Researchers conducting a study at a coronavirus disease 2019 (COVID-19) intensive care unit (ICU) in São Paulo, Brazil, have warned that infection control guidelines need to include a universal policy regarding the disinfection of mobile phones in the hospital setting.
A team from the University of São Paulo, Brazil, conducted a cross-sectional study at the ICU to investigate healthcare workers’ knowledge about the cross-contamination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - the agent responsible for COVID-19.
Although most workers understood the significance of cross-transmission and the importance of adhering to hand hygiene and mobile phone disinfection practices, SARS-CoV-2 ribonucleic acid (RNA) – the virus’ genetic material – was still detected on some of the devices, say Evelyn Patricia Sanchez Espinoza and colleagues.
The researchers say the finding that healthcare worker’s mobile phones can be contaminated with SARS-CoV-2 suggests these devices could form part of the transmission chain in healthcare settings.
“Implementation of official hospital policies to guide HCWs [healthcare workers] regarding disinfection and care of personal MP [mobile phones] are needed,” warns the team.
A preprint version of the paper is available on the medRxiv* server while the article undergoes peer review.
Concerns about mobile phones in hospitals
Espinoza and colleagues say that the mobile phone is now commonly regarded as a workplace tool in the hospital setting.
However, although SARS-CoV-2 has been detected on mobile phones belonging to patients with COVID-19, the devices have not been flagged up as a potential source of transmission in the hospital environment.
At the same time, concerns are growing about the cross-transmission of SARS-CoV-2, following recent descriptions of how the virus can persist on surfaces in the hospital setting, says the team.
“However, there are no official policies from the Centers for Disease Control and Prevention (CDC) about its [mobile phone] disinfection in healthcare facilities,” write the researchers. “Little is known about [the] virus on MPs or its potential for cross-contamination.”
Investigating healthcare workers’ knowledge about the risk of mobile phones
Espinoza and colleagues set out to investigate healthcare workers’ knowledge about the cross-transmission of SARS-CoV-2 and whether they understood its potential to persist on their own mobile phones and form part of the transmission train.
They conducted a cross-sectional study involving staff members working in the adult ICU of a teaching hospital in São Paulo.
The ICU has 11 separate rooms for individual patients. Healthcare staff use scrubs, N95-respirators and surgical-caps as standard while working inside the unit, and they also wear a surgical-gown, face shield and gloves if entering a patient’s room.
An educational campaign was held about SARS-CoV-2 cross-transmission and mobile phone disinfection at the beginning of the pandemic.
“Informative posters were left in the unit that had a QR-code with access to a video of the campaign,” said Espinoza and team.
In the video, healthcare workers were advised to use 70% alcohol swabs to clean the phones and a screen protector to maintain the oleophobic coating. They were also advised to avoid using the devices while providing patient care and while in the restroom.
Ten days after the campaign was held, the researchers took swabs of the participants’ phones and sent them for SARS-CoV-2 testing by reverse transcriptase-polymerase chain reaction (RT-PCR).
An electronic questionnaire about hand hygiene and the use and disinfection of mobile phones was also administered.
What did the study find?
Although most healthcare workers understood the significance of cross-transmission and increased their adherence to hand hygiene and mobile phone disinfection during the pandemic, SARS-CoV-2 RNA was still detected on two of the devices.
Fifty-one of fifty-three staff members working in the unit participated in the survey and responded to the questionnaire. Nine (18%) had covered their phone with kitchen-plastic film in an effort to facilitate disinfection. Eleven (16%) said they did not recall the campaign and three (6%) said that it had not changed their behavior.
Only four (8%) of the healthcare workers did not believe that the virus could persist on mobile phones and only one (4%) did not believe that it could persist on the hands.
Ninety-eight percent of participants said they had washed their hands more since the beginning of the pandemic.
Of fifty-one swabs collected from mobile phones, SARS-CoV-2 RNA was detected by RT-PCR on two devices.
A universal policy regarding care of electronic devices in hospitals is needed
Espinoza and colleagues say the findings show that healthcare workers’ mobile phones can become contaminated with SARS-CoV-2.
“Thus, it is possible MPs [medical professionals] may be a part of the chain of virus transmission in healthcare settings,” they write.
“Our findings suggest the need of a universal policy in the infection-control guidelines on how to care for electronic devices in the hospital,” concludes the team.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.