Coronavirus: Understanding Disinfection Options
Editor’s Note: Since the first wave of news about coronavirus/COVID-19 hit the U.S. in January, R&R has been committed to delivering as much information to restoration and remediation contractors as possible. This effort has included a number of video interviews with experts on a variety of topics related to disinfection services – including protocols, best practices, liability insurance and legal concerns, education on the virus itself, and options for chemicals, systems, and equipment that have been tested again pathogens similar to COVID-19. This R&R Roundtable brings in scientists and product experts to discuss several options contractors have for effective disinfection, and to provide data to prove efficacy. Conversations like this are meant to gather important information in one place to allow contractors to then form their own, educated decisions. Keep in mind, it is critical to be properly trained and to have written protocols and contracts in place before offering services like this.
Panel of Experts
Sam DeAth | Vice President of Environmental Restoration Group | ICP Building Solutions Group
Roger Sheppard| President & CEO | Odorox Hydroxyl Group
Dr. Halden Shane | CEO | TOMI/SteraMist
Which of your products have been proven effective in killing viruses like coronavirus?
DeAth: ICP Building Solutions Group (BSG) has a suite of disinfectants from Fiberlock and Benefect® that have been proven effective against viruses like the coronavirus. These include botanical disinfectants from Benefect, such as Decon 30, as well as concentrate and ready-to-use (RTU) Fiberlock disinfectants like ShockWave and ShockWave RTU.
Sheppard: The Odorox MDU/Rx machine was the one tested and approved by the FDA as a Class II Medical Device for use in occupied areas. The tests were performed in 2014 by the Aerosol Research and Engineering Laboratories (ARE), an independent commercial laboratory that specializes in studying aerosolized microbiological organisms. The MDU/Rx uses the same patented Odorox technology found in the other commercial units - Oasis+, Boss, and Boss XL3. However, the MDU/Rx is the least powerful of the machines and would typically be used in small occupied spaces like a school classroom or hospital room. The Oasis+, Boss, and Boss XL3 machines are more powerful and are typically the ones used in the restoration industry for larger areas.
Dr. Shane: All of TOMI’s SteraMist products using our DARPA-produced Binary Ionization Technology (BIT™) technology platform are effective against coronaviruses. However, we use the word “inactivate”. By destroying the protein and disrupting the DNA/RNA, the virus cannot replicate and is rendered ineffective. Because viruses aren’t alive, they can’t be killed, making the distinction between the words “kill” and “inactivate” of crucial importance.
I don't think viruses qualify as being alive. They are, in essence, inert — unless they come into contact with a living cell. However, there are some characteristics of viruses that put them on the cusp of being alive: they have genetic material. DNA or RNA. It's not the same thing as a rock, but it's clearly not the same thing as bacteria in regard to self-sustaining and self-generating acts. Without a cell, a virus cannot reproduce. And so, from that standpoint, if you consider life to be something that can reproduce by itself independently, it's really not alive.
However, if you loosen your definition of life to something that can make copies of itself with help, then you could call it ‘alive’. It's thought that some of the very first life-forms on life were RNA molecules, and under the right conditions, they could make copies of themselves. Viruses likely evolved from that ancestor, but eventually lost the capability to self-replicate.
What kind of testing was done to prove your product’s efficacy? How does that translate to coronavirus?
DeAth: All Benefect and Fiberlock disinfectants have been tested against various types of viruses to prove the efficacy spectrum: small to large enveloped (such as HIV-1, influenza A and avian influenza) plus non-enveloped viruses (such as norovirus and rhinovirus), which are much more difficult to kill. ICP BSG’s disinfectants also have testing and approvals for human coronavirus.
It is important to note, however, that it is impossible to have preexisting lab data on all organisms in the world, especially “novel” strains like the coronavirus that causes COVID-19. As far as we know, no product on the market has specific data on COVID-19. The Environmental Protection Agency (EPA), Centers for Disease Control and Prevention (CDC), Health Canada and World Health Organization (WHO), etc., are all looked to have immediate recommendations when there are outbreaks. So they categorize viruses based on their structure, which logically correlates to their susceptibility to be killed.
- This translates to coronavirus this way:
- The EPA has created a “preapproved” claim for “Emerging Viral Pathogens,” which describes the criteria a product needs to be able to publicly claim effectiveness against whatever strain of virus has currently emerged. If a product has efficacy against small enveloped viruses or nonenveloped viruses, it can be expected to inactivate COVID-19. In order to publicly claim specific killing effectiveness, a product must have this “Emerging Viral Pathogens” claim. This is a new approach that the EPA is taking so the list of products that have this claim are short. All ICP BSG disinfectants meet the requirements of this program.
- The CDC and Health Canada recommend any Hospital-Grade Disinfectant as sufficient to inactivate COVID-19 because their goal is to protect the public.
Sheppard: The Odorox MDU/Rx was tested on a variety of viruses, bacteria, and mold chosen by the FDA as some of the toughest. The viruses and bacteria were aerosolized in the test to mimic the way they are often transmitted through actions like people coughing. All of the tests had kill rates of between 4 and 5 log reductions (99.99% - 99.999%) within 2 hours.
Testing the coronavirus at this time is not possible because only top national labs like the CDC and NIH can get samples so soon after an outbreak like this. However, one of the viruses included in the ARE laboratory testing was the MS2 virus, which is an excellent surrogate for the coronavirus as both are positive-sense single-stranded RNA, or (+)ssRNA viruses. Based on the results with MS2, we believe that Odorox is effective against the coronavirus.
Dr. Shane: SteraMist has been successfully verified through testing, such as the EPA, using protocols that are under Good laboratory Procedures (GLP) and standards, along with many others including the CDC of China, European Union, health minister of Israel, and FDA of Taiwan. SteraMist is present on lists G, K, L, and M for efficacy against Norovirus, C. difficile, Ebola, and Influenza, respectively, and remains EPA-compliant against numerous pathogenic threats. SteraMist was also used in both the Kingdom of Saudi Arabia and South Korea when they had an outbreak of MERS. MERS, like SARS, is a respiratory syndrome virus very similar to today’s current coronavirus. Most notable, however, is our validated efficacy against the notoriously difficult to kill thermo spore ‘gold standard’: Geobacillus stearothermophilus. The ability to kill Geobacillus stearothermophilus spores translates into efficacy against more susceptible viruses, including this contagious coronavirus. With multiple completed GLP studies through independent laboratories including adenovirus, H1N1, norovirus, and all EPA-accepted studies on the current label, TOMI meets the standard to respond to emerging pathogens, such as the current coronavirus (COVID-19) outbreak.
What is the protocol for using your product to treat/kill coronavirus?
DeAth: Coronavirus does not require any special protocol. Simply follow the label directions.
Sheppard: It’s quite simple - you just plug them in and turn them on. We have been very conservative with our recommended time to treat areas. Odorox machines should operate for two hours in areas that are 10,000 cubic feet. Larger and smaller areas can be adjusted with more machines or shorter/longer time to run them. Odorox should be added to the infection control protocol already being used that includes things like spraying chemicals, wiping surfaces, and other disinfection methods. Odorox is focused on the aerosolized viruses while spraying and wiping is best for surfaces. They work extremely well together to provide clients with a complete solution.
Dr. Shane: With the coronavirus able to remain on surfaces for up to nine days, our product’s application via mist or fog is perfectly suited to the task. One of the most attractive qualities of SteraMist BIT™ is that it may be integrated into a large variety of protocols in a wide array of industries. In the particular example of coronavirus, you would remove the infected subject from the immediate area and consider the areas previously visited by the subject. Once these areas have been positively identified, non-essential personnel should be evacuated, the area should be closed off, and any infected surfaces should be noted. Depending on the scope, you may either choose to fog the entire room or surgically pinpoint surfaces to be treated by manual application (mist) after initially removing visible biomass and possible contaminants.
While SteraMist products may differ in application method, each product is driven by the same no-touch disinfection and decontamination technology: Binary Ionization Technology (BIT™). The first EPA-registered equipment and solution, the technology features a two-step process where a low-level hydrogen peroxide sole active ingredient solution is dispersed through a cold plasma arc, creating ionized Hydrogen Peroxide (iHP™). This fine mist is able to damage non-enveloped and enveloped pathogens (such as the coronavirus) with a high-log efficacy.
Will your product help, at all, with the prevention of the virus and/or its spread?
DeAth: Standard surface sanitation in general will help prevent the spread, particularly “hot spots” such as doorknobs. But don’t forget hand-washing is also very key! Avoid handshakes and keep your hands away from your face.
Sheppard: Yes. There are two ways Odorox can be used. One is it can be part of a protocol to treat an area that may already be affected. Odorox would handle the air and other methods would focus on the surfaces. However, once the treatment is over, there is nothing still in place to handle the viruses if someone walks in with it. Odorox could help in these scenarios if it stayed onsite and continued running 24/7.
Dr. Shane: As mentioned above, when used in tandem with proper cleaning protocols, SteraMist can very much act as a final step in the fighting and prevention of coronavirus and other pathogenic threats. Due to a small micron size of 0.05-3, whether you’re aiming to treat an entire room or pinpoint specific high-touch surfaces and high-traffic areas, the mist applied is able to quickly disperse thoroughly and evenly, reaching pathogens in the tightest of nooks and corners. Continual preventive treatment with SteraMist along with using good hand cleaning practices (A 20-second minimum hand wash with both soap and water) will help prevent further spreading of the virus.
What are some specific applications where your product would be a smart choice? (i.e. disinfecting a school where a child tested positive for the virus, disinfecting school locker rooms ahead of any confirmed cases, etc.)
DeAth: Our products are suitable for most if not all preventive and decontamination applications that are part of a standard, routine cleaning and disinfecting protocol.
Sheppard: Anywhere people congregate. Many companies are reaching out to areas like schools, senior living facilities, daycare centers, hotels, medical facilities, office buildings, government facilities, etc. They are looking to help these various locations be proactive and keep both the air and surfaces as clean as possible until this coronavirus is no longer an issue.
Dr. Shane: As portable products with a high material compatibility rate, SteraMist can be utilized in many situations, including the aforementioned examples of schools. Whether you choose to apply it during a weekend or during school closures, the speed of iHP™ efficacy ensures that a facility can return to operations quickly. This effectively makes SteraMist indispensable for any area that operates within a tight and precise schedule, such as educational facilities, laboratories, commercial and residential areas, and even public and private transportation.
DeAth: The most important message we want to send is not to panic—every year the world deals with novel strains of viruses such as the flu (which infects many more people every year). The world is not a sterile place; microorganisms are part of our world, including mold, bacteria and viruses. If we practice common-sense personal hygiene and surface sanitation, we will minimize the risk of spreading. We cannot shut down the country every time there is a new strain.
Sheppard: The COVID-19 virus has brought many people into an unknown territory and there is a lot to learn from it. Many of the questions we’ve been asked are about the science behind the Odorox technology, how to use the Odorox machines, where to use them, when to use them, how long they should run, etc. We would like everyone to know that we encourage asking us these questions and we will do our best to quickly provide clear and precise answers. We understand circumstances are tough right now, and we are committed to providing answers and information to help everyone get through this challenging period.
Dr. Shane: With coronavirus spreading at an alarming rate, having a technology on hand that can be rapidly deployed in response to emergency situations and preemptive treatment is absolutely invaluable. A significant perk of SteraMist BIT™ is that you can essentially tailor it to your unique needs and trust in the fact that, no matter what, you’re getting the trusted efficacy of ionized Hydrogen Peroxide across the board to ensure a healthier environment. In our effort to continue innovating for a safer world, SteraMist is already deployed both domestically and internationally, successfully combatting coronavirus in a number of regions including China, Israel, Thailand, Singapore, South Korea, and the United Kingdom.