Stability of SARS-CoV-2 in cold-chain transportation environments and the efficacy of disinfection measures.

Background: Low temperature is conducive to the survival of COVID-19. Some studies suggest that cold-chain environment may prolong the survival of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and increase the risk of transmission. However, the effect of cold-chain environmental factors and packaging materials on SARS-CoV-2 stability remains unclear. Methods: This study aimed to reveal cold-chain environmental factors that preserve the stability of SARS-CoV-2 and further explore effective disinfection measures for SARS-CoV-2 in the cold-chain environment. The decay rate of SARS-CoV-2 pseudovirus in the cold-chain environment, on various types of packaging material surfaces, i.e., polyethylene plastic, stainless steel, Teflon and cardboard, and in frozen seawater was investigated. The influence of visible light (wavelength 450 nm-780 nm) and airflow on the stability of SARS-CoV-2 pseudovirus at -18°C was subsequently assessed. Results: Experimental data show that SARS-CoV-2 pseudovirus decayed more rapidly on porous cardboard surfaces than on nonporous surfaces, including polyethylene (PE) plastic, stainless steel, and Teflon. Compared with that at 25°C, the decay rate of SARS-CoV-2 pseudovirus was significantly lower at low temperatures. Seawater preserved viral stability both at -18°C and with repeated freeze-thaw cycles compared with that in deionized water. Visible light from light-emitting diode (LED) illumination and airflow at -18°C reduced SARS-CoV-2 pseudovirus stability. Conclusion: Our studies indicate that temperature and seawater in the cold chain are risk factors for SARS-CoV-2 transmission, and LED visible light irradiation and increased airflow may be used as disinfection measures for SARS-CoV-2 in the cold-chain environment.

High-Intensity Ultraviolet-C Irradiation Efficiently Inactivates SARS-CoV-2 Under Typical Cold Chain Temperature.

SARS-CoV-2 contaminated items in the cold chain becomes a threat to public health, therefore the effective and safe sterilization method fit for the low temperature is needed. Ultraviolet is an effective sterilization method while its effect on SARS-CoV-2 under low-temperature environment is unclear. In this research, the sterilization effect of high-intensity ultraviolet-C (HIUVC) irradiation against SARS-CoV-2 and Staphylococcus aureus on different carriers at 4 °C and - 20 °C was investigated. The results showed that dose of 15.3 mJ/cm2 achieved more than 3 log reduction of SARS-CoV-2 on gauze at 4 °C and - 20 °C. The vulnerability of coronavirus to HIUVC under - 20 °C was not significantly different than those under 4 °C. Four models including Weibull, biphasic, log-linear tail and log linear were used to fit the survival curves of SARS-CoV-2 and Staphylococcus aureus. The biphasic model fitted best with R2 ranging from 0.9325 to 0.9878. Moreover, the HIUVC sterilization correlation between SARS-CoV-2 and Staphylococcus aureus was established. This paper provides data support for the employment of HIUVC under low-temperature environment. Also, it provides a method of using Staphylococcus aureus as a marker to evaluate the sterilization effect of cold chain sterilization equipment.

Alternate Approach in Storing and Shipment of SARS-CoV-2 RNA Samples with the Use of FTA Cards.

Shipment of COVID-19 specimens within the country or overseas at long distances requires cold chain facility using dry ice and triple packing to prevent the risk of COVID-19 infection to the personnel involved in sample transport. The present study aimed to utilize FTA card technology as an alternate means of sample transport and storage across the country. Twenty-one SARS-CoV-2 lab confirmed samples with different Ct value (High, medium & low) were used to detect viral load in samples loaded on FTA card and further compared with VTM samples. The SARS-CoV-2 RNA was detected by rRT-PCR after storing for 14 days at 4 °C and 37 °C. The present study evaluated the utility of FTA cards for preserving the SARS CoV-2 RNA for 14-day period. A significant difference (P < 0.05) was observed in the cycle threshold (ΔCt 4-5) values obtained from FTA and VTM viral samples but it did not affect the positivity. The SARS-CoV-2 RNA could be recovered efficiently from FTA sample stored at 4 °C and 37 °C for 14 days. Thus, FTA cards could be an alternate option for transporting the samples at ambient temperature for a long time.

Analysis of network disruption evolution of Chinese fresh cold chain under COVID-19.

The spread of the global COVID-19 epidemic, home quarantine, and blockade of infected areas are essential measures to prevent the spread of the epidemic, but efforts to prevent and control the outbreak lead to the disruption of fresh and cold chain agricultural products in the region. Based on the multi-layer management model of non-scale agricultural households in China, we applied the complex network theory to construct an evolutionary model of the Chinese fresh cold chain network with adaptation degree priority connection, dual local world considering transport distance connection relationship, and superiority and inferiority mechanism. Based on this model, we studied the evolution of fresh cold chain disruption, and puts forward the optimal design of fresh cold chain network disruption and reconnection from the perspective of practicality and economy.

Risk Assessment of Import Cold Chain Logistics Based on Entropy Weight Matter Element Extension Model: A Case Study of Shanghai, China.

The development of world trade and fresh-keeping technology has led to the rapid development of international cold chain logistics. However, the novel coronavirus epidemic continues to spread around the world at the present stage, which challenges disease transmission control and safety supervision of international cold chain logistics. Constructing an Import Cold Chain Logistics Safety Supervision System (ICCL-SSS) is helpful for detecting and controlling disease import risk. This paper constructs an evaluation index system of ICCL safety that comprehensively considers the potential risk factors of three ICCL processes: the logistics process in port, the customs clearance process, and the logistics process from port to door. The risk level of ICCL-SSS is evaluated by combining the Extension Decision-making Model and the Entropy Weight Method. The case study of Shanghai, China, the world's largest city of ICCL, shows that the overall risk level of ICCL-SSS in Shanghai is at a moderate level. However, the processes of loading and unloading, inspection and quarantine, disinfection and sterilization, and cargo storage are at high risk specifically. The construction and risk assessment of ICCL-SSS can provide theoretical support and practical guidance for improving the safety supervision ability of ICCL regulation in the post-epidemic era, and helps the local government to scientifically formulate ICCL safety administration policies and accelerate the development of world cold chain trade.

The implementation of cold chain approach at transportation and storage of immunobiological preparations.

In the modern conditions of the coronavirus pandemic, the issue of transportation of immunobiological drugs is particularly actual, since control measures in this direction provide for supply of vaccines to different states, that naturally involves duration of transportation and compliance with certain established temperature regime at all stages of logistics chain, violation of which results in loss of pharmaceutical properties by drugs. The analysis demonstrated that currently transportation of immunobiological drugs is carried out within the framework of cold chain approach, which establishes mandatory compliance with temperature range of storage and transportation. Thus, the most important issue is control of compliance with temperature regime, which requires appropriate technical equipment at all levels of cold chain, ensuring fixation of detected violations.

Transmission of SARS-CoV-2 on Cold-Chain Food: Precautions Can Effectively Reduce the Risk.

The COVID-19 pandemic has generated a new era in the world, also in the food safety. Up to now, there is no evidence to suggest that people can infect COVID-19 via food contaminated by SARS-CoV-2. Here, we analyzed the results of regular SARS-CoV-2 nucleic acid testing of considerable cold-chain food practitioners, cold-chain food surfaces, and their internal or external packaging as well as their associated environments, aiming to explore the risk of cold-chain food being contaminated by SARS-CoV-2 and the probability of people infecting COVID-19 through contaminated cold-chain food in the context of COVID-19 epidemic. This study found that only two batches of cold-chain food were contaminated by SARS-CoV-2, none of the cold-chain food handler were infected due to effective regulatory measures for cold-chain food. Therefore, effective supervision and preventive methods could effectively reduce the transmission risk of SARS-CoV-2 on cold-chain food.

Factors Influencing Consumers' Purchase Intention on Cold Chain Aquatic Products under COVID-19: An Investigation in China.

Following the detection of COVID-19 in cold chain aquatic products (CCAP) at Xinfadi Produce Wholesale Market in Beijing, China, in June 2020, novel coronavirus positive tests of CCAP have been reported in such markets of Dalian, Xi'an, Qingdao, Taiyuan, and other places, which has aroused the concern of Chinese consumers. The CCAP outbreak puts tremendous pressure on public health management and threatens customer well-being. This article uses the theoretical model of planned behavior (TPB) to investigate Chinese consumers' purchasing intentions of CCAP under this circumstance. A total of 783 questionnaires were administered in China with empirical analysis through a structural equation model. The results show that attitudes (ATT) towards the safety of CCAP and subjective norms (SN) have significant positive effects on customers' purchasing behavior intention (BI); the emotional response to the health concern (EM) of CCAP has a significant positive impact on SN, ATT, and BI; and BI of CCAP is significantly affected by individual characteristics. The BI of CCAP for those married consumers living in cities and towns with a low monthly consumption frequency is more likely to be affected by the new coronavirus epidemic events. This paper is one of the first studies that contribute to the literature by exploring the influencing factors of the consumption behavior intention over the COVID-19 pandemic in China from a public health perspective. The findings provide significant implications for cold chain operators, market managers, and policymakers to develop guidelines and offer a framework to initiate and support the produce market and boost consumer health confidence in CCAP at the practitioner level.

Ensuring quality and integrity of vaccines throughout the cold chain: the role of temperature monitoring.

INTRODUCTION: Vaccines have continually proven their inestimable value to the world through the eradication of smallpox, gains achieved toward a polio-free world, and controlling other vaccine-preventable diseases. Although vaccines require certain temperatures and conditions to maintain their potency, supply chain controls vary greatly at different legs of the global journey. Vaccine manufacture is closely managed, but inconsistencies plague the cold chain when vaccines are shipped and stored in variable conditions. Monitoring vaccine temperatures throughout the cold chain is of paramount importance to ensure quality. The emerging COVID-19 vaccines present the world with new challenges and additional opportunities to establish best practices for safeguarding human health. AREAS COVERED: We review the risks associated with the vaccine cold chain that require temperature monitoring throughout shipment and storage. Electronic and chemical monitoring devices are compared along with data needs. Regulatory oversight and guidance are also discussed. EXPERT OPINION: Regulatory oversight has contributed to the creation of a risk management and quality culture among private sector players in the vaccine field. Meanwhile, the public sector (the main player at the country level) remains largely untouched by regulatory oversight. Adherence to best practices shall only be possible with increased regulatory oversight of public sector operations.

Thermostable vaccines: an innovative concept in vaccine development.

INTRODUCTION: Vaccines represent he most common and safer ways of combating infectious diseases. Loss of potency owing to thermal denaturation or degradation of almost all the vaccines necessitates their storage, transportation, and final dissemination under refrigerated conditions. However, maintenance of a continuous cold chain raises the costs of vaccines significantly. A large number of life-saving vaccines are discarded before their application owing to exposure to sub-optimum temperatures. Therefore, there is a pressing need for the development of a thermostable vaccine with a long shelf life at ambient temperature. AREAS COVERED: A literature search was performed to compile a list of different vaccines, and their storage and handling conditions. Similarly, a separate list was prepared for different coronavirus vaccines. A literature survey was also performed to look at different approaches undertaken globally to address the issue of the cold-chain problem. We emphasized the importance of yeast cells in the development of thermostable vaccines. In the end, we discussed why thermostable vaccines are required, not only in resource-poor countries but also for resource-rich countries . EXPERT OPINION: Temperature change can severely impact the stability of various life-saving vaccines. Therefore, there is a pressing need for the development of thermostable vaccines with a long shelf lives.

Dataset of ultralow temperature refrigeration for COVID 19 vaccine distribution solution.

Most COVID-19 vaccines require temperature control for transportation and storage. Two types of vaccine have been developed by manufacturers (Pfizer and Moderna). Both vaccines are based on mRNA and lipid nanoparticles requiring low temperature storage. The Pfizer vaccine requires ultra-low temperature storage (-80 °C to -60 °C), while the Moderna vaccine requires -30 °C storage. However, the last stage of distribution is quite challenging, especially for rural or suburban areas, where local towns, pharmacy chains and hospitals may not have the infrastructure required to store the vaccine at the required temperature. In addition, there is limited data available to address ancillary challenges of the distribution framework for both transportation and storage stages, including safety concerns due to human exposure to large amounts of CO2 from dry-ice sublimation, issues due to the pressure increase caused by dry-ice sublimation, and the potential issue caused by non-uniform cryogenic temperatures. As such, there is a need for test dataset to assist the development of a quick, effective, secure, and safe solution to mitigate the challenges faced by vaccine distribution logistics.

Exploring Challenges to COVID-19 Vaccination in the Darfur Region of Sudan.

The current COVID-19 pandemic has affected the ability of health systems to provide essential services globally. The Darfur region, located in the western part of Sudan, has been largely devastated by the war that began in 2003 and has been drawing considerable attention from the international community. The war, which erupted as a result of environmental, political, and economic factors, has led to tragic outcomes. Collapsing health-care infrastructures, health workforce shortages, lack of storage facilities for medicines and medical products, and inadequate access to health services are some of the effects of the war. After Sudan received the AstraZeneca COVID-19 vaccine through the COVID-19 Vaccines Global Access facility, significant challenges have been implicated in the delivery, storage, and use of the vaccine in the Darfur region. Lack of vaccine storage and transportation facilities, vaccination hesitancy, inequity in the distribution to health facilities, and shortage of health-care professionals resulting from insecurity and instability have added an extra layer of burden on local authorities and their ability to manage COVID-19 vaccinations in the region adequately. Addressing the impact of COVID-19 requires an effectively managed vaccination program. In the face of current challenges in Darfur, ensuring a fully vaccinated population might remain far-fetched and improbable if meaningful efforts are not put in place by all stakeholders and actors to address some of the challenges identified.

Stability of Captisol-enabled versus propylene glycol-based melphalan at room temperature and after refrigeration.

PURPOSE: To compare the chemical stability of Captisol-enabled (CE) melphalan ("CE-melphalan"; Evomela, Acrotech Biopharma LLC) and propylene glycol (PG)-based melphalan ("PG-melphalan"; Alkeran, GlaxoSmithKline) admixtures prepared with 0.9% sodium chloride injection in polyvinyl chloride (PVC) bags or reconstituted vials stored at room temperature (RT) and under refrigeration. METHODS: Lyophilized CE-melphalan and generic PG-melphalan were reconstituted to 5 mg/mL with 0.9% sodium chloride injection or manufacturer-supplied diluent, respectively. The reconstituted vials were then diluted to the desired concentrations with 0.9% sodium chloride injection in PVC bags and were stored at RT (23oC) or under refrigeration (4oC). Aliquots were withdrawn from the bags and reconstituted vials of CE-melphalan and PG-melphalan immediately after preparation and at predetermined time intervals. Melphalan concentrations were measured using a validated high-performance liquid chromatography method. RESULTS: CE-melphalan reconstituted in PVC bags at concentrations of 1 and 2 mg/mL was stable for 6 and 24 hours, respectively, at RT and for 8 and 24 hours, respectively, at 4oC. PG-melphalan reconstituted in bags at 1, 1.5, and 2 mg/mL was stable for 1, 2, and 2 hours, respectively, at RT and for 2, 4, and 4 hours, respectively, at 4oC. Reconstituted CE-melphalan vials were stable for 48 hours at both RT and 4oC, whereas PG-melphalan vials were stable for 6 hours at RT but formed precipitate within 2 hours at 4oC. CONCLUSION: CE-melphalan remained stable longer than generic PG-melphalan under the test conditions. CE-melphalan at 2 mg/mL has 24-hour stability at RT and can be used for extended infusion times or may be compounded ahead of time. Reconstituted CE-melphalan vials are stable for 48 hours at both RT and 4oC.

Extended storage of SARS-CoV-2 nasopharyngeal swabs does not negatively impact results of molecular-based testing across three clinical platforms.

With the global outbreak of COVID-19, the demand for testing rapidly increased and quickly exceeded the testing capacities of many laboratories. Clinical tests which receive CE (Conformité Européenne) and Food and Drug Administration (FDA) authorisations cannot always be tested thoroughly in a real-world environment. Here we demonstrate the long-term stability of nasopharyngeal swab specimens for SARS-CoV-2 molecular testing across three assays recently approved by the US FDA under Emergency Use Authorization. This study demonstrates that nasopharyngeal swab specimens can be stored under refrigeration or even ambient conditions for 21 days without clinically impacting the results of the real-time reverse transcriptase-PCR testing.

Environmental friendly micro cold storage for last-mile Covid-19 vaccine logistics.

Globally, vaccination plays a vital role in controlling the Covid-19 pandemic. However, the cold supply chain is essential for vaccine storage and logistics services. In a country like India, the last-mile logistics of vaccines is a challenging task. The cold chain is indispensable for the Covid-19 vaccine drive to the rural areas. The demand for cold storage increases rapidly due to the rapid Covid-19 vaccine drive. The conventional cold storage facility has a more significant threat to the grid power quality and environmental impacts. The energy demand and greenhouse gas emission of traditional cold storage lead to global warming. The micro cold storage facility has to be developed rapidly to accelerate the vaccine drive to the last mile of the county with reliable and affordable energy sources. In addition, climate change mitigation is ensured by the renewable energy utilization in the Covid-19 vaccine drive. The proposed novel micro cold storage aims to be silent, clean, mobile, without moving parts, and reliable for the last-mile vaccine logistics as a vaccine carrier to the remote rural areas. This paper deals with the novel design, development, and experimental investigation of solar photovoltaic powered thermoelectric-based micro cold storage as a Covid-19 vaccine carrier for rural areas. The design consideration of Covid-19 vaccine storage has been reported. The experimental results ensure the World Health Organization recommended vaccine storage (i.e., vaccine carrier) temperature range of +2 to +8 °C. Therefore, green energy and refrigeration system provide environmental sustainability by mitigating 700kg of annual carbon emission.

How to deal with the transmission of SARS-COV-2 on the surface of Cold-chain foods to people: a review.

OBJECTIVE: The outbreak of SARS-CoV-2 in 2020 has become the world's largest public health event, causing global attention and concern. Despite national efforts to control this emerging infectious disease, it still cannot be contained. China, which reported the disease early, was able to control the outbreak quickly, but there is the problem of imported infections abroad. This review aims to summarize SARS-CoV-2 detected on the outer packaging of imported cold chain food and lead to the transmission of novel coronavirus. MATERIALS AND METHODS: We reviewed information on SARS-COV-2 detected on the outer packaging of imported cold chain food and relevant literature.  We searched the following databases: PubMed, Web of Science, EMBASE and CNKI. search terms were "2019 nCoV", "SARS-CoV-2", "COVID-19", "cold-chain", "item surface", "spread", "people". RESULTS: We found that SARS-CoV-2 survives on the surface of cold-chain food for a long period of time and these active viruses can be transmitted to humans. CONCLUSIONS: We believe that while strictly preventing and controlling the importation of infected patients, we should strengthen the management of imported cold-chain food and its workers to prevent the transmission of SARS-CoV-2 to humans on the surface of cold-chain food objects.