COVID-19, or coronavirus, has dominated headlines and is a major threat to healthcare systems worldwide. It has been classified as a high consequence infectious disease (HCID). The virus was understood to be spread primarily through respiratory transmission, or secondarily through contact with infected surfaces. However, recent reports have suggested COVID-19 could also be transmitted through the faecal-oral route. Recent studies have revealed the presence of live virus shed through faeces (Zhang et al. 2019; Yongjian Wu et al 2020). Faecal-oral transmission may help explain some previously non-understood contractions of the virus and also its rapid spread (Zhang et al. 2019).
Managing faecal-oral transmission routes
Given the update on potential faecal-oral transmission of COVID-19, healthcare centres should review existing practices to ensure they reduce opportunities of contamination in infection pathways. Faecal-oral transmission is particularly high risk for healthcare centres. Facilities must analyse current processes for potential infection points, and possible stages where risk could be reduced.
Global guidelines
UK government guidelines on COVID-19 recommend secure disposal of single-use bedpans. WHO and Centres for Disease Control and Prevention have also recommended the use of disposable non-critical patient care equipment to minimise contamination risk. Healthcare facilities which do not yet use such one-way waste systems should consider using single-use bedpans in high-risk areas and disposing of them in offensive waste refuse points, in line with global infection control advice.
Assessing human waste management systems
Below are some key factors to consider when analysing human waste management processes.
Further Reading
“SARS-CoV-2 and COVID-19: The most important research questions.”
“Detection of SARS-CoV-2 in Different Types of Clinical Specimens”
“COVID-19: Gastrointestinal manifestations and potential fecal-oral transmission”
“Fecal Specimen Diagnosis 2019 Novel Coronavirus-Infected Pneumonia.”
“Public health might be endangered by possible prolonged discharge of SARS-CoV-2 in stool”
“Anal swab findings in an infant with COVID‐19”
References
Yong Zhang, Cao Chen, Shuangli Zhu, Chang Shu, Dongyan Wang, Jingdong Song, et al. Isolation of 2019-nCoV from a Stool Specimen of a Laboratory-Confirmed Case of the Coronavirus Disease 2019 (COVID-19)[J]. China CDC Weekly, 2020, 2(8): 123-124
Yongjian Wu, Cheng Guo, Lantian Tang, Zhongsi Hong, Jianhui Zhou, Xin Dong, “Prolonged presence of SARS-CoV-2 viral RNA in faecal samples”, The Lancet, March 19, 2020. https://doi.org/10.1016/S2468-1253(20)30083-2
Infection Control: Interim Infection Prevention and Control Recommendations for Patients with Confirmed Coronavirus Disease 2019 (COVID-19) or Persons Under Investigation for COVID-19 in Healthcare Settings, Centres for Disease Control and Prevention, updated February 21 2020 https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html. Accessed 4 March 2020
World Health Organisation. Interim Guidance: “Infection prevention and control during health care when COVID-19 is suspected”. 19 March 2020. Accessed 7 April 2020.
