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      Mobile phones: a forgotten source of SARS-CoV-2 transmission.

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          Abstract

          Dear editor, The emergence SARS-CoV-2, a novel coronavirus, has become a global health and economic concerns, embodying one of the most disruptive pandemic in more than a century. SARS-CoV-2 is highly contagious via droplets, and could be spread by human contact as well as contaminated surfaces causing high morbidity and mortality burden (1). Consequently, the world's economy has shut down, and nearly one third of the worlds’ population has been forced to home confinement. With the deconfinment phase to start soon in different countries, educating the population to adopt preventive measures has become crucial to limit a second wave of SARS-CoV-2 infection. These measures include physical distancing, washing hands regularly with soap and water or sanitizers, avoid face-touching, and wearing facemask especially in public and crowded places. In addition, the use of mobile phone (MP) applications has been proposed to help track infected individuals. However, there is one caveat. MP could be a source of contagion higher than expected. In our opinion there is very little warning regarding this subject from public-health experts. In fact, it has been shown that MP could be colonized by microorganisms, including bacteria, fungi (2, 3) and even RNA viruses (4), as it could be the case with the SARS-CoV-2 which is also an RNA virus. Some authors have proposed that MP had amplified previous virus outbreaks like Ebola (5). SARS-CoV-2 is not an exception. In fact, it has been shown that this new virus can persist on inanimate surfaces like metal, glass or plastic for up to 9 days (1). Due to their excessive use (6), added to the fact that they are rarely cleaned after handling, MP could become a source of virus transmission through repetitive cyclic hand-face contamination (7). In addition, healthcare professionals do frequently use MP during their shifts, searching for medical information that could help them in their daily work. This could also be a source of nosocomial infection even in intensive care units (3, 8).To our knowledge, no study has yet addressed the issue related to SARS-CoV-2 transmission through MP. It could indeed explain an important part in the transmission of the infection to patients who claim adopting recommended safety measures. Hence, several measures should be endorsed to tackle the MP-related SARS-CoV-2 transmission risk. Disinfection with bactericidal wipes adapted to MP could not be completely effective, and specific sanitization protocols should be developed especially for healthcare workers' (3). Until then, it is crucial during the deconfinment phase to educate the population to limit the use of MP as much as possible, especially in public places and health care institutions. To our opinion, this procedure should be included in the recommended safety measures that are widely broadcasted through the media and science information thread.

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          Most cited references7

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          Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

          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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            Cell-Phone Addiction: A Review

            We present a review of the studies that have been published about addiction to cell phones. We analyze the concept of cell-phone addiction as well as its prevalence, study methodologies, psychological features, and associated psychiatric comorbidities. Research in this field has generally evolved from a global view of the cell phone as a device to its analysis via applications and contents. The diversity of criteria and methodological approaches that have been used is notable, as is a certain lack of conceptual delimitation that has resulted in a broad spread of prevalent data. There is a consensus about the existence of cell-phone addiction, but the delimitation and criteria used by various researchers vary. Cell-phone addiction shows a distinct user profile that differentiates it from Internet addiction. Without evidence pointing to the influence of cultural level and socioeconomic status, the pattern of abuse is greatest among young people, primarily females. Intercultural and geographical differences have not been sufficiently studied. The problematic use of cell phones has been associated with personality variables, such as extraversion, neuroticism, self-esteem, impulsivity, self-identity, and self-image. Similarly, sleep disturbance, anxiety, stress, and, to a lesser extent, depression, which are also associated with Internet abuse, have been associated with problematic cell-phone use. In addition, the present review reveals the coexistence relationship between problematic cell-phone use and substance use such as tobacco and alcohol.
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              Are healthcare workers' mobile phones a potential source of nosocomial infections? Review of the literature.

              Mobile communication devices help accelerate in-hospital flow of medical information, information sharing and querying, and contribute to communications in the event of emergencies through their application and access to wireless media technology. Healthcare-associated infections remain a leading and high-cost problem of global health systems despite improvements in modern therapies. The objective of this article was to review different studies on the relationship between mobile phones (MPs) and bacterial cross-contamination and report common findings. Thirty-nine studies published between 2005 and 2013 were reviewed. Of these, 19 (48.7%) identified coagulase-negative staphylococci (CoNS), and 26 (66.7%) identified Staphylococcus aureus; frequency of growth varied. The use of MPs by healthcare workers increases the risk of repetitive cyclic contamination between the hands and face (e.g., nose, ears, and lips), and differences in personal hygiene and behaviors can further contribute to the risks. MPs are rarely cleaned after handling. They may transmit microorganisms, including multiple resistant strains, after contact with patients, and can be a source of bacterial cross-contamination. To prevent bacterial contamination of MPs, hand-washing guidelines must be followed and technical standards for prevention strategies should be developed.
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                Author and article information

                Contributors
                Journal
                Am J Infect Control
                Am J Infect Control
                American Journal of Infection Control
                Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
                0196-6553
                1527-3296
                26 May 2020
                26 May 2020
                Author notes
                [* ]Corresponding author: Tony IBRAHIM M.D., M.Sc., ORCID: 0000-0001-9728-8554, International department of medical oncology, Gustave Roussy cancer campus, Villejuif, France, phone: +33 1 42 11 42 11 tony.ibrahim@ 123456gustaveroussy.fr
                Article
                S0196-6553(20)30282-0
                10.1016/j.ajic.2020.05.019
                7247981
                f9afd80e-ef30-4740-b7d0-756065f44a98
                © 2020 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.

                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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