley equation to assess risk under both steady-state and non-steady-state conditions. Additionally, the impact of face mask-wearing by occupants on airborne infection transmission risk was also evaluated. The risk of airborne infection transmission across all salons and all exposure scenarios when not wearing face masks ranged from <0.015% to 99.25%, with an average airborne infection transmission risk of 24.77%. Wearing face masks reduced airborne infection transmission risk to between <0.01% and 51.96%, depending on the salon, with an average airborne infection transmission risk of 7.30% across all salons. Increased outdoor airflow rates in nail salons were generally strongly correlated with decreased average airborne infection transmission risk. The results of this study indicate that increased outdoor airflow rates and the use of face masks by both employees and customers could substantially reduce SARS-CoV-2 transmission in New York City nail salons. Businesses should utilize multiple layers of infection control measures (e.g. social distancing, face masks, and outdoor airflow) to reduce airborne infection transmission risk for both employees and customers.