SARS-CoV-2 RNA viability on high-touch surfaces and evaluation of a continuous-flow ozonation treatment

Background: The COVID-19 emergency has highlighted the importance of prevention systems and environ-mental microbiological monitoring as fundamental elements in the response to epidemics and other such threats to individual and collective health. The use of automated "No-touch" room disinfection systems eliminates or reduces the dependence on operators, thus allowing an improvement in the effectiveness of terminal disinfection. Study design: In the present study, we focused on possible SARS-CoV-2 contamination of surfaces of com-mercial services, and the effectiveness of ozone treatment on the virus. Methods: Analyses were conducted on 4-7 October and 27-30 December 2021 in four supermarkets in an Apulian city;supermarkets A and B were equipped with an ozonisation system, while C and D were without any environmental remediation. Results: SARS-CoV-2 RNA was detected by real-time RT-PCR only in December, in 6% of the surfaces tested, and all examined samples were found to be negative after viral culture, since no cytopathic effect was observed. A statistically significant difference emerged from the comparison of October vs. December (p = 0.0289), but no statistically significant difference (p = 0.6777) emerged from the comparison between supermarkets with and without the ozonisation system. Conclusions: Although no important changes were observed by treating the environments with ozonisation systems, further studies are needed to validate the effectiveness of environmental treatments with airborne disinfectants.

COVID-19 Risk Management in Dental Offices: A Review Article

BACKGROUND: As all the dental staff, including nurses and practitioners, are exposed to various routes of contamination due to the novel COVID-19 virus, which is still unknown to the scientific world, developing strategies to reduce the risk of transmission and decontaminate surfaces in a dental office would be of high importance. Although there is still insufficient data on managing this virus in dental offices, several studies have suggested protocols for improving care. AIM: This study aimed to review present investigations and reach a conclusion on what we know and need to know to combat this virus. MATERIALS AND METHODS: In this review, Scopus, PubMed, and MEDLINE databases were searched using the keywords "COVID-19,” "SARS-CoV-2,” "Medical Disinfectants,” "Personal Protective Equipment's,” and "Surface Decontamination.” Articles were reviewed, and finally, relevant articles published during 2000–2022 were included in the final paper. RESULTS: The present research concluded that using a combination of the face shield and N95 masks protected the eyes, nose, and mouth. To have more efficient protection, water-resistant long-sleeved gowns and gloves were highly suggested. To overcome aerosols, high-performance air filters and ultraviolet were found quite effective. Allowing the patient to use antiseptic mouthwash before starting the treatment could reduce oral microorganisms and the following airborne contamination. CONCLUSION: This review has gathered all available data regarding dentistry and COVID-19 in order to conclude what has been achieved yet in the prevention of this virus through dental offices;however, more investigations are needed to have a definitive protocol against the virus.

Fate of Exhaled Droplets From Breathing and Coughing in Supermarket Checkouts and Passenger Cars.

The global pandemic of COVID-19 has highlighted the importance of understanding the role that exhaled droplets play in virus transmission in community settings. Computational Fluid Dynamics (CFD) enables systematic examination of roles the exhaled droplets play in the spread of SARS-CoV-2 in indoor environments. This analysis uses published exhaled droplet size distributions combined with terminal aerosol droplet size based on measured peak concentrations for SARS-CoV-2 RNA in aerosols to simulate exhaled droplet dispersion, evaporation, and deposition in a supermarket checkout area and rideshare car where close proximity with other individuals is common. Using air inlet velocity of 2 m/s in the passenger car and ASHRAE recommendations for ventilation and comfort in the supermarket, simulations demonstrate that exhaled droplets <20 µm that contain the majority of viral RNA evaporated leaving residual droplet nuclei that remain aerosolized in the air. Subsequently ~ 70% of these droplet nuclei deposited in the supermarket and the car with the reminder vented from the space. The maximum surface deposition of droplet nuclei/m2 for speaking and coughing were 2 and 819, 18 and 1387 for supermarket and car respectively. Approximately 15% of the total exhaled droplets (aerodynamic diameters 20-700 µm) were deposited on surfaces in close proximity to the individual. Due to the non-linear distribution of viral RNA across droplet sizes, however, these larger exhaled droplets that deposit on surfaces have low viral content. Maximum surface deposition of viral RNA was 70 and 1.7 × 103 virions/m2 for speaking and 2.3 × 104 and 9.3 × 104 virions/m2 for coughing in the supermarket and car respectively while the initial airborne concentration of viral RNA was 7 × 106 copies per ml. Integrating the droplet size distributions with viral load distributions, this study helps explain the apparent importance of inhalation exposures compared to surface contact observed in the pandemic.

Transfer of a critically ill coronavirus disease patient

Coronavirus disease (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Acute respiratory distress syndrome (ARDS) is a feature of SARS-CoV-2, and transferring patients with severe ARDS is challenging owing to their condition and risk of infection during the transfer process. The hemodynamic instability of critically ill patients adds to the challenge of safe transfer, which requires thorough preparation of personnel, medication, equipment, and communication and transport methods, all of which must be organised within the infection control framework. In this case report we discuss a woman, 37 years of age, with suggested COVID-19, intubated due to severe ARDS. Owing to the hospital referral policy in Indonesia, the patient was transferred to a specialist infectious disease hospital by land ambulance, with a special transfer team formed to adhere to infection control protocols and critical patient transfer procedures. Copyright © 2020, Australasian College of Paramedicine. All rights reserved.

Recycling Discarded Facemasks of COVID-19 Pandemic to New Novel Composite Thermal Insulation and Sound-Absorbing Materials

The COVID-19 pandemic has forced the whole world to wear single-use disposable facemasks for health protection. Studies have shown that about 129 billion facemasks are wasted each month, which will contaminate the environment and create a big problem in getting rid of them. These discarded facemasks are usually dumped in garbage bins, in landfills, or in some cases littering them on the streets, which creates a health hazard to human beings. In order to solve such environmental problems, the current study presents new novel composite materials developed by recycling discarded facemasks. These materials have great potential to be used for both thermal insulation and sound-absorbing for building walls. Experiments have been performed to make bound composite materials using the discarded facemasks as new raw materials with wood adhesive as a binder. The discarded facemasks were first heated for one and half-hour at 120 degrees C to kill any contaminants (biological or others). Five different composites are made: the first uses the complete facemasks, the second uses facemasks with iron nose clip only, the third uses facemasks with no both ear loops and iron nose clip, the fourth one contains the elastic ear loops only, and the fifth one has facemasks with elastic ear loops only. Coefficients of thermal conductivity for the five samples are obtained as 0.0472, 0.0519, 0.05423, 0.0619, 0.0509 (#5, e), and 0.04347 (#5, f) W/m K at 25 degrees C, respectively. The sound-absorbing coefficient for samples 1, 2, and 3 is above 0.5 in general and, at some frequencies, approaches 0.8. Results show that the soft samples with low binder concentration have a good sound absorbing coefficient at high frequency, while the one with high binder concentration has that at a low frequency for the same facemasks' mass. Mechanical properties of all samples are also reported by performing the three-point bending moment. Composite samples have a low moisture content (0.2%) and have high thermal stability up to 325 degrees C. These composite samples could replace the petrochemical and synthetic thermal insulation materials and, at the same time, get rid of the huge discarded waste facemasks, which is considered a huge environmental problem.

Design, Implementation, and Evaluation of an N95 Respirator Decontamination and Reuse Program for Healthcare Workers During the COVID-19 Pandemic.

Early in the COVID-19 pandemic, substantial disruptions in personal protective equipment (PPE) supply chains forced healthcare systems to become resourceful to ensure PPE availability for healthcare workers. Most worrisome was the global shortage of N95 respirators. In response, a collaboration between the Department of Infection Control and Healthcare Epidemiology and the Department of Biosafety at the University of Texas Medical Branch developed a PPE recycling program guaranteeing an adequate supply of respirators for frontline staff. The team successfully developed and implemented a novel workflow that included validated decontamination procedures, education, and training programs as well as transportation, labeling, and storage logistics. In total, 15,995 respirators of various types and sizes were received for recycling. Of these, 12,752 (80%) were recycled. Following the program's implementation, we surveyed 134 frontline healthcare workers who overwhelmingly graded our institution's culture of safety positively. Overall impressions of the N95 respirator recycling program were mixed, although interpretation of those results was limited by a lower survey response rate. In an era of increasing health security threats, innovative recycling programs like this one may serve as a model for other health systems to respond to future PPE supply chain disruptions.

The Use of Digital Technology for COVID-19 Detection and Response Management in Indonesia: Mixed Methods Study.

BACKGROUND: The COVID-19 pandemic has triggered a greater use of digital technologies as part of the health care response in many countries, including Indonesia. It is the world's fourth-most populous nation and Southeast Asia's most populous country, with considerable public health pressures. OBJECTIVE: The aim of our study is to identify and review the use of digital health technologies in COVID-19 detection and response management in Indonesia. METHODS: We conducted a literature review of publicly accessible information in technical and scientific journals, as well as news articles from September 2020 to August 2022 to identify the use case examples of digital technologies in COVID-19 detection and response management in Indonesia. RESULTS: The results are presented in 3 groups, namely (1) big data, artificial intelligence, and machine learning (technologies for the collection or processing of data); (2) health care system technologies (acting at the public health level); and (3) COVID-19 screening, population treatment, and prevention population treatment (acting at the individual patient level). Some of these technologies are the result of government-academia-private sector collaborations during the pandemic, which represent a novel, multisectoral practice in Indonesia within the public health care ecosystem. A small number of the identified technologies pre-existed the pandemic but were upgraded and adapted for current needs. CONCLUSIONS: Digital technologies were developed in Indonesia during the pandemic, with a direct impact on supporting COVID-19 management, detection, response, and treatment. They addressed different areas of the technological spectrum and with different levels of adoption, ranging from local to regional to national. The indirect impact of this wave of technological creation and use is a strong foundation for fostering future multisectoral collaboration within the national health care system of Indonesia.

The effectiveness of phototherapy for surface decontamination against SARS-Cov-2. A systematic review.

COVID-19 appeared in December 2019, needing efforts of science. Besides, a range of light therapies (photodynamic therapy, ultraviolet [UV], laser) has shown scientific alternatives to conventional decontamination therapies. Investigating the efficacy of light-based therapies for environment decontamination against SARS-CoV2, a PRISMA systematic review of Phototherapies against SARS-CoV or MERS-CoV species discussing changes in viral RT-PCR was done. After searching MEDLINE/PubMed, EMBASE, and Literatura Latino-Americana e do Caribe em Ciências da Saúde we have found studies about cell cultures irradiation (18), blood components irradiation (10), N95 masks decontamination (03), inanimate surface decontamination (03), aerosols decontamination (03), hospital rooms irradiation (01) with PDT, LED, and UV therapy. The best quality results showed an effective low time and dose UV irradiation for environments and inanimate surfaces without human persons as long as the devices have safety elements dependent on the surfaces, viral charge, humidity, radiant exposure. To interpersonal contamination in humans, PDT or LED therapy seems very promising and are encouraged.

Evaluating the effects of air disinfectants in decontamination of COVID-19 aerosols.

Introduction: Airborne transmission is the most  crucial mode of COVID-19 transmission. Therefore, disinfecting the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) aerosols float can have important implications in limiting COVID-19 transmission. Herein, we aimed to review the studies that utilized various disinfectants to decontaminate and inactivate the SARS-CoV-2 aerosols. Methods: This study was a review that studied related articles published between December 1, 2019 and August 23, 2022. We searched the online databases of PubMed, Scopus, Web of Science, Cochrane, on August 23, 2021. The studies were downloaded into the EndNote software, duplicates were removed, and then the studies were screened based on the inclusion/exclusion criteria. The screening process involved two steps; first, the studies were screened based on their title and abstract and then their full texts. The included studies were used for the qualitative analysis. Results: From 664 retrieved records, only 31 met the inclusion criteria and were included in the final qualitative analysis. Various materials like Ozone, H2O2, alcohol, and TiO2 and methods like heating and using Ultraviolet were described in these studies to disinfect places contaminated by COVID-19. It appeared that the efficacy of these disinfectants varies considerably depending on the situation, time, and ultimately their mode of application. Conclusion: Following reliable protocols in combination with the proper selection of disinfectant agents for each purpose would serve to achieve desired elimination of the SARS-CoV-2 transmission.

Effect of dry heat treatment between room temperature and 160 °C on surgical masks.

The Covid-19 crisis has led to a high demand and use of surgical masks worldwide, causing risks of shortages and pollution. Therefore, decontamination of surgical masks could be an opportunity to reduce these risks. In our study, we applied dry heat to the masks for 15 min at different temperatures and studied the consequences of heat on surface chemistry and fiber morphology. We focus here on the effects of dry heat treatment on the masks and not on the verification of mask disinfection, which has been thoroughly studied in existing literature. The masks that were heated to 70 °C, 100 °C, 130 °C, 140 °C, 150 °C did not show significant changes at the nanometric scale and the standard deviation of the surface temperature of the worn masks is similar to that of the unheated control mask. However we show a slight heating altered the hydrophobicity of the surface, and induced a significative modification of the wetting angle of water droplets. The mask heated to 157 °C has a higher surface temperature standard deviation and fused fibers are observed by scanning electron microscopy. The mask heated to 160 °C melted and then hardened as it cooled making it completely unusable.

Surface Contamination of Reusable Respirators and Face Shields During Care of Critically Ill COVID-19 Patients.

BACKGROUND: With the emergence of SARS-CoV-2, healthcare workers (HCW) have relied on reusable personal protective equipment (PPE), including respirators and face shields (FSs). The effectiveness of decontamination procedures outside experimental settings is unclear. We examined the prevalence of surface contamination on reusable PPE used by HCWs at a hospital incorporating daily centralized decontamination and post-use wiping by sampling for common pathogens. METHOD: Samples were collected from HCWs' CleanSpace Halo respirator face masks (FMs) and FSs at the start of shift, immediately after use, and after cleaning with disinfecting wipes. Samples were analyzed for pathogens using the Applied Biosystems™ TaqPath™ COVID-19 Combo Kit and ThermoFisher TaqMan Array Card. Patient charts were reviewed for clinical correlation. FINDINGS: Of the 89 samples, 51 from FMs and 38 from FSs, none tested positive for SARS-CoV-2, despite 58 being obtained from PPE used in the care of patients with COVID-19, many with recent aerosol-generating procedures. Four samples tested positive (4.5%) for Staphylococcus aureus, two each from FMs and FSs. FMs that tested positive were not worn concurrently with FSs that tested positive. The FM and FS samples testing positive were worn in the care of patients without diagnosed S. aureus infection. No FMs tested positive following wipe-based disinfection, but both positive FS samples were found after disinfection wiping. CONCLUSION/APPLICATION TO PRACTICE: Contamination of reusable PPE appears uncommon, especially with SARS-CoV-2, when regular decontamination programs are in place. The rare presence of S. aureus highlights the importance of doffing procedures and hand hygiene by HCW to prevent surface contamination.