The Power of Copper Against Germs (and Why Hospitals Should Use It)
The healthcare industry is in constant battle against infection and disease, and any new tool or material that could keep infections at bay is practically priceless. As research over the past few years is showing, copper could end up with a critical place as an indispensible and relatively simple tool in this battle.
Copper in Study
In 2013, researchers at the Medical University of South Carolina published a study in the journal Infection Control and Hospital Epidemiology discussing the results of an experiment testing the antibacterial properties of copper. These researchers examined the effects of coating certain hospital surfaces in intensive care units—areas like trays and bed rails, remote controls, and IV poles—with a copper alloy. The study found that, even with the copper alloy covering only limited high traffic surface areas within a room, this simple treatment could be enough to reduce the spread of bacteria like methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) by more than 50 percent.
2013 was far from the first time that science has turned to copper for its antibacterial properties—the metal has been the subject of numerous medical papers in various publications, and has been recognized for these properties for centuries. But what exactly is it about copper that can make it such an effective deterrent to bacteria? It comes down to the way that copper interacts with a bacterial cell’s physical makeup:
Copper is used to transmit electrons in walls for electricity. Similarly, bacteria will donate electrons to the copper metal, which places the organism in an electrical deficit. As a consequence, free radicals are generated inside the cell. The cell's proteins essentially get bleached, and its DNA get fractured. The electrical potential of the cell also gets collapsed.
DNA fracturing is clearly inconvenient for bacteria trying to reproduce, but it’s good news for facilities looking to prevent and eradicate a bacterial colony’s spread.
Copper in Action
Some hospitals are already experimenting with implementing copper alloy on select surfaces. One has been the Asklepios Clinic Harbur in Hamburg, Germany, where stainless steel door handles have been systematically replaced with handles made of copper alloy. As the hospital reports, its findings as a result of its own experiment match up perfectly with previous reports of copper alloy reducing bacterial presence by half:
When compared to handles of stainless steel or artificial materials, copper reduced microbes by 50 percent. "We were able to determine that, on copper handles, fewer pathogens were traceable," says Susanne Huggett, who heads the clinic's large-scale MEDILYS laboratory.
The clinic has been on a long term quest to test the potential of copper in a medical setting, working with Germany’s Copper Alliance, and has proven a decrease in not only bacteria but fungal infection and virus transfer as well. At the time of the report, it was leading the copper movement in Europe with the opening of a new wing featuring 600 copper door handle replacements.
Are There Any Disadvantages?
If copper sounds too good to be true, why haven’t more hospitals already adopted the metal wholesale? The truth is that there are a couple of disadvantages that have kept would-be users at bay. For one thing, as the Hamburg clinic found out, copper has an image problem:
Copper furnishings do have a superficial disadvantage, however. They often look dirty, even when freshly cleaned. In addition, says Hugget, "the handles were discolored, since they were regularly - at least once per day - cleaned with surface disinfectant." The laboratory director adds that while the greenish hue of oxidized copper might appear beautiful on roofs or rainspouts, green door handles leave the impression of an unsanitary clinic.
The clinic is attempting to fix this with tests on a different type of copper alloy that could resist oxidation. Nevertheless, this does not combat the second problem with copper: it’s expensive. It’s more expensive than steel, and much more expensive than plastic—it can be difficult to find funds within a hospital’s budget to accommodate a switchover to copper bed rails and door handles when there are so many other concerns like updated equipment and renovations to consider as well.
Why Start Now?
Despite the drawbacks, the numbers speak for themselves: according to the World Health Organization, 7 out of 100 hospitalized patients at any given time will acquire a health care-associated infection—that number climbs to 10 out of 100 in developing countries, and to 30 percent among intensive care patients.
“Hundreds of millions of patients are affected by health care-associated infections worldwide each year, leading to significant mortality and financial losses for health systems,” the organization states, adding that the costs are significant in more ways than one. In the United States alone, these infections account for roughly 99,000 deaths annually and nearly $6.5 billion in financial losses for healthcare facilities.
On both counts, these are losses that no hospital can afford. It seems that while the initial costs of copper might be high, the ROI in terms of improved health could be worth their weight in gold.
How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.