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21 april 2020

Surgical Perspective: A Practical Decontamination Framework for COVID-19 Front-Line Workers Returning Home - Annals of Surgery

In press; https://journals.lww.com/annalsofsurgery/Documents/Surgical%20Perspective.pdf
By: Harris, et al. 

Aim
Describe how health care workers should decontaminate in order to keep their household safe.

Keys

  • See figures for effective decontamination measures in transit to and from work to home

Summary

  • PPE’s are mainly based on spread primarily through inhaling droplets. However, transferring virus from contaminated surfaces to mucous membranes is also possible. The precise contact time necessary to transmit SARS-CoV-2 is unknown; data suggests that 5 second is enough.
  • SARS-CoV-2 survives better on hard surfaces (glass, metal, plastic). In some studies up to 9 days infectious. Viral particles remained visible in the Diamond Princess cruise ship up to 17 days after disembarking.
  • Soft, porous materials (cardboard, fabric) are more resistant. 
  • The virus favours humid and colder environment
  • Cleaning products that are >62% ethanol (with other sources preferring those >75%), 0.5% hydrogen peroxide (commercially available topical solutions are usually around 3%), and 0.1% sodium hypochlorite (bleach) effectively kill the virus.
  • Guidelines for front-line workers do not exist. Strategies need to be tailored on the risk profile of the family (e.g. immunocompromised children). High-risk workers might even consider quarantine as the most effective measure. 
  • Other guidelines: