Frontline defence

The novel coronavirus (2019-nCoV) has sparked worldwide alarm, with more than 190,600 confirmed cases of across the globe and more than 7700 deaths*.

Coronaviruses (CoV) refers to a family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). The 2019-nCoV, officially named Covid-19, was first identified in humans in Wuhan, China, in December 2019.

In February the global death toll surpassed that of the Severe Acute Respiratory Syndrome (SARS) outbreak, which reported 774 deaths and more than 8000 cases between November 2002 and July 2003.

As of 18 March 2020, there have been 454 confirmed cases of COVID-19 in Australia. Of the 454 confirmed cases in Australia, 43 have recovered and five have died from COVID-19.

According to the Australian Health Department, 228 cases were considered to be overseas acquired. Most of the overseas cases were acquired in the USA, Iran, Italy and the UK. 62 cases are contacts of previously confirmed cases.

This week a state of emergency was also declared in Victoria, ACT and WA to deal with the spread of coronavirus. Covid-19 has also been declared a public health emergency of international concern by the World Health Organization (WHO).

Many viruses cannot live for long outside a human or animal host, whereas other viruses can survive for prolonged periods on contaminated surfaces.

According to Dr Greg Whiteley, Covid-19 sits somewhere in the middle of the risk zone. It can survive on a contaminated surface, but probably not for long.

“Coronavirus is an enveloped virus, and typically these viruses are not terribly difficult to kill on a surface. There is a tendency, in the context of a new pandemic, to go for the strongest disinfectant conceivable for surface disinfection. With a harder to kill virus, or a virus with particularly high mortality, that may be appropriate, however, for 2019-nCoV that appears to be unwarranted.

“There’s widespread concern in the general community because it is the fear of the unknown. The virus has already surpassed the death rate of SARS; however, we don’t know if it is going to mutate or how fast it will spread around the world. At the stage, the spread of the virus outside of China appears to be slow, but it still remains a concern.”

According to Dr Whiteley the virus appears to have a relatively slow incubation period, with the time from infection to the sign of disease symptoms currently appearing to be between 4 and 14 days.

“In comparison, the onset of influenza is generally just over two days. This means the way this global pandemic will move will be different from an influenza outbreak, and we might not see the full implications for several months.

“It is also currently winter in the northern hemisphere. What happens typically with influenza is that it sweeps through one part of the globe in the winter and moves to the other part of the globe the next winter. So, we must ask, where will that leave Australia when it comes to our winter in the middle of the year?”

Pandemic preparedness

The rise of the coronavirus has seen cleaning companies in vulnerable areas enacting Safe Work Plans in response to the pandemic to protect their staff, clients and the wider community who frequent major public spaces.

Bridget Gardner, director of HPC Solutions, says it is critical cleaning companies have pandemic cleaning policies, especially if they manage public facilities and educational facilities, such as airports and universities with high international student populations. However, she states it’s not just about the cleaning protocols, but also protecting cleaners who are in the frontline.

“Face masks, hand hygiene education and high touch point cleaning protocols should be given to all cleaners.”

With blue-chip clients in transport hubs, student accommodation, universities, hospitals and aged care, Academy Services has enacted a pandemic plan for infection control. Via toolbox meetings, staff have been educated about coronavirus, its causes and its spread. Infection control methods have also been reinforced.

Academy Services CEO James Pollock says the pandemic plan means staff, clients and the public can be assured the company is doing all it can to ensure a safe and clean environment.

“Health and safety is the number one operational priority for the group, and we are taking the recent coronavirus outbreak very seriously.”

Through consultation with key stakeholders including staff, a Safe Work Procedure (SWP) aligned to the best practice methodology set out by WHO and the Australian Department of Health has been enacted by Academy Services to provide high-level infection control and to our staff and our clients that all precautions are being undertaken to ensure their health and safety.

A working group has been established to focus on the issue, monitor the WHO organisation’s recommendations and ensure they are undertaken. Via toolbox meetings, safety alerts and regular communications, staff have been educated about coronavirus, its causes and its spread, with the need for strict hygienic cleaning protocols reinforced.

The Adelaide-based company has also executed additional communications campaigns with employees to reinforce HSE standards and reviewing their protocols around infection control processes and their crisis management plans in case of further escalations.

“In today’s environment, our clients are looking for effective but responsible strategies.”

Research funded by Whiteley Corporation has shown that once on surfaces, microorganisms can be transmitted to many other surfaces via contaminated hands and fingers.

It is therefore essential, according to Dr Whiteley, that appropriate hand hygiene with an alcohol-based hand rub (approved by the TGA), be used after touching any potentially contaminated surface.

He says thorough cleaning and disinfection is the most important component to prevent the transmission of superbugs.

“Data from the REACH study published last year found there are massive improvements still required in terms of surface disinfection and hand hygiene compliance at healthcare facilities in Australia is certainly an area to be improved

“There’s a vast number of cleaning systems and disinfecting processes in place, but as the research found, they’re generally not done properly unless there’s efficient monitoring being conducted, and the same applies for hand hygiene.

“Data published by Professor Mary-Louise McLaws last year found when people are being monitored hand hygiene compliance is as high as 80 per cent. However, when people are not being monitored, hand hygiene compliance is reduced to between 20 and 30 per cent. These are unacceptable rates.

“During a global pandemic, I would hope all people are following WHO’s five moments of hand hygiene – as they should be doing even without the threat of an outbreak.”

Infection prevention

Pollock says it’s all about the basics when it comes to preventing the spread of infection.

“A basic mistake that cleaners can make is incorrectly applying cleaning techniques. This happens by cleaners using too much cleaning chemicals, for example floor cleaner, or not applying a product, such as disinfectant, for long enough. Alternatively, the incorrect use of cleaning cloths and systems.”

According to Pollock, places of concern are locations where people congregate in large numbers or feature vulnerable communities. These could be locations such as transport hubs, schools and universities, student accommodation or aged-care residences.

“It is important to note, that in the event of a pandemic or declared outbreak all major facilities follow the advice of the WHO and Department of Health in relation to infection control.”

He adds any common-use surfaces such as door handles, bathrooms, kitchens, shared desks or common meeting rooms are considered high touch point areas most at risk.

“The best way to combat infection control is to target these high touchpoint surfaces and ensure they are adequately cleaned, disinfected and sanitised as per the SWP.”

The WHO and Department of Health are the lead agencies in the development of the National Framework for Communicable Disease Control that provides up to date information for the purpose of the re-evaluation process of our SWPs and risk management.

Pollock says key factors to consider in the develop of infection prevention and control plans include location and weather conditions; population and high-frequency use of an area; a clearly defined communication strategy which applied to both internal and external stakeholders; consideration of employees and strict adherence to hygiene procedures to avoid any unnecessary risks by thorough cleaning, disinfection and sanitising techniques.

“Finally, it is important as part of emergency management process is that education and competency evaluation is completed as part of an ongoing process.Educating staff does not end with teaching the protocol in an emergency situation.

“Academy Services ensures that through regular inspections and monitoring of identified risk controls along with annual or biannual training opportunities and competency testing for staff.

“Each staff member must demonstrate his or her ability to perform assigned duties routinely as well as whenever tasks, procedures or products change.”

Dr Whiteley advises companies and facilities to use proven and reliable technologies, warning the industry needs to be wary of misleading product claims.

“If you’re going to review your cleaning and hygiene processes, you should be using materials and methods that have been proven to work and that have proven data claims. Best still is using only cleaning and disinfecting products that are registered with the TGA and are entered in the Australian Register of Therapeutic Goods.

“However, at this point there isn’t anyone that has a claim against this novel coronavirus. The best anyone can claim at this point is that their product can be used against other coronaviruses.

“The TGA has made it clear that if you’re going to make a coronavirus claim you must make it very clear which coronavirus you’re claiming against.  Any false claims will be dealt with swiftly and aggressively by the TGA compliance branch.”

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This first appeared in the March/April issue of INCLEAN magazine 

*Updated since the time of publication 

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