Background: In late 2019, a novel human coronavirus e severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) e emerged in Wuhan, China. This virus has caused a global pandemic involving more than 200 countries. SARS-CoV-2 is highly adapted to humans and readily transmits from person-to-person. Aim: To investigate the infectivity of SARS-CoV-2 under various environmental and pH conditions. The efficacies of various laboratory virus inactivation methods and home disinfectants against SARS-CoV-2 were investigated. Methods: The residual virus in dried form or in solution was titrated on to Vero E6 cells on days 0, 1, 3, 5 and 7 after incubation at different temperatures. Viral viability was determined after treatment with various disinfectants and pH solutions at room temperature (20e25 o C). Findings: SARS-CoV-2 was able to retain viability for 3e5 days in dried form or 7 days in solution at room temperature. SARS-CoV-2 could be detected under a wide range of pH conditions from pH 4 to pH 11 for several days, and for 1e2 days in stool at room temperature but lost 5 logs of infectivity. A variety of commonly used disinfectants and laboratory inactivation procedures were found to reduce viral viability effectively. Conclusion:This study demonstrated the stability of SARS-CoV-2 on environmental surfaces, and raises the possibility of faecaleoral transmission. Commonly used fixatives, nucleic acid extraction methods and heat inactivation were found to reduce viral infectivity significantly, which could ensure hospital and laboratory safety during the SARS-CoV-2 pandemic.

Aim Reduction in the surgical mortality has been observed in Hong Kong public hospitals after the implementation of the Surgical Outcomes Monitoring and Improvement Program (SOMIP). The aim of the present study was to identify factors and strategies that allow surgeons to improve their outcome after the implementation of the SOMIP. Patients and Methods A qualitative study among surgeons in SOMIP‐participating hospitals using semistructured interviews was performed, with questions focused on knowledge of the SOMIP, comments on SOMIP methodology and actions taken by hospitals to drive quality improvement. Results Fifteen surgeons from five public hospitals in Hong Kong were recruited. The provision of objective data, culture change, surgeons' motivation to improve, advice from external reviewers, leadership and support from administration were identified as factors driving outcome improvement after the implementation of the SOMIP. Most surgeons strongly agreed that SOMIP can be used as a quality improvement tool and there was a need to disclose hospital results. Conclusions A risk‐adjusted, outcome‐based, quality improvement program could provide objective data as feedback to surgical units and benchmark with peers. Together with the driving force from public reporting, change in culture, appropriate resource allocation and service planning, improvement in the structure, process and outcome can be achieved.

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