SARS-CoV-2 hospital dynamics: shoe soles, computer mice, and aerosolization distance

  • Guo ZD & al.
  • Emerging Infect Dis
  • 10 Apr 2020

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • SARS-CoV-2 was detectable in the air and on multiple surfaces in ICUs and general wards (GWs) where patients with COVID-19 received hospital care in Wuhan, China.

Why this matters

  • Improved safety practices may be warranted, including disinfection of shoe soles
  • Authors say home isolation for suspected COVID-19 "might not be a good control strategy" in the absence of significant personal protective gear.

Key results

  • Samples taken from 15 affected patients in ICU and 24 on GW.
  • Positivity rates in samples from the wards: 
    • ICU: 43.5% (54/124).
    • GW: 7.9% (9/114).
  • Positive floor swabs:
    • ICU: 70% (7/10).
    • GW: 15.4% (2/13).
  • Positive floor swabs, pharmacy: 100%. 
  • Medical staff shoe soles: 50%.
  • Computer mice: 
    • ICU: 75% (6/8).
    • GW: 20% (1/5).
  • Trash cans:
    • ICU: 60% (3/5).
    • GW:  0% (0/8).
  • Patient bed handrails:
    • ICU: 42.9% (6/14).
    • GW: 0% (0/12).
  • Doorknobs:
    • ICU: 0% (0/34).
    • GW: 8.3% (1/12).
  • Aerosol transmission positivity:
    • ICU: 35% (14/40). 
    • GW: 12.5% (2/16).
  • SARS-CoV-2 aerosol: 
    • Near air outlets: 35.7% (5/14). 
    • Patient rooms: 44.4% (8/18). 
    • Doctors' office areas: 12.5% (1/8). 
    • Maximum transmission: 4 m, 1 site.
  • As of March 30, no hospital staff were infected.

Study design

  • Prospective swab sampling study, Wuhan, China, 19 February-2 March.
  • Funding: National Major Research & Development Program of China.

Limitations

  • Virus viability unknown.
  • Aerosol transmission distance not confirmed given unknown minimal infectious dose.