Risk of “coronavirus Sars-CoV-2” in the hotel room and bathroom.

Reusable textiles, hygiene safety for guests and staff in hotels and other accommodation facilities.

Risk of the SARS-CoV-2 coronavirus in hotel rooms and bathrooms. Information, prevention, and tips for improving hygiene when using textiles.

Notice on Covid-19 and linens of February 21, 2020

Introduction

1. What is a coronavirus?

Coronaviruses are a large family of viruses known to cause illnesses ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). They are positive-stranded RNA viruses, appearing like a crown under an electron microscope. To date, seven coronaviruses have been shown to infect humans: Common human coronaviruses: HCoV-OC43 and HCoV-HKU1 (Betacoronavirus) and HCoV-229E and HCoV-NL63 (Alphacoronavirus); they can cause common colds but also serious lower respiratory tract infections. Other human coronaviruses (Betacoronavirus): SARS-CoV, MERS-CoV, and Sars-CoV-2.

2. What is a new coronavirus?

A novel coronavirus (nCoV) is a new strain of coronavirus that has not previously been identified in humans. Specifically, the one called SARS-CoV-2 was first reported in Wuhan, China, in December 2019. On February 11, 2020, the WHO announced that the respiratory disease caused by the novel coronavirus had been named COVID-19. The new acronym is a combination of the terms CO-rona VI-rus D-isease and the year of identification, 2019.

3. Can coronaviruses be transmitted from person to person?

Yes, some coronaviruses can be transmitted from person to person, usually through close contact with an infected patient, such as among family members or in a healthcare setting. The new coronavirus responsible for the respiratory disease COVID-19 can also be transmitted from person to person through close contact with an infected person.

4. What can I do to protect myself?

Stay informed about the spread of the epidemic by reading the official websites: Ministry of Health, Istituto Superiore di Sanità, ECDC (European Centre for Disease Prevention and Control), and the WHO website , and adopt the following personal protective measures:

• Wash your hands frequently with soap and water or with hydroalcoholic solutions to sanitize your hands and eliminate possible viral contamination.

• Keep a certain distance – at least one meter – from potentially at-risk individuals, especially when they cough or sneeze or if they have a fever, because the virus is contained in saliva droplets and can be transmitted through breathing at close range.

• Avoid touching your eyes, nose, and mouth if you have a fever, cough, or difficulty breathing and have recently traveled to China or have been in close contact with a person returning from China with a respiratory illness.

• If you have a fever, cough, or difficulty breathing and have recently traveled to China, or have been in close contact with a person returning from China with a respiratory illness, report it to the toll-free number 1500 set up by the Ministry of Health and follow the instructions provided. Remember that there are various causes of respiratory illness, and the new coronavirus may be one of them. If you have mild symptoms and have not recently been to China or had contact with anyone who has been there, stay home until your symptoms resolve, practicing hygiene measures. These include hand hygiene (washing your hands frequently with soap and water or an alcohol-based hand rub) and respiratory hygiene (sneezing or coughing into a tissue or into a flexed elbow, wearing a surgical mask, and disposing of used tissues in a closed bin immediately after use and washing your hands).

5. How long does the new coronavirus survive on surfaces?

Preliminary information suggests that the virus can survive for a few hours in the air and on dry surfaces, but up to 6 days in a humid environment at room temperature. The use of common disinfectants can kill the virus, eliminating its ability to infect humans. These include disinfectants containing 75% alcohol (ethanol) or chlorine-based disinfectants (bleach) with a minimum concentration of 1% active chlorine.

When using linens and textiles in hotels, particularly in bedrooms and bathrooms, what additional methods, in addition to standard sanitization, should be used to best protect guests and staff from potential infection by viruses from the coronavirus family?

It should be considered that, to date, there are no specific in-depth studies on the new strain of coronavirus, but the data and characteristics of the coronaviruses responsible for mild clinical forms that cause flu-like conditions every year and of the Sars and Mers viruses are known; these data indicate that the survival of the coronavirus family in the environment (outside the human body) is considered short, in the order of a few dozen minutes, even if the literature is less optimistic with studies where the survival of coronaviruses is decidedly higher. The study “Environmental survival and microbicide inactivation of coronaviruses” (1) relating to the environmental survival of SARS-CoV indicates that the infectivity of the virus remained detectable on a cloth and other porous materials for 72 hours.

Given the current epidemiological situation, it does not appear necessary to significantly modify the standard operating procedures followed for room tidying; however, as a precautionary measure, and to strengthen the protection of the in-house staff member responsible for tidying rooms and incoming guests against any virus that may be present, the following best practices are recommended to enhance existing room tidying and sanitization protocols.

At each tidying, cleaning and sanitization of the room for guest changes:

- Strengthen protocols and provide staff with information regarding frequent hand and forearm hygiene. Hand hygiene must be performed before and after tidying and sanitizing the room, as well as before and after food preparation, before eating, after using the restroom, and whenever hands appear dirty. If hands are not visibly dirty, hand hygiene can be performed with hydroalcoholic products. Perform hand hygiene with soap and water when hands are visibly dirty. (This also applies to daily tidying up without guest changes.)

- ensure that the staff responsible for cleaning rooms wear an appropriate work uniform[1]; the possible use of gloves and masks and their type must be assessed internally by the facility managers and the safety manager based on the risk posed by the level of hygiene of the environment in which they are working and the type and origin of the guests.

-Air the room thoroughly (also apply to daily tidying up without changing guests)

- collect soiled laundry in closed containers (bags or large bags in trolleys), handling and shaking it as little as possible in the surrounding area before placing it in the bag and sending it to the qualified company (whether external or internal to the organization) responsible for washing and sanitizing it.

- replace used bed linen and towels with linen sanitized by a qualified company (e.g. certified " UNI EN 14065:2016 Textiles treated in laundries - Biocontamination control system" according to Assosistema guidelines *)

- As a precaution, in addition to the duvet cover, sheets, and pillowcases, replace the pillowcase(s) and mattress cover(s) with the same number of items sanitized by a qualified company (e.g. , UNI EN 14065:2016 certified or equivalent) whenever rooms are cleaned for a change of guests. Also replace the bedspread and top sheet, if present.

Normally, in order to maintain a low overall bacterial count that can be considered adequate for textile use in hotel facilities, when there is no particular risk of infection or objective reasons that would require immediate changes (e.g., poor environmental hygiene, liquid spillage, etc.), a good frequency for changing pillow covers and mattress covers is recommended: every 7 days of use, and in any case, if used at least once, within 2 weeks of application to the mattress/pillow.

MANAGEMENT OF RISK ENVIRONMENTS

If a guest has stayed in the room who is suspected of being infected according to the case definition criteria (symptoms, geographic origin, contact with others with a confirmed COVID-19 diagnosis), it may be appropriate to isolate the room they occupied until the diagnosis is ruled out (no special intervention is necessary) or confirmed (in which case the procedure described below must be strictly followed). In the latter case, the waiting time for laboratory results is longer than the minimum recommended time before intervening in a room where a patient carrying an airborne disease has stayed.

Two phases must be distinguished:

a) Removal and removal of bed linens and bathroom linens, and "bedding effects."

b) Cleaning of inanimate surfaces.

a) Removal and removal of bed linens and bathroom linens, and "bedding effects." Removing bed linens and bedding is an activity at risk of aerosolization. Staff handling linens must be previously briefed and trained in the procedure and must be provided with a disposable gown, a hair cap, non-sterile disposable gloves, goggles or a face shield, and an FFP2 respiratory protection device. When receiving linens, do not shake the sheets or bring them close to your body. Place the linens in a hermetically sealed bag, clearly labeled, so that the qualified sanitization company, upon receiving them, is informed and can apply appropriate hygienic handling and treatment procedures. All linens must be removed and placed in a closed bag (including bedspreads, top sheets, duvets, sheets, pillowcases, pillow covers, mattress covers, bedside rugs, bathrobes, bath towels, hand towels, bidet wipes, bath mats, etc.). Staff must don and doff personal protective equipment strictly following the sequence learned and perform hand hygiene before and after removing gloves (Annex 1). The wash cycle used by the company qualified for sanitization or by the facility's in-house laundry must have a minimum temperature of 60 degrees for at least 30 minutes.

b) Cleaning inanimate surfaces. Allow at least three hours between disposing of linens and cleaning surfaces. Personnel responsible for cleaning floors and surfaces must wear disposable gowns and rubber gloves. If the above precautions have been observed, respiratory protection is not strictly necessary because there is no aerosolization from surfaces.

Do not use aerosol-generating vacuum cleaners to clean floors. Clean surfaces with a disposable mop soaked in a cleaning product. Rinse with water using another disposable mop. Let dry. Disinfect the floor and surfaces with a hypochlorite solution at a concentration of 0.1% active chlorine using a disposable mop or cloth.

Only then proceed to rearrange the room with sanitized linen in compliance with the UNI EN 14065:2016 standard or equivalent.

Personnel who performed the procedures should not be considered contact cases, except in situations where protective measures were not observed or in the event of accidental exposure. *Using textiles for bed and bathroom making from a textile rental company whose facility(ies) is certified " UNI EN 14065:2016 Textiles treated in laundries - Biocontamination control system" according to Assosistema guidelines, combined with an adequate (indicated) frequency of changing the bed system textiles and the application of the best environmental cleaning and sanitization methods for the bedroom and bathroom by trained and specialized operators, ensures the best basic hygiene conditions are created to accommodate guests of the hotel and non-hotel facility in good safety.

This document is intended for owners, managers, directors, housekeepers, supervisors, risk managers, hotel and floor staff, and for hospitality and community groups where professional textiles are used, rented from specialized companies or sanitized by laundries within the same tourist and hospitality facilities. It was conceived and developed by a working group from Orio Team and Padana Emmedue, companies specializing in textile rental for the hotel industry in northern Italy, in collaboration with Dr. Livio Marossi, biologist, and with the scientific support of Prof. Gaetano Privitera, Full Professor of Hygiene, Director of the Department of Translational Research at the University of Pisa, and coordinator of the Disinfection and Antisepsis working group of SIMPIOS, the Italian Multidisciplinary Society for the Prevention of Infections in Healthcare Organizations.

For information and further details on the topic and products: info@igienicroom.it

February 21, 2020 References:

1. Environmental survival and microbicidal inactivation of coronaviruses

a. Manfred H. Wolff,1 Syed A. Sattar,2 Olusola Adegbunrin2 and Jason Tetro2

b. 1 Faculty of Bioscience, Institute of Microbiology and Virology, Stockumer Str. 10, D-58453 Witten, Germany

c. 2 Center for Research on Environmental Microbiology (CREM), Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada K1H 8M5

2. ECDC TECHNICAL REPORT Interim guidance for environmental cleaning in non-healthcare facilities exposed to 2019-nCoV , 7 February 2020

3. Government of Canada. Fiches Techniques Santé-Sécurité : Agents Pathogènes : - MERS-CoV : https://www.canada.ca/fr/santepublique/services/biosecurite-biosurete-laboratoire/fiches-techniques-santesecurite-agents-pathogenes-evaluation-risques/coronavirus-syndrome-respiratoiremoyen-orient.html#a7 - SARS-CoV: https://www.canada.ca/fr/santepublique/services/biosecurite-biosurete-laboratoire/fiches-techniques-santesecurite-agents-pathogenes-evaluation-risques/coronavirus-syndrome-respiratoireaigu-severe.html#a7

4. Société française d'Hygiène Hospitalière AVIS relatif au traitement du linge, au netyage des locals have hosted a patient confirmed with 2019-nCoV and the protection of personnel 07 February 2020 https://www.sf2h.net/wp-content/uploads/2020/02/AVIS-SF2H-Prise-en-charge-linge-et-locaux-2019-nCoV-07-02-2020.pdf

ANNEX 1

BEHAVIORAL PROCEDURES FOR DRESSING AND UNDRESSING THE PROFESSIONAL OPERATOR

Dressing:

1. Wash your hands[2];

2. Put on the disposable gown;

3. Put on the FFP2 filtering facepiece;

4. Put on gloves on the cuffs of the gown;

5. Put on protective glasses or a protective visor.

Undressing:

1. Remove the gown by pulling it off from behind and rolling it up from the inside out;

2. Remove gloves

3. Thoroughly clean your hands

4. Put on a new pair of gloves

5. Remove eye protection

6. Remove the mask or filter facepiece from the back of the head using the strings or elastic bands

7. Remove gloves and repeat thorough hand hygiene.

PROCEDURES FOR USE, DISPOSAL , AND DECONTAMINATION OF PPE

Respiratory Protection

The use of a disposable FFP2 respiratory protection device is sufficient to protect against the airborne transmission of SARS-CoV-2. Personnel using respiratory protection devices must be trained in their use. In particular, care must be taken to ensure that the FFP2 filter facepiece fits properly on the operator's face. Long beards prevent the filter facepiece from adhering properly to the face. Once worn and cleaned, the device must be considered potentially contaminated and contact with its external surface must be avoided. Upon leaving the room, the device must be removed and disposed of as potentially infectious waste, and the operator must wash their hands.

Face Protection: The mask must be used with face protection consisting of a visor or side-shield glasses. Eyeglasses do NOT provide sufficient protection. After use, the outer surface of the glasses must be considered contaminated. The device, if reusable, must be washed and disinfected after each use.

Protective Clothing : When performing any high-risk operations, the use of non-woven gowns lined with waterproof material is recommended.

Gloves: Disposable, non-sterile gloves that cover the first third of the forearm must be used. The gloves must overlap the wrist of the gown.

[1] The work uniform, although not PPE, is primarily an element of protection for the operator, for the environment (separating the domestic from the professional sphere) and for the guest; it is recommended that it be kept tidy, clean and sanitized through a specific washing and sanitization service (UNI EN 14065:2016 certified or equivalent system) for hygiene reasons and also to convey an adequate professional image to guests. [2] Thorough hand hygiene is essential in any case of contact with a suspected case of Sars-CoV-2 infection or with objects or surfaces that may have been contaminated. Hand washing with soap and water can be replaced, in the absence of obvious dirt, by the use of an alcohol-based disinfectant lotion.