Preventing SARS-CoV-2 superspreading events with antiviral intranasal sprays

George Booth; Christoforos Hadjichrysanthou; Keira L Rice; Jacopo Frallicciardi; Zoltán Magyarics; Frank de Wolf; Jaap Goudsmit; Anna L Beukenhorst; Roy Anderson

arXiv · 2505.08053

Preventing SARS-CoV-2 superspreading events with antiviral intranasal sprays

George Booth·Christoforos Hadjichrysanthou·Keira L Rice·Jacopo Frallicciardi·Zoltán Magyarics·Frank de Wolf·Jaap Goudsmit·Anna L Beukenhorst·Roy Anderson

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Abstract

Superspreading events are known to disproportionally contribute to onwards transmission of epidemic and pandemic viruses. Preventing infections at a small number of high-transmission settings is therefore an attractive public health goal. Here, we use deterministic and stochastic mathematical modelling to quantify the impact of intranasal sprays in containing outbreaks at a known superspreading event (the 2020 SARS-CoV-2 outbreak at the Diamond Princess cruise ship) and a conference event that led to extensive transmission. We find that in the Diamond Princess cruise ship case study, there exists a 7-14-day window of opportunity for widespread prophylactic spray usage to significantly impact the number of infections averted. Given an immediate response to a known SARS-CoV-2 outbreak, alongside testing and social distancing measures, prophylactic efficacy and coverage greater than 65% could reduce the average number of infections by over 90%. In the conference case study, in the absence of additional public health interventions, analyses suggest much higher prophylactic efficacies and coverages are required to achieve a similar outcome. However, prophylactic use can half an individual's probability of being infected, and significantly reduce the probability of developing a severe infection. These results suggest that at a known potential superspreading event, early use of intranasal sprays can complement quarantining measures and significantly suppress a SARS-CoV-2 outbreak, even at suboptimal coverage. At a potential superspreading event of short duration, intranasal sprays can reduce individuals' risk of infection, but cannot prevent all infections or onwards community transmission.

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George Booth, Christoforos Hadjichrysanthou, Keira L Rice, Jacopo Frallicciardi, Zoltán Magyarics, Frank de Wolf, Jaap Goudsmit, Anna L Beukenhorst, Roy Anderson. 2025-05-12. Preventing SARS-CoV-2 superspreading events with antiviral intranasal sprays. https://arxiv.org/abs/2505.08053

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