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Research > Phase 1 - Systematic literature review

Phase 1 - Systematic literature review

This Phase 1 review includes analysis and summary of findings from available scientific literature on SARS-CoV-2 (the virus that causes COVID-19) through mid-May 2020. This review focused on studies of how the virus is spread, virus attenuation on commonly found materials, and effectiveness of prevention and decontamination measures.

Please note: A Phase 2 systematic literature review will be published in mid-October that includes updated or revised findings that have emerged since this review was produced.

Key takeaways from the review

How the virus spreads

  • SARS-CoV-2 is generally thought to spread through virus-containing water droplets expelled from infected persons through sneezing, coughing, speaking, and other breathing-related actions; and objects that contain the virus on their surfaces (also known as fomites). 

  • Other possible ways in need of more study are small aerosol particles, fecal matter (in solid and aerosol forms), and other airborne routes.

  • Environmental factors such as humidity, temperature, ventilation/air flow, and air conditioning may also affect the spread of SARS-CoV-2. But additional research is needed to verify and/or clarify these ideas. 

Survival on surfaces

  • If SARS-CoV-2 gets spread to surfaces or materials, it seems to survive for different amounts of time depending on the type of surface or material, before dying off on its own. 

  • A few early studies (not peer-reviewed) reported that the virus may survive longer on plastics and stainless steel than on paper products and other metals, such as copper. 

  • However, it is not possible to draw firm conclusions from their results at this time. That’s because there were a small number of studies, differences in the way scientists conducted the studies, and other confounding factors. 

Prevention and decontamination

  • Researchers suggested several feasible, low-cost options for reducing the presence of SARS-CoV-2, which may help keep people from getting the virus:

    • Frequent handwashing with soap and water or alcohol-based hand sanitizers.
    • Wearing of personal protective equipment (PPE) that covers the mouth and nose.
    • Cleaning surfaces often with cleaning agents such as sodium dichloroisocyanurate, sodium hypochlorite, ethanol, and hydrogen peroxide. 
  • Other ways that need more studies to find out if they work are heat treatment, sunlight and other light-based treatments, ventilation systems, and open spaces.

Notes for the reader

As you read this systematic literature review, keep in mind a few key points:

  1. The research and information captured in the findings include both peer-reviewed and non-peer-reviewed studies. In the interest of publishing emerging research related to the COVID-19 pandemic as quickly as possible, publication has been expedited rather than waiting for time-intensive peer review.
  2. The studies included in the review have been conducted by different researchers, under different conditions, likely using different concentrations—and possibly sources—of the virus. This makes it difficult, if not impossible, for a reviewer to make a straight comparison across studies; and, interpreting the results may be challenging for readers without a science background. Part of the REALM project’s future efforts will be more interpretation of these results for a lay audience.
  3. The review includes findings for industries, such as health care, that operate under considerably different constraints and risk factors than do libraries, archives, and museums (LAMs). However, in this preliminary search, it was important to consider a broad range of available research to determine what may be applicable to LAM operations and identify what research gaps exist. The research captured in the review does not represent recommendations or guidance for LAMs.
  4. A Phase 2 systematic literature review was conducted in August-September 2020 and will be published in mid-October.
  5. A helpful resource for those interested in tracking the "known unknowns" about this virus is the DHS Master Question List for COVID-19 (caused by SARS-CoV-2)

Download the systematic review

Supplemental documents: