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      An emerging source of plastic pollution: Environmental presence of plastic personal protective equipment (PPE) debris related to COVID-19 in a metropolitan city

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          Abstract

          The COVID-19 pandemic has resulted in an unprecedented surge of production, consumption, and disposal of personal protective equipment (PPE) including face masks, disposable gloves, and disinfectant wipes, which are often made of single use plastic. Widespread public use of these items has imposed pressure on municipalities to properly collect and dispose of potentially infectious PPE. There has been a lack of structured monitoring efforts to quantify the emerging trend of improperly disposed of PPE debris. In this study, we present a baseline monitoring survey to describe the spatial distribution of PPE debris during the COVID-19 pandemic from the metropolitan city of Toronto, Canada. Our objectives were to: (1) quantify PPE debris types among surveyed areas and; (2) identify PPE debris densities and accumulation of surveyed areas. A total of 1306 PPE debris items were documented, with the majority being disposable gloves (44%), followed by face masks (31%), and disinfecting wipes (25%). Of the face masks, 97% were designed for single use while only 3% were reusable. Of the surveyed locations, the highest daily average densities of PPE debris were recorded in the large and medium-sized grocery store parking lots and the hospital district (0.00475 items/m 2, 0.00160 items/m 2, and 0.00133 items/m 2 respectively). The two surveyed residential areas had the following highest PPE densities (0.00029 items/m 2 and 0.00027 items/m 2), while the recreational trail had the lowest densities (0.00020 items/m 2). Assuming a business-as-usual accumulation, an estimated 14,298 PPE items will be leaked as debris in just the surveyed areas annually. To facilitate proper disposal of PPE debris by the public we recommend development of municipal efforts to improve PPE collection methods that are informed by the described PPE waste pathways.

          Graphical abstract

          Highlights

          • Public use of personal protective equipment (PPE) results with improper disposal.

          • Of the 1306 PPE debris items recorded disposable gloves were the most abundant.

          • We surveyed residential areas, grocery parking lots, a trail and a hospital district.

          • The grocery store parking lot and hospital district resulted with the most debris.

          • Policy decisions about PPE waste management should be informed by monitoring surveys.

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          Most cited references 58

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          Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1

          To the Editor: A novel human coronavirus that is now named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (formerly called HCoV-19) emerged in Wuhan, China, in late 2019 and is now causing a pandemic. 1 We analyzed the aerosol and surface stability of SARS-CoV-2 and compared it with SARS-CoV-1, the most closely related human coronavirus. 2 We evaluated the stability of SARS-CoV-2 and SARS-CoV-1 in aerosols and on various surfaces and estimated their decay rates using a Bayesian regression model (see the Methods section in the Supplementary Appendix, available with the full text of this letter at NEJM.org). SARS-CoV-2 nCoV-WA1-2020 (MN985325.1) and SARS-CoV-1 Tor2 (AY274119.3) were the strains used. Aerosols (<5 μm) containing SARS-CoV-2 (105.25 50% tissue-culture infectious dose [TCID50] per milliliter) or SARS-CoV-1 (106.75-7.00 TCID50 per milliliter) were generated with the use of a three-jet Collison nebulizer and fed into a Goldberg drum to create an aerosolized environment. The inoculum resulted in cycle-threshold values between 20 and 22, similar to those observed in samples obtained from the upper and lower respiratory tract in humans. Our data consisted of 10 experimental conditions involving two viruses (SARS-CoV-2 and SARS-CoV-1) in five environmental conditions (aerosols, plastic, stainless steel, copper, and cardboard). All experimental measurements are reported as means across three replicates. SARS-CoV-2 remained viable in aerosols throughout the duration of our experiment (3 hours), with a reduction in infectious titer from 103.5 to 102.7 TCID50 per liter of air. This reduction was similar to that observed with SARS-CoV-1, from 104.3 to 103.5 TCID50 per milliliter (Figure 1A). SARS-CoV-2 was more stable on plastic and stainless steel than on copper and cardboard, and viable virus was detected up to 72 hours after application to these surfaces (Figure 1A), although the virus titer was greatly reduced (from 103.7 to 100.6 TCID50 per milliliter of medium after 72 hours on plastic and from 103.7 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). The stability kinetics of SARS-CoV-1 were similar (from 103.4 to 100.7 TCID50 per milliliter after 72 hours on plastic and from 103.6 to 100.6 TCID50 per milliliter after 48 hours on stainless steel). On copper, no viable SARS-CoV-2 was measured after 4 hours and no viable SARS-CoV-1 was measured after 8 hours. On cardboard, no viable SARS-CoV-2 was measured after 24 hours and no viable SARS-CoV-1 was measured after 8 hours (Figure 1A). Both viruses had an exponential decay in virus titer across all experimental conditions, as indicated by a linear decrease in the log10TCID50 per liter of air or milliliter of medium over time (Figure 1B). The half-lives of SARS-CoV-2 and SARS-CoV-1 were similar in aerosols, with median estimates of approximately 1.1 to 1.2 hours and 95% credible intervals of 0.64 to 2.64 for SARS-CoV-2 and 0.78 to 2.43 for SARS-CoV-1 (Figure 1C, and Table S1 in the Supplementary Appendix). The half-lives of the two viruses were also similar on copper. On cardboard, the half-life of SARS-CoV-2 was longer than that of SARS-CoV-1. The longest viability of both viruses was on stainless steel and plastic; the estimated median half-life of SARS-CoV-2 was approximately 5.6 hours on stainless steel and 6.8 hours on plastic (Figure 1C). Estimated differences in the half-lives of the two viruses were small except for those on cardboard (Figure 1C). Individual replicate data were noticeably “noisier” (i.e., there was more variation in the experiment, resulting in a larger standard error) for cardboard than for other surfaces (Fig. S1 through S5), so we advise caution in interpreting this result. We found that the stability of SARS-CoV-2 was similar to that of SARS-CoV-1 under the experimental circumstances tested. This indicates that differences in the epidemiologic characteristics of these viruses probably arise from other factors, including high viral loads in the upper respiratory tract and the potential for persons infected with SARS-CoV-2 to shed and transmit the virus while asymptomatic. 3,4 Our results indicate that aerosol and fomite transmission of SARS-CoV-2 is plausible, since the virus can remain viable and infectious in aerosols for hours and on surfaces up to days (depending on the inoculum shed). These findings echo those with SARS-CoV-1, in which these forms of transmission were associated with nosocomial spread and super-spreading events, 5 and they provide information for pandemic mitigation efforts.
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            The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak

            Coronavirus disease (COVID-19) is caused by SARS-COV2 and represents the causative agent of a potentially fatal disease that is of great global public health concern. Based on the large number of infected people that were exposed to the wet animal market in Wuhan City, China, it is suggested that this is likely the zoonotic origin of COVID-19. Person-to-person transmission of COVID-19 infection led to the isolation of patients that were subsequently administered a variety of treatments. Extensive measures to reduce person-to-person transmission of COVID-19 have been implemented to control the current outbreak. Special attention and efforts to protect or reduce transmission should be applied in susceptible populations including children, health care providers, and elderly people. In this review, we highlights the symptoms, epidemiology, transmission, pathogenesis, phylogenetic analysis and future directions to control the spread of this fatal disease.
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              Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

               G Kampf,  D Todt,  S. Pfaender (2020)
              Summary Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05–0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.
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                Author and article information

                Journal
                Environ Pollut
                Environ Pollut
                Environmental Pollution (Barking, Essex : 1987)
                Elsevier Ltd.
                0269-7491
                1873-6424
                4 December 2020
                15 January 2021
                4 December 2020
                : 269
                : 116160
                Affiliations
                [a ]Canadian Ocean Literacy Coalition, Canadian Museum of Nature, 1740 Pink Road Natural Heritage Campus, Gatineau, Quebec, J9J 3N7, Canada
                [b ]School of Fisheries, Fisheries and Marine Institute of Memorial University, 155 Ridge Road, St. John’s, Newfoundland and Labrador, A1C 5R3, Canada
                [c ]College of Engineering, New Materials Institute, Center for Circular Materials Management, University of Georgia, Riverbend Research Lab South, 220 Riverbend Road, Athens, GA, 30602, United States
                [d ]Department of Integrative Biology, University of Guelph, 50 Stone Road East, Guelph, Ontario, N1G 2W1, Canada
                Author notes
                []Corresponding author.
                Article
                S0269-7491(20)36849-4 116160
                10.1016/j.envpol.2020.116160
                7833877
                33316501
                © 2020 Elsevier Ltd. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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