Stability of SARS-CoV-2 in different environmental conditions

Exploring possible strategies for treating SARS-CoV-2 in sewage wastewater: A review of current research and future directions

The advent of acute respiratory coronavirus disease (COVID-19) is convoyed by the shedding of the virus in stool. Although inhalation from person-to-person and aerosol/droplet transmission are the main modes of SARS-Coronavirus-2 (SARS-CoV-2) transmission, currently available evidence indicates the presence of viral RNA in the sewerage wastewater, which highlights the need for more effective corona virus treatment options. In the existing COVID-19 pandemic, a substantial percentage of cases shed SARS-CoV-2 viral RNA in their faeces. Hence the treating this sewerage wastewater with proper surveillance is essential to contain this deadly pathogen from further transmission. Since, the viral disinfectants will not be very effective on sewerage waste as organic matter, and suspended solids in water can protect viruses that adsorb to these particles. More effective methods and measures are needed to prevent this virus from spreading. This review will explore some potential methods to treat the SARS-CoV-2 infected sewerage wastewater, current research and future directions.

A robotic arm for safe and accurate control of biomedical equipment during COVID-19

Purpose

Hospital facilities and social life, along with the global economy, have been severely challenged by COVID-19 since the World Health Organization (WHO) declared it a pandemic in March 2020. Since then, countless ordinary citizens, as well as healthcare workers, have contracted the virus by just coming into contact with infected surfaces. In order to minimise the risk of getting infected by contact with such surfaces, our study aims to design, prototype, and test a new device able to connect users, such as common citizens, doctors or paramedics, with either common-use interfaces (e.g., lift and snack machine keyboards, traffic light push-buttons) or medical-use interfaces (e.g., any medical equipment keypad).

Method

To this purpose, the device was designed with the help of Unified Modelling Language (UML) schemes, and was informed by a risk analysis, that highlighted some of its essential requirements and specifications. Consequently, the chosen constructive solution of the robotic system, i.e., a robotic-arm structure, was designed and manufactured using computer-aided design and 3D printing.

Result

The final prototype included a properly programmed micro-controller, linked via Bluetooth to a multi-platform mobile phone app, which represents the user interface. The system was then successfully tested on different physical keypads and touch screens. Better performance of the system can be foreseen by introducing improvements in the industrial production phase.

Conclusion

This first prototype paves the way for further research in this area, allowing for better management and preparedness of next pandemic emergencies.

Assessment of SARS-CoV-2 Stability in human and environmental matrices, and potential hazards

In the context of the ongoing pandemic of COVID-19, SARS-CoV-2 was detected in human excreta and environmental matrices. The occurrence of SARS-CoV-2 in environmental compartments raises questions on its fate and stability in these matrices and its potential to spread in the exposed communities. This review focused on the stability of the SARS-CoV-2 in human excreta, wastewater, soils, crops, and other environmental matrices, that may be reached through human excreta and sewage products spreading. Little is known about the persistence and survival of SARS-CoV-2 in the environment. Up to now sewage sludge, soil and crops are seldom investigated implying the convenience of considering future researches focusing on SARS-CoV-2 in soils receiving wastewater and sewage sludge, as well as on grown crops. Information regarding SARS-CoV-2 persistence in environmental media is crucial to establish and implement effective policies and measures for mitigating the transmission of COVID-19 and tackling eventual future outbreaks.

Usefulness of open data to determine the incidence of COVID-19 and its relationship with atmospheric variables in Spain during the 2020 lockdown

The SARS-CoV-2 pandemic and the spread of the COVID-19 disease led to a lockdown being imposed in Spain to minimise contagion from 16 March 2020 to 1 May 2020. Over this period, measures were taken to reduce population mobility (a key factor in disease transmission). The scenario thus created enabled us to examine the impact of factors other than mobility (in this case, meteorological conditions) on the incidence of the disease, and thus to identify which environmental variables played the biggest role in the pandemic's evolution. Worthy of note, the data required to perform the study was entirely extracted from governmental open data sources. The present work therefore demonstrates the utility of such data to conduct scientific research of interest to society, leading to studies that are also fully reproducible. The results revealed a relationship between temperatures and the spread of COVID-19. The trend was that of a slightly lower disease incidence as the minimum temperature rises, i.e. the lower the minimum temperature, the greater the number of cases. Furthermore, a link was found between the incidence of the disease and other variables, such as altitude and proximity to the sea. There were no indications, however, in the study's data, of a relationship between incidence and precipitation or wind.

Designing Self-Inhibitory fusion peptide analogous to viral spike protein against novel severe acute respiratory syndrome (SARS-CoV-2)

COVID-19 is a highly contagious viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is declared pandemic by the World Health Organization (WHO). The spike protein of SARS-CoV-2 is a key component playing a pivotal role in facilitating viral fusion as well as release of genome into the host cell. Till date there is no clinically approved vaccine or drug available against Covid-19. We designed four hydrophobic inhibitory peptides (ITPs) based on WWIHS (Wimley and White interfacial hydrophobicity scale) score, targeting the HR1 domain of spike protein. Two inhibitory peptides out of four have a strong affinity to the hydrophobic surface of HR1 domain in pre-fusion spike protein. The MD simulation result showed the strong accommodation of ITPs with HR1 domain surface. These self-inhibitory peptides mimic the function of HR2 by binding to HR1 domain, thus inhibiting the formation of HR1-HR2 post-fusion complex, which is a key structure for virus-host tropism.Communicated by Ramaswamy H. Sarma.

Persistence and occurrence of SARS-CoV-2 in water and wastewater environments: a review of the current literature

As the world continues to cope with the COVID-19 pandemic, emerging evidence indicates that respiratory transmission may not the only pathway in which the virus can be spread. This review paper aims to summarize current knowledge surrounding possible fecal-oral transmission of SARS-CoV-2. It covers recent evidence of proliferation of SARS-CoV-2 in the gastrointestinal tract, as well as presence and persistence of SARS-CoV-2 in water, and suggested future directions. Research indicates that SARS-CoV-2 can actively replicate in the human gastrointestinal system and can subsequently be shed via feces. Several countries have reported SARS-CoV-2 RNA fractions in wastewater systems, and various factors such as temperature and presence of solids have been shown to affect the survival of the virus in water. The detection of RNA does not guarantee infectivity, as current methods such as RT-qPCR are not yet able to distinguish between infectious and non-infectious particles. More research is needed to determine survival time and potential infectivity, as well as to develop more accurate methods for detection and surveillance.

The propensity of fomite spread of SARS-CoV-2 virus through produce supply chain

BACKGROUND

The global community has battled the spread of SAR-CoV-2 for almost 2 years, and the projection is that the virus may be recurrent like the seasonal flu. The SARS-CoV-2 pandemic disrupted activities within the food supply chain that cost billions of dollars globally. This has heightened concerns about fomite spread of the virus through surfaces. There is an urgent need to understand the risk portends by this virus along the produce supply chain with conditions (low temperature and high relative humidity) conducive to extended survival of the virus.

MAIN BODY

Pre-dating SARS-CoV-2 are other types of coronaviruses that had lower infection and mortality rates. There are some similarities between the former and the new coronavirus, especially with regards to transmission modes and their survivability on surfaces. There is evidence of other coronaviruses' survival on surfaces for weeks. Currently, there are limited evidence-based studies to enlighten us on how the virus is transmitted within the produce supply chain. A few studies claim that the virus could spread through the cold supply chains. However, these are not sufficient to make a conclusive inference about the deadly SARS-CoV-2.

CONCLUSIONS

This paper provides a succinct review of the literature on current understanding of the transmission, survivability, and risk SARS-CoV-2 portend to humans within the produce supply chain and calls for more evidence-based research to allay or alert us of the potential risk of fomite transmission of SARS-CoV-2. The paper also highlights examples of conventional and novel non-thermal inactivation and sanitation methods applicable to this type of virus.

Transmission of SARS-CoV-2 on Cold-Chain Food: Precautions Can Effectively Reduce the Risk

The COVID-19 pandemic has generated a new era in the world, also in the food safety. Up to now, there is no evidence to suggest that people can infect COVID-19 via food contaminated by SARS-CoV-2. Here, we analyzed the results of regular SARS-CoV-2 nucleic acid testing of considerable cold-chain food practitioners, cold-chain food surfaces, and their internal or external packaging as well as their associated environments, aiming to explore the risk of cold-chain food being contaminated by SARS-CoV-2 and the probability of people infecting COVID-19 through contaminated cold-chain food in the context of COVID-19 epidemic. This study found that only two batches of cold-chain food were contaminated by SARS-CoV-2, none of the cold-chain food handler were infected due to effective regulatory measures for cold-chain food. Therefore, effective supervision and preventive methods could effectively reduce the transmission risk of SARS-CoV-2 on cold-chain food.

Occurrence of SARS-CoV-2 in excreta, sewage, and environment: epidemiological significance and potential risks

The detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients' excreta raises the issue of its occurrence and fate in sewage. This review has focused on the presence of the SARS-CoV-2 in human excreta, wastewater, sewage sludge, and river waters. It explored the potential use of the wastewater-based epidemiology approach to report on the situation of current and eventual future SARS-CoV-2 outbreaks. The main concern of the occurrence of SARS-CoV-2 in the environment is the public health risks at sites of sewage products disposal and reuse, especially in low-income countries with inadequate sanitation, where direct discharge and reuse of raw sewage are common practices. The review also addressed the role sewage-irrigated agriculture can have in SARS-CoV-2 spread in the environmental compartments reached through sewage products application. An overview was made on the interest of sewage management, water safety, and hygienic practices for controlling the environmental dissemination of SARS-CoV-2.

A Novel Antipathogenic Agent for Nonwoven Fabric

Medical-grade masks and N95 respirators containing non-woven fibers are designed to prevent the spread of airborne diseases. While they effectively trap respiratory droplets and aerosols, they cannot lyse entrapped pathogens. Embedded antimicrobial agents such as silver, copper, zinc, iodine, peptides, quaternary ammonium salts, or nanoparticles have been used to overcome this limitation. However, their effectiveness remains debatable because these materials can be toxins, allergens, irritants, and environmental hazards. Recently, silicon nitride (Si3N4) was found to be a potent antipathogenic compound, and it may be an ideal agent for masks. In powder or solid form, it is highly effective in inactivating bacteria, fungi, and viruses while leaving mammalian tissue unaffected. The purpose of this study was to serially assess the antiviral efficacy of Si3N4 against SARS-CoV-2 using powders, solids, and embedded nonwoven fabrics. Si3N4 powders and solids were prepared using conventional ceramic processing. The “pad-dry-cure” method was used to embed Si3N4 particles into polypropylene fibers. Fabric testing was subsequently conducted using industrial standards—ISO 18184 for antiviral effectiveness, ASTM F2299 and EN 13274-7 for filtration efficiency, EN 14683 for differential pressure drop, and ISO 18562-2 for particle shedding. A modification of ISO 18562-3 was also employed to detect ammonia release from the fabric. Antiviral effectiveness for Si3N4 powders, solids, and embedded fabrics were 99.99% at ≤ 5 min, ~ 93% in 24 h, and 87% to 92% in 120 min, respectively. Results of the standard mask tests were generally within prescribed safety limits. Further process optimization may lead to commercial Si3N4-based masks that not only “catch” but also “kill” pathogenic microbes.

Regressing SARS-CoV-2 Sewage Measurements Onto COVID-19 Burden in the Population: A Proof-of-Concept for Quantitative Environmental Surveillance

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus, a member of the coronavirus family of respiratory viruses that includes severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East respiratory syndrome (MERS). It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries during the past 8 months. Widespread testing and tracing efforts are being employed in many countries in attempts to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common and that the virus RNA can be detected in wastewater. This indicates that wastewater monitoring may provide a potentially efficient tool for the epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. In particular, this provides important means of (i) estimating the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements, (ii) managing the early-warning system quantitatively and efficiently, and (iii) verifying disease elimination. Here we report different virus concentration methods using polyethylene glycol (PEG), alum, or filtration techniques as well as different RNA extraction methodologies, providing important insights regarding the detection of SARS-CoV-2 RNA in sewage. Virus RNA particles were detected in wastewater in several geographic locations in Israel. In addition, a correlation of virus RNA concentration to morbidity was detected in Bnei-Barak city during April 2020. This study presents a proof of concept for the use of direct raw sewage-associated virus data, during the pandemic in the country as a potential epidemiological tool.

Dentistry pathways of coronaviruses transmission: a review

The nCoV-19 in a short period of time, in lower than two months has been spread as a pandemic in all over the world. This novel type of Coronavirus which shows itself with coughing, sneezing, fatigue and respiratory symptoms which is similar to cold illness has killed more than 100,000 people. However, many protocols have been established to minimize the number of infected people, but without any border and regardless the nationality, this virus has been spread in all countries. In this review, with broad mechanistic and interdisciplinary consideration the dentistry pathways of transmission, physiology, effective and available drugs and their biological inhibiting pathways have been discussed. Among many reasons that have caused higher rate of spreading, the dental services and surgeries involve to professional-patient close contacts could be seen as one of the probable pathways of transmission for this virus. According to the more recently reported literatures, the blueprint of many individual and instrumental reasons in dentistry, could be observed in nCoV-19 infection and spreading which raise the concern of the professionals about the efficiency of conventional antiviral methods. So, results of many studies attributed to the facts that the superhydrophobic antiviral materials and surfaces are potential candidates for designing dentistry instruments with more antiviral properties.

Surface contamination with SARS-CoV-2: A systematic review

Little is known about contaminated surfaces as a route of transmission for SARS-CoV- 2 and a systematic review is missing and urgently needed to provide guidelines for future research studies. As such, the aim of the present study was to review the current scientific knowledge and to summarize the existing studies in which SARS-CoV-2 has been detected in inanimate surfaces. This systematic review includes studies since the emergence of SARS-CoV-2, available in PubMed/MEDLINE and Scopus. Duplicate publications were removed, and exclusion criteria was applied to eliminate unrelated studies, resulting in 37 eligible publications. The present study provides the first overview of SARS-CoV-2 detection in surfaces. The highest detection rates occurred in hospitals and healthcare facilities with COVID-19 patients. Contamination with SARS-CoV-2 on surfaces was detected in a wide range of facilities and surfaces. There is a lack of studies performing viability testing for SARS-CoV-2 recovered from surfaces, and consequently it is not yet possible to assess the potential for transmission via surfaces.

Estimation and optimal control of the multiscale dynamics of Covid-19: a case study from Cameroon

This work aims at a better understanding and the optimal control of the spread of the new severe acute respiratory corona virus 2 (SARS-CoV-2). A multi-scale model giving insights on the virus population dynamics, the transmission process and the infection mechanism is proposed first. Indeed, there are human to human virus transmission, human to environment virus transmission, environment to human virus transmission and self-infection by susceptible individuals. The global stability of the disease-free equilibrium is shown when a given threshold T 0 is less or equal to 1 and the basic reproduction number R 0 is calculated. A convergence index T 1 is also defined in order to estimate the speed at which the disease extincts and an upper bound to the time of infectious extinction is given. The existence of the endemic equilibrium is conditional and its description is provided. Using Partial Rank Correlation Coefficient with a three levels fractional experimental design, the sensitivity of  R 0 , T 0 and T 1 to control parameters is evaluated. Following this study, the most significant parameter is the probability of wearing mask followed by the probability of mobility and the disinfection rate. According to a functional cost taking into account economic impacts of SARS-CoV-2, optimal fighting strategies are determined and discussed. The study is applied to real and available data from Cameroon with a model fitting. After several simulations, social distancing and the disinfection frequency appear as the main elements of the optimal control strategy against SARS-CoV-2.

COVID-19: The impact in US high-rise office buildings energy efficiency

The COVID-19 pandemic, through stay-at-home orders, forced rapid changes to social human behavior and interrelations, targeting the work environments to protect workers and users. Rapidly, global organizations, US associations, and professionals stepped in to mitigate the virus's spread in buildings' living and work environments. The institutions proposed new HVAC settings without efficiency concerns, as improved flow rates and filtering for irradiation, humidity, and temperature. Current literature consensually predicted an increase in energy consumption due to new measures to control the SARS-CoV-2 spread. The research team assumed the effort of validating the prior published outcomes, applied to US standardized high-rise office buildings, as defined and set by the key entities in the field, by resorting to a methodology based on software energy analysis. The study compares a standard high-rise office building energy consumption, CO₂ emissions and operations costs in nine US climate zones - from 0 to 8, south to north latitudes, respectively -, assessed in the most populated cities, between the previous and post COVID-19 scenarios. The outcomes clarify the gathered knowledge, explaining that climate zones above mixed-humid type tend to increase relative energy use intensity by 21.72%, but below that threshold the zones decrease relative energy use intensity by 11.92%.

Effect of gamma irradiation on filtering facepiece respirators and SARS-CoV-2 detection

To cope with the shortage of filtering facepiece respirators (FFRs) during the coronavirus (COVID-19) pandemic, healthcare institutions were forced to reuse FFRs after applying different decontamination methods including gamma-irradiation (GIR). The aim of this study was to evaluate the effect of GIR on the filtration efficiency (FE) of FFRs and on SARS-CoV-2 detection. The FE of 2 FFRs types (KN95 and N95-3 M masks) was assessed at different particle sizes (0.3-5 µm) following GIR (0-15 kGy) delivered at either typical (1.65 kGy/h) or low (0.5088 kGy/h) dose rates. The detection of two SARS-CoV-2 RNA genes (E and RdRp4) following GIR (0-50 kGy) was carried out using RT-qPCR assay. Both masks showed an overall significant (P < 0.001) reduction in FE with increased GIR doses. No significant differences were observed between GIR dose rates on FE. The GIR exhibited significant increases (P ≤ 0.001) in the cycle threshold values (ΔCt) of both genes, with no detection following high doses. In conclusion, complete degradation of SARS-CoV-2 RNA can be achieved by high GIR (≥ 30 kGy), suggesting its potential use in FFRs decontamination. However, GIR exhibited adverse effects on FE in dose- and particle size-dependent manners, rendering its use to decontaminate FFRs debatable.

From the environment to the cells: An overview on pivotal factors which affect spreading and infection in COVID-19 pandemic

Several factors ranging from environmental risks to the genetics of the virus and that of the hosts, affect the spread of COVID-19. The impact of physicochemical variables on virus vitality and spread should be taken into account in experimental and clinical studies. Another avenue to explore is the effect of diet and its interaction with the immune system on SARS-CoV-2 infection and mortality rate. Past year have witnessed extensive studies on virus and pathophysiology of the COVID-19 disease and the cellular mechanisms of virus spreading. However, our knowledge has not reached a level where we plan an efficient therapeutic approach to prevent the virus entry to the cells or decreasing the spreading and morbidity in severe cases of disease. The risk of infection directly correlates with the control of virus spreading via droplets and aerosol transmission, as well as patient immune system response. A key goal in virus restriction and transmission rate is to understand the physicochemical structure of aerosol and droplet formation, and the parameters that affect the droplet-borne and airborne in different environmental conditions. The lifetime of droplets on different surfaces is described based on the contact angle. Hereby, we recommend regular use of high-quality face masks in high temperature and low humidity conditions. However, in humid and cold weather conditions, wearing gloves and frequently hand washing, gain a higher priority. Additionally, social distancing rules should be respected in all aforementioned conditions. We will also discuss different routes of SARS-CoV-2 entry into the cells and how multiple genetic factors play a role in the spread of the virus. Given the role of environmental and nutritional factors, we discuss and recommend some strategies to prevent the disease and protect the population against COVID-19. Since an effective vaccine can prevent the transmission of communicable diseases and abolish pandemics, we added a brief review of candidate SARS-CoV-2 vaccines.

Critical Capability Needs for Reduction of Transmission of SARS-CoV-2 Indoors

Coordination of efforts to assess the challenges and pain points felt by industries from around the globe working to reduce COVID-19 transmission in the indoor environment as well as innovative solutions applied to meet these challenges is mandatory. Indoor infectious viral disease transmission (such as coronavirus, norovirus, influenza) is a complex problem that needs better integration of our current knowledge and intervention strategies. Critical to providing a reduction in transmission is to map the four core technical areas of environmental microbiology, transmission science, building science, and social science. To that end a three-stage science and innovation Summit was held to gather information on current standards, policies and procedures applied to reduce transmission in built spaces, as well as the technical challenges, science needs, and research priorities. The Summit elucidated steps than can be taken to reduce transmission of SARS-CoV-2 indoors and calls for significant investments in research to enhance our knowledge of viral pathogen persistence and transport in the built environment, risk assessment and mitigation strategy such as processes and procedures to reduce the risk of exposure and infection through building systems operations, biosurveillance capacity, communication form leadership, and stakeholder engagement for optimal response. These findings reflect the effective application of existing knowledge and standards, emerging science, and lessons-learned from current efforts to confront SARS-CoV-2.

Which strategy for using medical and community masks? A prospective analysis of their environmental impact

INTRODUCTION

The use of personal protective equipment, especially medical masks, increased dramatically during the COVID-19 crisis. Medical masks are made of synthetic materials, mainly polypropylene, and a majority of them are produced in China and imported to the European market. The urgency of the need has so far prevailed over environmental considerations.

OBJECTIVE

Assess the environmental impact of different strategies for the use of face mask.

METHOD

A prospective analysis was conducted to assess the environmental impact of different strategies for the use of medical and community masks. Eight scenarios, differentiating the typologies of masks and the modes of reuse are compared using three environmental impact indicators: the Global Warming Potential (GWP100), the ecological scarcity (UBP method, from German 'Umweltbelastungpunkte') and the plastic leakage (PL). This study attempts to provide clear recommendations that consider both the environmental impact and the protective effectiveness of face masks used in the community.

RESULTS

The environmental impact of single-use masks is the most unfavourable, with a GWP of 0.4-1.3 kg CO2 eq., depending on the transport scenario, and a PL of 1.8 g, for a 1 month protection against COVID-19. The use of home-made cotton masks and prolonged use of medical masks through wait-and-reuse are the scenarios with the lowest impact.

CONCLUSION

The use of medical masks with a wait and reuse strategy seems to be the most appropriate when considering both environmental impact and effectiveness. Our results also highlight the need to develop procedures and the legal/operational framework to extend the use of protective equipment during a pandemic.

Plastic Pollution by COVID-19 Pandemic: An Urge for Sustainable Approaches to Protect the Environment

COVID-19 pandemic has created a prolonged impact globally and destructed the life all over the world. The necessary use of personal protective equipments, masks, gloves and other plastic products has to some extent reduced transmission of virus. However, the impact of plastic waste generated worldwide due to the pandemic has affected the environment globally. The coronavirus disease (COVID-19) has destructed and altered every part of life and environment globally. Potential impacts on the environment are seen due to the transmission of virus as well as a slowdown in economic activities as lockdown prevails. Increased biomedical waste, improper usage and disposal of surgical masks, disinfectants, gloves, and increasing plastics wastes from domestic households continuously endangers environment. Not only it has an impact on environment, but also deteriorates human health in the future. Global environmental sustainability is necessitated to overcome the plastic pollution problem and facilitate strategies to recycle and reuse plastics products. This review highlights the influence of COVID-19 on wastes generated by plastic products along with environmental challenges and repercussions. Also, measures to combat the plastic pollution problem have to be implemented for future protection and safety of the environment.

Exposure Profile of Severe Acute Respiratory Syndrome Coronavirus 2 in Canadian Food Sources

ABSTRACT

A new coronavirus strain known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide. This virus is the causative agent for coronavirus disease 2019 (COVID-19) and spreads primarily through human-to-human transmission via infected droplets and aerosols generated by infected persons. Although COVID-19 is a respiratory virus, the potential for transmission of SARS-CoV-2 via food is considered theoretically possible and remains a concern for Canadian consumers. We have conducted an exposure assessment of the likelihood of exposure of SARS-CoV-2 in Canadian food sources at the time of consumption. This article describes the exposure routes considered most relevant in the context of food contamination with SARS-CoV-2, including contaminated food of animal origin, other contaminated fresh foods, fomites, and SARS-CoV-2-contaminated feces. The likelihood of foodborne infection of SARS-CoV-2 via the human digestive tract also was considered. Our analysis indicates that there is no evidence that foodborne transmission of SARS-CoV-2 has occurred, and we consider the likelihood of contracting COVID-19 via food and food packaging in Canada as low to remote. Adherence to safe food practices and cleaning procedures would in any case prevent a potential foodborne infection with SARS-CoV-2.

HIGHLIGHTS

Disinfection Measures during COVID-19 for Dental Operatories

Background:

In the dental health-care setups, the environmental object and surfaces are expected to be infected by the COVID virus wherein definite procedures are performed. Consequently, these objects and surfaces, particularly where COVID-19 patients are being treated, must be appropriately cleaned and sanitized to stop further spread.

Objective:

The present article is intended for providing protocols about the cleaning and disinfection of objects and surfaces in the circumstances of COVID-19 for Dental operatories.

Methods:

Studies evaluating the surface characteristics of the virus as well as effective disinfection measures have been documented.

Results:

Various chemicals in different concentrations have a virocidal effect. The devices introduced include used UV radiation and ozone.

Conclusion:

These changes in dental clinical practice are needed to save humanity by preventing further transmission of disease.

Questioning COVID-19 Surface Stability and Fomite Spreading in Three Aeromedical Cases: A Case Series

It is well established that coronavirus disease 2019 is primarily transmitted through respiratory droplets, and there is mounting research speculation that it may also be transmitted via fomites. Several studies have shown that the virus can persist on both porous and nonporous surfaces for hours to days, depending upon the material. This article examines three cases of polymerase chain reaction–proven severe acute respiratory syndrome coronavirus 2 infection with several additional individuals meeting CDC close contact criteria. In 1 case, 195 downstream contacts were all tested to prevent a mass outbreak in a deployment posture. Analysis of these contacts yielded only a single positive test, which could be reasonably ascribed to respiratory droplet transmission. While these cases and their contacts ultimately represent a small sample size, we suggest fomite spread may not be a significant means of transmission for severe acute respiratory syndrome coronavirus 2 in real-world operational scenarios.

Point of care detection of COVID-19: Advancement in biosensing and diagnostic methods

The recent outbreak of COVID-19 has created much inconvenience and fear that the virus can seriously affect humans, causing health hazards and death. This pandemic has created much worry and as per the report by World Health Organization (WHO), more than 43 million individuals in 215 countries and territories were affected. People around the world are still struggling to overcome the problems associated with this pandemic. Of all the available methods, reverse-transcriptase polymerase chain reaction (RT-PCR) has been widely practiced for the pandemic detection even though several diagnostic tools are available having varying accuracy and sensitivity. The method offers many advantages making it a life-saving tool, but the method has the limitation of transporting to the nearest pathology lab, thus limiting its application in resource limited settings. This has a risen a crucial need for point-of-care devices for on-site detection. In this venture, biosensors have been used, since they can be applied immediately at the point-of-care. This review will discuss about the available diagnostic methods and biosensors for COVID-19 detection.

SARS-CoV-2 in the environment-Non-droplet spreading routes

The new coronavirus SARS-CoV-2, first identified in Wuhan (China) in December 2019, represents the same family as the Serve Acute Respiratory Syndrome Coronavirus-1 (SARS-CoV-1). These viruses spread mainly via the droplet route. However, during the pandemic of COVID-19 other reservoirs, i.e., water (surface and ground), sewage, garbage, or soil, should be considered. As the infectious SARS-CoV-2 particles are also present in human excretions, such a non-droplet transmission is also possible. A significant problem is the presence of SARS-CoV-2 in the hospital environment, including patients' rooms, medical equipment, everyday objects and the air. Relevant is selecting the type of equipment in the COVID-19 hospital wards on which the virus particles persist the shortest or do not remain infectious. Elimination of plastic objects/equipment from the environment of the infected person seems to be of great importance. It is particularly relevant in water reservoirs contaminated with raw discharges. Wastewater may contain coronaviruses and therefore there is a need for expanding Water-Based Epidemiology (WBE) studies to use obtained values as tool in determination of the actual percentage of the SARS-CoV-2 infected population in an area. It is of great importance to evaluate the available disinfection methods to control the spread of SARS-CoV-2 in the environment. Exposure of SARS-CoV-2 to 65-70% ethanol, 0.5% hydrogen peroxide, or 0.1% sodium hypochlorite has effectively eliminated the virus from the surfaces. Since there are many unanswered questions about the transmission of SARS-CoV-2, the research on this topic is still ongoing. This review aims to summarize current knowledge on the SARS-CoV-2 transmission and elucidate the viral survival in the environment, with particular emphasis on the possibility of non-droplet transmission.

Could thermodynamics and heat and mass transfer research produce a fundamental step advance toward and significant reduction of SARS-COV-2 spread?

We are living an extraordinary season of uncertainty and danger, which is caused by SARS-Cov-2 infection and consequent COVID-19 infection. This preliminary study comes from both a mix of entrepreneurial experience and scientific research. It is aimed by the exigency to reach a new and more effective analysis of the risks on the filed and to reduce them inside a necessary cooperation process which may regard both research and some of the economic activities which are damaged by passive protection measures such as indiscriminate lockdowns. This global emergency requires specific efforts by any discipline that regards specific problems which need to be solved urgently. The characteristic airborne diffusion patterns of COVID-19 shows that the airborne presence of viruses depends on multiple factors which include the dimension of microdroplets emitted by a contagious person, the atmospheric temperature and humidity, the presence of atmospheric particulate and pollution, which may act as a transport vehicle for the virus. The pandemic diffusion shows a particular correlation with the air quality and levels of atmospheric pollution. Specific problems need to solved to understand better the virus, its reliability, diffusion, replication, how it attacks the persons and the conditions, which drives to both positive and deadly evolution of the illness. Most of these problems may benefit from the contribution from both heat and mass transfer and the unsteady thermodynamics of living systems which evolves according to constructal law. After the bibliographic research on the virus, emissive and spread modes, and consequent today adopted protection, a detailed analysis of the contributions which may be assessed by research in thermodynamics, heat and mass transfer, technical and chemical physics. Some possible areas of research have been identified and discussed to start an effective mobilization which may support the effort of the research toward a significant reduction of the impacts of the pandemic infection and the economic risks of new generalized lockdowns.

Rapid Assessment of SARS-CoV-2 Transmission Risk for Fecally Contaminated River Water

Following the outbreak of severe acute respiratory syndrome coronavirus (SARS-CoV-2), airborne water droplets have been identified as the main transmission route. Identifying and breaking all viable transmission routes are critical to stop future outbreaks, and the potential of transmission by water has been highlighted. By modifying established approaches, we provide a method for the rapid assessment of the risk of transmission posed by fecally contaminated river water and give example results for 39 countries. The country relative risk of transmission posed by fecally contaminated river water is related to the environment and the populations' infection rate and water usage. On the basis of in vitro data and using temperature as the primary controller of survival, we then demonstrate how viral loads likely decrease after a spill. These methods using readily available data suggest that sewage spills into rivers within countries with high infection rates could provide infectious doses of >40 copies per 100 mL of water. The approach, implemented in the supplementary spreadsheet, can provide a fast estimate of the upper and lower viral load ranges following a riverine spill. The results enable evidence-based research recommendations for wastewater epidemiology and could be used to evaluate the significance of fecal-oral transmission within freshwater systems.

Challenges, Strategies, and Recommendations for the Huge Surge in Plastic and Medical Waste during the Global COVID-19 Pandemic with Circular Economy Approach

After December 2019, the globe was affected by a new coronavirus (SARS-CoV-2) that causes severe respiratory illnesses, which is responsible for increasing environmental problem consequences related to the extra consumption of medical waste and single-use plastics (such as personal protective equipment (PPE) and packaging plastics). Although the consumption of these plastics protects our life during this crisis, it is pivotal to move toward plastic recycling processes and environmentally friendly and sustainable alternatives, like bio-based degradable plastics with a circular economy perspective. This review article collected scattered information and provided a future perspective on how worldwide COVID-19 disruption can perform as a catalyst to improve plastic and medical waste management. Additionally, this paper illustrates the most effective disinfection technologies for COVID-19 wastes, such as high/low heat technologies and chemical disinfection, and PPE reusing processes, including dry heat, vaporized hydrogen peroxide, ozone, and UV light during the outbreak. In this vein, medical waste treatment facilities must be more automatic, with a minimum of personnel involved. Moreover, some recent valid guidelines from different international organizations and countries, future outlook, and practical recommendations that could be effective during this epidemic or even in the post-pandemic world for plastic and medical waste management were provided. Ultimately, governments should improve their waste management because of the potential of pathogen transmission or increased plastic and medical waste generation and try to enhance the environmental knowledge of society. People also should revise their viewpoints on plastic consumption by elevating sustainable behaviors, abandoning old habits, and adjusting to novel ones.

Ozone potential to fight against SAR-COV-2 pandemic: facts and research needs

The greatest challenge the world is facing today is to win the battle against COVID-19 pandemic as soon as possible. Until a vaccine is available, personal protection, social distancing, and disinfection are the main tools against SARS-CoV-2. Although it is quite infectious, the SARS-CoV-2 virus itself is an enveloped virus that is relatively fragile because its protective fatty layer is sensitive to heat, ultraviolet radiation, and certain chemicals. However, heat and liquid treatments can damage some materials, and ultraviolet light is not efficient in shaded areas, so other disinfection alternatives are required to allow safe re-utilization of materials and spaces. As of this writing, evidences are still accumulating for the use of ozone gas as a disinfectant for sanitary materials and ambient disinfection in indoor areas. This paper reviews the most relevant results of virus disinfection by the application of gaseous ozone. The review covers disinfection treatments of both air and surfaces carried out in different volumes, which varies from small boxes and controlled chambers to larger rooms, as a base to develop future ozone protocols against COVID-19. Published papers have been critically analyzed to evaluate trends in the required ozone dosages, as a function of relative humidity (RH), contact time, and viral strains. The data have been classified depending on the disinfection objective and the volume and type of the experimental set-up. Based on these data, conservative dosages and times to inactivate the SARS-CoV-2 are estimated. In small chambers, 10-20 mg ozone/m3 over 10 to 50 min can be sufficient to significantly reduce the virus load of personal protection equipment. In large rooms, 30 to 50 mg ozone/m3 would be required for treatments of 20-30 min. Maximum antiviral activity of ozone is achieved at high humidity, while the same ozone concentrations under low RH could result inefficient. At these ozone levels, safety protocols must be strictly followed. These data can be used for reducing significantly the viral load although for assuring a safe disinfection, the effective dosages under different conditions need to be confirmed with experimental data.

SARS-CoV-2 as Enteric Virus in Wastewater: Which Risk on the Environment and Human Behavior?

Microorganisms such as viruses, bacteria, and protozoa are the cause of many waterborne human infections. These microbes are either naturally present in aquatic environments or transferred within them by fecal sources. They remain in these environments for varying lengths of time before contaminating a new host. With the emergence of the COVID-19 pandemic, some studies have reported the presence of viral nucleic acids in stool samples from COVID-19 patients, suggesting the possibility of fecal-oral transmission. The SARS-CoV-2 RNA was thereby detected in the wastewater of symptomatic and asymptomatic people with a risk to human and environmental health. In this work, we try to discuss the different potential sources of this contamination, the forms of persistence in the environment, the techniques of partial elimination, and the possibility of creating new reservoirs.

SiO2-Ag Composite as a Highly Virucidal Material: A Roadmap that Rapidly Eliminates SARS-CoV-2

COVID-19, as the cause of a global pandemic, has resulted in lockdowns all over the world since early 2020. Both theoretical and experimental efforts are being made to find an effective treatment to suppress the virus, constituting the forefront of current global safety concerns and a significant burden on global economies. The development of innovative materials able to prevent the transmission, spread, and entry of COVID-19 pathogens into the human body is currently in the spotlight. The synthesis of these materials is, therefore, gaining momentum, as methods providing nontoxic and environmentally friendly procedures are in high demand. Here, a highly virucidal material constructed from SiO2-Ag composite immobilized in a polymeric matrix (ethyl vinyl acetate) is presented. The experimental results indicated that the as-fabricated samples exhibited high antibacterial activity towards Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) as well as towards SARS-CoV-2. Based on the present results and radical scavenger experiments, we propose a possible mechanism to explain the enhancement of the biocidal activity. In the presence of O2 and H2O, the plasmon-assisted surface mechanism is the major reaction channel generating reactive oxygen species (ROS). We believe that the present strategy based on the plasmonic effect would be a significant contribution to the design and preparation of efficient biocidal materials. This fundamental research is a precedent for the design and application of adequate technology to the next-generation of antiviral surfaces to combat SARS-CoV-2.

Chlorine Solutions for a Safe Method of Decontamination of Breast Pump Milk Collection Kits Before and After the Coronavirus Disease 2019 Pandemic

To promote breast feeding and breast pumping is essential for the most vulnerable infants even if the current coronavirus disease 2019 (COVID-19) pandemic sanitary crisis imposes more stringent hygienic measures. As recommended by the Centers for Disease Control and Prevention, World Health Organization, and Milk Bank Association, "after each pumping session, all pump part that come into contact with breast milk should be appropriately disinfected." The present study proposed different methods than can be used and focus on the safety analysis of chlorine solution (CS) in terms of residual hypochlorous acid (HCA) and total trihalomethanes (THM). We also performed an efficacy testing of the CS approach to decontaminate the devices used to collect the milk (breast pumps and bottles). The bacteriologic results of 1,982 breast pump milk samples collected in three different settings showed a major decrease of the microbial contamination using either sterile device or decontamination with CS compared to a simple soap washing. The main messages from our study are to propose a guideline for the safe use of CS and to define situations when breast pump decontamination might be necessary: vulnerable babies for which sterile device is recommended; special circumstances, for example the current COVID-19 pandemic; special situations, for example women living in precarious conditions; or women pumping their milk at work but that would have low or no access to boiled water. Overall, cold decontamination reduced losses of milk for bacteriological reasons in human milk banks and may also be interesting to prevent horizontal contamination by virus like COVID-19.

Coronavirus 2 (SARS-CoV-2) in water environments: Current status, challenges and research opportunities

The outbreak of COVID-19 has posed enormous health, social, environmental and economic challenges to the entire human population. Nevertheless, it provides an opportunity for extensive research in various fields to evaluate the fate of the crisis and combat it. The apparent need for imperative research in the biological and medical field is the focus of researchers and scientists worldwide. However, there are some new challenges and research opportunities in the field of water and wastewater treatment concerning the novel coronavirus 2 (SARS-CoV-2). This article briefly summarizes the latest literature reporting the presence of SARS-CoV-2 in water and wastewater/sewage. Furthermore, it highlights the challenges, potential opportunities and research directions in the water and wastewater treatment field. Some of the significant challenges and research opportunities are the development of standard techniques for the detection and quantification of SARS-CoV-2 in the water phase, assessment of favorable environments for its survival and decay in water; and development of effective strategies for elimination of the novel virus from water. Advancement in research in this domain will help to protect the environment, human health, and managing this type of pandemic in the future.

Occurrence, fate and removal of SARS-CoV-2 in wastewater: Current knowledge and future perspectives

The coronavirus disease 2019 (COVID-19), a pandemic of global concern, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recently, many studies have documented the detection of SARS-CoV-2 in human excreta and wastewater. The presence of SARS-CoV-2 in human excreta and wastewater poses serious implications for wastewater treatment. Thus, this review aims to understand the fate of SARS-CoV-2 in the urban water cycle and its inactivation in different stages of treatment in wastewater treatment plants (WWTPs) for effective control to prevent any recurrence of the outbreak. The viral load of SARS-CoV-2 in feces of individuals tested positive has been reported to be in the range of 10⁴-10⁸ copies/L depending on the infection stages. In the wastewater, dilution of feces results in the decrease of the viral load in the range of 10²-10^6.5 copies/L. Monitoring of SARS-CoV-2 in WWTP samples following the wastewater-based epidemiology (WBE) can complement real epidemiological data from clinical testing to help to monitor disease outbreaks in a community. Though promising, high uncertainty involved with the WBE technique warrants further research for reliable and quantitative information. Inactivation of SARS-CoV-2 in WWTPs depends on the operational parameters and is generally enhanced by the tertiary treatment and disinfection techniques with a higher dosage. However, the risk of SARS-CoV-2 dissemination by the treated effluent intended to be disposed of or reused in the urban water cycle needs to be assessed with respect to the extent of viral infectivity.

A systematic review of emerging human coronavirus (SARS-CoV-2) outbreak: focus on disinfection methods, environmental survival, and control and prevention strategies

Recently, an outbreak of a novel human coronavirus which is referred to as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (COVID-19) by the World Health Organization (WHO) was identified in Wuhan, China. To help combat the pandemic, a systematic review (SR) was performed to collect all available studies concerning inactivation methods, environmental survival, and control and prevention strategies. A comprehensive literature survey yielded 42 eligible studies which included in the SR. The results confirmed that the WHO recommended two alcohol-based hand rub formulations (ethanol 70-95% and 2-propanol 70-100%) had an efficient virucidal activity in less than 60 s by more and equal 4 log₁₀ (≥ 99.99) approximately and could be used for disinfection in public health and health-care facilities. The findings indicated that SARS-CoV-1 and SARS-CoV-2 can survive under different environmental conditions between 4 and 72 h approximately. The results also demonstrate that temperature and relative humidity are important factors in the survival of SARS-CoV-2. The main strategies recommended by the WHO to avoid contracting SARS-CoV-2 are hand washing several times in the day and maintaining social distancing with others. It is important to note that the more studies require addressing, the more possible airborne transmission due to the survival of SARS-CoV-2 in aerosols for 3 h approximately. We hope that the results of the present SR can help researchers, health decision-makers, policy-makers, and people for understanding and taking the proper behavior to control and prevent further spread of SARS-CoV-2.

Regressing SARS-CoV-2 Sewage Measurements Onto COVID-19 Burden in the Population: A Proof-of-Concept for Quantitative Environmental Surveillance

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus, a member of the coronavirus family of respiratory viruses that includes severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East respiratory syndrome (MERS). It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries during the past 8 months. Widespread testing and tracing efforts are being employed in many countries in attempts to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common and that the virus RNA can be detected in wastewater. This indicates that wastewater monitoring may provide a potentially efficient tool for the epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. In particular, this provides important means of (i) estimating the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements, (ii) managing the early-warning system quantitatively and efficiently, and (iii) verifying disease elimination. Here we report different virus concentration methods using polyethylene glycol (PEG), alum, or filtration techniques as well as different RNA extraction methodologies, providing important insights regarding the detection of SARS-CoV-2 RNA in sewage. Virus RNA particles were detected in wastewater in several geographic locations in Israel. In addition, a correlation of virus RNA concentration to morbidity was detected in Bnei-Barak city during April 2020. This study presents a proof of concept for the use of direct raw sewage-associated virus data, during the pandemic in the country as a potential epidemiological tool.

Regressing SARS-CoV-2 Sewage Measurements Onto COVID-19 Burden in the Population: A Proof-of-Concept for Quantitative Environmental Surveillance

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an RNA virus, a member of the coronavirus family of respiratory viruses that includes severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East respiratory syndrome (MERS). It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries during the past 8 months. Widespread testing and tracing efforts are being employed in many countries in attempts to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common and that the virus RNA can be detected in wastewater. This indicates that wastewater monitoring may provide a potentially efficient tool for the epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. In particular, this provides important means of (i) estimating the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements, (ii) managing the early-warning system quantitatively and efficiently, and (iii) verifying disease elimination. Here we report different virus concentration methods using polyethylene glycol (PEG), alum, or filtration techniques as well as different RNA extraction methodologies, providing important insights regarding the detection of SARS-CoV-2 RNA in sewage. Virus RNA particles were detected in wastewater in several geographic locations in Israel. In addition, a correlation of virus RNA concentration to morbidity was detected in Bnei-Barak city during April 2020. This study presents a proof of concept for the use of direct raw sewage-associated virus data, during the pandemic in the country as a potential epidemiological tool.

Survival of the enveloped bacteriophage Phi6 (a surrogate for SARS-CoV-2) in evaporated saliva microdroplets deposited on glass surfaces

Survival of respiratory viral pathogens in expelled saliva microdroplets is central to their transmission, yet the factors that determine survival in such microdroplets are not well understood. Here we combine microscopy imaging with virus viability assays to study survival of three bacteriophages suggested as good models for respiratory pathogens: the enveloped Phi6 (a surrogate for SARS-CoV-2), and the non-enveloped PhiX174 and MS2. We measured virus viability in human saliva microdroplets, SM buffer, and water following deposition on glass surfaces at various relative humidities (RH). Saliva and water microdroplets dried out rapidly, within minutes, at all tested RH levels (23%, 43%, 57%, and 78%), while SM microdroplets remained hydrated at RH ≥ 57%. Generally, the survival of all three viruses in dry saliva microdroplets was significantly greater than those in SM buffer and water under all RH (except PhiX174 in water under 57% RH survived the best among 3 media). Thus, atmosphere RH and microdroplet hydration state are not sufficient to explain virus survival, indicating that the virus-suspended medium, and association with saliva components in particular, likely play a role in virus survival. Uncovering the exact properties and components that make saliva a favorable environment for the survival of viruses, in particular enveloped ones like Phi6, is thus of great importance for reducing transmission of viral respiratory pathogens including SARS-CoV-2.

Understanding air and water borne transmission and survival of coronavirus: Insights and way forward for SARS-CoV-2

The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in unprecedented disease burden, healthcare costs, and economic impacts worldwide. Despite several measures, SARS-CoV-2 has been extremely impactful due to its extraordinary infection potential mainly through coronavirus-borne saliva respiratory and droplet nuclei of an infected person and its considerable stability on surfaces. Although the disease has affected over 180 countries, its extent and control are significantly different across the globe, making it a strong case for exploration of its behavior and dependence across various environmental pathways and its interactions with the virus. This has spurred efforts to characterize the coronavirus and understand the factors impacting its transmission and survival such as aerosols, air quality, meteorology, chemical compositions and characteristics of particles and surfaces, which are directly or indirectly associated with coronaviruses infection spread. Nonetheless, many peer-reviewed articles have studied these aspects but mostly in isolation; a complete array of coronavirus survival and transmission from an infected individual through air- and water-borne channels and its subsequent intractions with environmental factors, surfaces, particulates and chemicals is not comprehensively explored. Particulate matter (PM) is omnipresent with variable concentrations, structures and composition, while most of the surfaces are also covered by PM of different characteristics. Learning from the earlier coronavirus studies, including SARS and MERS, an attempt has been made to understand the survival of SARS-CoV-2 outside of the host body and discuss the probable air and water-borne transmission routes and its interactions with the outside environment. The present work 1) Helps appreciate the role of PM, its chemical constituents and surface characteristics and 2) Further identifies gaps in this field and suggests possible domains to work upon for better understanding of transmission and survival of this novel coronavirus.

Environment and COVID-19: Pollutants, impacts, dissemination, management and recommendations for facing future epidemic threats

Coronavirus disease 2019 (COVID-19) has become a global pandemic. Its relationship with environmental factors is an issue that has attracted the attention of scientists and governments. This article aims to deal with a possible association between COVID-19 and environmental factors and provide some recommendations for adequately controlling future epidemic threats. Environmental management through ecosystem services has a relevant role in exposing and spreading infectious diseases, reduction of pollutants, and control of climatic factors. Pollutants and viruses (such as COVID-19) produce negative immunological responses and share similar mechanisms of action. Therefore, they can have an additive and enhancing role in viral diseases. Significant associations between air pollution and COVID-19 have been reported. Particulate matter (PM2.5, PM10) can obstruct the airway, exacerbating cases of COVID-19. Some climatic factors have been shown to affect SARS-CoV-2 transmission. Yet, it is not well established if climatic factors might have a cause-effect relationship to the spreading of SARS-CoV-2. So far, positive as well as negative indirect environmental impacts have been reported, with negative impacts greater and more persistent. Too little is known about the current pandemic to evaluate whether there is an association between environment and positive COVID-19 cases. We recommend smart technology to collect data remotely, the implementation of "one health" approach between public health physicians and veterinarians, and the use of biodegradable medical supplies in future epidemic threats.

A Risk-Based Approach to the COVID-19 Pandemic: The Experience in National Dental Centre Singapore

The emergence of a highly infectious coronavirus strain, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to a major global public health emergency. The increasing number of infected cases and fatalities worldwide forced several countries into lockdown in a bid to control virus transmission. The practice of dentistry is considered high-risk due to the generation of aerosols associated with most dental procedures, and healthcare professionals must take appropriate precautions whilst working in this challenging environment. This review aims to provide an overview on transmission routes and shares a risk-based approach to coronavirus disease 2019 (COVID-19) in a specialty tertiary center. Risk assessment and mitigation focussed on staff and patient safety, adopting a wide safety margin, and responding dynamically to the level of risk at the workplace. As the severity of the pandemic depends on many still-unknown factors and shows little sign of abating, the routine practice of dentistry will continue to be disrupted in the near future. We describe a color-coded framework to maximize safety and to minimize disease spread. Areas covered include healthcare team management, personal protective equipment, clinical work, and dental education. Guidelines in each category change with the corresponding severity of the situation, and we believe it will be useful for the safer practice of dentistry in this current climate and can be modified for future similar disease outbreaks.

An enhanced isothermal amplification assay for viral detection

Rapid, inexpensive, robust diagnostics are essential to control the spread of infectious diseases. Current state of the art diagnostics are highly sensitive and specific, but slow, and require expensive equipment. Here we report the development of a molecular diagnostic test for SARS-CoV-2 based on an enhanced recombinase polymerase amplification (eRPA) reaction. eRPA has a detection limit on patient samples down to 5 viral copies, requires minimal instrumentation, and is highly scalable and inexpensive. eRPA does not cross-react with other common coronaviruses, does not require RNA purification, and takes ~45 min from sample collection to results. eRPA represents a first step toward at-home SARS-CoV-2 detection and can be adapted to future viruses within days of genomic sequence availability.

Modeling the stability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on skin, currency, and clothing

A new coronavirus (SARS-CoV-2) emerged in the winter of 2019 in Wuhan, China, and rapidly spread around the world. The extent and efficiency of SARS-CoV-2 pandemic is far greater than previous coronaviruses that emerged in the 21st Century. Here, we modeled stability of SARS-CoV-2 on skin, paper currency, and clothing to determine if these surfaces may factor in the fomite transmission dynamics of SARS-CoV-2. Skin, currency, and clothing samples were exposed to SARS-CoV-2 under laboratory conditions and incubated at three different temperatures (4°C± 2°C, 22°C± 2°C, and 37°C ± 2°C). We evaluated stability at 0 hours (h), 4 h, 8 h, 24 h, 72 h, 96 h, 7 days, and 14 days post-exposure. SARS-CoV-2 was stable on skin through the duration of the experiment at 4°C (14 days). Virus remained stable on skin for at least 96 h at 22°C and for at least 8h at 37°C. There were minimal differences between the tested currency samples. The virus remained stable on the $1 U.S.A. Bank Note for at least 96 h at 4°C while we did not detect viable virus on the $20 U.S.A. Bank Note samples beyond 72 h. The virus remained stable on both Bank Notes for at least 8 h at 22°C and 4 h at 37°C. Clothing samples were similar in stability to the currency. Viable virus remained for at least 96 h at 4°C and at least 4 h at 22°C. We did not detect viable virus on clothing samples at 37°C after initial exposure. This study confirms the inverse relationship between virus stability and temperature. Furthermore, virus stability on skin demonstrates the need for continued hand hygiene practices to minimize fomite transmission both in the general population as well as in workplaces where close contact is common.

Controlled Heat and Humidity-Based Treatment for the Reuse of Personal Protective Equipment: A Pragmatic Proof-of-Concept to Address the Mass Shortage of Surgical Masks and N95/FFP2 Respirators and to Prevent the SARS-CoV2 Transmission

Background: The coronavirus infectious disease-2019 (COVID-19) pandemic has led to an unprecedented shortage of healthcare resources, primarily personal protective equipment like surgical masks, and N95/filtering face piece type 2 (FFP2) respirators.

Objective: Reuse of surgical masks and N95/FFP2 respirators may circumvent the supply chain constraints and thus overcome mass shortage. Methods, design, setting, and measurement: Herein, we tested the effects of dry- and moist-air controlled heating treatment on structure and chemical integrity, decontamination yield, and filtration performance of surgical masks and FFP2 respirators.

Results: We found that treatment in a climate chamber at 70°C during 1 h with 75% humidity rate was adequate for enabling substantial decontamination of both respiratory viruses, oropharyngeal bacteria, and model animal coronaviuses, while maintaining a satisfying filtering capacity.

Limitations: Further studies are now required to confirm the feasibility of the whole process during routine practice.

Conclusion: Our findings provide compelling evidence for the recycling of pre-used surgical masks and N95/FFP2 respirators in case of imminent mass shortfall.

SARS-CoV-2 in wastewater: State of the knowledge and research needs

The ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a Public Health Emergency of International Concern, which was officially declared by the World Health Organization. SARS-CoV-2 is a member of the family Coronaviridae that consists of a group of enveloped viruses with single-stranded RNA genome, which cause diseases ranging from common colds to acute respiratory distress syndrome. Although the major transmission routes of SARS-CoV-2 are inhalation of aerosol/droplet and person-to-person contact, currently available evidence indicates that the viral RNA is present in wastewater, suggesting the need to better understand wastewater as potential sources of epidemiological data and human health risks. Here, we review the current knowledge related to the potential of wastewater surveillance to understand the epidemiology of COVID-19, methodologies for the detection and quantification of SARS-CoV-2 in wastewater, and information relevant for human health risk assessment of SARS-CoV-2. There has been growing evidence of gastrointestinal symptoms caused by SARS-CoV-2 infections and the presence of viral RNA not only in feces of infected individuals but also in wastewater. One of the major challenges in SARS-CoV-2 detection/quantification in wastewater samples is the lack of an optimized and standardized protocol. Currently available data are also limited for conducting a quantitative microbial risk assessment (QMRA) for SARS-CoV-2 exposure pathways. However, modeling-based approaches have a potential role to play in reducing the impact of the ongoing COVID-19 outbreak. Furthermore, QMRA parameters obtained from previous studies on relevant respiratory viruses help to inform risk assessments of SARS-CoV-2. Our understanding on the potential role of wastewater in SARS-CoV-2 transmission is largely limited by knowledge gaps in its occurrence, persistence, and removal in wastewater. There is an urgent need for further research to establish methodologies for wastewater surveillance and understand the implications of the presence of SARS-CoV-2 in wastewater.

The SARS-CoV-2 Outbreak: an Epidemiological and Clinical Perspective

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak started with the detection of an increasing number of pneumonia cases of unknown origin in Wuhan, China, since December 2019. The disease caused by SAS-CoV-2 was subsequently named coronavirus disease 2019 (COVID-19). Currently, the ongoing COVID-19 pandemic poses a global health concern with more than 28.9 million confirmed cases, taking away the lives of more than 900,000 people worldwide. To prevent further spread of the disease, an understanding of the clinical characteristics and how the disease spread is essential, especially for an emerging disease like COVID-19. Individuals who are infected with SARS-CoV-2 show diverse clinical features, and the disease severity can range from asymptomatic to death. The disease has been shown to affect not just the respiratory system but also other systems of the body. This review will discuss the pulmonary and extra-pulmonary clinical manifestations of COVID-19 in general, as well as the clinical characteristics in different groups of patients such as children, the elderly, pregnant women, patients with comorbidities and those with a compromised immunity. It will also critically examine existing evidence from relevant studies and discuss the SARS-CoV-2 outbreak from an epidemiological perspective. With the easing of control measures in many countries after months of lockdown, it is important to revisit the lessons learnt from research, as the world enters a new normal with the coexistence of SARS-CoV-2.

Infección por COVID-19, una mirada a los factores ambientales relacionados con la pandemia

La pandemia global por COVID-19 ha generado un sin número de alertas y cambios en las formas de habitar y de consumo. La triada medio ambiente-salud-individuo vuelve a ser protagonista en este escenario, en donde se aprecian graves fracturas en los sistemas de salud pública, hábitat y seguridad alimentaria. Como factor transversal a esos elementos, la contaminación ambiental se convirtió en un efecto facilitador de la pandemia pues la transmisión por contacto entre humanos a través de aerosoles representa la vía de contagio. Esta situación obligó al distanciamiento y confinamiento preventivo, medida que logró hacer evidente la pobreza, la inequidad y la desigualdad que se vive globalmente. Por otro lado, los cambios en la movilidad y la frecuencia de producción en industrias de manufactura trajo una reducción en los gases de efecto invernadero.