COVID-19

A New Emerging Threat

A new (novel) coronavirus has been identified in Wuhan City, China. It has been named 2019-nCoV, or, colloquially, or the respiratory disease caused by infection with the virus had been termed COVID-19 by the WHO. Coronavirus is a large family of zoonotic viruses, meaning they transmit easily from animals to humans, and range from flu-like diseases to deadly respiratory diseases. We have all been exposed to some type of coronavirus before, however some strains pose greater health concerns than others. 2019-nCoV, like its viral cousins Severe Acute Respiratory Syndrome (SARS) coronavirus and Middle Eastern Respiratory Syndrome (MERS) coronavirus, presents the potential for widespread epidemic. The severity of the outbreak is aptly reflected by China’s Communist party, who released a bleak warning Tuesday, January 21, 2020, warning those who hide infection will “forever nailed to history’s pillars of shame.”

Since China first announced the emergence of the virus, more than 4,500 individuals have been hospitalized with respiratory complications from COVID-19, and at least 1,100 have died.  Up to date information on total cases and deaths can be found at this link. The virus has been traced back to a single meat, seafood and animal market in Wuhan City. On the 1st of January, the market was shut-down for disinfection and sanitation.

Transmission, Risks, & Symptoms
Like all coronaviruses, 2019-nCoV is carried by infected animals, however, person to person transmission has been observed. In addition to community transmission of the virus, hospital associated transmission has been reported both to patients and healthcare workers. Transmission occurs from coming into contact with an infected person, their secretions, or a carrier of the virus. Infected persons many or may not be symptomatic, which is proving difficult to accurately isolate screen potential carriers and identify how easily the virus is transmitted.

Risk Factors include:

  • History of travel from Wuhan City, China
  • Close contact with person with 2019-nCoV (suspected or confirmed)
  • Close contact is defined by the Centers for Disease Control (CDC) as physical contact as well as being in close quarters, approximately 2 meters (approximately 6 feet), or within the room or care area of an infected patient for a prolonged period of time while not wearing personal protective equipment. This contact can include caring for, living with, visiting or sharing a healthcare room or area. Additionally, coming into contact with secretions without proper personal protective equipment constitutes a health risk.
  • Onset of symptoms can occur up to 14 days after exposure, and may vary with age and underlying health conditions.

COVID-19 Symptoms include:

  • Fever
  • Cough
  • Shortness of breath
  • Difficulty breathing

If treatment is not sought, these symptoms may develop into severe complications, to include:

  • Pneumonia
  • Acute Respiratory Distress
  • Kidney failure
  • Death

What you can do to protect yourself:

When protecting yourself, your healthcare team, and your patients against transmission of new viral outbreaks, it is imperative to reinforce proper infection prevention techniques with proven technology to drastically reduce rates of transmission with the highest rates of efficiency. When patients present with violent respiratory symptoms, small water droplets are projected into the nearby environment. Those contaminated droplets infect the surface area of nearly everything in the room. According to researchers at Massachusetts Institute of Technology (MIT), a cough travels at approximately 50mph (80km/h) with about 3,000 droplets. A sneeze is a greater offender- at nearly 100mph (161km/h) and more than 100,000 droplets!

What Can Xenex do?

Use of LightStrike™ Germ-Zapping™ Robots during the cleaning process has been proven to kill pathogens on surfaces in the environment that are known to cause healthcare associated infections.

The LightStrike™ disinfection technology has been tested against the MERS coronavirus. In a study published by Stibich et al (2016), PX-UV demonstrated a reduction in the MERS coronavirus after a 5-minute disinfection cycle. As such, Xenex standard protocols are sufficient and longer cycle times are not needed.
Xenex’s standard protocol is to perform disinfection with the LightStrike™ Robot after manual cleaning has been performed. However, out of an abundance of caution in the interest of protecting healthcare workers, disinfection may be performed both before and after manual cleaning is completed.

If a facility suspects they may be at risk of receiving a patient who has contracted 2019-nCoV, we recommend keeping a Robot stationed in close proximity to the Emergency Department. This will allow rapid disinfection of ER waiting room and other potentially contaminated spaces. Click here to request more information.

These recommendations are evolving as more information is obtained by global health organizations.

References
Stibich, M., & Stachowiak, J. (2016). The microbiological impact of pulsed xenon ultraviolet disinfection on resistant bacteria, bacterial spore and fungi and viruses. South African Journal of Infectious Disease, 31(1), 12–15.
In the Cloud: How Coughs and Sneezes Float Farther Than You Think Dizikes, P.- MIT News Office – http://news.mit.edu/2014/coughs-and-sneezes-float-farther-you-think
As New Virus Spreads From China, Scientists See Grim Reminders Grady, D., – https://www.nytimes.com/2020/01/22/health/corona-virus-china.html?action=click&module=Top+Stories&pgtype=Homepage
China’s Communist Party Scrambles To Confront Coronavirus Outbreak, a Test Of Its Transparency, Hernández, J. – https://www.nytimes.com/2020/01/21/world/asia/china-coronavirus-wuhan.html?action=click&module=Top+Stories&pgtype=Homepage Clinical Criteria: Evaluating 2019-ncov

Puis https://www.cdc.gov/coronavirus/2019-nCoV/clinical-criteria.html
Maps: Where the Wuhan Coronavirus Has Spread, Rebecca, K. – https://www.nytimes.com/interactive/2020/01/21/world/asia/china-coronavirus-maps.htmlferences
How Fast Is a Sneeze Versus a Cough? Cover Your Mouth Either Way! 2016 Editorial Staff May 12 – https://www.lung.org/about-us/blog/2016/05/sneeze-versus-cough.html

Author: Sarah Simmons, DrPH, Xenex Disinfection Services, Amanda Berard, MS, Healthcare Clinical Researcher at Xenex Disinfection Services

Credit Kim Manganello