We conducted a systematic review of hygiene intervention effectiveness against SARS-CoV-2, including developing inclusion criteria, conducting the search, selecting articles for inclusion, and summarizing included articles. Overall, 96 268 articles were screened and 78 articles met inclusion criteria with outcomes in surface contamination, stability, and disinfection. Surface contamination was assessed on 3343 surfaces using presence/absence methods. Laboratories had the highest percent positive surfaces (21%, n = 83), followed by patient-room healthcare facility surfaces (17%, n = 1170), non-COVID-patient-room healthcare facility surfaces (12%, n = 1429), and household surfaces (3%, n = 161). Surface stability was assessed using infectivity, SARS-CoV-2 survived on stainless steel, plastic, and nitrile for half-life 2.3–17.9 h. Half-life decreased with temperature and humidity increases, and was unvaried by surface type. Ten surface disinfection tests with SARS-CoV-2, and 15 tests with surrogates, indicated sunlight, ultraviolet light, ethanol, hydrogen peroxide, and hypochlorite attain 99.9% reduction. Overall there was (1) an inability to align SARS-CoV-2 contaminated surfaces with survivability data and effective surface disinfection methods for these surfaces; (2) a knowledge gap on fomite contribution to SARS-COV-2 transmission; (3) a need for testing method standardization to ensure data comparability; and (4) a need for research on hygiene interventions besides surfaces, particularly handwashing, to continue developing recommendations for interrupting SARS-CoV-2 transmission.

We conducted a systematic review of hygiene intervention effectiveness against SARS-CoV-2, including developing inclusion criteria, conducting the search, selecting articles for inclusion, and summarizing included articles. We reviewed 104,735 articles, and 109 articles meeting inclusion criteria were identified, with 33 additional articles identified from reference chaining. Herein, we describe results from 58 mask disinfection and reuse studies, where the majority of data were collected using N95 masks. Please note, no disinfection method consistently removed >3 log of virus irrespective of concentration, contact time, temperature, and humidity. However, results show it is possible to achieve >3 log reduction of SARS-CoV-2 using appropriate concentrations and contact times of chemical (ethanol, hydrogen peroxide, peracetic acid), radiation (PX-UV, UVGI), and thermal (autoclaving, heat) disinfection on N95 masks. N95 mask reuse and failure data indicate that hydrogen peroxide, heat, and UV-GI are promising for mask reuse, peracetic acid and PX-UV need more data, and autoclaving and ethanol lead to mask durability failures. Data on other mask types is limited. We thus recommend focusing guidelines and further research on the use of heat, hydrogen peroxide, and UVGI for N95 mask disinfection/reuse. All of these disinfection options could be investigated for use in LMIC and humanitarian contexts.TOC ArtSynopsisIn resource-limited contexts, N95s are reused. We recommend using heat, hydrogen peroxide, or UVGI to disinfect and reuse N95 masks.