In the early days of the COVID-19 pandemic, it felt like the virus was everywhere — and on everything.
Some people washed their mail or wore gloves to the grocery store, while policymakers cordoned off playgrounds and encouraged businesses to scrub every surface.
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But as the months passed, scientific consensus began to crystallize, suggesting some of those precautions might be missing the bigger picture of how the SARS-CoV-2 virus transmits.
The main way people get infected, most leading public health officials and scientists now agree, is through exposure to this virus through the air, not through contaminated surfaces known scientifically as “fomites.”
Yet Omicron, the highly contagious variant known for slipping around some of our best defences, might be surviving longer on everyday objects than its early predecessor — raising questions about which basic precautions to prevent surface-based transmission might still be warranted.
That’s a key finding from a new pre-print paper from researchers at the University of Hong Kong’s school of public health, which is published online but has not yet been peer-reviewed.
After conducting lab-based research, the team found Omicron “is more stable than the ancestral SARS-CoV-2 on different surfaces.”
“Our findings imply that (Omicron) has an increased likelihood to be transmitted by the fomite route,” the researchers concluded.
“Hand hygiene and frequent disinfection of common touch surfaces in public areas are highly recommended.”
In the early days of the pandemic, some people washed their mail or wore gloves to the grocery store, while policymakers cordoned off playgrounds and encouraged businesses to scrub every surface. (Etienne Laurent/EPA/Shutterstock)
‘More evidence is needed’
Building off other recent research which showed Omicron’s heavily-mutated spike protein is more stable than the ancestral strain, and their own previous findings on SARS-CoV-2’s level of infectiousness on various surfaces, the Hong Kong team explored what would happen if droplets containing Omicron — the BA.1 lineage, specifically — were applied to surfaces like stainless steel, paper, and glass.
In each instance, infectious amounts of Omicron were recovered for longer amounts of time than the samples of the original virus.
On several types of paper, infectious amounts of ancestral SARS-CoV-2 were only recoverable for five to 15 minutes — compared to more than 30 minutes for Omicron.
On smooth surfaces, Omicron lasted more than a week, while infectious amounts of the original virus were recovered up to just four days on polypropylene plastic and stainless and up to seven days on glass.
“More evidence is needed to account for the increased transmissibility of (Omicron) observed in various community studies,” the researchers wrote.
“The extra virus stability on surfaces may be one possible factor and should be taken into consideration when recommending control measures against the infection.”
Linsey Marr, a researcher on the airborne transmission of viruses like SARS-CoV-2 and a professor at Virginia Tech, agreed that the results show Omicron seems to survive better, which could be contributing to its heightened transmissibility.
“This might affect the balance of transmission routes favouring more fomite transmission than we saw before,” she said.
But Marr stressed the study’s conditions don’t reflect real-world scenarios. The volume of droplets used in the lab research — five microlitres — might sound small, but it’s “actually huge compared to droplets we usually spew out,” she said.
That means the exact timings might not pan out for people living their daily lives, though Marr did feel the comparison between the ancestral virus and Omicron was notable.
WATCH | Omicron surge triggers new lockdowns in China:
China locks down cities to stop Omicron surge
2 days ago
Duration 2:00
Millions of people in China have been forced into lockdown, ordered to stay home to protect themselves from the country’s biggest COVID-19 outbreak in two years. 2:00
Virus ‘fragile’ outside controlled settings
Other members of the scientific and medical community also had mixed views on what this new study actually tells us about how Omicron spreads.
Emanuel Goldman, a microbiology professor at the New Jersey Medical School of Rutgers University, said in an article published in The Lancet journal in 2020 that the risk of COVID-19 infection from surfaces at that time was “exaggerated.”
When asked about the new Hong Kong results, he said any findings based on the “same old techniques” in a laboratory don’t change that, since figuring out transmission is about more than just how viruses survive within controlled settings.
“You’re never going to find that much virus in a small area that you touch,” he said.
“The virus is fragile; these mutations haven’t changed that. It’s still going to die very quickly in the environment.”
‘Hand hygiene and frequent disinfection of common touch surfaces in public areas are highly recommended,’ say a team of Hong Kong researchers. (Evan Mitsui/CBC)
Arinjay Banerjee, a virologist working with the University of Saskatchewan’s Vaccine and Infectious Disease Organization, echoed that.
“Doing experiments inside a lab where humidity is controlled is one thing. Applying that to real life is an entirely different thing,” he said.
Sunlight and humidity, for instance, can both contribute to how long viruses are able to survive on surfaces outdoors, he noted.
The study authors themselves did note the limitations at play, including the controlled, lab-based setting and differences in the droplets used in the research compared to respiratory droplets, which may all impact the stability of the virus.
It’s also not clear exactly how much virus is needed for a productive SARS-CoV-2 infection, Banerjay said, with more research needed.
Even so, he said the findings suggest it’s worth being cautious.
“I think we shouldn’t drop our guard against SARS-CoV-2, period.”
Hand washing, basic cleaning still matter, experts say
So what’s the takeaway for Canadians who are trying to navigate a reopening society while mitigating the risk of falling ill with COVID-19?
“We’ve been so focused on airborne transmission and masks that, maybe, we’ve kind of neglected to wash our hands,” Marr said.
Dr. Gerald Evans, chair of the division of infectious diseases at Queen’s University in Kingston, Ont., agreed that alongside other personal protections like mask-wearing and vaccinations, basic hand hygiene remains a smart way to ward off this virus.
Regular sanitization of toys and other items in daycares and schools where children are at play may also be helpful, Dr. Gerald Evans said. (Robert Short/CBC)
Regular sanitization of toys and other items in daycares and schools where children are at play may also be helpful, he said, given how often kids put items directly in their mouths.
But he warned the public not to panic, and avoid resorting to heavy-handed precautions.
“If you wash your hands — not obsessively, but just thoughtfully and carefully — that’s going to reduce any transmission you see out there,” Evans said.
“Certainly I don’t want to see people going back to wiping their groceries down with disinfectants and leaving things sitting for days on end in the hope that what virus might be there isn’t going to infect them. We know that this is not in any shape, manner, or form a major transmission route for this virus.”
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Patients who are older, don’t speak English, and don’t have a high school education are more likely to experience harm during a hospital stay in Canada, according to new research.
The Canadian Institute for Health Information measured preventableharmful events from 2023 to 2024, such as bed sores and medication errors,experienced by patients who received acute care in hospital.
The research published Thursday shows patients who don’t speak English or French are 30 per cent more likely to experience harm. Patients without a high school education are 20 per cent more likely to endure harm compared to those with higher education levels.
The report also found that patients 85 and older are five times more likely to experience harm during a hospital stay compared to those under 20.
“The goal of this report is to get folks thinking about equity as being a key dimension of the patient safety effort within a hospital,” says Dana Riley, an author of the report and a program lead on CIHI’s population health team.
When a health-care provider and a patient don’t speak the same language, that can result in the administration of a wrong test or procedure, research shows. Similarly, Riley says a lower level of education is associated with a lower level of health literacy, which can result in increased vulnerability to communication errors.
“It’s fairly costly to the patient and it’s costly to the system,” says Riley, noting the average hospital stay for a patient who experiences harm is four times more expensive than the cost of a hospital stay without a harmful event – $42,558 compared to $9,072.
“I think there are a variety of different reasons why we might start to think about patient safety, think about equity, as key interconnected dimensions of health-care quality,” says Riley.
The analysis doesn’t include data on racialized patients because Riley says pan-Canadian data was not available for their research. Data from Quebec and some mental health patients was also excluded due to differences in data collection.
Efforts to reduce patient injuries at one Ontario hospital network appears to have resulted in less harm. Patient falls at Mackenzie Health causing injury are down 40 per cent, pressure injuries have decreased 51 per cent, and central line-associated bloodstream infections, such as IV therapy, have been reduced 34 per cent.
The hospital created a “zero harm” plan in 2019 to reduce errors after a hospital survey revealed low safety scores. They integrated principles used in aviation and nuclear industries, which prioritize safety in complex high-risk environments.
“The premise is first driven by a cultural shift where people feel comfortable actually calling out these events,” says Mackenzie Health President and Chief Executive Officer Altaf Stationwala.
They introduced harm reduction training and daily meetings to discuss risks in the hospital. Mackenzie partnered with virtual interpreters that speak 240 languages and understand medical jargon. Geriatric care nurses serve the nearly 70 per cent of patients over the age of 75, and staff are encouraged to communicate as frequently as possible, and in plain language, says Stationwala.
“What we do in health care is we take control away from patients and families, and what we know is we need to empower patients and families and that ultimately results in better health care.”
This report by The Canadian Press was first published Oct. 17, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
CALGARY – Alberta’s health minister says a new agency responsible for primary health care should be up and running by next month.
Adriana LaGrange says Primary Care Alberta will work to improve Albertans’ access to primary care providers like family doctors or nurse practitioners, create new models of primary care and increase access to after-hours care through virtual means.
Her announcement comes as the provincial government continues to divide Alberta Health Services into four new agencies.
LaGrange says Alberta Health Services hasn’t been able to focus on primary health care, and has been missing system oversight.
The Alberta government’s dismantling of the health agency is expected to include two more organizations responsible for hospital care and continuing care.
Another new agency, Recovery Alberta, recently took over the mental health and addictions portfolio of Alberta Health Services.
This report by The Canadian Press was first published Oct. 15, 2024.
Rana Van Tuyl was about 12 weeks pregnant when she got devastating news at her ultrasound appointment in December 2020.
Her fetus’s heartbeat had stopped.
“We were both shattered,” says Van Tuyl, who lives in Nanaimo, B.C., with her partner. Her doctor said she could surgically or medically pass the pregnancy and she chose the medical option, a combination of two drugs taken at home.
“That was the last I heard from our maternity physician, with no further followup,” she says.
But complications followed. She bled for a month and required a surgical procedure to remove pregnancy tissue her body had retained.
Looking back, Van Tuyl says she wishes she had followup care and mental health support as the couple grieved.
Her story is not an anomaly. Miscarriages affect one in five pregnancies in Canada, yet there is often a disconnect between the medical view of early pregnancy loss as something that is easily managed and the reality of the patients’ own traumatizing experiences, according to a paper published Tuesday in the Canadian Medical Association Journal.
An accompanying editorial says it’s time to invest in early pregnancy assessment clinics that can provide proper care during and after a miscarriage, which can have devastating effects.
The editorial and a review of medical literature on early pregnancy loss say patients seeking help in emergency departments often receive “suboptimal” care. Non-critical miscarriage cases drop to the bottom of the triage list, resulting in longer wait times that make patients feel like they are “wasting” health-care providers’ time. Many of those patients are discharged without a followup plan, the editorial says.
But not all miscarriages need to be treated in the emergency room, says Dr. Modupe Tunde-Byass, one of the authors of the literature review and an obstetrician/gynecologist at Toronto’s North York General Hospital.
She says patients should be referred to early pregnancy assessment clinics, which provide compassionate care that accounts for the psychological impact of pregnancy loss – including grief, guilt, anxiety and post-traumatic stress.
But while North York General Hospital and a patchwork of other health-care providers in the country have clinics dedicated to miscarriage care, Tunde-Byass says that’s not widely adopted – and it should be.
She’s been thinking about this gap in the Canadian health-care system for a long time, ever since her medical training almost four decades ago in the United Kingdom, where she says early pregnancy assessment centres are common.
“One of the things that we did at North York was to have a clinic to provide care for our patients, and also to try to bridge that gap,” says Tunde-Byass.
Provincial agency Health Quality Ontario acknowledged in 2019 the need for these services in a list of ways to better manage early pregnancy complications and loss.
“Five years on, little if any progress has been made toward achieving this goal,” Dr. Catherine Varner, an emergency physician, wrote in the CMAJ editorial. “Early pregnancy assessment services remain a pipe dream for many, especially in rural Canada.”
The quality standard released in Ontario did, however, prompt a registered nurse to apply for funding to open an early pregnancy assessment clinic at St. Joseph’s Healthcare Hamilton in 2021.
Jessica Desjardins says that after taking patient referrals from the hospital’s emergency room, the team quickly realized that they would need a bigger space and more people to provide care. The clinic now operates five days a week.
“We’ve been often hearing from our patients that early pregnancy loss and experiencing early pregnancy complications is a really confusing, overwhelming, isolating time for them, and (it) often felt really difficult to know where to go for care and where to get comprehensive, well-rounded care,” she says.
At the Hamilton clinic, Desjardins says patients are brought into a quiet area to talk and make decisions with providers – “not only (from) a physical perspective, but also keeping in mind the psychosocial piece that comes along with loss and the grief that’s a piece of that.”
Ashley Hilliard says attending an early pregnancy assessment clinic at The Ottawa Hospital was the “best case scenario” after the worst case scenario.
In 2020, she was about eight weeks pregnant when her fetus died and she hemorrhaged after taking medication to pass the pregnancy at home.
Shortly after Hilliard was rushed to the emergency room, she was assigned an OB-GYN at an early pregnancy assessment clinic who directed and monitored her care, calling her with blood test results and sending her for ultrasounds when bleeding and cramping persisted.
“That was super helpful to have somebody to go through just that, somebody who does this all the time,” says Hilliard.
“It was really validating.”
This report by The Canadian Press was first published Oct. 15, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
