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As efforts to contain the spread of the COVID-19 outbreak continue, the CDC clarifies important distinctions for remediation efforts. Infection Control Technologies, the biohazard remediation division of Insurance Restoration Specialists, Inc., outlines the proper approach to COVID-19-related decontamination.

What is the difference between cleaning, sanitizing, and disinfecting?

What is cleaning? Removing dirt and debris.

Cleaning refers to the removal of germs, dirt and impurities from surfaces. Cleaning does NOT kill germs, but by removing them lowers their numbers and the risk of spreading infection. Dirt and organic material make some disinfectants less effective, so in most cases cleaning is necessary before disinfecting.

DecontaminationCleaning Tables

DecontaminationCleaning Desks

DecontaminationCleaning Phones and Staplers

What is sanitizing? Low-level killing/deactivation of germs.

Sanitizing is the use of a chemical product or device that reduces the number of germs on a surface or objects by killing or deactivating most, but not all. For food service, a sanitizer should reduce the number of germs on a surface by 99.999% within 30 seconds. For non-food-service hard surfaces, the level should be at least 99.9%. Sanitizers should be used in accordance for surfaces intended as indicated on product labels. Sanitizing does not necessarily clean dirty surfaces or remove germs. Sanitizing is better than cleaning alone but the reduction of pathogen populations on environmental surfaces is exponentially better when you disinfect.

What is disinfecting? Intermediate to Higher-level killing/deactivation of germs.

When you sanitize, you are killing/reducing the number of bacteria present by 99.9 percent (3 log). Sanitizing is better than cleaning alone but the reduction of pathogen populations on environmental surfaces is exponentially better when you disinfect.

The minimum level of effectiveness in a modern-day high level disinfectant is 100 percent kill/deactivation of 99.9999% (6 log) of a claimed organism. A sanitizer is only required to reduce that (6 log) down to (3 Log). We can put that into real numbers. If we start with 1 million organisms on a surface then a disinfectant must kill 100 percent of them; zero left. A sanitizer only reduces the number of organisms down to 1,000.

Disinfecting refers to using chemicals that claim to kill or deactivate between 99.99 (4-Log) – 99.9999% (6-Log) germs on hard, non-porous surfaces or objects on contact and is generally considered more effective than sanitizing. Like sanitizing, however, disinfecting does not necessarily clean dirty surfaces or remove germs. It is the process of killing germs at a higher level when the disinfectant sits visibly wet or dwells on the surface for a specific length of time after the surface has been cleaned.

Does disinfecting sterilize surfaces?

Disinfecting does not sterilize a surface. Sterilizing is killing 100% of the pathogens , and generally requires heat or treatment to surfaces that are not commonly available by standard custodial practices. Please see the EPAs guidance on room space sterilization. Disinfecting will kill/deactivate claimed microorganisms from 99.99% to 99.9999%,(6-Log) which is better than sanitizing (general surface cleaning) but it is not 100%. In order for a disinfectant to be considered sporicidal, it must claim it inactivates 99.9999% (6-Log) of spores of Clostridium difficile on a hard, non-porous surface. Sterilization is 100% kill and must be proven by proper testing.

Always look at the label to determine the disinfectants efficacy by the hierarchy of microorganisms and its ability to deactivate them.

What processes are most effective for COVID-19-Related decontamination?

Infection Control Technologies biohazard experts use a two-step cleaning and disinfection process. They begin by removing dirt and other surface pollutants to prevent deactivation of active ingredients in the disinfection products. This is followed by disinfectants applied directly to all surfaces. For hard-to-access surfaces, airborne mist delivery is used.

It is important to note that disinfection is temporary. As soon as surfaces have been touched or coughed, sneezed, or breathed on, or the space is reoccupied the risk of cross-contamination returns. Staying diligent on a routine cleaning protocol is important to having any clinical significance during an outbreak.

What should be decontaminated in an area with a suspected COVID-19 outbreak?

Transmission of the 2019 novel coronavirus (2019-nCoV or SARS-CoV-2) occurs much more commonly through respiratory droplets and direct contact with body fluids with a viral load than from contact with fomites.

What’s a fomite? Fomites are objects, materials or surfaces which infectious agents can survive and can be a secondary exposure from human sources.

So while one is more likely to become infected by being sneezed on directly, it is also possible to contract the virus by touching a surface that has been sneezed on. It is also believed that airborne virus particles can travel over 10 feet, settling on multiple surfaces. Current evidence suggests that the novel coronavirus may remain infectious for hours or days on surfaces, but the infectious dose required to cause an active infection is unknown.

Cleaning of visibly dirty surfaces followed by disinfection is the best practice or measure for the prevention of COVID-19 and other pathogenic illness in households and community settings. A typical “dirty” surface? Look at the film buildup on a well-used electronic touch screen device.

Practice routine cleaning of frequently touched-surfaces, such as tables, door knobs, light switches, handles, desks, toilets, faucets, sinks, phones, copy machines, pens and staplers. Clean with a general household cleaner and then use an EPA-registered disinfectant that is appropriate for the surface to be cleaned; read and follow the manufactures instructions carefully to allow the product to perform the deactivation of the pathogen.

What products should be used for COVID-19-related decontamination?

The most important step in selecting cleaning and disinfecting products is simply reading the label. Labels contain instructions for safe and effective use of the cleaning product, including safety precautions that should be taken when applying the product. Typically this includes wearing gloves or eye protection and be to use in well-ventilated areas.

Labels will also state if the product is effective on coronaviruses and should have an EPA registration number for such or be on the EPA List N with an Emerging Pathogens Claim. The label may have instructions to dilute the product and dilution ratios should be followed. In some cases, the solutions do not need to be mixed or “Ready to Use” (RTU). Changing how the product is distributed (Fogging or Misting) may change the PPE requirements.

Products may state they have a different kill time. This is also called contact time, wet time or dwell time and indicates the time that the disinfectant needs to stay wet on a surface in order to ensure efficacy. Some products state 30 second contact time and others state 10 minutes contact time for deactivation efficacy. It can be difficult to keep some surfaces wet for 10 minutes. Some of the shorter dwell times can be sprayed and let air dry, but only as per the manufacturer’s instructions.

In addition, all accompanying Safety Data Sheets should be read completely.

Decontamination
Decontamination
Decontamination

In summary, you should know if you are cleaning, disinfecting or both cleaning and disinfecting and know what you are cleaning with. Sanitizing (lowering the level of germs on a surface) is a little gentler than disinfecting (killing more of them), which requires a more powerful agent. Cleaning, in the technical sense, is just wiping away debris or dirt, without necessarily killing or removing any bacteria.

Who should be performing COVID-19-related decontaminations?

For facility managers, a routine cleaning protocol is recommended to decrease the likelihood of surface transmission. If there is no known threat of COVID-19, the users should still be equipped with masks, suitable eye protection, and gloves.

When a person has been tested or suspected COVID-19 positive, decontamination should be performed by with higher standards, qualified staff with HAZMAt training and/or certified bio-recovery technicians who are properly trained. They should perform established industry site risk assessments to secure the area before proceeding. Full personal protective equipment (PPE) will be used, including Powered Air Purifying Respirators (PAPRS), full-face respirators, suites, gloves, and chemical cartridges.

For more information regarding COVID-19-related decontamination, contact Tom Peter (CIH), CEO of Insurance Restoration Specialists, Inc.

Infection Control Technologies, (ICT) a division of Insurance Restoration Specialists, Inc. (IRS) is one of the nation’s leading Building Hygiene contractors. ICT provides Facility Hygiene Services and Emergency Decontamination for some of the nation’s most respected real estate and Risk Management Professionals, Health Care, Municipalities, Institutions, Food Safety, Transportation, and government organizations.

Insurance Restoration Specialists, Inc. (IRS) is a premier provider of disaster recovery mitigation, environmental remediation, biohazard emergency response and HVAC inspection and cleaning in the New Jersey-Philadelphia-New York City area. IRS is certified by NADCA and have Certified Air Systems Cleaning Technicians and a Certified Ventilation System Inspector on staff. Services include mold removal,water damage restoration, fire damage restoration, flood damage cleanup, smoke damage remediation, and biohazard remediation.