Abstract
As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has surged across the globe, great effort has been expended to understand mechanisms of transmission and spread. From a hospital perspective, this topic is critical to limit and prevent SARS-CoV-2 iatrogenic transmission within the healthcare environment. Currently, the virus is believed to be transmitted primarily through respiratory droplets, but a growing body of evidence suggests that spread is also possible through aerosolized particles and fomites. Amidst a growing volume of patients with coronavirus disease 2019 (COVID-19), the purpose of this study was to evaluate the potential for SARS-CoV-2 transmission through fomites. Samples collected from the exposed skin of clinicians (n = 42) and high-touch surfaces (n = 40) were collected before and after encounters with COVID-19 patients. Samples were analyzed using two assays: the CDC 2019-nCoV Real-Time Reverse Transcription polymerase chain reaction (RT-qPCR) assay, and a SYBR Green assay that targeted a 121 bp region within the S-gene of SARS-CoV-2. None of the samples tested positive with the CDC assay, while two high-touch surface areas tested positive for SARS-CoV-2 using the Spike assay. However, viral culture did not reveal viable SARS-CoV-2 from the positive samples. Overall, the results from this study suggest that SARS-CoV-2 RNA were not widely present either on exposed skin flora or high-touch surface areas in the hospital locations tested. The inability to recover viable virus from samples that tested positive by the molecular assays, however, does not rule out the possibility of SARS-CoV-2 transmission through fomites.
Highlights
As of 22 April 2021, the coronavirus disease 2019 (COVID19) pandemic has affected more than 144 million people worldwide.[1]
To prevent potential of transmission of SARS-CoV-2, patients were individually housed in negative pressure isolation rooms that were retrofitted with portable high-efficiency particulate air (HEPA) exhaust fans to provide a minimum of 12 air changes per hour, and at least 2.5 Pa of negative pressure to the adjacent hallway.[8]
When a subset of the samples was examined for viable virus using Vero E6 cells, two samples showed evidence of cytopathic effect (CPE), suggesting the presence of replicating virus
Summary
As of 22 April 2021, the coronavirus disease 2019 (COVID19) pandemic has affected more than 144 million people worldwide.[1] One route of transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, is through inhalation of respiratory droplets and aerosols expelled from an infected individual during coughing/sneezing, talking or exhaling.[2] While aerosolized particles persist in the air for minutes to hours, exhaled droplets will quickly settle on nearby inanimate objects and surfaces. SARS-CoV-2 contamination has been detected on numerous high-contact surfaces, on bed rails, tables, call panels, and door handles of rooms housing COVID-19 patients.[3,4,5] While fomite spread had been associated with nosocomial transmission of other
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