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      Investigating SARS-CoV-2 surface and air contamination in an acute healthcare setting during the peak of the COVID-19 pandemic in London

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          ABSTRACT

          Background

          Evaluation of SARS-CoV-2 surface and air contamination during the COVID-19 pandemic in London.

          Methods

          We performed this prospective cross-sectional observational study in a multi-site London hospital. Air and surface samples were collected from seven clinical areas, occupied by patients with COVID-19, and a public area of the hospital. Three or four 1.0 m 3 air samples were collected in each area using an active air sampler. Surface samples were collected by swabbing items in the immediate vicinity of each air sample. SARS-CoV-2 was detected by RT-qPCR and viral culture; the limit of detection for culturing SARS-CoV-2 from surfaces was determined.

          Results

          Viral RNA was detected on 114/218 (52.3%) of surfaces and 14/31 (38.7%) air samples but no virus was cultured. The proportion of surface samples contaminated with viral RNA varied by item sampled and by clinical area. Viral RNA was detected on surfaces and in air in public areas of the hospital but was more likely to be found in areas immediately occupied by COVID-19 patients than in other areas (67/105 (63.8%) vs. 29/64 (45.3%) (odds ratio 0.5, 95% confidence interval 0.2-0.9, p=0.025, Chi squared test)). The high PCR Ct value for all samples (>30) indicated that the virus would not be culturable.

          Conclusions

          Our findings of extensive viral RNA contamination of surfaces and air across a range of acute healthcare settings in the absence of cultured virus underlines the potential risk from environmental contamination in managing COVID-19, and the need for effective use of PPE, physical distancing, and hand/surface hygiene.

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          Author and article information

          Journal
          Clin Infect Dis
          Clin. Infect. Dis
          cid
          Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
          Oxford University Press (US )
          1058-4838
          1537-6591
          08 July 2020
          : ciaa905
          Affiliations
          [1 ] Department of Infectious Disease, Imperial College London, London, UK
          [2 ] National Institute for Healthcare Research Health Protection Research Unit (NIHR HPRU) in HCAI and AMR, Imperial College London & Public Health England, Hammersmith Hospital
          [3 ] Imperial College Healthcare NHS Trust, St. Mary’s Hospital, London, UK
          [4 ] Department of Surgery and Cancer, Imperial College London, London, UK
          Author notes
          Corresponding author: Dr Jonathan Otter, Imperial College London, NIHR Health Protection Research Unit, Hammersmith Hospital, Du Cane Road, W12 0HS. Tel: 020 331 33271, Email: j.otter@ 123456imperial.ac.uk

          Joint first authors

          Article
          ciaa905
          10.1093/cid/ciaa905
          7454437
          32634826
          cc9d73e2-e42d-4ca1-a66c-bb9c702eedc5
          © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

          This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

          This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

          History
          : 02 June 2020
          Categories
          Major Article
          AcademicSubjects/MED00290
          Custom metadata
          PAP
          accepted-manuscript

          Infectious disease & Microbiology
          sars-cov-2,covid-19,transmission,air contamination,surface contamination

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