distributions and risks of sars cov 2 in hospital outdoor environment CORD-Papers-2021-10-25 (Version 1)

Title: Distributions and risks of SARS-CoV-2 in hospital outdoor environment
Abstract: The outbreak of coronavirus infectious disease-2019 (COVID-19) pneumonia since 2019 has rapidly spread throughout over 200 countries around the world. Till 14th May 2020, there are over 4 million confirmed cases and 300,000 deaths globally. To date, numerous studies focus on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in indoor areas for its main transmission routes via human respiratory droplets and direct contact. It remains unclear about the distribution and transmission risks of SARS-CoV-2 in outdoor environment despite its threats to healthy people and communities. Here, we investigated the presence of SARS-CoV-2 virus in 73 specimens from outdoor environment of three hospitals in Wuhan. We found SARS-CoV-2 in soils (205-550 copies/g), wastewaters (255 to 1.9x104 copies/L) and aerosols (285-1130 copies/m3) in locations close to departments receiving COVID-19 patients or in wastewater treatment sectors, which revealed significant viral spill-over in hospital outdoor environment that was possibly via respiratory droplets from patients or airborne aerosols from wastewater containing SARS-CoV-2. In contrast, SARS-CoV-2 was not detected in other areas or on surfaces with regular disinfection. Soils eventually behave as viral receptors through deposition and potentially a secondary source spreading SARS-CoV-2 for a prolonged time. Our findings map the high-risk areas in hospital outdoor environment possessing spread risks of SARS-CoV-2, which require particular attention and complete sanitation for preventing SARS-CoV-2 outdoor transmission.
Published: 5/18/2020
DOI: 10.1101/2020.05.12.20097105
DOI_URL: http://doi.org/10.1101/2020.05.12.20097105
Author Name: Zhang, D
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhang_d
Author Name: Yang, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/yang_y
Author Name: Huang, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/huang_x
Author Name: Jiang, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/jiang_j
Author Name: Li, M
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_m
Author Name: Zhang, X
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhang_x
Author Name: Ling, H
Author link: https://covid19-data.nist.gov/pid/rest/local/author/ling_h
Author Name: Li, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_j
Author Name: Liu, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/liu_y
Author Name: Li, G
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_g
Author Name: Li, W
Author link: https://covid19-data.nist.gov/pid/rest/local/author/li_w
Author Name: Yi, C
Author link: https://covid19-data.nist.gov/pid/rest/local/author/yi_c
Author Name: Zhang, T
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhang_t
Author Name: Jiang, Y
Author link: https://covid19-data.nist.gov/pid/rest/local/author/jiang_y
Author Name: Deng, S
Author link: https://covid19-data.nist.gov/pid/rest/local/author/deng_s
Author Name: Zhao, P
Author link: https://covid19-data.nist.gov/pid/rest/local/author/zhao_p
Author Name: Qu, J
Author link: https://covid19-data.nist.gov/pid/rest/local/author/qu_j
sha: 09d6930365b3f6a0d1d1d43b3f3b8fbf82c9372d
license: medrxiv
source_x: MedRxiv; WHO
source_x_url: https://www.who.int/
url: http://medrxiv.org/cgi/content/short/2020.05.12.20097105v1?rss=1 https://doi.org/10.1101/2020.05.12.20097105
has_full_text: TRUE
Keywords Extracted from Text Content: disease-2019 COVID-19 coronavirus SARS-CoV-2 human respiratory droplets coronavirus 2 https://doi.org/10.1101/2020.05.12.20097105 doi COVID-19 4-6 Wuchang Fangcang ×10 4 specimens SARS-CoV-2 (Table S1 wastewaters soil medRxiv COVID-19 patients patient Huoshenshan people soils SARS-CoV-2 virus COVID-19 [12] [13] [14] samples Figure 1 Jinyintan Wuchang Fangcang Hospitals water medRxiv preprint SARS-CoV-2 viral DNA Wuhan people 5,7-9 patients Soils SARS-CoV-2 surface
Extracted Text Content in Record: First 5000 Characters:The outbreak of coronavirus infectious disease-2019 (COVID-19) pneumonia since 2019 has rapidly spread throughout over 200 countries around the world. Till 14 th May 2020, there are over 4 million confirmed cases and 300,000 deaths globally 1 . To date, numerous studies focus on the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in indoor areas for its main transmission routes via human respiratory droplets and direct contact 2,3 . It remains unclear about the distribution and transmission risks of SARS-CoV-2 in outdoor environment despite its threats to healthy people and communities. Here, we investigated the presence of SARS-CoV-2 virus in 73 specimens from outdoor environment of three hospitals in Wuhan. We found SARS-CoV-2 in soils (205-550 copies/g), wastewaters (255 to 1.9×10 4 copies/L) and aerosols (285-1130 copies/m 3 ) in locations close to departments receiving COVID-19 patients or in wastewater treatment sectors, which revealed significant viral spill-over in hospital outdoor environment that was possibly via respiratory droplets from patients or airborne aerosols from wastewater containing SARS-CoV-2. In contrast, SARS-CoV-2 was not detected in other areas or on surfaces with regular disinfection. Soils eventually behave as viral receptors through deposition and potentially a secondary source spreading SARS-CoV-2 for a prolonged time. Our findings map the high-risk areas in hospital outdoor environment possessing spread risks of SARS-CoV-2, which require particular attention and complete sanitation for preventing SARS-CoV-2 outdoor transmission. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 18, 2020. . https://doi.org/10.1101/2020.05. 12.20097105 doi: medRxiv preprint It is clear that SARS-CoV-2 causing COVID-19 4-6 is transmitted among people 5,7-9 via direct contact and respiratory droplet routes 6, 10, 11 , while aerosol or faecal transmission route is arguable [12] [13] [14] . Accordingly, many studies have addressed SARS-CoV-2 in hospital indoor environment to understand its transmission dynamics and find solutions protecting medical staffs or drop-in visitors 3, 15 . For healthy people and communities, there is still no knowledge about its presence in outdoor environment. It is of great urgency to evaluate the potential spill-over into open space and distribution in outdoor environmental matrices of SARS-CoV-2, that potentially survives for a prolonged time and threatens public health. We collected seventy-three outdoor environmental specimens of water (28), aerosol (16) , soil (15) and surface (14) from 13 sites in three specialized hospitals dedicated for COVID-19 treatments, i.e., Jinyintan Hospital, Huoshenshan Hospital and Wuchang Fangcang Hospital, during their operation receiving COVID-19 patients in March and April ( Figure 1 and Table S1 , see Methods for details). Three out of 15 soil samples (20%) exhibited positive results for SARS-CoV-2 viral RNA, and they are located in wastewater treatment sector and outside patient departments (Table 1) . Of two soils collected in wastewater treatment sector of Jinyintan Hospital, the one with 2 m distance to the adjusting tank had 253 copies/g of SARS-CoV-2 (Table S1) , whereas the other one 2 m away from the disinfection tank was negative. There was 205 copies/g of SARS-CoV-2 in soils with 5 m distance to the outpatient department but non-detected in those 20 m away from inpatient department. In Huoshenshan Hospital, only soil with 2 m distance to the first adjusting tank had SARS-CoV-2 viral DNA detected (550 copies/g), and soils . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted May 18, 2020. Wastewater treatment sector 0% (0/4) 0% (0/2) 53.8% (7/13) - To trace the source of SARS-CoV-2 in soils, we investigated the surrounding aerosols. Inside the adjusting tank of Jinyintan Hospital and Huoshenshan Hospital where viruses were found in soils, the aerosols contained 285 copies/m 3 and 603 copies/m 3 of SARS-CoV-2, respectively (Table 1 and Table S1 ). They were of similar levels as those detected in intensive care units (ICU) 3 is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 18, 2020. . https://doi.org/10.1101/2020.05.12.20097105 doi: medRxiv preprint results, e.g., background area of Jinyintan Hospital, medical staff living area of Huoshenshan Hospita
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