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New Delhi, May 15: A group of doctors from the AIIMS, Raipur has recommended restrictions on the use of mobile phones in healthcare institutions amid the COVID-19 pandemic, warning that such devices can be a potential carrier of the virus and lead to infection among healthcare workers.

In a commentary published in the BMJ Global Health journal, the doctors stated that mobile phone surfaces are a peculiar 'high-risk' surface, which can directly come in contact with the face or mouth, even if hands are properly washed and one study indicates that some healthcare workers use phones every 15 minutes to two hours.

Though there have been many significant guidelines from various health organisations like the WHO and CDC focusing on prevention and control of disease, the commentary highlighted "there is no mention of or focus on mobile phones in these guidelines, including the WHO infection control and prevention guidelines, which recommends the use of handwashing".

In healthcare facilities, phones are used to communicate with other health care workers, look up recent medical guidelines, research drug interactions, understand adverse events and side effects, conduct telemedicine appointments and track patients among others, stated the document.

The document has been authored by Dr Vineet Kumar Pathak, Dr Sunil Kumar Panigrahi, Dr M Mohan Kumar, Dr Utsav Raj and Dr Karpaga Priya P from the Department of Community and Family Medicine.

"In their tendency to come in direct contact with the face, nose or eyes in healthcare settings, mobile phones are perhaps second only to masks, caps or goggles," the authors said.

"However, they are neither disposable nor washable like these other three, thus warranting disinfection. Mobile phones can effectively negate hand hygiene... There is growing evidence that mobile phones are a potential vector for pathogenic organisms," they said.

It is the need of the hour to address proper hygienic use of mobile phones in healthcare settings. In a study in India, almost 100 per cent of health workers of a tertiary care hospital used mobile phones in the hospital, but only 10 per cent of them had at any time wiped their mobile phones clean, the commentary published on April 22 said.

"The safest thing to do is to consider your phone as an extension of your hand, so remember you are transferring whatever is on your phone to your hand," Dr Pathak said.

Amidst the ongoing pandemic, two biggest mobile phone companies have uploaded their user support guidelines, saying that 70 pc isopropyl alcohol or Clorox Disinfecting Wipes can be used to gently wipe the exterior surface of phones in switched-off mode.

However, in doing so, the use of bleach or entry of moisture through any of the openings must be avoided, and any harsh chemical may damage the oleophobic screen, leading to damage in the touch screen sensitivity of the phone, the article stated.

Mobile phones are one of the most highly touched surfaces according to the Centers for Disease Control and Prevention (CDC), along with counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets and bedside tables.

The doctors recommended restriction on mobile phone usage in healthcare settings like hospital wards, ICUs and operation theatres, while advocating the use of headphones to prevent contact with the face while talking.

There should be no sharing of mobile phones, headphones or headsets of any kind. In addition, where available, the use of interdepartmental intercom facility may be promoted.

"Although hand hygiene and mobile phone use by a person are not mutually exclusive, it is high time to acknowledge the potential role of mobile phones in disease transmission cascade and to take evidence-based appropriate actions. This is especially important, given the ongoing COVID-19 pandemic," the authors said.

They said it is necessary for government agencies and the WHO to generate public awareness and to formulate suitable information, education and communication material on mobile phone hygiene, especially in healthcare settings.

AIIMS, New Delhi, Resident Doctors' Association (RDA) General Secretary, Dr Srinivas Rajkumar T said even outside health care settings, people should pay special attention to the usage of mobile phones as they carry them to all places.

"Phone and computer peripherals like keyboard, mouse, etc. should be covered with transparent plastic covers which can be cleaned without interfering with their function. Cleaning hands by soap or alcohol-based hand sanitizer before and after contact with phone and between contact with other surfaces can decrease the risk of potential transmission.

"Using a handsfree headset, dedicated operator/assistant per ward handling the communication via common line in hospitals while on duty can enable communication without compromising safety," Dr Srinivas said.

New Delhi, Fevb 10: Of the countries most at risk of importing coronavirus cases, India ranks 17th, researchers have found on the basis of a mathematical model for the expected global spread of the virus that originated in China's Wuhan area in December 2019.

So far, India has reported three coronavirus positive cases -- all from Kerala.

Among the airports in India, the Indira Gandhi International Airport in New Delhi is most at risk, followed by airports in Mumbai, Kolkata, Bengaluru, Chennai, Hyderabad and Kochi, according to the model.

The new model for predicting global novel coronavirus cases has been developed by researchers from Humboldt University and Robert Koch Institute in Germany.

"The spread of the virus on an international scale is dominated by air travel," said the study.

"Wuhan, the seventh largest city in China with 11 million residents, was the relevant major domestic air transportation hub with many connecting international flights before the city was effectively quarantined on January 23, 2020, and the Wuhan airport was closed. By then the virus had already spread to other Chinese provinces as well as other countries," it added.

The researchers said that it is possible to estimate how likely it is that the virus spreads to other areas by looking at air travel passenger numbers.

"The busier a flight route, the more probable it is that an infected passenger travels this route. Using these probabilistic concepts, we calculate the relative import risk to other airports. When calculating the import risk, we also take into account connecting flights and travel routes that involve multiple destinations," said the study.

The top 10 countries and regions at risk of importing coronavirus cases are: Thailand, Japan, South Korea, Hong Kong, Taiwan, USA, Vietnam, Malaysia, Singapore and Cambodia, according to the model.

While Thailand's national import risk is 2.1%, it is 0.2% for India, found the research.

The foundation of the model is the worldwide air transportation network (WAN) that connects approximately 4,000 airports with more than 25,000 direct connections.

The model accounts for both, the current distribution of confirmed cases in mainland China as well as airport closures that were implemented as a mitigation strategy.

This network theoretic model is based on the concept of effective distance and is an extension of a model introduced in the 2013 paper "The Hidden Geometry of Complex, Network-Driven Contagion Phenomena" published in the journal Science.

The current outbreak of the 2019-nCoV virus started in Wuhan city, Hubei province, China. While the first cases were reported as early as December 8, 2019, the outbreak gained global attention on December 31, 2019, when the World Health Organization was alerted to "several cases of pneumonia" by an unknown virus.

The new virus was soon identified as a novel coronavirus and named 2019-nCOV. It belongs to the family of viruses that include the common cold and viruses such as SARS and MERS. On January 20, 2020, it was confirmed that the coronavirus can be transmitted between humans, greatly increasing the risk of a global spread.

The death toll due to the novel coronavirus outbreak in China has increased to 811 on Sunday, surpassing that of the Severe Acute Respiratory Syndrome (SARS) epidemic in 2003.

Although about 20 countries have confirmed cases, China has accounted for about 99 per cent of those infected. The first foreign victims of the virus both died on Saturday in Wuhan.