INF ECTION P R EVENTION
stable on plastic and stainless steel (up to 72 hours) compared with copper (up to 4 hours) and cardboard (up to 24 hours).7
In
healthcare settings, SARS-CoV-2 is widely distributed in the air and on object surfaces (e.g., floors, rubbish bins, handrails, and computers) across a range of acute healthcare settings including intensive care units.8 In a recent study, surface samples were collected from the rooms of COVID-19 patients, and environmental surface contamination was found in the rooms of 66.7% of patients.9
These findings are
supported by similar studies of SARS-CoV-2 contamination on healthcare environmental surfaces.10,11
Infection prevention and control measures should include enhanced surface cleaning and disinfection in healthcare settings.1
This
is of particular significance when managing COVID-19 patients where viral RNA has been extensively detected on surfaces underlining the need for effective surface hygiene.12
A recent study aimed to determine the presence of SARS-CoV-2 on surfaces frequently touched by hospitalised COVID-19 patients. The aim was to assess the scope of contamination and transmissibility where the outbreaks occurred. In areas where prior disinfection/cleaning had been performed before environmental sampling, all environmental surfaces tested negative for SARS-CoV-2.
Whereas virus positive samples were found where prior disinfection/cleaning had not taken place, these results suggest that prompt disinfection and cleaning of potentially contaminated surfaces is an effective infection control measure. By inactivating SARS- CoV-2 (an enveloped virus) with disinfection/ cleaning, the infectivity and transmission of the virus is blocked.11
Disinfectant wipes are frequently used in healthcare settings as they are quick and convenient to use, but there is considerable variation of performance between available wipes. Given the links between environmental contamination and
A study undertaken in a Wuhan hospital examined transmission routes for SARS-CoV-2. The transmission of the virus usually followed contamination of the health worker’s hands after touching either patients or fomites.
pathogen transfer, it is ever more important to select the most appropriate wipes for use in healthcare settings. To ensure the efficacy of a disinfectant wipe against viruses like SARS-CoV-2, there is a recognised microbiological test for virucidal activity, according to the European Norm (EN) standard EN14476. A positive result means that the solution within the wipes/ tissue is efficacious against enveloped viruses. Choosing a wipe with ‘virucidal efficacy against enveloped viruses’ combined with mention of EN14476 is a useful indicator for the selection of the disinfection wipe. Passing the EN14476 test means that the disinfectant solution can kill viruses like SARS-CoV-2, but what influences the practical application of the wipe is the required contact time. This is the time required for the solution to be in contact with pathogens in order to eliminate or inactivate them.
A disinfectant wipe could be EN14476
certified but may require a contact time of five minutes to be effective, compared to another requiring only 30 seconds. A long contact time is more likely to damage a surface over a period of time, than a shorter one. A shorter contact time will save time, help simplify the cleaning/disinfection process and is likely to make compliance easier to adhere to. The EN16615 test is the highest level of testing for antimicrobial wipes under the recognition of the European Standards committee. The test examines the efficacy of the wipe as a whole i.e. the wipe plus the disinfectant component. When selecting a wipe for the clinical
setting, it cannot be assumed that all wipes will have this ‘gold standard’ EN16615 certification. A wipe like mikrozid has both EN14476 and EN16615 certification. However, many wipes will have EN14476 certification without EN16615, which should raise questions about whether these wipes are fit for purpose in hospitals.
Hands
Hand hygiene is universally recognised as a vital measure in preventing the transmission of pathogens in healthcare settings. The World Health Organization states that ‘Hand Hygiene is one of the most effective actions you can take to reduce the spread of pathogens and prevent infections, including the COVID-19 virus,’.13 A study undertaken in a Wuhan hospital examined transmission routes for SARS- CoV-2. The transmission of the virus usually followed contamination of the health worker’s hands after touching either patients or fomites. The study found that SARS- CoV-2 fomite transmission is significant, and that hand hygiene can significantly reduce residual viruses on hands.14 The stability of SARS- CoV-2 compared to Influenza A Virus (IAV) on human skin has recently been evaluated under laboratory conditions. The survival time of SARS-CoV-2 on the skin was approximately nine hours and was significantly longer than that of IAV, which was approximately 1.8 hours. This means it is likely that SARS-CoV-2 will have a higher risk of contact transmission than IAV because the first is much more stable on human skin than the latter.15
The long,
nine-hour, survival time of SARS-CoV-2 on human skin may increase the risk of viral invasion in the body or its transmission from the skin to other surfaces or people, with a potential impact on the acceleration of the SARS-CoV-2 pandemic.15
Proper hand
hygiene is important to prevent the spread of SARS-CoV-2 infections’.15
Another study confirmed an inverse relationship between virus stability and temperature. The researchers commented that ‘virus stability on skin demonstrates the need for continued hand hygiene practices to minimise fomite transmission’.16 Although in healthcare settings hand hygiene compliance is particularly focused on staff, contamination of patients’ hands
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