Sowerby LJ, Nichols AC, Gibson R, et al. - Detection of live severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus in saliva, sputum, bile, feces, and blood and its viability in aerosols for at least 3 hours have been reported, raising a particular safety concern regarding direct transmission to surgical staff from aerosolized virus in an electrocautery plume (as observed with other viruses). Findings from this study suggest electrocautery smoke is not a source of SARS-CoV-2 transmission for health care workers.

• Examined was the presence of live SARS-CoV-2 in electrocautery plumes.

• Three different methods (monopolar cut, monopolar coagulate, and bipolar electrocautery [Erbe USA]) were used to apply electrocautery at 25 W for 1 minute on raw chicken breast with an added 4 mL of Dulbecco modified eagle medium (DMEM) or a DMEM:blood mixture containing 1 × 10^5.7 median tissue culture infectious dose (TCID_{50) per mL of SARS-CoV-2.}

• Repetition of each experimental condition was done in triplicate.

• During the monopolar cut, monopolar coagulate, and bipolar electrocautery, vaporization of an estimated volume of 1.7 ± 0.3 mL, 1.5 ± 0.1 mL, and 1.0 ± 0.2 mL of liquid was done, respectively, and vapors were collected using a Western AirScan air sampler at 60 L per minute onto a gelatin filter in triplicate (Sartorius Canada).

• For a positive control, aerosolization of around 0.3 mL of both viral media and blood with SARS-CoV-2 (without heat) was done in the chamber and the collection was done in the same fashion.

• Aerosol cautery plume generated from electrocautery had no detection of SARS-CoV-2 in any of the conditions studied despite using the high viral titers.

• A minimum of a 9 log reduction of viral RNA was observed with any of the electrocautery methods by mimicking surgery on a patient with a high SARS-CoV-2 load.