The presence and distribution of novel coronavirus in a medical environment
Authors: Qianli Jiang, Yinghua Chen, Yingchun Dai, Shaoxi Cai, Guodong Hu
Journal: Journal of the American Academy of Dermatology (2020)

To the Editor: Coronavirus disease 2019 (COVID-19) has constituted a global pandemic,1Bedford J. Enria D. Giesecke J. et al.COVID-19: towards controlling of a pandemic.Lancet. 2020; 395: 1015-1018Abstract Full Text Full Text PDF PubMed Scopus (1015) Google Scholar and infections of medical staff with severe acute respiratory syndrome-coronavirus-2 (SARS-Cov-2) are a major concern because the number of infected medical staff in Spain has exceeded 10,000.2Anelli F. Leoni G. Monaco R. et al.Italian doctors call for protecting healthcare workers and boosting community surveillance during COVID-19 outbreak.BMJ. 2020; 368: m1254Crossref PubMed Scopus (69) Google Scholar A significant undertaking is to explore possible routes of infection for medical staff to strengthen their protection, reduce the infection rate, and effectively control the epidemic.3The Lancet. COVID-19: protecting health-care workers.Lancet. 2020; 395: 922Abstract Full Text Full Text PDF Scopus (853) Google Scholar Because of daily disinfection and cleaning, the presence and distribution of SARS-COV-2 in a medical environment may differ from that in other environments. To detect COVID-19 in a medical environment, samples from surfaces of personal protective equipment, medical facilities, and the belongings of patients with confirmed disease were collected in Hankou Hospital, Wuhan. All samples were sent to the Wuhan Dean medical laboratory center for COVID-19 nucleic acid detection, which adopted real-time polymerase chain reaction technology to detect nucleic acid sequences at 3 targets, with a sensitivity of greater than 90%. After the medical staff removed their protective face shields and goggles and left the isolation ward, test swabs were daubed on the outer surfaces of the equipment 3 times. A total of 30 face shields and 30 sets of protective goggles were tested for SARS-Cov-2. In addition, the surfaces of a total of 20 nurse rolling carts and station tables were tested with the swabs in the same way. Surfaces of the belongings of 20 patients with confirmed disease, such as water cups and screens of mobile telephones, were also tested with swabs, and 30 samples were sent to the laboratory for nucleic acid testing for COVID-19 (Table I).Table INucleic acid testing on the surface of personal protective equipment, medical facilities, and the belongings of patientsLocationNo. of testsNo. of positive resultsFace shields300Protective goggles300Nurse rolling carts150Nurse station tables50Patients' water cups100Patients' mobile telephones201 Open table in a new tab All surfaces of the face shields and protective goggles were devoid of SARS-Cov-2. Additionally, the surface test results for nurse stations and rolling carts and the water cups were negative, except for 1 positive result from the surface of a mobile telephone of a patient with COVID-19 (Table I). It is well known that COVID-19 can be transmitted by an airborne route4Guan L. Zhou L. Zhang J. Peng W. Chen R. More awareness is needed for severe acute respiratory syndrome coronavirus 2019 transmission through exhaled air during non-invasive respiratory support: experience from China.Eur Respir J. 2020; 55: 2000352Crossref PubMed Scopus (47) Google Scholar; however, it was not clear whether the virus could float on surfaces in a medical environment and cause contact infection of medical staff. This study revealed that the probability that COVID-19 on surfaces can cause contact transmission is low; instead, more attention should be paid to personal isolation and protection from air transmisson. However, fomites such as patient belongings are a potential route of transmission, and therefore it is essential for hand washing and disinfection after contact with such items.5Lotfinejad N. Peters A. Pittet D. Hand hygiene and the novel coronavirus pandemic: the role of healthcare workers.J Hosp Infect. 2020; (https://doi.org/10.1016/j.jhin.2020.03.017)Abstract Full Text Full Text PDF Scopus (87) Google Scholar We thank Inuk Zandvakili for revising the manuscript.