Risk assessment of banknotes as a fomite of SARS-CoV-2 in cash payment transactions.

The COVID 19 pandemic has triggered concerns and assumptions globally about transmission of the SARS-CoV-2 virus via cash transactions. This paper assesses the risk of contracting COVID-19 through exposure to SARS-CoV-2 via cash acting as a fomite in payment transactions. A quantitative microbial risk assessment was conducted for a scenario assuming an infectious person at the onset of symptoms, when virion concentrations in coughed droplets are at their highest. This person then contaminates a banknote by coughing on it and immediately hands it over to another person, who might then be infected by transferring the virions with a finger from the contaminated banknote to a facial mucous membrane. The scenario considered transfer efficiency of virions on the banknote to fingertips when droplets were still wet and after having dried up and subsequently being touched by finger printing or rubbing the object. Accounting for the likelihood of the scenario to occur by considering (1) a local prevalence of 100 COVID-19 cases/100,000 persons, (2) a maximum of about one-fifth of infected persons transmit high virus loads, and (3) the numbers of cash transactions/person/day, the risk of contracting COVID-19 via person-to-person cash transactions was estimated to be much lower than once per 39,000 days (107 years) for a single person. In the general populace, there will be a maximum of 2.6 expected cases/100,000 persons/day. The risk for a cashier at an average point of sale was estimated to be much less than once per 430 working days (21 months). The depicted scenario is a rare event, therefore, for a single person, the risk of contracting COVID-19 via person-to-person cash transactions is very low. At a point of sale, the risk to the cashier proportionally increases but it is still low.

Transfer of Phi6 bacteriophage between human skin and surfaces common to consumer-facing environments.

AIMS: This study aimed to determine the extent of Phi6 (Φ6) transfer between skin and surfaces relevant to consumer-facing environments based on inoculum matrix, surface type and contact time. METHODS AND RESULTS: Φ6 transfer rates were determined from skin-to-fomite and fomite-to-skin influenced by inoculum matrix (artificial saliva and tripartite), surface type (aluminium, plastic, stainless steel, touchscreen, vinyl and wood) and contact time (5 and 10 s). Significant differences in estimated means were observed based on surface type (both transfer directions), inoculum matrix (skin-to-fomite) and contact time (both transfer directions). During a sequential transfer experiment from fomite-to-skin, the maximum number of consecutive transfer events observed was 3.33 ± 1.19, 2.33 ± 1.20 and 1.67 ± 1.21 for plastic, touchscreen and vinyl, respectively. CONCLUSIONS: Contact time significantly impacted Φ6 transfer rates, which may be attributed to skin absorption dynamics. Surface type should be considered for assessing Φ6 transfer rates. SIGNIFICANCE AND IMPACT OF THE STUDY: Although the persistence of Φ6 on fomites has been characterized, limited data are available regarding the transfer of Φ6 among skin and fomites. Determining Φ6 transfer rates for surfaces in consumer-facing environments based on these factors is needed to better inform future virus transmission mitigation strategies.

Aerosol Transmission and Control of SARS-CoV-2

One fundamental question about any novel pathogen is: how does it transmit? Answering this question will help to protect ourselves from the agent, at least until effective vaccines and antiviral therapies can be developed, especially if it is an agent of moderate to high lethality. Initially, at the start of the Coronavirus disease 2019 (COVID-19) pandemic, more emphasis was placed on handwashing rather than on droplet and aerosol transmission. Although severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2)-infected secretions such as saliva can spread the virus to hands, it became increasing evident that the virus mostly transmitted through close contact (though not necessarily touching), whilst people were breathing, talking, laughing, singing, coughing and sneezing near one another. During such respiratory activities, droplets and aerosols are produced together, and the amount of transmission due to these differentsized liquid particles will likely vary between individuals at different stages of their infection and illness. This question became even more complex as it emerged that viral transmission can occur for several days before symptom onset, and that asymptomatic cases can also shed just as much virus and potentially transmit it just as well as symptomatic cases. This chapter summarizes our understanding of how SARS-CoV-2 transmits and the infection control precautions to reduce this. © 2023 by World Scientific Publishing Co. Pte. Ltd.

[Viruses present in the environment: virological considerations and examples of their impact on human health]. / Les virus dans l'environnement, considérations virologiques et exemples de leur impact en santé humaine.

Animal viruses are present in most human environments. Their viability in these media is very variable and the most important element that conditions this viability is the existence or not of a phospholipid envelope surrounding the nucleocapsid. After some general considerations on the structure of viruses, their multiplication cycle and their resistance to different physico-chemical agents, some examples of the impact of animal viruses present in the environment on human health will be presented. The situations that are related concern recent epidemiological events: circulation of type 2 polioviruses derived from the Sabin vaccine strain in the wastewater of New York, London and Jerusalem; risk of transmission of Sars-CoV-2 during the spreading of sludge from wastewater treatment plants on agricultural land in the era of the Covid-19 pandemic; « new ¼ forms of food-borne poisoning of viral origin (hepatitis E, tick-borne encephalitis, Nipah virus infection); contamination by epidemic viruses of mobile phones used by pediatricians; role of fomites in the spread of orthopoxvirus infections (smallpox, cowpox, monkeypox). The risk attached to animal viruses present in the environment must be assessed in a measured way without overestimating or underestimating their potential consequences for human health.

Low risk of environmental contagion by SARS-CoV-2 in non-sanitary spaces.

OBJECTIVE: To study the presence of SARS-CoV-2 on surfaces (high, medium and low contact) and airs in non-sanitary spaces with high public influx to evaluate the risk of environmental contagion. METHODS: Surfaces and airs were analysed by RT-qPCR to detect the presence of SARS-CoV-2. RESULTS: 394 surfaces and air samples were obtained from spaces with high public influx such as offices, shopping centres and nursing homes. The virus was not detected in any of the samples analysed. CONCLUSION: Although we cannot emphatically conclude that there is no risk of environmental 27 infection by SARS-CoV-2 in non-sanitary spaces, we can affirm that the risk is almost non- existent.

Stability and transmissibility of SARS-CoV-2 in the environment.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing the ongoing global coronavirus disease 2019 (COVID-19) pandemic, is believed to be transmitted primarily through respiratory droplets and aerosols. However, reports are increasing regarding the contamination of environmental surfaces, shared objects, and cold-chain foods with SARS-CoV-2 RNA and the possibility of environmental fomite transmission of the virus raises much concern and debate. This study summarizes the current knowledge regarding potential mechanisms of environmental transmission of SARS-CoV-2, including the prevalence of surface contamination in various settings, the viability and stability of the virus on surfaces or fomites, as well as environmental factors affecting virus viability and survival such as temperature and relative humidity. Instances of fomite transmission, including cold-chain food transmission, and the importance of fomite transmission in epidemics, are discussed. The knowledge gaps regarding fomite transmission of SARS-CoV-2 are also briefly analyzed.

Surface Inactivation of a SARS-CoV-2 Surrogate with Hypochlorous Acid is Impacted by Surface Type, Contact Time, Inoculum Matrix, and Concentration.

Indirect contact with contaminated surfaces is a potential transmission route for COVID-19. Therefore, it is necessary to investigate convenient and inexpensive surface sanitization methods, such as HOCl, against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The SARS-CoV-2 surrogate, Phi6 (~ 7 log PFU/mL), was prepared in artificial saliva and tripartite matrices, spot inoculated on coupons of either stainless steel or vinyl, and allowed to dry. The coupons were sprayed with either 500 ppm or 1000 ppm HOCl, and remained on the surface for 0 s (control), 5 s, 30 s, or 60 s. Samples were enumerated via the double agar overlay assay. Statistical analysis was completed in R using a generalized linear model with Quasipoisson error approximations. Time, concentration, surface type, and inoculum matrix were all significant contributors to log reduction at P = 0.05. Significant three-way interactions were observed for 1000 ppm, vinyl, and 60 s (P = 0.03) and 1000 ppm, tripartite, and 60 s (P = 0.0121). A significant two-way interaction between vinyl and 60 s was also observed (P = 0.0168). Overall, increased HOCl concentration and exposure time led to increased Phi6 reduction. Notably, the highest estimated mean log reduction was 3.31 (95% CI 3.14, 3.49) for stainless steel at 60 s and 1000 ppm HOCl in artificial saliva, indicating that this method of sanitization may not adequately reduce enveloped viruses to below infective thresholds.

Leveraging Bluetooth Low-Energy Technology to Improve Contact Tracing in Healthcare Settings during the COVID-19 Pandemic

Background. COVID-19 rapidly evolved into a global pandemic. Contact tracing with isolation and quarantine contribute to epidemic control but they are time consuming, costly and may be incomplete. We set out to assess the usability and performance characteristics of Bluetooth Low-Energy (BLE) wireless technology for indoor localization applied to contact tracing in healthcare settings. Methods. Consented healthcare workers (HCW) from 2 designated COVID-19 wards (one intensive care unit (ICU) and one medical ward) were equipped with coinsized BLE- emitting beacons. The signal was captured by small embedded computers (anchors) placed at designated locations, time-stamped and transmitted to an edge server via secure Wi-Fi where data were stored and real time contact algorithms were run (Fig.1). We developed experiments mimicking clinical scenarios and tested indoor localization during observed clinical activity for 6 months. We constructed our algorithms based on room structure (e.g. open spaces vs computer rooms) and activity characteristics (e.g. rounding in a large group vs 2 healthcare workers sitting together). We used 1) radio fingerprint localization where an initial virtual radio map was developed, 2) semantic localization which carries additional information such as proximity to a computer to define indirect transmission via fomites, and 3) clustering contact tracing to identify individuals rounding together. Close contact was defined as per the CDC guidelines. Fig. 1 System configuration Results. Consent rate was 43.3% with 187 HCW enrolled in the study. Consent rate was higher in the ICU and among attendings. All participants were compliant with wearing the beacons for the duration of the study. The performance characteristics for contact tracing using fingerprinting methods were AUROC 0.93, AUPRC 0.96, sensitivity 0.9, specificity 0.77 with F1 score of 0.89 and overall accuracy of 0.85. The clustering contact tracing registered a sensitivity of 0.86, specificity 0.89, F1 score 0.91 and accuracy 0.87. Computation time necessary to generate a list of close contacts as per specified criteria was less than 30 minutes. Conclusion. We have developed and tested a reliable and accurate, low-cost and easily deployable system based on BLE technology to improve contact tracing among healthcare workers.

Impact of Quaternary Ammonium Disinfectants on Transfer of viruses from Fomites to the Finger

Background. Hard and soft surfaces (fomites) can play a role in the transmission of both enteric and respiratory viruses. Transmission can occur by touching of contaminated surfaces and bringing the hand to the either the mouth or nose or by reaerosolization of the virus from the surface. In adults face touching occurs every 3 to 4 minutes. The amount of virus transfer which occurs depends on the nature of the surface, the virus and the degree and type of activity within a facility. Methods. We conducted studies on the finger transfers of both a non-enveloped (MS-2 coliphages) and an enveloped virus (coronavirus 229E). Results. The greatest degree of the non-enveloped virus occurred with acrylic plastic and stainless steel, while the greatest transfer of the enveloped virus occurred from porcelain. Transfer to the finger from surfaces of the coronavirus was reduced by treatment of surfaces with various commercially available quaternary ammonium disinfectants after 24 hours of application to the fomites by 37% to 99.9%. Using MS-2 coliphage as a tracer virus placed on a high touch fomite, we found that the use of quaternary ammonium containing disinfecting wipes in a long term care facility reduced the contamination of fomites by 80%. Conclusion. The results indicate that spread of viruses in a facility and exposure via hand contact can be significantly reduced by disinfection of fomites.

A Multifaceted and Multi-Institutional Analysis of the COVID19-Associated Mucormycosis Outbreak in the Delhi Area Indicates the Simultaneous Convergence of Multiple Risk Factors

Background. A major outbreak of COVID19-associated mucormycosis (CAM) in India in spring 2021 aggravated the death toll of COVID19. As the causes of that CAM outbreak remain unclear, we performed a multifaceted study of host, pathogen, environmental, and heath care-related factors in adult CAM patients (pts) in the metropolitan New Delhi area. Methods. We reviewed the records of all pts diagnosed with culture- or biopsyproven CAM at 7 hospitals in the New Delhi area (April 1 - June 30, 2021). We used a multivariate logistic regression model to compare clinical characteristics of either all CAM cases (analysis 1, n = 50) or only pts with CAM after moderate or severe COVID19 (analysis 2, n = 31). As controls for both analyses, we used 69 COVID19-hospitalized contemporary pts. Selected hospital fomites were cultured for Mucorales. Additionally, we compared meteorological data and fungal spore concentrations in outdoor air before the CAM outbreak (January-March 2021) and during the outbreak (April-June 2021). Mucorales isolates from CAM pts were identified by MALDI-TOF-MS and ITS sequencing. A subset of 15 isolates underwent whole genome sequencing (WGS). Results. Risk factors for CAM in both analyses were newly diagnosed diabetes mellitus (odds ratio [OR] 8.26/5.67) and active cancer (OR 5.98/5.68) (Figure 1). Supplemental oxygen for COVID19 was associated with a lower CAM risk in both analyses (OR 0.13/0.17). Another significant CAM risk predictor identified only in analysis 1 was severe COVID19 (WHO score >= 6, OR 4.09), while remdesivir therapy (OR 0.40) and ICU admission for COVID19 were protective (OR 0.41) (Figure 1). No Mucorales were cultured from hospital fomites. The CAM incidence peak coincided with a significant uptick in environmental spore concentrations but was not linked to specific meteorological factors. Rhizopus was the predominant Mucorales genus (64%) identified by MALDI-TOF-MS and ITS sequencing;WGS found no clonal population of isolates but detected 2 cases of the rare pathogen Lichtheimia ornata. Figure 1 Conclusion. An intersection of host, environmental, pathogen and healthcare-related factors might have contributed to the emergence of CAM. Surrogates of access to advanced treatment of COVID19 were associated with lower CAM risk.

It is time to acknowledge coronavirus transmission via frozen and chilled foods: Undeniable evidence from China and lessons for the world.

Since the broke out of the novel coronavirus disease at the end of 2019, nearly 650 million people have been infected around the globe, and >6.6 million have died from this disease. The first wave of infections in mainland China had been effectively controlled within a short period, with no domestic cases of infection for 56 consecutive days from April 16, 2020. Nonetheless, the re-emergence of several outbreaks in multiple Chinese cities posed a new challenge for public health authorities after new cases of infections were found in Xinfadi Market in Beijing on June 11, 2020. In the following series of re-emergent outbreaks, findings from epidemiological investigations suggested that more than twenty re-emergent outbreaks were caused by fomite transmission, predominantly via imported frozen and chilled foods contaminated by the SARS-CoV-2 virus. Seven of the eleven incidents involving frozen and chilled foods were identified by screening individuals with occupational exposure to imported cold-chain foods and associated individuals. Evidence showed that low temperatures and poor ventilation typically maintained through cold-chain logistics create amenable environments for the survival of SARS-CoV-2, making transnational cold chain logistics a congenial vehicle to spread the virus through global transport of consumer goods. To address this gap, here we present a scrutiny of the findings from epidemiological investigations in recent re-emergent outbreaks in China caused by fomite transmission via imported foods and goods. A national regime of traceable cold-chain foods and reinforced customs inspection protocols were established by public health authorities in mainland China as emergency responses to recurring outbreaks from fomite transmission via imported goods. We urge that more attention needs to be given to this specific route of pathogenic transmission to ensure biosecurity and to increase the preparedness for epidemic or pandemic scenarios by the global food industry and logistics carriers.

COVID-19 and Food Safety

Concerns over whether people can be infected with SARS-CoV-2 from food and packaging have caused significant disruption to global food trade. SARS-CoV-2, the virus that causes COVID-19, can remain infectious and detectable on packaging or some foods under certain cold-chain conditions. However, there is minimal evidence that people have been infected with SARS-CoV-2 from packaging or from foodborne transmission. Cooking of food will inactivate the virus. Any infectious SARS-CoV-2 present in consumed food would likely be inactivated by stomach acid. Nonetheless, good food hygiene practices are sensible precautions to minimize any possibility of food or packaging acting as a vector for SARS-CoV-2.

The propensity of fomite spread of SARS-CoV-2 virus through produce supply chain.

Background: The global community has battled the spread of SAR-CoV-2 for almost 2 years, and the projection is that the virus may be recurrent like the seasonal flu. The SARS-CoV-2 pandemic disrupted activities within the food supply chain that cost billions of dollars globally. This has heightened concerns about fomite spread of the virus through surfaces. There is an urgent need to understand the risk portends by this virus along the produce supply chain with conditions (low temperature and high relative humidity) conducive to extended survival of the virus. Main body: Pre-dating SARS-CoV-2 are other types of coronaviruses that had lower infection and mortality rates. There are some similarities between the former and the new coronavirus, especially with regards to transmission modes and their survivability on surfaces. There is evidence of other coronaviruses' survival on surfaces for weeks. Currently, there are limited evidence-based studies to enlighten us on how the virus is transmitted within the produce supply chain. A few studies claim that the virus could spread through the cold supply chains. However, these are not sufficient to make a conclusive inference about the deadly SARS-CoV-2. Conclusions: This paper provides a succinct review of the literature on current understanding of the transmission, survivability, and risk SARS-CoV-2 portend to humans within the produce supply chain and calls for more evidence-based research to allay or alert us of the potential risk of fomite transmission of SARS-CoV-2. The paper also highlights examples of conventional and novel non-thermal inactivation and sanitation methods applicable to this type of virus.

Viral cultures for assessing fomite transmission of SARS-CoV-2: a systematic review and meta-analysis.

BACKGROUND: The role of fomites in the transmission of SARS-CoV-2 is unclear. AIM: To assess whether SARS-CoV-2 can be transmitted through fomites, using evidence from viral culture studies. METHODS: Searches were conducted in the World Health Organization COVID-19 Database, PubMed, LitCovid, medRxiv, and Google Scholar to December 31st, 2021. Studies that investigated fomite transmission and performed viral culture to assess the cytopathic effect (CPE) of positive fomite samples and confirmation of SARS-CoV-2 as the cause of the CPE were included. The risk of bias using a checklist modified from the modified Quality Assessment of Diagnostic Accuracy Studies - 2 (QUADAS-2) criteria was assessed. FINDINGS: Twenty-three studies were included. The overall risk of bias was moderate. Five studies demonstrated replication-competent virus from fomite cultures and three used genome sequencing to match fomite samples with human clinical specimens. The mean cycle threshold (CT) of samples with positive viral culture was significantly lower compared with cultured samples that returned negative results (standardized mean difference: -1.45; 95% confidence interval (CI): -2.00 to -0.90; I2 = 0%; P < 0.00001). The likelihood of isolating replication-competent virus was significantly greater when CT was <30 (relative risk: 3.10; 95% CI: 1.32 to 7.31; I2 = 71%; P = 0.01). Infectious specimens were mostly detected within seven days of symptom onset. One study showed possible transmission of SARS-CoV-2 from fomites to humans. CONCLUSION: The evidence from published studies suggests that replication-competent SARS-CoV-2 is present on fomites. Replication-competent SARS-CoV-2 is significantly more likely when the PCR CT for clinical specimens and fomite samples is <30. Further studies should investigate the duration of infectiousness of SARS-CoV-2 and the frequency of transmission from fomites.

Characterization of Exhaled Particle Deposition and Ventilation in an Indoor Setting

Exhalation of infectious micrometer-sized particles has been strongly implicated in respiratory infection spread. An important fundamental question is then the fate of infectious exhaled particles in indoor spaces, i.e., whether they will remain suspended in an aerosol until ventilation leads to their clearance or whether they will deposit, and if so, on what surfaces in an indoor space. We investigated the interplay between deposition and ventilation using model experiments with a breathing simulator manikin in an office environment. The breathing simulator utilized physiologically correct exhalation and inhalation breathing waveforms as well as an anatomically correct manikin. The simulator output fluorescein-doped particles with a volume distribution spanning the 1-3 um range. The office environment was a 344 m3 room equipped with desks. Four different test conditions were created by changing the simulator location and via different air change rates and MERV ratings of filters in the HVAC system. We found that the rate of ventilation exceeds the rate of deposition on all surfaces (quantified by Stanton numbers, which were below unity) with several important exceptions: (1) surfaces close to (within 2 m) the simulator;and (2) non-passive surface exteriors (return grilles and diffusers). A detectable decrease in Stanton number with distance suggests that the room environment cannot be approximated as truly well-mixed. The finding of enhanced deposition on non-passive surfaces at all distances from the room highlights that infectious particles may preferentially deposit on such surfaces in indoor spaces. Finally, while our results highlight particular surfaces with enhanced deposition, our results confirm the importance of ventilation in a room as a means to reduce infectious aerosol particle concentrations, as in large part the clearance for particles appears to occur by ventilation.

Virus Dynamics and Decay in Evaporating Human Saliva Droplets on Fomites.

The transmission of most respiratory pathogens, including SARS-CoV-2, occurs via virus-containing respiratory droplets, and thus, factors that affect virus viability in droplet residues on surfaces are of critical medical and public health importance. Relative humidity (RH) is known to play a role in virus survival, with a U-shaped relationship between RH and virus viability. The mechanisms affecting virus viability in droplet residues, however, are unclear. This study examines the structure and evaporation dynamics of virus-containing saliva droplets on fomites and their impact on virus viability using four model viruses: vesicular stomatitis virus, herpes simplex virus 1, Newcastle disease virus, and coronavirus HCoV-OC43. The results support the hypothesis that the direct contact of antiviral proteins and virions within the "coffee ring" region of the droplet residue gives rise to the observed U-shaped relationship between virus viability and RH. Viruses survive much better at low and high RH, and their viability is substantially reduced at intermediate RH. A phenomenological theory explaining this phenomenon and a quantitative model analyzing and correlating the experimentally measured virus survivability are developed on the basis of the observations. The mechanisms by which RH affects virus viability are explored. At intermediate RH, antiviral proteins have optimal influence on virions because of their largest contact time and overlap area, which leads to the lowest level of virus activity.

Role of environmental parameters on the survival of coronaviruses on surfaces

Several reviews and models have suggested that indirect contact transmission involving contaminated surfaces could be the predominant transmission route for certain respiratory viruses. Indeed, contaminated environmental surfaces are considered to represent a significant vector for hospital-acquired viral infections. For any environmental contamination to be relevant, a virus should not only remain infectious on the recipient surface but also persist at a sufficient concentration to enable it to reach the respiratory tract via finger contamination. In general terms, the potential of a fomite to spread a given infectious agent is directly related to the capacity of the agent to survive on that surface. The surface stability of viruses is generally influenced by the type of surface, environmental factors such as relative humidity and temperature, and the presence of body fluid secretions (respiratory excretions, feces, blood.). We investigated the influence of such parameters on the stability of several alpha and betacoronaviruses, including 3 variants of SARS-CoV-2 (SARS-CoV-2 variant 2020, SARS-CoV-2 variant UK and SARS-CoV2 variant delta), on stainless steel discs and porous surface corresponding to borosilicate discs. Assays were done at 7 °C and 25 °C with a relative humidity of 65%. Artificial mucus/saliva or BSA/yeast extract mixtures were used as fluid mimetics for respiratory and enteric viruses, respectively. Our results showed significant variable stability of the viruses depending on both the porous/non-porous nature of the surfaces and the temperature. Beneficial or negative impacts of the body fluids were also observed. This study characterizes for the first time the behaviour of human and animal coronaviruses, including highly pathogenic betacoronaviruses, on several surfaces with fixed environmental parameters.

Low Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission by Fomites: A Clinical Observational Study in Highly Infectious Coronavirus Disease 2019 Patients.

BACKGROUND: The contribution of droplet-contaminated surfaces for virus transmission has been discussed controversially in the context of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. More importantly, the risk of fomite-based transmission has not been systematically addressed. Therefore, the aim of this study was to evaluate whether confirmed hospitalized coronavirus disease 2019 (COVID-19) patients can contaminate stainless steel carriers by coughing or intensive moistening with saliva and to assess the risk of SARS-CoV-2 transmission upon detection of viral loads and infectious virus in cell culture. METHODS: We initiated a single-center observational study including 15 COVID-19 patients with a high baseline viral load (cycle threshold value ≤25). We documented clinical and laboratory parameters and used patient samples to perform virus culture, quantitative polymerase chain reaction, and virus sequencing. RESULTS: Nasopharyngeal and oropharyngeal swabs of all patients were positive for viral ribonucleic acid on the day of the study. Infectious SARS-CoV-2 could be isolated from 6 patient swabs (46.2%). After coughing, no infectious virus could be recovered, however, intensive moistening with saliva resulted in successful viral recovery from steel carriers of 5 patients (38.5%). CONCLUSIONS: Transmission of infectious SARS-CoV-2 via fomites is possible upon extensive moistening, but it is unlikely to occur in real-life scenarios and from droplet-contaminated fomites.

Bringing Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) to the Surface: Is There a Role for Fomites?

Understanding the contribution of routes of transmission, particularly the role of fomites in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission is important in developing and implementing successful public health infection prevention and control measures. This article will look at case reports, laboratory findings, animal studies, environmental factors, the need for disinfection, and differences in settings as they relate to SARS-CoV-2 transmission.

Assessment of Awareness About COVID-19 Infection among Medical Personnel and General Public of Rahim Yar Khan

Objective: Assessment of awareness about COVID-19 among medical personnel and general public. Study Description: It is a Cross-Sectional study carried out in R.Y.Khan from June 2020 to September 2020. Methodology: About 430 subjects (medical personnel and general public) were asked to fill a pre-designed questionnaire by using convenient sampling technique. The questionnaire included information regarding their bio-data and study questions. Then SPSS Version 21 was used for data analysis. Results: Our study shows that 90.5% study subjects think that they are well aware about COVID-19 while 9.5% subjects think that they aren’t. In response to question “Is it lethal?” 25.3% subjects replied Always, 67% said Sometimes and 7.7% said Never. 68.6% subjects said that it is Always transmissible, 15.8% said Sometimes and 15.6% said Never. Regarding modes of its spread, 76.5% subjects agreed to Cough, 67.9% to Handshake, 27.9% to Food-sharing, 35.6% to Room-sharing, 28.6% to Utensils-sharing, 21.2% to Fomites-sharing. 6.7% subjects said that its vaccine is Available, 72.1% replied as Not-Available and 21.2% said that they don’t know. 24.9% subjects said that its specific treatment is Available, 53.3% replied as Not-Available and 21.9% said that they don’t know. 71.9% subjects said that it is preventable by adopting specific preventive measures, 8.8% said it isn’t and 19.3% said that they don’t know. Regarding effectiveness of PPEs as preventive measures, 85.8% subjects agreed to Mask, 57.2% to Gown, 52.3% to Goggles, 45.6% to Head-cover, 35.1% to Shoe-cover, 55.8% to Gloves, 70.7% to Social-distancing, 58.4% to use of Hand-wash/Hand-Sanitizer. Conclusion: There is observed some lack of knowledge in different areas regarding COVID-19, almost equally, among medical personnel as well as among general public that results in spread of infection at exponential rates due to negligence of people including poor understanding and poor compliance to the preventive measures advised by health authorities worldwide.