Water & Sanitation This WHO-UNICEF Initiative Is Fighting so Everyone Can Wash Their Hands Against COVID-19

Nearly half of the world population can’t wash their hands at home.

Why Global Citizens Should Care

COVID-19 has been called an equaliser, because it doesn’t discriminate based on race, gender, geography, sexuality or religion. Yet, in the months since the World Health Organisation declared coronavirus a pandemic, it’s become increasingly evident that people from marginalised communities and poor countries bear the brunt of the virus due to lack of access to resources, like water and sanitation. You can join us here to take actions to help mitigate the impact of COVID-19 on the world’s most vulnerable communities.

It’s often been said that changing personal behaviour is vital in containing COVID-19: wearing a mask in public, maintaining social distance, and frequently washing hands with soap and clean water.

Yet for 3 billion people globally, access to hygiene is not as simple as turning on a tap, according to the United Nations Children’s Fund (UNICEF).

That’s 40% of the world population who cannot wash their hands with soap and water in their homes.

The majority are in sub-Saharan Africa, while children and people who live in informal settlements, refugee camps, or conflict areas are most affected by the continent’s lack of clean water and sanitation facilities.

The World Health Organisation (WHO) and UNICEF have recently launched a hand-washing initiative aimed at bringing attention to the plight of people who don’t have access to clean water and are, therefore, unable to protect themselves effectively from COVID-19.

“Hand hygiene has never been more critical, not only to combat COVID-19, but to prevent a range of other infections. Yet, nearly six months since the onset of the pandemic, the most vulnerable communities around the world continue to lack access to basic hand hygiene,” said the executive directors of UNICEF and WHO, Henrietta Fore and Dr. Tedros Adhanom Ghebreyesus, in a joint statement.

The statement added: “According to our [UNICEF and WHO] latest data, the majority of people in the least developed countries are at immediate risk of COVID-19 infection due to a lack of hand hygiene facilities.”

The statement said one billion people are at direct risk of contracting COVID-19 as a result of not having water and soap in their homes, and that almost half of then are children.

However, it’s not only homes that lack access to clean water, the statement added. “All too often, schools, clinics, hospitals and other public spaces also lack hand hygiene facilities, putting children, teachers, patients and health workers at risk. Globally, two in five in health care facilities do not have hand hygiene at points of care,” said the statement.

A report by World Vision revealed that nine out of 10 countries in the world with the worst access to water are African.

These include: Eritrea, where 81% of the population do not have clean drinking water. In Uganda, 61% of the population doesn’t have basic water services. The figures are 61% in Ethiopia, 60% in Somalia, 59% in Angola, 58% in the Democratic Republic of the Congo, 58% in Chad, 54% in Niger, and 53% in Mozambique.

“The COVID-19 pandemic has exposed an uncomfortable truth: too many people around the world simply cannot clean their hands,” said the statement.

UNICEF and WHO said they will be working through the initiative with other international partners, national governments, the public and private sectors, and community organisations to ensure that products and services are available and affordable, and to enable a culture of hygiene. This includes ensuring that handwashing stations are accessible, especially in disadvantaged areas and among marginalised communities.

“We must also ramp up investment in hygiene, water and sanitation, and in infection prevention and control,” said the statement. “We urge countries to scale up, systemise, and institutionalise hand hygiene and commit to strengthening the enabling environment, supply vital products and services, and to actively promote hygiene practices as part of a package of actions that save lives.”

You can join us to help mitigate the impact of COVID-19 on the world’s most vulnerable and marginalised communities by taking action here.

By Lerato Mogoatlhe
Published July 2, 2020
https://www.globalcitizen.org


Controlling COVID-19: hand hygiene must be accessible to all

UNICEF and the World Health Organization have launched the ‘Hand Hygiene for All’ joint initiative to help control the spread of COVID-19.

In a bid to control the spread of the novel COVID-19 infection the United Nations Children’s Fund (UNICEF) and the World Health Organization have launched a new join initiative ‘Hand Hygiene for All’ to help make hand hygiene accessible to all, including the least developed countries that have a lack of hygiene facilities.

Hand Hygiene for All

Henrietta Fore, Executive Director of UNICEF, and Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, made a statement on the launch of the initiative. “As the world struggles to cope with a new disease, one of the most effective tools to prevent its spread is also one of the most basic. Hand hygiene has never been more critical, not only to combat COVID-19, but to prevent a range of other infections. Yet, nearly six months since the onset of the pandemic, the most vulnerable communities around the world continue to lack access to basic hand hygiene.

“According to our latest data, the majority of people in the least developed countries are at immediate risk of COVID-19 infection due to a lack of hand hygiene facilities. In the 60 highest-risk countries, two out of three people – 1 billion people in total – lack basic handwashing facilities with soap and water at home. Around half are children.

“All too often, schools, clinics, hospitals and other public spaces also lack hand hygiene facilities, putting children, teachers, patients and health workers at risk. Globally, two in five healthcare facilities do not have hand hygiene at points of care. We cannot overstate the threat.

“Many of the those who lack access to basic handwashing live in overcrowded, desperately poor conditions. Even before the pandemic, children and families faced barriers to accessing health and hygiene services. Now the grave risk of COVID-19 threatens further suffering and spread of this deadly disease.

“If we are going to control COVID-19, we have to make hand hygiene accessible to all. That is why we are launching a new global initiative to move the world towards the same goal: supporting the most vulnerable communities with the means to protect their health and environment.

“We are joining our efforts with those of other international partners, national governments, public and private sectors, and civil society organisations to ensure affordable products and services are available, especially in disadvantaged areas, and to enable a culture of hygiene.

“Public health response plans and reopening plans should couple physical distancing and other control measures with hand hygiene and access to safe water and sanitation, and must reach the most vulnerable communities.

“Our teams are developing comprehensive country roadmaps and committing human and financial resources to support global and local implementation efforts. Task teams will facilitate learning and knowledge exchange, while multisector stakeholders will strengthen hygiene programming and monitor global progress. Leaders and community mobilisers will advise on strategies and advocate for their implementation. Only together can we achieve universal hand hygiene.

“We must also ramp up investment in hygiene, water and sanitation, and in infection prevention and control. We urge countries to scale up, systemise and institutionalise hand hygiene and commit to strengthening the enabling environment, supply vital products and services, and to actively promote hygiene practices as part of a package of actions that save lives.

“The COVID-19 pandemic has exposed an uncomfortable truth: too many people around the world simply cannot clean their hands. But we can help to reduce the spread, and we can prevent future infectious diseases from following a similar path. It starts by making sure everyone, everywhere has access to basic hand hygiene facilities with soap and clean water or alcohol-based products in homes, schools and healthcare facilities.”

 

Published


The One Mistake You Shouldn't Make When Washing Your Hands. How you dry your hands is equally as important as how you wash them.

Washing your hands should always be part of your personal hygiene, but it’s especially important now, amid the coronavirus pandemic. One of the first guidelines released by the Centers for Disease Control and Prevention (CDC) outlined how to wash your hands with soap and water for 20 seconds. While you probably have the hand-washing part down, we bet you’ve made this one crucial mistake when drying your hands: You’re using a cloth towel instead of a paper towel.

Because paper towels are thrown away, there’s less risk of cross-contamination, unlike reusable towels. According to commercial bathroom products supplier One Point Partitions, “If multiple people use the same cloth towel to dry their hands and one of them hasn’t cleaned their hands appropriately or they touched a contaminated surface before they dried their hands, every subsequent person who uses the same towel will pick up germs during the hand drying process.”

One Point Partitions adds that “because users will throw out their paper towels after they dry their hands, paper towels don’t have the same risk of cross-contamination.” The World Health Organization (WHO) also recommends that you use single-use towels to dry your hands.

Once you’re done drying off, “use a paper towel to touch any surfaces—doors, faucets—in the bathroom before exiting,” Taylor Graber, MD, a resident physician at UC San Diego, previously told Best Life.

This last step is essential as faucet handles and doorknobs are two of the dirtiest touch points.

In fact, the faucet handles in your kitchen and bathroom contain so much bacteria that they were ranked the sixth germiest place in your home, according to the National Sanitation Foundation. And for more hygiene errors you should avoid, here’s how You Haven’t Been Rubbing in Your Hand Sanitizer Correctly, CDC Says.

By Chelsea Bengier
Published June 15, 2020
https://bestlifeonline.com


European Commission awards Resani Seal of Excellence for Covid-19 Response

Press Release: Oslo, Norway, 08.06.20

The European Commission has awarded Resani the Seal of Excellence for its Horizon 2020 proposal with relevance to addressing the challenges of Covid-19 and recommends the proposal for funding. The Seal of Excellence is a quality label, co-signed by the European Commissioner for Innovation, Research, Culture and Youth, Mariya Gabriel, and by Commissioner for Cohesion and Reforms, Elisa Ferreira, and is awarded only to proposals deemed excellent and evaluated worth of funding.

In a highly competitive process, consisting of more than 4000 proposals that were submitted under the European Innovation Council (EIC) Accelerator Pilot for Covid-19 Response in March 2020, Resani was one of 230 applicants invited to present our project before an international panel of independent experts, and was scored as “a high-quality project proposal” and despite qualifying for funding, the European Commission could not grant Resani’s proposal funding given the limited resources available for the call.

However, we are very proud to have received the Seal of Excellence from the European Commission, and because of it, we are more motivated than ever and see this as a great validation for our vision to reshape the global approach to hand sanitisation and to better equip and shield our societies against Covid-19 and future viral outbreaks. We remain confident that we will find the perfect partners within the next weeks and months that will help us in the final steps in bringing Resani’s technology to the world; a world that is in desperate need of new accessible, reliable and sustainable hand sanitisation technology that will help save lives.

Stay tuned!

For more information, please contact:
Ingvild M.S. Løken
CEO
Email: isl@resani.com

resani.com


A (Surprisingly) Brief History Of Handwashing

Handwashing can help kill the coronavirus. But you may be surprised by how short the history of handwashing actually is among humans.

Guests

Miryam Wahrman, professor of biology at William Paterson University. Author of “The Hand Book: Surviving in a Germ-Filled World,” published in 2016. (@MiryamWahrman)

Peter Ward, professor emeritus of history at the University of British Columbia. Author of the 2019 book “The Clean Body: A Modern History.” (@UBC_History)

Emma Robbins, director of the Navajo Water Project at DigDeep, a human rights nonprofit dedicated to water access in America. Navajo artist and activist. (@robbinzintherez)

Interview Highlights

On the effectiveness of handwashing

Miryam Wahrman: “Soap is hydrophobic. And as are cell membranes. And also the coverings around viruses. And so that type of hydrophobic interaction can disrupt the structure. But the other part of the process of cleansing hands is that various things can stick on our hands. And soap helps to break the bonds between what has attached to our skin and it helps to get rid of it. And then we just rinse it down the drain. So that’s another really important part of the process of why soap and water are the most effective way to cleanse the hands. Not everything has to get killed, not all the microbes have to get killed, as long as they are removed from the surface of the skin. Then we rinse them away.”

When is it that we first began to see soap or handwashing in the context of health?

Peter Ward: “It’s a surprisingly recent development, actually. And it’s really related to the long, long, complicated history of human hygiene. It’s a story that … [goes] back to the Roman times. But it really picks up in the period from about the beginning of the 17th century onward. And there’s been since that period of time a huge transformation of body care and body treatment that sort of began in the upper reaches of a number of Western communities and gradually diffused and percolated downwards to our own dear times, when we are now obsessed with our cleanliness. At least in some respects, it seems we exempt our hands to some extent. But the rest of us, we really pay a lot of attention to.”

On handwashing in the 20th century

Miryam Wahrman: “As we get to the mid-20th century, we begin to see that hand hygiene, in fact hygiene in general and the access to clean water, has changed the landscape in terms of human health very dramatically. And the average life expectancy from 100 years ago to today has increased from about the mid-40s, up to about 80 or more. And some of that has to do with public health and hygiene and even the simple act of having access to soap and water and the types of procedures that are done in hospitals using a septic technique now. Where now we don’t have as high a risk of infection of our patients, going from patient to patient.

“These are all tremendously important improvements in terms of health, in terms of average life expectancy, in terms of recovery from disease. And these all came about thanks to scientists that were able to show the link between germs and disease, and specific germs and specific disease. So it is a long story and it does cover about 150 years, but they’re really tremendously exciting. 150 years in terms of science. I think the thing we have to keep in mind is that the science is critical in terms of helping us to move forward and to be able to deal with this challenge.”

How have things changed in terms of access to running water, bathrooms, et cetera?

Peter Ward: “About half of American homes had a bathroom in the 1940 census. And today, virtually all American homes have a bathroom. As indeed, the homes everywhere [in] the Western world. Some of them have many. So that transformation has been gradual and varied from one part of the country to the next. One social group to the next, as well. But it’s really been one of the fundamental changes that’s been associated with the hygienic revolution and the handwashing part of all that.”

” … There are these additional layers that have to do with access to privacy, access to water, development of effective sewage systems, and so on and so forth. And the people who are marginal in our world today are the people who live beyond the edges of these things. There are certainly — I know people in the United States who do live beyond the edges. And there certainly are people in my own country as well. Who many of them are First Nations people, the indigenous peoples of North America, who live in more remote areas and who do not have easy access to clean water.”

On access to clean water in the Navajo Nation

Emma Robbins: “When you are able to wash your hands, it’s very empowering. You’re reducing the risk and you’re literally in your hands, you have the ability to save lives. However, when you don’t have running water in your homes, you can’t do that for 20 seconds. You know, you can use bottled water, but that takes a ton of bottled water to wash your hands. And many families don’t have that luxury. And so there’s a third element that I always say.

“Well, number one, when you’re leaving your house to go get water, you’re exposing yourself to the virus potentially. You know, oftentimes you can get to stores and there isn’t any bottled water that’s left either on the reservation or in border towns. The second thing is when you’re doing that, there’s a lot of stress that’s involved. And we see constantly on social media, on the Internet and TV that those are the things that we can do, staying at home, handwashing. But when you can’t do that, it’s scary. You know, you start to feel like the other, that you’re not able to protect yourselves or your families. And it can be really, really, really impactful on everybody of all ages. And, you know, we’re already all experiencing not having money, not having work, you know, having to stay at home, especially in the Navajo Nation. They have a 57 hour curfew on the weekends and it’s hard. And so not having that is a lot more stressful.”

From The Reading List

Excerpt from “The Clean Body: A Modern History” by Peter Ward

Excerpted from “The Clean Body: A Modern History” by Peter Ward © 2019. Published by McGill-Queen’s University Press. Reprinted with the permission of the publisher, McGill-Queen’s University Press. All rights reserved.

Excerpt from “The Hand Book: Surviving in a Germ-Filled World” by Miryam Wahrman

Excerpted from “The Hand Book: Surviving in a Germ-Filled World” by Miryam Wahrman © 2016. Published by ForeEdge, an imprint of University Press of New England. Reprinted with the permission of the publisher, University Press of New England. All rights reserved.

The Embryo Project Encyclopedia (Originally published in The New England Quarterly Journal of Medicine and Surgery): “‘The Contagiousness of Puerperal Fever’ (1843), by Oliver Wendell Holmes” — “In 1843, physician Oliver Wendell Holmes wrote and published “The Contagiousness of Puerperal Fever,” an essay about puerperal fever, a disease that occurs mainly as a result of bacterial infection in the uterine tract of women after giving birth or undergoing an abortion. In the essay, Holmes argues that puerperal fever is spread through birth attendants like physicians and midwives who make contact with the disease and carry it from patient to patient. The article was published in The New England Quarterly Journal of Medicine and Surgery in 1843.”

Vox: “The evolution of hand-washing, explained by a historian” — “Are we all washing our hands several times a day? As the Covid-19 coronavirus pandemic spreads, we should all be washing our hands several times a day. Take a moment right now, go give your hands a scrub with some warm soapy water for 20 seconds, and then come back. Maybe spritz around some hand sanitizer if you don’t have access to a sink. Put on a little hand lotion so your skin doesn’t get too chapped.”

Popular Mechanics: “The Shockingly Recent History of People Actually Washing Their Hands” — “It has become a ubiquitous mantra in the time of COVID-19: Wash your hands. Cheap and easy to do, it’s one of the few pieces of advice that is essentially without controversy. And yet, hand-washing is a more recent development than you might expect, and the habit did not catch on quickly.”

Washington Post: “Americans are told to wash hands to fight coronavirus. But some don’t trust the tap.” — “For the Chavez family and many others in California’s fertile San Joaquin Valley, bottled water is the toilet paper of their coronavirus pandemic — an everyday necessity that vanished from supermarket shelves.”

The Guardian: “Keep it clean: The surprising 130-year history of handwashing” — “It felt strange when Boris Johnson emerged from the first Covid-19 Cobra meeting on 2 March and told us to wash our hands while singing Happy Birthday. The preppers among us had panic-shopped while awaiting his pronouncements, and others fretted about vulnerable loved ones, travel plans, the nightmare of simultaneous homeworking and home-schooling, and not being able to work at all. And all our leader had was this?”

Freethink: “COVID’s Unique Challenge For the Navajo Nation” — “Sprawling across roughly 27,000 square miles of deserts and high plateaus, the Navajo Nation is not immune to the impact of the COVID-19 pandemic. The sovereign nation’s battle with SARS-CoV-2 has seen 2,373 confirmed cases, as of May 2, and 73 deaths. Its per capita infection rate trailed only New York and New Jersey by late April.”

This article was originally published on WBUR.org.
Copyright 2020 NPR. To see more, visit https://www.npr.org.

Published May 11th  2020 at: https://wamu.org


Could COVID-19 Permanently Change Hand Hygiene?

An anthropologist tackles the slippery subject of hand sanitization in a world torn between concerns over contagion and antibiotic resistance.

Here in the Philippines, as in many parts of the world, there’s been an outbreak of hand sanitizers. Since late January, pump dispensers and bottles have appeared everywhere: airports, schools, dining tables, handbags. In SM, the country’s largest chain of shopping malls, large containers of hand sanitizers greet visitors as they pass through security. “This is a sanitized zone,” SM’s posters read. “Thank you for using the alcohol/disinfectant provided.”

When the enhanced community quarantine started here on March 17, sanitizer showed up at road checkpoints. And though the shops in the mall are closed, customers can still shop at mall supermarkets—after the staff sprays alcohol on their hands.
This is not surprising. The COVID-19 pandemic has spurred people around the world to panic-buy Purell and other hand sanitizers, soaps, and antibacterial wipes. What is surprising is that, until the pandemic hit Western countries, the trend was going in the opposite direction.

Over the past decade, there’s been a growing concern that the impulse to kill all germs could have serious consequences, such as the creation of resistant superbugs. This has certainly impacted people’s hand hygiene habits.

For the last few years, the U.S. Food and Drug Administration (FDA) has advised people to stop using antibacterial soap, which is no more effective at preventing illness than regular soap and may negatively impact health. After discovering that common ingredients in antibacterial soap—most notably triclosan and triclocarban—disrupt hormones in lab animals and induce antibiotic resistance, the FDA banned those chemicals in 2016 and replaced them with alternatives.

However, when soap and water are unavailable, hand sanitizers and wipes are considered an acceptable alternative because they rely on alcohol to vanquish certain viruses (including coronaviruses) and bacteria.

Still, before the current pandemic, some health experts urged people to cut back even on alcohol-based hand sanitizer. That’s partly because some bacteria are becoming more tolerant of alcohol. And it’s partly due to concerns that sanitizers might harm the microbiome—the trillions of microbes living on and in the human body that are essential for healthy immune function, digestion, and more.
In recent years, many researchers have expressed concerns that over-sanitized societies are contributing to autoimmune disorders, allergies, and inflammatory conditions. This “hygiene hypothesis” is controversial, but there’s no question that scientists and the public have been awakening to the fact that some microbes can be beneficial.

Yet in the midst of the COVID-19 pandemic, everyone is understandably consumed by the process of hand sanitizing, and many people are finding it nearly impossible to buy sanitizer online or in stores. People who just weeks ago purposely petted dogs to boost the diversity of their microbiomes now find themselves disinfecting their hand sanitizer bottles with antibacterial wipes.

To understand this sudden change, it is revealing to explore the complex history and anthropology of hand cleansing. What motivates people’s handwashing habits? How do beliefs about sanitizers and microbes figure in? How have previous epidemics led to shifts in these notions? And what might the post-COVID future hold for hand hygiene?
Even before 19th-century scientists discovered that germs cause disease, handwashing was important for hygienic and symbolic purposes in many societies and religious traditions. The Prophet Muhammad, for instance, called on Muslims to wash their hands in a variety of situations, including “before and after any meal,” “after going to the toilet,” “after touching a dog, shoes, or a cadaver,” and “after handling anything soiled.”

In other societies, hand hygiene practices primarily originated from secular discoveries. In 1846, Hungarian doctor Ignaz Semmelweis observed that mothers giving birth were more likely to die if they were treated by doctors who handled cadavers beforehand. So, Semmelweis mandated that hospital staff wash their hands with soap and chlorine. He later became known as the father of hand hygiene. A few years later, forward-thinking nurse Florence Nightingale implemented handwashing in British army hospitals.

Despite the efforts of these pioneers, the practice of widespread, regular handwashing was slow to take off in most of the world. In the U.S., the first national hand hygiene guidelines weren’t published until the 1980s, spurred by several foodborne outbreaks and hospital-associated infections. It was in that decade that a global hand cleansing movement was born.

The rise of hand sanitizers mirrors this move of hand hygiene from the hospital to the world at large. Some accounts claim that Lupe Hernandez, a nursing student in California, invented hand sanitizer in 1966 when she realized alcohol mixed with gel could help hospital staff clean their hands in a jiffy.

Others trace its beginnings to Gojo, a family-owned Ohio company that launched a hand cleanser for auto mechanics then tweaked the recipe and released it in 1988 as Purell. After a slow start, the product achieved the near ubiquity it enjoys today.
Incidentally, alcohol-based hand sanitizers once caused ambivalence among Muslims, owing to alcohol being haram (forbidden). But today, Muslim health care workers largely accept them, even though the question of whether hand sanitizers are halal (permissible) continues to spark debate.

Epidemics have repeatedly stimulated the popularity of hand sanitizers. In the Philippines, a clothing store called Bench introduced Alcogel shortly after the 1997 H1N1 outbreak. It attained “phenomenal success,” according to Bench’s CEO Ben Chan. A similar sanitization surge occurred in the U.S. during the H1N1 epidemic of 2009.
As The Guardian’s Laura Barton wrote in 2012, “Thanks to the heightened fear of contamination experienced during recent flu epidemics, there is now a value judgment attached to carrying and using an antibacterial gel.”

Infectious disease outbreaks have also influenced societies’ soap-and-water habits. A 2003 study of six international airports found that in Toronto—which was hit by a major outbreak of severe acute respiratory syndrome (SARS) that year—95 percent of male travelers and 97 percent of female travelers washed their hands in the public restrooms. By contrast, in New York’s John F. Kennedy Airport, only 63 percent of men and 78 percent of women washed their hands.

So, is fear of disease a great motivator for soaping up or squirting hand gel? Perhaps during a pandemic, the answer is yes. However, fear generally has only a temporary effect on ablutions, according to a review led by anthropologist Valerie Curtis. Furthermore, Curtis has warned, creating cleanliness campaigns that play on people’s anxiety is not good for mental health.

Instead, she recommends harnessing a different emotion.

In the early 2000s, Curtis was aiming to change the handwashing habits of people in Ghana, where only 4 percent of adults regularly used soap after going to the bathroom. Previous campaigns had failed, and the situation was urgent, since an estimated 84,000 children were dying of diarrhea each year.

So, Curtis created a campaign designed to generate disgust. At the time, bathrooms were considered cleaner alternatives to pit latrines, so they didn’t inspire an ick factor that might prompt Ghanaians to lather up. Curtis and her group developed ads that showed mothers and children exiting bathrooms with their hands covered in purple pigment, which they then transferred to everything they touched. Soap use subsequently rose by 13 percent following trips to the toilet and by 41 percent before eating.

Such a campaign could inspire future efforts in the wake of COVID-19. In a study released in December 2019, researchers at the Massachusetts Institute of Technology (MIT) and the University of Cyprus calculated that if travelers at airports raised the bar on their soap-use habits, the impact of a future pandemic could be reduced by 24 to 69 percent. Yet the same researchers estimated that, although 70 percent of air travelers wash their hands, most do not wash them adequately (frequently, with soap, for at least 20 seconds), so only 20 percent actually have clean hands.
Pandemics arguably tip the scale back to a Pasteurian paradigm.

Shifting views about microbes may complicate the issue of disgust. MIT anthropologist Heather Paxson has written that many people hold a Pasteurian worldview, in which they “blame colds on germs, demand antibiotics from doctors, and drink ultra-pasteurized milk and juice, while politicians on the campaign trail slather on hand sanitizer.”

But Paxson also points out that there is an emergent, alternative paradigm: a “post-Pasteurian” view. Post-Pasteurians “might be concerned about antibiotic resistance” and embrace microbiome diversifiers like probiotics, unpasteurized milk, kombucha, and unsanitized handshakes.

Since Paxson’s work was published in 2008, this post-Pasteurian paradigm has grown. Scientists have even considered ways they might promote more positive feelings for microorganisms and foster collaboration in human-microbe relationships.

Pandemics arguably tip the scale back to a Pasteurian paradigm. Currently, people are bombarded with images (and imaginings) of a potentially deadly virus for which there is, at least at the moment, neither vaccine nor cure. Thus, hand sanitizers and wipes emblazoned with the statement “kills 99.9 percent of germs” give people a sense of control over an unseen, and suddenly hostile, microbial world.
But people’s hand hygiene practices are also motivated by a visible and often friendlier force.

In 2016, researchers found that doctors and nurses at a California hospital washed or sanitized their hands 57 percent of the time when they knew that designated “hygiene patrol” nurses were watching them but only 22 percent of the time when volunteers who they didn’t recognize observed them.

Just like the wearing of face masks, social pressure can certainly motivate people to clean their hands. A recent review from Curtis and other researchers showed that people were more likely to lather up when there was more than one person present in a public restroom.

Prompted by the COVID-19 pandemic, some health experts are attempting to “responsibilize individuals” by framing handwashing as a selfless act that saves lives. Social media campaigns like #SafeHands and #HandwashingHeroes are also making appeals to social responsibility by showing celebrities and adorable children getting sudsy to prevent disease.

Similarly, face masks became an emblem of “public spiritedness” during the 1918 influenza pandemic. In some places, for instance, Japan, the practice of wearing masks continued and became part of the country’s hygiene culture.

In the aftermath of past pandemics, people have generally returned to their previous handwashing habits. But the COVID-19 crisis is different from other outbreaks. Never before have hand sanitizing and social distancing practices been enacted on such a global scale.

So, could COVID-19 cause permanent changes to handwashing habits around the planet? Could hand sanitizer become an enduring symbol of responsible world citizenship? Could the pro-microbe perspective swing back to a Pasteurian panic over germs?
Only time will tell. But it’s something to ponder while you scrub or sanitize your hands for at least 20 seconds.

By Gideon Lasco
He is a senior lecturer of anthropology at the University of the Philippines.
Published  8 April 2020
https://www.sapiens.org


In a pandemic, hospital staffers need to get better at hand-washing

After visiting Ellis Island in 1906, President Theodore Roosevelt noted the lack of hand-washing by doctors and wrote the Public Health Service that he was “struck by the way doctors made the examinations with dirty hands,” turning the examinations themselves into “a fruitful source of carrying infection.”

Fast forward 114 years: Today’s hospitals aren’t doing much better at hand-washing. That’s a serious problem in ordinary times; during the Covid-19 national emergency it could become extraordinarily dangerous. One way the government can protect public safety is by immediately setting specific hand hygiene standards for doctors, nurses, and hospital staff.

There’s not even monitoring of a national compliance rate, although hand-washing remains “the most important intervention” to reduce the “staggering mortality” associated with hospital infections, according to an article in an infection control journal.

The most recent hand hygiene data — an 18-year-old study from the Centers for Disease Control and Prevention — is discouraging. It concluded that adherence “has remained low.”

How low is “low”? According to the CDC, health care providers in U.S. hospitals clean their hands less than half the time they should. In comparison, people using bathrooms in New York train stations washed their hands afterward 80% of the time.

The medical literature doesn’t show much systemic improvement in hand-washing since the CDC last looked at the issue or, for that matter, since the Public Health Service issued an educational video showing hospital staff how to wash their hands back in 1961!

Hospitals with hand hygiene compliance in the 50% to 60% range include the kind of large, urban medical centers designated by the CDC as “first tier” treatment centers during the 2014-16 Ebola outbreak. After reviewing hundreds of inspection reports, ProPublica recently reported that “infection control has been a recurring problem at some of the very hospitals that would likely be called upon to treat Covid-19 patients.”

Better hand-washing won’t solve all infection control issues, of course, but it would significantly improve safety. The first step to achieving it is valid measurement.

A new standard from the Leapfrog Group, a nonprofit focused on improving patient safety where one of us (L.B.) works, encourages hospitals to measure hand hygiene using electronic monitoring of clinician compliance. This kind of technology is commonplace in retail and other industries.
Related:
‘We didn’t follow through’: He wrote the Ebola ‘lessons learned’ report for Obama. Now he weighs in on coronavirus response

Hospitals traditionally measure hand hygiene by having someone spot violations and report them, a technique with questionable reliability. Monitoring hand hygiene in a way that yields accurate data is vital. The Leapfrog standard is evidence-based; the government should adopt it.

The next step, getting to universal compliance with hand hygiene best practices, is even more crucial.

Based on what hospitals have already shown they can achieve, the secretary of Health and Human Services should call on all hospitals to meet an 85% hand hygiene goal within 90 days. While President Trump’s well-known use of hand sanitizer even before the Covid-19 crisis should make this an easy step for the administration to take, its obvious importance should also draw support from both parties in Congress.

Meanwhile, the Centers for Medicare and Medicaid Services should start the process of issuing formal regulations that would include an aggressive time frame for 100% hand hygiene compliance by any health care facility receiving Medicare payments — which is virtually all of them.

It took 98 years from the time President Roosevelt pointed out the hand-washing problem at Ellis Island until U.S. hospitals were required to institute a hand hygiene program that followed the CDC’s recommendations. If a deadly pandemic doesn’t justify urgently demanding accountability for making patients safer by the simple act of clinicians washing their hands, it’s hard to imagine what will.

Leah Binder is CEO of the Leapfrog Group. Michael L. Millenson is a patient safety activist, researcher, consultant, and author of “Demanding Medical Excellence: Doctors and Accountability in the Information Age” (University of Chicago Press).

 

 

By Leah Binder and Michael L. Millenson

Published March 25, 2020
https://www.statnews.com


How Do You Wash Your Hands To Fend Off Coronavirus If Water Is Scarce?

It’s something we’ve heard again and again from health authorities in the coronavirus pandemic. Wash your hands. Frequently. With soap and water. For at least 20 seconds. That’s an effective way to eliminate viral particles on your hands.

But for the 2.2 billion people in the world who lack safe drinking water — mostly in low- and middle-income countries — that advice will be difficult to heed. In these places, water is scarce for a number of reasons. It could be due to drought or climate change. Or local water supplies could be contaminated. Or the nearest source of water may be far away from home.

Aid groups and public health officials are doing all they can to help people in these communities overcome the obstacles and wash up. Washing your hands, they say, is a small action that can make a huge difference in the coronavirus pandemic.

“Hand-washing is one important tool to check and control spread,” says Amanda Glassman, executive vice president at the think tank Center for Global Development — along with other known interventions such as testing, isolating the sick and social distancing.

Water that is safe enough to drink is the best option for hand-washing. The ideal is to use clean, running water to wash away germs because it is less likely to contain harmful pathogens like e-coli, which can make you sick.

So how do you get water to those in need? Aid groups can truck in vast amounts of water, for example, but many say that’s expensive and unsustainable.

In less than ideal circumstances, other types of water can be used to wash hands. Non-potable water (for example, water that’s been used to clean dishes or do laundry) — along with soap — can be effective, according to a 2019 study published in the journal Environmental Science and Technology.

Small-scale solutions work, too – like setting up a network of public hand-washing stations – something done in West Africa during the Ebola outbreak of 2014. “When Ebola hit, one of the big concerns was the lack of running water and sanitation for hand-washing and proper waste disposal,” says Joia Mukherjee, chief medical officer of Partners In Health and associate professor of global health at Harvard Medical School. “It almost seemed like an unsolvable problem. And yet relatively rapidly, solutions were put together.”

The simplest kind of hand-washing station needs just two buckets. One bucket contained a mix of chlorine and water for the washing, with a spigot so people could tap into the supply, she explains. A second bucket, underneath the spigot, caught the wastewater.

These hand-washing stations were put in public buildings, schools and markets in Ebola-affected areas — and public health officials stressed why it was important to wash hands. Soon “people adopted this hand-washing technique everywhere,” says Mukherjee.

Mukherjee was heartened to see these stations again in February on trips to Liberia and Sierra Leone — set up by the countries’ health authorities to combat the spread of coronavirus. “I was very pleasantly surprised that they had already re-initiated this type of hand-washing at airports and outside of public buildings like the Ministry of Health. The lessons learned from Ebola were immediately being used.”

This kind of innovation is exactly what the developing world needs right now to ward off coronavirus, says Glassman, who is the author of Millions Saved: New Cases of Proven Success in Global Health. “We should deploy and test everything we’ve got,” she says, citing the hand-washing stations. “Affordability and fast availability is what matters now.”

The lower the technology, the better, says Glassman. If people can use objects and materials available in their own communities, like buckets, it makes the solution more likely to work.

One such device — which has been praised by global water researchers — is the SE200 Community Chlorine Maker. Developed by the global organization PATH, it can make chlorine from just water, salt and a car battery. Chlorine is commonly used to disinfect water because it kills many bacteria and viruses but isn’t always easy to obtain. The clean water can then be used to safely wash hands.

In preparation for the surge in coronavirus cases, 13 countries from sub-Saharan Africa as well as from Myanmar and Vietnam have put in requests to PATH for the devices. The group is finalizing logistics to get them up and running.

Then there’s the question of how to keep hand-washing stations safe from being a hot spot for disease transmission. Myriam Sidibe, a senior fellow at the Harvard Kennedy School, is working with the aid group WaterAid in Kenya to figure that out. They are trying to find ways to make 10,000 water stations across the country safe for people to congregate around.

The plan is introduce “social distancing nudges on the ground, similar to what we are seeing in supermarkets in some countries,” says Sidibe, who is based in Nairobi. “These can be red dots painted on concrete or if the surface is more uneven you can get stones or pieces of wood and sort of partially bury it in the dirt and then paint the visible bit red.”

As for soap, it’s not as much of a problem as water.

Soap is available to purchase almost everywhere in the world, says Sidibe. Most people, including those living in poverty in rural and urban areas, have some kind of basic soap, even if just for laundry, she says.

But in this time of crisis, soap supplies may run short — or people who lose their income because of the pandemic may find soap is not affordable.

In New Delhi, Sudhanshu S. Singh, CEO of the nonprofit Humanitarian Aid International, has been collecting donations of soap and hand sanitizer — increasingly in short supply as the city is in lockdown — for the 1,000 refugee families he serves in Delhi.

The families fled Pakistan from persecution and are living in camp settlements in a slum. Because they are stateless, they don’t have the same rights to water as Indians living in the slum, says Singh, and have even less access to water. “They’re living in absolute abysmal conditions. They’re vulnerable to different kinds of diseases and health issues. Eventually the virus is going to affect them.”

So far, he’s distributed a 15-day ration of hygiene materials and taught them proper hand-washing. To ensure the families have enough water to wash their hands, he and other groups petitioned the government to bring more water to the part of the slum where the refugees live. Last week, the authorities brought in a tanker of water to provide additional supply for drinking and hand-washing and will do so regularly.

But offering soap and water is no guarantee that people are going to wash their hands. In every country, from high income to low income, there are a lot of folks for whom a thorough scrub is not a regular habit.

“Just instructing people to wash their hands is not going to get them to do it,” says Sidibe, who previously worked at a project at Unilever focused on changing hand-washing behaviors in 55 countries. “People don’t practice hand-washing. It’s inconvenient and they have other priorities. To change behavior, you need to create an enabling environment. You need to establish a positive social norm. And you need to make it a desirable thing to do.”

In Nigeria, where there are only 111 reported coronavirus cases so far, aid groups like UNICEF have been emphasizing the importance of hand-washing in the low-income areas they serve. “We are trying to spread the message through celebrities, community and religious leaders, and reaching out to media and radio stations,” says Zaid Jurji, head of UNICEF’s water, sanitation and hygiene program, based in Abuja.

They’re collaborating with artists to sing about hand-washing, too.

On Sunday, UNICEF posted “We go win (Corona)” to their YouTube channel. It’s an original song from the popular Nigerian musician Cobhams Asuquo.

The lyrics go, “Corona no big pass us … as long as we remember to always do the right thing: wash your hands, love each other, we go win.”

The idea that a song could change behavior may seem naive, but it did work during the Ebola outbreak.

By Malaka Gharib
Published March 30, 2020
https://www.npr.org


World Water Day: Hand hygiene essential to containing spread of COVID-19

Today is World Water Day. It is set aside to celebrate water and raise awareness of the 2.2 billion people living without access to safe water.

It is about taking action to tackle the global water crisis. A core focus of World Water Day is to support the achievement of Sustainable Development Goal 6: water and sanitation for all by 2030.

According to the UN, “The theme for 2020 is “Water and Climate Change” and explores how the two issues are inextricably linked.

“In light of the growing COVID-19 pandemic, the 2020 campaign also promoted messages around handwashing and hygiene and gave guidance on staying safe while supporting the campaign.

“The campaign also shows how our use of water will help reduce floods, droughts, scarcity and pollution, and will help fight climate change itself.

“By adapting to the water effects of climate change, we will protect health and save lives. And, by using water more efficiently, we will reduce greenhouse gases.

“Our key messages for this day are clear:

We cannot afford to wait. Climate policy makers must put water at the heart of action plans.
Water can help fight climate change. There are sustainable, affordable and scalable water and sanitation solutions.

“Everyone has a role to play. In our daily lives, there are surprisingly easy steps we can all take to address climate change.

“Hand hygiene is essential to containing the spread of COVID-19, as well as other infectious diseases. Wash hands with soap and water

Published 24 March 2020: https://www.tvcnews.tv


Slowing down transmission of COVID-1

One of the most important contributions we can make to slowing down transmission of COVID-19 and keeping ourselves and our communities safe is to wash our hands. Global COVID-19 Prevention.

This short animated video from Stanford Medicine illustrates how the novel coronavirus — the virus that causes the respiratory disease COVID-19 — is transmitted among people and how transmission can be prevented.

For more information, please visit https://med.stanford.edu/covid19.html