---
title: "Hypothesis: Airborne Transmission of COVID-19 from Asymptomatic Individuals by Speaking"
id: "pubmed-41320299"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-41320299"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/41320299/"
doi: "10.7883/yoken.JJID.2025.169"
published_at: "2026-09-17T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Hypothesis: Airborne Transmission of COVID-19 from Asymptomatic Individuals by Speaking
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-41320299
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/41320299/)
- **DOI:** [10.7883/yoken.JJID.2025.169](https://doi.org/10.7883%2Fyoken.JJID.2025.169)
- **Published At:** 2026-09-17T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- The author proposes that **asymptomatic** SARS-CoV-2–infected persons can transmit COVID-19 by producing two distinct infectious respiratory particle types during speaking: large **droplets** and small **aerosols**. - Large droplets are hypothesized to originate from saliva when pronouncing plosive consonants such as /p/ or /t/ and can infect others by direct collision with the face, causing droplet infection. - Small aerosols are hypothesized to be generated from **laryngeal** secretions when vocal cords vibrate during vowel voicing; these lighter particles can remain suspended and accumulate in poorly ventilated rooms, leading to **airborne infection**. - The paper links this mechanism to epidemiologic observations: higher COVID-19 mortality in high-income hygienic countries and transmission by individuals without symptoms. - The author suggests that global differences in COVID-19 epidemiology may be influenced by three factors: climate and housing structure, cultural behaviors, and differences in languages spoken in various countries. - The article is presented as a hypothesis and review; it frames mechanisms of particle generation during specific speech sounds and contrasts droplet collision versus aerosol accumulation as pathways for transmission. - Keywords emphasized in the source include **aerosols**, **asymptomatic infection**, **droplets**, and **speaking**. Details about experimental data, quantitative measurements, or confirmatory studies were not reported in the PubMed abstract and would require consultation of the full text. - Publication details from the source: Sakae Inouye, Jpn J Infect Dis, 2026;79(5):218–221. PMID 41320299; DOI 10.7883/yoken.JJID.2025.169.
## Clinical Analysis & Structured Key Points
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Epub 2025 Nov 28. # Hypothesis: Transmission of COVID-19 through the Air from Asymptomatic Individuals by Speaking [Sakae Inouye](https://pubmed.ncbi.nlm.nih.gov/?term=Inouye+S&cauthor_id=41320299)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41320299/#full-view-affiliation-1 "Honorary Member, National Institute of Infectious Diseases, Japan Institute of Health Security, Japan.") Affiliations Expand ### Affiliation * 1 Honorary Member, National Institute of Infectious Diseases, Japan Institute of Health Security, Japan. * PMID: **41320299** * DOI: [ 10.7883/yoken.JJID.2025.169 ](https://doi.org/10.7883/yoken.jjid.2025.169) Free article Item in Clipboard Review # Hypothesis: Transmission of COVID-19 through the Air from Asymptomatic Individuals by Speaking Sakae Inouye. Jpn J Infect Dis. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Jpn J Infect Dis Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Jpn+J+Infect+Dis%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Jpn+J+Infect+Dis%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/41320299/) . 2026 Sep 17;79(5):218-221. doi: 10.7883/yoken.JJID.2025.169. Epub 2025 Nov 28. ### Author [Sakae Inouye](https://pubmed.ncbi.nlm.nih.gov/?term=Inouye+S&cauthor_id=41320299)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/41320299/#short-view-affiliation-1 "Honorary Member, National Institute of Infectious Diseases, Japan Institute of Health Security, Japan.") ### Affiliation * 1 Honorary Member, National Institute of Infectious Diseases, Japan Institute of Health Security, Japan. * PMID: **41320299** * DOI: [ 10.7883/yoken.JJID.2025.169 ](https://doi.org/10.7883/yoken.jjid.2025.169) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract COVID-19 mortality seems to be higher in high-income, hygienic countries, but this is contrary to conventional communicable diseases, which usually occur in low-income countries. Another characteristic of COVID-19 is that a proportion of infected individuals had no symptoms but transmitted the virus to others. In this paper, the author proposes a hypothesis that infected but asymptomatic individuals produce two kinds of infectious respiratory particles by speaking: large droplets and small aerosols. The large droplets are produced from the saliva by pronouncing a plosive, /p/ or /t/, whereas the small aerosols are produced from the laryngeal secretion by the vibration of vocal cords during the voicing of vowels. The heavy droplets collide with other people's faces in conversation, resulting in droplet infection. In contrast, the lighter aerosols float in the air, accumulate inside a non-ventilated room after prolonged conversation, and cause airborne infection in other people in the same room. Then, the author discusses the global epidemiology of COVID-19, which may have depended on 1) climate and housing structure, 2) cultural behaviors, and 3) languages among different countries. **Keywords:** aerosols; asymptomatic infection; droplets; speaking. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Airborne Precautions. ](https://pubmed.ncbi.nlm.nih.gov/30285363/) Ather B, Mirza TM, Edemekong PF.Ather B, et al.2023 Mar 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–.2023 Mar 13. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–.PMID: 30285363Free Books & Documents. * [ Heterogeneity in transmissibility and shedding SARS-CoV-2 via droplets and aerosols. ](https://pubmed.ncbi.nlm.nih.gov/33861198/) Chen PZ, Bobrovitz N, Premji Z, Koopmans M, Fisman DN, Gu FX.Chen PZ, et al.Elife. 2021 Apr 16;10:e65774. doi: 10.7554/eLife.65774.Elife. 2021.PMID: 33861198Free PMC article. * [ Air cleaning technologies: an evidence-based analysis. ](https://pubmed.ncbi.nlm.nih.gov/23074468/) Medical Advisory Secretariat.Medical Advisory Secretariat.Ont Health Technol Assess Ser. 2005;5(17):1-52. 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