Soap and water cleaning versus bleach-based cleaners for eliminating SARS-CoV-2 infection

Background: Households and community settings are important hubs for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As understanding of viral transmission improves, infection prevention and control (IPC) policies need to be updated.

Aim: To compare the effectiveness of soap and water alone to bleach-based cleaners in eliminating SARS-CoV-2 infection in households and community settings.

Setting: We conducted a virtual search through the Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane database of systematic reviews, PubMed, EMBASE, and Effective Practice and Organisation of Care (EPOC).

Methods: We assessed studies which compared the effect of soap and water cleaning on SARS-CoV-2 among humans to that of bleach-based cleaning, both in households and communities. We prioritised systematic reviews and randomised studies and only included other study designs, such as laboratory studies, which had interventions of relevant interest.

Results: We retrieved 1192 articles from the search. We summarised evidence from three laboratory studies as there were no randomised controlled trials (RCTs) or comparative effectiveness studies that met our inclusion criteria. Indirect evidence suggests that soap and bleach-based cleaners were effective at different concentrations. Substantial heterogeneity between the cited studies precludes any inference on effectiveness in reducing risk of SARS-CoV-2 infection in humans. Both interventions remain important components of IPC measures.

Conclusion: There was no evidence for comparison of soap and water versus bleach-based cleaners against SARS-CoV-2 in humans in household and community settings. Indirect evidence shows both interventions to be effective against the virus.Contributions: Primary studies addressing this critical question are required to guide public health recommendations and policies.