Inactivation of Severe Acute Respiratory Syndrome Coronavirus 2 by WHO-Recommended Hand Rub Formulations and Alcohols

Abstract

S evere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third highly pathogenic human coronavirus to cross the species barrier into the human population during the past 20 years (1-3). SARS-CoV-2 infection is associated with coronavirus disease (COVID-19), which is characterized by severe respiratory distress, fever, and cough and high rates of mortality, especially in older persons and those with underlying health conditions (3). The World Health Organization (WHO) declared SARS-CoV-2 a pandemic on March 11, 2020 (4), and by April 8, a total of 1,447,466 confirmed cases and 83,471 deaths from SARS-CoV-2 had been reported worldwide (5). Human-to-human transmission of SARS-CoV-2 is efficient, and infected persons can transmit the virus even when they have no, or only mild, symptoms (3). Because no antiviral drugs or vaccines are available, virus containment and prevention of infection are the current highest priorities. To limit virus spread, effective hand hygiene is crucial. Therefore, easily available but efficient disinfectants are needed. WHO's guidelines for hand hygiene in healthcare suggest 2 alcohol-based formulations for hand sanitization to reduce the infectivity and spread of pathogens (6). WHO's recommendations are based on fastacting, broad-spectrum microbicidal activity, along with accessibility and safety. The original WHO formulations failed to meet the efficacy requirements of European Norm 1500 in previous tests (7). However, Suchomel et al. (8) suggested modified versions with increased concentrations of ethanol: 80% (wt/ wt) (85.5% [vol/vol]; formulation I), or isopropanol, 75% (wt/wt) (81.3% [vol/vol]; formulations II). Later, they complemented these by reducing the glycerol concentrations (9). We previously showed that these modified WHO formulations were able to inactivate severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV; 10), which are related to SARS-CoV-2. Current recommendations to inactivate SARS-CoV-2 were translated from findings of other coronaviruses (11). To evaluate whether these alcohol-based disinfectants also effectively inactivate SARS-CoV-2, we tested different concentrations of the original and modified WHO formulations I and II (6,9), ethanol, and 2-propanol for virucidal activity.

Mathematical model of COVID-19 intervention scenarios for São Paulo- Brazil

“…Mortality rates associated with COVID-19 may rise when hospitals become overwhelmed and have fewer resources to treat patients with life-threatening symptoms (https://www.hopkinsmedicine.org/coronavirus). This result provides additional support for the notion that personal protection is critical for maintaining control over the COVID-19 pandemic [15][16][17][18][19].…”

“…high rates of testing have been emphasized to mitigating the spread of COVID-19 in addition to SD [15][16][17][18][19] .…”

Infection control in dental health care during and after the SARS‐CoV‐2 outbreak

“…Surfaces that may be contaminated with SARS-CoV-2 can effectively be disinfected within 1 min by applying at least 62% alcohol, 0.5% hydrogen peroxide or 1,000 ppm (0.1%) sodium hypochlorite (Kampf, Todt, Pfaender, & Steinmann, 2020). Effective disinfection with different alcohol-based hand rub formulations and lower dilutions of alcohol has also been reported (Kratzel et al, 2020).…”

Clinical Questions and Answers on Gastrointestinal Endoscopy during the Novel Coronavirus Disease 2019 pandemic

“…#2 Hand sterilization and mask wearing in the waiting room is recommended for all patients. 11,12 Alcohol disinfectant for hand disinfection must be available in the waiting room. 11 #3 Patients should be seated at least 2 meters apart, 13,14 the chairs being positioned to avoid patients sitting face to face.…”