The new coronavirus WN-CoV presents professional washers with some problems, writes Richard Neale from LTC, who has compiled important information and guidelines for dealing with the virus for laundries and laundry distributors
At the time of going to press, there has been an outbreak of a novel and occasionally fatal coronavirus from the same family, including SARS (severe acute respiratory syndrome) and MERS (Middle Eastern respiratory syndrome). The outbreak is concentrated in Wuhan, China, but has spread rapidly, causing multiple infections in multiple countries and more than 500 deaths at press time.
We are investigating how the professional laundry and textile rental company can manage the risks associated with this outbreak and minimize the potential impact on employees and customers.
What exactly is the new virus?
The virus is commonly referred to as WN-CoV (Wuhan Corona Virus). It belongs to the corona virus family, which includes the common cold. It is a physically large virus, typically about 0.125 microns in diameter, with a surface covered by spiky protrusions. This makes it too big to survive or stay in the air for a very long time or to move over several meters.
Corona viruses have an incubation period and the time delay from infection to symptoms with the new defect is unknown. The longer it takes, the greater the likelihood that epicentres will develop around some of the travelers who have returned to their home countries from an affected country. When each infected traveler infects two or three more people, the number of cases increases sharply, similar to what is currently reported for Wuhan. While other factors play a role (e.g. the speed and extent of the official response), the increase in cases of WN-CoV in 2020 appears to be much steeper than in SARS in 2003.
Corona viruses are generally very susceptible to destruction at elevated temperatures. For example, the SARS virus stays healthy and active at 22-25 ° C and 40-50% relative humidity for about five days. If these conditions are raised to 38 ° C and above 95% relative humidity, however, a decrease of more than 3log10 is recorded. A 3log10 reduction is not sufficient for the hospitality industry or healthcare (for example, the UK Health Service requires a reduction of at least 5log10), but it is very likely that the implicit thermal disinfection washing conditions used worldwide will be effective deal with it.
It is recommended that the new coronavirus be effectively removed from surfaces by wiping with an EPA approved disinfectant such as sodium hypochlorite at a concentration of 950 ppm or 0.1%. This is far more powerful than the bleach rinse on the UK Department of Health Council's advice, which requires a rinse concentration of 150 ppm sodium hypochlorite, provided the rinse time is at least 3 minutes plus mixing time.
How can the professional washer best ward off the risks of the new virus?
It is unlikely that a sufficient amount of the new virus will be isolated for experiments in laundromats around the world, and most professional washers will likely initially rely on general control measures that have been shown to work for the larger corona virus family.
Since corona viruses are generally effectively killed by heat, as shown by the work on the SARS virus, it makes sense for laundries to use the main wash temperature to achieve implicit thermal disinfection, which gives customers safety for routine work in the hospitality industry and in Healthcare offers. This may require a temporary increase in the main wash temperature and thus an increase in the CO2 footprint of the laundry (and its customers).
This is unfortunate as it risks reversing the recent low temperature washing trend in the commercial laundry sector. Increasing the main wash temperature to 71 ° C for 3 minutes plus mixing time for cotton towels (or to 65 ° C / 10 minutes for polyester-cotton blends) would significantly increase the energy consumption of the wash house if many work successfully at 40 ° C.
However, the coronavirus' susceptibility to chemical disinfection (as evidenced by its destruction when bleaching sodium hypochlorite) means that if the laundry that washes at a low temperature also uses chemical disinfection (as it should be), it should also do so the new virus. Disinfection when washing at low temperature can be achieved not only with sodium hypochlorite, as already described, but also by injecting ozone into each stage or by peracetic acid in the main wash and / or for final neutralization.
There is still no definitive evidence that any of these methods (whether implicit thermal disinfection or chemical treatment) work with WN-CoV, but due to a lack of research, they are probably sufficient because they are effective against other members of the coronavirus family work.
This leads us directly to the procedures that must be used in commercial and medical laundry to cope with the outbreak. The following systematic approach is recommended until official guidelines are published:
• Start implementing the required procedures immediately – don't hesitate. In any country to which travelers from the countries concerned have recently returned are at risk of a rapid increase in cases where WN-CoV plays a role and this should now be dealt with calmly and competently.
• Work by customers who are not known to be affected by the virus should be accepted in the normal way. However, they should be processed as described in the following sections to minimize the inadvertent spread of disease by occasionally infected people who are not yet aware of it.
• Pick-up personnel / drivers should be equipped with gloves that are either washable or disposable and instructed to wear them at work. This offers first-class protection against accidental infections due to contaminated surfaces at the customer and on laundry bags. Eating and drinking while collecting should not be allowed.
• If cases of WN-CoV are reported in the country of use, the protective clothing should be expanded to include face masks and goggles or face shields. Both should fit snugly against the wearer's face to avoid penetration through gaps in the nose, mouth or eyes. Even then, the protection they offer is limited, but much better than nothing. An N95 mask is better than a paper mask (because if it is properly attached, 95% of the particles / aerosols are removed), but a paper mask is better than no mask at all.
• Sorting staff and wash house staff should be immediately provided with washable gloves and goggles / face masks and should take precedence over N95 masks, if available, because they must handle and move any incoming item and are therefore at higher risk than drivers. WN-CoV is often an aerial virus.
• The ventilation in the sorting room should be switched on and arranged in such a way that clean air to the sorting staff and contaminated air are drawn off from above by the sorters over the workpiece to be sorted.
• If necessary, washing programs should be revised and redesigned (in collaboration with chemical suppliers) to ensure disinfection either by thermal or chemical means. Chemical suppliers generally have much more information than is generally available, from their initial research and testing attempts, than they have formulated and certified their processes. To avoid doubt, disinfection during washing must take place regardless of the heat in the downstream finishing processes, since it has been shown that, despite the seemingly high finishing temperatures, they are not effective for disinfection. In some of LTC's early work, 22 minutes in a tunnel finisher at 150 ° C still germinated enough insects in the seams of a workwear garment to create a foul stench on the clean garment within three days.
• In this case, special care must be taken to avoid re-infection of the clean objects that can occur from outside a washer that has not been wiped with disinfectant after the last load. Transmission can occur if the clean items, even when wrapped, are left near the sorting area. If an infected employee or driver coughs or sneezes at a batch of clean items, it is likely enough to pass it on to a customer who processes the goods. The virulence of this particular virus then appears to be sufficient to trigger further transmission.
• Every employee, visitor and contractor is recommended to wash their hands frequently, especially before eating or drinking. Personnel should be informed of the recognized NHS hand washing method and persuaded to comply.
• Personnel should wear protective suits and these should be washed frequently and not taken home.
All of these precautions are well known to laundries that are currently active in the healthcare sector, and it makes sense to conclude that any healthcare provider who works in accordance with the latest version of the European standard EN14065, WN-CoV is effective and effective when it comes to incoming work satisfactory kills low level.
The advice just given does not contain anything except the widespread need for eye, nose and mouth protection. The advice is probably only needed as a precaution to prevent the spread of WN-CoV among commercial and healthcare customers.
In the less likely case that an epicenter of the epidemic in a country with thousands of cases will spread, more is needed. The precautions listed should already be in place, and it is recommended that their effectiveness be checked in the laboratory facilities by chemical suppliers, microbial specialists and local technical service companies. A quick test for WN-CoV is expected to be spread much more quickly, which will significantly improve the matter. Laundries may then want to receive copies of the certification for the processes they use to ensure that it is sufficiently effective against WN-CoV, thereby fulfilling their duty of care.
If the laundry and textile rental sector responds quickly and competently to the recommendations contained in this article, it is likely that the virus will be brought under control quickly with very few new sources of infection. However, it won't go away in the short term and the worst risks to the industry will only be recognized if the laundries do nothing about it.
IMAGE: Courtesy of Centers for Disease Control and Prevention (CDC)
• Icahn School of Medicine, Department of Public Health Science.
• Chan K H et al.: Hindawi Open Access: Advances in Virology: Volume 2011 Article ID 734690.
• CDC recommendation from the United States Centers for Disease Control.
• Notice from the UK Department of Health HSG (95) 18 – hospital laundry for used and infected laundry.