Up In The Air: How Coronavirus Lives in the Air and On Surfaces

Members | March 25, 2020 | by Dee Pekruhn

Many people are rightly asking long how this novel coronavirus lives in the air and on surfaces, once it is shed by another person; researchers are racing to find answers. Here, below, is a quick review of three emerging studies, and the official word – so far - from the CDC and WHO

On what surfaces and matter can the virus survive?

To answer this question, we reviewed three studies, by the New England Journal of Medicine (NEJM), the Journal of the American Medical Association (JAMA), and Cold Spring Harbor Laboratory (CSHL.) We must emphasize that data on the virus is still in the early stages, so these details may change. However, so far, the studies together have explored how long the virus can survive for a period of time on the following surfaces or matter: air, plastic, steel, cardboard, copper, shoes, floor surfaces, and fecal matter.

So, how long can it survive in AIR?

The NEJM’s lab experiments attempted to replicate the hospital environment. They found the virus was “viable in aerosols,” meaning that the virus can live in the air in droplets that are smaller than 5 micrometers. The virus remained suspended in the air for 30-34 minutes, and was viable for up to three hours. However, the study also revealed that the virus deteriorates rapidly once suspended, effectively indicating a low risk of exposure to the virus if you are not in close proximity to someone with COVID19 when the virus becomes airborne.

The JAMA study only found airborne elements of the virus on samples collected from air ducts – air samples themselves came back negative for the virus. The researchers suggested this may be because the virus may have become airborne after being disturbed from a surface deposit, and the whisked up to the air duct by the air currents in the room. The JAMA study was field-based in Singapore, and followed three patients’ virus-shedding emissions for five days after they were hospitalized for COVID 19.

Conducted in the early days of the Wuhan outbreak, the CSHL review found that, not surprisingly, the permutation of the virus in the air samples increased when the number of infected patients in a given space increased; no further findings were discussed about its viability in air.

On what Other Surfaces, and For How Long, Can It Survive?

In the lab environment, the NEJM study found that:

  • Plastic and Steel: 72 hours.
  • Cardboard: 24 hours
  • Copper: 4 hours.

In the field environment, the JAMA study did find viable virus fragments in fecal matter samples of one patient, suggesting it may be actively transmissible by fecal matter. Additionally, a swab from one healthcare worker’s shoe – shoe covers were not part of PPE – revealed a viable fragment of the virus. With the caveat that this was a very small sample set, the JAMA study concluded that the risk of transmission from fecal matter or a shoe was very low, provided that there was “strict adherence to both environmental and hand hygiene.”

So, how do we prevent the spread of the coronavirus from these surfaces?

Collectively, the studies recommended:

  • Be sure to follow droplet precautions, as required by CMS, when in close proximity to a person with COVID19.
  • Be careful when removing PPE and cleaning floor surfaces. The virus may have settled on PPE or on the floor, and could be “re-suspended” in the air.
  • Practice strict adherence to environmental cleaning. The JAMA study space used 5000 PPM of sodium dichloroisocyanurate to disinfect high touch surfaces. (Sodium dichloroisocyanurate is most often used as a disinfectant in swimming pools or in the food service industry.) NEJM also said that “disinfectant wipes” of various kinds may be used. And be sure to disinfect the toilet.
  • Practice strict adherence to hand hygiene. CDC has given clear standards on this practice.
  • Ensure good room ventilation.
  • Do not over-concentrate people with confirmed cases to small spaces. CSHL suggested that overcrowding of people with COVID19 increases the risk of exposure to airborne coronavirus.

LeadingAge continues to follow the emerging information and news on coronavirus as it becomes available. This article will be updated as future studies reveal additional relevant data. To read the original studies, or the official information from CDC and WHO on the virus and how it spreads, please review the sources below.