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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.

The World Bank says that a lack of credit and drop in private consumption have led to a gloomy growth outlook for India with a steep cut in growth rate for the current fiscal year and only a modest gain projected for the next year.

India's growth rate is forecast to be only 5 per cent for the current fiscal year, weighed down by a growth of only 4.5 per cent in the July-September quarter, according to the 2020 Global Economic Prospects report released on Wednesday.

"In India, [economic] activity was constrained by insufficient credit availability, as well as by subdued private consumption," the Bank said.

The growth rate is forecast by the Bank to pick up to 5.8 per cent in the next fiscal year and to 6.1 per cent in 2021-22.

India's growth rate was 6.8 per cent in 2018-19.

The 5 per cent growth rate projection for the current financial year is a sharp cut of 2.5 per cent from the 7.5 per cent forecast made by the Bank in January last year, toppling it from the rank of the world's fastest growing economy.

India's performance follows a global trend of lowered growth weighed down by developed economies.

The report estimated world economic growth rate to be only 2.4 per cent last year and forecast it to edge up 0.1 per cent to 2.5 per cent in the current year.

Even with the lower growth rate of 5 per cent in the current fiscal year and 5.8 per cent forecast for the next, India holds the second rank among large economies, behind only China with an estimated growth rate of 6.1 per cent for 2019 and 5.9 per cent this year.

The report blamed "weak confidence, liquidity issues in the financial sector" and "weakness in credit from non-bank financial companies" for India's slowdown.

The Bank predicated India's recovery to 5.8 per cent in the coming financial year for India but "on the monetary policy stance remaining accommodative" and the assumption that "the stimulative fiscal and structural measures already taken will begin to pay off."

It also warned that sharper-than-expected slowdown in major external markets such as United States and Europe, would affect South Asia through trade, financial, and confidence channels, especially for countries with strong trade links to these economies."

The Bank said that the growth of advanced economies was 1.6 per cent last year and "is anticipated to slip to 1.4 per cent in 2020 in part due to continued softness in manufacturing."

In contrast the growth of emerging market and developing countries is expected to accelerate from 3.5 per cent last year to 4.1 per cent this year, the report said.

In South Asia, Bangladesh is estimated to have the highest growth rate of 7.2 per cent in the current fiscal year, although down from 8.1 per cent last fiscal year.

But its higher regional growth rates are coming off a lower base with a per capital gross domestic product of $1,698 compared to $2,010 for India.

Bangladesh is expected to grow by 7.3 per cent in the next financial year.

Pakistan's growth rate is estimated at only 2.4 per cent in the current fiscal year and is projected to rise to 3 per cent in the next, according to the Bank.

The Bank blamed monetary tightening in Pakistan for a sharp deceleration in fixed investment and a considerable softening in private consumption for the fall in growth rate from 3.3 per cent in the 2018-19 fiscal year.

Sri Lanka's growth rate was estimated to be 2.7 per cent last year and forecast to grow to 3.3 per cent this year.

Nepal grew by an estimated 6.4 per cent in the current fiscal year and will rise to 6.5 per cent in the next.