During April and May 2020, we studied 20 hospitalized COVID-19 patients, their hospital rooms (fomites and aerosols), and their close contacts for molecular and culture evidence of SARS-CoV-2 virus. Among the more than 400 samples, we found molecular evidence of virus in most sample types, especially the nasopharygeal (NP), saliva, and fecal samples, but the prevalence of molecular positivity among fomites and aerosols was low. The agreement between NP swab and saliva positivity was high (89.5%, Kappa 0.79). Two NP swabs collected from patients on one and seven days post-symptom onset had evidence of infectious virus (2 passages over 14 days in Vero E6 cells). In summary, the low molecular prevalence and lack of viable SARS-CoV-2 virus in fomites and air samples implied low nosocomial risk SARS-CoV-2 transmission through inanimate objects or aerosols.
In this paper we review recent human respiratory virus epidemics, their zoonotic nature, and our current inability to identify future prepandemic threats. We propose a cost-efficient, One Health surveillance strategy that will be more efficient and more sustainable than previous efforts.
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