(h/t to Jonathan Eisen for the original article)
Virtually all the discussion these days is about aerosol/airborne transmission of SARS-CoV-2, and probably rightly so… there’s a lot of evidence that these are the primary routes of transmission. But as a recent Medscape article admonishes; “Don’t Forget the Fomites as Face-to-Face Care Ramps Up“. It’s still unclear what risk, if any, fomites play in the transmission of this coronavirus. It’s very hard to tease out since in most cases where aerosols are being deposited on surfaces that might present risk, people are also exposed to those same aerosols directly. As with everything, masks probably help because the reduce the deposition on surfaces as well as directly between people.
This article highlights a report from May called “Report into a nosocomial outbreak of coronavirus disease 2019 (COVID-19) at Netcare St. Augustine’s Hospital“. While this is not a published study, it’s a very detailed dive into this particular outbreak at a hospital in South Africa.
Of particular interest to me were the following couple of statements:
We present evidence that suggests there was a single introduction of SARS-CoV-2 into St. Augustine’s Hospital followed by widespread transmission to patients and health care workers…
And they do indeed present evidence that most of the people who got COVID-19 in outbreak, got it from the hospital.
As for fomites, here’s the conclusion of the study:
The spatial distribution of cases and exposed individuals who became infected on the wards suggests that the indirect contact via health care workers or fomite transmission were the predominant modes of transmission between patients in this outbreak.
I think this is an important reminder about how much we still don’t understand regarding the transmission dynamics of this virus and which activities/spaces present the most risk.