Pandemic management requires exposure science

COVID-19 was first detected in Wuhan, China, on 8.12.2019, and WHO announced it a pandemic on 11.3.2020. No vaccines or medical cures against COVID-19 were available in the first corona year. Instead, different combinations of generic non-pharmaceutical interventions – to slow down the spread of infections via exposure restrictions to ‘flatten the curve’ so that it would not overburden the health care systems, or to suppress the virus to extinction – were applied with varying levels of strictness, duration and success in the Pacific and North Atlantic regions. Due to an old misconception, almost all public health authorities dismissed the possibility that the virus would be transmitted via air. Opportunities to reduce the inhalation exposure – such as wearing effective FFP2/N95 respirators, improving ventilation and indoor air cleaning – were missed, and instead, hands were washed and surfaces disinfected. The fact that aerosols were acknowledged as the main route of COVID-19 transmission in 2021 opened avenues for more efficient and socially less disruptive exposure and risk reduction policies that are discussed and evaluated here, demonstrating that indoor air and exposure sciences are crucial for successful management of pandemics. To effectively apply environmental and personal exposure mitigation measures, exposure science needs to target the human-to-human exposure pathways of the virus.