When to Clean, When to Disinfect, and What Science Says about SARS-CoV-2 on Surfaces
well good afternoon everyone my name is nora spencer lovell and i'd like to welcome you to today's cdc partner update on cover 19. this call serves as a way for cdc to share weekly updates on cover 19 and our latest resources and guidance and to answer questions submitted by participants on today's call we'll discuss content excuse me on today's call we'll be discussing uh when to clean and when to disinfect what we lovingly call fomites first we will hear from one of our science officers on cdc's covet 19 emergency response we'll describe where we are in the response and give us insight into recent scientific findings and then we'll hear from an expert in the waterborne disease prevention branch on an overview of cleaning guidance for homes and community facilities and afterward our speakers will answer questions we received over the last week via email and although i know we had live questions uh several weeks ago for the moment but we won't be taking live questions today because we have quite a few submitted via emails so please feel free if you have questions to send them in and we'll get to them on the next call for more information about these webinars visit cdc's coven 19 weekly partner call webpage where you can register for future calls and see recordings of previous webinars if this is your first call with us welcome these generally occur monday at 3 p.m eastern standard time um please see the link in the chat to subscribe and receive future call invitations and please note although this call is not intended for media you are certainly welcome please if you're a reporter and have a question reach out to media cdc.gov they can help you out all right as i mentioned these calls are designed to share the latest science guidance and resources from cdc as you know cdc has issued thousands of resources and guidance materials for individuals businesses and the public on our website cdc.gov so here are some highlights of a few recent additions on our website the first cdc is launching a new web page health equity in action for visitors to learn more about cdc's collaborative efforts to address health disparities among populations at higher risk for cova 19. cdc and its
and our partners are committed to reducing the disproportionate burden of coven 19 among populations at increased risk for infection severe illness and for death health equity in action highlights some of the multiple cdc efforts in place related to code 19 from across city season response and partnerships and these projects align with the health equity strategy for by cdc and offer web page visitors examples of cdc efforts to improve the health outcomes of populations disproportionately disproportionately affected excuse me cdc prioritizes opportunities to address these health disparities and to help the united states succeed against this public health threat cdc is working with state territorial local and tribal authorities community serving organizations and public and private groups to ensure all public health efforts address the specific cultural linguistic environmental historical and other needs and priorities of each population we continue to engage in collaborative projects where people live learn work play and worship this page provides health equity resources and connections to some of cdc's relevant materials and offer an excuse me an effort supporting communities at higher risk for open19 and second cdc has recently updated our website to include safety information about the johnson and johnson jansen covid19 vaccine last week as many of you saw in order to ensure safety and transparency cdc and fda recommended a pause in the use of johnson and johnson's jansen cova 19 vaccine of the nearly 7 million doses administered so far in the u.s a small number of cases of a rare and severe type of blood clot have been reported in people receiving the jnj vaccine all reports occurred among women between the ages of 18 and 48 and symptoms occurred six to 13 days after vaccination as of april 13th no cases have been reported among the more than 180 million people who've received pfizer or modern vaccines which is a completely different type of vaccine than the judson and johnson covin19 vaccine safety is a top priority for the federal government frankly for all of us and all reports of health problems following cloven 19 vaccination are taking their taken very seriously this potential safety issue was caught early and this pause reflects the federal government's commitment to transparency as cdc and fda review the data we do not know enough yet to say if the vaccine is related to or caused this health issue but to be extra careful cdc and fda recommend that that vaccine not be given until we learn more and this pause also will allow cdc's independent advisory committee the advisory committee on immunization practices or also known as esip to meet to review the cases and assess the potential significance so asap met last wednesday april 14th and they'll begin meeting again this friday april 23rd to further discuss all right so today i'm pleased to be joined by two cbc experts dr cynthia ogden is a science officer in support of the chief medical officer on the cdc's coven 19 emergency response and dr vince hill is chief of the waterborne disease prevention branch on the cdc's covenanting emergency response first i'm going to turn it over to dr ogden for some general updates thanks nora and welcome everyone i'm glad you're joining us today my name is dr cynthia ogden and as mentioned i'm a science officer serving in support of the chief medical officer for the response at cdc and today i'd like to provide a brief update on the response and review some of the latest scientific developments [Music] next slide please thanks first a situational update you can see from the slide that national covet 19 cases and deaths have slightly increased over the past week as compared to the previous week as of april 17th the seven-day average in cases increased by 1.7 over the previous seven day average the seven-day average in deaths increased by 3.3 percent over the previous seven-day average reported covet uh 19 cases and hospital admissions have been on an upward trend since march 20th 2021. so these statistics really do
provide us with valuable information when percentages are decreasing this tells us that the mitigation efforts are working when case counts increase this tells us that we need to step up mitigation efforts to slow the spread of covet 19. so on the vaccine front as of april 18th 209 million vaccine doses have been administered in the united states about 131 million people or 39.5 percent of the us population have received at least one covet 19 vaccine dose and 25.4 percent a quarter of the u.s population are fully vaccinated we encourage you to visit cdc's data tracker and the new weekly review for the latest stats and key indicators for the pandemic next slide please [Music] so in terms of some science updates new this week i want to share some of what we've learned from a few reports released in cdc's morbidity and mortality weekly report or the mmwr in the interest of time i'm only going to touch briefly on the high points of these reports and you will see the links to the reports in the chat and you can visit cdc.gov to read the full reports the first mmwr entitled laboratory modeling of sars cov2 exposure reduction through physically distanced seating in aircraft cabins using bacteriophage aerosol in this report scientists at cdc and the university of kansas modeled covet 19 exposures using various aircraft seating arrangements they found that full occupancy seating increased exposure to the vari the virus that causes covet 19. with
reduced seating including vacant middle seats exposure was reduced by up to 57 percent compared to full occupancy based on this laboratory model keeping aircraft middle cabin middle seats vacant reduces the risk of exposure to the virus that causes covid19 so current cdc guidelines recommend against travel for people who have not been vaccinated and masks for all people while on aircraft physical distancing of aircraft passengers including through policies such as middle seat vacancy could provide additional reduction in covet 19 exposure risk [Music] so the second mmwr entitled emergency department visits for covet 19 by race and and is an ethnicity that's the title of the second one the data in this report show hispanic non-hispanic american indian or alaska native and non-hispanic black people have higher rates of hospitalizations and death due to covet 19 compared with non-hispanic white people using ed data or emergency department visit data from 13 states obtained from the national syndromic surveillance program cdc assessed the rate of ed visits with a coveted 19 discharge discharge diagnosis between october and december 2020 by age and race ethnicity and so results showed that compared with non-hispanic white people hispanic people were 1.8 times more likely to seek care at an ed for covert 19. similarly non-hispanic american indian or alaska native people were 1.7 times more likely to seek care and non-hispanic black people were 1.4 times more likely to seek care [Music] so these differences in e.d visit rates suggest ongoing racial and ethnic disparities in incidents these findings can be used to prioritize prevention resources including covet 19 vaccination to reach disproportionately affected communities and reduce the need for emergency care for covet 19. so the final mmwr we'd like to
highlight is on covid19 and influenza discharge diagnoses as a percentage of emergency department visits in late june 2020 through july 2020 almost three percent of all emergency department visits in the united states were for covet 19. visits for covet 19 then declined through august 2020 and a larger and more prolonged increase in covet 19 ed visits began in september 2020 and peaking in early january 2021 with more than seven percent of all visits from covet 19. while influenza activity generally begins in october and occurs throughout the winter months influenza accounted for less than 0.1 percent of all emergency department visits during june 2020 through march 2021 and just as a comparison this compares to data from the beginning of february 2019 when the percentage of ed visits for influenza reached 5 [Music] with that it is now my pleasure to hand the call over to my esteemed colleague in the waterborne disease prevention branch [Music] great thank you dr ogden as mentioned earlier my name is vincent hill i'm the chief of the waterborne disease prevention branch and i'm supporting the cdc covet 19 emergency response as a senior advisor for environmental microbiology next slide so uh sarsko v2 transmission is complicated especially for transmission of the virus from contaminated surfaces in this figure from public health england transmission pathways are illustrated often it is not possible to isolate a single pathway responsible for a case or a cluster of cases for the purpose of this presentation we will focus on transmission related to surface contamination in the center bottom of this figure next slide this adapted figure will show just the surface transmission route for this transmission route an infected person has normal respiratory activity in other words regular breathing or may cough or sneeze expelling respiratory secretions in large droplets in addition to aerosols and small droplets focusing on the large droplets and respiratory secretions these can directly contaminate the infected person's hands or may land on surfaces in the surrounding in the area surrounding the person thus virus may contaminate surfaces through droplets or when contaminated hands from an infected person touch a surface virus can be transmitted from the contaminated surface to the hand of a susceptible person when that person touches the surface virus on a susceptible person's hands can then be transferred to a mucous membrane in the eyes nose or mouth when the susceptible person touches their face the person may then become infected it is important to note that masks are a barrier that can reduce the amount of virus that might land on surfaces and cleaning hands can prevent contamination of surfaces as well as the transfer of virus from contaminated hands to a susceptible person's face next slide transmission of the virus that causes covid19 by direct contact inhaling and inhaling aerosols and droplets is more likely than by touching surfaces the same relative transmission risk is supported by scientific evidence for other respiratory illnesses particularly for transmission of cold and flu viruses respiratory viruses such as sars phobia2 shown in the image on the right influenza virus and rhinovirus which causes colds have an outer layer called an envelope shown in the image on the right and this envelope can be damaged relatively easily in the environment especially outdoors where sunlight and heat can damage these viruses quickly respiratory etiquette like sneezing into a tissue and cleaning hands have demonstrated effectiveness for preventing respiratory illness during the pandemic cdc has collected data on unintended health impacts from increased use of cleaning and disinfection products and heard many reports from partners and the public on challenges and following our guidance throughout the pandemic the public has been able to get answers to questions by submitting them to cdc info which is cdc's national contact center for the public to ask questions of cdc experts and obtain publication resources the most common type of hygiene related questions that cdc has received have been related to cleaning and disinfection these questions from the public often ask about how when and what products to use for cleaning and disinfection early in the pandemic we heard from various partners that implementing cleaning and disinfection guidance was challenging often due to a lack of availability of epa list and disinfectant disinfection products list n is an epa list of disinfectant products that epa expects to be effective for killing stars cov2 in school settings we have heard from administrators and educators that recommended cleaning and disinfection procedures were difficult to implement due to lack of time and competing priorities there have also been reports of highly visible cleaning and disinfection behaviors including the use of fogging sprayers as shown in the picture on the right that could be used as a form of hygiene theater or putting on a show of cleaning and disinfectant such cleaning procedures may be used to give people a sense of security that they are being protected from the virus but this may be a false sense of security if other prevention measures like wearing masks physical distancing and hand hygiene are not being consistently performed it also could make people feel less need to engage in these other important prevention measures based on surveys and public inquiries regarding how when and what to use to clean and disinfect surfaces one of the consequences of frequent disinfection is that people may be using disinfectants in ways that are unsafe public inquiries indicate that some people may purposely drink inhale or spray their skin with disinfectants without understanding that use of disinfectants in this way can cause serious harm to their bodies data from a cdc survey suggested important gaps in public knowledge and practice in the safe use of cleaners and disinfectants for example only 58 percent knew that bleach should not be mixed with ammonia because mixing bleach and ammonia creates a toxic gas that harms people's lungs 19 wash food products with bleach which could lead to their consumption of bleach that isn't washed off which can damage the body because bleach is toxic and 18 used household cleaner on bare skin which can damage the skin causing rashes and burns in association with a dramatic increase in disinfectant use and gaps in public understanding of proper use and safety practices national poison data system surveillance during the pandemic shows that caused the poison centers for disinfectants in 2020 shown by the black line in the figure exceeded calls in 2018 and 2019 the gray and blue lines of the figure the yellow line depicts calls to u.s poison centers through early 20th april 2021 and shows continued higher call volume for disinfectant exposures than in 2019 and 2018 although the numbers are lower than we saw in the spring and summer of 2020.
next using evidence from epidemiological and field investigations experimental studies and quantitative risk assessments cdc completed a scientific review of sars kuvy 2 surface transmission lists based on the findings from these sources of evidence cdc determined that the risk of surface transmission is low and secondary to the primary routes of virus transmission through direct contact droplets and airborne aerosols we found little evidence indicating that there is significant transmission of the virus from contaminated surfaces which are also referred to as fomites although it can be difficult to distinguish surface transmission from other transmission routes there are some case reports that suggest that people are at increased risk of surface transmission within the first 24 hours after a sick person has been in this space one study of households in which an infected person was residing found that cleaning and disinfection appeared to be associated with lower transmission of the virus within the household one of the important sources of information used in the science review were quantitative risk assessments quantitative risk assessments help us understand and characterize the relative risk of transmission and evaluate the need for and effectiveness of prevention measures multiple published risk assessment studies were available and all of them supported a determination that the risk of infection from surfaces is low and generally less than one in ten thousand meaning that each contact with a contaminated surface has less than a one in ten thousand chance of causing an infection the risk assessments use surface contamination data from indoor and outdoor surfaces the risk of infection from touching a surface is generally less in an outdoor setting than an indoor setting due to harsher environmental conditions outdoors like sunlight and heat wearing a well-fitted mask reduces the amount of respiratory droplets and therefore virus that can land on surfaces and thus is a prevention measure that can further reduce surface transmission risks evidence also shows that hand hygiene can act as a barrier to transmission and thus further reduce surface transmission risk in our scientific review we looked at experimental data from studies investigating the survival of sars kobe 2 on common indoor surfaces we focused on survival data under typical indoor conditions with temperature in the range of 20 to 25 degrees celsius or 68 to 77 degrees fahrenheit and relative humidity of 30 to 65 most studies reported the virus dying off rapidly on soft surfaces like cloth with inability to detect to detect infectious virus within minutes to hours for hard surfaces like stainless steel researchers generally found that 99 of the virus died off within three days as depicted in the graph on the right in this graph the amount of virus shown here using the word tighter uh on the uh on the vertical axis um at the beginning of the experiments at time zero the data is shown in black dots in the upper left corner at the level of ten to the five or a hundred thousand virus particles as the virus particles sit on a surface in this case on stainless steel they become more and more damaged over time and lose their ability to infect in this set of experiments the amount of virus shown as dots decreases with time measured in hours in these experiments after approximately 72 hours or halfway between the 50 and 100 hour time points the dots are approximately 99 lower than at the start of the experiments the straight green lines are a way of showing how fast the die off is occurring we looked at published experimental data for hard surfaces commonly found in homes and facilities like stainless steel but also plastic and glass and in general these experiments indicate that 99 of the virus will die off on hard surfaces in indoor settings within three days in addition to examining the relative risk of surface transmission the scientific brief examined two of the main ways that we can reduce the risk of surface transmission after a surface is already contaminated which are cleaning with the household complete with health with household cleaners and containing sober detergent or using a disinfectant product registered with epa's list n which is epa's list of products determined to be effective against stars w2 cleaning is the process of removing dirt and germs from surfaces whereas disinfection is the process of killing germs on those surfaces cleaning and disinfection can both reduce the risk of surface transmission i will describe a bit about how these processes work cleaning with a soap or detergent product reduces the amount of soil on surfaces including dirt and germs like viruses soap and detergent chemicals are molecules that have one end of the molecule that is attracted to water shown in the images as blue dots attached to squiggly lines and the other end of the molecule that is attracted to organic materials like dirt and germs soap and detergent molecules create micelles which are spherical structures that surround dirt and germs and help remove them through washing and wiping off a surface cleaning with soap and water or detergent product made for surface cleaning can reduce virus levels on surfaces by 90 to 99 percent depending on the cleaning method and surface being cleaned for sars kobe 2 shown in the image with black in black with spikes soap molecules can also damage the virus however soap and detergent products are designed for cleaning not for killing the virus unless they contain at this unless the products contain a disinfecting chemical and are registered on epa less 10 for products that are effective against sarge cov2 disinfectant products are designed with chemicals that cause damage to the outside or inside parts of germs so they cannot cause infection there are many types of disinfectants that are effective against the virus that causes fluid 19. to substantially kill the virus on surfaces the surface must be treated with a disinfectant product registered with epa's listed surfaces should be cleaned before applying a disinfectant so that so that the disinfectant can work well if the disinfectant product does not already contain a cleaning agent the surface should be cleaned before disinfectant so in conclusion uh the science the cdc science brief described some important findings on surface transmission of the virus uh the most important finding uh is that the scientific evidence uh indicates that the virus that the risk of surface transmission is low in most situations mask wearing can substantially reduce the amount of virus from infected people that gets into the environment onto surfaces hand hygiene and cleaning and disinfection can be effective for reducing surface transmission risks when cyrus cov2 viruses land on surfaces they rapidly die within hours on soft porous surfaces they can live longer on hard surfaces but can be expected to die off by 99 within three days cleaning alone can be effective for removing virus from surfaces and reducing already low surface transmission risk epa listen disinfectants are highly effective for killing the virus this infection of surfaces is warranted within the first 24 hours after surface contamination when infectious virus is more likely to be present so now i'd like to um talk about uh our updated cleaning and disinfection guidance uh based on the scientific review of surface transmission uh that we i just uh told you about next one it's important to note that the science review and updated guidance are for community settings not for health care settings or facilities that have specific regulations community settings include locations such as homes educational institutions workplaces and other indoor or outdoor locations that serve the general public as a general principle in most situations cleaning surfaces using soap or detergent and not disinfecting is enough to reduce the already low risk of virus transmission from surfaces mask wearing and practicing hand hygiene are also important for reducing surface transmission risks in homes and shared housing cdc recommends cleaning regularly for example daily and after you have visitors in your home disinfecting surfaces is typically not necessary unless a sick person or if someone positive for coca 19 has been in the home within the last 24 hours when cleaning focus on high touch surfaces like doorknobs handles light switches tables and countertops more in-depth disinfection in areas occupied by the sick person is needed if someone in the household is sick use products that are suitable for each surface and always follow the label instructions on the product in community settings like offices and stores in most situations daily cleaning is usually enough to reduce any virus present on surfaces some situations may prompt more frequent cleaning or may warrant choosing to disinfect for example in settings where there is a high transmission of coping 19 in the community low mass usage where hand hygiene is not performed frequently and consistently and in places where people in the facility are at increased risk for severe illness from covet 19. when cleaning or disinfecting if needed focus cleaning procedures on those high touch surfaces like handles countertops and store payment devices ensure that cleaning staff are trained and have the needed safety supplies if choosing to disinfect use epa list and disinfectants and follow the product use guidance on the label if a person who is sick or positive for covid19 is known or suspected to have been in your home or facility follow these cleaning and disinfection guidelines if the person is residing in the space or has been in the space within the last 24 hours disinfect surfaces after cleaning if it has been more than 24 hours but less than three days then disinfection is not needed but surfaces particularly commonly touched surfaces should be cleaned with soap and water or detergent product if it has been more than three days since the person who is sick or positive for cover 19 has been in the space no additional cleaning or disinfection is needed routine daily cleaning is recommended here are steps for cleaning and disinfecting when an infected person has been into space within the last 24 hours before cleaning and disinfecting the space close off the areas used by the person wait as long as possible to enter the room at least several hours while cleaning and disinfecting ventilate the room by opening doors and windows and using fans or central air wear a face mask and gloves while inside the area if vacuuming use a vacuum that is equipped with a high efficiency particulate air filter or hepa filter thank you for your interest in cdc's recommendations for cleaning and disinfection and scientific assessment of the role of surfaces in cova-19 transmission if you would like to learn more about these topics here are some available resources thank you so much dr hill and dr ogden both presentations were incredibly informative and before we move on to the q a portion of the call to our audience please go ahead and take a moment to answer the questions through the poll on your screen shortly now for those of you who submitted questions in advance of this call thank you so much we received so many and we'll try to get to as many as we can do we have the poll uh control tower there we go all right dr hill this first group of questions is for you the first question is how has cdc's cleaning and disinfection guidance changed great thank you um cdc guidance has been updated based on scientific evidence indicating in most situations the risk of getting coveted 19 from touching surfaces is low and that cleaning surfaces using soap or detergent is enough to further reduce the already low chance of covet 19 spread from surfaces the updated guidance only recommends disinfecting surfaces in higher risk situations such as when there has been a sick person or someone who has tested positive for covet 19 in a home or facility within the last 24 hours previously cbc guidance recommended cleaning and disinfecting indoor spaces up to seven days after a known or suspected cobit 19 case based on the scientific review cdc's guidelines now indicate that cleaning and disinfecting is only recommended within the first 24 hours after a known or suspected covet 19 case has been in an indoor space if it has been more than 24 hours but less than three days since a known or uh suspected code 19 case then only cleaning of the area the sick person used as needed not this infection if it has been more than three days no additional cleaning aside from regular cleaning is needed all right great thank you second question how can i put the new cdc cleaning and disinfection guidance into practice in my setting if i'm concerned that i may have a higher risk situation thanks we've we've gotten this question a number of times um the recommendation to clean surfaces in most situations instead of disinfecting them is based on the based on the weight of available scientific evidence this evidence indicates that the risk of getting infected by the virus from surfaces and objects is low the evidence also shows that cleaning can be effective at further reducing risk by removing virus from surfaces these findings and others reinforce our understanding that the main risk of spreading the virus is from close contact with an infected person not from touching surfaces layered prevention measures are critical for stopping the spread of the virus and include hand hygiene and surface cleaning and in some cases in some situations disinfection along with a primary focus on vaccinations wearing masks and physical distancing it's important to recognize that the scientific evidence is not sufficient to inform detailed surface cleaning and disinfection recommendations in specific settings and procedures based on the way the virus can be transmitted from surfaces cdc's cleaning and disinfecting your facility guidance identifies conditions that can increase the relative risk of infection while recognizing that the risk of surface transmission is low these conditions include high transmission of cobit 19 in your community low number of people wearing masks infrequent hand hygiene or the facility space being occupied by certain populations such as people at increased risk for severe illness from covert 19. in these situations
facilities may want to develop plans in which more frequent than daily cleaning is performed or choosing to disinfect in some situations ultimately it's up to people setting cleaning plans to judge the nature of who occupies space what happens in the space and any other potential risks involved and to use that information to decide how often to clean or if they should disinfect thank you so much dr hill all right this third question is the one you've all been waiting for and in essence do i need to keep wiping down my groceries but i'll read the full question it isn't necessary to clean food containers food related surfaces and or groceries if so what is the recommended approach friends of mine have been disinfecting food contact surfaces and groceries not realizing this may leave a non-food safe residue on the surface of the food great thanks um so the risk of infection by the virus from food products food packaging or bags is thought to be very low currently no cases of covet 19 have been identified where infection was thought to have occurred by touching food food packaging or shopping bags it's always important to follow good food safety practices to reduce the risk of illness from common foodborne pathogens so in homes and shared housing special cleaning and disinfection activities are only needed when someone else is sick in the home in these situations caregivers should wear gloves when handling dishes and utensils for the person who is sick and should wash the dishes and utensils with soap and hot water or in the dishwasher if needing to disinfect a food contact surface like a kitchen counter use a disinfectant product from epa's list app when using disinfectants always follow the directions on the label to ensure safe and effective use of the product before preparing food on a disinfected surface the surface should be rinsed with water it's important also important to note that the cdc cleaning and disaffecting your facility guidance is intended for cleaning and disinfecting buildings and community settings to reduce the risk of coping 19 spreading this guidance is not intended for healthcare settings or for operators of facilities such as food and agricultural production or processing workplace settings manufacturing workplace settings or food preparation in food service areas where specific regulations or practices for cleaning and disinfection may apply great thank you so much um okay let's turn to disinfection in spaces used by kids how do you recommend cleaning public playground equipment excuse me public playground equipment and shared toys for young children at a community facility great thanks thanks for that question um so cbc recommends that schools and community facilities for children use and layer multiple prevention strategies to reduce transmission of cyrus cov2 including good hand hygiene and maskware an additional strategy is cleaning and maintaining healthy facilities high touch surfaces on playground equipment like grab bars and railings should be cleaned regularly for example using soap and water or a household surface cleaner cleaning of wood plate structures like that in those natural wood plate structures is not recommended for facilities serving young children and others who may not consistently or properly wear masks wash hands or cover coughs and sneezes the relative risk of surface transmission is low compared to the risk of respiratory and direct contact transmission however it's still prudent to limit the use of shared objects in those cases and consider performing more frequent cleaning to the extent practical as noted previously cdc's cleaning and disinfecting your facility guidance identifies conditions that can increase the relative risk of infection from surfaces including shared objects while recognizing that the risk of surface transmission is low these conditions include high transmission of copper 19 in your community low number of people wearing mass and infrequent hand hygiene which may be present in settings with young children all right thank you so much um turning now to the the virus itself how is sars kobe 2 survival different for hard surfaces versus clothes for example if i sit on contaminated surfaces at rest a restaurant or someone sneezes and starts kobe 2 get in my clothes can the germs get from my clothes to others in my family how to disinfect clothes is washing enough et cetera great this is a really interesting question um the virus will likely survive longer on hard surfaces than in clothes studies report being unable to detect infectious virus within minutes to hours on soft porous surfaces like clothing whereas on hard non-porous surfaces like counter tops infectious virus can be detected for week to four days to weeks the relatively shorter survival the virus on soft pore surfaces might be due to the difference in how respiratory droplets containing the virus attach to pores which you can think of as holes and passageways on the surface which may cause them to dry up faster and damage the fires quicker the risk of getting covet 19 from touching clothes is likely very low in those situations particularly if nobody is sick in those situations cdc recommends washing clothing and other soft items that can be washed in the laundry in handling dirty laundry from a person who is sick it is safe to wash the laundry with other people's items but cdc recommends protecting yourself by wearing gloves and a mask thank you so much dr hill okay moving on how effective are technologies that claim to neutralize or kill stars kobe 2 such as ozonated or ozone water water tablets electrostatic misting sprayers with uv light etc other than alcohol-based disinfectants are there any other commercial chemicals that could kill the virus on hard surfaces yeah thank you this is one that you know there are a lot of pictures about this and it's a pretty visible uh question that people have so the effectiveness of many alternative disinfection technologies against sarge kobe 2 these alternative disinfection technologies it just hasn't they haven't been fully established the effectiveness particularly under real world settings outside of controlled laboratory conditions in most cases technologies using fogging fumigation and wide area or electrostatic spraying are not recommended as primary methods of surface disinfection based on efficacy and potential safety concerns to find products that are effective disinfectants epa maintains list n which is the best place to find a product uh as of april 15th more than 600 commercial products are listed there and cdc recommends using products in general using products that are shown to be effective against sars kobe 2. thank you okay one more question for you it's a doozy uh there is concern across some industries such as food and agricultural production manufacturing workplace or food service but cdc's guidance results in mixed messaging related to surface disinfection so a whole system approach to pathogen risk reduction includes frequent cleaning and disinfection of surfaces especially for controlling difficult pathogens with known fomite transmission routes such as norovirus or hepatitis a virus there is concern that the updated guidance implies that surface disinfection is not necessary in general and that this could take away from controlling pathogens other than stars cov2 can cdc clarify cleaning and disinfection related to controlling these other pathogens great thanks uh i really appreciate having this question because it is important to clarify um so part of this question refers to food industries and food service uh so it's important to note again that the cdc cleaning and disinfecting your facility guidance is not intended for operators of facilities such as food and agriculture production or processing workplace settings manufacturing workplace settings and for food and preparation and food service areas because those those areas have specific regulations or practices for cleaning and sanitization or disinfection that that may apply and so those you know nothing that we put out supersede any of those kinds of regulations and practices that you've got potentially in those workplaces the updated guidance applies to covet specific situations and does not supersede right these cleaning or disinfection guidance for other pathogens or regulated settings cdc agrees wholeheartedly that cleaning and disinfection are important actions that the public and facility managers can take to prevent spread of infectious diseases thanks dr hill for the presentation and for those incredibly helpful answers i'm going to turn now over to dr ogden for the next set of questions first to you is is a person who has had covet already likely to have antibodies excuse me antibody levels similar to a vaccinated individual so getting covet 19 may offer some natural protection known as immunity however experts don't know for sure how long this protection lasts and the risk of severe illness and death from covet 19 far outweighs any benefits of natural immunity covid19 vaccination will help protect you by creating an antibody or immune system response without having to experience sickness both natural immunity and immunity produced by a vaccine are important parts of covet 19 disease that experts are trying to learn more about and cdc will keep the public informed as new evidence becomes available cdc continues to recommend vaccination for people who have already been infected with covet 19. thanks okay this one asks for your thoughts on the brazil variant and it's spread in the u.s so this variant p1 it emerged in brazil in the amazona state the p1 variant shares some of the spike protein substitutions observed in another variant the b-1351 variant first seen in south africa p1 was first identified in the united states on january 25th in minnesota in one case with travel history to brazil but has also been detected in other states and individuals with no known travel history to brazil indicating the likelihood of community transmission we have much less data about this about how this variant is spreading the currently estimated national prevalence of the p1 variant is 1.4 for the two-week period ending march 27 2021.
there are regional differences in the prevalence of this variant based on data available to cdc the state level prevalence of the p1 variant ranges from 0.1 to 7.9 percent we do not yet know if the severity of disease this variant causes is clinically different from other stars cov2 variants most experts believe it is likely to cause similar disease with severity not being much greater than we are seeing now we will continue to provide updates as we learn more about this new variant and our guidance may change as we better understand it cdc continues to emphasize the importance of compliance with public health measures such as wearing a mask saying it staying at least six feet apart from others avoiding crowds ventilating indoor spaces and washing hands frequently these are our best tools for preventing the spread of this virus no matter the strain there is evidence that this variant may spread more easily so increased compliance with these prevention measures will be critical to slow at spread and cdc continues to recommend vaccination as soon as the vaccine is available to you thanks dr ogden and i think as of today that's for all adults in the u.s that's right um okay third question if a cms center for medicare medicaid services is opening visitations in nursing homes with moderate community transmission of kovid is it still recommended to quarantine new nursing home admissions for 14 days and refrain these new patients from visits so residents with confirmed sars kofi ii infection who have not met criteria for discontent discontinuation of transmission-based precautions you'll see a link for that in the chat should be placed in designated coven 19 care units in general all other new nursing home admissions and readmissions should be placed in a 14-day quarantine even if they have negative tests upon admission exceptions include residents within three months of asar's cov2 infection and fully vaccinated residents as described in cdc's updated health care infection prevention and control recommendation in response to covet 19 vaccination again in the chat facilities located in areas with minimal to no community transmission might elect to use a risk-based approach for determining which residents require quarantine upon admission decisions should be based on whether the resident had close contact with someone with sars cov2 infection while outside the facility and if there was a if there was consistent adherence to infection prevention and control practices in healthcare settings during transportation or in the community prior to admission thank you okay dr ogden if a person experiences side effects from the first dose of an mrna vaccine that's pfizer or moderna should they go ahead and receive the second dose considering the first dose has as good of an efficacy as some single dose vaccines a good question yes to get the most protection you should get the second shot even if you've had side effects after the first shot unless a vaccination provider or your doctor tells you not to get it in most cases discomfort from pain or fever is a normal sign that your body is building protection you know contact your doctor or your health care provider if the redness or tenderness where you got the shot gets worse after 24 hours or if your side effects are worrying you or do not seem to be going away after a few days talk to your doctor about taking over-the-counter medicine such as ibuprofen acetaminophen aspirin or antihistamines for any pain and discomfort you may experience after getting vaccinated you can take these medications to relieve post-vaccination side effects if you have no other medical reasons that prevent you from taking these medications normally it's not recommended that you take these medications before vaccinations for the purpose of trying to prevent side effects thank you so finish the dose finish the vaccine um final question for you um so somebody wrote my husband just tested positive for covid19 he was treated aggressively for cancer two years ago with chemo and radiation should he speak to his oncologist yes he should speak to his oncologist older adults and people who have severe underlying medical conditions including a history of cancer seem to be at a higher risk for developing more serious complications from covid19 illness cancer survivors should speak with their healthcare providers about steps to take to manage their health and any symptoms that may develop thank you so much dr elkin well this concludes today's discussion thanks so much to everyone who joined our call as you know recording of this call will be posted on our weekly partner call webpage where you can subscribe to future calls and you can find recordings and information about previous webinars the link is listed on the slide or feel free to copy click and copy the link in the chat box one key note we will be changing the frequency of these partner calls and so stay tuned we will have our next call next monday april 26th the call is titled keeping up with critical diabetes care and prevention during coven 19 and then following that call will stagger the calls uh for to be a little bit more infrequently likely and once a month so that we can get you a little more content um and you can take advantage of some of the other sources of information that cdc is producing as well until next time please wear a mask stay six feet apart avoid crowds and get a vaccine thanks so much everyone