ABSTRACT
Although SARS-CoV-2 is primarily transmitted by respiratory droplets and aerosols, transmission by fomites remains plausible. During Halloween, a major event for children in numerous countries, SARS-CoV-2 transmission risk via candy fomites worries many parents. To address this concern, we enrolled 10 recently diagnosed asymptomatic or mildly/moderately symptomatic COVID-19 patients to handle typical Halloween candy (pieces individually wrapped) under three conditions: normal handling with unwashed hands, deliberate coughing and extensive touching, and normal handling following handwashing. We then used a factorial design to subject the candies to two posthandling treatments: no washing (untreated) and household dishwashing detergent. We measured SARS-CoV-2 load by reverse transcriptase quantitative PCR (RT-qPCR) and loop-mediated isothermal amplification (LAMP). From the candies not washed posthandling, we detected SARS-CoV-2 on 60% of candies that were deliberately coughed on, 60% of candies normally handled with unwashed hands, but only 10% of candies handled after hand washing. We found that treating candy with dishwashing detergent reduced SARS-CoV-2 load by 62.1% in comparison to untreated candy. Taken together, these results suggest that although the risk of transmission of SARS-CoV-2 by fomites is low even from known COVID-19 patients, viral RNA load can be reduced to near zero by the combination of handwashing by the infected patient and ≥1 min detergent treatment after collection. We also found that the inexpensive and fast LAMP protocol was more than 80% concordant with RT-qPCR.
IMPORTANCE The COVID-19 pandemic is leading to important tradeoffs between risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission and mental health due to deprivation from normal activities, with these impacts being especially profound in children. Due to the ongoing pandemic, Halloween activities will be curtailed as a result of the concern that candy from strangers might act as fomites. Here, we demonstrate that these risks can be mitigated by ensuring that, prior to handling candy, the candy giver washes their hands and, after receipt, by washing candy with household dishwashing detergent. Even in the most extreme case, with candy deliberately coughed on by known COVID-19 patients, viral load was reduced dramatically after washing with household detergent. We conclude that with reasonable precautions, even if followed only by either the candy giver or the candy recipient, the risk of viral transmission by this route is very low.
Inclusion of steps to enhance mucus clearance may provide benefit for symptomatic COVID patients by reducing total viral load, time to recovery, risk of complications and transmission risk
