Earlier this Spring, hand sanitizers disappeared from shelves due to COVID-19. Companies were unable to keep up with the sudden demand for the product. Health Canada expedited production processes to keep up with the surge in demand.1 The FDA in the United States has made similar efforts to make these products available faster.2 What role do hand sanitizers play in combating COVID-19, and how exactly do hand sanitizers help?
It’s All About Hygiene
People travel faster and more frequently, and therefore communicable diseases can spread quickly and widely. A local outbreak has the potential to become a global pandemic in today’s world.3 COVID-19 is a disease caused by a novel coronavirus, and one of the most important ways to combat it is hygiene. Good hygiene plays a critical role in slowing down the rate of infections.
COVID-19 spreads primarily through the respiratory droplets that come out of our noses and mouths when we breathe, talk, laugh, cough, and sneeze. The other route is by touching one’s mouth, nose, or eyes with hands that have touched a contaminated surface. Since the hands come into contact with many surfaces throughout the day, they can contact all sorts of bacteria and viruses. Hand hygiene, therefore, is critical in fighting not only COVID-19 but many other infections as well. One peculiar finding with COVID-19 is that men are being hit harder than women. Their symptoms are more severe, and their outcomes are worse.4 Numerous factors are likely contributing to this, but one crucial factor in this gender gap may have to do with differences in hygiene standards. Men have consistently been shown to hand-wash less after handling food, petting animals, using the washroom, handling money, and other activities that may contaminate the hands.5 They are also less likely to wear masks and more likely to engage in risky behaviour.
Better hygiene habits will lead to less infection, slower spread, and better outcomes. Hand sanitizers are one way to help with this fight. Along with hand-washing, the use of hand sanitizers and disinfecting hard surfaces will help reduce infection.
Hand-Washing, Hand Sanitizers, Disinfectants, and Masks
Hand-washing is the first line of defence and the most critical step to protect yourself. Regularly and thoroughly wash your hands with soap (20 seconds is recommended) after using the washroom, going outside, or coming into contact with surfaces.
Soap and Water vs. Hand Sanitizers
Hand sanitizers have limitations. Soap and water is more effective at killing germs.6 If the hands are dirty or greasy from eating food, for example, hand sanitizers will be much less effective as they won’t cut through the grime.
Role of Hand Sanitizers
What role do hand sanitizers play? Like sunscreens, hand sanitizers aren’t the most effective intervention in isolation, but they are often the most pragmatic. The advantage of hand sanitizers is that they are portable and practical.
- Time Efficiency
Hand sanitizers are often seen in public spaces and are especially useful at grocery stores where traffic is high. Unlike kitchen sinks, a large number of customers can access the hand sanitizer while maintaining distance. It only takes a few seconds to apply hand sanitizer and is usually located at the entrance or exit where people pass through. Hand sanitizers are also portable in small bottles, making them ideal for outdoor use. Just as sunscreens should not replace sun avoidance (staying in the shade, remaining indoors), sanitizers should not replace hand-washing.
The entire family of Coronavirus is vulnerable to simple disinfectants.7 Reducing the number of microorganisms by wiping down commonly touched surfaces such as doorknobs, phones, and desks can reduce the transmission of COVID-19. While COVID-19 is at the top of the news cycle, it isn’t the only villain in town. Good hygiene protects you and others from exposure to the common cold, the seasonal flu, and many other threats.
Masks play a similar complementary role in slowing down spread. Non-medical grade masks only provide marginal protection from coronavirus, but the evidence suggests that they are effective in preventing spread.8
Consistent hygiene habits like these work in tandem. Individually, they only confer limited protection, but considering how many interactions we have with others who may be unknowing carriers, small risks add up. When a population becomes more aware of the importance of hygiene, you multiply its protective effects.
How do Hand Sanitizers Work?
There are two types of hand sanitizers: Alcohol-based, and alcohol-free. Health Canada has a working list of authorized hand sanitizers and disinfectants. Both are effective at reducing the number of microorganisms and reducing infection.
The majority of hand sanitizers are alcohol-based. For alcohol-based sanitizers, the CDC recommends a concentration of 60% or higher.9 Alcohol in high concentrations (60% and higher), effectively kills most bacteria and other microorganisms. They work by breaking apart cell protein and cell metabolism of disease-causing pathogens.10 When you apply hand sanitizers, wait for it to dry and don’t touch other objects in the meantime.
Examples of alcohol-based hand sanitizer that is authorized by Health Canada: Alcare, Antiseptic Biohand Cleaner, Isagel
Examples of alcohol-free hand sanitizer that is authorized by Health Canada: DermSafe, Dustbane, Softside
Should I get an alcohol-based sanitizer or an alcohol-free one?
Both types are effective and will serve its purpose. For maximum efficacy, most organizations like the CDC recommend alcohol-based sanitizers.11 Each type has its strengths and weaknesses, however. Alcohol-based sanitizers can cause alcohol poisoning if ingested, so small children need to be watched. For some people, alcohol may be drying to the skin. On the other hand, alcohol-based sanitizers tend to dry off faster and are less sticky, which is often an upside.
Lastly, hand sanitizers are widely available in Canada. Hand sanitizers are not the type of products that you want to make at home. Health Canada’s warning is clear and straightforward:
“Health Canada does not recommend making your own hand sanitizer, no matter what the recipe is. Even a reputable formula, such as the one recommended by the World Health Organization, it is not appropriate to make the product at home. That recipe is intended for use by licensed producers, which manufacture it in a controlled environment so the final concentration of ingredients is accurate.“
Health Canada has a list of approved hand sanitizers and disinfectants here.
3 https://www.who.int/emergencies/diseases/managing-epidemics-interactive.pdf (page 25)