Coronavirus, more precisely known as, is becoming increasingly scary. With multiple deaths reported in the US, France, Japan, Italy, and China, we're beginning to deal with what may become a global health crisis.
That said, COVID-19 still doesn't hold a candle to the 2019 to 2020 strain of the flu for actual illness and deaths reported. As of the moment of writing, there were 90,279 confirmed cases of COVID-19 and 3,085 deaths. But the US Centers for Disease Control (CDC) estimates that there were 32 million to 45 million cases of the 2019 to 2020 flu, including 310,000 to 560,000 hospitalizations and somewhere between 18,000 to 46,000 deaths.
That's not to say that COVID-19 isn't serious. Its infection-to-death rate is unusually high. But our regular, yearly flu is pretty brutal all on its own, and we're not succumbing to hysteria over that.
There's been a lot of discussion about how conferences have been canceled due to COVID-19 concerns and how there supplies like masks and even food are being hoarded by concerned citizens. We've been advised to not breathe on each other and to wash our hands, valid precautions at any time.
But what about our devices? Our gear and objects are subject to a worldwide supply chain. If they're built or packed by someone with COVID-19 or the flu, what are the chances the surfaces will transmit illness?
We discussed that generally, along with some excellent best practices, in Charlie Osborne's recent coverage on smartphone and gear hygiene. But we wanted to take it a step further. We wanted to get expert input.
For those of you who don't have the time or interest to read through our expert's guidance, here's a quick five-point summary:
- Don't worry about boxes and products. They're extremely unlikely to cause you to get sick.
- There's a far greater chance you'll get sick from a salesperson than the products they're selling.
- Always wash your hands and face.
- Avoid touching your face and nose.
- If you're super-paranoid, you could wash down the object with an alcohol-based wipe.
We reached out to five infectious disease experts and conducted detailed interviews. They include:
- Scott Pauley: Press officer, News Media Branch, Division of Public Affairs, Office of the Associate Director for Communications, Centers for Disease Control and Prevention (CDC)
- Amesh A. Adalja, MD, FIDSA, FACP, FACEP: Senior scholar, Johns Hopkins Center for Health Security
- Brian Labus, PhD, MPH, REHS: Assistant professor, School of Public Health, University of Nevada Las Vegas, a Registered Environmental Health Specialist, and an expert in outbreak investigation
- Adrian Cotton, MD: Chief of medical operations at Loma Linda University Health and internal medicine physician
- Saskia Popescu, PhD, MPH, MA, CIC: A senior hospital infection prevention epidemiologist at HonorHealth, a network of hospitals in Scottsdale, Ariz. During her work as an infection preventionist, she performed surveillance for infectious diseases, preparedness, and Ebola-response practices. She holds a doctorate in biodefense from George Mason University, where her research focuses on the role of infection prevention in facilitating global health security efforts. She is certified in infection control and has worked in both pediatric and adult acute care facilities.
Our reasoning for this somewhat rigorous approach is we wanted to make sure we got a very good overall understanding of the issues involved. We didn't want to talk to just one expert but wanted to be able to cross-check the analysis of all four of our doctors as well as the CDC representative.
We'll start with the CDC response and then walk through our interview questions. As we go through the interviews, we'll group all the expert's answers for each of our concerns. This should give you one of the most in-depth understandings of the issues involved in disease transmissions on porous and nonporous surfaces you'll find anywhere.
First, the official CDC response.
Centers for Disease Control
We started our research by reaching out to the CDC. I spoke to CDC Press Officer Scott Pauley, who told me this about three weeks ago:
"At this time, CDC can't fully evaluate the risks from products that are shipped from affected areas, but coronaviruses have generally spread most often by respiratory droplets and there's no evidence that supports transmission of this coronavirus is associated with imported goods. No cases in the U.S. are associated with imported goods."
That may not be the latest news. Last week, Reuters wrote that CDC Director Dr. Robert Redfield, a virologist, reported to Congress that, "On copper and steel it's pretty typical, it's pretty much about two hours. But I will say on other surfaces -- cardboard or plastic -- it's longer."
Reuters also reported that the US Food and Drug Administration said it has no evidence of COVID-19 contaminated goods, but the agency is continuing to "assess and update guidance as needed."
Our questions to the doctors
We asked our four doctors a series of questions about both COVID-19 and the flu. To make sure you're reading their direct answers, what we're publishing here is edited only for formatting style and punctuation.
Can COVID-19 survive on porous and non-porous surfaces?
Dr. Adalja from Johns Hopkins: "It's important to know that how viable a virus remains in the laboratory studies [does] not necessarily directly extrapolate to everyday life. So while you may see a virus remain viable on many different surfaces, it does not mean that it substantially contributes to the force of an outbreak."
Dr. Labus of UNLV: "We don't know how long COVID-19 can survive on different surfaces, but it is probably similar to other coronaviruses that cause disease in humans. Those viruses can survive up to a week given ideal conditions, but it can be shorter depending on the surface, temperature, humidity, and UV light exposure. We see shorter survival times on porous surfaces like cardboard or paper."
Dr. Cotton of Loma Linda University Health: "There is no data available on the novel coronavirus, but we can look at the common human coronavirus as a frame of reference for what might be the case. Research shows human coronaviruses can survive on non-porous surfaces such as metal, glass or plastic for up to nine days if it does not go through proper disinfection procedures during that time.
"Research also shows that appropriate surface disinfection procedures can inactivate the virus. In the Journal of Hospital Infection, we are starting to see the research that addresses how to inactivate the virus with biocidal agents, such as ethanol, hydrogen peroxide, and sodium hypochlorite."
Dr. Popescu of HonorHealth: "Studies have shown that coronaviruses (MERS, SARS) can live on inanimate objects (plastic, glass, and metal) for up to nine days. These are not environmentally-hardy organisms and they do not survive long on surfaces/objects (especially not a porous surface like a cardboard box).
"Moreover, coronaviruses are easily killed by using EPA-registered disinfectants such as Clorox Healthcare Hydrogen Peroxide Cleaner Disinfectant Wipes and Clorox Healthcare Disinfecting Wipes. When people ask about these viruses persisting on shipped items, it's a helpful reminder that the shipping conditions also degrade the virus further. Viruses, in general, do not survive long outside of a host. While there are viruses that are more environmentally hardy, coronaviruses are not one of them.
"Coronaviruses are transmitted primarily through those respiratory droplets (cough and/or sneeze). While contaminated surfaces/objects can pose a risk, they also require a person to touch them and then touch their eyes/mouth/nose. Overall, the risk for transmission from an imported good is extremely low and previous outbreaks have shown that there is no evidence such transmission occurs."
Does COVID-19 pose a risk for the supply chain?
Dr. Adalja from Johns Hopkins: "I suspect that this phenomenon will not be a major factor in the spread of this virus, however, it will cause unnecessary panic."
Dr. Labus of UNLV: "There is no risk in using or unpacking a product. Even if a worker sick with COVID-19 coughed onto your new phone in a factory, any virus that was on your phone would be long dead. The time it takes to produce a product and ship it to the US provides protection -- the virus simply can't survive long enough."
Dr. Cotton of Loma Linda University Health: "Without knowing the safety and health requirements of the factories or distributors, we can't know that, but we do believe the risk is minor. Theoretically, industrial and factory safety guidelines could help avoid this possibility. The bigger concern would be spread from person-to-person, which happens when in close contact of about six feet."
Dr. Popescu of HonorHealth: "The risk for users unpacking and using products here in the US is extremely minimal as it's exceedingly unlikely the virus would survive that long on a porous surface, let alone during the transportation process."
What about the flu? Can the flu survive on porous and non-porous surfaces?
Dr. Adalja from Johns Hopkins: "Influenza viruses can remain viable on surfaces for some time, depending upon environmental conditions."
Dr. Labus of UNLV: "Flu viruses can survive two days on a hard surface like a phone and less time on a porous surface like cardboard packaging. If you are going to be infected while buying a new phone, it's going to by the salesperson and not the phone itself."
Dr. Cotton of Loma Linda University Health: "As of Friday [Feb. 7], there have been an estimated flu 34,157 deaths in the US. This is still our top concern. While coronavirus is new and may garner more attention, the flu has been taking far more lives and has clear actions to prevent the flu that people can and should still take. What we do know is the flu virus can remain active on some surfaces for up to 24 to 48 hours."
Dr. Popescu of HonorHealth: "Studies have shown that influenza viruses don't survive long in the environment -- mostly 24 to 72 hours or so. Transmission via a contaminated fomite (surface/object) is possible but unlikely after a long period of time, as the virus dies. This is tied to the concentration of the virus -- more concentration, the longer survival. Again, those non-porous surfaces aren't great for the flu virus to live. Phones pose a larger risk for bioburden as they are high-touch objects, rarely cleaned and often encased in plastic and/or metal.
"It's important to note that most viruses, including coronavirus, do not live long outside the body. The biggest risk from a contaminated object or surface is when a person touches it and then their mucous membranes. That's where the transfer of germs occurs."
Would you advise technology users to be concerned about virus transmission via physical electronic products?
Dr. Adalja from Johns Hopkins: "No."
Dr. Labus of UNLV: "The time it takes for tech products produced all over the world to reach consumers provides a layer of protection against disease. Viruses can only survive short periods of time on tech products, and they are long dead by the time you would receive and use that product.
"The real risk of disease is in the way we use these products. Phones, keyboards, and other high-touch items provide a great way for cold and flu viruses to spread. If you touch something that a sick person just touched, a virus could easily be spread to you. If something is on your hands, you can easily transfer it to your phone. The best way to protect yourself is with regular hand-washing, and of course, getting your flu shot every year."
Dr. Cotton of Loma Linda University Health: "The risk of transmission is very low, but if someone is highly concerned, they could wipe down the packaging and product with an alcohol-based wipe. There is a greater likelihood that someone will get the flu because they are unvaccinated, they touch their nose and mouth often, or they don't wash their hands.
"Realistically, you should be equally concerned about virus transmission on all surfaces - a doorknob, a car handle, a light switch - that may have been touched by an infected person. However, these infected surfaces shouldn't pose a threat if you're washing your hands with soap and water (or alcohol gel if soap and water are not available), receiving your annual vaccination, and avoiding touching your face and nose."
Dr. Popescu of HonorHealth: "This poses an extremely low risk. A box and the phone within it (that is cleaned prior to packaging) is highly unlikely going to act as a vector for disease transmission. No previous outbreaks have shown us anything to suggest this will change with 2019-nCoV. These are just not conducive environments for microbial survival."
Other recommendations from our doctors
Dr. Labus of UNLV: "Many factories have had to stop production due to worker shortages. The products people are concerned about aren't even being made right now, and even if they were being made, there isn't a risk of being infected by your new tech products. Of all the things to be concerned about during this cold and flu season, catching COVID-19 from Siri or Alexa shouldn't be one of them."
Dr. Cotton of Loma Linda University Health: "It's especially critical for people - especially those who are more vulnerable to sickness - to take preventative measures to keep themselves healthy. Since there are currently no vaccines available against coronavirus, take other steps to reduce your risk of infection.
"One should always take precautions when interacting with others, including washing their hands with soap and water, or using an alcohol-based hand wipe; avoiding touching mouth, nose, face with hands; receiving the recommended CDC vaccines. If one has concerns about possible exposure, they should call their doctor's office rather than going in directly to see their provider."
Dr. Popescu of HonorHealth: "I think it's great to talk about high-risk objects/surfaces for disease transmission. While we do consider them for respiratory viruses (including coronaviruses), the risk is easily remedied by surface disinfection and good hand hygiene. The topic of boxes and mail shipped truly isn't considered a real risk."
Final thoughts and one more recommendation
I'd like to thank Doctors Adalja, Labus, Cotton, and Popescu for taking their time and giving us this detailed understanding. A quick thanks also goes out to my CDC contact Scott Pauley for taking time from his insanely busy schedule to get me a good answer on the CDC's official position.
Finally, I'd like to point you to What should IT be doing to prepare for the coronavirus? This is an article posted on LinkedIn by Richard Echeandia. I've known Richard for more than 20 years (!) and his advice is always smart and relevant. If you're concerned about COVID-19 or the flu and what your organization can do about it, Richard's article is a must-read.
What are your thoughts on coronavirus, flu, and protecting yourself and your loved ones from infection? Did you get your flu vaccine this season? Does your company have any special procedures in place for this season's flu?
You can follow my day-to-day project updates on social media. Be sure to follow me on Twitter at @DavidGewirtz, on Facebook at Facebook.com/DavidGewirtz, on Instagram at Instagram.com/DavidGewirtz, and on YouTube at YouTube.com/DavidGewirtzTV.