By May, the WHO and health agencies around the world were recommending that people in ordinary community settings — houses, buses, churches, schools and shops — should clean and disinfect surfaces, especially those that are frequently touched. Disinfectant factories worked around the clock to keep up with heavy demand. But Goldman, a microbiologist at Rutgers New Jersey Medical School in Newark, decided to take a closer look at the evidence around fomites. What he found was that there was little to support the idea that SARS-CoV-2 passes from one person to another through contaminated surfaces.
He wrote a pointed commentary for The Lancet Infectious Diseases in July, arguing that surfaces presented relatively little risk of transmitting the virus 2. His conviction has only strengthened since then, and Goldman has long since abandoned the gloves.
Many others reached similar conclusions. As evidence has accumulated over the course of the pandemic, scientific understanding about the virus has changed. Studies and investigations of outbreaks all point to the majority of transmissions occurring as a result of infected people spewing out large droplets and small particles called aerosols when they cough, talk or breathe. These can be directly inhaled by people close by. Surface transmission, although possible, is not thought to be a significant risk.
That means that governments, companies and individuals continue to invest vast amounts of time and money in deep-cleaning efforts. In November, Chinese authorities introduced guidelines requiring disinfection of imported frozen-food packages. Experts say that it makes sense to recommend hand washing, but some researchers are pushing back against the focus on surfaces. Excessive attention on making surfaces pristine takes up limited time and resources that would be better spent on ventilation or the decontamination of the air that people breathe, she says.
The focus on fomites — rather than aerosols — emerged at the very beginning of the coronavirus outbreak because of what people knew about other infectious diseases. So as soon as people started falling ill from the coronavirus, researchers began swabbing hospital rooms and quarantine facilities for places the virus could be lurking. And it seemed to be everywhere. In medical facilities, personal items such as reading glasses and water bottles tested positive for traces of viral RNA — the main way that researchers identify viral contamination.
So, too, did bed rails and air vents. In quarantined households, wash basins and showers harboured the RNA, and in restaurants, wooden chopsticks were found to be contaminated. And early studies suggested that contamination could linger for weeks. Seventeen days after the Diamond Princess cruise ship was vacated, scientists found 3 viral RNA on surfaces in cabins of the passengers and crew members who tested positive for COVID Sanitization of public transport in New York City cost hundreds of millions of dollars in But contamination with viral RNA is not necessarily cause for alarm, says Goldman.
To address that part of the equation, researchers began testing whether coronavirus samples left for days on various surfaces could infect lab-grown cells. One study in April found that the virus remained infectious on hard surfaces such as plastic and stainless steel for 6 days; on bank notes, it lasted for 3 days; and on surgical masks, at least 7 days 4.
A later study announced that viable virus was present on skin for up to 4 days, but on clothes it survived for less than 8 hours 5. And others found infectious virus on library books bound in natural and synthetic leather after 8 days 6. Other tests have used mock saliva and controlled conditions such as humidity and temperature, all of which widen the gulf between experimental and real-world conditions, says Goldman.
Only a handful of studies have looked for viable virus outside the lab. Tal Brosh-Nissimov, who heads the infectious-diseases unit at the Assuta Ashdod University Hospital in Israel, and his colleagues swabbed personal items and furniture in hospital isolation units and rooms at a quarantine hotel. Half of the samples from two hospitals and more than one-third of samples from the quarantine hotel were positive for viral RNA.
But none of the viral material was actually able to infect cells, the researchers reported 7. Indeed, researchers have struggled to isolate viable virus from any environmental samples, not just fomites. In the only study 8 that has succeeded, researchers grew virus particles from hospital air samples collected at least 2 metres from a person with COVID Nevertheless, scientists warn against drawing absolute conclusions. Human exposure studies of other pathogens provide additional clues about fomite transmission of respiratory viruses.
In , researchers at the University of Wisconsin— Madison put healthy volunteers in a room to play cards with people infected with a common-cold rhinovirus 9. When the healthy volunteers had their arms restrained to stop them touching their faces and prevent them transferring the virus from contaminated surfaces, half became infected.
A similar number of volunteers who were unrestrained also became infected. In a separate experiment, cards and poker chips that had been handled and coughed on by sick volunteers were taken to a separate room, where healthy volunteers were instructed to play poker while rubbing their eyes and noses. The only possible mode of transmission was through the contaminated cards and chips; none became infected.
The combination of experiments provided strong evidence that rhinoviruses spread through the air. Cleaning efforts involved sanitizing tables and chairs at a school in Karachi, Pakistan, in September Estimates of transmission based on levels of viral RNA persisting in the environment seem to bear this out. From April to June, environmental engineer Amy Pickering then at Tufts University in Medford, Massachusetts, and her colleagues took weekly swabs of indoor and outdoor surfaces around a town in Massachusetts.
On the basis of the levels of RNA contamination and how often people touched surfaces such as doorknobs and buttons at pedestrian crossings, the team estimated 10 that the risk of infection from touching a contaminated surface is less than 5 in 10, — lower than estimates for SARS-CoV-2 infection through aerosols, and lower than surface-transmission risk for influenza or norovirus. That might explain why a global comparison of government interventions to control the pandemic in its early months found that cleaning and disinfection of shared surfaces ranked one of the least effective at reducing transmission Social distancing and travel restrictions, including lockdowns, worked the best.
That leaves researchers sorting through messy epidemiological data about how the virus spreads. Hundreds of studies of COVID transmission have been published since the pandemic began, yet there is thought to be only one that reports transmission through a contaminated surface, by what it termed the snot—oral route.
According to the report, a person with COVID in China blew his nose with his hand and then pressed a button in his apartment building elevator. A second resident in the building then touched the same button and flossed with a toothpick immediately after, thereby transferring the virus from button to mouth In one other case, eight people in China are thought to have been infected after stepping in sewage containing the virus on the street and then walking the contamination into their homes Despite the rarity of published examples of fomite transmission, Chinese authorities require that imported frozen food be disinfected.
The change in guidelines followed a report, which has not been released in detail, that a worker at a frozen-food business in the northern port city of Tianjin became infected after handling contaminated packaging of frozen pork imported from Germany. But the WHO and other experts have disputed claims that people can be infected through the food chain in this manner.
Cowling says that more detailed investigations are needed, carefully tracking who infects whom, and what surfaces and spaces they shared around the time of infection. Australian universities provide subsidised places for domestic students or full-fee places for international students. Refugee students on temporary visas — such as bridging visa Es or temporary protection visas — are categorised as international students and are not eligible for subsidised commonwealth-supported places.
This means refugee adolescents face significant barriers to accessing tertiary education, even when they are legally permitted to study, and must rely on university scholarships to be able to afford it. In , Sukirtha Krishnalingam, a year-old Sri Lankan refugee was medevaced from Nauru to Melbourne due to her critical health condition. She completed the Victorian Certificate of Education in and was offered a full-tuition scholarship to study a double degree in commerce-arts at Deakin University, a scholarship to RMIT University as well as an offer from Monash University.
She had to decline all these opportunities because she is subject to ministerial residential determination and is barred from study. Under the Tertiary Education Quality Standards Agency , refugees and asylum seekers are not included as an equity group.
She explains that some higher education institutions claim they do not have the resources to customise their services for a small cohort of refugee students, such as providing one-on-one case management with specialist trauma-informed health professionals. Alma and Anashid were six and seven years old when their parents split in Iran. After their father remarried, they fled persecution in Iran and arrived on Christmas Island in The family was initially transferred to Nauru, but they were moved to Darwin detention after their stepmother became pregnant.
In , their family was placed in community detention in Melbourne. The sustained stress on the family caused conflict between the sisters and their stepmother; in their father received an apprehended violence order and was sent back to detention. The sisters then lived with foster carers. Even when students are supported by powerful advocates, the system can be impossible to navigate.
To date, the requests have remained unanswered. In the case of year-old Iranian refugee Armin Aslani Faal, he was forced to choose between joining his family for resettlement in the US or completing his degree in Australia where he fought to be allowed to study. For the next three years, they remained in various immigration detention centres in Australia. After their mental health deteriorated, they were released to community detention in
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