Assessing the risk of COVID-19 from multiple pathways of exposure to SARS-CoV-2: Modeling in health-care settings and effectiveness of nonpharmaceutical interventions

Mizukoshi, Atsushi; Nakama, Chikako; Okumura, Jiro; Azuma, Kenichi

doi:10.1016/j.envint.2020.106338

Cited by 51 publications

(63 citation statements)

References 68 publications

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“…Similarly, comparable fomite-mediated risks on the order of 1 in 10,000 were reported by Pitol & Julian (2021) and Harvey et al (2021) associated with contacting community fomites (playgrounds, crosswalk buttons etc.). In contrast, higher relative risks associated with SARS-CoV-2 fomite transmission (range: 2 × 10 −2 – 3.2 × 10 −1 infection risks) were reported in modeling studies of child daycare centers ( Kraay et al, 2021 ) and hospitals ( Jones, 2020 ; Mizukoshi et al, 2021 ). SARS-CoV-2 bioburden on environment-specific fomites ( Wilson et al, 2021 ) and fomite-specific contact frequencies likely explain these differences in risk estimates.…”

Section: Resultsmentioning

confidence: 88%

Decontamination of SARS-CoV-2 from cold-chain food packaging provides no marginal benefit in risk reduction to food workers

et al. 2022

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Countries continue to debate the need for decontamination of cold-chain food packaging to reduce possible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) fomite transmission among frontline workers. While laboratory-based studies demonstrate persistence of SARS-CoV-2 on surfaces, the likelihood of fomite-mediated transmission under real-life conditions is uncertain. Using a quantitative microbial risk assessment model of a frozen food packaging facility, we simulated 1) SARS-CoV-2 fomite-mediated infection risks following worker exposure to contaminated plastic packaging; and 2) reductions in these risks from masking, handwashing, and vaccination. In a frozen food facility without interventions, SARS-CoV-2 infection risk to a susceptible worker from contact with contaminated packaging was 1.5 × 10 −3 per 1h-period (5th – 95th percentile: 9.2 × 10 −6 , 1.2 × 10 −2 ). Standard food industry infection control interventions, handwashing and masking, reduced risk (99.4%) to 8.5 × 10 −6 risk per 1h-period (5th – 95th percentile: 2.8 × 10 −8 , 6.6 × 10 −5 ). Vaccination of the susceptible worker (two doses Pfizer/Moderna, vaccine effectiveness: 86–99%) with handwashing and masking reduced risk to 5.2 × 10 −7 risk per 1h-period (5th – 95th percentile: 1.8 × 10 −9 , 5.4 × 10 −6 ). Simulating increased transmissibility of current and future variants (Delta, Omicron), (2-, 10-fold viral shedding) among a fully vaccinated workforce, handwashing and masking continued to mitigate risk (1.4 × 10 −6 - 8.8 × 10 −6 risk per 1h-period). Additional decontamination of frozen food plastic packaging reduced infection risks to 1.2 × 10 −8 risk per 1h-period (5th – 95th percentile: 1.9 × 10 −11 , 9.5 × 10 −8 ). Given that standard infection control interventions reduced risks well below 1 × 10 −4 (World Health Organization water quality risk thresholds), additional packaging decontamination suggest no marginal benefit in risk reduction. Consequences of this decontamination may include increased chemical exposures to workers, food quality and hazard risks to consumers, and unnecessary added costs to governments and the global food industry.

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Section: Resultsmentioning

confidence: 88%

Decontamination of SARS-CoV-2 from cold-chain food packaging provides no marginal benefit in risk reduction to food workers

et al. 2022

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“…Having the patient wear a mask or face shield does reportedly make it possible to curb the risk of infection effectively, but this approach would not be feasible in dental therapy. In simulations, combining face masks and face shields reportedly provides 63% to >99.9% protection against infection in medical practice [30]. Therefore, using personal protective equipment such as masks, face shields, or aprons, is important for preventing infections [11,31,32].…”

Section: Discussionmentioning

confidence: 99%

Dispersion of Aerosols Generated during Dental Therapy

Takanabe

Maruoka

Junko

et al. 2021

IJERPH

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The novel coronavirus pandemic has resulted in an urgent need to study the risk of infection from aerosols generated during dental care and to conduct a review of infection controls. However, existing studies on aerosol particles related to dental treatment have mainly evaluated only the scattering range. Few studies have been conducted on the specifics of the generation of aerosol particles in clinical settings, their mechanisms and patterns of distribution throughout open or enclosed spaces, the duration that they remain suspended in air, and the amount and size of particles present. To minimize the influence of background particles, laser lights, a high-sensitivity camera, and particle counters were used in a large super clean laboratory to investigate the dynamics of aerosols generated during the operation of dental micromotors. The results indicate that aerosols tend to scatter upward immediately after generation and then gradually disperse into the surroundings. Most of the particles are less than 5 µm in size (only a few are larger), and all particles are widely distributed over the long term. Our research clearly elucidates that aerosols produced in dental care are distributed over a wide area and remain suspended for a considerable time in dental clinics before settling.

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“…Environmental disinfection and hand washing Contact transmission from surface of rooms and belongings is a cause of infection when the virus concentration in the saliva is high. Therefore, environmental disinfection is an important intervention to reduce viral exposure [33]. In contrast to norovirus, a special environmental decontamination or strong disinfectant is not needed to inactivate SARS-CoV-2 [34].…”

mentioning

confidence: 99%

Prevention and Control of COVID-19 in Imperfect Condition: Practical Guidelines for Nursing Homes by Japan Environment and Health Safety Organization (JEHSO)

Ochi,

Murakami,

Hasegawa

et al. 2021

IJERPH

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Infection control at nursing homes is a top priority to address the COVID-19 pandemic because people who are the most vulnerable to the pathogen live in close contact. Currently, control measures specifically for nursing homes often ignore under-resourced condition of the facilities. To make guidelines assuming realistic conditions, an expert meeting with 16 members established the key challenges in nursing homes, the basics of infection control, and the major transmission routes. A list of existing guidance was compiled and each item in the list was peer-reviewed by eight experts considering three aspects: significance, scientific validity, and feasibility. Factors related to the nursing home environment, the nature of SARS-CoV-2 transmission, and patient characteristics were identified as the causes of difficulties in infection control at nursing homes. To develop realistic prevention measures in under-resourced condition such as nursing homes, we may need to accept there are no perfect control measures that can achieve zero risk. Instead, the guidelines are based on the concept of deep defense, and practical checklists with 75 items were established. The evaluation of nursing homes by independent organizations using the checklists would be helpful to achieve sustainable infection control.

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Assessing the risk of COVID-19 from multiple pathways of exposure to SARS-CoV-2: Modeling in health-care settings and effectiveness of nonpharmaceutical interventions

Cited by 51 publications

References 68 publications

Decontamination of SARS-CoV-2 from cold-chain food packaging provides no marginal benefit in risk reduction to food workers

Decontamination of SARS-CoV-2 from cold-chain food packaging provides no marginal benefit in risk reduction to food workers

Dispersion of Aerosols Generated during Dental Therapy

Prevention and Control of COVID-19 in Imperfect Condition: Practical Guidelines for Nursing Homes by Japan Environment and Health Safety Organization (JEHSO)

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