Dealing with the new Coronavirus13 March 2020
New Coronavirus COVID-19 poses a few problems for the professional launderer, writes LTC’s
Richard Neale who has compiled essential information and guidelines for dealing with the virus for laundries and linen rental businesses
At the time of going to press, we are witnessing the outbreak of a novel, and occasionally lethal, Coronavirus of the same family that includes SARS (severe acute respiratory syndrome) and MERS (Middle Eastern respiratory syndrome). The outbreak centres on Wuhan, China, but has spread rapidly to cause multiple infections in several countries and caused in 2,663 deaths to date (25 Feb). We look at how the professional launderer and textile rental operator can cater for the risks associated with this outbreak and minimise its potential to affect staff and customers.
What exactly is the new virus?
The virus that was widely being referred to as WN-CoV (Wuhan Coronavirus) has now been renamed COVID-19. It is one of the family of Coronaviruses, which includes the common cold. It is a physically large virus, typically about 0.125 micron across with a surface covered by spiky projections, making it too large to survive or stay suspended in air for very long or to travel more than a few metres1.
Coronaviruses have an incubation period and the time delay from infection to symptoms with the new bug is not known. The longer it is, then the greater the likelihood of epicentres developing around some of the travellers who have returned from an affected country to their home countries. If each infected traveller is infecting two or three more people, then there will be a steep initial increase in cases, much like the one currently being reported for Wuhan. Although there are other factors at play (such as the speed and magnitude of the official response), it does appear that the increase in cases of COVID-19 in 2020 is much steeper than for SARS in 2003.
Coronaviruses in general are very susceptible to destruction at elevated temperatures. For example, the SARS virus remains healthy and active for around five days at 22 – 25C and 40 – 50% relative humidity (RH) but suffers a reduction in excess of 3log10 if these conditions are increased to 38C and over 95% RH2. A reduction of 3log10 is insufficient for either hospitality or healthcare (the UK National Health Service calls for a minimum reduction of 5log10 for example), but it is very likely that the conditions for implied thermal disinfection in laundering used worldwide will deal effectively with it.
It is advised3 that the new corona virus can be effectively removed from surfaces by wiping with an EPA-approved disinfectant such as sodium hypochlorite at a concentration of 950ppm or 0.1%. This is much stronger than the bleach rinse in the UK Department of Health advice to launderers, which calls for a rinse concentration of 150ppm sodium hypochlorite, provided the rinse time is at least three minutes plus mixing time4.
How can the professional launderer best guard against the risks posed by the new virus?
Isolation of sufficient of the new virus for experimentation in laundering laboratories worldwide is unlikely to happen quickly and most professional launderers will probably rely initially on general control measures which have been proven to work for the wider family of Coronaviruses.
Because Coronaviruses are generally killed effectively by heat, as demonstrated by the work on the SARS virus, then it is reasonable for launderers to use main wash temperature to achieve implied thermal disinfection to provide customer assurance for routine hospitality and healthcare work. This may require a temporary increase in main wash temperature and a consequent increase in the carbon footprint of the laundry (and its customers). This is unfortunate because it risks reversing the recent trend towards low temperature washing across the professional laundering sector. Increasing main wash temperatures back up to 71C for three minutes plus mixing time for cotton towels (or to 65C/10 minutes for polyester cotton blends) would increase significantly the energy consumption of the washhouse, when many are working successfully at 40C.
However, the susceptibility of the Coronavirus to chemical disinfection (as evidenced by its destruction in sodium hypochlorite bleaching) does mean that if the laundry practising low temperature washing is also using chemical disinfection (as it should be), then this ought also to deal with the new virus. Disinfection in low temperature washing can be achieved not only with sodium hypochlorite, as already described, but also using ozone injection into every stage, or peracetic acid in the main wash and/or for final neutralisation. There is as yet no definitive proof that any of these methods (whether implied thermal disinfection or chemical treatment) will work with COVID-19, but in the absence of the necessary research at the moment, they are likely to be adequate simply because they are working effectively against other members of the corona virus family.
Suggested procedures to be Followed
This leads us directly onto the procedures that need to be adopted in the commercial and healthcare laundry to deal with the outbreak (outlined in the box above). This systematic approach is recommended until official guidance is published.
All of these precautions will look very familiar to laundries currently handling healthcare work and it is quite reasonable to draw the conclusion that every healthcare provider working to the latest version of European Standard EN14065 will be effectively killing COVID-19 on incoming work down to a satisfactorily low level. The advice just given includes nothing additional, except the more widespread need for eye, nose and mouth protection. The advice is likely to be needed only as a precaution to prevent the spread of COVID-19 amongst commercial and healthcare customers.
In the less likely event of a more widespread epicentre of the epidemic developing in a country, with cases numbering in the thousands, then more is needed. The precautions already listed should have already been instituted and it is recommended that the effectiveness of these be cross-checked using the laboratory facilities of chemicals suppliers, microbial specialists and local technical service companies. It is expected a rapid test for COVID-19 will quickly become more widely available, which will help considerably.
Laundries may then wish to obtain copies of the certification for the processes they are using, providing assurance that it is sufficiently effective against COVID-19, and so discharging their duty of care.
If the laundry and textile rental sector responds swiftly and expertly to the advice herein then the likelihood is the virus will be brought quickly under control, with very few new centres of significant infection. The ‘WHO Coronavirus situation report No.35’ refers to 80,000 cases and 2,663 deaths. It charts (illustrated) the rise and fall of the virus cases in China and in the other countries. This shows very clearly that in the case of China and at least one other country, the number of cases has peaked and is declining. This shows the effectiveness of early preventive action. However, it is not going to disappear in the short term and the worst risks to the sector are only going to be realised if laundries do nothing to address them.