Complete Guide to Hand Hygiene and COVID-19 [2021]

Complete Guide to Hand Hygiene and COVID-19 [2021]

2020 was a tumultuous year shaped almost entirely by the coronavirus and the still ongoing COVID-19 pandemic. What was largely ignored and laughed off as nothing more than the flu in January and February of this year very quickly changed our entire world. As cases rose and many countries enforced full national coronavirus lockdowns, the outlook was bleak.

COVID-19: A quick history

The current outbreak of what was then the new coronavirus disease, COVID-19, was first reported on December 31, 2019, in Wuhan, China. By early March 2020 more than 90,000 people from 71 countries had been infected. At the time of writing in December, over 68.5 million cases have been reported and 1.56 million have died.

It is not clear what the fatality rate is, and indeed this may not be known until the outbreak is over. However, the World Health Organization (WHO) believes that it’ll be around 2.5 per cent. Other diseases carry a much higher fatality rate, such as Ebola which has a fatality rate of 50 per cent, and tuberculosis which kills 4,100 people every single day worldwide.

So why then has the world gone into a full-on panic mode with national lockdowns and restrictions?

The reason for the panic was that COVID-19 (SARS-CoV-2) is a newly discovered virus that we still know very little about, other than it’s highly infectious and that it’s potentially fatal for certain vulnerable people. As the WHO director-general famously said: we are entering uncharted territory.

One thing that we do know and that has been hammered home more than anything else during the pandemic is the importance of hand hygiene: Regular hand washing, in conjunction with using Hand Sanitizer Dispenser, is the best line of defence against COVID-19 after social distancing—and the science proves it.

Why does hand washing help stop the spread of coronavirus?

Hand washing is a tried and tested, scientifically proven preventative method that reduces the likelihood of spreading both viral and bacterial diseases.

Science has shown that hand washing decreases both respiratory and diarrhoeal diseases in countries across the world. One particular review found that hand washing alone reduced cases of diarrhoea by 30 per cent because it prevented bacteria being transmitted from faeces to the mouth.

More recently, the Massachusetts Institute of Technology (MIT) conducted a study to find out the most effective mitigation strategy for hand hygiene that could contribute most to the reduction of global epidemic risk.

It found that if 60 per cent of travellers moving through airports had clean and safe hands, the spread of global disease could fall by more than 70 per cent. And if this rate could be maintained in only 10 of the busiest airports internationally, an astounding 37 per cent of infections could be prevented.

Why are governments advising us to wash our hands?

Coronaviruses like COVID-19 are respiratory droplet infections that are spread incredibly easy. They are spread through virus-laden droplets from our respiratory tracts through coughs and sneezes.

If you’re unable to catch your coughs and sneezes in tissue and safely dispose of it, the virus can find its way onto surfaces where it can remain for quite a long time depending on the type of surface. If someone else touches that contaminated surface, the virus can transfer onto their hands, and they themself can spread it further to other surfaces.

And it’s not just other people you could infect, either. If you’ve picked up a virus or bacteria from a surface that you’ve touched, you could infect yourself by touching your eyes, mouth, or nose. Although you may not think that you touch our face all that often, you’ll do it subconsciously much more often than you realise. In 2015, a study found that most people touch their faces on average more than 20 times per hour.

How hand washing with soap kills coronavirus

SARS-CoV-2, the COVID-19 coronavirus, is what is known as an ‘enveloped virus’. This means that the virus has a protective outer layer called a ‘lipid bilayer’.

The molecules that make up this layer are sort-of tadpole-shaped, with a hydrophilic (water-loving; attracted to water) round head and a hydrophobic (water-hating) tail.

These molecules arrange themselves into a ‘bilayer’: a scientific term for two layers piled on top of one another into a sheet, with tails pointing inwards and heads pointing outwards. The molecules are pulled closely into one another to protect the hydrophobic tails from the water in your respiratory droplets when you cough or sneeze. Meanwhile, the sticky hydrophilic heads cling onto your hands and other surfaces, perfect for the microbe that’s evolved to infect us.

A lipid bilayer with the round, hydrophilic heads pointing outwards and the hydrophobic tails pointing inwards. Public domain image used with thanks to ‘LadyofHats’/ Mariana Ruiz Villarreal via Wikimedia Commons.

Soap molecules also have this type of tadpole structure, and this is what makes it so effective at cleaning our hands. Because soap molecules are so similar to the molecules making up the exterior of an enveloped virus, the molecules in the lipid bilayer are as strongly attracted to the soap molecules as each other. This disrupts the ordered shell around the virus, dissolving it and killing the now unprotected virus.

How to wash your hands effectively

Despite the science and significant efforts from health organisations and governments, hand washing habits worldwide still leave a lot to be desired. In many cases, they’re woefully inadequate.

Will washing my hands stop me from getting coronavirus?

Unfortunately, nothing can be guaranteed. It’s impossible to know whether any particular case of coronavirus could have been avoided by better hand washing.

While it is possible to get coronavirus by touching your face with contaminated hands, you can also contract it directly from the coughs or sneezes of another person you are near to. This is why social distancing has been enforced worldwide: infected droplets are unlikely to travel 2 metres, meaning that they’re less likely to enter your own respiratory tract and infect you.

So, while washing your hands does not mean that you’re 100 per cent safe, it is a sensible and powerful mitigation measure. It, when used in conjunction with the observation of other control measures such as social distancing, goes a long way in preventing the virus’ spread.

How to wash your hands properly

The U.S. Centers for Disease Control and Prevention (CDC) recommends the following simple approach, broken down into five parts:

1. Wet your hands;

2. Lather up with soap (any kind: bar or gel);

3. Rub your hands together for at least 20 seconds);

4. Rise; and

5. Dry off with a clean towel, disposable paper towels, or a hand dryer.

This is pretty much similar to advice given by the WHO on hand washing:

A guide to hand washing from the World Health Organization. Image used with thanks to the WHO.

You should wash your hands whenever they are visibly dirty or soiled. You should also do it before you eat and if you’ve been in an area likely to have contaminated surfaces, such as in a hospital, bathroom, or public transport. According to the CDC, you should wash your hands:

  • Before, during, and after food prep.
  • Before eating.
  • Before and after tending to someone who’s sick.
  • Before and after treating a cut or other wound.
  • After going to the bathroom.
  • After changing diapers or helping a child in the bathroom.
  • After blowing your nose, coughing, or sneezing.
  • After touching an animal, or touching pet food or pet waste.
  • After handling pet food or pet treats.
  • After touching garbage.

The WHO also recommends:

  • Regular use of a protective hand cream or lotion applied twice daily.
  • Not to wash immediately before or after using alcohol hand sanitisers.
  • Not to use hot water to rinse your hands.
  • Letting hands dry completely before putting on gloves.
  • Not wearing artificial nails or extenders where possible.
  • Keeping fingernails at a natural, short length.

What about hand sanitisers? Do they work?

If you’re not able to wash your hands, the next best alternative is hand sanitiser dispenser. Sanitiser Dispenser is far more accessible and convenient than having to visit a sink each time you want to clean your hands, and it yields virtually the same results as hand washing so far as coronaviruses are concerned (hand sanitisers aren’t effective against all viruses, i.e., norovirus, but they do kill coronaviruses like COVID-19).

What is hand sanitiser?

As you’ll most likely be well aware by now, hand sanitiser is a liquid or gel that’s used on the hands to kill germs and bacteria. Although there are lots of different hand sanitisers and brands, they all do the same thing and have the same or very similar active ingredients.

mage credit: Kelly Sikkema via Unsplash

The main difference between hand sanitisers is whether or not they contain alcohol or are alcohol-free. Some hand sanitisers may also come with extra ingredients such as fragrances or skin softeners. No matter what the brand, the bones of an alcohol-based or alcohol-free hand sanitiser will remain the same.

Alcohol vs alcohol-free hand sanitiser

Alcohol-based hand sanitisers will contain an active ingredient such as alcohol or isopropanol. Alcohols are super effective antiseptics that kill many of the pathogens, germs, and bacteria that end up on our hands. Including, as we just mentioned, coronavirus. Strong alcohol hand sanitisers are widely used in clinical settings because they work.

The U.S. Food and Drug Administration (FDA) recommends that an alcohol hand sanitiser should contain between 60 per cent and 95 per cent alcohol in order to be effective. As you may expect, hand sanitisers at the higher end of the alcohol concentration spectrum are mostly found in hospitals and clinics.

On the other hand, alcohol-free hand sanitisers, which typically come in the form of a foam rather than a liquid or gel, contain a different active ingredient, usually the quaternary ammonium Benzalkonium Chloride. This is an organic salt used in cleaning agents that can be used as both an antiseptic and preservative.

Alcohol-free hand sanitisers still provide the same level of protection against coronavirus as alcohol-based hand sanitiser. Unlike alcohol-based sanitisers, alcohol-free ones aren’t as harsh on the skin and are entirely non-toxic. They’re provided as an alternative for people who cannot use alcohol-based sanitisers due to things like religious observations, sensitive skin, or child considerations.

How do hand sanitisers work?

In both alcohol-based and alcohol-free hand sanitisers, it’s the active ingredient that does all the work to kill bacteria and viruses on your hands.

Alcohols kill germs by attacking their protective outer bilayers and dissolve their membranes. This stops the virus from reproducing and functioning, effectively killing them. In alcohol-free hand sanitisers, the active ingredient works in the same way.

How do you use hand sanitiser?

Hand sanitisers by design are extremely easy to use. If you’re going to use them, however, it makes sense to ensure you’re doing it right.

The WHO has produced their own guidance on how to effectively use hand sanitiser, or ‘handrub’:

A guide to using hand sanitiser from the World Health Organization. Image used with thanks to the WHO.

As you can see from the graphic, you need to use enough sanitiser so that all parts of your hand can be adequately covered in the gel, liquid, or foam. At the same time, try not to use so much that your hands are literally dripping.

Once the sanitiser is on your hands, thoroughly rub it in so that there’s no residue left at all. Don’t stop rubbing your hands together until all the sanitiser has evaporated and your hands have dried completely. Depending on the sanitiser you’re using and its alcohol content, this can take anywhere from a few seconds to a minute or so.

When to use hand sanitiser

As we’ve already covered, the most effective way to keep your hands clean is to wash them with soap and water. Only when this isn’t a feasible option should you use a hand sanitiser. If your hands are visibly dirty, always wash them with soap and water, even if it means going out of your way to do so.

Consider using hand sanitiser when:

  • You can’t use soap and water to wash your hands.
  • You want extra protection after you’ve washed your hands.

You should avoid using hand sanitiser when:

  • It’s possible to wash with soap and water.
  • Your hands are visibly dirty.
  • You have chemicals on your hands.
  • You’re in a high infection situation or environment.

Why does it matter? Is it really all that important to stop the spread of coronavirus?

While it’s true that coronavirus isn’t a particularly dangerous illness for most people, it’s still important that we get it under control and stop its spread.

Most of us will only get a very mild set of symptoms after contracting the virus, symptoms that are very similar to a mild flu. And we’ll recover just fine. In fact, some of us may show no symptoms at all and may have no idea that we’ve had the virus. That’s not important, though. The problem is that while we’re infected, we’re passing it onto other people who are vulnerable and could suffer more from the virus, with potentially dire consequences.

As you’re probably well aware by this late stage, slowing down the spread of the virus helps us to ‘flatten the curve’. Meaning, the number of cases will rise to a peak and drop off again.

We’ve seen this in action with the UK where the initial number of cases sharply rose, flattened off, and then fell with the introduction of initial lockdown restrictions, only for them to rise again when restrictions were eased in July. This led to the tiered approach to restrictions and a second national lockdown.

So in the interest of protecting ourselves and others, and getting our lives back to something resembling normality, it’s a good idea for us all to do more to keep our hands clean.


  1. […] However, we shouldn’t get complacent; it’s still as important as it ever has been to keep our hands clean, wear our masks, and keep our […]

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