Interrogating the Effect of Assay Media on the Rate of Virus Inactivation of High-Touch Copper Surfaces: A Materials Science Approach

Contamination of high-touch surfaces with infected droplets of bodily secretions is a known route of virus transmission. Copper surfaces have been reported to inactivate human coronaviruses after several minutes, via the release of Cu cations. Utilization of copper alloys for high-touch surfaces can be a pivotal preemptive strategy for preventing the next pandemic. Understanding the true efficacy by which copper, and copper alloys, inactivate the virus under realistic conditions is essential for tuning intrinsic alloy features such as composition, grain orientation, and surface attributes, to optimize for antiviral function. However, virus inactivation measurements depend on the presence of an assay media (AM) solution as a carrier for the virus, and its effects on the surface properties of pure copper that regulate oxidative copper release are previously unknown. Herein, these properties and the influence of AM on the efficacy of virus inactivation occurring on the surface of pure copper are investigated. The process is uncovered by which a five-fold decrease in virus half-life is observed in simulated real-life conditions, relative to exposure to traditional AM. The investigation highlights the notion that virus inactivation on copper surfaces may be significantly more effective than previously thought. © 2022 The Authors. Advanced Materials Interfaces published by Wiley-VCH GmbH.

Recollections of the intensive care unit experience among families of patients with COVID-19

RATIONALE: Clinicians typically encourage family presence in the Intensive Care Unit (ICU) as a way to improve both patient and family outcomes. To limit the spread of the disease, families were typically prohibited from visiting the ICU during the COVID-19 pandemic. Little is known about the approach clinicians should take when engaging with families in times when they cannot visit the hospital. METHODS: Surrogates of critically ill patients with COVID-19 who participated in a clinical trial at a single academic center were contacted after ICU discharge to participate in a follow up study dealing with their ICU experience. Upon enrollment in this post-ICU discharge study, the subject (surrogate of the ICU patient) completed the Critical Care Family Needs Inventory (CCFNI) questionnaire and participated in a semi-structured telephone interview. The CCFNI questionnaire includes 14 questions dealing with aspects of the ICU experience that are important to family members. The answers to each question range from 1 (almost all the time) to 4 (none of the time), with lower scores indicating a better experience. Telephone interviews were transcribed and coded using thematic content analysis. RESULTS: Of the 58 subjects enrolled from September 2020 to December 2020, 23 (40%) respective patients were deceased. Subjects of deceased patients had higher median CCFNI scores than subjects of surviving patients, reflecting greater dissatisfaction with the ICU experience (1.82 [1.45-2.00] vs 1.45 [1.27-1.72], respectively, p=0.009). Subjects recollected that they typically received at least one medical update from the patient's ICU team each day. While many subjects felt that telephone communication with the ICU team was adequate, some believed they were unable to fully understand the patient's condition. In addition, some subjects feared the patient was clinically worsening when they did not receive frequent updates, which had a negative impact on their experience. Nearly all subjects reported that visitor restrictions made the ICU experience more difficult. Some subjects believed that the medical decisions that were made and the care the patient received were negatively impacted by not having family present at the bedside. CONCLUSION: During the COVID-19 pandemic, families of critically ill patients typically received medical updates by phone daily because they were unable to visit. These aspects of ICU care delivery had differential effects on the ICU experience of families, with more negative experiences among families of deceased patients. These data suggest that more individualized approach to family engagement is needed during times of visitor restrictions.

Psychological symptoms after discharge from the intensive care unit among families of patients with covid-19

RATIONALE: Family members of intensive care unit (ICU) patients are at high risk of developing the postintensive care syndrome - family (PICS-F), which includes increased post-traumatic stress, depression, anxiety, and complicated grief. The COVID-19 pandemic has created a number of unique and potentially traumatic stressors both during and after the ICU stay, which may have amplified the burden of psychological symptoms among families of critically ill COVID-19 patients. METHODS: Surrogate decision makers of critically ill COVID-19 patients enrolled in an ongoing clinical trial were contacted 6 months after the hospitalization and enrolled in a follow up study. Post ICU-discharge, they completed the 14-question Hospital Anxiety and Depression scale (HADS) and the 22-question Impact of Events-Revised scale (IES-R), a measure of post-traumatic stress disorder symptoms. Scores were reported as medians with interquartile ranges. They also participated in a semistructured phone interview regarding their mental health and coping. Interviews were transcribed and coded using thematic content analysis. RESULTS: Of the 58 participants enrolled from September 2020 to December 2020, 23 (40%) respective patients were deceased. Participants with deceased patients had significantly higher median HADS-anxiety, HADS-depression, and IES-R scores compared to those with patients who were alive (higher scores indicating increased severity of symptoms): 12 [7-13] vs. 6 [2-9] p=0.001, 7 [4-11] vs. 3 [1-5] p<0.001, 36 [24-53] vs. 14 [7-34] p=0.001, respectively. Regardless of patient outcome, participants reported multiple different types of stressors since hospital discharge including emotional distress, sleep disturbance, and financial concerns. Some stressors were specific to COVID-19 such as the concern for contracting COVID-19, infection among family members, and being unable to visit patients at rehabilitation facilities. The most common coping methods participants described utilizing included faith/spirituality, emotional support, and instrumental support (eg assistance or advice from others). Many participants mentioned they had referenced friends or family who were healthcare providers to better understand the patients' condition which helped to reduce their stress. Although few participants had sought out mental health services, many thought it could be beneficial. CONCLUSION: Families of critically ill patients with COVID-19 report a high prevalence of psychological symptoms after ICU discharge, particularly for patients who were deceased. Family focused interventions both during and after the ICU-stay may help lessen this burden.