1. Statement of Purpose

We, citizens of the world, request that the World Health Organization (WHO) recognize the compelling scientific evidence that SARS-CoV-2 spreads by aerosol transmission (“airborne”) and urge the WHO to immediately develop and initiate clear recommendations to enable people to protect themselves.

In the early stages of the pandemic, WHO forcefully communicated that COVID-19 was not transmitted through the air, and called it “misinformation” (March 28, “FACT: COVID-19 is NOT airborne”). That message was heard loud and clear around the world and became entrenched in many people’s understandings of the virus' transmission pathways. It still influences mitigation strategies, despite that WHO has since softened this position and now acknowledges that airborne transmission of SARS-CoV-2 may be possible, albeit not very important.

WHO has made some updates to its practical guidance, which stemmed from its limited recognition of airborne transmission. However, even WHO's limited updated guidance has not been vehemently communicated or explained to the public. WHO’s lack of clarity and urgency regarding airborne transmission has led citizens, and those in key policymaking roles, to assume that additional precautions are not necessary. We know this is wrong. We know washing hands, distancing, and masks are not enough.

WHO has a duty to communicate all relevant and available scientific information to the world. Its influence on public health authorities must be used to shift practical guidance toward educating and mitigating the risk of airborne transmission. WHO must clearly explain why ventilation measures are needed and update its guidance to recommend facial coverings even when physical distance can be maintained indoors. WHO’s ambiguity sows confusion and causes serious harm by slowing the global COVID-19 response.

Airborne transmission of SARS-CoV-2 is a fact. As a result, some countries have already recognized it. In many other countries, informed people are already undertaking measures to protect their families and loved ones. However, not everyone has the same resources or access to information. The only way for protection measures can reach the entire population equally is through local authorities, most of which follow WHO recommendations. Given this reality, the lack of clear guidance from WHO contributes to increasing social inequalities.

2. Action Requested

We, citizens from all around the world, ask the WHO to:

1. Clearly acknowledge that SARS-CoV-2 transmits through aerosols, both in close proximity and when sharing room air. This is consistent with overwhelming evidence and follows the precautionary principle.

2. Urgently develop guidance, in consultation with multidisciplinary experts, that will reduce airborne transmission of SARS-CoV-2. This guidance should address how to wear appropriate masks that fit snugly around the face, and which should be worn indoors because there is no safe distance in shared indoor spaces; how to improve natural and HVAC ventilation, as well as air purification; and the use of CO2 meters to know if we are ventilating enough.

3. Urgently update guidance for personal protective equipment to be used by high-risk workers, especially in healthcare settings and nursing homes where SARS-CoV-2 spread affects not only the worker but also patients and vulnerable groups. At least a fit tested N95 / FFP2 mask should be recommended. Failure to acknowledge airborne transmission of SARS-CoV-2 has led to healthcare workers being under-protected.

4. Use WHO’s platform to clearly and quickly communicate these messages to the public, to governments, and to national and regional health agencies so they can act immediately to save lives. Initiate a widespread advertising campaign to prevent airborne transmission of SARS-CoV-2 informing all people around the world how the virus spreads through the air and promoting outdoor activities as much as possible. Unequivocally correct previous statements to the contrary. Mixed messages cost lives and weaken mitigation strategies.

5. Finally, the WHO must put diplomatic pressure on governments and national authorities who do not adjust their public recommendations to align with scientifically-based guidelines, thus jeopardizing the health and lives of their citizens.

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