How to Wash your Hands during COVID 

By  Dr. Mike Hansen

Handwashing with soap and water is the single best way to avoid getting sick, and it’s also the easiest way. It not only mechanically removes many germs, but it also chemically kills a lot of germs by busting that germ open, breaking it apart. This includes busting to open the virus that causes COVID, SARS-CoV-2. But it also does it for most other viruses and bacteria.

Many people skip washing their hands because they think it’s not that important and doesn’t want to take the time to do it. I can’t tell you many times I’ve seen guys in the men’s bathroom skip washing their hands after using the urinal or toilet.

How to Wash your Hands during COVID

If I had to guess, I would say only 20% of guys in the men’s bathroom wash their hands afterward.

And for those of you who do wash your hands, most people don’t do it correctly.

A study was done in 2013…

Hand Wash Study Report Paper Cutting

…had trained observers discreetly watch more than 3,700 people wash their hands, and what that study showed was that, on average, most people wash their hands for about 6 seconds.

25% of people did the “splash and dash,” meaning they just wet their hands without soap.

Only 5% spent more than 15 seconds washing, rubbing, and rinsing their hands.

Only5% of them washed their hands correctly.

Also, a 2017 study comparing liquid and foam soaps from the same brand found that washing with foam soap was less effective than liquid soap, probably because you can rinse it off faster with the foam.

So if you get to choose which soap to go with, go for the liquid.

If there’s no soap available, just rubbing your hands together under the water is better than nothing. A 2011 study from researchers at the London School of Tropical Hygiene found that washing with water alone reduced bacteria on hands to about one-quarter of their pre-wash state.

There are some commonly missed areas when people wash their hands. We know this based on some studies done when researchers smother people’s hands with Glo Germ — a product that glows under a black light. By using Glo Germ before washing, researchers could see the areas people tended to miss.

The most common areas are the lower palm, fingernails, and nail bed area.

And so, the correct way to wash your hands:

  1. Turn water on
  2. Rinse hands
  3. Apply soap
  4. Lather vigorously for at least 20 seconds
  5. Clean all parts of hands (back of hands, fingers, fingertips, fingernails, thumbs,&wrists
  6. Rinse
  7. Dry with paper towel. If not available, dryer.
  8. Use paper towel to turn off faucet (unless its one of those automatic faucets)
  9. And if there’s no paper towels, and its not one of the faucets that turn off immediately, leave the running water. I’m kidding, use your feet.

And when it comes to drying your hands, paper towels have a beneficial effect because dry hands are also less likely to spread contamination than wet hands.

Also, don’t scrub because scrubbing can damage your skin, especially if you do it often, and the resulting cracks and minor cuts give viruses and bacteria a place to grow. That’s also why you should keep your fingernails short, because Bacteria like to live in that area underneath your fingernails, and Long nails make it harder to keep those areas clean.

Also, use hand lotion, especially during the winter. Keeping the skin on your hands intact (free of cracks) is essential to good hand hygiene.

Don’t be in such a hurry. Hand washing should last at least 20 seconds, but this should be the minimum time. Singing happy birthday equates to about 20 seconds, but sing your favorite song for 20 seconds.

And that 20 seconds does not include the time you take to dry your hands. It takes about one minute to wash and dry your hands from start to finish properly.

You should also wash your hands if they are visibly dirty.

But as long as your hands are not visibly dirty, hand sanitizer is an excellent alternative to washing your hands if you can’t get to a sink.

But, if you can’t wash your hands, you should use hand sanitizer.

Most viruses, including covid and influenza viruses, have lipid membranes killed by alcohol-based hand sanitizer. This applies to most bacteria as well.

Just make sure it’s at least 62% alcohol.

Make sure to use enough hand sanitizer so that it covers all the surfaces on your hands. Rub that on until your hands feel dry, which should take about 20 seconds.

To be effective, alcohol-based rubs need to come into contact with all surfaces of your hands—back, front, in between the fingers, and so forth. For that reason, as studies have shown, using small amounts—0.2 to 0.5 milliliters, about the amount in one squirt—is no better than washing with plain soap and water. So use several squirts when you use alcohol-based hand sanitizers.

In all but most studies, alcohol-based cleaners reduced bacterial counts on hands better than plain soap. But alcohol doesn’t kill everything. For example, it does not kill some bacterial spores, like that of the bacterium clostridium difficile or C diff for short. It doesn’t kill the norovirus, the virus often found in outbreaks on cruise ships. It does kill influenza, as well as covid, though.

Then there’s the question, how often should you wash your hands or use hand sanitizer?

There’s no specific number of times you need to wash your hands; it depends on your activities.

According to the CDC, you should do it.

  • Before, during, and after preparing food, and before eating
  • Before and after tending to someone who’s sick
  • After using the bathroom
  • After blowing your nose, coughing, or sneezing
  • After touching garbage
  • After touching an animal, or touching pet food or pet waste

But you should also wash them after shaking someone’s hand or touching any commonly touched surfaces, like cell phones, money, and doorknobs. It might be practical to wash your hands in these scenarios. Still, it’s essential to always have clean hands before touching your face because that’s the most common way viruses and bacteria go from surfaces to inside your body.

And we knew this before COVID became a thing.

But most people brush off the importance of hand hygiene.

Rinsing your hands with water by itself does a pretty decent job of mechanically removing germs from your hands. Still, soap increases the overall effectiveness by pulling unwanted material off your skin and into the water.

And drying your hands is an essential step in the hand-washing process, because generally speaking, wet hands are more likely to spread germs than dry hands.

Besides handwashing, there are some other things you can do to avoid getting—and spreading—cold and flu germs:

Keep your hands away from your eyes, nose, and mouth because that’s how the germs get in your body.

When you’re sick, keep your distance from others to protect them from becoming infected.

Cover your mouth and nose with a tissue when you cough or sneeze, and throw away the tissue right away. If you don’t have a tissue handy, sneeze or cough into your elbow, not your hands.

Doctor Mike Hansen, MD
Internal Medicine | Pulmonary Disease | Critical Care Medicine

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