Handwashing in the time of coronavirus

Keith Hayward

‘Frequent and proper hand hygiene is one of the most important measures that can be used to prevent infection with the Covid-19 virus.’ So said the World Health Organization (WHO) in its mid-March interim guidance on the coronavirus pandemic.

WHO issued the document to provide a summary of the current understanding and thinking around Covid-19 in relation to water, sanitation, hygiene, and waste management, especially in the context of health care settings and of homes and communities.

Broadly, its message was that this understanding and thinking remains consistent with the position pre-Covid-19. That drew on our understanding of viruses generally, of the more specific case of viruses with a structure that includes an external envelope, and of coronaviruses in particular. The latter includes the strain responsible for SARS.

Specific points in the guidance included that the Covid-19 virus had not been detected in drinking water supplies – and, based on current evidence, the risk to water supplies is low. Also, it said there was no evidence so far that the virus has been transmitted via sewerage systems, with or without wastewater treatment.

There are though gaps in our knowledge. This is particularly so regarding the presence of the virus in wastewater. The race is under way to clarify these gaps for the new disease, and to progress the science to fill them and update advice, including the advice on the safety of sector workers.

Clearly, hand hygiene is just part of a wider public health response, not least given the primary concern of respiratory transmission through coughing and sneezing, and the consequent value of social distancing.

What is extraordinary is the scale on which the basic public health message about hand hygiene is being deployed. Iterations of the WHO words are being circulated and promoted at every level, from governments and health bodies, to media outlets, businesses, schools and small community organisations. Probably more so than at any other time in history, the global population is tuned in to the importance of hand hygiene, with the 20-second rule for handwashing at the heart of this.

It should be a short step from here to appreciating the fundamental importance of access to clean water and sanitation.  Workers in the sector rarely receive public mention as being among the essential workers needed to keep communities functioning.

It should be another very short step to appreciate the health prospects of those without ready access to clean water and sanitation.

With even the most advanced health systems struggling, the coronavirus pandemic is the latest reminder of the importance of the need to secure water supply and sanitation for all.


“Probably more so than at any other time in history, the global population is tuned in to the importance of hand hygiene”