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Study Shows Need for Containment, Prevention of Coronavirus Spread

Print Article Contributed by BSM Staff

LONDON -- Human coronaviruses can remain infectious on inanimate surfaces at room temperature for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62-71 percent ethanol, 0.5 percent hydrogen peroxide, or 0.1 percent sodium hypochlorite within one minute, according to a study in the Journal of Hospital Infection.

Other biocidal agents such as 0.05-0.2 percent benzalkonium chloride, or 0.02 percent chlorhexidine digluconate are less effective. As no specific therapies are available for 2019-nCoV, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.

At a temperature of 30°C or more the duration of persistence is shorter. Veterinary coronaviruses have been shown to persist even longer for 28 days. Contamination of frequent touch surfaces in healthcare settings are therefore a potential source of viral transmission.

Data on the transmissibility of coronaviruses from contaminated surfaces to hands were not found. However, it could be shown with influenza A virus that a contact of 5 seconds can transfer 31.6 percent of the viral load to the hands.

Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces.

Although the viral load of coronaviruses on inanimate surfaces is not known during an outbreak situation, it seems plausible to reduce the viral load on surfaces by disinfection, especially of frequently touched surfaces in the immediate patient surrounding where the highest viral load can be expected.

The WHO recommends “to ensure that environmental cleaning and disinfection procedures are followed consistently and correctly. Thoroughly cleaning environmental surfaces with water and detergent and applying commonly used hospital-level disinfectants (such as sodium hypochlorite) are effective and sufficient procedures.”

The typical use of bleach is at a dilution of 1:100 of 5 percent sodium hypochlorite resulting in a final concentration of 0.05 percent. Summarized data with coronaviruses suggest that a concentration of 0.1% is effective in 1 minute. That is why it seems appropriate to recommend a dilution 1:50 of standard bleach in the coronavirus setting.

For the disinfection of small surfaces, ethanol (62-71 percent; carrier tests) revealed a similar efficacy against coronavirus. A concentration of 70 percent ethanol is also recommended by the WHO for disinfecting small surfaces.

No data were found to describe the frequency of hands becoming contaminated with coronavirus, or the viral load on hands either, after patient contact or after touching contaminated surfaces. The WHO recommends to preferably apply alcohol-based hand rubs for the decontamination of hands, e.g. after removing gloves.

Two WHO recommended formulations (based on 80 percent ethanol or 75 percent 2-propanol) have been evaluated in suspension tests against SARS-CoV and MERS-CoV, and both were described to be very effective. No in vitro data were found on the efficacy of hand washing against coronavirus contaminations on hands.

For more on this study, go to www.journalofhospitalinfection.com/article/S0195-6701(20)30046-3/fulltext.

 

 

 

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