Washing your hands: University hygiene expert on Coronavirus and cultural shifts

Panic buying is underway, the hand washing posters are up, and we’re on the frontline of the coronavirus battle.

But just what should we be doing to ensure victory? Here, Dr Derek Watson, Professor in Cultural Management at the University of Sunderland, reveals how this is more about winning a cultural mind-shift war.

“Coronaviruses were first discovered in the 1960s and initially cause diseases in birds and mammals.

The name coronavirus originates from the Latin name ‘corona’, meaning crown or halo which refers to its characteristic appearance.

Origins of the infectious bronchitis viruses were found in poultry and two subsequent viruses were traced to human patients’ nasal cavities. Individuals exhibited common cold symptoms.

Medical evidence confirms human-to-human transmission is correlated through close contact via respiratory droplets trigged from unguarded coughing and sneezing. There are currently no vaccines or specific drugs to protect or remedy infections and the symptoms range from a minor common cold to more serious direct viral pneumonia or secondary bacterial pneumonia.

It is important to put coronavirus into context. Each year there are 600 million cases of food contamination, of which 450,000 people die.

The UK Food Standard Agency in 2020 indicated that approximately 2.4 million people fall ill in the UK each year due to food poisoning.

Globally, it is estimated that 42.9 million people fell ill during the 2018-2019 flu season, 647,000 people were hospitalized and 61,200 died. Furthermore, Chris Whitty, one the four UK Governments Chief Medical Officers, indicated that early data suggests that the vast majority who contract the illness will have mild to moderate but self-limiting illness similar to flu.

The UK Parliamentary message is not out of step with other countries, in that the public play a pivotal role in helping to delay the coronavirus peak, thus buying precious time for the NHS to prepare against an influx of high dependency coronavirus cases.

UK citizens are now being actively encouraged to take a leading role. Especially in correctly washing their hands and in the ‘catch it, bin it, kill it’ strategy for those with coughs and sneezes. As it is important to note that 80% of communicable disease are transferred by touch.

Evidence confirms that hand washing with non-antibacterial soap is far more effective in reducing cross contamination than with water alone. However, washing hands thoroughly with warm water can in many cases, significantly dissipate bacteria and viruses.

The debate around alcohol sanitizer as a quick fix can also be effective with those sanitizers that have over 70% of alcohol (mainly ethyl). However, the unease about the coronavirus has resulted in the panic buying of such commodities and due to unprecedented demand, have led to clear internet exploitation in terms of inflated prices.

Heightened hand washing campaigns stress that it is a critical component in infection control. Furthermore, health care personnel are going back to basics concerning infection prevention and amongst other initiatives are focusing on hand hygiene.

However, such a cultural transition may not be readily adopted as WHO data indicates globally that only 40% of doctors and nurses effectively follow hygiene guidelines. Such non-compliance is not restricted to the health sector, as research indicates only 20% of people wash hands before preparing food. Less than 75% of women and below 50% of men wash their hands after going to the bathroom.

It is highly recommended that individuals should wash their hands approximately two minutes regularly throughout the day. Contrary to belief, the temperature is not a critical factor and warm water will suffice. But is important that organisations ensure that the water is not too hot and flows effectively as this may prevent thorough washing and rinsing.

A key process is that of hand drying. However, figures indicate that only 20% of people effectively dry their hands.

Data also supports thorough hand drying eradicates moisture and generates friction which further reduces the threat of cross contamination. Evidence suggests that disposable paper towels are also considered the most hygienic method.

The above process of hand washing can be undermined when the hand-washer manually turns of the tap with their fingers and then to exit, opens the restroom door with their hand. I would therefore recommend the following ‘three-tissue rule’.

  1. Use a disposable tissue to open the restroom door, then dispose
  2. After hand washing, use a disposable tissue to turn off the tap, then dispose
  3. Use a disposable tissue to open the rest room door, and dispose.

Effective hand hygiene also needs to be duplicated at home as well as in the working environment. There is a sense of urgency concerning the coronavirus and hence in the main a willingness from the public to comply with recommended hygiene practices.  Organisations are also encouraged to adopt the following key strategies to further encourage employee hygiene compliance:

  1. Information highlighting the risk of infection, pictorial as well as wording
  2. Organisational wide transactional discussion, particularly during team or tool box talks
  3. Education, training and repeat training
  4. Develop buddy systems to encourage best practice
  5. Monitor hand washing compliance
  6. Reward and recognition

For many employees, the adoption of effective hand washing is a logical move to delay the spread of the virus.

However, the challenge is ensuring that the cultural change becomes second nature. It is not a case of willpower as this is often short lived, you need only look at gym attendance and dieting in term of its sustained effectiveness.

People need to build good habits whilst dismantling poor hygiene habits. They need to be self-reinforcing and to move from conscious action to automatic habituation.

This ultimately takes time to be embed into their subconscious daily routine. Such cultural transformation cannot be done in isolation and requires the support of co-workers, management and the government.”