Fomite workshop recommendations addressing the role of surfaces in virus transmission in the built environment

The emergence of SARS-CoV-2 has led to a need to assess the role of fomites in viral transmission within the built environment. Assessing the role of fomites is necessary for developing intervention strategies for controlling emerging pathogens. A fomite workshop with experts was convened in November 2024 by academia, several government agencies, and public health officials to evaluate existing data and discuss how to mitigate risks. Fomite transmission is influenced by the nature of the built environment, population density and proximity, environmental factors (humidity, heat, etc.), virus survival, surface type, engineering controls (ventilation, physical barriers, etc.), and human behaviors. Based on our current data, direct contact with a contaminated surface/fomite, even for respiratory viruses, presents a risk of viral exposure and transmission by both contact with the fomite and resuspension in the air. Even respiratory viruses can be resuspended from fomites following human and pet movement, activities (e.g., vacuuming, toilet flushing, etc.), or changes in ventilation/indoor airflow. After resuspension from surfaces, microbes can be potentially inhaled (contributing to droplet and/or aerosol exposure) and/or re-deposited from primary to secondary fomites. Development of standard methods (molecular, chemical/physical, and infectivity assays) for detecting the presence of viruses on fomites and human behavior modeling would help to determine the most effective infection prevention strategies.