Environmental Surface Contamination with SARS-CoV-2: Toilets as the Most Contaminated Surfaces in COVID-19 Referral Hospital.

INTRODUCTION: The possibility of surface transmission in hospitals with high density of COVID- 19 patients is unneglectable. The aim of this study is to determine the extent of surface contamination in coronavirus central hospital of Ilam province in western Iran. MATERIALS AND METHODS: In this experimental study, 205 samples were taken from environmental surfaces in hospital. SARS-CoV-2 RNA detected by Real-time RT-PCR. RESULTS: 121 out of 205 (50.02%) samples were positive. The most contaminated objects were toilet sites (5/5,100% ICU; 5/5, 100% isolation wards). CONCLUSION: High surface contamination with SARS-CoV-2 proposes the surface as a potential route of transmission.

Negligible risk of surface transmission of SARS-CoV-2 in public transportation.

BACKGROUND: Exposure to pathogens in public transport systems is a common means of spreading infection, mainly by inhaling aerosol or droplets from infected individuals. Such particles also contaminate surfaces, creating a potential surface-transmission pathway. METHODS: A fast acoustic biosensor with an antifouling nano-coating was introduced to detect SARS-CoV-2 on exposed surfaces in the Prague Public Transport System. Samples were measured directly without pre-treatment. Results with the sensor gave excellent agreement with parallel qRT-PCR measurements on 482 surface samples taken from actively used trams, buses, metro trains, and platforms between 7-9 April 2021, in the middle of the lineage Alpha SARS-CoV-2 epidemic wave when 1 in 240 people were COVID-19 positive in Prague. RESULTS: Only ten of the 482 surface swabs produced positive results and none of them contained virus particles capable of replication, indicating that positive samples contained inactive virus particles and/or fragments. Measurements of the rate of decay of SARS-CoV-2 on frequently touched surface materials showed that the virus did not remain viable longer than 1-4 hours. The rate of inactivation was the fastest on rubber handrails in metro escalators and the slowest on hard-plastic seats, window glasses, and stainless-steel grab rails. As a result of this study, Prague Public Transport Systems revised their cleaning protocols and the lengths of parking times during the pandemic. CONCLUSIONS: Our findings suggest that surface transmission played no or negligible role in spreading SARS-CoV-2 in Prague. The results also demonstrate the potential of the new biosensor to serve as a complementary screening tool in epidemic monitoring and prognosis.

Monitoring of SARS-CoV-2 RNA in Public Areas: An Investigation of Environmental Surface Contamination

Although droplets and aerosol are considered the main transmission routes of SARS-CoV-2, indirect contact has been indicated to play a critical role in transmission. The aim of this study is to evaluate the presence of SARS-CoV-2 RNA on different environmental surfaces in public areas in Cyprus. Using RT-qPCR, samples from 50 swab specimens collected from high-touch surfaces were analyzed for viral RNA. Six surfaces (12.0%) in all were positive for SARS-CoV-2. Among the examined surfaces within supermarkets, SARS-CoV-2 was detected in 22.2% (n=4/18) of the sampling points, with shopping trolley handles and POS keyboards being the most frequently contaminated items. In the hospital setting, two (n=2/5, 40%) samples were positive for SARS-CoV-2. Our results indicate that, at the current stage of the pandemic, viral contamination of public spaces exists in the community. Lifting protective measures may have contributed to fomite transmission in public spaces. [ FROM AUTHOR] Copyright of Erciyes Medical Journal / Erciyes Tip Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

SARS-CoV-2 surface and air contamination in an acute healthcare setting during the first and second pandemic waves.

BACKGROUND: Surfaces and air in healthcare facilities can be contaminated with SARS-CoV-2. In a previous study, we identified SARS-CoV-2 RNA on surfaces and air in our hospital during the 'first wave' of the COVID-19 pandemic (April 2020). AIM: To explore whether the profile of SARS-CoV-2 surface and air contamination had changed between April 2020 and January 2021. METHODS: A prospective, cross-sectional, observational study in a multisite London hospital. In January 2021, surface and air samples were collected from comparable areas to those sampled in April 2020 comprising six clinical areas and a public area. SARS-CoV-2 was detected using RT-PCR and viral culture. Sampling was additionally undertaken in two wards with only natural ventilation. The ability of the prevalent variants at the time of the study to survive on dry surfaces was evaluated. FINDINGS: No viable virus was recovered from surfaces or air. 5% (14) of 270 surfaces and 4% (1) of 27 air samples were positive for SARS-CoV-2, which was significantly lower than in April 2020 (52% (114) of 218 of surfaces and 48% (13) of 27 air samples (p<0.001, Fisher's Exact Test)). There was no clear difference in the proportion of surfaces and air samples positive for SARS-CoV-2 RNA based on the type of ventilation in the ward. All variants tested survived on dry surfaces for at least 72 hours with a <3-log10 reduction in viable count. CONCLUSION: Our study suggests that enhanced infection prevention measures have reduced the burden of SARS-CoV-2 RNA on surfaces and air in healthcare.

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.

SARS-CoV-2 Detection on Artificially Contaminated Surfaces by Rapid Antigen Test

Objective: Evaluation of an antigen-based rapid test for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on artificially contaminated objects in comparison with a real-time reverse transcription-polymerase chain reaction (RT-qPCR) standard method. Materials and Methods: Artificial surface contamination with inactivated SARS-CoV-2 was tested on ten different objects comprising fruits and common materials. Three contamination levels with virus titers of 103, 104, and 105 pfu/100 μl were studied. Each object was spiked with 200 μl of virus suspension, samples were then collected by swabbing and evaluated by rapid antigen test and RT-qPCR. Additionally, 3 and 5-day contamination with SARSCoV‑2 at 105 pfu/100 μl was tested for some materials. Results: The detection rate obtained by the rapid antigen test with 103, 104, and 105 pfu/100 μl of SARS-CoV-2 was 10%, 90%, and 90%, respectively for the tested objects. RT‑qPCR showed a detection rate of 100% at all virus titers. Furthermore, both rapid antigen test and RT-qPCR were able to detect the 3 and 5-day extended contamination with SARS-CoV-2. Conclusion: The collected data suggests that the evaluated rapid antigen test is suitable for detection of SARS-CoV-2 adhered to non-human samples as a screening method. This simple method can reduce costs and turnaround time when compared to a standard molecular assay. It may be applied to enhance safety policies for COVID-19 prevention in public health and international export-businesses © All material is licensed under terms of the Creative Commons Attribution 4.0 International (CC-BY-NC-ND 4.0) license unless otherwise stated

Infectivity of SARS-CoV-2 on Inanimate Surfaces: Don't Trust Ct Value.

SARS-CoV-2 RNA is frequently identified in patient rooms and it was speculated that the viral load quantified by PCR might correlate with infectivity of surfaces. To evaluate Ct values for the prediction of infectivity, we investigated contaminated surfaces and Ct-value changes after disinfection. Viral RNA was detected on 37 of 143 investigated surfaces of an ICU. However, virus isolation failed for surfaces with a high viral RNA load. Also, SARS-CoV-2 could not be cultivated from surfaces artificially contaminated with patient specimens. In order to evaluate the significance of Ct values more precisely, we used surrogate enveloped bacteriophage Φ6. A strong reduction in Φ6 was achieved by three different disinfection methods. Despite a strong reduction in viability almost no change in the Ct values was observed for UV-C and alcoholic surface disinfectant. Disinfection using ozone resulted in a lack of Φ6 recovery as well as a detectable shift in Ct values indicating strong degradation of the viral RNA. The observed lack of significant effects on the detectable viral RNA after effective disinfection suggest that quantitative PCR is not suitable for predicting the infectivity of SARS-CoV-2 on inanimate surfaces. Ct values should therefore not be considered as markers for infectivity in this context.

Knowledge, Attitudes, and Perceptions Towards Hand Hygiene of Optometry Students Pre- and Peri-COVID-19 at a Tertiary Institution in Johannesburg, South Africa.

Purpose: Limited research has been completed relating to the knowledge, attitudes and practices (KAP) towards hand hygiene in optometry. The necessity of identifying possible gaps in the cycle of the optometric examination that may have an impact on standard hygiene practices is essential, especially seen in the context of the COVID-19 pandemic. The purpose of the study was to determine if optometry students' KAP towards hand hygiene changed pre- and peri-COVID-19 to minimize the risk of possible infection it may have for their patients, family, and themselves. Patients and Methods: A cross-sectional purposeful sample study was completed among optometry students at a training institution in Johannesburg, South Africa, pre- (2019) and peri-COVID-19 (2022). The WHO hand hygiene knowledge and perception questionnaires for health care workers were adapted and used in the current study. Statistical analyses were performed to test for significant changes between the two groups. Results: There was a significant change (p < 0.01) in the use of alcohol-based hand rub (ABHR) in 2022 (87.2%) compared to 2019 (46.5%), although only 41% of students peri-COVID-19 (2022), were aware that a minimum of 20 seconds is required to effectively clean hands. Students, both pre-COVID-19 (63.8%) and peri-COVID-19 (81.8%) perceived performing a hand hygiene regime during an optometric examination to be problematic. A significant peri-COVID-19 (2022) change in perception (p < 0.01) regarding the importance of completing required hand hygiene practices in front of a patient during examination was seen. Conclusion: The COVID-19 pandemic provided a unique opportunity to research a possible change in KAP towards hand hygiene practices in optometry students that have not been investigated before. Students were more aware of the impact of hand hygiene practices and the perception thereof, especially by patients and fellow students during the peri-COVID-19 (2022) period. An important finding was the difficulty that students experienced to perform a hand hygiene regime during an optometric examination.

Evaluation of the cycle threshold values of RT-PCR for SARS-CoV-2 in COVID-19 patients in predicting epidemic dynamics and monitoring surface contamination.

To evaluate the application of cycle threshold (Ct) values of coronavirus disease 2019 (COVID-19) patients in predicting epidemic dynamics and monitoring surface contamination. The Ct value of reverse transcriptase-polymerase chain reaction for SARS­CoV-2 from COVID-19 patients inbound overseas in Xiamen, China was collected from October 2020 to December 2021, and the correlation of patients' Ct values with epidemic dynamics and surface contamination was evaluated. The results showed that there was an extreme inverse correlation of positivity rate in the current calendar month (ORF1ab, r = -0.692, P = 0.004; N,r = -0.629, P = 0.012) and the following calendar month (ORF1ab,r = -0.801, P = 0.001; N,r = -0.620, P = 0.018) with the median Ct values. Ct value showed better performance for monitoring surface contamination, with the area under the curve value 0.808(95 %CI: 0.748-0.869) for ORF1ab and 0.807(95 %CI:0.746-0.868) for the N gene. The patients' ORF1ab Ct value< 29.09 or N Ct value< 28.03 were 11.25 times and 10.48 times more likely to result in surface contamination than those with ORF1ab Ct value ≥ 29.09 or N Ct value≥ 28.03 (OR:11.25,95 % CI: 5.52-22.35; OR:10.48,95 % CI:5.29-20.70). Ct values were associated with the positivity rate in the current or following calendar month and predicted the epidemic dynamics. The Ct values can be used as a predictor for monitoring surface contamination to develop public health responses to COVID-19.

Viral, bacterial, and fungal contamination of Automated Teller Machines (ATMs)

Introduction and objective: While the qualitative information about bacterial and fungal pollution of automated teller machine (ATM) surfaces is available in the scientific literature, there are practically no studies precisely quantifying this type of contamination. Regarding viruses, such data in relation to ATM surfaces are not available at all. Material and methods: The quantitative and qualitative control of adeno- and coronaviruses, including SARS-CoV-2 (based on qPCR/RT-qPCR and v-qPCR/v-RT-qPCR), bacterial and fungal contaminants (based on morphological and biochemical characteristics followed by PCR/RAPD typing) deposited on internal and external ATM surfaces (swab sampling), as well as present in the air of premises housing the ATM machines (inertial impaction sampling) belonging to the network of one of the largest Polish banks was performed. Results: As the air of premises housing ATMs was relatively clean, the internal (i.e. safe boxes and cash dispenser tracks) and external (i.e. touch screens and keypads) ATM surfaces were heavily polluted, reaching 599 CFU/cm2, 522 CFU/cm2, 17288 gc/cm2 and 2512 gc/cm2 for bacterial, fungal, coronaviral and adenoviral contaminants, respectively. The application of propidium monoazide (PMA) dye pretreatment for v-qPCR/v-RT-qPCR allows detection of the potentially infectious SARS-CoV-2 and adenoviral particulates on ATM surfaces. Conclusions: The packaged banknotes and people involved in their distribution, as well as general population using ATMs, can be the sources of this type of contamination and its potential victims. Highly efficient hygienic measures should be introduced to prevent unwanted pollution of both the distributed means of payment and ATM surfaces, and to avoid subsequent dissemination of microbial contaminants.

A hand-targeted auxiliary personal protective equipment for intervention of fomite transmission of viruses.

In COVID-19, fomite transmission has been shown to be a major route for the spreading of the SARS-CoV-2 virus due to its ability to remain on surfaces for extended durations. Although glove wearing can mitigate the risk of viral transmission especially on high touch points, it is not prevalent due to concerns on diversion of frontline medical resources, cross-contamination, social stigma, as well as discomfort and skin reactions derived from prolonged wearing. In this study, we developed FlexiPalm, a hand-targeted auxiliary personal protective equipment (PPE) against fomite transmission of viruses. FlexiPalm is a unique palmar-side hand protector designed to be skin-conforming and transparent, fabricated from medical-grade polyurethane transparent film material as a base substrate. It serves primarily as a barrier to microbial contamination like conventional gloves, but with augmented comfort and inconspicuousness to encourage a higher public adoption rate. Compared to conventional glove materials, FlexiPalm demonstrated enhanced mechanical durability and breathability, comparable hydrophobicity, and displayed a minimal adsorption of SARS-CoV-2 spike protein and virus-like particles (VLP). Importantly, FlexiPalm was found to bind significantly less viral protein and VLP than artificial human skin, confirming its ability to reduce viral contamination. A pilot study involving participants completing activities of daily living showed a high level of comfort and task completion, illustrating the usability and functionality of FlexiPalm. Moreover, we have demonstrated that surface modification of FlexiPalm with microtextures enables further reduction in viral adsorption, thereby enhancing its functionality. An effective implementation of FlexiPalm will bolster PPE sustainability and lead to a paradigm shift in the global management of COVID-19 and other infectious diseases in general.

Surface contamination by SARS-CoV2 RNA in dedicated COVID care area of a tertiary care hospital in North India.

Environmental surfaces are potential source of SARS-CoV2 transmission. The study assessed the efficacy of hospital disinfection policy and contamination of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) RNA in COVID management Hospital. Inanimate surfaces from both patient areas (n = 70) and non-patient areas (n = 39) were sampled through surface swabbing and subjected to Reverse transcriptase PCR. Out of the 70 samples collected from the COVID hospital, SARS-CoV2 RNA positivity of 17.5% (7/40) and 6.7% (2/30) was seen in high risk and moderate risk area respectively. Samples from Non COVID related patient area such as CD ward and administrative block were assessed and the SARS CoV-2 RNA positivity was 0% and 10% respectively. Among the total 8 environmental surface samples positive for SARS-CoV2 RNA detected from the area surrounding the SARS-CoV2 infected patients, maximum positivity of 31.8% (7/22) was found among the environmental samples collected around the patients with < 20 Ct value in nasopharyngeal swab samples followed by 3.3% positivity (1/30) around patients with Ct value ranging from 20 to 25 whereas no SARS-CoV2 RNA (0/5) was detected around the patient with > 25 Ct value. Nearly 50% (2/4) of the surface samples came positive from the resident PPE and mobile of the treating doctors which largely elaborates the need for stringent doffing measurement and hand hygiene policy post doffing. The study emphasizes the necessity of frequent and aggressive disinfection policy to prevent nosocomial infection in such high risk areas within close vicinity of the patients.

Revisiting SARS-CoV-2 environmental contamination by patients with COVID-19: The Omicron variant does not differ from previous strains.

SARS-CoV-2 Omicron strain emergence raised concerns that its enhanced infectivity is partly due to altered spread/contamination modalities. We therefore sampled high-contact surfaces and air in close proximity to patients who were verified as infected with the Omicron strain, using identical protocols applied to sample patients positive to the original or Alpha strains. Cumulatively, for all 3 strains, viral RNA was detected in 90 of 168 surfaces and 6 of 49 air samples (mean cycle threshold [Ct]=35.2±2.5). No infective virus was identified. No significant differences in prevalence were found between strains.

Investigation of mouse hepatitis virus strain A59 inactivation under both ambient and cold environments reveals the mechanisms of infectivity reduction following UVC exposure.

The surface contamination of SARS-CoV-2 is becoming a potential source of virus transmission during the pandemic of COVID-19. Under the cold environment, the infection incidents would be more severe with the increase of virus survival time. Thus, the disinfection of contaminated surfaces in both ambient and cold environments is a critical measure to restrain the spread of the virus. In our study, it was demonstrated that the 254 nm ultraviolet-C (UVC) is an efficient method to inactivate a coronavirus, mouse hepatitis virus strain A59 (MHV-A59). The inactivation rate to MHV-A59 coronavirus was up to 99.99% when UVC doses were 2.90 and 14.0 mJ/cm2 at room temperature (23 °C) and in cold environment (-20 °C), respectively. Further mechanistic study demonstrated that UVC could induce spike protein damage to partly impede virus attachment and genome penetration processes, which contributes to 12% loss of viral infectivity. Additionally, it can induce genome damage to significantly interrupt genome replication, protein synthesis, virus assembly and release processes, which takes up 88% contribution to viral inactivation. With these mechanistic understandings, it will greatly contribute to the prevention and control of the current SARS-CoV-2 transmissions in cold chains (low temperature-controlled product supply chains), public area such as airport, school, and warehouse.

Germi-X herbal-based spray disinfects smartphone surfaces: implication on fomite-mediated infection spread.

Inanimate objects/surfaces become fomites upon contacting infectious agents such as disease-causing bacteria, fungi and viruses. Smartphones are one of the most prominent among these fomites. COVID-19 pandemic has raised the awareness on mobile sanitization, as an active measure to curb fomite-mediated viral transmission. Available mobile sanitizers and ultraviolet (UV) ray mediated mobile sanitization have their own sets of pros and cons, often being less user-friendly. This study explored the germicidal efficacy of an herbal-based sanitizer, Germi-X spray, on hands and mobiles, through microbiological techniques of micro-broth dilution and Kirby-Bauer disc diffusion assay, thumb print assay and swab test. Notably, Germi-X spray was found to be 6-67% more effective against surface pathogens, like, Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas fluorescens and Pseudomonas aeruginosa, as compared to a very popular product in the Indian market, which was taken as a control for this study. The observed anti-bacterial activity of the spray from disc-diffusion assay suggests its greater surface retentivity as compared to the control. Germicidal potency of Germi-X spray, when used to sanitize hands, was found to be greater than 80%. There was ~ 17-fold reduction in microbial counts after sanitizing smartphones with Germi-X spray. The novelty of this study lies in providing experimental evidence for this herbal-based surface sanitizer in efficiently disinfecting one of the super contaminated fomite, the smartphones. In conclusion, having an herbal base with a high germicidal efficacy against surface pathogens, together with longer surface retention, Germi-X spray appears to be an eco-friendly and cost-effective sanitizer for the surfaces of electronic gadgets like smartphones.

Detection of SARS-CoV-2 genome on inanimate surfaces in COVID-19 intensive care units and emergency care cohort.

INTRODUCTION: Understanding the different transmission routes of SARS-CoV-2 is crucial in planning effective interventions in healthcare institutions. This study aimed to evaluate the presence of SARS-Cov-2 genome on inanimate surfaces in COVID-19 intensive care unit and emergency care cohorts. METHODS: This is a prospective cross-sectional study. Samples of the environmental surface of objects and furniture were collected between July 15 and October 15, 2020, at COVID-19 intensive and emergency care units. The presence of SARS-CoV-2 genome was determined by quantitative RT-qPCR. The positivity rate for SARS-Cov-2 genome is presented as the arithmetic mean of the sum of the values obtained in each collection. Values of 1.0, 0.5, and 0.0 were assigned for positive, indeterminate, and negative events, respectively. RESULTS: In the intensive care unit, 86% of samples collected at the stethoscope and bed rail surfaces were positive. In the emergency care unit, 43% of bathroom tap, bed rails, and bedside table samples were positive. SARS-CoV-2 genome was not detected at the computer mouse and keyboard. At the emergency care unit, 14.3% of the samples from the collection room armchair were positive. CONCLUSIONS: SARS-CoV-2 genome can be found at the environmental surface of objects and furniture at COVID-19 care units. They can represent a potential source of indirect transmission pathway for COVID-19, especially within health service institutions.

Occurrence of SARS-CoV-2 in Indoor Environments With Increased Circulation and Gathering of People.

At the time of sampling (2020/2021), the number of new cases of SARS-CoV-2-positive individuals in the Czech Republic significantly exceeded the numbers in neighboring countries and in the EU. In terms of the number of deaths, the country ranked near the top of the list. Legislative orders required wearing masks indoors, disinfecting surfaces in public places, and limiting the number of people per sales area in commercial spaces. Due to an situation, most schools and shops were closed. The entire country anticipated a total lockdown. To assess the risk to public health regarding SARS-CoV-2 transmission, air and surfaces were sampled in two public places: a post office and a shopping center. Samples were also collected at the COVID-19 unit at the local hospital. Neither air nor surface samples were positive for SARS-CoV-2 virus particles in the post office or shopping center. Positive results were found in the hospital ward, with floors being the most and highest contaminated surface. Based on our results, we believe that public places do not pose a risk in relation to SARS-CoV-2 transmission, especially when epidemiological measures to reduce transmission are followed, such as wearing masks, using disinfectant or limiting the number of customers per retail establishment.

Investigating Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Surface and Air Contamination in an Acute Healthcare Setting During the Peak of the Coronavirus Disease 2019 (COVID-19) Pandemic in London.

BACKGROUND: We evaluated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) surface and air contamination during the coronavirus disease 2019 (COVID-19) pandemic in London. METHODS: Prospective, cross-sectional, observational study in a multisite London hospital. Air and surface samples were collected from 7 clinical areas occupied by patients with COVID-19 and a public area of the hospital. Three or four 1.0-m3 air samples were collected in each area using an active air sampler. Surface samples were collected by swabbing items in the immediate vicinity of each air sample. SARS-CoV-2 was detected using reverse-transcription quantitative polymerase chain reaction (PCR) and viral culture; the limit of detection for culturing SARS-CoV-2 from surfaces was determined. RESULTS: Viral RNA was detected on 114 of 218 (52.3%) surfaces and in 14 of 31 (38.7%) air samples, but no virus was cultured. Viral RNA was more likely to be found in areas immediately occupied by COVID-19 patients than in other areas (67 of 105 [63.8%] vs 29 of 64 [45.3%]; odds ratio, 0.5; 95% confidence interval, 0.2-0.9; P = .025, χ2 test). The high PCR cycle threshold value for all samples (>30) indicated that the virus would not be culturable. CONCLUSIONS: Our findings of extensive viral RNA contamination of surfaces and air across a range of acute healthcare settings in the absence of cultured virus underlines the potential risk from environmental contamination in managing COVID-19 and the need for effective use of personal protective equipment, physical distancing, and hand/surface hygiene.

A Systematic Review of Surface Contamination, Stability, and Disinfection Data on SARS-CoV-2 (Through July 10, 2020).

We conducted a systematic review of hygiene intervention effectiveness against SARS-CoV-2, including developing inclusion criteria, conducting the search, selecting articles for inclusion, and summarizing included articles. Overall, 96 268 articles were screened and 78 articles met inclusion criteria with outcomes in surface contamination, stability, and disinfection. Surface contamination was assessed on 3343 surfaces using presence/absence methods. Laboratories had the highest percent positive surfaces (21%, n = 83), followed by patient-room healthcare facility surfaces (17%, n = 1170), non-COVID-patient-room healthcare facility surfaces (12%, n = 1429), and household surfaces (3%, n = 161). Surface stability was assessed using infectivity, SARS-CoV-2 survived on stainless steel, plastic, and nitrile for half-life 2.3-17.9 h. Half-life decreased with temperature and humidity increases, and was unvaried by surface type. Ten surface disinfection tests with SARS-CoV-2, and 15 tests with surrogates, indicated sunlight, ultraviolet light, ethanol, hydrogen peroxide, and hypochlorite attain 99.9% reduction. Overall there was (1) an inability to align SARS-CoV-2 contaminated surfaces with survivability data and effective surface disinfection methods for these surfaces; (2) a knowledge gap on fomite contribution to SARS-COV-2 transmission; (3) a need for testing method standardization to ensure data comparability; and (4) a need for research on hygiene interventions besides surfaces, particularly handwashing, to continue developing recommendations for interrupting SARS-CoV-2 transmission.

Environmental contamination and personal protective equipment contamination with SARS-CoV-2 virus in a real-life clinical setting.

The importance of SARS-CoV-2 transmission via contact routes and its stability on surfaces is becoming increasingly recognised. There is ongoing concern that patients can become infected through person-to-person spread and environment-to-person spread. This study assessed whether SARS-CoV-2 viral RNA can be detected in the environment either on staff members' personal protective equipment (PPE), on high-touch surfaces or around the bedspace of COVID-19-positive patients in a range of different ward settings to evaluate if there was any contamination of these. Results showed all PPE and high-touch surface swabs were negative. All swabs taken in the negative-pressure room where aerosol-generating procedures (AGPs) were being undertaken detected viral RNA (5/5 positive), whereas there was minimal contamination in the intensive therapy unit (1/5 positive) and none detected in the cohort bay. These findings would be consistent with the understanding that areas where AGPs are regularly performed are at higher risk of environmental contamination.