Analysis: very few of us wash our hands adequately, which is why preventable infectious diseases are easily transmitted

Hand-washing is one of the most important factors in preventing the spread of coronavirus and other diseases. The coronavirus outbreak, which originated in Wuhan in China, has now spread to more than 40 countries, and infected more than 80,000 people worldwide. It has also caused a number of deaths, mainly amongst those living and working at the centre of the outbreak, but also amongst the most vulnerable people in society such as elderly people, young children and those with weak immune systems.

This impending pandemic has increased people's fear over travel and coming into contact with anyone who may be infected. Dr Tedros Adhanom Ghebreyesus, Head of the World Health Organization has stated that the fight against coronavirus is now at a "decisive point", urging countries to take action to help stop the further spread of the deadly virus.

At an individual level, people have rushed out to buy facemasks, bleach and hand sanitiser in an effort to stop themselves from catching the virus. While these items help in preventing catching and spreading the disease, it is vitally important that the current public health messages of "catch it, bin it, kill it" and "wash your hands" are prioritised.

From RTÉ Radio 1's This Week, Dr Padraig McGarry, President of the Irish Medical Organisation, Dr Kim Roberts, Professor of Microbiology at Trinity College and Dr Margaret Ann Harris from the World Health Organization discuss the spread of coronavirus

Experts agree that hand-washing is the most effective method in preventing the spread of infectious diseases such as coronavirus. But while the current message of hand-washing is being encouraged by various public health bodies, there is little information on how people should be washing their hands in response to this disease outbreak.

Over the past five years, I have researched the general public's hand-washing habits and found them to be wholly inadequate. I specifically looked at people's hand-washing habits when using public toilets and found two main issues. Firstly, there is a proportion of the general public who do not wash or dry their hands at all after using the toilet. Secondly, most people who do wash their hands fail to do so adequately.

This hand-washing behaviour was categorised into four areas; adequate hand-washing, basic hand-washing, poor hand-washing and non-hand-washing. The adequate method for hand-washing was defined based upon previous research and relevant World Health Organisation guidance. It includes applying water and soap to the hands, and then spending at least 20 seconds or more scrubbing hands thoroughly while making sure to cover all surfaces and crevices to remove any germs. This is followed by rinsing off any excess soapy water and then drying the hands thoroughly using either a hand dryer, paper towel or cloth towel.

From RTÉ News, are you washing your hands properly?

Basic hand-washing refers to washing hands using water and soap, and then drying afterwards using either a hand dryer, paper towel or cloth towel, but not spending the correct length of time doing so. Poor hand-washing refers to either washing hands with only water, or not drying hands using an appropriate drying method (for example using clothes or toilet paper), or both. Finally, non-hand-washing refers to not washing and drying hands at all.

Using these categories of hand-washing, I was able to determine the general public’s hand-washing habits by observing two sets of public toilets using thermal-imaging cameras for 60 days. Out of 1,149 members of the general public who were observed, just 91 (less than 8%) washed their hands adequately. Around 607 (nearly 53%) practiced basic hand hygiene, 189 (17%) washed their hands poorly and about 262 (22%) did not wash their hands at all after using the public toilet.

The reasons why most people do not wash their hands properly are complex. There is research that suggests that our hand-washing habits are mostly inherent in nature, as in it develops as a habitual behaviour at an early age and becomes ingrained. This means that many people can go throughout life completely unaware that they may be practicing hand-washing inadequately because they do not know any different and no one has ever corrected them.

"The reasons why most people do not wash their hands properly are complex"

Inadequate hand-washing habits may also occur because most people are unaware that most infectious diseases like the coronavirus are primally spread via hands and therefore they do not link hand-washing as being important in preventing it. The fact that very few members of the general public currently wash their hands adequately is a significant factor in why many preventable, infectious diseases like coronavirus have been easily transmitted from person-to-person and subsequently spread to a number of countries. 

Therefore, the current message of "wash your hands" needs to be reinforced by a message of "here's how you should wash your hands". It is vital that the general public are equipped with the correct knowledge to wash their hands adequately. If everyone was to do this, the ability of diseases like coronavirus to spread so easily would be minimised to a greater extent than at present and this would ultimately save lives. 

The views expressed here are those of the author and do not represent or reflect the views of RTÉ