Abstract
The current COVID-19 pandemic has revealed there is a need for all areas of public health to work together in a coordinated manner in order for infection prevention and control to be more effective. After a two-month containment phase, Spain is beginning ease the lockdown. In this new scenario, the environmental health services of the Spanish Autonomous Communities face challenges which are different and complementary to those of the previous phase and which must be taken into account. Thus, the reopening of establishments and industries whose water systems have been stagnant for so long can increase microbiological and even chemical risks. Likewise, the resumption of recreational activities that revolve around water—both in public swimming pools and on beaches—requires health recommendations for safe use in this new stage. The same applies to the widespread start of collective HVAC systems or of sanitation facilities, which could in theory facilitate the transmission of SARS-CoV-2 through potential new pathways.
The purpose of this paper is to analyze these potential risks from an environmental health perspective in order to better prevent or minimize them, all within the context of the current lockdown-lifting phase and in view of the new scientific knowledge that is currently being generated.
References
Ministerio de Sanidad. Información científico-técnica. Enfermedad por coronavirus, COVID-19. Actualización 18 de mayo 2020. [Citado 20/05/2020] Disponible en: https://www.mscbs.gob.es/ en/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/ITCoronavirus.pdf.
World Health Organization. Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations. Scientific brief 29 march 2020. [Citado 12/05/2020] Disponible en: file:///C:/Users/HP/Downloads/WHO-2019-nCoV-Sci_Brief-Transmission_modes-2020.2-eng.pdf.
Kampf G, Todt D, Pfaender S et al. Persitence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J. Hosp. Infect. 2020. Doi.org/10.1016/j.jhin.2020.01.022.
Van Doremalen N, Morris DH, Holbrook MG, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020. DOI: 10.1056/NEJMc2004973.
Chin AWH, Chu JTS, Perera MRA, et al. Stability of SARS-CoV-2 in different environmental conditions. The Lancet Microbe. 2020. [Citado 21/04/2020] Disponible en: https://www.mscbs.gob. es/en/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/recomendacionesAperturaPiscinas.pdf.
World Health Organization. Cleaning and disinfection of environmental surfaces in the context of COVID-19. Interim guidance 15 de mayo 2020. [Citado 20/05/2020] Disponible en: file:///C:/Users/HP/Downloads/WHO-2019-nCoV-Disinfection-2020.1-eng%20(1).pdf.
World Health Organization. Operational considerations for COVID-19 management in the accommodation sector. Interim Guidance. (consultado el 06 de abril de 2020). Disponible en: https://apps.who.int/iris/handle/10665/331638?locale- attribute=es&.
World Health Organization. Water, sanitation, hygiene, and waste management for the COVID-19 virus. (consultado el 5 de abril de 2020). Disponible en: file:///C:/Users/HP/Downloads/WHO-2019-nCoV-IPC_WASH-2020.2-eng%20(1).pdf.
Sociedad Española de Sanidad Ambiental. Estrategia desde la Salud Ambiental. II.-Situación de desconfinamiento. [Citado 14/04/2020] Disponible en: https://www.sanidadambiental.com/wp-content/uploads/2020/05/SALUD-AMBIENTAL-Y-COVID-19_Desconfinamiento.pdf.
Allende A, de Andrés A, Figueras A, et al. Informe sobre transmisión del SARS-CoV-2 en playas y piscinas. Consejo Superior de Investigaciones Científicas (CSIC). (consultado el 5 de mayo de 2020). Disponible en: https://www.csic.es/sites/default/files/informe_playasypiscinas_csic.pdf.
Ministerio de Sanidad. Recomendaciones para la apertura de la actividad en las piscinas tras la crisis del COVID-19. [Citado 14/05/2020].
Yao M, Zhang L, Ma J et al. On airborne transmission and control of SARS-Cov-2. Sci Total Environ 2020; 731,139178.
Ministerio de Sanidad. Recomendaciones para la apertura de playas y zonas de baño tras la crisis del COVID-19. (consultado el 25 de mayo de 2020). Disponible en: https://www.mscbs.gob.es/en/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Recomendaciones_apertura_playas.pdf.
Real Decreto 463/2020, de 14 de marzo, por el que se declara el estado de alarma para la gestión de la situación de crisis sanitaria ocasionada por el COVID-19. BOE núm. 67, de 14 de marzo de 2020.
Comunidad de Madrid. (consultado el 14 de mayo de 2020). Disponible en: https://www.comunidad.madrid/noticias/2020/04/25/consumo-agua-comunidad-ha-disminuido-75-declaracion-estado-alarma.
Proctor CR, Rhoads WJ, Keane T et al. Considerations for Large Building Water Quality after Extended Stagnation. DOI 10.31219/osf.io/qvj3b.
Flemming HK. Executive Summary: Results of the Collaborative Research Project Detection and Treatment of Transiently Nonculturable Pathogens in Drinking Water Installations (“Biofilm Management”). (consultado el 14 de mayo de 2020). Disponible en: https://mafiadoc.com/results-of-the-collaborative-research-project-_5b7554ac097c47a3158b4629.html.
Arashiro T, Nakamura S, Asami T, et al. SARS-CoV-2 and Legionella Co-infection in a Person Returning from a Nile Cruise. J Travel Med. 2020 (16). doi: 10.1093/jtm/taaa05.
Xing Q, Li G, Xing Y, et al. Precautions are Needed for COVID-19 Patients with Coinfection of Common Respiratory Pathogens. https://www.medrxiv.org/content/10.1101/2020.02.29.20027698v2.
Sociedad Española de Sanidad Ambiental (SESA) y Sociedad Española de Medicina Preventiva, Salud Pública e Higiene. COVID-19: Recomendaciones higiénico-sanitarias para los hoteles medicalizados y los hoteles abiertos para servicios esenciales. [Citado 07/05/2020] Disponible en: https://www. sanidadambiental.com/wp-content/uploads/2020/04/HOTELES-MEDICALIZADOS.pdf.
Crespí S. Prevención de Legionella y seguridad hídrica en instalaciones de alojamiento turístico declaradas como servicios esenciales y/o medicalizadas. Guía rápida y criterios básicos de actuación. [Citado 30/03/2020] Disponible en: https://cehat. com/adjuntos/fichero_9355_20200330.pdf.
ESGLI- Guidance for managing legionella in hospital water systems during the COVID-19 pandemic. [Citado 21/04/2020] Disponible en: https://www.escmid.org/fileadmin/src/media/ PDFs/3Research_Projects/ESGLI/COVID_ESGLI_GUIDANCE_FOR_MANAGING_LEGIONELLA_IN_HOSPITAL_WATER_ SYSTEMS_DURING_THE_COVID-19_PANDEMIC__20200409_v01.00.pdf.
ESGLI. Guidance for managing legionella in nursing and care home Waters systems during the COVID-19 pandemic. [Citado 21/04/2020] Disponible en: https://www.escmid.org/fileadmin/ src/media/PDFs/3Research_Projects/ESGLI/COVID_ESGLI_GUIDANCE_FOR_MANAGING_LEGIONELLA_IN_NURSING__CARE_HOME_WATER_SYSTEMS_DURING_THE_COVID-19_ PANDEMIC__20200409_v01.00.pdf
Bin X, Guangzhou Y Zhicong Y. COVID-19 Outbreak associated with air conditioning in restaurant, Guangzhou, China, 2020. Emerg Infect Dis 2020; 26(7):1-4.
Park SY, Kim YM, Yi S, Lee S, Na BJ, Kim CB, et al. Coronavirus disease outbreak in call center, South Korea. Emerg Infect Dis. 2020; 26(8):1-5.
Liu Y, Ning Z , Chen Y, et al. Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals. Nature, 2020. DOI: 10.1038/s41586- 020-2271-3.
Fears AC, Klimstra, WB, Duprex P et al. Comparative dynamic aerosol efficiencies of three emergent coronaviruses and the unusual persistence of SARS-CoV-2 in aerosol suspensions. medRxiv preprint. DOI:10.1101/2020.04.13.20063784.
Shen Y, Li C, Dong H, et al. Airborne transmission of COVID-19: epidemiologic evidence from two outbreak investigations. DOI: 10.13140/RG.2.2.36685.38881.
Federation of European Heating, Ventilation and Air Conditioning Association (REHVA). REHVA COVID-19 guidance document, Updated April 3, 2020. How to operate and use building services in order to prevent the spread of the coronavirus disease (COVID-19) virus (SARS-CoV-2) in workplaces. [Citado 07/05/2020] Disponible en: https://www.rehva.eu/activities/covid-19-guidance.
Asociación Técnica Española de Climatización y Refrigeración (ATECYR). Documento de REHVA sobre cómo operar y utilizar las instalaciones térmicas en la edificación para prevenir la propagación del coronavirus (COVID-19) (SARS-CoV-2) en los lugares de trabajo (traducción). [Citado 07/05/2020] Disponible en: https://www.atecyr.org/actualidad/noticias/noticia-atecyr.php?nid=1273.
Monsolar y Colegio de Ingenieros Industriales de la Comunitat Valenciana. Recomendaciones preventivas en climatización para vía de transmisión aérea de la enfermedad (COVID-19) por coronavirus (SARS-CoV-2). [Citado 07/05/2020] Disponible en: https://iicv.net/wp-content/uploads/2020/03/COVID19_Monsolar-COIICV_2020_04.pdf.
Federación de Empresas de Calidad Ambiental en Interiores (FEDECAI). Guía de recomendaciones preventivas en calidad del aire interior, para edificios de pública concurrencia frente al coronavirus (SARS-CoV-2). [Citado 07/05/2020] Disponible en: https://www.fedecai.org/DESCARGAS/GUIA-EDIFICIOS-PUBLICA-CONCURRENCIA.pdf.
Asociación Técnica Española de Climatización y Refrigeración (ATECYR). Guía de Atecyr de recomendaciones de operación y mantenimiento de los sistemas de climatización y ventilación para edificios de uso no sanitario para la prevención del contagio por SARS CoV 2. [Citado 14/05/2020] Disponible en: https://www.atecyr.org/actualidad/noticias/noticia-atecyr.php?nid=1277.
Federación de Empresas de Calidad Ambiental en Interiores (FEDECAI). Guía de recomendaciones preventivas en calidad del aire interior, para viviendas frente al coronavirus (SARS-CoV-2). [Citado 14/05/2020] Disponible en: https://www.fedecai.org/ DESCARGAS/GUIA-RESIDENCIAS.pdf.
Lodder WJ, de Roda AM. SARS-CoV-2 in wastewater: potential health risk, but also data source. The Lancet 2020. https://doi.org/doi:10.1016/j.ijid.2020.04.057.
Amirian ES. Potential fecal transmission of SARS-CoV-2: Current evidence and implications for public health. Int J of Infect Dis. 2020; (95):363–70.
Wu Y, Guo C, Tang L, et al. Prolonged presence of SARS- CoV-2 viral RNA in faecal simples. The Lancet 2020. https://doi.org/10.1016/S2468-1253(20)30083-2.
World Health Organization. Water, sanitation, hygiene, and waste management for the COVID-19 virus Interim guidance 23 April 2020. [Citado 14/05/2020]. Disponible en: file:///C:/Users/HP/Downloads/WHO-2019-nCoV-IPC_WASH-2020.3-eng.pdf.
Xiao F, Sun J, Xu Y, Li F, Huang X, Li H, et al. Infectious SARS- CoV-2 in feces of patient with severe COVID-19. Emerg Infect Dis 2020. https://doi.org/10.3201/eid2608.200681.
Murphy H, Soule BM. Can coronavirus spread through defective bathroom sewage pipes?. [Citado 14/05/2020]. Disponible en: https://waterandhealth. org/disinfect/preventing-infection/can-coronavirus- spread-through defective-bathroom-sewage-pipes/.
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