Preventing infections caused by nosocomial bacteria is an important concern for emergency department. Patients who visit the emergency room are not the only ones to be infected while receiving treatment, but may infect other patients or hospital staff due to their own ailments. Viral and bacteria are transferred through dropping nuclei in airborne droplets, large particle droplets, or direct contact with patients and their immediate environment. 
There are a variety of recommendations for the prevention and control of hospital infections, including hand hygiene, environmental hygienepractices, antibiotic management and vaccinations, etc. [2,3] Among them, hand hygiene is the easiest method, and many studies have confirmed that frequent hand washing is effective in preventing and avoid illnesses. [4,5]
Making use of mobile phones to communicate is a common practice in emergency departments; however many studies have revealed that they could act as vectors for bacteria and viruses. [6-9] So, some hospital staff began wrapping their mobile phones in plastic as they believed it could reduce the risk of contamination. The study assessed the effectiveness of plastic wraps in reducing the amount of bacterial contamination that occurs on mobile phone surfaces.
We used mobile phones of 6 people working in the emergency room and two individuals per group. When the first 2 people worked together, they randomly picked who would be using a phone wrapped in paper wrap. After the second and subsequent participants collaborated for the following stage of the experiment the phone was replaced and wrapped in a fresh plastic wrap package. Four phases were conducted for each group. That includes twice with plastic wraps, and then without.
We monitored the bacterial growth on the mobile phone’s surfaces at different intervals (Fig. 1). We utilized cotton swabs to capture the bacteria on the phone following each six-hour work shift. We also used sterilized cotton swabs to scratch the smart phone surfaces and used them to build agar plates. After a 48-hour incubation period under a 37°C aerobic environment, we counted the bacterial colonies growing across the surface of our Mueller-Hinton Agars. To reduce the chance of bias, the same person collected the swab and wrapped the mobile phone. The steps needed for this procedure are shown in Figure 1..
Image 1:The experimental process and samples of descriptions at 6 intervals.
After using the culture dishes to identify the cultured colonies of bacterial, we applied the Clean-Trace 3M NG luminometer (Taipei, Taiwan) to detect the presence of colonies on phone’s surface. The luminometer can be used in conjunction in conjunction with Clean-Trace testing of surfaces as well as water tests to determine the amount of contamination in samples. Results are available in seconds. Adenosine triphosphate is a standard measurement of biological residue and an effective marker for assessing the cleanliness of a surface. The 3M Clean-Trace Luminometer cell counts are evaluated by levels of triphosphate adenosine.  The steps and times of the experiment are identical to those of the culture dishes in addition to the number of experiments.
The statistical methods employed included Wilcoxon signed rank tests and Mann-Whitney U tests to analyze whether there were notable differences before and after alcohol disinfection. After a shift, the variations in the level of bacterial colonies and contamination on the surface of the mobile phones before and after being wrapped in plastic were observed. This study is not involving the collection of health records or body fluids related with the body of a human. It’s solely to identify the colony of bacteria on the phone. The board of review for institutional research at Kaohsiung Medical University Hospital Kaohsiung Medical University Hospital waived the need for ethical approval to conduct the study.
The results from culture dishes and luminometer recordings are shown in the appendix file. In this test, the starting point indicated the state of the mobile phone prior the time it was used. It was evident that bacteria on the surface of the phones were brought into the hospital from home.
When we compared the initial and second time-points by using Wilcoxon Signed rank test, it was found that 75% alcohol-based Sanitizers successfully reduced the bacterial colonies found on phones’ surfaces ( P < .05; Table 1). We also compared the fourth and fifth time points, and got the same results. In other words, with or without the wraps, using a 75% alcohol solution effectively reduced the colonies ( P < .05; Table 1). The third time point of the test the newly placed plastic phone wraps were almost clean, and made even cleaner following disinfection using the alcohol cleanser.
Table 1.The effect of alcohol disinfection on the surface of mobile cellphones as well as plastic wrap.
We then compared the information of mobile phones that had the absence of plastic wrap in the 6th timepoint with the fourth time point using wrapped plastic using a Mann-Whitney U test. After the shift, we discovered that there were colonies attached to the surfaces of the mobile phones as well as plastic wraps. There were no noticeable differences between the 2 types of groups ( P > .05; Table 2). Finally, we compared the phones using and without plastic wraps at the six-minute point. We found that the plastic wraps dramatically reduced the number of bacterial colonies on the phone’s surfaces ( P < .05; Table 2).
Table 2:Comparison on the amount of colony forming bacteria, and contamination on mobile phones with and without wrapping in plastic.
Bacteria and viruses are spread in three main ways: droplets or contact exposure, and airborne. The most frequent pathogens spread by droplets are Hemophilus influenzae, Group A Streptococcus, Bordetella pertussis, respiratory viruses, seasonal influenza and meningococcal disease. As part of standard precautions, wearing a surgical mask will provide adequate droplet protection to healthcare professionals. 
In the case of transmission by contact as per previous studies that patients infected with multidrug-resistant bacteria can be identified in the emergency room. The pathogens transmitted in this manner include methicillin-resistant Staphylococcus aureus, Pseudomonas aeruginosa, Enterobacteriaceae, vancomycin-resistant Enterococcus, vancomycin-resistant Enterococcus, Acinetobacter baumannii and other enteric pathogens. For prevention of contact, it is necessary to wearing of protective clothing and gloves when caring for patients to avoid healthcare personnel from being infected by these pathogens , and transmitting them to patients.
The pathogens that can be transmitted within the emergency department include measles and tuberculosis flu, tuberculosis and serious acute respiratory distress syndrome. Appropriate protection to prevent droplet becoming infected with nuclei in the air requires the use of N95 or electronic purifying air respirators. After the coronavirus disease 2019 (COVID-19) broke out within Wuhan, China, in December of this year, it quickly spread worldwide.  The first case of COVID-19 to occur in Taiwan has been confirmed as of January 21, the 21st of January, 2020.
A variety of strategies for infection prevention in hospitals were suggested such as limiting the number of patients who visit simultaneously and drive-through pharmacies that are geared towards long-term medication control patients, the introduction of new equipment and methods for testing patients who may be suffering by COVID-19. They also suggested denying admission to a hospital
History of travel
If the patient has a prior contacts or a history of travel and was presenting signs of fever or an upper respiratory infection. Hand hygiene using alcohol-based hand sanitizers is practiced worldwide to prevent COVID-19 cross-transmission, and has proven to be an extremely effective, easy and cheapest procedures. In our modern times electronic devices such as laptops, mobile phones, as well as desktop computers, are crucial elements of our daily lives. Although people are taught to wash their hands regularly and to maintain a good general hygiene However, they aren’t cleaning these devices
Touchscreens and keyboards) frequently enough as they ought to. Based on previous research, bacteria may not only be found on keyboards but also on the mobile phones. The most prevalent pathogens on mobile phones include Coagulase-negative Staphylococcus, S. aureus Micrococcus species Enterobacter species, Escherichia E. coli Klebsiella species and Enterococcus species. This includes not only pathogens but also bacteria that are resistant to many drugs such as methicillin-resistant S. aureus.
Possibility of viruses
Furthermore the possibility of viruses is present on mobile phones. Some viruses that were previously seen on mobile phones include influenza viruses, noroviruses, rotaviruses, and respiratory syncytial infections. [15,16] The transmission of infectious diseases through mobile phones isn’t restricted to medical institutions since phones are commonplace in every community and have been proven to be a potential source of transmission.
However, previous research has demonstrated that 70% alcohol wipes are effective in reducing the amount of colonies and further reduce the risk of nosocomial infection,  alcohol may cause harm to phones, which is one reason the reason why people are hesitant to try this method.
on our results, bacteria could be found on mobile phones prior to and after medical professionals make use of them during their job. Cleaning with 75% alcohol-based sanitizers will effectively decrease the amount of colonies that are present on mobile phone or its temporary plastic covering. A plastic wrapping is inexpensive and simple to replace. Mobile phones wrapped in plastic is able to be completely disinfected using alcohol without getting the alcohol to contact the phone itself. Additionally, we have found that bacterial colonies don’t contaminate or adhere to the plastic wrapping any easier than to mobile phones.
The outcomes of two experiment methods (luminometer and cookery dish) demonstrated the effectiveness of wrapping plastic to protect mobile phones. Both methods have their advantages and disadvantages. Culture dishes are very economical, but they require incubation, and take an extended time to yield results. The Luminometers yield results faster however they are more costly.
Our study has some limitations, including our small sample size, differences in hygiene habits between the participants, the differing patterns in workload , as well as the frequency of contact with patients and the dimension of the brands of mobile phones among other possible factors that could affect the results. To mitigate potential bias, our sampling process, the plastic wrap and estimation of the number colonies on wraps and phones were all carried out by the same individual.
To summarize the findings of our research we believe that encasing smartphones in wrapped plastic is a reliable method of preventing them from becoming vectors for bacterial transmission.