Researchers conducting the study at the 2019 coronavirus disease (COVID-19) intensive care unit (ICU) in São Paulo, Brazil, have warned that infection control guidelines need to include a universal policy regarding the disinfection of cell phones in hospitals.
A team from the University of São Paulo, Brazil, conducted a cross-sectional study in the ICU to investigate health workers’ knowledge of cross-contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the agent responsible for COVID-19.
Although most workers understand the importance of cross-transmission and the importance of adhering to hand hygiene and mobile phone disinfection practices, SARS-CoV-2 ribonucleic acid (RNA) – the genetic material for the virus – is still being detected in some devices, said Evelyn Patricia Sanchez Espinoza and colleagues.
The researchers said the finding that healthcare workers’ cell phones could be contaminated with SARS-CoV-2 suggests these devices could be part of a chain of transmission in health care settings.
“Implementation of official hospital policies to guide health workers [healthcare workers] regarding disinfection and personal MP care [mobile phones] is needed, ”the team warned.
A preprinted version of the paper is available at medRxiv* server when articles undergo peer review.
Worries about cell phone in hospital
Espinoza and colleagues say that cell phones are now generally considered a working tool in hospitals.
However, although SARS-CoV-2 has been detected on the cell phones belonging to patients with COVID-19, the devices have not been identified as a potential source of transmission in a hospital setting.
At the same time, concerns are growing about cross-transmission of SARS-CoV-2, following recent descriptions of how the virus can survive on surfaces in hospitals, the team said.
“However, there is no official policy from the Centers for Disease Control and Prevention (CDC) about it [mobile phone] disinfection in health facilities, ”write the investigators. “Little is known about [the] viruses in MPs or their potential for cross-contamination. “
Investigate healthcare workers’ knowledge of the risks of cell phones
Espinoza and colleagues set out to investigate health workers’ knowledge of SARS-CoV-2 cross-transmission and whether they understand its potential to survive on their own cell phones and be part of the transmission chain.
They conducted a cross-sectional study involving staff members working in the adult ICU at a teaching hospital in São Paulo.
The ICU has 11 separate rooms for each patient. Health care staff use scrubs, N95 respirators and surgical caps as standard when working within the unit, and they also wear surgical gowns, face shields and gloves when entering patient rooms.
An educational campaign on cross-transmission of SARS-CoV-2 and mobile disinfection was launched at the start of the pandemic.
“Informative posters were left on units that had QR codes with access to campaign videos,” said Espinoza and the team.
In the video, health workers are advised to use 70% alcohol swabs to clean phones and screen protectors to keep the oleophobic coating. They are also advised to avoid using the device when providing patient care and while in the restroom.
Ten days after the campaign was held, researchers took participants’ cell phones and sent them for SARS-CoV-2 testing by reverse transcriptase-polymerase chain reaction (RT-PCR).
Electronic questionnaires on hand hygiene and mobile phone use and disinfection were also administered.
What did the research find?
Although most health care workers understood the importance of cross-transmission and increased their adherence to hand hygiene and mobile disinfection during the pandemic, SARS-CoV-2 RNA was still detected in two devices.
Fifty-one out of fifty-three staff members working in the unit participated in the survey and answered the questionnaire. Nine (18%) had covered their cell phones with kitchen plastic film in an effort to facilitate disinfection. Eleven (16%) said they did not remember the campaign and three (6%) said they had not changed their behavior.
Only four (8%) healthcare workers do not believe that the virus can survive on mobile phones and only one (4%) do not believe that the virus can survive on hand.
Ninety-eight percent of participants said they had washed their hands more since the start of the pandemic.
Of the fifty-one swabs collected from the cell phone, SARS-CoV-2 RNA was detected by RT-PCR on two devices.
There is a need for a universal policy regarding the care of electronic devices in hospitals
Espinoza and colleagues said the findings suggest that healthcare workers’ phones could be contaminated with SARS-CoV-2.
“So, maybe members of parliament [medical professionals] may be part of the chain of transmission of the virus in health care settings, ”they wrote.
“Our findings suggest the need for universal policies in infection control guidelines on how to care for electronic devices in hospitals,” the team concluded.
* Important Notice
medRxiv publishes preliminary scientific reports that are not peer reviewed and, therefore, should not be construed as conclusions, guidelines for health-related clinical / behavioral practice, or are treated as defined information.