Hand Washing to Slow Epidemics

A new study has estimated that improving rates of hand washing by travelers going through only ten of the world’s leading airports could significantly reduce the spread of a good number of infectious diseases. Additionally, the greater the improvement in how people wash their hands in airports, the even more dramatic effect on slowing down the spread of disease.

The findings which deal with a variety of infectious diseases in general including influenza were published right before the current outbreak of the coronavirus in Wuhan, China. The authors say the results would apply to any such disease and also relevant to the current disease.

To prevent the spread of viral infections, doctors recommend practicing good hand hygiene. And the recent research indicates that hand washing is helpful in the context of an epidemic. When it comes to the prevention of viral infections and especially those that spread through droplets from sneezes and coughs, proper hand washing is always the first line of defense.

A lot of people can be very casual about washing their hands even in crowded areas such as airports where people from many different locations are touching a variety of surfaces such as check in kiosks, chair armrests, restroom doorknobs and faucets, and checkpoint trays. The team used data from previous research by groups including the American Society of Microbiology (ASM) and found that on average only about 20% of people in airports have clean hands. This means that they have been washed with both soap and water for at least 15 seconds and within the last hour or so. The other 80% of people are potentially contaminating everything they come in contact with whatever germs they may be carrying.

70% of people who use the toilet do wash their hands afterwards based on findings from a previous ASM study. The other 30% do not and of those that do only 50% actually do it correctly. Many people just rinse their hands briefly with water rather than using soap and water and do not spend the 15 to 20 seconds recommended for proper hand washing. This figure combined with estimates of exposure to many potentially contaminated surfaces that people will come in contact with in airports, leads to the research teams estimate that only about 20% of travelers in airports actually have clean hands.

By improving hand washing at all the world’s airports by triple that rate so that 60% of travelers have clean hands at any given time, would have the greatest impact which could potentially slow down the spread of global disease by almost 70%. Reaching such a high level of compliance may be impractical, however the study suggests that a significant reduction in the spread of infectious disease could still be achieved by picking just 10 of the most significant airports based on the initial location of a viral outbreak. By focusing hand washing messaging in these 10 airports could potentially slow the spread of disease by as much as 37%.

The team arrive at their estimates by using detailed epidemiological simulations which involved data on worldwide flights including distance, duration, and interconnections, estimate of wait times, and studies on typical rates of interactions between people with a variety of elements in their surroundings and with other people.

Even just small improvements in hand hygiene could make a noticeable dent. By increasing the prevalence of clean hands in all airports throughout the world by just 10%, the team believes this could slow down the global rate of the spread of disease by about 24%.

Eliciting an increase in good hand hygiene is certainly a challenge, however new approaches in awareness, education, and socially media nudges have proven to be effective in engaging better and more frequent hand washing practices.

The findings are consistent with recommendations that have been made by both the World Health Organization and the U. S. Centers for Disease Control. Both organizations have indicated that proper hand hygiene is the most cost effective and most efficient way to control the spread of infectious diseases. There are other useful roles in limiting the spread of disease such as airport closures, surgical face masks and travel restrictions, hand washing is still considered the first line of defense and an easy one for people to implement.

To view the original scientific study click below

Hand-Hygiene Mitigation Strategies Against Global Disease Spreading through the Air Transportation Network.