Under the Microscope with David Weber: The role of the healthcare surface environment in SARS-CoV-2 transmission and potential control measures

Author: David Weber, MD, MPH, FSHEA, FIDSA, FMSM (London)

Categories: Clinical Pathogens/Alerts November 5, 2020
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This Week’s Review:

The role of the healthcare surface environment in SARS-CoV-2 transmission and potential control measures, written by Kanamori H, Weber DJ, and Rutala WA1, provides a comprehensive review of the literature that assessed the role of the healthcare surface environment in SARS-CoV-2 transmission. More than 20 studies reviewed assessed surface contamination in hospitals with SARS-CoV-2. The authors noted that human coronaviruses, including SARS-CoV-2, could survive for hours to days on surfaces depending on experimental conditions (i.e., viral titer, surface substrate, temperature and relative humidity).

Overall, the contamination rate of the healthcare environment with SARS-CoV-2 as measured by RT-PCR varied from 0% to 75% (median, 12.1%), depending on the status of cleaning/disinfection in environmental sampling rather than on the symptomatic status of COVID-19 patients. Environmental studies sampled before cleaning/disinfection reported infrequent to frequent contamination while studies samples after cleaning/disinfection revealed zero to infrequent contamination. Only four studies assessed the presence of viable virus by culture, and viable SARS-CoV-2 was not confirmed from environmental samples. However, Santarpia et al. {Sci Rep 2020;10(1):12732} did observe the presence of intact SARS-CoV-2 virions by electron microscopy of a windowsill sample after 3 days of culture.

The authors provided a detailed list of recommendations for cleaning and disinfection of environmental surfaces and medical devices in rooms occupied by known or suspected COVID-19 patients. Key recommendations were as follows:

  • Follow CDC recommendations for letting the room remain empty regardless of personal protective equipment after patient discharge for the specified time period;
  • Use an EPA-registered disinfectant on EPA List N that has qualified under emerging viral pathogens program for use against SARS-CoV-2;
  • All noncritical touchable surfaces and medical devices should be cleaned/disinfected at least once a day and when visibly soiled;
  • Assess cleaning thoroughness with a validation method (e.g., fluorescent dye markers); and,
  • Consider no-touch methods (e.g., ultraviolet light devices) when available as an adjunct to chemical disinfection for terminal disinfection.

Under the Microscope with Dr. David Weber explores what’s new in industry literature and provides a synopsis, along with key takeaways.

Clinical Infectious Diseases, ciaa1467, https://doi.org/10.1093/cid/ciaa1467 Published: 28 September 2020


David Weber MD, MPH
Dr. David Weber, Associate Chief Medical Officer for UNC Medical Center Associate Chief Medical Officer for UNC Medical Center


Dr. David Jay Weber received his Bachelors of Arts (B.A.) degree from Wesleyan University in 1973, his Medical Degree (M.D.) from the University of California, San Diego in 1977, a Master’s in Public Health (M.P.H.) from Harvard University in 1985, and completed his medicine residency and infectious disease fellowship at the Massachusetts General Hospital in 1985.

He is Board Certified in Internal Medicine, Infectious Disease, Critical Care Medicine, and Preventive Medicine.  Dr. Weber has been on the faculty of the University of North Carolina at Chapel Hill since 1985 where he is currently the Charles Addison and Elizabeth Ann Sanders Distinguished Professor of Medicine, Pediatrics and Epidemiology in the UNC School of Medicine, and UNC Gillings School of Global Public Health.

He serves as an Associate Chief Medical Officer for UNC Medical Center. He also serves as Medical Director of the Department of Infection Prevention UNC Medical Center. He is the Medical Director of the North Carolina Statewide Infection Control Program (SPICE), a Chair of UNC Biomedical IRB, and serves as the UNC Principle Investigator on the CDC sponsored Duke-UNC Epicenter. Dr. Weber is an Associate Editor of Infection Control Hospital Epidemiology and the Secretary of the SHEA Board. He is the Chair of the NC Health Department’s Tuberculosis Advisory Committee.

Dr. Weber has published more than 470 scientific papers in the peer-reviewed literature and more than 650 total papers and chapters. He is the Senior Editor of Mayhall’s “Hospital Epidemiology and Infection Prevention, 2020”. His research interests include the epidemiology of healthcare-associated infections, disinfection and sterilization, new and emerging infectious diseases (novel influenza, SARS-coV-2, MERS-coV, Ebola, Candida auris), response to biothreats, nontuberculous mycobacteria, control of drug resistant pathogens, immunization practices (especially of healthcare personnel), zoonotic diseases, and epidemiology of tuberculosis.

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