Investigating factors in indoor transmission of respiratory disease through agent-based modeling

The transmission of respiratory diseases such as COVID-19 is exacerbated in densely populated urban areas and crowded indoor settings. Despite the majority of transmissions occurring in such settings, controlling viral spread through individual-level contacts indoors remains challenging. Experimental studies have investigated the transmission patterns of respiratory behaviors such as coughing or sneezing in controlled spatial environments. However, the effects of dynamic movement and spatial structures have been ignored, making it difficult to apply findings to urban policy and planning. To address this gap, we developed agent-based simulations to investigate individual virus inhalation patterns across multiple scenarios in a symmetrical and formulaic indoor space. We conducted sensitivity analysis using regression emulator models to identify significant factors for viral transmission. Our results indicate positive associations with viral transmission in descending order of: (1) stay time; (2) encounter frequency; and (3) initial infected population; while negative associations are: (4) mask wearing; (5) distance to infected people; (6) nearest infected people's mask wearing; and (7) distance to entrance. We also found that narrow passages between obstacles increase virus transmission from breathing. Furthermore, we conducted a case study to investigate the potential of reducing the amount of individually inhaled virus by controlling behaviors and spatial environments. Our findings suggest that mask wearing and reduced stay time can substantially reduce transmission risk, while a large number of contacts and high grouping time result in the growth of the infected population at a certain threshold. These results provide guidance for decision makers to formulate guidelines for curbing the spread of respiratory diseases in indoor spaces.