#COVID19 Preprint Journal Club: “Toilets dominate environmental detection of SARS-CoV-2 virus in a hospital”

Another short #COVID19 Preprint with relevance to the built environment came out yesterday.  This one from a hospital in Nanjing, China where they collected 107 samples from the air and various surfaces.  Most of those were negative (RT qPCR as usual) but most of the positives were found in the bathroom.   Abstract below:

Abstract

Background: Respiratory and faecal aerosols play a suspected role in transmitting the SARS-CoV-2 virus. We performed extensive environmental sampling in a dedicated hospital building for Covid-19 patients in both toilet and non-toilet environments, and analysed the associated environmental factors.

Methods: We collected data of the Covid-19 patients. 107 surface samples, 46 air samples, two exhaled condensate samples, and two expired air samples were collected were collected within and beyond the four three-bed isolation rooms. We reviewed the environmental design of the building and the cleaning routines. We conducted field measurement of airflow and CO2 concentrations.

Findings: The107 surface samples comprised 37 from toilets, 34 from other surfaces in isolation rooms (ventilated at 30-60 L/s), and 36 from other surfaces outside isolation rooms in the hospital. Four of these samples were positive, namely two ward door-handles, one bathroom toilet-seat cover and one bathroom door-handle; and three were weakly positive, namely one bathroom toilet seat, one bathroom washbasin tap lever and one bathroom ceiling-exhaust louvre. One of the 46 air samples was weakly positive, and this was a corridor air sample. The two exhaled condensate samples and the two expired air samples were negative.

Interpretation: The faecal-derived aerosols in patients’ toilets contained most of the detectedSARS-CoV-2 virus in the hospital, highlighting the importance of surface and hand hygiene for intervention.