Keeping our hands clean is one of the most important habits we can adopt to prevent contracting Covid-19 and spreading the coronavirus that causes the disease to others. Without washing properly and killing off the coronavirus — and other viruses, bacteria and germs we pick up from raw meats, fecal matter and respiratory droplets — it can spread between people and cause disease.
"The COVID-19 pandemic provides an important reminder that handwashing with soap and water is one of the simplest, most effective ways to stop the spread of germs and stay healthy," said Vincent Hill, chief of the Waterborne Disease Prevention Branch of the US Centers for Disease Control and Prevention, via email. "Many germs that can make people sick are spread when we don't wash our hands with soap and clean, running water.
"Handwashing with soap and water can prevent 1 in 3 people from getting sick with diarrhea and 1 in 5 people from getting a respiratory illness. That is why handwashing is so important, especially at key times such as after using the bathroom, when preparing food, before eating, and after coughing, sneezing, or blowing your nose."
Of course, people are more focused on handwashing during the pandemic. A July poll found that 88% of Americans said they were washing their hands more frequently. Despite the risks of catching or spreading disease, handwashing is performed only by 51% after events of potential fecal contact — and that's in regions with high access to handwashing facilities.
"Hand Hygiene for All" is the theme of this year's Global Handwashing Day, following a recent World Health Organization initiative calling for improved hand hygiene. Global Handwashing Day is an annual global advocacy day established by the Global Handwashing Partnership to advocate for handwashing with soap as an easy, effective and frugal way to prevent diseases and save lives.
Here's why some people don't wash their hands, why others are unable to and how to increase motivation to hand-wash more often.
Why some people don't wash their hands
The factors that influence handwashing behaviors are likely to be optimistic bias — thinking disease can't happen to them — or underestimating the severity of the risk, said Barbara Mullan, a professor and director of the Health Psychology & Behavioural Medicine Research Group at Curtin University in Australia.
"Some argue that we humans are prone to physiological disgust reactions, that is when really horrible looking grime and filth are observed we are motivated to remove ourselves from the disgusting situation or remove the disgusting agent," said Thomas Berry, an associate professor in the department of psychology at Christopher Newport University in Virginia, via email.
"But as to Covid-19, this virus is mercurial; much of the confusion and debate is directly related to its invisibility. We all know that Covid-19 is out there somewhere, but exactly where and with whom is the big question."
Feeling that the benefits aren't worth the effort and men thinking that such small germs couldn't possibly harm them are other deterrents, Mullan added.
Being in a rush with work responsibilities can make us forgetful, Berry said. And the handwashing cues that serve as reminders — like signs and social cues since we care what others think — are not always present while we're physically distancing. However, handwashing is a privilege that billions of people wouldn't take for granted.
The repercussions of these disparities have been disastrous and far-reaching. Annually, around 289,000 children under 5 die from diarrheal diseases partly caused by the inability to wash their hands with soap.
"Because of gender divisions of labor in many countries around the world, the burden of water collection often falls to women and girls, who spend more time collecting water and less time doing more productive activities, including education," Hill said. "And inadequate access to sanitation and hygiene resources in schools can be a barrier to education for girls who are menstruating."
Protecting your hands during the pandemic and winter
Constantly washing our hands with soap and rubbing in hand sanitizer can make our hands feel like sandpaper. For this reason, some people have opted out of handwashing or doing so as often as they should. And the dryness is a concern for some as we approach winter — when low humidity, indoor heating and snuggling up to a fireplace can zap moisture from our skin.
After washing your hands, pat them dry with a clean towel but leave them slightly damp "to lock in the moisture" from ointments and creams that you'll work into your skin, fingertips and nails, said Dr. Paul M. Friedman, director of the Dermatology & Laser Surgery Center in Houston and practitioner at the Laser & Skin Surgery Center of New York.
Moisturizers containing mineral oil or petrolatum are recommended since they are "key lubricating ingredients exceptional for hydrating dry skin," Friedman said. Ointments and creams in tubes are better than bottles since tubes minimize air exposure and are thus more effective, he added. Products that are free of fragrance and dye are less irritating for the skin. And if you wear lotion, be sure to apply ointments and creams over the lotion since lotions are least moisturizing.
Alcohol, the primary ingredient in hand sanitizer, is "one of the most common irritating ingredients to the skin," Friedman said. "Dry cracked skin impairs the skin's protective barrier (and) makes it easier for bacteria and other germs to get inside the body. Applying moisturizer after handwashing helps heal dry skin," strengthening the skin barrier.
After using hand sanitizer, the same steps apply. If you're using a topical medication for a skin condition, Friedman added, apply products with the same key ingredients over your medication. For an extra moisture boost, apply petrolatum jelly before bed, wear white cotton gloves at night to keep cream on and use a humidifier since heating contributes to dry skin.
Tips for washing your hands more often
Increasing "motivation to hand wash in the face of stress and busyness is a difficult challenge," Berry said. Since we don't have the signage and social cues we usually do in public, a few strategies could help grow motivation and "go a long way to remind us of our motivations to be more hygienic."
Tape to your entrance hall and bathroom wall or mirror pieces of paper that say, "Don't forget to wash hands."
Further internalize the habit and motivation by creating a routine and considering yourself a role model for others.
By thinking of oneself as a role model, "we engage the activity differently; we consciously begin to identify that hand washing is an important" personal and social value to be shared with others, Berry said. "You begin to see yourself as an active participant in the solution, making the world better, and it feels good to do something positive too."