A systematic review of human coronaviruses survival on environmental surfaces

Epidemic Characteristics and Meteorological Risk Factors of Hemorrhagic Fever With Renal Syndrome in 151 Cities in China From 2015 to 2021: Retrospective Analysis

BACKGROUND

Hemorrhagic fever with renal syndrome (HFRS) continues to pose a significant public health threat to the population in China. Previous epidemiological evidence indicates that HFRS is climate sensitive and influenced by meteorological factors. However, past studies either focused on too-narrow geographical regions or investigated time periods that were too early. There is an urgent need for a comprehensive analysis to interpret the epidemiological patterns of meteorological factors affecting the incidence of HFRS across diverse climate zones.

OBJECTIVE

In this study, we aimed to describe the overall epidemic characteristics of HFRS and explore the linkage between monthly HFRS cases and meteorological factors at different climate levels in China.

METHODS

The reported HFRS cases and meteorological data were collected from 151 cities in China during the period from 2015 to 2021. We conducted a 3-stage analysis, adopting a distributed lag nonlinear model and a generalized additive model to estimate the interactions and marginal effects of meteorological factors on HFRS.

RESULTS

This study included a total of 63,180 cases of HFRS; the epidemic trends showed seasonal fluctuations, with patterns varying across different climate zones. Temperature had the greatest impact on the incidence of HFRS, with the maximum hysteresis effects being at 1 month (-19 ºC; relative risk [RR] 1.64, 95% CI 1.24-2.15) in the midtemperate zone, 0 months (28 ºC; RR 3.15, 95% CI 2.13-4.65) in the warm-temperate zone, and 0 months (4 ºC; RR 1.72, 95% CI 1.31-2.25) in the subtropical zone. Interactions were discovered between the average temperature, relative humidity, and precipitation in different temperature zones. Moreover, the influence of precipitation and relative humidity on the incidence of HFRS had different characteristics under different temperature layers. The hysteresis effect of meteorological factors did not end after an epidemic season, but gradually weakened in the following 1 or 2 seasons.

CONCLUSIONS

Weather variability, especially low temperature, plays an important role in epidemics of HFRS in China. A long hysteresis effect indicates the necessity of continuous intervention following an HFRS epidemic. This finding can help public health departments guide the prevention and control of HFRS and develop strategies to cope with the impacts of climate change in specific regions.

Simple colorimetric paper-based test strip for point-of-use quality testing of ethanol-based hand sanitizers

A novel, simple, affordable, and reliable colorimetric paper-based analytical device (PAD) was developed for the point-of-use quality testing of ethanol-based hand sanitizers, mainly against adulteration by water. The principle was based on the novel solvatochromism of methylparaben (MPB)-Fe3+ complex, where water is essential for complex formation and ethanol is necessary for MPB solubility. The intensity of the formed violet color, measured at 528 nm, showed a good correlation (R2 = 0.996) with the percentage water in the reaction media over a range from 40% to 100% (0-60% ethanol), with excellent accuracy and precision as indicated by the percent recovery within 100.00% ± 2% and %RSD of <2%. A PAD was prepared by the sequential immobilization of Fe3+ ions and MPB on chitosan-modified filter paper. The developed PAD was successfully applied for the quality testing of ethanol-based hand sanitizers using an established color index, where clearly distinct colors were observed as a function of the percentage ethanol (0-100%). The developed test strips could achieve on-site lab-quality results without expensive or sophisticated instruments using a few milligrams of FeCl3 and MPB in addition to regular filter paper. Accordingly, it can be used as a test strip for the quality checking of ethanol-based hand sanitizers by end users.

Reduction of acute respiratory infections in day-care by non-pharmaceutical interventions: a narrative review

Objective

Children who start in day-care have 2-4 times as many respiratory infections compared to children who are cared for at home, and day-care staff are among the employees with the highest absenteeism. The extensive new knowledge that has been generated in the COVID-19 era should be used in the prevention measures we prioritize. The purpose of this narrative review is to answer the questions: Which respiratory viruses are the most significant in day-care centers and similar indoor environments? What do we know about the transmission route of these viruses? What evidence is there for the effectiveness of different non-pharmaceutical prevention measures?

Design

Literature searches with different terms related to respiratory infections in humans, mitigation strategies, viral transmission mechanisms, and with special focus on day-care, kindergarten or child nurseries, were conducted in PubMed database and Web of Science. Searches with each of the main viruses in combination with transmission, infectivity, and infectious spread were conducted separately supplemented through the references of articles that were retrieved.

Results

Five viruses were found to be responsible for ≈95% of respiratory infections: rhinovirus, (RV), influenza virus (IV), respiratory syncytial virus (RSV), coronavirus (CoV), and adenovirus (AdV). Novel research, emerged during the COVID-19 pandemic, suggests that most respiratory viruses are primarily transmitted in an airborne manner carried by aerosols (microdroplets).

Conclusion

Since airborne transmission is dominant for the most common respiratory viruses, the most important preventive measures consist of better indoor air quality that reduces viral concentrations and viability by appropriate ventilation strategies. Furthermore, control of the relative humidity and temperature, which ensures optimal respiratory functionality and, together with low resident density (or mask use) and increased time outdoors, can reduce the occurrence of respiratory infections.

A review on sterilization methods of environmental decontamination to prevent the coronavirus SARS-CoV-2 (COVID-19 virus): A new challenge towards eco-friendly solutions

In recent years, the COVID-19 pandemic is currently wreaking havoc on the planet. SARS-CoV-2, the Severe Acute Respiratory Syndrome Coronavirus, is the current term for this outbreak. Reports about this novel coronavirus have been presented since the pandemic's breakout, and they have demonstrated that it transmits rapidly from person to person, primarily by droplets in the air. Findings have illustrated that SARS-CoV-2 can survive on surfaces from hours to days. Therefore, it is essential to find practical solutions to reduce the virus's impact on human health and the environment. This work evaluated common sterilization methods that can decontaminate the environment and items. The goal is that healthcare facilities, disease prevention organizations, and local communities can overcome the new challenge of finding eco-friendly solutions. Further, a foundation of information encompassing various sterilization procedures and highlighting their limits to choose the most appropriate method to stop disease-causing viruses in the new context has been presented. The findings of this crucial investigation contribute to gaining insight into the comprehensive sterilization approaches against the coronavirus for human health protection and sustainable environmental development.

Presence of coronaviruses in the common pipistrelle (P. pipistrellus) and Nathusius´ pipistrelle (P. nathusii) in relation to landscape composition

Changes in land use can modify habitat and roosting behaviour of bats, and therefore the transmission dynamics of viruses. Within bat roosts the density and contact rate among individuals increase and may facilitate the transmission of bat coronaviruses (CoVs). Landscape components supporting larger bat populations may thus lead to higher CoVs prevalence, as the number of roosts and/or roost size are likely to be higher. Hence, relationships between landscape composition and the presence of CoVs are expected to exist. To increase our understanding of the spread and shedding of coronaviruses in bat populations we studied the relationships between landscape composition and CoVs prevalence in the species Pipistrellus pipistrellus and Pipistrellus nathusii. Faecal samples were collected across The Netherlands, and were screened to detect the presence of CoV RNA. Coordinates were recorded for all faecal samples, so that landscape attributes could be quantified. Using a backward selection procedure on the basis of AIC, the landscape variables that best explained the presence of CoVs were selected in the final model. Results suggested that relationships between landscape composition and CoVs were likely associated with optimal foraging opportunities in both species, e.g. nearby water in P. nathusii or in areas with more grassland situated far away from forests for P. pipistrellus. Surprisingly, we found no positive association between built-up cover (where roosts are frequently found) and the presence of bat-CoVs for both species. We also show that samples collected from large bat roosts, such as maternity colonies, substantially increased the probability of finding CoVs in P. pipistrellus. Interestingly, while maternity colonies of P. nathusii are rarely present in The Netherlands, CoVs prevalence was similar in both species, suggesting that other mechanisms besides roost size, participate in the transmission of bat-CoVs. We encourage further studies to quantify bat roosts and colony networks over the different landscape compositions to better understand the ecological mechanisms involved in the transmission of bat-CoVs.

Persistence of SARS-CoV-2 and its surrogate, bacteriophage Phi6, on surfaces and in water

IMPORTANCE

The COVID-19 pandemic spurred research on the persistence of SARS-CoV-2 and its surrogates. Here we highlight the importance of evaluating viral surrogates and experimental methodologies when studying pathogen survival in the environment.

SARS-CoV-2 transmission via maritime cold chains: A statistical analysis of nucleic acid detection results of cold chain food imported from Fuzhou ports

Numerous epidemic outbreaks related to cold chains have occurred since the coronavirus disease 2019 (COVID-19) outbreak, suggesting the potential danger of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission through cold chain foods (CCFs). By analyzing SARS-CoV-2 RNA contamination of CCFs imported from Fuzhou ports, this study evaluated the contamination and transmission of SARS-CoV-2 RNA via maritime cold chains, with the aim of provide suggestions for CCFs supervision and public health management. The statistical analysis included 131,385 samples. The majority of the CCFs imported into Fuzhou ports was aquatic raw food that originated in Southeast Asia (57.08 %), South America (19.87 %), and South Asia (11.22 %). South Asia had the highest positivity rate of 0.37 %, followed by Southeast Asia (0.21 %) and South America (0.08 %). The positivity rate showed that the outer packaging of CCFs was the most easily contaminated, accounting for 81.33 % of all positive samples. This suggested that CCFs storage and loading processes were the weak links vulnerable to SARS-CoV-2 contamination. The positivity rates in outer packaging, inner packaging, and content of raw food were 0.48 %, 0.08 %, and 0.05 %, respectively, which were obviously higher than those of processed and refined food. This indicated that increasing the mechanization of factories and implementing sensible worker management practices may decrease viral contamination. The monthly positivity rates varied widely from 0 % (March 2021) to 0.40 % (January 2021), with an average of 0.19 %. The positivity rates in outer packaging, inner packaging and content of crustaceans from Southeast Asia were 2.47 %, 0.41 %, and 0.69 %, which were approximately 5-14 times higher than those of fish and cephalopods. Meanwhile, the monthly detection number show that SARS-CoV-2 epidemic prevention strategies affected the trade of imported CCFs.

Emerging infectious diseases, focus on infection prevention, environmental survival and germicide susceptibility: SARS-CoV-2, Mpox, and Candida auris

BACKGROUND

New and emerging infectious diseases continue to represent a public health threat. Emerging infectious disease threats include pathogens increasing in range (eg, Mpox), zoonotic microbes jumping species lines to cause sustained infections in humans via person-to-person transmission (SARS-CoV-2) and multidrug-resistant pathogens (eg, Candida auris).

MATERIALS AND METHODS

We searched the published English literature and reviewed the selected articles on SARS-CoV-2, Mpox, and Candida auris with a focus on environmental survival, contamination of the patient's hospital environment, susceptibility of the pathogen to antiseptics and disinfectants and infection prevention recommendations.

RESULTS

All three pathogens (ie, SARS-CoV-2, Mpox, and Candida auris) can survive on surfaces for minutes to hours and for Mpox and C auris for days. Currently available antiseptics (eg, 70%-90% alcohol hand hygiene products) are active against SARS-CoV-2, Mpox and C auris. The U.S Environmental Protection Agency provides separate lists of surface disinfectants active against SARS-CoV-2, Mpox, and C auris.

DISCUSSION

The risk of environment-to-patient transmission of SARS-CoV-2, Mpox and Candida auris, is very low, low-moderate and high, respectively. In the absence of appropriate patient isolation and use of personal protection equipment, the risk of patient-to-health care provider transmission of SARS-CoV-2, Mpox, and C auris is high, moderate and low, respectively.

CONCLUSIONS

Appropriate patient isolation, use of personal protective equipment by health care personnel, hand hygiene, and surface disinfection can protect patients and health care personnel from acquiring SARS-CoV-2, Mpox, and C auris from infected patients.

Quantifying individual-level heterogeneity in infectiousness and susceptibility through household studies

The spread of SARS-CoV-2, like that of many other pathogens, is governed by heterogeneity. "Superspreading," or "over-dispersion," is an important factor in transmission, yet it is hard to quantify. Estimates from contact tracing data are prone to potential biases due to the increased likelihood of detecting large clusters of cases, and may reflect variation in contact behavior more than biological heterogeneity. In contrast, the average number of secondary infections per contact is routinely estimated from household surveys, and these studies can minimize biases by testing all members of a household. However, the models used to analyze household transmission data typically assume that infectiousness and susceptibility are the same for all individuals or vary only with predetermined traits such as age. Here we develop and apply a combined forward simulation and inference method to quantify the degree of inter-individual variation in both infectiousness and susceptibility from observations of the distribution of infections in household surveys. First, analyzing simulated data, we show our method can reliably ascertain the presence, type, and amount of these heterogeneities given data from a sufficiently large sample of households. We then analyze a collection of household studies of COVID-19 from diverse settings around the world, and find strong evidence for large heterogeneity in both the infectiousness and susceptibility of individuals. Our results also provide a framework to improve the design of studies to evaluate household interventions in the presence of realistic heterogeneity between individuals.

Detection of different variants of SARS-CoV-2 RNA (genome) on inanimate surfaces in high-touch public environmental surfaces

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease started in late 2019 and still continues as a global pandemic, spreading among people around the world. There is limited knowledge about the role of contaminated environmental surfaces, especially high-touch public surfaces, in the transmission of the disease. The objective of the present investigation was detection of different variants (Delta, UK, and Omicron) of SARS-CoV-2 RNA (genome) on inanimate surfaces in high-touch public environmental surfaces in different seasons. Automated teller machines of banks (ATM), point-of-sale (POS) machine, gas station pump nozzles, and escalator handrails of malls were selected as high-touch environmental surfaces in public places. Overall, 75 samples were collected from these places and examined for the presence of SARS-CoV-2 RNA (genome), and 21 samples (28%) were positive. Although the role of fomite transmission of COVID-19 is understood, more studies should be conducted to determine the virus survival rate as well as the required efforts to prevent the spread of SARS-CoV-2 such as frequent cleaning and the use of efficient disinfectants on environmental surfaces, especially high-touch public places. In conclusion, the results address the importance of touching contaminated inanimate objects as well as transmission through environmental surfaces, and they could be used to establish an effective protocol to prevent indirect environmental transmission of SARS-CoV-2, slow down the spread of the virus, and reduce the risk of infection.

Utilizing nanozymes for combating COVID-19: advancements in diagnostics, treatments, and preventative measures

The emergence of human severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses significant challenges to global public health. Despite the extensive efforts of researchers worldwide, there remains considerable opportunities for improvement in timely diagnosis, specific treatment, and effective vaccines for SARS-CoV-2. This is due, in part, to the large number of asymptomatic carriers, rapid virus mutations, inconsistent confinement policies, untimely diagnosis and limited clear treatment plans. The emerging of nanozymes offers a promising approach for combating SARS-CoV-2 due to their stable physicochemical properties and high surface areas, which enable easier and multiple nano-bio interactions in vivo. Nanozymes inspire the development of sensitive and economic nanosensors for rapid detection, facilitate the development of specific medicines with minimal side effects for targeted therapy, trigger defensive mechanisms in the form of vaccines, and eliminate SARS-CoV-2 in the environment for prevention. In this review, we briefly present the limitations of existing countermeasures against coronavirus disease 2019 (COVID-19). We then reviewed the applications of nanozyme-based platforms in the fields of diagnostics, therapeutics and the prevention in COVID-19. Finally, we propose opportunities and challenges for the further development of nanozyme-based platforms for COVID-19. We expect that our review will provide valuable insights into the new emerging and re-emerging infectious pandemic from the perspective of nanozymes.

Out of the 'host' box: extreme off-host conditions alter the infectivity and virulence of a parasitic bacterium

Disease agents play an important role in the ecology and life history of wild and cultivated populations and communities. While most studies focus on the adaptation of parasites to their hosts, the adaptation of free-living parasite stages to their external (off-host) environment may tell us a lot about the factors that shape the distribution of parasites. Pasteuria ramosa is an endoparasitic bacterium of the water flea Daphnia with a wide geographical distribution. Its transmission stages rest outside of the host and thus experience varying environmental regimes. We examined the life history of P. ramosa populations from four environmental conditions (i.e. groups of habitats): the factorial combinations of summer-dry water bodies or not, and winter-freeze water bodies or not. Our goal was to examine how the combination of winter temperature and summer dryness affects the parasite's ability to attach to its host and to infect it. We subjected samples of the four groups of habitats to temperatures of 20, 33, 46 and 60°C in dry and wet conditions, and exposed a susceptible clone of Daphnia magna to the treated spores. We found that spores which had undergone desiccation endured higher temperatures better than spores kept wet, both regarding attachment and subsequent infection. Furthermore, spores treated with heightened temperatures were much less infective and virulent. Even under high temperatures (60°C), exposed spores from all populations were able to attach to the host cuticle, albeit they were unable to establish infection. Our work highlights the sensitivity of a host-free resting stage of a bacterial parasite to the external environment. Long heatwaves and harsh summers, which are becoming more frequent owing to recent climate changes, may therefore pose a problem for parasite survival. This article is part of the theme issue 'Infectious disease ecology and evolution in a changing world'.

Analysis of the Virus SARS-CoV-2 as a Potential Bioweapon in Light of International Literature

INTRODUCTION

As of early 2022, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic still represents a worldwide medical emergency situation. The ongoing vaccination programs can slow down the spread of the virus; however, from time to time, the newly emerging variants of concern and antivaccination movements carry the possibility for the disease to remain in our daily lives. After the appearance of SARS-CoV-2, there was scholarly debate whether the virus was of natural origin, or it emerged from a laboratory, some even thinking the agent's potential biological weapon properties suggest the latter scenario. Later, the bioweapon theory was dismissed by the majority of experts, but the question remains that despite its natural origin, how potent a biological weapon the SARS-CoV-2 virus can become over time.

MATERIALS AND METHODS

Based on 12 bioweapon threat assessment criteria already published in 2018, we performed a literature search and review, focusing on relevant potential bioweapon properties of the virus SARS-CoV-2. Instead of utilizing a survey among experts, we tried to qualify and quantify characteristics according to the available data found in peer-reviewed papers. We also identified other key elements not mentioned in the original 12 bioweapon criteria, which can play an important role in assessing future biological weapons.

RESULTS

According to the international literature we analyzed, SARS-CoV-2 is a moderately infectious agent (ID50 estimated between 100 and 1,000), with high infection-to-disease ratio (35%-45% rate of asymptomatic infected) and medium incubation period (1-34 days, mean 6-7 days). Its morbidity and mortality rate can be categorized as medium (high morbidity rate with significant mortality rate). It can be easily produced in large quantities, has high aerosol stability, and has moderate environmental stability. Based on laboratory experiments and statistical model analysis, it can form and is contagious with droplet nuclei, and with spray technique utilization, it could be weaponized effectively. Several prophylactic countermeasures are available in the form of vaccines; however, specific therapeutic options are much more limited. In connection with the original assessment criteria, the SARS-CoV-2 only achieved a "0" score on the ease of detection because of readily available, relatively sensitive, and specific rapid antigen tests. Based on the pandemic experience, we also propose three new assessment categories: one that establishes a mean to measure the necessary quarantine restrictions related to a biological agent, another one that can represent the personal protective equipment required to work safely with a particular agent, and a third one that quantifies the overall disruptive capability, based on previous real-life experiences. These factors could further specify the threat level related to potential biological weapons.

CONCLUSIONS

Our results show that the virus can become a potent bioweapon candidate in the future, achieving a total score of 24 out of 36 on the original 12 criteria. The SARS-CoV-2 has already proven its pandemic generating potential and, despite worldwide efforts, still remains an imminent threat. In order to be prepared for the future possibility of the virus arising as a bioweapon, we must remain cautious and take the necessary countermeasures.

One-year monitoring SARS-CoV-2 RNA surface contamination in hospitals reveals no correlation with organic material and negative pressure as a limiting factor for contamination

Understanding transmission routes of SARS-CoV-2 is crucial to establish effective interventions in healthcare institutions. Although the role of surface contamination in SARS-CoV-2 transmission has been controversial, fomites have been proposed as a contributing factor. Longitudinal studies about SARS-CoV-2 surface contamination in hospitals with different infrastructure (presence or absence of negative pressure systems) are needed to improve our understanding of their effectiveness on patient healthcare and to advance our knowledge about the viral spread. We performed a one-year longitudinal study to evaluate surface contamination with SARS-CoV-2 RNA in reference hospitals. These hospitals have to admit all COVID-19 patients from public health services that require hospitalization. Surfaces samples were molecular tested for SARS-CoV-2 RNA presence considering three factors: the dirtiness by measuring organic material, the circulation of a high transmissibility variant, and the presence or absence of negative pressure systems in hospitalized patients' rooms. Our results show that: (i) There is no correlation between the amount of organic material dirtiness and SARS-CoV-2 RNA detected on surfaces; (ii) SARS-CoV-2 high transmissible Gamma variant introduction significantly increased surface contamination; (iii) the hospital with negative pressure systems was associated with lower levels of SARS-CoV-2 surface contamination and, iv) most environmental samples recovered from contaminated surfaces were assigned as non-infectious. This study provides data gathered for one year about the surface contamination with SARS-CoV-2 RNA sampling hospital settings. Our results suggest that spatial dynamics of SARS-CoV-2 RNA contamination varies according with the type of SARS-CoV-2 genetic variant and the presence of negative pressure systems. In addition, we showed that there is no correlation between the amount of organic material dirtiness and the quantity of viral RNA detected in hospital settings. Our findings suggest that SARS CoV-2 RNA surface contamination monitoring might be useful for the understanding of SARS-CoV-2 dissemination with impact on hospital management and public health policies. This is of special relevance for the Latin-American region where ICU rooms with negative pressure are insufficient.

The impact of plastic during the COVID-19 pandemic: The point of view of the environmental science literature

COVID-19 is the official name of the disease provoked by a coronavirus called SARS-CoV-2. Since the advent of the first cases of the new coronavirus, our society has been completely changed. Due to the changes, new environmental challenges were imposed, principally due to the considerable growth in using plastic materials in packages and personal protective equipment such as face masks. The impact of plastic during the COVID-19 pandemic was discussed in the present work from the point of view of the environmental science area. Bibliometric analysis and mapping were performed based on Scopus database search results. Emphasis was placed on analyzing the authors' keywords of the publications. The main concern of the research area concerning the use of plastic during the COVID-19 pandemic is the pollution of water bodies by plastic.

Impact of Plastic-Wrap Properties and Cleaning Intervals on the Disinfection of Elevator Buttons

Fomite transmission is a possible route by which different pathogens spread within facilities. In hospital settings, elevator buttons are widely observed to be covered with various types of plastic wraps; however, limited information is available concerning the impact of different plastic materials on cleaning. Our study aimed to identify which plastic material is suitable for the coverage of elevator buttons and the optimal intervals for their cleaning. We tested six plastic covers, including polyethylene (PE), polymethylpentene (PMP), polyvinyl chloride (PVD), and polyvinylidene chloride (PVDC) plastic wraps; a thermoplastic polyurethane (TPU) keyboard cover; and a polyethylene terephthalate-ethylene vinyl acetate (PET-EVA) laminating film, which are plastic films. The bioburden on the elevator buttons at different time intervals was measured using an adenosine triphosphate (ATP) bioluminescence assay. Our results show that wraps made of PVDC had superior durability compared with those of PMP, PVC, and PVDC, in addition to the lowest detectable ATP levels among the six tested materials. Regarding different button locations, the highest ATP values were found in door-close buttons followed by door-open, and first-floor buttons after one- and three-hour intervals (p = 0.024 and p < 0.001, respectively). After routine disinfection, the ATP levels of buttons rapidly increased after touching and became more prominent after three hours (p < 0.05). Our results indicate that PVDC plastic wraps have adequate durability and the lowest residual bioburden when applied as covers for elevator buttons. Door-close and -open buttons were the most frequently touched sites, requiring more accurate and precise disinfection; therefore, cleaning intervals of no longer than three hours may be warranted.

Indoor Spatiotemporal Contact Analytics Using Landmark-Aided Pedestrian Dead Reckoning on Smartphones

Due to the prevalence of COVID-19, providing safe environments and reducing the risks of virus exposure play pivotal roles in our daily lives. Contact tracing is a well-established and widely-used approach to track and suppress the spread of viruses. Most digital contact tracing systems can detect direct face-to-face contact based on estimated proximity, without quantifying the exposed virus concentration. In particular, they rarely allow for quantitative analysis of indirect environmental exposure due to virus survival time in the air and constant airborne transmission. In this work, we propose an indoor spatiotemporal contact awareness framework (iSTCA), which explicitly considers the self-containing quantitative contact analytics approach with spatiotemporal information to provide accurate awareness of the virus quanta concentration in different origins at various times. Smartphone-based pedestrian dead reckoning (PDR) is employed to precisely detect the locations and trajectories for distance estimation and time assessment without the need to deploy extra infrastructure. The PDR technique we employ calibrates the accumulative error by identifying spatial landmarks automatically. We utilized a custom deep learning model composed of bidirectional long short-term memory (Bi-LSTM) and multi-head convolutional neural networks (CNNs) for extracting the local correlation and long-term dependency to recognize landmarks. By considering the spatial distance and time difference in an integrated manner, we can quantify the virus quanta concentration of the entire indoor environment at any time with all contributed virus particles. We conducted an extensive experiment based on practical scenarios to evaluate the performance of the proposed system, showing that the average positioning error is reduced to less than 0.7 m with high confidence and demonstrating the validity of our system for the virus quanta concentration quantification involving virus movement in a complex indoor environment.

Infectivity of SARS-CoV-2 on Inanimate Surfaces: Don't Trust Ct Value

SARS-CoV-2 RNA is frequently identified in patient rooms and it was speculated that the viral load quantified by PCR might correlate with infectivity of surfaces. To evaluate Ct values for the prediction of infectivity, we investigated contaminated surfaces and Ct-value changes after disinfection. Viral RNA was detected on 37 of 143 investigated surfaces of an ICU. However, virus isolation failed for surfaces with a high viral RNA load. Also, SARS-CoV-2 could not be cultivated from surfaces artificially contaminated with patient specimens. In order to evaluate the significance of Ct values more precisely, we used surrogate enveloped bacteriophage Φ6. A strong reduction in Φ6 was achieved by three different disinfection methods. Despite a strong reduction in viability almost no change in the Ct values was observed for UV-C and alcoholic surface disinfectant. Disinfection using ozone resulted in a lack of Φ6 recovery as well as a detectable shift in Ct values indicating strong degradation of the viral RNA. The observed lack of significant effects on the detectable viral RNA after effective disinfection suggest that quantitative PCR is not suitable for predicting the infectivity of SARS-CoV-2 on inanimate surfaces. Ct values should therefore not be considered as markers for infectivity in this context.

Quantifying individual-level heterogeneity in infectiousness and susceptibility through household studies

The spread of SARS-CoV-2, like that of many other pathogens, is governed by heterogeneity. "Superspreading," or "over-dispersion," is an important factor in transmission, yet it is hard to quantify. Estimates from contact tracing data are prone to potential biases due to the increased likelihood of detecting large clusters of cases, and may reflect variation in contact behavior more than biological heterogeneity. In contrast, the average number of secondary infections per contact is routinely estimated from household surveys, and these studies can minimize biases by testing all members of a household. However, the models used to analyze household transmission data typically assume that infectiousness and susceptibility are the same for all individuals or vary only with predetermined traits such as age. Here we develop and apply a combined forward simulation and inference method to quantify the degree of inter-individual variation in both infectiousness and susceptibility from observations of the distribution of infections in household surveys. First, analyzing simulated data, we show our method can reliably ascertain the presence, type, and amount of these heterogeneities with data from a sufficiently large sample of households. We then analyze a collection of household studies of COVID-19 from diverse settings around the world, and find strong evidence for large heterogeneity in both the infectiousness and susceptibility of individuals. Our results also provide a framework to improve the design of studies to evaluate household interventions in the presence of realistic heterogeneity between individuals.

Meteorological change and hemorrhagic fever with renal syndrome epidemic in China, 2004-2018

Hemorrhagic fever with renal syndrome (HFRS), caused by hantavirus, is a serious public health problem in China. Despite intensive countermeasures including Patriotic Health Campaign, rodent control and vaccination in affected areas, HFRS is still a potential public health threat in China, with more than 10,000 new cases per year. Previous epidemiological evidence suggested that meteorological factors could influence HFRS incidence, but the studies were mainly limited to a specific city or region in China. This study aims to evaluate the association between monthly HFRS cases and meteorological change at the country level using a multivariate distributed lag nonlinear model (DLNM) from 2004 to 2018. The results from both univariate and multivariate models showed a non-linear cumulative relative risk relationship between meteorological factors (with a lag of 0-6 months) such as mean temperature (Tmean), precipitation, relative humidity (RH), sunshine hour (SH), wind speed (WS) and HFRS incidence. The risk for HFRS cases increased steeply as the Tmean between - 23 and 14.79 °C, SH between 179.4 and 278.4 h and RH remaining above 69% with 50-95 mm precipitation and 1.70-2.00 m/s WS. In conclusion, meteorological factors such as Tmean and RH showed delayed-effects on the increased risk of HFRS in the study and the lag varies across climate factors. Temperature with a lag of 6 months (RR = 3.05) and precipitation with a lag of 0 months (RR = 2.08) had the greatest impact on the incidence of HFRS.

The role of clinical engineers in the coronavirus disease 2019 pandemic

The duties of a clinical engineer (CE) during the coronavirus infection 2019 (COVID-19) pandemic were diverse. The original duties of a CE included operation and maintenance of life support equipment used for respiratory therapy, hemodialysis, and extracorporeal membrane oxygenation. The management of life support equipment is critical. The PB-840 ventilator is equipped with a heat sink system that dissipates internal heat through thermal conduction. Therefore, internal contamination is less likely to occur. The exhalation filter used in the PB- 840 can be used for up to 15 days. It can be used for long periods of time without maintenance, reducing the risk of infection. The PB-840 is a suitable device for patients with COVID-19. Its use in critically ill patients was determined to be a priority. Thus, use of an appropriate device for infection control requires a proper understanding of and familiarity with the device in question.

SARS-CoV-2 Contamination of Ambulance Surfaces and Effectiveness of Routine Decontamination Procedure: A Classic Hygiene Lesson for A Novel Pathogen

The efficacy of standard operating procedures (SOPs) for the decontamination of ambulances against SARS-CoV-2 has been debated. In Italy, the differential use of ambulances was implemented by regional health authorities, with selected vehicles being used exclusively for transporting COVID-19 patients. We investigated the presence of SARS-CoV-2 on high-touch surfaces in ambulances to assess contamination dynamics and the effectiveness of decontamination SOPs. Four high-touch surfaces were sampled before and after decontamination (T0; T1). The gloves of the EMS crew chief were also sampled. RNA extraction was performed with a commercial kit, followed by RT-qPCR molecular detection of SARS-CoV-2. A total of 11 transports were considered. Seven transports had at least one positive sample; all were related to a COVID-19 patient. Three of the negative transports had dealt with COVID-19 case, and one had dealt with a COVID-19-negative patient. One door handle and one oxygen knob were positive at T0, with negative T1 swabs. The monitors were positive in 5 transports at T0, yet they were never positive at T1. Three stretcher handles tested positive at T0, and two of them also at T1, possibly having bypassed decontamination during personnel dismounting. Gloves were contaminated in five transports, in which 1 to 3 additional samples (monitor, knob, stretcher) resulted as positive. Overall, the efficacy of decontamination SOPs was confirmed under the unprecedented conditions of the COVID-19 emergency. However, the importance of correct hand-hygiene and glove-disposal should be further emphasized through the dedicated training of EMS personnel.

UltraButton: A Minimalist Touchless Multimodal Haptic Button

We present UltraButton a minimalist touchless button including haptic, audio and visual feedback costing only $200. While current mid-air haptic devices can be too bulky and expensive (around $2 k) to be integrated into simple mid-air interfaces such as point and select, we show how a clever arrangement of 83 ultrasound transducers and a new modulation algorithm can produce compelling mid-air haptic feedback and parametric audio at a minimal cost. To validate our prototype, we compared its haptic output to a commercially-available mid-air haptic device through force balance measurements and user perceived strength ratings and found no significant differences. With the addition of 20 RGB LEDs, a proximity sensor and other off-the-shelf electronics, we then propose a complete solution for a simple multimodal touchless button interface. We tested this interface in a second experiment that investigated user gestures and their dependence on system parameters such as the haptic and visual activation times and heights above the device. Finally, we discuss new interactions and applications scenarios for UltraButtons.

Pneumococcal nasopharyngeal carriage in children under 5 years of age at an outpatient healthcare facility in Novi Sad, Serbia during the COVID-19 pandemic

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The prevalence of nasopharyngeal pneumococcal carriage in children aged 24–60 months was 31.7%.

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The prevalence was high and increased during the coronavirus disease 2019 (COVID-19) pandemic.

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This ruled out a major role of COVID-19 in suppressing carriage and, probably, transmission.

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The dominant serotypes were 15B, 6B, 19F, 11A, 6C, 6A, 3, 23F and 19A.

Objectives

To assess whether pneumococcal nasopharyngeal carriage among children aged 24–60 months reduced during the coronavirus disease 2019 (COVID-19) pandemic in Novi Sad, Serbia, and to investigate the overall prevalence of carriage, serotype distribution and dominant serotypes 2–3 years after the introduction of pneumococcal conjugate vaccine 10.

Design and methods

This prospective, observational study was conducted in February–March 2020, September–November 2020 and April–June 2021, enabling the comparison of results in the pre-pandemic/early pandemic period with two periods during the COVID-19 pandemic. Pneumococci were identified by standard microbiological methods. Serotype identification was performed using conventional multiplex polymerase chain reaction assays.

Results

Among 1623 children tested, 515 (31.7%, 95% confidence interval 29.4–34.0%) carried pneumococci. A significant increase in prevalence was found between February–March 2020 and September–November 2020 (P=0.0085), with no difference found between September–November 2020 and April–June 2021 (P=0.0524). Pneumococcal colonization was significantly higher in children who were fully vaccinated and among children who attended day care centres. The dominant serotypes were 15B, 6B, 19F, 11A, 6C, 6A, 3, 23F and 19A, representing 66.4% of all isolates.

Conclusions

This study found that pneumococcal nasopharyngeal carriage in children aged 24–60 months was high before the COVID-19 pandemic, and then increased during the pandemic. This rules out a major role of COVID-19 in the suppression of carriage and, probably, transmission.

ZnO-based antimicrobial coatings for biomedical applications

Rapid transmission of infectious microorganisms such as viruses and bacteria through person-to-person contact has contributed significantly to global health issues. The high survivability of these microorganisms on the material surface enumerates their transmissibility to the susceptible patient. The antimicrobial coating has emerged as one of the most interesting technologies to prevent growth and subsequently kill disease-causing microorganisms. It offers an effective solution a non-invasive, low-cost, easy-in-use, side-effect-free, and environmentally friendly method to prevent nosocomial infection. Among antimicrobial coating, zinc oxide (ZnO) stands as one of the excellent materials owing to zero toxicity, high biocompatibility to human organs, good stability, high abundancy, affordability, and high photocatalytic performance to kill various infectious pathogens. Therefore, this review provides the latest research progress on advanced applications of ZnO nanostructure-based antibacterial coatings for medical devices, biomedical applications, and health care facilities. Finally, future challenges and clinical practices of ZnO-based antibacterial coating are addressed.

Risk of air and surface contamination of SARS-CoV-2 in isolation wards and its relationship with patient and environmental characteristics

Air and surface contamination of the SARS-CoV-2 have been reported by multiple studies. However, the evidence is limited for the change of environmental contamination of this virus in the surrounding of patients with COVID-19 at different time points during the course of disease and under different conditions of the patients. Therefore, this study aims to understand the risk factors associated with the appearance of SARS-CoV-2 through the period when the patients were staying in the isolation wards. In this study, COVID-19 patients admitted to the isolation wards were followed up for up to 10 days for daily collection of air and surface samples in their surroundings. The positivity rate of the environmental samples at different locations was plotted, and multiple multi-level mixed-effect logistic regressions were used to examine the association between the positivity of environmental samples and their daily health conditions and environmental factors. It found 6.6 % of surface samples (133/2031 samples) and 2.1 % of air samples (22/1075 samples) were positive, and the positivity rate reached to peak during 2-3 days after admission to the ward. The virus was more likely to present at bedrail, patients' personal items and medical equipment, while less likely to be detected in the air outside the range of 2 m from the patients. It also revealed that higher positivity rate is associated with lower environmental temperature, fever and cough at the day of sampling, lower Ct values of latest test for respiratory tract samples, and pre-existing respiratory or cardiovascular conditions. The finding can be used to guide the hospital infection control strategies by identifying high-risk areas and patients. Extra personal hygiene precautions and equipment for continuously environmental disinfection can be used for these high-risk areas and patients to reduce the risk of hospital infection.

Routine Decontamination of Surfaces Relevant to Working Dogs: Neutralization of Superficial Coronavirus Contamination

Given the increased deployment of working dogs to settings with pathogenic biological agents, a safe, effective, and logistically feasible surface decontamination protocol is essential to protect both the animals and their human handlers. Our group previously found that superficial contamination on surfaces relevant to the working dog community, including leashes and toys, could be significantly reduced using a standardized wiping protocol with various cleansing products. To expand upon this work, we analyzed the ability of this protocol to decontaminate surface-deposited bovine coronavirus, which was used as a BSL2 surrogate for SARS-CoV-2. Unsurprisingly, the physical characteristics of a given surface, including porosity and texture, had a significant effect on the ability to recover viable virus remaining on the surface post treatment. After correcting for these differences, however, wiping with 70% isopropyl alcohol (IPA) and 0.5% chlorhexidine performed best, reducing viral titers by >3 log on plastic bumper toys and nylon collars, and by >2 log on rubber toys and tennis balls. Leather leashes and Velcro proved more difficult to decontaminate, but both still showed significant loss of viral contamination following wiping with IPA or chlorhexidine. This work (i) validates the utility of a simple protocol for the neutralization of viruses on several surfaces, (ii) identifies materials that are more difficult to decontaminate, which should, thus, be considered for removal from field use, and (iii) highlights the need for further development of protocols testing porous or textured surfaces.

Prophylactic Architecture: Formulating the Concept of Pandemic-Resilient Homes

The lockdown instituted during the COVID-19 pandemic has drawn the world’s attention to the importance of homes as integrated structures for practicing all aspects of life. The home has been transformed from a mere place to live into a complete piece of infrastructure accommodating all activities of life, including study, work, shopping, exercise, entertainment, and even telehealth. Although quarantines were necessary to protect against viral infection, we have faced social and psychological challenges due to the failure of the current home design to accommodate the new lockdown lifestyle during the pandemic. Thus, this study aims to set a foundation for the development and design of resilient homes in a post-quarantine world by establishing a comprehensive framework for quarantine-resilient homes. The framework was established on the basis of the relevant literature and proposals from architects and experts. It brings a perspective to the future requirements of homes so as to provide architects, stakeholders, and policymakers with the appropriate knowledge to mitigate the impact of lockdowns on mental health and well-being in residential buildings by focusing on the physical and architectural environment.

Electrostatic Spray Disinfection Using Nano-Engineered Solution on Frequently Touched Surfaces in Indoor and Outdoor Environments

The COVID-19 pandemic has resulted in high demand for disinfection technologies. However, the corresponding spray technologies are still not completely optimized for disinfection purposes. There are important problems, like the irregular coverage and dripping of disinfectant solutions on hard and vertical surfaces. In this study, we highlight two major points. Firstly, we discuss the effectiveness of the electrostatic spray deposition (ESD) of nanoparticle-based disinfectant solutions for systematic and long-lasting disinfection. Secondly, we show that, based on the type of material of the substrate, the effectiveness of ESD varies. Accordingly, 12 frequently touched surface materials were sprayed using a range of electrostatic spray system parameters, including ion generator voltage, nozzle spray size and distance of spray. It was observed that for most cases, the surfaces become completely covered with the nanoparticles within 10 s. Acrylic, Teflon, PVC, and polypropylene surfaces show a distinct effect of ESD and non-ESD sprays. The nanoparticles form a uniform layer with better surface coverage in case of electrostatic deposition. Quantitative variations and correlations show that 1.5 feet of working distance, an 80 μm spray nozzle diameter and an ion generator voltage of 3–7 kV ensures a DEF (differential electric field) that corresponds to an optimized charge-to-mass ratio, ensuring efficient coverage of nanoparticles.

The COVID-19 pandemic reshapes the plastic pollution research - A comparative analysis of plastic pollution research before and during the pandemic

The outbreak of the COVID-19 pandemic has exacerbated plastic pollution worldwide. So has the COVID-19 pandemic changed the research on plastic pollution? This work aims to explore the impact of the pandemic on plastic pollution research by comprehensively assessing the current status and prospects of plastic pollution research before and during the COVID-19 pandemic. A collection of publications on the topic of plastic pollution in the Web of Science database concludes that the COVID-19 pandemic has reshaped the plastic pollution research: (i) The COVID-19 pandemic has changed the trend of plastic pollution publication output. Since the COVID-19 pandemic, the number of publications on the topic of plastic pollution has shown a significant increase trend; (ii) The COVID-19 pandemic has reversed the global research landscape of research on the plastic pollution. Since the outbreak of the pandemic, more and more countries have begun to pay attention to plastic pollution. Before the pandemic, developed countries were global leaders in plastic pollution research. However, during the pandemic, developing countries began to have a significant share in the quality, quantity and international cooperation of publications; (iii) The COVID-19 pandemic has redefined the major hotspots of plastic pollution research. The focus of research has changed significantly since the pandemic. Solving plastic pollution has become a major research content. During the epidemic, in-depth research on microplastics was conducted. The results of mining the publications on plastic pollution show that there is currently no effective solution to plastic pollution caused by the COVID-19. However, given the seriousness of controlling plastic pollution, it is very necessary to continue to carry out more research.

Coronaviruses are stable on glass, but are eliminated by manual dishwashing procedures

Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is primarily transmitted from human to human via droplets and aerosols. While transmission via contaminated surfaces is also considered possible, the overall risk of this transmission route is assumed to be low. Nevertheless, transmission through contaminated drinking glasses may pose an increased risk as the glass is in direct contact with the mouth and oral cavity. Using human coronavirus 229E (HCoV-229E) as surrogate for SARS-CoV-2, this study examined coronavirus stability on glass, inactivation by dishwashing detergents, and virus elimination by a manual glass scrubbing device. Infectious HCoV-229E was recovered from glass for 7 and 21 days of storage under daylight and dark conditions, respectively. Near complete inactivation of HCoV-229E (>4 log₁₀ reduction) was observed after incubation with two common dishwashing detergents at room temperature for 15 s, whereas incubation at 43 °C for 60 s was necessary for a third detergent to achieve a similar titer reduction. The virus was efficiently removed from contaminated drinking glasses using a manual glass scrubbing device in accordance with German standard DIN 6653-3. The results confirm that coronaviruses are relatively stable on glass, but indicate that common manual dishwashing procedures can efficiently eliminate coronaviruses from drinking glasses.

SARS-CoV-2: low virus load on surfaces in public areas

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has led people to implement preventive measures, including surface and hand disinfection with a disinfectant to avoid viral transmission. The detection of coronaviruses on surfaces implies not always a high danger of infection. Different coronaviruses and SARS-CoV-2 can be detected under experimental conditions on surfaces for many days. However, there are no studies concerning the virus load and the risk for an infection. The aim of our study was to find out if we could detect SARS-CoV-2 with a virus load greater than 10⁶ copies/mL in public areas under real-life conditions. A total of 1200 swabs were performed on different environmental surfaces in public areas: handholds, press buttons in buses, tramways, tubes, elevators, shops, doorknobs in public buildings, public restrooms, touchscreens in shops and public transportation services, supermarket trolleys, banknotes and coins and immediately tested. We used Rapid Covid-19 Antigen Test (Clinitest®) by Siemens Healthineers (Healgen Scientific Limited Liability Company, Houston, USA, respectively, Shanghai International Holding Corp. GmbH (Europe), Hamburg, Germany). During our study, we were not able to detect SARS-CoV-2 with a virus load greater than 10⁶ copies/ml although we pooled the swabs. According to the negative antigen tests and with a theoretically probability calculation of 1/24.000, there seems no relevant risk of infection with SARS-CoV-2 in public areas. For people with underlying diseases or immunosuppression, the risk of transmission respectively infectivity cannot be excluded with this study.

Cold chain and severe acute respiratory syndrome coronavirus 2 transmission: a review for challenges and coping strategies

Since June 2020, the re-emergence of coronavirus disease 2019 (COVID-19) epidemics in parts of China was linked to the cold chain, which attracted extensive attention and heated discussions from the public. According to the typical characteristics of these epidemics, we speculated a possible route of transmission from cold chain to human. A series of factors in the supply chain contributed to the epidemics if the cold chain were contaminated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), such as temperature, humidity, personal hygiene/protection, and disinfection. The workers who worked in the cold chain at the receiving end faced a higher risk of being infected when they were not well protected. Facing the difficult situation, China put forward targeted and powerful countermeasures to block the cold chain-related risk. However, in the context of the unstable pandemic situation globally, the risk of the cold chain needs to be recognized and evaluated seriously. Hence, in this review, we reviewed the cold chain-related epidemics in China, analyzed the possible mechanisms, introduced the Chinese experience, and suggested coping strategies for the global epidemic prevention and control.

Honey bee (Apis mellifera L.) colonies as bioindicators of environmental SARS-CoV-2 occurrence

SARS-CoV-2 is responsible for the COVID-19 pandemic. Airflows sustain the infection spread, and in densely urbanized areas airborne particulate matters (PMs) are deemed to aggravate the viral transmission. Apis mellifera colonies are used as bioindicators as they allow environmental sampling of different nature, PMs included. This experiment demonstrates for the first time the possible use of honey bee colonies in the SARS-CoV-2 monitoring. The trial was conducted in Bologna on 18 March 2021, when the third wave of the Italian pandemic was at its peak and environmental conditions allowed high PM concentrations in the air. Sterile swabs were lined up at the hive entrance to sample the dusty material on the body of returning foragers. All of them resulted positive for the target genes of viral SARS-CoV-2 RNA. Likewise, internal samples were taken, but they resulted in no amplification of the target sequences. This experiment does not support speculations about the role of honey bees or their products in SARS-CoV-2 transmission. However, it indicates a novel use of A. mellifera colonies in the environmental detection of airborne human pathogens, at least in a densely urbanized area, deserving better understanding and possible integration with data from automatic air samplers.

Infant Pneumococcal Carriage in Belgium Not Affected by COVID-19 Containment Measures

Streptococcus pneumoniae is an important and frequently carried respiratory pathogen that has the potential to cause serious invasive diseases, such as pneumonia, meningitis, and sepsis. Young children and older adults are among the most vulnerable to developing serious disease. With the arrival of the COVID-19 pandemic and the concomitant restrictive measures, invasive disease cases caused by respiratory bacterial species, including pneumococci, decreased substantially. Notably, the stringency of the containment measures as well as the visible reduction in the movement of people appeared to coincide with the drop in invasive disease cases. One could argue that wearing protective masks and adhering to social distancing guidelines to halt the spread of the SARS-CoV-2 virus, also led to a reduction in the person-to-person transmission of respiratory bacterial species. Although plausible, this conjecture is challenged by novel data obtained from our nasopharyngeal carriage study which is performed yearly in healthy daycare center attending children. A sustained and high pneumococcal carriage rate was observed amid periods of stringent restrictive measures. This finding prompts us to revisit the connection between nasopharyngeal colonization and invasion and invites us to look closer at the nasopharyngeal microbiome as a whole.

Designing Post COVID-19 Buildings: Approaches for Achieving Healthy Buildings

The COVID-19 pandemic forced the accessibility, social gathering, lifestyle, and working environment to be changed to reduce the infection. Coronavirus spreads between people in several different ways. Small liquid particles (aerosols, respiratory droplets) from an infected person are transmitted through air and surfaces that are in contact with humans. Reducing transmission through modified heating, ventilation, and air conditioning (HVAC) systems and building design are potential solutions. A comprehensive review of the engineering control preventive measures to mitigate COVID-19 spread, healthy building design, and material was carried out. The current state-of-the-art engineering control preventive measures presented include ultraviolet germicidal irradiation (UVGI), bipolar ionization, vertical gardening, and indoor plants. They have potential to improve the indoor air quality. In addition, this article presents building design with materials (e.g., copper alloys, anti-microbial paintings) and smart technologies (e.g., automation, voice control, and artificial intelligence-based facial recognition) to mitigate the infections of communicable diseases.

Drying of virus-containing particles: modelling effects of droplet origin and composition

BACKGROUND AND PURPOSE

Virus-containing aerosol droplets emitted by breathing, speech or coughing dry rapidly to equilibrium with ambient relative humidity (RH), increasing in solute concentration with effects on virus survival and decreasing in diameter with effects on sedimentation and respiratory uptake. The aim of this paper is to model the effect of ionic and macromolecular solutes on droplet drying and solute concentration.

METHODS

Deliquescence-efflorescence concepts and Kohler theory were used to simulate the evolution of solute concentrations and water activity in respiratory droplets, starting from efflorescence data on mixed NaCl/KCl aerosols and osmotic pressure data on respiratory macromolecules.

RESULTS

In NaCl/KCl solutions total salt concentrations were shown to reach 10-13 M at the efflorescence RH of 40-55%, depending on the K:Na ratio. Dependence on K:Na ratio implies that the evaporation curves differ between aerosols derived from saliva and from airway surfaces. The direct effect of liquid droplet size through the Kelvin term was shown to be smaller and restricted to the evolution of breath emissions. Modelling the effect of proteins and glycoproteins showed that salts determine drying equilibria down to the efflorescence RH, and macromolecules at lower RH.

CONCLUSION

Differences in solute composition between airway surfaces and saliva are predicted to lead to different drying behaviour of droplets emitted by breathing, speech and coughing. These differences may influence the inactivation of viruses.

Alcohol-based hand sanitizer - composition, proper use and precautions

During the COVID-19 pandemic, the use of alcohol-based hand sanitizers (ABHS) increased worldwide among the public as well as the health care workers in pursuit to prevent the spread of SARS-CoV-2, the causative virus of COVID-19. Hand hygiene is one of the primary preventive measures to prevent the spread of harmful germs. Although ABHS are effective hand hygiene products and help reduce the transmission of pathogenic microorganisms, appropriate use of such products is necessary to ensure the maximum killing of pathogens and to prevent hazards associated with ABHS. The effectiveness of ABHS against different microorganisms, including SARS-CoV-2 is also documented, but proper knowledge on hand hygiene techniques, selection of appropriate hand sanitizer product, and safe handling of ABHS are required to avoid their adverse effects such as allergies, skin irritation, lung injury, fire hazards, and toxicities. The effectiveness of ABHS is dependent on several factors including its appropriate usage, manufacturing methods, the choice of active agents, and the appropriateness of the agent on the target pathogen. This article highlights the importance of proper usage, handling, and appropriate ABHS selection for maximum efficacy against intended pathogens and safe use of ABHS. User awareness can help promote the appropriate usage of ABHS and prevent its hazards, which ultimately can help in preventing the transmission of pathogenic microorganisms.

Effectiveness of antiviral metal and metal oxide thin-film coatings against human coronavirus 229E

Virucidal thin-film coatings have the potential to inactivate pathogens on surfaces, preventing or slowing their spread. Six potential nanoscale antiviral coatings, Cu, Cu2O, Ag, ZnO, zinc tin oxide (ZTO), and TiO2, are deposited on glass, and their ability to inactivate the HCoV-229E human coronavirus is assessed using two methods. In one method, droplets containing HCoV-229E are deposited on thin-film coatings and then collected after various stages of desiccation. In the second method, the thin-film coatings are soaked in the virus supernatant for 24 h. The Cu and Cu2O coatings demonstrate clear virucidal behavior, and it is shown that controlled delamination and dissolution of the coating can enhance the virucidal effect. Cu is found to produce a faster and stronger virucidal effect than Cu2O in the droplet tests (3 log reduction in the viral titer after 1 h of exposure), which is attributed, in part, to the differences in film adhesion that result in delamination of the Cu film from the glass and accelerated dissolution in the droplet. Despite Ag, ZnO, and TiO2 being frequently cited antimicrobial materials, exposure to the Ag, ZnO, ZTO, and TiO2 coatings results in no discernible change to the infectivity of the coronavirus under the conditions tested. Thin-film Cu coatings are also applied to the polypropylene fabrics of N95 respirators, and droplet tests are performed. The Cu fabric coating reduces the infectivity of the virus; it results in a 1 order-of-magnitude reduction in the viral titer within 15 min with a 2 order-of-magnitude reduction after 1 h.

The SARS-CoV-2 (COVID-19) pandemic in hospital: An insight into environmental surfaces contamination, disinfectants' efficiency, and estimation of plastic waste production

The current COVID-19 pandemic that is caused by SARS-CoV-2 has led all the people around the globe to implement preventive measures such as environmental cleaning using alcohol-based materials, and social distancing in order to prevent and minimize viral transmission via fomites. The role of environmental surface contamination in viral transmission in within hospital wards is still debatable, especially considering the spread of new variants of the virus in the world. The present comprehensive study aims to investigate environmental surface contamination in different wards of a hospital as well as the efficacy of two common disinfectants for virus inactivation, and tries to produce an estimate of plastic residue pollution as an environmental side effect of the pandemic. With regard to environmental surface contamination, 76 samples were taken from different wards of the hospital, from which 40 were positive. These samples were taken from contaminated environmental surfaces such as patient bed handles, the nursing station, toilet door handles, cell phones, patient toilet sinks, toilet bowls, and patient's pillows, which are regularly-touched surfaces and can pose a high risk for transmission of the virus. The number of positive samples also reveals that SARS-CoV-2 can survive on inanimate surfaces after disinfection by ethanol 70 % and sodium hypochlorite (0.001 %). The results correspond to the time that the VOC 202012/01 (lineage B.1.1.7) had emerged in the hospital and this should be considered that this variant could possibly have different traits, characteristics, and level of persistence in the environment. The plastic waste as an environmental side effect of the pandemic was also investigated and it was confirmed that the amount of plastic residue for a single (RT) PCR confirmatory test for COVID-19 diagnosis is 821.778 g of plastic residue/test. As a result, it is recommended that for improving plastic waste management programs, considering challenges such as minimizing plastic waste pollution, optimization of gas control technologies in incinerators, process redesign, reduction of single-use plastics and PPE, etc. Is of utmost importance.

Impact of the Coronavirus on Providing Oral Health Care in the Netherlands

OBJECTIVE

Transmission of SARS-CoV-2 during oral health care is potentially increased compared to regular social activities. Specific amendments to the Dutch national infection control guidelines were promulgated. This study aimed to map the impact of the coronavirus pandemic on providing oral health care during the first wave of the coronavirus pandemic in 2020 in the Netherlands.

METHODS

A cross-sectional web-based survey was sent via email to a representative sample of dental hygienists and dentists in the Netherlands.

RESULTS

Of the 1700 oral health care practitioners approached, 440 (25.9%) responded to the survey. Patient access to oral health care was severely restricted during the lockdown in the spring of 2020. A total of 1.6% of the oral health care practitioners had laboratory-confirmed COVID-19 during the study period, although this is likely to be an underrepresentation due to limited access to testing at that time. Over half of the participants perceived an increased risk of virus transmission during aerosol-generating treatments in their practices. A large majority (65.0%-87.1%) of the oral health care practitioners followed the COVID-19-specific amendments to the national infection control guidelines. Compared to the pre-pandemic period, additional personal protective equipment and protocols were applied. Factors related with compliance with the additional recommendations were age, employment status, and occupation.

CONCLUSIONS

The pandemic had a profound impact on both the accessibility and practice of oral health care. This survey study found that most Dutch oral health care practitioners paid extra attention to hygiene and infection control. Also, a low number of COVID-19 infections detected amongst Dutch oral health care practitioners was reported in the Netherlands. These overall outcomes suggest that safe oral health care can be provided when following the current infection control recommendations.

Innovative Textiles Used in Face Masks: Filtration Efficiency and Self-Disinfecting Properties against Coronaviruses

Within the current SARS-CoV-2 pandemic, personal protective equipment, including face masks, is one important tool to interrupt virus transmission chains within the community. In this context, the quality of different face masks is frequently discussed and should, therefore, be evaluated. In this study, nanofleece textiles with a particle filtering effect and textiles with a self-disinfecting treatment were examined, which may be combined in face masks. Firstly, newly developed nanofleece textiles were tested regarding their filtration efficiency against airborne coronavirus, using feline coronavirus (FCoV) as a surrogate for SARS-CoV-2. The tested nanofleece textiles showed filtration efficiencies of over 95% against FCoV when used as a double layer and were, therefore, almost on par with the FFP-2 mask material, which was used as a reference. Secondly, eight treated, self-disinfecting textiles, which may increase the safety in the handling of potentially contaminated masks, were tested against SARS-CoV-2. Three out of eight treated textiles showed significant activity against SARS-CoV-2 and achieved about three LOG10 (99.9%) of virus titer reduction after twelve hours of incubation. Since all possible transmission paths of SARS-CoV-2, as well as the minimal infection doses, remain unknown, both investigated approaches seem to be useful tools to lower the virus spread within the community.

Oxidative Inactivation of SARS-CoV-2 on Photoactive AgNPs@TiO2 Ceramic Tiles

The current SARS-CoV-2 pandemic causes serious public health, social, and economic issues all over the globe. Surface transmission has been claimed as a possible SARS-CoV-2 infection route, especially in heavy contaminated environmental surfaces, including hospitals and crowded public places. Herein, we studied the deactivation of SARS-CoV-2 on photoactive AgNPs@TiO₂ coated on industrial ceramic tiles under dark, UVA, and LED light irradiations. SARS-CoV-2 inactivation is effective under any light/dark conditions. The presence of AgNPs has an important key to limit the survival of SARS-CoV-2 in the dark; moreover, there is a synergistic action when TiO₂ is decorated with Ag to enhance the virus photocatalytic inactivation even under LED. The radical oxidation was confirmed as the the central mechanism behind SARS-CoV-2 damage/inactivation by ESR analysis under LED light. Therefore, photoactive AgNPs@TiO₂ ceramic tiles could be exploited to fight surface infections, especially during viral severe pandemics.

Microbial Air Quality in Healthcare Facilities

There is increasing evidence that indoor air quality and contaminated surfaces provide an important potential source for transmission of pathogens in hospitals. Airborne hospital microorganisms are apparently harmless to healthy people. Nevertheless, healthcare settings are characterized by different environmental critical conditions and high infective risk, mainly due to the compromised immunologic conditions of the patients that make them more vulnerable to infections. Thus, spread, survival and persistence of microbial communities are important factors in hospital environments affecting health of inpatients as well as of medical and nursing staff. In this paper, airborne and aerosolized microorganisms and their presence in hospital environments are taken into consideration, and the factors that collectively contribute to defining the infection risk in these facilities are illustrated.

Prevalence of SARS-CoV-2 RNA on inanimate surfaces: a systematic review and meta-analysis

Coronavirus disease (COVID-19) is a respiratory disease affecting many people and able to be transmitted through direct and perhaps indirect contact. Direct contact transmission, mediated by aerosols or droplets, is widely demonstrated, whereas indirect transmission is only supported by collateral evidence such as virus persistence on inanimate surfaces and data from other similar viruses. The present systematic review aims to estimate SARS-CoV-2 prevalence on inanimate surfaces, identifying risk levels according to surface characteristics. Data were obtained from studies in published papers collected from two databases (PubMed and Embase) with the last search on 1 September 2020. Included studies had to be papers in English, had to deal with coronavirus and had to consider inanimate surfaces in real settings. Studies were coded according to our assessment of the risk that the investigated surfaces could be contaminated by SARS-CoV-2. A meta-analysis and a metaregression were carried out to quantify virus RNA prevalence and to identify important factors driving differences among studies. Thirty-nine out of forty retrieved paper reported studies carried out in healthcare settings on the prevalence of virus RNA, five studies carry out also analyses through cell culture and six tested the viability of isolated viruses. Overall prevalences of SARS-CoV-2 RNA on high-, medium- and low-risk surfaces were 0.22 (CI₉₅ [0.152-0.296]), 0.04 (CI₉₅ [0.007-0.090]), and 0.00 (CI₉₅ [0.00-0.019]), respectively. The duration surfaces were exposed to virus sources (patients) was the main factor explaining differences in prevalence.