Hygiene Measures Under Covid-19

Coronavirus disease of 2019, is a respiratory infection caused by the SARS-CoV-2 virus, also known as the VID-19 virus.

Even robust health systems can be quickly overwhelmed and compromised by an explosive outbreak of COVID-19, so we must take steps to prevent an uncontrolled resurgence of COVID-19 transmission and a second wave of amplified cases, as happened in the fall of 1918 when the so-called Spanish Flu broke out.

In our country with the increase in cases that have been registered, today more than before we must take measures to take care of ourselves and others who may have the highest risk of bad evolution. It is important that health personnel continue to take preventive measures, because they are the ones who are on the front line putting their lives at risk.

This virus is mainly transmitted by close physical contact and by respiratory droplets and during medical maneuvers that generate aerosols. It is therefore suggested that the following measures be taken:

• Have good respiratory hygiene
• Wash your hands constantly and correctly
• Take physical distancing measures
• Avoiding touching your face
• When it is appropriate to identify oneself as a contact for a confirmed case
• Isolation in case of illness
• Correct use of masks, taking all hygiene measures

Hygienic conditions are essential to protect human health during all outbreaks of infectious diseases. Transmission of the disease by contact with coronavirus-contaminated surfaces in medical facilities has been linked. It has not been proven that the risk of transmission by casual hand contact with any non-living surface on which COVID-19 is found and subsequently touching one of our exposed mucous membranes such as the mouth, eyes or nose in hospitals is the same in any other environment outside these facilities. However, it is still important to reduce possible contamination by the COVID-19 virus.

So we will focus on the measures recommended by the World Health Organization (WHO), reducing any role that fomites might play in the transmission of VOC-19.

Several studies have evaluated the persistence of COVID-19 on different surfaces. In addition to the type of surface, the survival time of this virus is also influenced by temperature and relative humidity. In these studies, the virus was found to remain viable for the following periods of time:

It is important to implement regular cleaning and disinfection practices. Like other coronaviruses, SARS-CoV-2 has a fragile outer lipid layer that makes it more sensitive to disinfectants than other unwrapped viruses.

In health care facilities, surfaces in the immediate environment that are important to clean and disinfect are: furniture and other fixed objects inside and outside patients' rooms and bathrooms, such as tables, chairs, incubators, electrical switches, walls, sinks, toilets, and also surfaces of ordinary medical equipment, such as sphygmomanometer cuffs, stethoscopes.

In other environments, such as the home, offices, public access buildings, public transportation, religious facilities, schools, pharmacies, restaurants; it is important to clean and disinfect surfaces that are touched a lot in these places, for example, counter surfaces, food preparation areas, door and window handles, kitchen, bathroom surfaces, toilets and water faucets, personal touch screen devices, personal computer keyboards.

Existing recommended cleaning and disinfection procedures for health care facilities AND attention to suspected or infected cases of VIDOC-19

All persons in charge of environmental cleaning, laundry, and treatment of bedding, towels, and soiled clothing of patients with COVID-19 infection should wear heavy-duty gloves, a mask, eye protection (goggles or face shield), a long-sleeved gown, and closed-toed boots or shoes.

Must perform hand hygiene after exposure to blood or body fluids. Bedding and surfaces in contact with COVID-19 patients should be cleaned and disinfected frequently, at least once a day. It is recommended to machine wash with warm water at 60-90 °. If machine washing is not possible, the bedding can be soaked in hot, soapy water in a large drum with a stirring stick, taking care to avoid splashing.

The drum should then be emptied, and the bedding soaked in 0.05% chlorine for approximately 30 minutes. Finally, the clothes should be rinsed with clean water and the bedding allowed to dry completely, if possible, in sunlight.

Disinfection process

Surfaces should first be cleaned with water and soap or detergent to remove organic matter, and then disinfected.

Spraying of disinfectant is not recommended, as this poses a risk to eyes, respiratory or skin irritation. Rather, it is recommended to use a clean cloth or wipes soaked in products.

The disinfectant and its concentration must be carefully selected so as not to damage surfaces and to avoid or minimize toxic effects on household occupants or users of public places.

It is important to respect the times set by the manufacturers of the disinfectants or to let them act for at least 1 minute.

In hospital environments today, the WHO recommends using :

• 70% ethyl alcohol to disinfect small surfaces and equipment between uses, such as dedicated reusable equipment (e.g. thermometers);
• 0.1% (1000 ppm) sodium hypochlorite for disinfecting surfaces and 0.5% (5000 ppm) for disinfecting spills of blood or body fluids in health care facilities

At locations other than medical centers, sodium hypochlorite (bleach) at a recommended concentration of 0.1% (1000 ppm) is also recommended. Instead, alcohol at a concentration of 70-90% can be used to disinfect surfaces.

To prepare the disinfectant solutions, OPS recommends using the concentrations of sodium hypochlorite available in the country, preparing the solutions daily, following the table below which shows how to adjust the amounts:

Image extracted from the PAHO publication on April 10, 2020, recommendation of cleaning and disinfection at home without suspicious or confirmed cases.