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The truth about hand sanitizer | COMMENTARY

WASH YOUR HANDS | Cleanliness and proper hygiene is always an element of etiquette, and that’s more important now than ever. The CDC recommends properly washing your hands with warm soap and water for 20 seconds. If that option is unavailable, use hand sanitizer.
WASH YOUR HANDS | Cleanliness and proper hygiene is always an element of etiquette, and that’s more important now than ever. The CDC recommends properly washing your hands with warm soap and water for 20 seconds. If that option is unavailable, use hand sanitizer. (LightField Studios/Shutterstock)

COVID-19 has caused the world to think twice about how often and thoroughly we clean our homes and wash our hands, but has the pandemic made us think twice about what cleaning products and sanitizers we use?

Since the start of the pandemic, many of us have stocked up on products claiming they “KILLS 99.9% OF GERMS.” We find them on shelves in every corner in large part because many public health professionals advise the use of hand sanitizers to maintain personal sanitation.

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And they’re right, but it’s complicated.

Hand hygiene is a critical component to curbing the COVID-19 pandemic, but the role of hand sanitizer versus hand washing is often misunderstood. The detail that isn’t being stressed enough is that hand sanitizer should be used only when access to soap and water is unavailable.

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According to the Centers for Disease Control, hand sanitizer can “quickly reduce the number of germs on your hands but does not remove all germs.” When we battle microbes with antimicrobial products, we leave the strongest 0.1% behind. Research shows that hand sanitizer is ineffective against several important disease-causing germs. Furthermore, the American Contact Dermatitis Society reports an expected “increase in irritant contact and allergy contact dermatitis as a result of increased hand sanitizer use during the COVID-19 pandemic.” These irritants cause additional discomfort and expensive medical visits.

So, what is the solution? Wash off COVID-19 with plain soap and hot water, and only use hand-sanitizer when soap and water are not available. (Of note, the major exception to the hand-washing-only strategy is inside health care facilities, where the prevalence of infectious germs and immunosuppressed patients is higher.)

Here’s a fact: The world is not and will never be sterile. The human body is composed of more microbes than human cells. Viruses are the most abundant organism on the face of the Earth. Therefore, as much as humans love to think we run the world, we are simply outnumbered. This is OK; most microbes are beneficial to human digestion and immune system function, in addition to many other indirect benefits (fermentation, ecological function, etc.).

Rather than pointlessly eliminating all microbes, we should encourage a healthy balance with the microbes living among us. Like humans, microbes need space and nutrients to live. Humans compete in the housing market and for food security; microbes compete for space and nutrients on our hands and in our bodies. It is more effective to clean our homes and wash our hands with products that simply remove germs from our hands and wash them down the drain, rather than kill 99.9% of microbes with hand sanitizer and antimicrobial cleaning products, leaving the meanest germs behind.

In order to avoid another public health crisis, higher medical bills, more antibiotics and increased doctor visits, we need to decrease the amount of antimicrobial cleaning products we use in our homes, in our workplaces and on our bodies. Choose natural products that are gentler on our skin and to our microbe neighbors. Natural disinfectants often have a vinegar base and include non-toxic, biodegradable ingredients. Wash your hands with plain soap and warm water for 20 seconds with friction, which helps dissolve the adhesive that helps germs stick to skin. Save hand sanitizer for times when you’re in a pinch.

Emma Eisemann is a graduate student at the Johns Hopkins University Bloomberg School of Public Health. She can be reached at eeisema2@jh.edu.

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