Exploring SARS-CoV-2 hospital surface and air contamination in London

We have just had a study published in Clinical Infectious Diseases exploring the extent and magnitude of hospital surface and air contamination with SARS-CoV-2 during the (first!) peak of COVID-19 in London. The bottom line is that we identified pretty extensive surface and air contamination with SARS-CoV-2 RNA but did not culture viable virus. We concluded that this highlights the potential role of contaminated surfaces and air in the spread of SARS-CoV-2.

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The role contaminated surfaces in COVID-19 transmission: a HIS audience-led webinar

The next instalment of the HIS audience-led webinar series is on the role of contaminated surfaces in COVID-19 transmission. I was delighted to be part of the panel for this one:

  • Dr Lena Ciric – Associate Professor in Environmental Engineering, University College London
  • Dr Stephanie Dancer – Consultant Microbiologist, NHS Lanarkshire and Professor of Microbiology, Edinburgh Napier University, Scotland
  • Dr Manjula Meda – Consultant Clinical Microbiologist and Infection Control Doctor, Frimley Park Hospital
  • Dr Jon Otter – Infection prevention and control Epidemiologist, Imperial College London
  • Chair: Dr Surabhi Taori, Consultant microbiologist and infection control doctor, Kings College Hospital NHS Foundation Trust

Here’s the recording:

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Managing ventilation in the context of COVID-19: a HIS audience-led webinar

The next in the series of the HIS audience-led webinar on all-things ventilation in the management of COVID-19 went out recently. The panel consisted of:

  • Peter Hoffman – Consultant Clinical Scientist, London
  • Dr Chris Lynch – Graham Ayliffe Training Fellow, Sheffield Teaching Hospitals
  • Professor Catherine Noakes – Professor of Environmental Engineering for Buildings, University of Leeds
  • Karren Staniforth – Clinical Scientist, Nottingham University Hospitals NHS Trust
  • Dr James Price (chair) – Consultant in Infection Prevention & Control and Antimicrobial Stewardship, Imperial College Healthcare NHS Trust

The webinar video is below:

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HIS webinar – Understanding hospital-onset and hospital-acquired COVID-19 infection

The second in the series of excellent Healthcare Infection Society (HIS) interactive audience-led webinars went out a few weeks ago. The theme for this was hospital-onset and hospital-acquired COVID-19 infections, and here’s the video.

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Testing patients and staff without symptoms for SARS-CoV-2: beware false-positives (and negatives)

As we begin to look to the other side of the peak of COVID-19, this issue of more widespread testing of patients, staff (and indeed the general population) for infection with the SARS-CoV-2 virus whether or not they have symptoms is looming large. We need to think carefully about the risk of false positives when interpreting the meaning of a positive PCR test in a group of people with a low prevalence of SARS-CoV-2.

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Considering the role of environmental contamination in the spread of COVID-19

We know that respiratory viruses can be spread through droplets, occasionally aerosols, and contact routes (see Figure 1). But what is the relative importance of these transmission routes for the SARS-CoV-2 virus, which causes COVID-19? A new pre-print paper published yesterday provides evidence that the stability of the SARS-CoV-2 coronavirus is broadly comparable to the ‘original’ SARS coronavirus (SARS-CoV-1) on dry surfaces and in aerosols. This paper supports an important role for dry surface contamination and aerosols in the spread of SARS-CoV-2, and suggests that improved environmental persistence isn’t the key to the relative success of SARS-CoV-2 over SARS-CoV-1.

Figure 1: Transmission routes of respiratory viruses (from this review article).

covid transmission routes

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COVID-19 and my idea on masks

Next to the idea that we see many contraptions (you can’t even call them masks) we see many people with all kind of masks, in and outside our healthcare settings. Certainly after my last flight to a WHO meeting on COVID-19, I had the feeling that it is time to write about masks.

On my way to Geneva, the gentleman to my left (yes, thanks to a canceled flight, I was in the hated middle seat) was calm, sleepy and wearing a mask. The fellow on my right, clearly had the sniffles, came from somewhere far away and was spreading his respiratory secretions in all directions, including mine. I so wanted to pull of the mask from calm-sleepy-guy, to place it on the next-seat-germ-blower.

How easy could basic prevention be? Wouldn’t it be fantastic if people would adhere to simple principles of how to cough and sneeze in public: turn away from others, use a tissue or elbow, followed by hand hygiene? Why don’t the people on buses, trains and airplanes don’t know this? If in addition, anyone who is sick gets a surgical mask while in public, we might have a way of preventing (or at least delaying) the spread of respiratory viruses. Instead, masks are worn by the healthy, leaving the sick (and soon-to-be hospital patients) without the needed protection.

Talking about masks in healthcare; Nearly every country I know off, went for maximum safety, recommending FFP2 masks (similar to N95). I would have suggested to use FFP1 for the majority of cases, and FFP2 only during high-risk procedures. But how can I, if everyone else seems to go “full safety”. Another reason, why I believe that my idea wouldn’t have been too bad, is the high probability that soon we will have a shortage of FFP2 and will have to tell our HCWs that FFP1 and surgical masks are “equally save”. Yes, I can see how they believe me and willingly expose themselves to the increasing number of patients with less than previously needed PPE! I believe that we have valid reasons to consider evidence over maximum safety, and that while we didn’t even start to talk about discomfort and physical effects associated with prolonged use of FFP2. Continue reading