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Family members and health care workers should take precautions, experts said. Like a zombie in a horror film, the coronavirus can persist in the bodies of infected patients well after death, even spreading to others, according to two startling studies. The risk of contagion is mainly to those who handle cadavers, like pathologists, medical examiners and health care workers, and in settings like hospitals and nursing homes, where many deaths may occur. While transmission from corpses is not likely to be a major factor in the pandemic, bereaved family members should exercise caution, experts said. “In some countries, people who have died of Covid-19 are being left unattended or taken back to their homes,” said Hisako Saitoh, a researcher at Chiba University in Japan who published two recent studies on the phenomenon. “Therefore, I think that it is a knowledge that the general public should be aware of,” he wrote in an email. Several studies have found traces of infectious virus in corpses for as long as 17 days after death. Dr. Saitoh and his colleagues went further, showing that dead bodies may carry significant amounts of infectious virus, and that dead hamsters can transmit it to live cage mates. The research has not yet been vetted for publication in a scientific journal, but outside experts said that the studies were well-done and the results compelling. The risk of a live patient spreading the coronavirus is far greater than the potential transmission from corpses, Dr. Saitoh and other scientists emphasized. If infection from corpses accounted for a large number of cases, “we would have noticed, right?” said Vincent Munster, a virologist at the National Institute of Allergy and Infectious Diseases. Still, “If there is an infectious virus, there is always a risk for transmission,” he continued. “I don’t think it’s something which is often addressed.” In the United States, bodies usually are embalmed soon after death or cremated. But in the Netherlands, where Dr. Munster grew up, as in many parts of the world, family members may wash and dress the bodies. In July 2020, the Japanese government urged bereaved family members to keep their distance from dead bodies and refrain from touching them — or even viewing them. Officials also recommended sealing corpses in impermeable bags and cremating them within 24 hours. The guidelines were revised in May 2022 to allow family members to see loved ones who died of Covid, but “in an appropriately infection-controlled hospital room.” Those guidelines in part prompted Dr. Saitoh to explore what happens to the virus in the body after death. He and his colleagues looked at samples from the noses and the lungs of 11 people who had died of Covid. The researchers found that high amounts of virus persisted in six of the 11 corpses, even 13 days after death. “It was surprising that infectious titers were preserved at the same high levels as in the clinical patients,” Dr. Saitoh wrote. “What was most surprising, however, were the results of the animal experiments.” In those experiments, he and his colleagues found that hamsters that died within a few days of becoming infected with the coronavirus could transmit it to other animals. In people, too, contagion is most likely when a patient dies soon after infection, when the levels of virus in the body are very high, the researchers said. The team found more virus in the lungs of human corpses than in the upper respiratory tract. That suggests that those who perform autopsies should be particularly careful when handling the lungs, experts said. Dr. Saitoh pointed to a study from Thailand describing a forensic practitioner who appeared to have been infected during work. Gases that build up after death can be expelled through any orifice in the body, including the mouth, and may carry infectious virus, the researchers said. Embalming or practicing so-called “angel care” — a Japanese ritual in which the mouth, nose, ears and anus are plugged with cotton pads — prevented transmission, they found. Contagious corpses are not without precedent. Most famously, funeral and burial practices have triggered large outbreaks of Ebola virus in Africa. But the coronavirus is very different, noted Angela Rasmussen, a research scientist at the Vaccine and Infectious Disease Organization at the University of Saskatchewan in Canada. Up to 70 percent of those infected with Ebola die. The figure for Covid is nowhere near as high — greater than 3 percent in the early days of the pandemic, and something closer to 1 percent or even less now. And the Ebola virus floods every part of the body, so the risk of transmission, even after death, is far greater than might be seen with the coronavirus. “With Ebola, it’s clearly direct contact with bodily fluids, because there’s high titers of Ebola pretty much everywhere in somebody who’s died from Ebola,” Dr. Rasmussen said. She was initially skeptical that the coronavirus could spread from dead bodies but found the new studies convincing. “Most people probably still need to worry a lot more about getting Covid from their living neighbors than their recently deceased ones,” she said. But they “should be very cautious about physical contact with their loved ones’ remains,” she added. A correction was made on Dec. 15, 2022
: An earlier version of this article misstated the death rate for Covid patients. It is now 1 percent or less, not about 3 percent.
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Juan Lama
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For now, novel vaccine type needs to be frozen for storage and transport, with one requiring ultracold temperatures of –70°C. Today’s dramatic news that Moderna’s COVID-19 vaccine might work as well as one made by Pfizer and BioNTech means the world could have two powerful weapons to fight the COVID-19 pandemic. Now, the next hot vaccine topic is, well, heat. Both vaccines use a novel technology—strands of messenger RNA (mRNA), held within lipid particles—that is vulnerable to degradation at room temperature and requires doses to be frozen for transportation, then thawed for use. That’s where the Moderna vaccine may have an edge: Unlike Pfizer’s and BioNTech’s offering, it does not have to be stored at –70°C, but can tolerate a much warmer –20°C, which is standard for most hospital and pharmacy freezers. That difference means Moderna’s vaccine should be easier to distribute and store, particularly in the rural United States and developing countries that lack ultracold freezers. Moderna says years of development work enabled its vaccine to be stored at higher temperatures, but last week another mRNA vaccine company announced it is testing a COVID-19 vaccine that early studies suggest can survive at the even warmer temperatures of 2°C to 8°C found in refrigerators. Many types of vaccines must be stored and transported frozen, via a cold supply chain. Public health officials have even found ways to keep a vaccine ultracold, between –60°C to –80°C, in places like sub-Saharan Africa. There, for the past 5 years, a high-tech thermos called Arktek has helped distribute Ebola vaccines that must be kept ultracold. “In all likelihood, we’ll need a wide range of supply chain tools” to distribute COVID-19 vaccines, says Daniel Lieberman, a mechanical engineer with Global Health Labs in Seattle, a nonprofit created by the Bill & Melinda Gates Foundation, which funded Arktek’s development, and by a venture capital firm started by Bill Gates. Still, relying on an ultracold chain is expensive, and in some places it may make more sense to distribute a vaccine that can tolerate warmer temperatures even if it’s less effective. Both the Moderna and Pfizer/BioNTech vaccines give the body’s cells an mRNA template for making the spike protein of SARS-CoV-2, the virus that causes COVID-19. The protein then moves to the cell’s surface and triggers an immune response. This mRNA is relatively fragile compared with the proteins or protein fragments that often make up conventional vaccines, and it cleaves easily at room temperature, says Alana Gerhardt, who studies vaccine product development at the nonprofit Infectious Disease Research Institute (IDRI) in Seattle. Also, enzymes called ribonucleases that chew up mRNAs “are everywhere, even in the controlled environment of the lab,” from sources such as lab workers’ breath and skin, Gerhardt says. The companies give the mRNA some protection during production and storage by inserting it into a carrier, a fatlike substance called a lipid nanoparticle. The lipid also shields the mRNA from enzymes in the blood once it has been injected. But the nanoparticle is deliberately designed to slowly degrade, so it won’t build up in the liver and cause harm, says Massachusetts Institute of Technology geneticist and chemical engineer Daniel Anderson. Although the companies’ exact formulations are proprietary, Pfizer and BioNTech have so far said their vaccine has to be kept ultracold. But Barney Graham, a vaccine researcher at the U.S. National Institute of Allergy and Infectious Diseases who designed the mRNA used by both Moderna and Pfizer/BioNTech, says the temperature requirements are actually unclear. Pfizer and BioNtech started with –70°C when they first asked regulators to test their vaccine in humans, and Graham says the companies might ultimately be able to document that the mRNA survives warmer temperatures. In the meantime, at sites in Kalamazoo, Michigan, and Puurs, Belgium, Pfizer will pack shipments of 200 to 1000 vials each containing five doses in insulated boxes with thermal sensors on dry ice to provide the necessary chill. Pharmacies and doctor’s offices that lack $15,000 ultracold freezers can store it in the thermal box for about 2 weeks by refilling the dry ice every 5 days; once removed, the vaccine can be refrigerated for 5 days. Moderna’s vaccine, however, is stable for 6 months at –20°C, or in a standard freezer, and the company announced today its product can be kept at normal refrigerator temperatures for up to 30 days, longer than the 7 days initially expected....
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Swabbing of bank machines, shop-door handles and other frequently touched surfaces in a US city revealed that 8% of samples were positive for SARS-CoV-2 genetic material, but that material was present in small amounts. Amy Pickering at Tufts University in Medford, Massachusetts, and her colleagues repeatedly sampled 33 surfaces in public places in Somerville, Massachusetts (A. P. Harvey et al. Preprint at medRxiv https://doi.org/fgx9; 2020). The handles of a rubbish bin and a liquor store were the most frequently riddled with coronavirus RNA. All samples showed only “low-level” contamination, and the infection risk from touching one of the contaminated surfaces is low, the researchers say. The team found that the percentage of positive samples in one postal district peaked roughly 7 days before a spike in COVID-19 cases in the same district. Sampling of heavily touched surfaces might provide a warning of a surge of infections, the authors write. Preprint of the study available at medRxiv (Nov. 1, 2020): https://doi.org/10.1101/2020.10.27.20220905
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Researchers find SARS-Cov-2 survives for longer than thought - but only under certain conditions. The findings from Australia's national science agency suggest SARS-Cov-2 can survive for far longer than thought. However, the experiment was conducted in the dark. UV light has already been shown to kill the virus Some experts have also thrown doubt on the actual threat posed by surface transmission in real life. The coronavirus is mostly transmitted when people cough, sneeze or talk. But there is also evidence that it can also be spread by particles hanging in the air. It is also possible someone could get Covid-19 by touching infected surfaces such as metal or plastic, according to the US Centers for Disease Control. This is believed to be much less common, however. Previous laboratory tests have found that SARS-Cov-2 can survive for two to three days on bank notes and glass, and up to six days on plastic and stainless steel, although results vary. However, the research from Australian agency CSIRO found the virus was "extremely robust," surviving for 28 days on smooth surfaces such as glass found on mobile phone screens and both plastic and paper banknotes, when kept at 20C (68F), which is about room temperature, and in the dark. In comparison, the flu virus can survive in the same circumstances for 17 days. The study, published in Virology Journal, also found SARS-Cov-2 survived for less time at hotter temperatures than cooler temperatures; it stopped being infectious within 24 hours at 40C on some surfaces. It also stayed longer on smooth, non-porous surfaces than on porous materials such as cloth, which was found not to carry any infectious virus past 14 days. Prof Ron Eccles, former director Common Cold Centre at Cardiff University, criticised the study and said the suggestion that the virus could survive for 28 days was causing "unnecessary fear in the public". "Viruses are spread on surfaces from mucus in coughs and sneezes and dirty fingers and this study did not use fresh human mucus as a vehicle to spread the virus," he said. "Fresh mucus is a hostile environment for viruses as it contains lots of white cells that produce enzymes to destroy viruses and can also contain antibodies and other chemicals to neutralise viruses. "In my opinion infectious viruses will only persist for hours in mucus on surfaces rather than days." In a paper published by the Lancet in July, Emanuel Goldman, professor of microbiology at Rutgers University, said "the chance of transmission through inanimate surfaces is very small". He said studies that suggested a significant risk had been designed with "little resemblance to real-life scenarios" Last week Monica Gandhi, a professor of medicine at the University of California, said the coronavirus did not spread via surfaces. ... Study published in Virology Journal (Oct. 7, 2020): https://doi.org/10.1186/s12985-020-01418-7
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(Reuters) - Pfizer Inc and BioNTech SE have submitted new temperature data to the U.S. health regulator which they said on Friday could allow their COVID-19 vaccine to be stored in pharmacy freezers rather than in ultra-cold storage facilities. If approved, the less onerous storage requirements would provide a significant logistical relief for the roll-out of the vaccine, particularly in lower-income countries that do not have the necessary infrastructure. Pfizer/BioNTech's vaccine, along with Moderna Inc's two-dose shot, won the U.S. emergency use authorization (EUA) and is being widely distributed as part of the country's mass vaccination efforts. The new data has been submitted to the U.S. Food and Drug Administration to support a proposed update to the current EUA label that would allow vaccine vials to be stored at -25 to -15 degrees Celsius (-13°F to 5°F) for a total of two weeks as an alternative for storage in an ultra-low temperature freezer. "The data submitted may facilitate the handling of our vaccine in pharmacies and provide vaccination centers an even greater flexibility," BioNTech Chief Executive Officer Ugur Sahin said. Pfizer/BioNTech's current label requires the vaccine to be stored in an ultra-cold freezer at temperatures between -80ºC and -60ºC (-112ºF to -76ºF), calling for it to be shipped in specially designed containers. The new data also will be submitted to global regulatory agencies within the next few weeks, the two companies said. A BioNTech spokeswoman declined to provide more details on the timing and which agencies would be contacted.
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A week after Pfizer posted impressive early coronavirus vaccine efficacy numbers, Moderna took the spotlight early Monday with impressive findings of its own. But separate from its big announcement, the mRNA biotech said its vaccine can be kept at refrigerated temperatures for 30 days, reducing hurdles for a potential large-scale rollout. Moderna’s mRNA vaccine, mRNA-1273, can be stored at 36 degrees to 46 degrees Fahrenheit for up to 30 days, the company reported Monday, up from a prior estimate of just a week. It's also stable for 12 hours at room temperature. For longer-term storage and shipping, the vaccine needs to be kept at freezer temperatures of -4 degrees Fahrenheit, a temperature that distributors are familiar with, Moderna CEO Stéphane Bancel said on CNBC Monday. Bancel also stressed that Moderna’s vaccine won’t require dilution before it's administered to patients. That's a “big differentiator of our product," Bancel said on CNBC. Pfizer’s vaccine, another frontrunner, requires colder storage at -94 degrees Fahrenheit and will only last for 24 hours at refrigerated temperatures. But the company has an aggressive plan to tap experienced shipping partners to transport doses in newly designed, GPS-enabled storage containers. Moderna’s stability profile will “likely make it easier to widely distribute compared to Pfizer’s BNT162b2,” Barclays analysts wrote to clients Monday. Pfizer is working on a powder version of its vaccine that's stable at room temperature, the analysts noted. While Moderna and Pfizer are the only two players to post early efficacy numbers so far, a host of other players are advancing vaccines expected to be stable at refrigerated temperatures. CureVac, a German biotech in mid-stage testing, said last week its vaccine is stable for at least three months at refrigerated temperatures, and up to 24 hours at room temperature. The stability profile “has the potential both to enable decentralized storage and to significantly facilitate large-scale vaccination efforts during the current pandemic," chief production officer Florian von der Mülbe said in a statement. Other vaccines using various technologies, such as programs from Sanofi, AstraZeneca, Novavax and Johnson & Johnson, are also eying refrigerated storage. On the heels of its early data release Monday, Moderna said it’s on track to have about 20 million doses of its vaccine ready to ship in the U.S. by the end of the year. It’s expecting to be able to produce 500 million to 1 billion doses next year. Moderna's release (November 16, 2020): https://investors.modernatx.com/news-releases/news-release-details/moderna-announces-longer-shelf-life-its-covid-19-vaccine
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Juan Lama
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The stability of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on human skin remains unknown, considering the hazards of viral exposure to humans. We generated a model that allows the safe reproduction of clinical studies on the application of pathogens to human skin and elucidated the stability of SARS-CoV-2 on the human skin. We evaluated the stability of SARS-CoV-2 and influenza A virus (IAV), mixed with culture medium or upper respiratory mucus, on human skin surfaces and the dermal disinfection effectiveness of 80% (w/w) ethanol against SARS-CoV-2 and IAV. SARS-CoV-2 and IAV were inactivated more rapidly on skin surfaces than on other surfaces (stainless steel/glass/plastic); the survival time was significantly longer for SARS-CoV-2 than for IAV [9.04 h (95% confidence interval: 7.96–10.2 h) vs. 1.82 h (1.65–2.00 h)]. IAV on other surfaces was inactivated faster in mucus versus medium conditions, while SARS-CoV-2 showed similar stability in the mucus and medium; the survival time was significantly longer for SARS-CoV-2 than for IAV [11.09 h (10.22–12.00 h) vs. 1.69 h (1.57–1.81 h)]. Moreover, both SARS-CoV-2 and IAV in the mucus/medium on human skin were completely inactivated within 15 s by ethanol treatment. SARS-CoV-2 and IAV were inactivated more rapidly on skin surfaces than on other surfaces (stainless steel/glass/plastic); the survival time was significantly longer for SARS-CoV-2 than for IAV [9.04 h (95% confidence interval: 7.96–10.2 h) vs. 1.82 h (1.65–2.00 h)]. IAV on other surfaces was inactivated faster in mucus versus medium conditions, while SARS-CoV-2 showed similar stability in the mucus and medium; the survival time was significantly longer for SARS-CoV-2 than for IAV [11.09 h (10.22–12.00 h) vs. 1.69 h (1.57–1.81 h)]. Moreover, both SARS-CoV-2 and IAV in the mucus/medium on human skin were completely inactivated within 15 s by ethanol treatment. Published in Clinical Infectious Diseases (Oct. 3, 2020): https://doi.org/10.1093/cid/ciaa1517
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Juan Lama
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We report the stability of SARS-CoV-2 in different environmental conditions. We first determined the stability of SARS-CoV-2 at different temperatures. SARS-CoV-2 in virus transport medium (VTM; final concentration: ∼6.8 log TCID50/mL) was incubated for up to 14 days and then tested for its infectivity (Table A). The virus is highly stable at 4°C, but sensitive to heat. At 4°C, there was only ∼0.7-log unit reduction of infectious titre on Day 14. With the incubation temperature being increased to 70°C, the time for virus inactivation was reduced to 5 minutes. We further investigated the stability of this virus on different surfaces. In brief, a 5-µL droplet of virus culture (∼7.8 Log unit of TCID50/mL) was pipetted on a surface (Table B; ∼1cm2 per piece) and left at room temperature (22°C; Relative humidity: ∼65%). The inoculated objects retrieved at desired time points were immediately soaked with 200 µL of VTM for 30 minutes to elute the virus. No infectious virus could be recovered from printing and tissue papers after a 3-hour incubation, whereas no infectious virus could be detected from treated wood and cloth on Day 2. By contrast, SARS-CoV-2 was more stable on smooth surfaces. No infectious virus could be detected from treated smooth surfaces on Day 4 (glass and banknote) or Day 7 (stainless steel and plastic). Strikingly, a significant level of infectious virus could still be detected on the outer layer of a surgical mask on Day 7 (∼0.1% of the original inoculum). We also tested the virucidal effects of disinfectants by adding 15 µL of SARS-CoV-2 culture (∼7.8 Log unit of TCID50/mL) to 135 µL of various disinfectants at working concentration (Table C). With the exception of a 5-min incubation with hand soap, no infectious virus could be detected after a 5-minute incubation at room temperature. In addition, we also found that SARS-CoV-2 is extremely stable in a wide-range of pH values at room temperature (pH3-10; Table D). Overall, SARS-CoV-2 can be highly stable in a favourable environment4 , but it is also susceptible to standard disinfection methods. Published in medRxiv (March 27, 2020) : https://doi.org/10.1101/2020.03.15.20036673
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