How long can the coronavirus that causes COVID-19 survive on surfaces? What the research tells us so far.
Figure 1: Novel Coronavirus SARS-CoV-2. This scanning electron microscope image shows SARS-CoV-2 (yellow)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (blue/pink) cultured in the lab. Credit: NIAID-RML.1
%MCEPASTEBIN%The virus that causes COVID-19 (SARS-CoV-2), now considered a pandemic by the World Health Organization (WHO), leads all of us to be searching for more understanding of how the virus may be acquired from touching potentially contaminated surfaces or through the air. New studies are underway seeking answers to these questions and early findings are now available. These are preliminary reports that aren’t fully peer-reviewed and shouldn’t be regarded as conclusive. However, these reports provide key information about the stability of SARS-CoV-2 and help inform us in best practices for prevention.
How long can the new coronavirus survive on surfaces or in the air? We don’t know conclusively yet, but one new analysis found that the virus can remain viable on plastic and stainless steel up to 72 hours, on copper for up to 4 hours, or on cardboard up to 24 hours (Figure 2). The analysis showed that the virus can survive in droplets in the air (called aerosoles) for up to three hours. We don’t know yet how exposure to sunlight, heat, or cold, can affect these survival times. This study from the National Institutes of Health (NIH), CDC, UCLA, and Princeton University scientists was published March 17 in The New England Journal of Medicine (NEJM).2
Figure 2: Viability of SARS-CoV-1 and SARS-CoV-2 in Aerosols and on Various Surfaces. Credit: New England Journal of Medicine (March 17, 2020 DOI: 10.1056/NEJMc2004973).
The information coming out is changing virtually daily, and a new study published March 23 by the CDC looked at the results found on cruise ships: “SARS-CoV-2 RNA was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated on the Diamond Princess but before disinfection procedures had been conducted (Takuya Yamagishi, National Institute of Infectious Diseases, personal communication, 2020).”3 We don’t have a clear concensus yet on the stability of the virus on different surfaces.
Another study, published in March 2020 in The Journal of Hospital Infection,4 analyzed several dozen previously published papers on human coronaviruses to get a better idea of how long they can survive outside of the body. This study didn’t include the new coronavirus, but provided these results: “The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute.”
Since the virus survives less well on cardboard (up to 24 hours), packages that arrive in the mail most likely have low levels of the virus. Researchers have speculated that cardboard is less hospitable to the virus than other surfaces because of the fibrous quality of the packaging, which makes it more absorbent. Nonetheless, it is suggested that giving packages a once-over with a disinfecting wipe is a good idea.
Although the WHO originally considered the virus not to be airborne, the NEJM research and other studies indicate that it can be transported by air. A study published in the Journal of the American Medical Association (JAMA)5 found the virus on a ventilator in the hospital room of an infected patient, where it could only have reached via the air. Another study published in early March in bioRxiv,6 a preprint server for biology research, also supports this finding. Both studies indicate that the environment can be a potential medium of transmission, and key recommendations include enhanced room ventilation and sanitizing of floor surfaces, in addition to other standard surface-sanitizing procedures.
These study results so far, while not conclusive or peer-reviewed, provide us with information about the stability of SARS-CoV-2, the coronavirus that causes COVID-19 disease, and how the virus may be acquired by touching contaminated surfaces or through the air. “Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19 and other viral respiratory illnesses,” per current CDC guidelines. The EPA provides this full list of disinfectants for use against SARS-CoV-2: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2.
- https://www.niaid.nih.gov/news-events/novel-coronavirus-sarscov2-images National Institute of Allergy and Infectious Diseases | Now (NIAID | NOW), “New Images of Novel Coronavirus SARS-CoV-2 Now Available,” February 13, 2020.
New England Journal of Medicine, “Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1,” March 17, 2020.
CDC Morbidity and Mortality Weekly Report, “Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020,” March 23, 2020.
The Journal of Hospital Infection, “Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents,” March 2020.
Journal of the American Medical Association, “Air, Surface Environmental, and Personal Protective Equipment Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) From a Symptomatic Patient, March 4, 2020.
bioRxiv, “Aerodynamic Characteristics and RNA Concentration of SARS-CoV-2 Aerosol in Wuhan Hospitals during COVID-19 Outbreak,” March 10, 2020.
- Figure 1: Novel Coronavirus SARS-CoV-2. This scanning electron microscope image shows SARS-CoV-2 (yellow)—also known as 2019-nCoV, the virus that causes COVID-19—isolated from a patient in the U.S., emerging from the surface of cells (blue/pink) cultured in the lab. Credit: NIAID-RML.1
- Figure 2: Viability of SARS-CoV-1 and SARS-CoV-2 in Aerosols and on Various Surfaces. Credit: New England Journal of Medicine (March 17, 2020 DOI: 10.1056/NEJMc2004973).