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Reducing risks from coronavirus transmission in the home—the role of viral load

Paul Little, professor1,  Robert C Read, professor2,  Richard Amlôt, scientific programme, leader3,  Tim Chadborn, head of group4,  Cathy Rice, public contributor5,  Jennifer Bostock, research adviser6,  Lucy Yardley, professor7 8

BMJ2020;369doi: 06 May 2020)Cite this as:BMJ2020;369:m1728

Care is needed when extrapolating evidence from other disease, but viral load is likely to be important for covid-19. The precautionary principle suggests that people caring for household members who are unwell should be encouraged to take measures to reduce infecting viral load in order to reduce the incidence and severity of infection. Promoting infection control measures in the community is a priority for the UK government and will continue to be so as “stay at home” policies are lifted. Dissemination of evidence based behavioural interventions may help increase adoption of public health advice and reduce viral load.

Key messages

  • Government policy is aimed at reducing transmission of covid-19 between family units, but less attention has been given to transmission between family members

  • Evidence from controlled experiments in animal models, viral genome studies, and other epidemics suggests the infecting viral load may be important

  • A web based intervention has been shown to reduce incidence, transmission, and severity of seasonal flu

  • Use of such behavioural interventions could support public health advice to improve infection control in families

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