|LETTER TO EDITOR
|Year : 2020 | Volume
| Issue : 2 | Page : 175-176
Disinfection of environment in health-care settings: In COVID era
Raja Danasekaran, Vedapriya Dande Rajasekar
Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chengalpattu, Tamil Nadu, India
|Date of Submission||09-Jul-2020|
|Date of Decision||08-Sep-2020|
|Date of Acceptance||10-Oct-2020|
|Date of Web Publication||24-Dec-2020|
Dr. Raja Danasekaran
Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chengalpattu - 603 103, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Danasekaran R, Rajasekar VD. Disinfection of environment in health-care settings: In COVID era. Indian J Community Fam Med 2020;6:175-6
|How to cite this URL:|
Danasekaran R, Rajasekar VD. Disinfection of environment in health-care settings: In COVID era. Indian J Community Fam Med [serial online] 2020 [cited 2021 Jan 24];6:175-6. Available from: https://www.ijcfm.org/text.asp?2020/6/2/175/304801
Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by SARS-CoV-2. The disease is mainly transmitted by close contact and respiratory droplets, while the role of surface contamination, especially in health-care settings, is not conclusively proven. Keeping in view about the role of fomite transmission in case of other coronaviruses, the World Health Organization has given guidelines about the measures to be taken in health-care settings to avoid such spread. Environmental surfaces, mainly areas where COVID cases are managed, and medical procedures (bronchoscopy, endotracheal intubation, etc.) being carried out are more likely to be contaminated with the virus. Therefore, those areas must be demarcated and disinfected properly as per guidelines in order to avoid further transmission.
First, the environment has to be cleaned with soap and water mechanically in order to remove the dust, debris, and other organic matters. Then, a recommended disinfectant (like sodium hypochlorite) has to be applied in the right concentration (e.g., 1% sodium hypochlorite) and should be left for the recommended contact time (at least 10 min), so as to kill all the microbes. Metallic surfaces like door handles can be disinfected with 70% alcohol where bleach is not suitable. Proper disinfection of the environment involves adequate training, monitoring, and feedback of the staff involved. Appropriate personal protective equipment (PPE) need to be worn while preparing or using disinfectants to avoid exposure to chemicals. PPE which are advised include uniforms with long sleeves, closed work footwear, aprons, heavy-duty rubber gloves, triple-layer medical mask, and face shield. Special care needs to be taken while doffing the PPE so as to avoid self-inoculation with contaminated PPE or hands and a separate doffing room needs to be set up which has to be disinfected regularly.
Hypochlorite products such as sodium hypochlorite solution display a broad spectrum of action against majority of the microbes. As per the recommendations of National Guidelines for Infection Prevention and Control in health-care settings by the Government of India, 1% sodium hypochlorite solution can be used for disinfection of surfaces that might have got contaminated with the organism during patient care. Chlorine solutions decay rapidly in accordance with time and hence have to be prepared daily. [Table 1] shows some of the common surfaces that could get contaminated with the SARS-CoV-2 and the recommended method of disinfection.,
|Table 1: Guidelines for environmental disinfection in health-care settings|
Click here to view
Spraying or fogging using some disinfectants is not recommended, because of their ineffectiveness over the organic matter, in addition to the risk of adverse health effects among the workers. Some no-touch disinfectant methods such as ultraviolet irradiation and use of vaporized hydrogen peroxide are being tested and approved in some places but only for terminal disinfection and that too with prior removal of organic matter by cleaning. Furthermore, spraying disinfectants over people need to be avoided under any conditions, as it may lead to serious health consequences. All touchable surfaces have to be disinfected, but those high-touch surfaces (such as bed rails, door handles, and switches) have to be disinfected frequently.
Appropriate disinfectants have to be selected for health-care settings, while taking into consideration their efficacy against other health-care-associated infections too, apart from SARS-CoV-2. Even though there is not much evidence on the role of fomite risk in nonhealth-care settings (such as homes, schools, offices), high-touch surfaces need to be identified and disinfected regularly. Due to the fact that the Coronavirus can survive in the environment for days, disinfection of the environment, especially the health-care settings where COVID-19 patients are managed becomes imperative.,
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Ramesh N, Siddaiah A, Joseph B. Tackling corona virus disease 2019 (COVID 19) in workplaces. Indian J Occup Environ Med 2020;24:16-8. [Full text]
Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect 2020;104:246-51.