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2.
Sci Rep ; 11(1): 19216, 2021 09 28.
Article in English | MEDLINE | ID: covidwho-1442804

ABSTRACT

Global health organizations recommend the use of cloth face coverings to slow the spread of COVID-19. Seemingly overnight, companies whose primary business is in no way related to healthcare or personal protective equipment-from mattresses manufacturers to big box stores-transitioned into the "mask business." Many companies advertise antimicrobial masks containing silver, copper, or other antimicrobials. Often, the techniques used to load such antimicrobials onto mask fibers are undisclosed, and the potential for metal leaching from these masks is yet unknown. We exposed nine so-called "antimicrobial" face masks (and one 100% cotton control mask) to deionized water, laundry detergent, and artificial saliva to quantify the leachable silver and copper that may occur during mask washing and wearing. Leaching varied widely across manufacturer, metal, and leaching solution, but in some cases was as high as 100% of the metals contained in the as-received mask after 1 h of exposure.


Subject(s)
COVID-19/prevention & control , Masks , Personal Protective Equipment , Anti-Infective Agents , Filtration , Humans , Masks/virology , Metals , Personal Protective Equipment/virology , SARS-CoV-2 , Textiles
3.
Appl Environ Microbiol ; 87(14): e0052621, 2021 06 25.
Article in English | MEDLINE | ID: covidwho-1408384

ABSTRACT

The transmission of SARS-CoV-2 is likely to occur through a number of routes, including contact with contaminated surfaces. Many studies have used reverse transcription-PCR (RT-PCR) analysis to detect SARS-CoV-2 RNA on surfaces, but seldom has viable virus been detected. This paper investigates the viability over time of SARS-CoV-2 dried onto a range of materials and compares viability of the virus to RNA copies recovered and whether virus viability is concentration dependent. Viable virus persisted for the longest time on surgical mask material and stainless steel, with a 99.9% reduction in viability by 122 and 114 h, respectively. Viability of SARS-CoV-2 reduced the fastest on a polyester shirt, with a 99.9% reduction within 2.5 h. Viability on the bank note was reduced second fastest, with 99.9% reduction in 75 h. RNA on all surfaces exhibited a 1-log reduction in genome copy number recovery over 21 days. The findings show that SARS-CoV-2 is most stable on nonporous hydrophobic surfaces. RNA is highly stable when dried on surfaces, with only 1-log reduction in recovery over 3 weeks. In comparison, SARS-CoV-2 viability reduced more rapidly, but this loss in viability was found to be independent of starting concentration. Expected levels of SARS-CoV-2 viable environmental surface contamination would lead to undetectable levels within 2 days. Therefore, when RNA is detected on surfaces, it does not directly indicate the presence of viable virus, even at low cycle threshold values. IMPORTANCE This study shows the impact of material type on the viability of SARS-CoV-2 on surfaces. It demonstrates that the decay rate of viable SARS-CoV-2 is independent of starting concentration. However, RNA shows high stability on surfaces over extended periods. This has implications for interpretation of surface sampling results using RT-PCR to determine the possibility of viable virus from a surface, where RT-PCR is not an appropriate technique to determine viable virus. Unless sampled immediately after contamination, it is difficult to align RNA copy numbers to quantity of viable virus on a surface.


Subject(s)
COVID-19 , Fomites/virology , Personal Protective Equipment/virology , RNA, Viral/isolation & purification , SARS-CoV-2/isolation & purification , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Humans , Microbial Viability , Surface Properties
4.
ACS Nano ; 14(7): 9188-9200, 2020 07 28.
Article in English | MEDLINE | ID: covidwho-1387153

ABSTRACT

Filtration efficiency (FE), differential pressure (ΔP), quality factor (QF), and construction parameters were measured for 32 cloth materials (14 cotton, 1 wool, 9 synthetic, 4 synthetic blends, and 4 synthetic/cotton blends) used in cloth masks intended for protection from the SARS-CoV-2 virus (diameter 100 ± 10 nm). Seven polypropylene-based fiber filter materials were also measured including surgical masks and N95 respirators. Additional measurements were performed on both multilayered and mixed-material samples of natural, synthetic, or natural-synthetic blends to mimic cloth mask construction methods. Materials were microimaged and tested against size selected NaCl aerosol with particle mobility diameters between 50 and 825 nm. Three of the top five best performing samples were woven 100% cotton with high to moderate yarn counts, and the other two were woven synthetics of moderate yarn counts. In contrast to recently published studies, samples utilizing mixed materials did not exhibit a significant difference in the measured FE when compared to the product of the individual FE for the components. The FE and ΔP increased monotonically with the number of cloth layers for a lightweight flannel, suggesting that multilayered cloth masks may offer increased protection from nanometer-sized aerosol with a maximum FE dictated by breathability (i.e., ΔP).


Subject(s)
Coronavirus Infections/prevention & control , Masks/standards , Pandemics/prevention & control , Personal Protective Equipment/standards , Pneumonia, Viral/prevention & control , Respiratory Protective Devices/standards , Textiles/standards , Aerosols/chemistry , Betacoronavirus/pathogenicity , COVID-19 , Filtration , Humans , Masks/virology , Nanoparticles/chemistry , Nanoparticles/virology , Personal Protective Equipment/virology , Respiratory Protective Devices/virology , SARS-CoV-2 , Textiles/adverse effects , Textiles/virology
5.
J Hosp Infect ; 106(4): 678-697, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1385931

ABSTRACT

During the current SARS-CoV-2 pandemic new studies are emerging daily providing novel information about sources, transmission risks and possible prevention measures. In this review, we aimed to comprehensively summarize the current evidence on possible sources for SARS-CoV-2, including evaluation of transmission risks and effectiveness of applied prevention measures. Next to symptomatic patients, asymptomatic or pre-symptomatic carriers are a possible source with respiratory secretions as the most likely cause for viral transmission. Air and inanimate surfaces may be sources; however, viral RNA has been inconsistently detected. Similarly, even though SARS-CoV-2 RNA has been detected on or in personal protective equipment (PPE), blood, urine, eyes, the gastrointestinal tract and pets, these sources are currently thought to play a negligible role for transmission. Finally, various prevention measures such as handwashing, hand disinfection, face masks, gloves, surface disinfection or physical distancing for the healthcare setting and in public are analysed for their expected protective effect.


Subject(s)
COVID-19/diagnosis , Carrier State/transmission , Disease Transmission, Infectious/prevention & control , SARS-CoV-2/genetics , COVID-19/epidemiology , COVID-19/transmission , COVID-19/virology , Carrier State/virology , Gloves, Protective/virology , Hand Disinfection/methods , Health Facilities/standards , Humans , Masks/virology , Pandemics/prevention & control , Personal Protective Equipment/virology
6.
Arch Virol ; 166(9): 2487-2493, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1298567

ABSTRACT

The safety of personal protective equipment (PPE) is very important, and so is the choice of materials used. The ability of electrostatic charges (ESCs) generated from the friction of engineered materials to attract or repel viruses has a significant impact on their applications. This study examined the ESCs generated on the surface of PPE used by healthcare workers to enhance their potential effectiveness in protecting the wearer from viruses. This is a crucial consideration for the newly emerged severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which has a negative charge. The magnitudes and signs of generated ESCs on the surfaces of the PPE were determined experimentally using an Ultra Stable Surface DC Voltmeter. The high negative ESCs acquired by the polyethylene disposable cap and facemask are expected to repel negatively charged viruses and prevent them from adhering to the outer layer of the material. Also, the choice of polypropylene for facemasks and gowns is excellent because it is an aggressively negatively charged material in the triboelectric series. This property guarantees that facemasks and gowns can repel viruses from the wearer. However, the positive ESCs generated on latex glove surfaces are of great concern because they can attract negatively charged viruses and create a source of infection. In conclusion, it is necessary to ensure that PPE be made of materials whose surfaces develop a negative ESC to repel viruses, as well as to select polyethylene gloves.


Subject(s)
COVID-19/prevention & control , Health Personnel/education , Personal Protective Equipment/virology , SARS-CoV-2/chemistry , COVID-19/transmission , Hair/chemistry , Health Knowledge, Attitudes, Practice , Humans , Latex/chemistry , Materials Testing , Polyethylene/chemistry , Polypropylenes/chemistry , Skin/chemistry , Static Electricity
7.
World Neurosurg ; 153: e187-e194, 2021 09.
Article in English | MEDLINE | ID: covidwho-1275762

ABSTRACT

OBJECTIVE: To assess organizational and technical difficulties of neurosurgical procedures during the coronavirus disease 2019 (COVID-19) pandemic and their possible impact on survival and functional outcome and to evaluate virological exposure risk of medical personnel. METHODS: Data for all urgent surgical procedures performed in the COVID-19 operating room were prospectively collected. Preoperative and postoperative variables included demographics, pathology, Karnofsky performance status (KPS) and neurological status at admission, type and duration of surgical procedures, length of stay, postoperative KPS and functional outcome comparison, and destination at discharge. We defined 5 classes of pathologies (traumatic, oncological, vascular, infection, hydrocephalus) and 4 surgical categories (burr hole, craniotomy, cerebrospinal fluid shunting, spine surgery). Postoperative SARS-CoV-2 infection was checked in all the operators. RESULTS: We identified 11 traumatic cases (44%), 4 infections (16%), 6 vascular events (24%), 2 hydrocephalus conditions (8%), and 2 oncological cases (8%). Surgical procedures included 11 burr holes (44%), 7 craniotomies (28%), 6 cerebrospinal fluid shunts (24%), and 1 spine surgery (4%). Mean patient age was 57.8 years. The most frequent clinical presentation was coma (44 cases). Mean KPS score at admission was 20 ± 10, mean surgery duration was 85 ± 63 minutes, and mean length of stay was 27 ± 12 days. Mean KPS score at discharge was 35 ± 25. Outcome comparison showed improvement in 16 patients. Four patients died. Mean follow-up was 6 ± 3 months. None of the operators developed postoperative SARS-CoV-2 infection. CONCLUSIONS: Standardized protocols are mandatory to guarantee a high standard of care for emergency and urgent surgeries during the COVID-19 pandemic. Personal protective equipment affects maneuverability, dexterity, and duration of interventions without affecting survival and functional outcome.


Subject(s)
COVID-19/prevention & control , COVID-19/transmission , Infection Control , Neurosurgical Procedures/mortality , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19 Testing , Emergencies , Female , Humans , Infant , Infection Control/instrumentation , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Italy/epidemiology , Length of Stay/statistics & numerical data , Male , Middle Aged , Operating Rooms/organization & administration , Pandemics , Perioperative Care , Personal Protective Equipment/adverse effects , Personal Protective Equipment/virology , Prospective Studies , SARS-CoV-2 , Survival Analysis , Treatment Outcome
8.
Antimicrob Resist Infect Control ; 10(1): 82, 2021 05 27.
Article in English | MEDLINE | ID: covidwho-1247603

ABSTRACT

Aerosolization may occur during reprocessing of medical devices. With the current coronavirus disease 2019 pandemic, it is important to understand the necessity of using respirators in the cleaning area of the sterile processing department. To evaluate the presence of severe acute respiratory syndrome coronavirus (SARS-CoV-2) in the air of the sterile processing department during the reprocessing of contaminated medical devices. Air and surface samples were collected from the sterile processing department of two teaching tertiary hospitals during the reprocessing of respiratory equipment used in patients diagnosed with coronavirus disease 2019 and from intensive care units during treatment of these patients. SARS-CoV-2 was detected only in 1 air sample before the beginning of decontamination process. Viable severe acute respiratory syndrome coronavirus 2 RNA was not detected in any sample collected from around symptomatic patients or in sterile processing department samples. The cleaning of respiratory equipment does not cause aerosolization of SARS-CoV-2. We believe that the use of medical masks is sufficient while reprocessing medical devices during the coronavirus disease 2019 pandemic.


Subject(s)
Aerosols , Decontamination , Equipment Reuse , Personal Protective Equipment/virology , SARS-CoV-2/isolation & purification , Air Microbiology , Cross-Sectional Studies , Equipment and Supplies, Hospital/virology , RNA, Viral/isolation & purification , Tertiary Care Centers , Ventilators, Mechanical/virology
9.
Infect Control Hosp Epidemiol ; 42(4): 381-387, 2021 04.
Article in English | MEDLINE | ID: covidwho-1189143

ABSTRACT

OBJECTIVE: To characterize associations between exposures within and outside the medical workplace with healthcare personnel (HCP) SARS-CoV-2 infection, including the effect of various forms of respiratory protection. DESIGN: Case-control study. SETTING: We collected data from international participants via an online survey. PARTICIPANTS: In total, 1,130 HCP (244 cases with laboratory-confirmed COVID-19, and 886 controls healthy throughout the pandemic) from 67 countries not meeting prespecified exclusion (ie, healthy but not working, missing workplace exposure data, COVID symptoms without lab confirmation) were included in this study. METHODS: Respondents were queried regarding workplace exposures, respiratory protection, and extra-occupational activities. Odds ratios for HCP infection were calculated using multivariable logistic regression and sensitivity analyses controlling for confounders and known biases. RESULTS: HCP infection was associated with non-aerosol-generating contact with COVID-19 patients (adjusted OR, 1.4; 95% CI, 1.04-1.9; P = .03) and extra-occupational exposures including gatherings of ≥10 people, patronizing restaurants or bars, and public transportation (adjusted OR range, 3.1-16.2). Respirator use during aerosol-generating procedures (AGPs) was associated with lower odds of HCP infection (adjusted OR, 0.4; 95% CI, 0.2-0.8, P = .005), as was exposure to intensive care and dedicated COVID units, negative pressure rooms, and personal protective equipment (PPE) observers (adjusted OR range, 0.4-0.7). CONCLUSIONS: COVID-19 transmission to HCP was associated with medical exposures currently considered lower-risk and multiple extra-occupational exposures, and exposures associated with proper use of appropriate PPE were protective. Closer scrutiny of infection control measures surrounding healthcare activities and medical settings considered lower risk, and continued awareness of the risks of public congregation, may reduce the incidence of HCP infection.


Subject(s)
COVID-19/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Adult , Aged , COVID-19/prevention & control , Case-Control Studies , Female , Global Health/statistics & numerical data , Humans , Infectious Disease Transmission, Patient-to-Professional/statistics & numerical data , Logistic Models , Male , Middle Aged , Occupational Exposure/prevention & control , Occupational Exposure/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Personal Protective Equipment/virology , Respiratory Protective Devices/statistics & numerical data , Respiratory Protective Devices/virology , Young Adult
10.
Expert Rev Respir Med ; 15(6): 773-779, 2021 06.
Article in English | MEDLINE | ID: covidwho-1165209

ABSTRACT

Introduction: Bronchoscopy and related procedures have unambiguously been affected during the Corona Virus Disease 2019 (COVID-19) pandemic caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS COV-2). Ordinary bronchoscopy practices and lung cancer services might have changed over this pandemic and for the years to come.Areas covered: This manuscript summarizes the utility of bronchoscopy in COVID-19 patients, and the impact of the pandemic in lung cancer diagnostic services, in view of possible viral spread during these We conducted a literature review of articles published in PubMed/Medline from inception to November 5th, 2020 using relevant terms.Expert opinion: Without doubt this pandemic has changed the way bronchoscopy and related procedures are being performed. Mandatory universal personal protective equipment, pre-bronchoscopy PCR tests, dedicated protective barriers and disposable bronchoscopes might be the safest and simpler way to perform even the most complicated procedures.


Subject(s)
Bronchoscopy , COVID-19/epidemiology , COVID-19/therapy , Cross Infection/prevention & control , Practice Patterns, Physicians' , Bronchoscopes/microbiology , Bronchoscopes/standards , Bronchoscopes/virology , Bronchoscopy/instrumentation , Bronchoscopy/methods , Bronchoscopy/standards , COVID-19/prevention & control , COVID-19/transmission , Equipment Contamination/prevention & control , History, 21st Century , Humans , Lung Neoplasms/diagnosis , Medical Oncology/instrumentation , Medical Oncology/methods , Medical Oncology/standards , Pandemics , Personal Protective Equipment/virology , Practice Patterns, Physicians'/standards , Practice Patterns, Physicians'/trends , SARS-CoV-2/physiology
11.
Ann Otol Rhinol Laryngol ; 130(11): 1245-1253, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1140414

ABSTRACT

OBJECTIVES: Define aerosol and droplet risks associated with routine otolaryngology clinic procedures during the COVID-19 era. METHODS: Clinical procedures were simulated in cadaveric heads whose oral and nasal cavities were coated with fluorescent tracer (vitamin B2) and breathing was manually simulated through retrograde intubation. A cascade impactor placed adjacent to the nares collected generated particles with aerodynamic diameters ≤14.1 µm. The 3D printed models and syringes were used to simulate middle and external ear suctioning as well as open suctioning, respectively. Provider's personal protective equipment (PPE) and procedural field contamination were also recorded for all trials using vitamin B2 fluorescent tracer. RESULTS: The positive controls of nebulized vitamin B2 produced aerosol particles ≤3.30 µm and endonasal drilling of a 3D model generated particles ≤14.1 µm. As compared with positive controls, aerosols and small droplets with aerodynamic diameter ≤14.1 µm were not detected during rigid nasal endoscopy, flexible fiberoptic laryngoscopy, and rigid nasal suction of cadavers with simulated breathing. There was minimal to no field contamination in all 3 scenarios. Middle and external ear suctioning and open container suctioning did not result in any detectable droplet contamination. The clinic suction unit contained all fluorescent material without surrounding environmental contamination. CONCLUSION: While patients' coughing and sneezing may create a baseline risk for providers, this study demonstrates that nasal endoscopy, flexible laryngoscopy, and suctioning inherently do not pose an additional risk in terms of aerosol and small droplet generation. An overarching generalization cannot be made about endoscopy or suctioning being an aerosol generating procedure. LEVEL OF EVIDENCE: 3.


Subject(s)
Aerosols/adverse effects , COVID-19 , Disease Transmission, Infectious/prevention & control , Endoscopy , Otolaryngology , Risk Adjustment/methods , Suction , COVID-19/prevention & control , COVID-19/transmission , Cadaver , Endoscopy/adverse effects , Endoscopy/instrumentation , Endoscopy/methods , Humans , Otolaryngology/methods , Otolaryngology/standards , Outcome Assessment, Health Care , Personal Protective Equipment/classification , Personal Protective Equipment/virology , Research Design , Risk Assessment/methods , SARS-CoV-2 , Suction/adverse effects , Suction/instrumentation , Suction/methods
12.
Int J Infect Dis ; 104: 320-328, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1065182

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 pandemic increased global demand for personal protective equipment (PPE) and resulted in shortages. The study evaluated the re-use of surgical masks and respirators by analysing their performance and safety before and after reprocessing using the following methods: oven, thermal drying, autoclave, and hydrogen peroxide plasma vapour. METHODS: In total, 45 surgical masks and 69 respirators were decontaminated. Visual integrity, air permeability, burst resistance, pressure differential and particulate filtration efficiency of new and decontaminated surgical masks and respirators were evaluated. In addition, 14 used respirators were analysed after work shifts before and after decontamination using reverse transcription polymerase chain reaction (RT-PCR) and viral culturing. Finally, reprocessed respirators were evaluated by users in terms of functionality and comfort. RESULTS: Oven decontamination (75 °C for 45 min) was found to be the simplest decontamination method. Physical and filtration assays indicated that all reprocessing methods were safe after one cycle. Oven decontamination maintained the characteristics of surgical masks and respirators for at least five reprocessing cycles. Viral RNA was detected by RT-PCR in two of the 14 used respirators. Four respirators submitted to viral culture were PCR-negative and culture-negative. Reprocessed respirators used in work shifts were evaluated positively by users, even after three decontamination cycles. CONCLUSION: Oven decontamination is a safe method for reprocessing surgical masks and respirators for at least five cycles, and is feasible in the hospital setting.


Subject(s)
COVID-19/prevention & control , Decontamination/methods , Masks/virology , Pandemics , Personal Protective Equipment/virology , SARS-CoV-2/isolation & purification , Ventilators, Mechanical/virology , COVID-19/epidemiology , COVID-19/virology , Equipment Reuse , Hospitals , Hot Temperature , Humans , Hydrogen Peroxide/pharmacology , SARS-CoV-2/genetics
13.
Sci Rep ; 11(1): 2051, 2021 01 21.
Article in English | MEDLINE | ID: covidwho-1041626

ABSTRACT

The COVID-19 pandemic has led to widespread shortages of personal protective equipment (PPE) for healthcare workers, including of N95 masks (filtering facepiece respirators; FFRs). These masks are intended for single use but their sterilization and subsequent reuse has the potential to substantially mitigate shortages. Here we investigate PPE sterilization using ionized hydrogen peroxide (iHP), generated by SteraMist equipment (TOMI; Frederick, MD), in a sealed environment chamber. The efficacy of sterilization by iHP was assessed using bacterial spores in biological indicator assemblies. After one or more iHP treatments, five models of N95 masks from three manufacturers were assessed for retention of function based on their ability to form an airtight seal (measured using a quantitative fit test) and filter aerosolized particles. Filtration testing was performed at a university lab and at a National Institute for Occupational Safety and Health (NIOSH) pre-certification laboratory. The data demonstrate that N95 masks sterilized using SteraMist iHP technology retain filtration efficiency up to ten cycles, the maximum number tested to date. A typical iHP environment chamber with a volume of ~ 80 m3 can treat ~ 7000 masks and other items (e.g. other PPE, iPADs), making this an effective approach for a busy medical center.


Subject(s)
Hydrogen Peroxide/pharmacology , N95 Respirators/virology , Personal Protective Equipment/virology , Sterilization/methods , COVID-19/epidemiology , COVID-19/prevention & control , Equipment Reuse/statistics & numerical data , Humans , N95 Respirators/supply & distribution , Pandemics/prevention & control , Personal Protective Equipment/supply & distribution , Respiratory Protective Devices , SARS-CoV-2/isolation & purification , United States/epidemiology
17.
Am J Infect Control ; 49(4): 512-515, 2021 04.
Article in English | MEDLINE | ID: covidwho-866376

ABSTRACT

This study assessed the disinfection using 70% ethanol; H2O2-quaternary ammonium salt mixture; 0.1% sodium hypochlorite and autoclaving of four 3D-printed face shields with different designs, visor materials; and visor thickness (0.5-0.75 mm). We also investigated their clinical suitability by applying a questionnaire to health workers (HW) who used them. Each type of disinfection was done 40 times on each type of mask without physical damage. In contrast, autoclaving led to appreciable damage.


Subject(s)
COVID-19/prevention & control , Disinfectants/pharmacology , Disinfection/methods , Personal Protective Equipment/virology , Printing, Three-Dimensional , SARS-CoV-2 , COVID-19/epidemiology , Data Collection , Equipment Design , Ethanol/pharmacology , Health Personnel , Humans , Hydrogen Peroxide/pharmacology , Sodium Hypochlorite/pharmacology
18.
ACS Nano ; 14(10): 12341-12369, 2020 10 27.
Article in English | MEDLINE | ID: covidwho-842192

ABSTRACT

The global COVID-19 pandemic has attracted considerable attention toward innovative methods and technologies for suppressing the spread of viruses. Transmission via contaminated surfaces has been recognized as an important route for spreading SARS-CoV-2. Although significant efforts have been made to develop antibacterial surface coatings, the literature remains scarce for a systematic study on broad-range antiviral coatings. Here, we aim to provide a comprehensive overview of the antiviral materials and coatings that could be implemented for suppressing the spread of SARS-CoV-2 via contaminated surfaces. We discuss the mechanism of operation and effectivity of several types of inorganic and organic materials, in the bulk and nanomaterial form, and assess the possibility of implementing these as antiviral coatings. Toxicity and environmental concerns are also discussed for the presented approaches. Finally, we present future perspectives with regards to emerging antimicrobial technologies such as omniphobic surfaces and assess their potential in suppressing surface-mediated virus transfer. Although some of these emerging technologies have not yet been tested directly as antiviral coatings, they hold great potential for designing the next generation of antiviral surfaces.


Subject(s)
Antiviral Agents/chemistry , Coronavirus Infections/transmission , Nanostructures/chemistry , Personal Protective Equipment/virology , Pneumonia, Viral/transmission , Antiviral Agents/pharmacology , Betacoronavirus/drug effects , COVID-19 , Coronavirus Infections/prevention & control , Humans , Pandemics/prevention & control , Personal Protective Equipment/standards , Personal Protective Equipment/trends , Pneumonia, Viral/prevention & control , SARS-CoV-2
19.
Laryngoscope ; 131(5): E1415-E1421, 2021 05.
Article in English | MEDLINE | ID: covidwho-813318

ABSTRACT

OBJECTIVE: Recent anecdotal reports and cadaveric simulations have described aerosol generation during endonasal instrumentation, highlighting a possible risk for transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) during endoscopic endonasal instrumentation. This study aims to provide a greater understanding of particle generation and exposure risk during endoscopic endonasal instrumentation. STUDY DESIGN: Prospective quantification of aerosol generation during office-based nasal endoscopy procedures. METHODS: Using an optical particle sizer, airborne particles concentrations 0.3 to 10 microns in diameter, were measured during 30 nasal endoscopies in the clinic setting. Measurements were taken at time points throughout diagnostic and debridement endoscopies and compared to preprocedure and empty room particle concentrations. RESULTS: No significant change in airborne particle concentrations was measured during diagnostic nasal endoscopies in patients without the need for debridement. However, significant increases in mean particle concentration compared to preprocedure levels were measured during cold instrumentation at 2,462 particles/foot3 (95% CI 837 to 4,088; P = .005) and during suction use at 2,973 particle/foot3 (95% CI 1,419 to 4,529; P = .001). In total, 99.2% of all measured particles were ≤1 µm in diameter. CONCLUSION: When measured with an optical particle sizer, diagnostic nasal endoscopy with a rigid endoscope is not associated with increased particle aerosolization in patient for whom sinonasal debridement is not needed. In patients needing sinonasal debridement, endonasal cold and suction instrumentation were associated with increased particle aerosolization, with a trend observed during endoscope use prior to tissue manipulation. Endonasal debridement may potentially pose a higher risk for aerosolization and SARS-CoV-2 transmission. Appropriate personal protective equipment use and patient screening are recommended for all office-based endonasal procedures. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E1415-E1421, 2021.


Subject(s)
COVID-19/transmission , Endoscopy/adverse effects , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Nose Diseases/diagnosis , Personal Protective Equipment/standards , Aerosols , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Cadaver , Debridement/adverse effects , Debridement/methods , Disease Transmission, Infectious/prevention & control , Endoscopy/instrumentation , Humans , Mass Screening/standards , Nose Diseases/surgery , Nose Diseases/virology , Occupational Exposure/adverse effects , Occupational Exposure/prevention & control , Particle Size , Personal Protective Equipment/virology , Prospective Studies , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Simulation Training/methods , Suction/adverse effects
20.
Int J Health Plann Manage ; 36(2): 587-589, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-808319

ABSTRACT

Locally made, washable and reusable personal protective equipment (PPE), used in combination with N95 masks that were reused safely, has proven to be a viable alternative to disposable gowns and caps for hospital staff in low- and middle-income countries. Muhimbili University Hospital's children's cancer ward in Dar es Salaam, Tanzania, developed locally made PPE and created rigorous cleaning and disinfecting protocols, when the daily use of imported, disposable materials were not an option. These items continue to protect staff, children and parents. The novel PPE approach was able to prevent staff from becoming infected during the pandemic despite the fact that several parents, and subsequently their children, became infected with Covid-19 during cancer treatment at the facility.


Subject(s)
COVID-19/prevention & control , Disinfection/methods , Masks , Personal Protective Equipment , Personnel, Hospital , Disinfection/standards , Humans , Masks/virology , Personal Protective Equipment/virology , Tanzania
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