ABSTRACT
What is already known about this topic?: Hospitals have experienced a surge in admissions due to the increasing number of Omicron cases. Understanding the epidemiological features of coronavirus disease 2019 (COVID-19) and the strain it places on hospitals will provide scientific evidence to help policymakers better prepare for and respond to future outbreaks. What is added by this report?: The case fatality rate of COVID-19 was 1.4 per 1,000 persons during the Omicron wave. Over 90% of COVID-19-related deaths occurred in individuals aged 60 years or older, with pre-existing chronic conditions such as cardiac conditions and dementia, particularly among males aged 80 years or older. What are the implications for public health practice?: Public health policy is essential for preparing and preserving medical resource capacity, as well as recruiting additional clinicians and front-line staff in hospitals to address the increased demand. High-risk individuals should be prioritized for healthcare, vaccines, and targeted interventions.
ABSTRACT
Since the beginning of the COVID-19 pandemic in early 2020, global efforts to respond to and control COVID-19 have varied widely with some countries, including Australia, successfully containing local transmission, and minimising negative impacts to health and economies. Over this time, global awareness of climate variability due to climate change and the risk factors for emerging infectious diseases transmission has increased alongside an understanding of the inextricable relationship between the health of the environment, humans, and animals. Overall, the global response to the current pandemic suggests there is an urgent need for a One Health approach in controlling and preventing future pandemics, through developing integrated, dynamic, spatiotemporal early warning systems based on a One Health approach for emerging infectious diseases.
ABSTRACT
Effective hand drying is an important part of hand hygiene that can reduce the risk of infectious disease transmission through cross-contamination of surfaces by wet hands. However, hand drying methods may also cause aerosolisation of pathogenic microorganisms if they are present in washed hands. This study investigated experimentally the impact of washing hands and different hand drying methods on the concentration and size distribution of aerosols and bacteria in indoor air. In this experiment, aerosol and bacteria concentrations were measured in indoor air while volunteers rinsed their hands with water or washed with soap and water prior to drying them with paper towels or jet air dryers. Results showed that the concentration of aerosols and bacteria in air increased with people walking in the room and washing hands, with a further increase during the hand drying process. The concentration of aerosols decreased with particle size, with maximum concentrations after drying hands of 6.63 × 106 ± 6.49 × 105 and 2.28 × 104 ± 9.72 × 103 particles m−3 for sizes 0.3 to <0.5 and ≥5.0 μm, respectively. The concentration of bacteria in indoor air after drying hands increased to a maximum of 3.81 × 102 ± 1.48 × 102 CFU m−3 (jet air dryers) and 4.50 × 102 ± 4.35 × 101 CFU m−3 (paper towels). This study indicates that the increase of aerosols and bacteria in air after drying hands with jet air dryers or paper towels are comparable and not statistically different from concentrations associated with walking and washing hands in the same environment. This work can support the development of hand hygiene practices and guidelines for public washrooms.
ABSTRACT
BACKGROUND: The risk of infectious disease transmission in public washrooms causes concern particularly in the context of the COVID-19 pandemic. This systematic review aims to assess the risk of transmission of viral or bacterial infections through inhalation, surface contact, and faecal-oral routes in public washrooms in healthcare and non-healthcare environments. METHODS: We systematically reviewed environmental sampling, laboratory, and epidemiological studies on viral and bacterial infection transmission in washrooms using PubMed and Scopus. The review focused on indoor, publicly accessible washrooms. RESULTS: Thirty-eight studies from 13 countries were identified, including 14 studies carried out in healthcare settings, 10 in laboratories or experimental chambers, and 14 studies in restaurants, workplaces, commercial and academic environments. Thirty-three studies involved surface sampling, 15 air sampling, 8 water sampling, and 5 studies were risk assessments or outbreak investigations. Infectious disease transmission was studied in relation with: (a) toilets with flushing mechanisms; (b) hand drying systems; and (c) water taps, sinks and drains. A wide range of enteric, skin and soil bacteria and enteric and respiratory viruses were identified in public washrooms, potentially posing a risk of infection transmission. Studies on COVID-19 transmission only examined washroom contamination in healthcare settings. CONCLUSION: Open-lid toilet flushing, ineffective handwashing or hand drying, substandard or infrequent surface cleaning, blocked drains, and uncovered rubbish bins can result in widespread bacterial and/or viral contamination in washrooms. However, only a few cases of infectious diseases mostly related to faecal-oral transmission originating from washrooms in restaurants were reported. Although there is a risk of microbial aerosolisation from toilet flushing and the use of hand drying systems, we found no evidence of airborne transmission of enteric or respiratory pathogens, including COVID-19, in public washrooms. Appropriate hand hygiene, surface cleaning and disinfection, and washroom maintenance and ventilation are likely to minimise the risk of infectious disease transmission.