The recent viewpoint article by Qu et al. entitled “An Imperative Need for Research on the Role of Environmental Factors in Transmission of Novel Coronavirus (COVID-19)” highlights an imperative need for research on SARS-CoV-2 in environmental sciences.(1) It is promising that advanced environmental science and technology will identify environmental factors modifying the infectivity of the virus, the severity of COVID-19, and help to control its environmental spread. Here we highlight research showing the importance of basic sanitations to control the spread of infectious diseases applicable to the prevention of COVID-19. SARS-CoV-2 in culture media is easily disinfected with 70% ethanol, 0.05% chlorhexidine, 2% hand soap, 1% bleach, etc.(2) Hence, good hand hygiene is likely to prevent COVID-19 transmission via contacts. Although there has not yet been an intervention study for COVID-19, a previous meta-analysis of the effects of hand hygiene in a community setting showed significant reductions in the spread of gastrointestinal illness of 31% and also in respiratory illness of 21%.(3) Hand hygiene costs using alcohol-based handrubs in intensive care units was estimated at USD 0.025 per application, compared to nosocomial infections resulting in far higher cost implications (e.g., USD 25,546 for a surgical site infection).(4) The aerosol transmission route for SARS-CoV-2 in aerosols(5) means effective ventilation, including both natural and mechanical ventilation, is an important, easy and basic way to reduce risk of transmission. For example, in a study of the common cold (around a quarter caused by ordinary coronaviruses), low ventilation rates in dormitories was shown to increase the risk of infections among students.(6) While exhaust-only mechanical ventilation has an associated cost (e.g., USD 64 annually for a 1780 ft² home, including annualized cost of installation),(7) natural ventilation (opening windows and doors), provides a comparable efficient exchange of indoor air.(8) A case study of the nosocomial spread of SARS in a Vietnam hospital with 33 SARS patients during the 2003 SARS outbreak demonstrated the effectiveness of face masks, gloves, hand sanitizer, and cross-ventilation in the hospital in reducing cross-infection rates.(9) The cross-infection measures discussed are not state of the art, but remain underutilized in low- and middle-income countries. Although comparisons of the cost-effectiveness of basic versus advanced technologies are not yet available, COVID-19 cases in low- and middle-income countries are rapidly rising. We acknowledge the importance of these basic sanitations and engineering solutions for COVID-19, and encourage preparedness for future infectious diseases. The authors declare no competing financial interest. This article references 9 other publications.

中文翻译：

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致编辑的信，题为“迫切需要研究环境因素在新型冠状病毒 (COVID-19) 传播中的作用”，回归基础。

Qu 等人最近发表的观点文章。题为“迫切需要研究环境因素在新型冠状病毒（COVID-19）传播中的作用”强调了环境科学中对 SARS-CoV-2 研究的迫切需要。（1）先进的环境科学前景广阔技术将识别改变病毒传染性的环境因素、COVID-19 的严重性，并帮助控制其环境传播。在此，我们重点介绍一些研究，该研究表明基本卫生设施对于控制适用于预防 COVID-19 的传染病传播的重要性。培养基中的 SARS-CoV-2 很容易用 70% 乙醇、0.05% 氯己定、2% 洗手液、1% 漂白剂等消毒。(2) 因此，良好的手部卫生可能会防止 COVID-19 通过接触传播。尽管尚未针对 COVID-19 进行干预研究，但之前对社区环境中手卫生效果的荟萃分析显示，胃肠道疾病的传播显着减少了 31%，呼吸道疾病的传播也显着减少了 21%。 (3) 在重症监护病房中使用酒精类洗手液的手部卫生成本估计为每次使用 0.025 美元，而医院内感染导致的成本要高得多（例如，手术部位感染为 25,546 美元）。(4) 气溶胶SARS-CoV-2通过气溶胶传播的途径(5)意味着有效通风，包括自然通风和机械通风，是降低传播风险的重要、简单和基本的方法。例如，在一项针对普通感冒（约四分之一由普通冠状病毒引起）的研究中，宿舍通风率低会增加学生感染的风险。(6) 虽然仅排气机械通风会产生相关成本（例如，1780 英尺^{2 的}房屋每年 64 美元，包括年化安装成本），(7) 自然通风（打开门窗）可提供相当有效的室内空气交换。(8) 院内传播案例研究2003 年 SARS 爆发期间，越南一家医院收治了 33 名 SARS 患者，对 SARS 的治疗证明了口罩、手套、洗手液和医院内交叉通风在降低交叉感染率方面的有效性。(9) 讨论的交叉感染措施虽然不是最先进的，但在低收入和中等收入国家仍未得到充分利用。尽管尚未对基本技术与先进技术的成本效益进行比较，但低收入和中等收入国家的 COVID-19 病例正在迅速增加。我们认识到这些基本卫生设施和工程解决方案对 COVID-19 的重要性，并鼓励为未来的传染病做好准备。作者声明不存在竞争性经济利益。本文引用了其他 9 篇出版物。