When the COVID-19 pandemic began, cleaning and disinfection became top of mind for facilities and the people who occupy those spaces. Many facilities are now required to incorporate daily disinfection into their routine cleaning practice, which often means adding additional frequencies, labor, products and technologies to their operations. Electrostatic sprayers are one such technology that many facilities have turned towards to help meet the demand to disinfect more frequently in less time. Before investing in this technology, it is important to understand what electrostatic spraying is and how it is different from other application methods on the market.

Electrostatic spraying works by charging liquid droplets as they pass through a nozzle. The resulting charged droplets actively seek out surfaces. Once droplets reach their target surface, they stick to the surface and the charge dissipates. Because the droplets all hold the same charge, they repel one another, causing them to spread out and cover surfaces evenly. This enables facilities to apply disinfectants in less time and with better coverage compared to other application methods.  

When comparing electrostatic sprayers to other spray technologies like foggers, pump sprayers, and trigger sprayers, there are a few big differences. The main difference is that the disinfectant droplets are charged. Foggers can distribute disinfectants more evenly than a trigger or pump sprayer, but the disinfectant coming out of these devices is uncharged, which means that some surfaces may be missed. Charging disinfectants means that electrostatic sprayers can cover more surfaces in less time. Additionally, electrostatic spraying provides extra assurance that disinfectant will deposit on all sprayed surfaces, including curved or oddly shaped objects that can be difficult to cover with other spray technologies.

Another key difference is droplet size. Trigger and pump sprayers emit large droplets that are generally not respirable meaning that droplets are too large to be inhaled into the lungs. Electrostatic sprayers emit droplets that are slightly smaller than a trigger sprayer but are still above respirable range. Some disinfectants may not require any additional personal protective equipment (PPE) to spray them through an electrostatic sprayer, while others may require PPE. Foggers typically emit very small droplets that fall inside respirable range meaning that inhaled droplets could reach the deep lung. For this reason, humans cannot be present in the room during fogging without extensive PPE and room vents must be sealed prior to fogging. Foggers also typically require long wait times (up to two hours) before people can re-enter a treated room.

There are a number of additional technologies you may encounter when researching electrostatic spray technologies. For example, there are devices that emit UV light to kill pathogens on surfaces, surfaces embedded with antimicrobials, and air purification systems. These devices all have their place and may be a good addition to your disinfection practice. However, it is important to understand the limitations of these technologies before investing. For example, how the device fits into your current operating workflow for cleaning and disinfecting, how you will disinfect the spaces these devices cannot reach, and the staffing requirements for these devices.

In turn, you should always consider the entire process when considering these devices, the potential benefits may not outweigh the cost of adoption and maintenance.

Electrostatic spraying can be a great way to help facilities meet the increased need for disinfection, but it is important to choose the right technology for the right job. When choosing technologies to add to your cleaning and disinfection portfolio, consider the following:

Whichever disinfecting technologies you choose to add to your operation’s inventory, ensure the technology has documented evidence to support its use in practice and has been approved by the EPA for use. Look for studies to demonstrate real world reduction of microorganisms on surfaces. For electrostatic sprayers, make sure the disinfectant you’re using has been approved for use with an electrostatic sprayer by the EPA. Studies will also support EPA-approved claims that appear on disinfectant product labels as well as provide extra assurance that you will get the intended result when using the sprayer in practice.

For more information on the Clorox® Total 360® System, click here.

Ben Walker is a paid consultant for CloroxPro.

What do smallpox, polio, and measles1 all have in common? They have all been successfully eliminated in the U.S. via wide-spread vaccination. After ten long months, the COVID-19 vaccine roll-out is finally happening and we are well on our way to successfully combating another infectious disease.

What will determine if the new vaccines are successful?

Simply put, people need to get vaccinated for a vaccine to be effective. Yes, the vaccine itself must be safe and have high efficacy (i.e., create an adequate immune response in those vaccinated), but ultimately what determines if a vaccine is truly successful at eliminating a disease in a population comes down to herd immunity.

What is herd immunity?

Herd immunity is the act of protection that is provided when enough of a population gains immunity to an illness that it halts transmission. Every infectious disease has a reproduction number or R0 (pronounced “R naught”). This calculation is the average number of people an infected individual will infect in an at-risk (non-immune) population. Inevitably, for any given disease, the R0 calculations can vary widely, but are generally based on three primary characteristics:

  1. How long an individual is contagious while infected
  2. The likelihood of infection per contact between an infectious person and a susceptible person
  3. How often people are encountering one another (contact rate)

With COVID-19, R0 estimates change based on location and population, but some studies calculate it being as high as 5.7 (95% CI 3.8–8.9) .2 So, if I am infected with COVID-19 and interacting with a completely vulnerable group of individuals, on average, I could expect to infect five other people. To reach herd immunity, you essentially need to pass an immunity threshold that makes it so that an infected person has no one to transmit the infectious disease to because no one around them is susceptible (R0 < 1).3

Herd Immunity Blog Post

Why do we need to get vaccinated?

Herd immunity has been a hot topic throughout the pandemic as there are only two ways to truly achieve it: 1) natural immunity via infection and 2) immunity via vaccination. Unfortunately, when it comes to most infectious diseases, natural immunity through active infection might not be enough to offer full protection and any immunity provided could dissipate over time leaving some individuals vulnerable to reinfection. Additionally, waiting for a population to become infected, and therefore immune, can take a very long time and may result in unnecessary deaths and long-term health implications.

One great example of this is chickenpox. Not long ago, parents would purposely expose their children to infectious individuals to ensure immunity was developed at a young age. I can remember vividly being forced on a play date while covered in spots. Unfortunately, to achieve this natural herd immunity, each year, over 10,000 were hospitalized and an estimated 100-150 died. After the vaccine became widely available in the U.S. in 1995, more than 3.5 million cases of chickenpox are now prevented each year.4

How many people need to get vaccinated to achieve herd immunity?

The estimated number of people that need to get vaccinated to achieve herd immunity depends on several factors:

  1. The infectious disease and how contagious it is.
  2. The proportion of people that are susceptible in a population.
  3. The overall effectiveness of the vaccine.

Experts do not yet know what that threshold is for COVID-19. This is because we do not know how many of us already have immunity. Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, estimates that around 75% of the public needs to get vaccinated for herd immunity to provide protection and truly stop the spread of COVID-19.5

How do we learn more about the COVID-19 vaccines and the plan to reach herd immunity?

Concerns over the speed with which these vaccines were developed are warranted. We should all do our due diligence with any new public health intervention. Thankfully, the information on safety is widely available. Here are three comprehensive resources to help address any concerns you, your family, or your staff may have:

What can we do now?

The Centers for Disease Control and Prevention (CDC), in consultation with the U.S. Advisory Committee on Immunization Practices (ACIP), is prioritizing vaccine distribution in a fair and ethical way and continuing to provide transparent updates on the vaccine roll-out plan. While we wait for our turn to be vaccinated, we need to remind our family, friends, and staff to continue to do all the things that we have been doing – wear masks, maintain social distance, avoid indoor and poorly ventilated spaces, wash our hands, and clean and disinfect regularly. We do these things to protect ourselves, but more importantly, to protect others. That is also true of vaccines. We get them to create herd immunity and protect those in our society that are most vulnerable. I, for one, am looking forward to adding another eliminated disease to the above vaccine success list – smallpox, polio, measles, and COVID-19!

References

  1. Measles Elimination [Internet]. Centers for Disease Control and Prevention (CDC). 2020. [cited 2020 Dec 8] Available from: https://www.cdc.gov/measles/elimination.html
  2. Sanche S, Lin YT, Xu C, Romero-Severson E, Hengartner N, Ke R. High Contagiousness and Rapid Spread of Severe Acute Respiratory Syndrome Coronavirus 2. Emerg Infect Dis [Internet]. 2020. [cited 2020 Dec 8] Available from: https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article
  3. Delamater PL, Street EJ, Leslie TF, Yang YT, Jacobsen KH. Complexity of the basic reproduction number (R0). Emerg Infect Dis [Internet]. 2019. [cited 2020 Dec 8] Available from: https://wwwnc.cdc.gov/eid/article/25/1/17-1901_article
  4. Chickenpox (Varicella) [Internet]. Centers for Disease Control and Prevention (CDC). 2020. [cited 2020 Dec 8] Available from: https://www.cdc.gov/chickenpox/about/index.html
  5. Armour, S. Fauci Calls Coronavirus Vaccine a Game Changer, Decries Misinformation [Internet]. The Wall Street Journal. 2020 Dec 8. [cited 2020 Dec 8] Available from: https://www.wsj.com/articles/deborah-birx-and-anthony-fauci-to-discuss-coronavirus-response-11607432098

I just attended my favorite conference — APHA (American Public Health Association) 2020. Quoting APHA, “The APHA Annual Meeting and Expo is the largest and most influential yearly gathering of public health professionals, bringing the public health community together to experience robust scientific programming, networking, social events, poster sessions and more.

I was particularly excited this year as the conference was scheduled to be in my “backyard” (Bay Area, California). However, as a result of COVID-19, the event was cancelled and instead moved to a virtual format. That said, I was grateful for the opportunity to experience it in this way. While I did miss the ability to connect with colleagues and meet other passionate public health professionals face to face, I appreciated the ability to jump from session-to-session easily, and the ability to post questions in the chat box. Gone were the days of nervously standing up in front of the crowd and waiting for someone to bring over the mic.

What didn’t change was that the content was relevant and inspiring, and I’m excited to share three top takeaways, with lots of references for you to peruse.

Get ready: The time to prepare for the COVID-19 vaccine is now.

Vaccines are one of the most important tools in the public health toolbox, and I know we are all anxious for a safe and effective COVID-19 vaccine when it becomes available. The good news is that there are currently eight COVID-19 vaccines in stage three (final robust stage to ensure efficacy and safety) of development, and therefore it is likely that we will see one with approval soon. The FDA has also taken measures to ensure approved vaccines will be safe and effective and that the benefits outweigh the risks. 

When a vaccine is approved, however, it will take time to vaccinate a significant part of the population, which will be essential in order to move forward as quickly as possible. In fact, until herd immunity is reached, which is the goal of any successful vaccination campaign, current prevention measures will remain important to help mitigate the spread of the infection. So, while a vaccine is coming, social distancing, wearing masks, and hand and environmental hygiene won’t be going away for a while.

Another thing to prepare for is who will get the vaccine first, as demand is surely going to outpace supply. The National Academies of Sciences, Engineering and Medicine has published a Framework for prioritization of vaccines, based on those who need it most. Take a look and see where you and your employees line up.

Double check: Workplace safety is more important than ever.

According to the Occupational and Safety and Health Administration (OSHA), current requirements apply to preventing occupational exposure to SARS-CoV-2 (the virus that causes COVID-19). In addition, there are 28 OSHA-approved State Plans, operating statewide occupational safety and health programs, with standards and enforcement programs that are at least as effective as OSHA's and may have different or more stringent requirements.

Despite these facts, there continue to be concerns about too many workplace related deaths, injuries and illnesses each year, and concern continues to build as the U.S. works to keep the economy strong while controlling the spread of COVID-19. A recent assessment published by The Harvard Center for Population and Development Studies found a correlation between COVID-19 complaints to OSHA, and U.S. deaths 17 days later, suggesting ineffective workplace protections may be a driving factor behind the high U.S. death toll.

This and other data has led to a number of states, including Virginia, Oregon, Michigan and California to take additional measures (in the form of Executive Orders and/or Emergency Temporary Standards) to protect workers against COVID-19. Public health leaders like David Michaels, Ph.D, MD from George Washington University believe that ensuring employee health and safety is essential if we are going to stop the pandemic. With COVID-19 cases at an all-time high, it’s a good time to double check that you are doing everything possible to protect yourself and your employees from the consequences of infection with the virus.

OSHA also requires employers to protect workers from exposure to hazardous chemicals used for cleaning and disinfection, which is another important consideration given the increase in cleaning and disinfecting that many businesses have adopted as a result of the pandemic.

Get involved: Public Health is everyone’s business.

While much of public health is funded by government and non-profit organizations, public health helps everyone and should be a shared responsibility. The more we can all get involved, the less reliant we will be on the government for this basic human right.

Getting involved is easy. Here are some ideas to help you get started:

If you’re already involved, these ideas can help you continue with your public health journey. Remember, as the late C. Everett Koop (former pediatric surgeon and U.S. Surgeon General) once said, “Health care is vital to all of us some of the time, but public health is vital to all of us all of the time.”

Have you been asked to take on the role of part time cleaner in your facility or business? If so, welcome to the club!

With the COVID-19 virus still widespread across the U.S., employers everywhere, from schools, offices, athletic facilities, movie theaters, hotels, restaurants, hospitals, and more, are asking non-cleaning staff to clean.

In a recent back to school survey, more than half (58%) of 120 educators polled responded that they would be asking current staff members/teachers to do some cleaning and disinfecting as part of their regular duties. In other facilities, box office staff, airline gate attendants, check-out clerks, nurses, receptionists and more are being asked to help out with daily cleaning and disinfecting of frequently touched and shared surfaces. The CDC has even stated in the Reopening Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes, that “This guidance is intended for all Americans.”

Depending on your personality and past experiences, you may have had any one of these three reactions:

  1. What? No way, cleaning isn’t in my job description and I don’t have time for that!
  2. Great, cleaning is easy enough. I just use common sense, right?
  3. OK, but I don’t know how to clean properly. Where do I get training?

The good news is that no matter which group you fall into, the COVID-19 pandemic is offering up an opportunity to learn about something many of us wouldn’t have taken the time to do before. And that is how to clean and disinfect properly.

The truth is, although many don’t realize it, properly cleaning and disinfecting surfaces takes education, training, and even practice to perfect. In fact, there is an entire industry focused on helping to ensure that cleaning professionals get what they need to do their job well. IICRC, ISSA, and AHE are just a few examples of organizations with this goal in mind.

While your employer is ultimately responsible for making sure you are educated and trained, here are some basics to help get you started. You can use this information to talk to your employer about what’s important, and potentially even as a starting place for a “new cleaner” training guide for your facility.

What is the difference between cleaning, sanitizing, and disinfecting?

Does cleaning always need to be done before disinfecting?

No. Cleaning and disinfecting can be done at the same time if these criteria are met:

How can I be sure I’m using a product that kills “xyz” germ?

What else is important to understand about the product, and where can I get the information?

What else do I need to know to clean and disinfect properly?

COVID-19 has presented us with quite a challenge to say the least. Fortunately, there have also been a few “silver linings” along the way. One is the knowledge and skills about cleaning and disinfecting properly that few had before. If you have been asked to take on additional cleaning and disinfecting responsibilities as part of your current role, as in any profession, education and training on how to do the job right are essential. This will not only help ensure goals of the job (e.g., to reduce the spread of germs in the environment) are achieved, but to also ensure that the job is done safely.

With the ongoing pandemic and the flu season around the corner, it’s important to develop a plan for using disinfectants efficiently and effectively. There’s a time and place for cleaning, and a time and place for disinfection, and doing the right amount of each can help safeguard public health. During the pandemic, disinfectant use is on the rise, and there is a growing conversation around overuse of disinfectants.

To address this concern and make the most of the limited products available during the pandemic, it’s important to target disinfection to the surfaces and places where it is needed most. Depending on the type of facility and how people are using that facility, some areas might require cleaning only, while others may need both cleaning and disinfection. Smart disinfection—that is, targeting disinfectants to when and where they are needed most—can help conserve disinfectants and maximize protection for the people who use those spaces.

Cleaning, Sanitizing and Disinfecting

Before deciding on a plan for smart disinfection, it’s important to know the difference between cleaning, sanitizing, and disinfecting. Cleaning is the physical removal of dirt and debris from surfaces. Cleaning products contain a surfactant or detergent to break up dirt and debris, but are not Environmental Protection Agency (EPA) registered. Cleaning products cannot make claims to kill bacteria or viruses on surfaces. Sanitizers and disinfectants contain an antimicrobial active ingredient and are EPA registered. Sanitizers reduce the number of bacteria on surfaces, but cannot make claims against viruses, so they cannot be used to kill for example SARS-CoV-2, the virus that causes COVID-19. Disinfectants can be registered to kill bacteria, fungi and viruses on surfaces, including SARS-CoV-2. Some products are one-step cleaner disinfectants, meaning that they contain both surfactants and an antimicrobial ingredient, so they can clean and disinfect in the same step.

When and Where to Disinfect

Manual disinfectants like wipes and trigger sprays are great tools for regular disinfection of spaces and surfaces that people touch frequently throughout the day. In schools for example, it makes sense to disinfect desks, doorknobs and other high-touch surfaces by wiping or spraying them in between classes, but you may not need to disinfect every surface in every room throughout the day. On the other hand, high traffic areas like restrooms may need to be disinfected top to bottom, multiple times throughout the day. According to the Centers for Disease Control and Prevention (CDC), high-touch surfaces that may require frequent disinfection throughout the day include tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.1,2

Thorough cleaning and disinfection of the entire facility usually happens after hours, after building occupants have gone home. This process could involve cleaning (such as vacuuming and dusting), followed by manual disinfection with wipes, trigger sprays or dilutable disinfectants.

For extra assurance that all surfaces are disinfected, electrostatic spray disinfection can be added to and even replace parts of this routine. For example, you could clean high-touch surfaces in classrooms, and then use an electrostatic sprayer to apply a disinfectant quickly and evenly to all surfaces in the room. This could include soft surfaces or surfaces that are difficult to thoroughly clean, such as chairs and desks. Electrostatic spraying can also be used as a substitute for manual wipes and sprays in areas that are large and hard to disinfect manually, such as restrooms, locker rooms or cafeterias. Keep in mind however that high-touch surfaces should still be the focus when using an electrostatic sprayer in public spaces. For example, although walls and floors can be disinfected, these areas may only require cleaning depending on the facility type and room traffic.

Develop a Smart Disinfection Plan

To develop a smart disinfection plan, first determine which surfaces and areas in your facility need to be disinfected. Once you’ve identified the areas and surfaces in your facility that need to be disinfected, you can develop a plan to decide when those surfaces should be disinfected and by whom. Let staff know who is responsible for each area, and what needs to be done in that area. Checklists are a great tool to help staff and managers keep track of what has been done throughout the day. Staff should also be trained on the safe use of disinfectants. Disinfectants are safe when used as directed, so it’s important to always follow label instructions for use. Appropriate personal protective equipment should also be worn by the operators applying disinfectants.

If you need guidance to help you complete your smart disinfection plan, there are several comprehensive tools and resources available. For example, the CDC has guidance on cleaning and disinfecting public spaces, offices and businesses, schools, and homes that includes a disinfection decision tree.3 For educational facilities, there are multiple resources available on cleaning and disinfection, including information on how to open facilities safely.4,5

For more information, please see the following SARS-CoV-2 resources.

References

1. Centers for Disease Control and Prevention (CDC). Cleaning and Disinfecting Your Facility https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility.html (accessed Sep 3, 2020).
2. Centers for Disease Control and Prevention (CDC). Cleaning And Disinfecting Your Facility https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility-H.pdf (accessed Aug 28, 2020).
3. Centers for Disease Control and Prevention (CDC). Guidance for Cleaning and Disinfecting https://www.cdc.gov/coronavirus/2019-ncov/community/cleaning-disinfecting-decision-tool.html (accessed Aug 28, 2020).
4. National Education Association; The Clorox Company. Cleaning , Sanitizing , and Targeted Disinfecting in the Classroom.
5. Centers for Disease Control and Prevention. Guidance for Cleaning and Disinfecting https://www.cdc.gov/coronavirus/2019-ncov/community/pdf/Reopening_America_Guidance.pdf.

With the ongoing COVID-19 pandemic and the heightened scrutiny on cleaning and disinfecting, one of the biggest challenges facing professional cleaning managers is cutting through the noise. Dominating the narrative are a slew of mixed, conflicting and false information, regarding the purchase of tools and products that promise miraculous results.

The debate around whether a disinfecting product will kill SARS-CoV-2 has been covered at length. The EPA list of products that are approved for use against the virus can be found here: Environmental Protection Agency's (EPA) announced products were approved for use against SARS-CoV-2 if they met the criteria of list N.

While the microbial efficacy of traditional disinfectant products is fairly straight forward, there are several emerging technologies such as UV lights, electrostatic sprayers, foggers and misters to be aware of as they are not all created equally. Historically, I have maintained a healthy dose of skepticism for seemingly fantastic claims about fantastic new products, including electrostatic sprayers, as I originally did not recognize the need for them or understand the problem they solved for professional cleaning managers.

While electrostatic sprayers are not new, their application to daily cleanin is. It’s for this reason, I’m eager to share this whitepaper on evaluating electrostatic technology devices. It clearly outlines the nuances of why the technology is effective when deployed properly. I don’t expect anyone to take my observations at face value, however, I always apply three basic questions to determine the value for any given organization. Before making a large investment, I encourage you to read the full paper here and use the recommendations below to make the best decision for your cleaning operation.

Practical Evaluation and Application

Is it safe?

The safety of your workers and the building occupants should always be the top considerations when evaluating a new technology.

Due to the COVID-19 pandemic, the scramble is on for cleaning operations to stock up on disinfecting technology. With that comes the deluge of new product innovations with bold promises. Before making the investment, cross-reference kill claims with the Environmental Protection Agency’s (EPA) database. U.S. law requires that any product that claims to kill specific pathogens must be registered with the EPA. While this was somewhat of a black box previously, the EPA has recently published clear guidance on the use of disinfectants through electrostatic sprayers. The rationale for submitting data before market approval is because a product's safety and effectiveness may change based on use.

If a product's label does not include disinfection directions for electrostatic spraying, it means the EPA has not reviewed the data on whether the product is safe and effective when used by this method. Therefore, if you are evaluating an electrostatic sprayer for your facility, be sure to make sure the disinfectant you’re using has been approved for use in an electrostatic sprayer.

Will it work?

Before signing a purchase order for two dozen electrostatic sprayers, take the time to evaluate whether they will be a good fit for your operation. As counterintuitive as it may sound, slow down.

My suggestion is to pilot one machine, with one team, in one area, on a single shift. Some questions to answer include: 1. Who will use the product — is it a customer service tool or deep cleaning tool for a cleaning specialist? 2. Where and on what will it be used? Pilot in places with the most chances for realistic usage. 3. When will the product be used (i.e., will the building be full or empty, will kids be in or out of school)?

Before getting started, make sure everyone on the team is clear on how the unit is used, the areas the unit will be used, and plan to keep a daily log to record usage data.

At a minimum, usage data should include: how much cleaning product was used during the shift, how long the sprayer was in use, and what areas were covered. Compare this with your previous process and make a data-based decision on whether the technology is a good fit for your operation.

What tasks does it improve or replace?

Based on your pilot data, you'll have a good understanding of whether the product will work for you, and how it can benefit your organization. Use the productivity rates from your pilot to drive decision-making to implement the product into your organization moving forward. Include all the other variables you want to account for, adjust workload, update procedures and train personnel to follow them. Make sure everyone in the organization is clear on what has changed, how the new product is going to improve the operations. Do the due diligence before making the change.

My Final Take

In conclusion, as with any new technology, due diligence is my recommendation before making changes to your daily cleaning program. In this modern age of heightened scrutiny on daily cleaning, it is more important than ever to realistically meet the demand while confidently mitigating the worries that come with a pandemic.

The way we clean up our facilities daily may be getting more attention now because of the pandemic. However, we’re still responsible for cleaning up during outbreaks of influenza, norovirus and countless other forms of infectious disease. The process has not changed — the technology however might help make it more manageable.

Ben Walker is a paid consultant for CloroxPro.

Originally published by CleanLink.

About a year ago in this post, I asked the question “What can the U.S. learn from Australia’s 2019 Flu Season?”. One year later, and although a lot has changed since then, I’m asking myself the same question again. 

Last year, Australia’s flu season came two months earlier than normal and peaked around June. Early on, most of the cases were caused by influenza A, but as the season wore on, the proportion of cases caused by influenza B increased. The 2019 U.S. flu season also came a little early, but was characterized by an initial spike of influenza B which then receded before influenza A hit.  

Of course, we’re living in an entirely different world to the one 12 months ago.  In the U.S., there have been some warnings and concern that the country may get hit with a double whammy of COVID-19 and influenza during this year’s flu season. However, as we look at the current data coming out of Australia, which is in the middle of winter and therefore its influenza season, provides an interesting perspective and may contain learnings for the U.S. 

In Australia, lockdown began in late March, a little before influenza cases generally start to pick up. Many areas of the country eased restrictions toward the end of May and into June, but some went back into lockdown in July in response to regional surges in cases. This is typically peak influenza season in Australia.  For much of the lockdown period, wearing a mask was only recommended for those caring for a COVID-19 patient, but recently, the health department has recommended wearing masks when community transmission is occurring and when physical distancing is difficult.  At least one state, Victoria, has made masks mandatory. Additionally, as in most countries around the world, schools and universities have been closed and public gatherings prohibited.

Like COVID-19, influenza is a respiratory illness and is spread in similar ways, mostly by droplet transmission. Consequently, with these precautions in place, it’s interesting to learn that influenza cases in Australia are markedly down compared to 2019, a particularly bad year. Numbers from Australia’s National Notifiable Diseases Surveillance System show that in the first seven months of 2020, Australia reported 21,000 cases of influenza compared with around 214,000 for the same period of time in 2019.  Deaths for that same period are also down, from 486 in 2019 to 36 in 2020.  These are huge reductions. 

"I think if we could get this sort of effect every year, we'd be very happy," said Professor Ian Barr, deputy director of the World Health Organization Collaborating Centre for Reference and Research on Influenza, to the Australian Broadcasting Corporation.

This one bright spot in an otherwise difficult year has been welcomed amongst Australian medical professionals. The lower rate of community transmission of influenza is perhaps not surprising; the precautionary measures such as social distancing being taken for COVID-19 also help prevent the spread of influenza and have likely saved hundreds of lives.  Additionally, the shutting down of schools and aggressively closing borders are likely to be major contributors. A 30% increase in the number of influenza vaccinations administered is also thought to have helped Australia keep its influenza cases lower.

So the lessons seem clear: social distancing, the wearing of masks in public places, the closure of public spaces that are generally hotbeds for the transmission of influenza, border closures, and high vaccination rates can all help prevent the spread of COVID-19 AND influenza. And these results aren’t just limited to Australia. Other countries in the southern hemisphere such as Argentina, Chile, and South Africa are also reporting large decreases in influenza cases as well, thanks in part to the implementation of COVID-19 prevention measures.

The U.S. may have already seen the benefits of these measures earlier this year. Speaking to the U.S. edition of the The Guardian, Dr. Richard Kennedy of the Mayo Clinic’s vaccine research lab said that shutdown measures “shaved four to six weeks” off the U.S.’s 2019-2020 flu season. 

Unfortunately, as we’ve seen, implementation of such preventative measures varies widely across the country, and border closures have not been as aggressively implemented as in Australia. Meanwhile, flu vaccination rates are also low – according to the Centers for Disease Prevention and Control (CDC), flu vaccination rates hover at around 50% or less each year.  

With flu season approaching, it seems reasonable to assume that measures to help prevent the spread of COVID-19 can also help to prevent the spread of influenza. Aggressively adhering to these measures gives the U.S. the chance of avoiding the “double whammy” of a winter of COVID-19 AND influenza, something that may once again place an enormous burden on hospitals and communities nationwide.    

Also published on The Clorox Company’s Good Growth Blog, the following post offers cleaning and disinfection best practices and various resources available for healthcare and cleaning professionals to help prevent the spread of COVID-19.

In the midst of this pandemic, we’re all performing many actions every day to help slow the spread of SARS-CoV-2, the virus that causes COVID-19. We wear masks and keep at least six feet from others in public. We wash our hands more frequently and regularly clean and disinfect surfaces in our homes and workplaces.

My work life at Clorox, focused on cleaning and disinfection, has started to collide with my life outside work. I have witnessed what I’ve termed the “Disinfection Enlightenment” as people pay closer attention to the cleanliness of their homes and public spaces. In mainstream media and conversations with friends and family, I hear words like “sanitize,” “disinfect,” “EPA List N,” “dilution” and “contact time” that previously belonged to my work world. This mixing of my work and personal life became abundantly clear when my mom, a school teacher, called and asked, “How many desks can I clean with one disinfecting wipe and still be sure I’m killing the virus that causes COVID-19?”

Sure, most people will say that cleaning and disinfection are easy tasks. However, it takes training and practice to safely and effectively complete both.

When I started at Clorox many years ago, I became enlightened to the importance of using disinfectants properly. I “relearned” many of the basics — from the importance of using the proper dilution and freshly preparing bleach solutions when using Clorox® Germicidal Bleach to disinfect my bathroom to creating a cleaning path starting from the cleanest area of a room to the dirtiest area to prevent “cross-contamination” to the way germs spread from one surface to another.

In fact, my team and I spend a lot of time educating healthcare and cleaning professionals about the three P's of a robust cleaning and disinfection programs in public spaces. The three P's refer to:

  1. Training people and dedicating resources to the cleaning and disinfection process
  2. Selecting products to enable effective cleaning and disinfection
  3. Developing sustainable processes for creating and maintaining safer environments

Our new reality is that many more people are responsible for cleaning and disinfecting surfaces today, which means an increased need for education. The cleaning and disinfection world has its own lexicon and there are many nuances. The difference among cleaning and sanitizing and disinfecting is one example:

There are also a lot of questions around how to properly prepare and use surface disinfectants and where we should focus our disinfecting efforts.  In fact, a recent CDC report highlighted gaps in knowledge around the safe use of cleaning and disinfection products in household settings. In the survey of 502 U.S. adults, only 42% of respondents strongly agreed that they knew how to clean and disinfect their homes to help prevent the spread of the SARS-CoV-2 virus which causes COVID-19.

Because I understand firsthand how much people need additional education on cleaning and disinfection, I’m thrilled to be part of the Clorox team partnering with infection-control experts at the Cleveland Clinic to  develop free educational resources to help both consumers and professionals.1

Consumers looking for a comprehensive guide to help them protect themselves, loved ones and communities from further spread of COVID-19 can access Safer at Home: Your Guide to the Coronavirus Pandemic, which includes practical cleaning and disinfection tips for your home.

Employers and professionals looking for resources to help them ensure they’re leveraging best practices for cleaning and disinfecting in their workplaces can check out Six Building Blocks of a Robust Cleaning and Disinfection Program: A Guide for Employers. This guide contains a more in-depth approach for public spaces, including recommendations for organizational support, policies, procedures, product selection, staff training and monitoring.

There are always ways to enlighten ourselves about cleaning and disinfection best practices and do more to help control the spread of pathogens on hard, nonporous surfaces, and these resources are a great place to start.


1. The response to the coronavirus pandemic is continuously evolving as we learn more about the virus and the best techniques to address the associated risks. The Clorox Company has contributed its expertise to these guides in the areas of cleaning and disinfecting. All other guidance was developed through the expertise of Cleveland Clinic. Cleveland Clinic’s materials are based on currently available data and guidelines from the CDC and other resources as of July 29, 2020. This guidance may change from time to time and should be used only as a general reference.

As the COVID-19 pandemic continues, some companies are advertising cleaning services using antimicrobial products that they claim will continue to kill SARS-CoV-2 (the virus that causes COVID-19) on surfaces for days, weeks, or even months. Before you consider using these products or services, it’s important to understand what these claims really mean, what types of pathogens they relate to, and what claims the Environmental Protection Agency (EPA) does and does not allow. This article will help sort through the myths and facts around what are called residual or long-lasting claims.

What types of EPA-approved residual efficacy claims can a product have and what do they mean?

There are three types of residual, or long-lasting claims, that can appear on a product’s EPA approved master label (Table 1).

Table 1. Residual claims that may appear on a product’s EPA-approved master label

Note that all of these claims apply only to bacteria or fungi, and not to viruses. Therefore, these claims are not sufficient to support use against viruses, including SARS-CoV-2. Residual sanitization and residual disinfection claims are considered public health claims meaning they imply a direct impact on human health. These claims require data submission and approval before they can be listed on the product’s EPA master label. “Static” claims like “bacteriostatic,” “mildewstatic” and “fungistatic” are non-public health claims, meaning they do not imply a direct impact on human health. These claims do not require data submission to the EPA for approval at the federal level. However, some states may require data approval in order to make claims in that state.

What are “treated articles”?

In addition to antimicrobial products with residual claims, you may also encounter products with resistant or protection claims, known as treated articles. These treatments can be incorporated into surfaces (e.g., an odor resistant trash bag) or applied to surfaces (e.g., a protective surface coating) to protect the surface itself. The claims for treated articles are commonly used to address aesthetics such as discoloration, stains, or odors. Products that are found to have treated article claims will not have an EPA registration. According to the EPA, “treated articles cannot claim they are effective against viruses and bacteria that cause human illness. This means  they are not appropriate for controlling COVID-19.”1

How do I determine whether a product has EPA-approved residual efficacy claims?

To determine which residual efficacy claims a specific product carries, look up the EPA master label and search it for the key terms listed in Table 1. Products that do not make public health claims may not be EPA registered, and should not be used to kill microorganisms on surfaces. If the product is registered, here is how to find and search a product’s master label: 2

  1. Navigate to the EPA’s Pesticide Product Labeling System (PPLS) website.
  2. Enter the product’s EPA registration number into the field labeled “EPA Registration, Distributor Product, or Special Local Need Number:” and click “Search.” Companies should be able to provide this number to you, or it may appear on their product website. An example of an EPA registration number is “67619-38.”
  3. Open the most recent master label. The EPA includes the full history of master labels for each product, but only the most recent one will have all of the currently approved claims.
  4. Search the label for key terms. Terms like “residual disinfection,” “continuous disinfection,” “residual sanitization” or “residual self-sanitizer” must appear on labels that have approved residual sanitization or residual disinfection claims. Read the terms of the claim, including how often the product must be reapplied.

What is the EPA doing about residual claims in light of the pandemic?

The EPA recognizes the importance of residual kill claims against viruses in light of the COVID-19 pandemic, so they are investigating the possibility of adding these types of claims to certain product labels.3 However, until the EPA provides a clear path to obtaining residual efficacy claims against viruses, companies should not be advertising these types of claims.

Which products can I use against SARS-CoV-2?

For a full list of products that can be used against SARS-CoV-2, see EPA List N: Disinfectants for Use Against SARS-CoV-2 (COVID-19).4 List N includes products that have demonstrated efficacy against:

All of these products are approved for disinfection of hard non-porous surfaces, but they should not be used for residual disinfection of viruses, including SARS-CoV-2.

To learn about EPA’s List N in an ever-changing environment, please read this blog post by Associate Research Fellow, Richard Lowe.

References

1. U.S. Environmental Protection Agency. Is there anything I can do to make surfaces resistant to SARS-CoV-2? https://www.epa.gov/coronavirus/there-anything-i-can-do-make-surfaces-resistant-sars-cov-2 (accessed Jul 20, 2020).
2. U.S. Environmental Protection Agency. Pesticide Product and Label System https://oaspub.epa.gov/apex/pesticides/f?p=PPLS:1 (accessed Jul 20, 2020).
3. U.S. Environmental Protection Agency. Longer-Term SARS-CoV-2 Disinfection Evaluation https://www.epa.gov/healthresearch/longer-term-sars-cov-2-disinfection-evaluation (accessed Jul 20, 2020).
4. U.S. Environmental Protection Agency. List N: Disinfectants for Use Against SARS-CoV-2 (COVID-19) https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2-covid-19 (accessed Jul 24, 2020).

Updated July 31 to reflect additional updates from the EPA regarding List N.

As a follow-up to Richard’s earlier blog post, here’s a short update on the current status of EPA’s List N, Disinfectants for Use Against SARS-CoV-2 (COVID-19).

The EPA’s emerging viral pathogens guidance for COVID-19 has been in effect for a little over five months. The guidance outlines criteria that disinfectants must meet to enable the EPA to approve their use against SARS-CoV-2, the virus that causes COVID-19. To qualify, disinfectants must demonstrate efficacy against a harder to kill virus such as a large or small non-enveloped virus. The emerging viral pathogen guidance was designed exactly for situations like the COVID-19 pandemic, when the emerging virus causing the disease isn’t immediately available to laboratories to conduct disinfectant microefficacy testing to support label claims. 

However, for a few months now, the SARS-CoV-2 virus has been available for testing, and as you’d expect, multiple companies are having their disinfectants tested for efficacy. In July, the EPA announced that fifteen products had become the first to demonstrate efficacy against the virus following testing according to EPA-approved methods. These products can add a SARS-CoV-2 efficacy claim to their federal Master Labels. More will certainly follow. For all products, the efficacy data must still be reviewed by the California Department of Pesticide Regulations (DPR), and individual states will need to accept new labeling before the claim can be added to product labels.

What This Means for Disinfectant Selection

Let’s take a look at what this actually means. For several months now, the EPA has provided a list of disinfectants that can be used against this coronavirus. This is List N: Disinfectants for Use Against SARS-CoV-2 (COVID-19). The number of products on List N has increased each time the EPA has included a new criterion that a disinfectant can meet to be included. The EPA expects products on List N to kill SARS-CoV-2 because they meet one of four criteria:

  1. The product has an emerging viral pathogens claim, meaning that the products have demonstrated efficacy against a virus that is harder to kill than SARS-CoV-2 (COVID-19).
  2. The product has demonstrated efficacy against SARS-CoV-2 (COVID-19).
  3. The product has demonstrated efficacy against a harder-to-kill pathogen than SARS-CoV-2 (COVID-19), specifically norovirus, Mycobacterium boyis | Mycobacterium tuberculosis.
  4. The product has demonstrated efficacy against another type of human coronavirus similar to SARS-CoV-2 (COVID-19).

As of July 28, 2020, there are 468 products on the list. The majority of disinfectants on List N — 308 of them — are included because they have an emerging viral pathogens claim. An additional 102 disinfectants are included because they have an efficacy claim against a human coronavirus similar to SARS-CoV-2. With the availability of SARS-CoV-2 for microefficacy testing, we finally see products — currently 15 — that are included on the list because they have been shown to effectively kill the SARS-CoV-2 following testing according to an EPA-approved method. The remainder of products are effective against human coronavirus or a harder-to-kill pathogen than SARS-CoV-2.

What’s important to note is that EPA considers ALL of the products on List N to be effective and approved for use against SARS-CoV-2, even though only 15 have actually demonstrated efficacy against the SARS-CoV-2 virus in microefficacy tests. 

Why You Should Still Use List N

Given the potential for the COVID-19 pandemic to be long-lasting, it’s understood that List N will continue to be updated and remain as a resource, even as more products are tested against SARS-CoV-2.  The emerging viral pathogens guidance is based on a well-established and thoroughly researched hierarchy of virus susceptibility to disinfectants.  SARS-CoV-2 is an enveloped virus, making it an easy virus to kill.  With the proof of disinfectant efficacy being generated through EPA-approved methods, combined with the results of recent published studies, it’s clear that many household disinfectants as well as disinfectants designed for use in healthcare and other professional settings should be able to kill the virus on hard non-porous surfaces. This supports the rationale behind the EPA’s emerging viral pathogens guidance, and criteria for inclusion on List N.  Those looking for a disinfectant to use against SARS-CoV-2 can, and should, select any of the disinfectants on List N and be reassured that the product they are using will align with EPA and CDC guidance for cleaning and disinfecting against SARS-CoV-2.

For additional information on the SARS-CoV-2 virus, and how to help prevent the spread, visit the CloroxPro SARS-CoV-2 Hub.

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