Impact of a hygiene intervention on virus spread in an office building

Could hybrid work schedules offer infection risk reductions? Insights from a CO2 Sensor and Modeling Study

Hybrid work schedules are increasingly popular in post-COVID-19 work culture, and their potential for reducing communicable disease transmission is unknown. Our study objectives were to measure and compare carbon dioxide (CO2) concentrations and subsequent infection in an office on "anchor days" vs. "hybrid days." We installed two CO2 sensors in a breakroom connected to multipole staff areas in a 512 m2 office. Measured CO2 and office-reported occupancy data informed a Rudnick & Milton-adapted Wells-Riley model to estimate COVID-19 risks. Four modeling cases examined how uncertainty in infection prevalence and the proportion of symptomatic, in-person workers would impact COVID-19 risks. Air exchange rates (AER) were estimated with CO2 measures. Linear models were used to assess season-adjusted associations between occupancy, day type, and mean and maximum CO2. CO2 concentrations peaked (~1500 ppm) on anchor days in Spring and Winter, with the lowest AERs estimated for these seasons. When assuming the same prevalence of infectious individuals, infection risks on hybrid workdays were 0.06-0.13 less than on anchor days. Behavioral assumptions (i.e., proportions of those who would work in-person even if symptomatic), had a notable impact on infection risk reductions offered by hybrid workdays. Occupancy and day type were associated (p<0.001) with mean and maximum CO2 concentrations, adjusting for season. We provide initial support that hybrid work schedules may reduce infectious disease transmission. More data are needed to understand how work culture regarding concealed illnesses and preferences for working in person on hybrid days may affect the effectiveness of hybrid workdays in reducing risks.

Residence time of particles in indoor surface networks

Infectious microbes can spread rapidly from fomites (contaminated surfaces) via hand touch, with prolonged residence time on surfaces increasing transmission risk by extending exposure periods and/or involving more susceptible individuals. Existing studies have focused on decreasing microbial contamination, but not on the need for rapid removal from surface systems. This study introduces residence time as the time that a microbe spends within the surface system. We analyse both simple and generalised surface-touch networks using a compartmental model, predicting the spread and removal of infectious particles on surfaces. Our models reveal the physics of particle spread through four simple networks, yielding a closed-form analytical solution validated by laboratory data on a three-surface-touch network and Monte-Carlo Lagrangian simulations of a realistic network. Findings indicate that hands and surfaces, even without any particle source, can be highly contaminated. Transfer rates and removal rates are identified as the only influential parameters for equilibration time and the main influential parameters for residence time in a homogeneous network. Our theoretical model provides a solid foundation for investigating the fundamental physical process behind the transmission of infectious particles via the fomite route, contributing valuable insights for enhancing hygiene management in high-risk environments.

Quantifying fomite hotspots and targeted hygiene impacts in a hotel lobby

Environmental surfaces in public settings serve as reservoirs for microbial pathogens, including norovirus, rhinovirus, and adenovirus, which can persist and spread through hand-to-fomite contact. Despite limited evidence of SARS-CoV-2 fomite transmission, hygiene protocols were widely intensified during the pandemic. This study evaluates viral spread and infection risks in a hotel lobby and assesses the efficacy of a Targeted Hygiene intervention designed to reduce contamination while minimizing excessive chemical use. A viral tracer study, using bacteriophage Phi X174, and human behavior observations were utilized to monitor surface contamination patterns, followed by Quantitative Microbial Risk Assessment (QMRA) to estimate infection probabilities. Tracer organisms seeded on high-touch surfaces spread to 50 % of sampled fomites within 4 h. A subsequent Targeted Hygiene intervention, using disinfecting wipes, sprays, or aerosols tailored to surface types, resulted in a statistically significant 97.36 % reduction in viral concentrations (1.57 log10 reduction, p < 0.0001). The proportion of cross-contaminated surfaces (i.e., non-seeded sites testing positive) decreased from 13 % to 2 %, and the overall percentage of positive surfaces dropped from 50 % to 42 %. QMRA modeling demonstrated that infection risks from a single fomite-hand-face contact were highest for rhinovirus, rotavirus, and adenovirus. Following intervention, infection risk was reduced by over 97 % for all modeled pathogens. Risk levels for all viruses and bacteria met the U.S. EPA and WHO benchmark of less than 1 infection per 10,000 exposures used in drinking water guidelines. Notably, bacterial infection risks, already low pre-intervention, were further reduced to meet the more stringent 1 infection per 1,000,000 risk threshold. This is the first study to integrate real-world human behavior, viral tracer data, and QMRA modeling to assess Targeted Hygiene in a hospitality setting. Findings support the implementation of evidence-based hygiene protocols that prioritize high-risk surfaces and timing, offering a sustainable approach to reducing infection risks in public environments.

Office Workers' Views About the Uses, Concerns, and Acceptance of Hand Hygiene Data Collected From Smart Sanitizers: Exploratory Qualitative Interview Study

BACKGROUND

COVID-19 and the prospect of future pandemics have emphasized the need to reduce disease transmission in workplaces. Despite the well-established link between good hand hygiene (HH) and employee health, HH in nonclinical workplaces has received little attention. Smart sanitizers have been deployed in clinical settings to motivate and enforce HH. This study is part of a large project that explores the potential of smart sanitizers in office settings.

OBJECTIVE

Our previous study found that for office workers to accept the deployment of smart sanitizers, they would need to find the data generated as useful and actionable. The objectives of this study were to identify (1) the potential uses and actions that could be taken from HH data collected by smart sanitizers (2) the concerns of office workers for the identified uses and actions and (3) the circumstances in which office workers accept HH monitoring.

METHODS

An interview study was conducted with 18 office workers from various professions. Interview questions were developed using a framework from personal informatics. Transcripts were analyzed thematically.

RESULTS

A wide range of uses of smart sanitizer data was identified including managing hygiene resources and workflows, finding operating sanitizers, communicating the (high) standard of organizational hygiene, promoting and enforcing organizational hygiene policies, improving workers' own hygiene practices, executing more effective interventions, and identifying the causes of outbreaks. However, hygiene is mostly considered as a private matter, and it is also possible that no action would be taken. Office workers were also concerned about bullying, coercion, and use of hygiene data for unintended purposes. They were also worried that the data could be inaccurate or incomplete, leading to misrepresentation of hygiene practices. Office workers suggested that they would be more likely to accept monitoring in situations where hygiene is considered important, when there are clear benefits to data collection, if their privacy is respected, if they have some control over how their data are collected, and if the ways in which the data will be used are clearly communicated.

CONCLUSIONS

Smart sanitizers could have a valuable role in improving hygiene practices in offices and reducing disease transmission. Many actionable uses for data collected from smart systems were identified. However, office workers consider HH as a personal matter, and acceptance of smart systems is likely to be dynamic and will depend on the broad situation. Except when there are disease outbreaks, smart systems may need to be restricted to uses that do not require the sharing of personal data. Should organizations wish to implement smart sanitizers in offices, it would be advisable to consult widely with staff and develop systems that are customizable and personalizable.

Environmental dissemination of respiratory viruses: dynamic interdependencies of respiratory droplets, aerosols, aerial particulates, environmental surfaces, and contribution of viral re-aerosolization

During the recent pandemic of COVID-19 (SARS-CoV-2), influential public health agencies such as the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have favored the view that SARS CoV-2 spreads predominantly via droplets. Many experts in aerobiology have openly opposed that stance, forcing a vigorous debate on the topic. In this review, we discuss the various proposed modes of viral transmission, stressing the interdependencies between droplet, aerosol, and fomite spread. Relative humidity and temperature prevailing determine the rates at which respiratory aerosols and droplets emitted from an expiratory event (sneezing, coughing, etc.) evaporate to form smaller droplets or aerosols, or experience hygroscopic growth. Gravitational settling of droplets may result in contamination of environmental surfaces (fomites). Depending upon human, animal and mechanical activities in the occupied space indoors, viruses deposited on environmental surfaces may be re-aerosolized (re-suspended) to contribute to aerosols, and can be conveyed on aerial particulate matter such as dust and allergens. The transmission of respiratory viruses may then best be viewed as resulting from dynamic virus spread from infected individuals to susceptible individuals by various physical states of active respiratory emissions, instead of the current paradigm that emphasizes separate dissemination by respiratory droplets, aerosols or by contaminated fomites. To achieve the optimum outcome in terms of risk mitigation and infection prevention and control (IPAC) during seasonal infection peaks, outbreaks, and pandemics, this holistic view emphasizes the importance of dealing with all interdependent transmission modalities, rather than focusing on one modality.

Incidence of Isolated Biliary Atresia during the COVID Lockdown in Europe: Results from a Collaborative Project by RARE-Liver

BACKGROUND

Biliary atresia (BA) is a rare cholangiopathy where one of the proposed aetiological mechanisms is an infectious viral trigger. Coronavirus disease-19 (COVID) lockdown restrictions were implemented to reduce the transmission of infections. Strictness of lockdown varied across European countries. This study aimed to investigate if there was an association between strictness of lockdown and change in isolated BA (IBA) incidence in Europe.

METHODS

We approached European centres involved in the European Reference Network RARE-LIVER. We included IBA patients born between 2015 and June 2020. We calculated the number of IBA patients born per centre per month. The Stringency Index (SI) was used as lockdown strictness indicator. The association between percentage change of mean number of IBA patients born per month and the SI was assessed.

RESULTS

We included 412 IBA patients from thirteen different centres. The median number of patients per month did not change: 6 (1-15) pre-lockdown and 7 (6-9) during lockdown (p = 0.34). There was an inverse association between SI and percentage change in IBA (B = -0.73, p = 0.03). Median age at Kasai portoenterostomy (days) did not differ between time periods (51 (9-179) vs. 53 (19-126), p = 0.73).

CONCLUSION

In this European study, a stricter COVID-lockdown was seemingly accompanied by a simultaneous larger decrease in the number of IBA patients born per month in the lockdown. Results should be interpreted with caution due to the assumptions and limitations of the analysis.

Airborne transmission of biological agents within the indoor built environment: a multidisciplinary review

The nature and airborne dispersion of the underestimated biological agents, monitoring, analysis and transmission among the human occupants into building environment is a major challenge of today. Those agents play a crucial role in ensuring comfortable, healthy and risk-free conditions into indoor working and leaving spaces. It is known that ventilation systems influence strongly the transmission of indoor air pollutants, with scarce information although to have been reported for biological agents until 2019. The biological agents' source release and the trajectory of airborne transmission are both important in terms of optimising the design of the heating, ventilation and air conditioning systems of the future. In addition, modelling via computational fluid dynamics (CFD) will become a more valuable tool in foreseeing risks and tackle hazards when pollutants and biological agents released into closed spaces. Promising results on the prediction of their dispersion routes and concentration levels, as well as the selection of the appropriate ventilation strategy, provide crucial information on risk minimisation of the airborne transmission among humans. Under this context, the present multidisciplinary review considers four interrelated aspects of the dispersion of biological agents in closed spaces, (a) the nature and airborne transmission route of the examined agents, (b) the biological origin and health effects of the major microbial pathogens on the human respiratory system, (c) the role of heating, ventilation and air-conditioning systems in the airborne transmission and (d) the associated computer modelling approaches. This adopted methodology allows the discussion of the existing findings, on-going research, identification of the main research gaps and future directions from a multidisciplinary point of view which will be helpful for substantial innovations in the field.

Racial Disparity in Potential Occupational Exposure to COVID-19

BACKGROUND

Nationwide, as of 20 June 2021, COVID-19 has claimed more than 599,000 lives and infected nearly 33 million people. Studies have shown that COVID-19 disproportionately affects some racial and ethnic minority groups. This study examined whether certain racial and ethnic groups were overrepresented in occupations with potentially high COVID-19 exposure risks, relative to their share in the total workforce. The study incorporates white collar workers, who to date have not gotten as much attention in terms of workers safety.

METHODS

Using the March and April 2020 Current Population Survey and O*Net data, this study examined whether certain racial and ethnic groups were overrepresented in occupations with potentially high risk of exposure to COVID-19 (exposure to disease and infection at work, inability to maintain physical distancing at work, and inability to work from home) relative to their share in the total workforce.

RESULTS

The results showed that Black workers were overrepresented in occupations with high potential risk of exposure to disease and infection at work and inability to maintain physical distancing at work. Hispanic workers were overrepresented in occupations where potential risk of inability to work from home was the highest.

CONCLUSION

Occupation can be one of the risk factors for the current disproportionately high COVID-19 infection rates among Black and Hispanic workers. COVID-19-related prevention measures at high risk occupations, including providing adequate personal protective equipment, training, working space, and vaccinations, could help to reduce not only the spread of COVID-19 and infectious diseases but also their disproportionately high impact in certain minority racial and ethnic groups.

Explaining the Challenges of Coping with Coronavirus Crisis in the Workplaces: A Qualitative Study

Background

Workplaces play a highly important role in controlling or spreading the prevalence of coronavirus disease 2019 (COVID-19). Therefore, the lack of proper implementation of hygienic protocols in these environments might increase the risk of getting infected with the COVID-19 among the employees, following the increase of the COVID-19 at the family and community levels. This qualitative study aims to explain the challenges of coping with the coronavirus crisis in the workplaces.

Methods

The present qualitative study was conducted with a conventional content analysis approach. We used purposeful sampling with maximum diversity in terms of working processes. Data were collected through semi-structured interviews. Interviews were performed to the point of information saturation. MAXQDA software version 10 was used for data management.

Results

Through the content analysis of the interviews with the participants, we identified two main classes and nine sub-classes. The main classes included intra-organizational challenges (job nature, budget allocation problems, individual factors, disorganization, manpower and equipment, lack of commitment, and insufficient support of managers) and extra-organizational challenges (lack of accessibility to valid information, black market, and inter-sectorial coordination problems).

Conclusion

The study findings indicated that organizations and industries face numerous internal and external challenges in coping with the COVID-19 pandemic. Paying attention to the mentioned limitations and attempting to eliminate them, especially by the governmental organizations, employers, and managers, could help in effectively confronting the COVID-19 pandemic.

Transmission of SARS-CoV-2 infections and exposure in surfaces, points and wastewaters: A global one health perspective

The persistence of SARS-CoV-2 or its RNA on surfaces, points, or wastewaters may increase the risk of transmission of this virus. Therefore, we conducted this review to discuss the places and surfaces with the highest potential for infection and spread of the SARS-CoV-2 virus. Several common and public areas, hospitals, elevators, public transport, local markets, and surfaces such as public toilets, door handles, untreated and treated wastewaters, wastewater plants, and public washrooms are also considered major points for spreading of SARS-CoV-2. Highly contaminated surfaces or places often have materials or contain items made of materials on which the SARS-CoV-2 virus can persist (e.g., metal, wood, and plastic). For example, SARS-CoV-2 can exist up to 4 days on doorknobs made by those materials. For public places such as public transports, elevators, and local markets, crowding and enclosed spaces are major source for transmission. Several measures such as using copper alloy surfaces instead of metal surfaces, disinfectants, and suitable personal protective equipment have been suggested. Our research could be the basis to help develop studies on the existence and transmissibility of SARS-CoV-2 as well as its RNA to take measures to prevent and limit the harmful effects of COVID-19 pandemic.

Characterizing observable COVID-19 controls in Pacific Northwest grocery stores

Utilizing a longitudinal, observational study, grocery store health and safety controls implemented during the COVID-19 pandemic across stores in two cities were characterized. Sixteen stores between Seattle, WA (n = 9) and Portland, OR (n = 7) were visited monthly by the study team from May 2020 to January 2021, and observations of controls were recorded using a standardized checklist in REDCap. The checklist included questions on the presence or absence of controls such as physical barriers, social distancing markers, required masking of customers, cleaning of check-out stands, and closures of store areas. Descriptive analyses were conducted to determine the proportion of stores with a certain control each month. Mixed-effects logistic regression was used to explore how controls changed over time, and whether differences were observed between cities or by income of the area the store serves. Source control (e.g., mask requirements) and engineering controls (e.g., physical barriers at checkout) were the most common and consistent controls observed across stores and over the study period. Controls such as having special hours for vulnerable populations, demarcations on aisles for directionality, and cleaning check-out stands between customers varied significantly over time (p < 0.05 in the mixed-effects model). Having an employee present to clean baskets and carts, as well as physical barriers between self-checkouts, were significantly more common in stores in areas above the median income (p < 0.05 in the mixed-effects model). To best protect workers and shoppers from infectious agents, controls should be evidence-based, consistently implemented across grocery stores, and coupled with administrative practices and policies to promote worker wellbeing.

Transmission of COVID-19 and other infectious diseases in public washrooms: A systematic review

BACKGROUND

The risk of infectious disease transmission in public washrooms causes concern particularly in the context of the COVID-19 pandemic. This systematic review aims to assess the risk of transmission of viral or bacterial infections through inhalation, surface contact, and faecal-oral routes in public washrooms in healthcare and non-healthcare environments.

METHODS

We systematically reviewed environmental sampling, laboratory, and epidemiological studies on viral and bacterial infection transmission in washrooms using PubMed and Scopus. The review focused on indoor, publicly accessible washrooms.

RESULTS

Thirty-eight studies from 13 countries were identified, including 14 studies carried out in healthcare settings, 10 in laboratories or experimental chambers, and 14 studies in restaurants, workplaces, commercial and academic environments. Thirty-three studies involved surface sampling, 15 air sampling, 8 water sampling, and 5 studies were risk assessments or outbreak investigations. Infectious disease transmission was studied in relation with: (a) toilets with flushing mechanisms; (b) hand drying systems; and (c) water taps, sinks and drains. A wide range of enteric, skin and soil bacteria and enteric and respiratory viruses were identified in public washrooms, potentially posing a risk of infection transmission. Studies on COVID-19 transmission only examined washroom contamination in healthcare settings.

CONCLUSION

Open-lid toilet flushing, ineffective handwashing or hand drying, substandard or infrequent surface cleaning, blocked drains, and uncovered rubbish bins can result in widespread bacterial and/or viral contamination in washrooms. However, only a few cases of infectious diseases mostly related to faecal-oral transmission originating from washrooms in restaurants were reported. Although there is a risk of microbial aerosolisation from toilet flushing and the use of hand drying systems, we found no evidence of airborne transmission of enteric or respiratory pathogens, including COVID-19, in public washrooms. Appropriate hand hygiene, surface cleaning and disinfection, and washroom maintenance and ventilation are likely to minimise the risk of infectious disease transmission.

A solution scan of societal options to reduce transmission and spread of respiratory viruses: SARS-CoV-2 as a case study

Societal biosecurity – measures built into everyday society to minimize risks from pests and diseases – is an important aspect of managing epidemics and pandemics. We aimed to identify societal options for reducing the transmission and spread of respiratory viruses. We used SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) as a case study to meet the immediate need to manage the COVID-19 pandemic and eventually transition to more normal societal conditions, and to catalog options for managing similar pandemics in the future. We used a ‘solution scanning’ approach. We read the literature; consulted psychology, public health, medical, and solution scanning experts; crowd-sourced options using social media; and collated comments on a preprint. Here, we present a list of 519 possible measures to reduce SARS-CoV-2 transmission and spread. We provide a long list of options for policymakers and businesses to consider when designing biosecurity plans to combat SARS-CoV-2 and similar pathogens in the future. We also developed an online application to help with this process. We encourage testing of actions, documentation of outcomes, revisions to the current list, and the addition of further options.

Overview of legal measures for managing workplace COVID-19 infection risk in several Asia-Pacific countries

Background

Despite the lack of official COVID-19 statistics, various workplaces and occupations have been at the centre of COVID-19 outbreaks. We aimed to compare legal measures and governance established for managing COVID-19 infection risks at workplaces in nine Asia and Pacific countries and to recommend key administrative measures.

Methods

We collected information on legal measures and governance both general citizens and workers regarding infection risks such as COVID-19 from industrial hygiene professionals in nine countries (Indonesia, India, Japan, Malaysia, New Zealand, Republic of the Philippines, Republic of Korea, Taiwan, and Thailand) using a structured questionnaire.

Results

A governmental body overseeing public health and welfare was in charge of containing the spread and occurrence of infectious diseases under an infectious disease control and prevention act or another special act, although the name of the pertinent organizations and legislation vary among countries. Unlike in the case of other traditional hazards, there have been no specific articles or clauses describing the means of mitigating virus risk in the workplace that are legally required of employers, making it difficult to define the responsibilities of the employer. Each country maintains own legal systems regarding access to the duration, administration, and financing of paid sick leave. Many workers may not have access to paid sick leave even if it is legally guaranteed.

Conclusion

Specific legal measures to manage infectious disease risks, such as providing proper personal protective equipment, education, engineering control measures, and paid sick leave are recommended to be stipulated in occupational safety and health related acts.

Characteristics of hand-to-environment contact during indoor activities in daily life among Korean adults using a video-based observation method

Objectives

The aim of this study was to describe the characteristics of hand-to-environmental contact (HEC) and to identify the factors influencing HEC behavior in Korean adults’ indoor daily life.

Methods

Thirty participants were enrolled from January 14 to February 12, 2018 after providing informed consent for being videotaped. Data were collected by recording their indoor daily lives for 2 hours, resulting in 4,732 HEC cases. To ensure the accuracy and reliability of the HEC readings, 3 training sessions were conducted for the videotape readers. Rereading and verifying randomly selected data ensured the validity of intra- and inter-reader readings.

Results

The most frequent contact items were phones, papers, computer accessories, and furniture surfaces. The contact density (frequency-duration/min) was highest for category II (items occasionally shared by others, 56.8), followed in descending order by category I (items for individual use, 35.9), and category III (public use items, 3.4). Significant differences in contact density were found according to participants’ demographic characteristics.

Conclusion

As mobile phones were the most frequent contact item, regular and strict mobile phone cleansing or disinfection strategies are needed, in addition to preventative measures taken for category II and III items. Avoiding sharing personal items with others, refraining from unnecessary HEC, and maintaining strict hand hygiene are recommended.

Assessment of COVID-19 control strategies in a steel industry using a SWOT matrix

According to the health regulations, industrial environments due to the gathering of people are considered as one of the highest-risk places during the COVID-19 pandemic. Thus, planning with regard to health concerns can decisively help in infection control and continuity of businesses during the pandemic. The aim of this study was to evaluate the COVID-19 control management measures in the Sepid-farab Kavir Steel Complex (SKS complex) located in Isfahan province (Iran) using strengths, weaknesses, opportunities, and threats (SWOT) matrix. After a literature review and field surveys, all weak, strong, threatening, and opportunity points were collected and were listed using the internal factor evaluation (IFE) and external factor evaluation (EFE) matrices and then were prioritized and weighted. Next, given the sum of scores of IFE and EFE, the SWOT matrix was constructed, the disease prevention and control strategies in the complex was determined, and finally, experts proposed corrective measures to improve the current situation. The results of the IFE matrix (IFE) analysis showed that in terms of corona control, there are more weaknesses than strengths within the company (the score of this matrix was 201.12). Also the score of 165 on the EFE matrix indicated that external threats were predominant, compared to external opportunities of company. SWOT analysis showed that despite some external problems and challenges, the existence of a favorable internal decision-making system had an important role in developing appropriate health strategies and implementing effective prevention measures in SKS complex against the COVID-19.

Model for Mitigation of Workplace Transmission of COVID-19 Through Population-Based Testing and Surveillance

The coronavirus disease-2019 (COVID-19) pandemic is having a widespread impact on societies across the globe. As part of the effort to control transmission in the United States, many businesses either closed or instituted nonpharmaceutical control measures and allowed only essential workers on-site. During summer and fall of 2020, employers began formulating "return to work" strategies designed to mitigate the risk of transmission among employees. On a population level, several countries implemented national testing and surveillance strategies that proved effective in mitigating citizen-to-citizen transmission and contributed to suppressing COVID-19. A crucial component of many such strategies is population-based testing to identify and engage individuals with asymptomatic or presymptomatic infection, which also is relevant to return-to-work strategies. The authors describe an approach that multisite employers might use to help mitigate transmission of COVID-19 in the workplace. This approach leverages a bioinformatics platform informed by real-time PCR test data at the county and subcounty (eg, Public Use Microdata Area) level, allowing for population-based testing to be selectively targeted for employees in geographies with elevated SARS-CoV-2 positivity. A "Command Center" application integrates data from multiple sources (eg, local infection trends, employee symptom diaries, Bluetooth thermometers) in real time, which can be used to inform decisions regarding surveillance and employee self-isolation or quarantine; a mobile phone-based application provides for rapid, secure communication with employees. This overview is based on peer-reviewed literature and the early experience of a large employer with implementing bioinformatics tools to mitigate the impact of the pandemic on the workplace.

Surface texture limits transfer of S. aureus, T4 bacteriophage, influenza B virus and human coronavirus

Spread of pathogens on contaminated surfaces plays a key role in disease transmission. Surface technologies that control pathogen transfer can help control fomite transmission and are of great interest to public health. Here, we report a novel bead transfer method for evaluating fomite transmission in common laboratory settings. We show that this method meets several important criteria for quantitative test methods, including reasonableness, relevancy, resemblance, responsiveness, and repeatability, and therefore may be adaptable for standardization. In addition, this method can be applied to a wide variety of pathogens including bacteria, phage, and human viruses. Using the bead transfer method, we demonstrate that an engineered micropattern limits transfer of Staphylococcus aureus by 97.8% and T4 bacteriophage by 93.0% on silicone surfaces. Furthermore, the micropattern significantly reduces transfer of influenza B virus and human coronavirus on silicone and polypropylene surfaces. Our results highlight the potential of using surface texture as a valuable new strategy in combating infectious diseases.

Practical, rapid, and cost-efficient interior architectural precautions for prevention of COVID-19 in the workplace

BACKGROUND

During the COVID-19 pandemic, it has been essential for some workplaces to stay open. Considering the rapid spread of the virus, interior architectural re-designing of these essential workplaces such as markets, banks, and drugstores is crucial for prevention. The employees, as well as the customers in these workplaces, have a high infection rate. Some precautions need to be taken urgently to prevent the spread of the disease. Some workplaces may have already performed their action plan whereas others have not.

OBJECTIVE

Some practical, rapid, and cost-efficient preventive precautions are presented in this paper for employers to take action in their workplaces.

METHODS

Two new proposals are advised to be carried out. The contents of these newly designed barriers will be introduced.

RESULTS

Some practical and cost-efficient ideas are given within this report.

CONCLUSION

All the preventions proposed in this paper are claimed to reduce the spread of COVID-19 and may save lives around the country as well as the world.

How Will the COVID-19 Pandemic Affect the Future of Urban Life? Early Evidence from Highly-Educated Respondents in the United States

Attitudes and habits are extremely resistant to change, but a disruption of the magnitude of the COVID-19 pandemic has the potential to bring long-term, massive societal changes. During the pandemic, people are being compelled to experience new ways of interacting, working, learning, shopping, traveling, and eating meals. Going forward, a critical question is whether these experiences will result in changed behaviors and preferences in the long term. This paper presents initial findings on the likelihood of long-term changes in telework, daily travel, restaurant patronage, and air travel based on survey data collected from adults in the United States in Spring 2020. These data suggest that a sizable fraction of the increase in telework and decreases in both business air travel and restaurant patronage are likely here to stay. As for daily travel modes, public transit may not fully recover its pre-pandemic ridership levels, but many of our respondents are planning to bike and walk more than they used to. These data reflect the responses of a sample that is higher income and more highly educated than the US population. The response of these particular groups to the COVID-19 pandemic is perhaps especially important to understand, however, because their consumption patterns give them a large influence on many sectors of the economy.

Behavioral strategies to prevent and mitigate COVID-19 infection

The single stranded RNA virus SARS-CoV-2 has caused a massive addition to the already leading global cause of mortality, viral respiratory tract infections. Characterized by and associated with early and deleteriously enhanced production of pro-inflammatory cytokines by respiratory epithelial cells, severe COVID-19 illness has the potential to inflict acute respiratory distress syndrome and even death. Due to the fast spreading nature of COVID-19 and the current lack of a vaccine or specific pharmaceutical treatments, understanding of viral pathogenesis, behavioral prophylaxis, and mitigation tactics are of great public health concern. This review article outlines the immune response to viral pathogens, and due to the novelty of COVID-19 and the large body of evidence suggesting the respiratory and immune benefits from regular moderate intensity exercise, provides observational and mechanistic evidence from research on other viral infections that suggests strategically planned exercise regimens may help reduce susceptibility to infection, while also mitigating severe immune responses to infection commonly associated with poor COVID-19 prognosis. We propose that regular moderate intensity exercise should be considered as part of a combinatorial approach including widespread hygiene initiatives, properly planned and well-executed social distancing policies, and use of efficacious facial coverings like N95 respirators. Studies discerning COVID-19 pathogenesis mechanisms, transfer dynamics, and individual responses to pharmaceutical and adjunct treatments are needed to reduce viral transmission and bring an end to the COVID-19 pandemic.

Estimating the burden of United States workers exposed to infection or disease: A key factor in containing risk of COVID-19 infection

INTRODUCTION

With the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of contracting disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Quantifying the number of workers who are frequently exposed to infection and disease in the workplace, and understanding which occupational groups they represent, can help to prompt public health risk response and management for COVID-19 in the workplace, and subsequent infectious disease outbreaks.

METHODS

To estimate the number of United States workers frequently exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with a BLS O*NET survey measure reporting how frequently workers in each occupation are exposed to infection or disease at work. This allowed us to estimate the number of United States workers, across all occupations, exposed to disease or infection at work more than once a month.

RESULTS

Based on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair).

CONCLUSIONS

The large number of persons employed in occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. Given the proportion of the United States workforce exposed to disease or infection at work, this analysis also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve.

Quantifying the relative impact of contact heterogeneity on MRSA transmission in ICUs - a modelling study

Background

An efficient surface cleaning strategy would first target cleaning to surfaces that make large contributions to the risk of infections.

Methods

In this study, we used data from the literature about methicillin-resistant Staphylococcus aureus (MRSA) and developed an ordinary differential equations based mathematical model to quantify the impact of contact heterogeneity on MRSA transmission in a hypothetical 6-bed intensive care unit (ICU). The susceptible patients are divided into two types, these who are cared by the same nurse as the MRSA infected patient (Type 1) and these who are not (Type 2).

Results

The results showed that the mean MRSA concentration on three kinds of susceptible patient nearby surfaces was significantly linearly associated with the hand-touch frequency (p < 0.05). The noncompliance of daily cleaning on patient nearby high-touch surfaces (HTSs) had the most impact on MRSA transmission. If the HTSs were not cleaned, the MRSA exposure to Type 1 and 2 susceptible patients would increase 118.4% (standard deviation (SD): 33.0%) and 115.4% (SD: 30.5%) respectively. The communal surfaces (CSs) had the least impact, if CSs were not cleaned, the MRSA exposure to Type 1 susceptible patient would only increase 1.7% (SD: 1.3). The impact of clinical equipment (CE) differed largely for two types of susceptible patients. If the CE was not cleaned, the exposure to Type 1 patients would only increase 8.4% (SD: 3.0%), while for Type 2 patients, it can increase 70.4% (SD: 25.4%).

Conclusions

This study provided a framework to study the pathogen concentration dynamics on environmental surfaces and quantitatively showed the importance of cleaning patient nearby HTSs on controlling the nosocomial infection transmission via contact route.

Assessing virus infection probability in an office setting using stochastic simulation

Viral infections are an occupational health concern for office workers and employers. The objectives of this study were to estimate rotavirus, rhinovirus, and influenza A virus infection risks in an office setting and quantify infection risk reductions for two hygiene interventions. In the first intervention, research staff used an ethanol-based spray disinfectant to clean high-touch non-porous surfaces in a shared office space. The second intervention included surface disinfection and also provided workers with alcohol-based hand sanitizer gel and hand sanitizing wipes to promote hand hygiene. Expected changes in surface concentrations due to these interventions were calculated. Human exposure and dose were simulated using a validated, steady-state model incorporated into a Monte Carlo framework. Stochastic inputs representing human behavior, pathogen transfer efficiency, and pathogen fate were utilized, in addition to a mixed distribution that accounted for surface concentrations above and below a limit of detection. Dose-response curves were then used to estimate infection risk. Estimates of percent risk reduction using mean values from baseline and surface disinfection simulations for rotavirus, rhinovirus, and influenza A infection risk were 14.5%, 16.1%, and 32.9%, respectively. For interventions with both surface disinfection and the promotion of personal hand hygiene, reductions based on mean values of infection risk were 58.9%, 60.8%, and 87.8%, respectively. This study demonstrated that surface disinfection and the use of personal hand hygiene products can help decrease virus infection risk in communal offices. Additionally, a variance-based sensitivity analysis revealed a greater relative importance of surface concentrations, assumptions of relevant exposure routes, and inputs representing human behavior in estimating risk reductions.

Estimating the burden of United States workers exposed to infection or disease: A key factor in containing risk of COVID-19 infection

INTRODUCTION

With the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of contracting disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Quantifying the number of workers who are frequently exposed to infection and disease in the workplace, and understanding which occupational groups they represent, can help to prompt public health risk response and management for COVID-19 in the workplace, and subsequent infectious disease outbreaks.

METHODS

To estimate the number of United States workers frequently exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with a BLS O*NET survey measure reporting how frequently workers in each occupation are exposed to infection or disease at work. This allowed us to estimate the number of United States workers, across all occupations, exposed to disease or infection at work more than once a month.

RESULTS

Based on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair).

CONCLUSIONS

The large number of persons employed in occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. Given the proportion of the United States workforce exposed to disease or infection at work, this analysis also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve.