Study brings fomites’ role in COVID-19 transmission to light
By Brooke Beery
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As optometric offices reopen for in-person consultations, most ODs are zeroing in on measures to prevent respiratory transmission of SARS-CoV-2, the novel coronavirus that causes COVID-19. Experts are now stressing that practitioners should not ignore the role fomites can play in transmission.
Fomites are inanimate objects which can become contaminated with the COVID-19 virus and facilitate the transmission of it to another person.
A study that ran from March 9 to April 30 of this year looked at a coronavirus outbreak at a university hospital in Durban, South Africa. It was led by Richard J. Lessells, MB ChB, PhD, an infectious disease specialist at the KwaZulu-Natal Research Innovation and Sequencing Platform at Nelson R. Mandela School of Medicine in Durban.1
Lessells and his team found no indication that aerosol, or airborne, transmission contributed to the outbreak. It is thought that aerosol transmission might have been repressed by masks and social distancing efforts. The virus spread predominantly from hand-to-hand contact and from highly touched fomites, including medical equipment, such as thermometers, blood pressure cuffs and stethoscopes.
The researchers noted that while SARS‐CoV‐2 can be highly stable on certain surfaces, particularly plastic and stainless steel, it responds well to standard disinfection techniques. This finding is supported by research published in the New England Journal of Medicine.2
According to the Centers for Disease Control and Prevention,3 evidence shows that SARS-CoV-2 can remain on some surfaces from a timeframe of a few hours to multiple days, depending on the type of surface material.
"This virus spreads very easily and quickly in a healthcare environment and will exploit any gap or weakness in your infection prevention and control,” Lessells says.
Another key takaway from the study is that there is a clear risk of transmission between healthcare workers where physical distancing is challenging.
“We have seen outbreaks that seem to be associated with transmission in common areas when masks are off, in tea rooms, changing rooms, and crowded transport to and from the hospital," Lessells says. "Unfortunately, we can't switch off at any stage. We have to remain vigilant at all times, and we must try to change our practices to reduce the risks in all these situations.”
1. R Lessells, Moosa Y, de Oliveira T. Report into a nosocomial outbreak of coronavirus disease 2019 (COVID-19) at Netcare St. Augustine’s Hospital. Available at: https://www.krisp.org.za/manuscripts/StAugustinesHospitalOutbreakInvestigation_FinalReport_15may2020_comp.pdf. Accessed 6/22/20.
2. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, Harcourt JL, Thornburg NJ, Gerber SI, Lloyd-Smith JO, de Wit E, Munster VJ. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020 Apr 6;382(16):1564-1567.
3. Centers for Disease Control and Prevention. Cleaning and disinfection for Households. Available at: www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html. Accessed 6/22/20.