Ferrets have been extensively characterised as models for SARS-CoV-2 transmission experiments, showing fairly robust infection and transmission. we assessed whether Spike mutations were selected for during experimental ferret infections in our laboratory, and, having detected a virus with a single Y453F mutation, we analysed the effect of this change on replication in ferrets, and in primary human airway epithelial cells. We confirm that these mutations likely adapt virus to mink/ferrets by enhancing entry into cells expressing mustelid ACE2. In addition, we assessed whether this single amino acid change altered neutralization of pseudovirus or live virus by antibodies in convalescent sera of individuals infected and recovered from COVID-19 during the first wave in the UK. We performed a prospective cross-sectional observational study in a multi-site London hospital. Air and surface samples were collected from seven clinical areas, occupied by patients with COVID-19, and a public area of the hospital. Three or four 1.0 m3 air samples were collected in each area using an active air sampler. Surface samples were collected by swabbing items in the immediate vicinity of each air sample. SARS-CoV-2 was detected by RT-qPCR and viral culture; the limit of detection for culturing SARS-CoV-2 from surfaces was determined. Viral RNA was detected on 114/218 (52.3%) of surfaces and 14/31 (38.7%) air samples but no virus was cultured. The proportion of surface samples contaminated with viral RNA varied by item sampled and by clinical area. Viral RNA was detected on surfaces and in air in public areas of the hospital but was more likely to be found in areas immediately occupied by COVID-19 patients than in other areas (67/105 (63.8%) vs. 29/64 (45.3%) (odds ratio 0.5, 95% confidence interval 0.2-0.9, p=0.025, Chi squared test)). The high PCR Ct value for all samples (>30) indicated that the virus would not be culturable. Our findings of extensive viral RNA contamination of surfaces and air across a range of acute healthcare settings in the absence of cultured virus underlines the potential risk from environmental contamination in managing COVID-19, and the need for effective use of PPE, physical distancing, and hand/surface hygiene.