Hands, face, space – ‘hygiene theatre’ or sensible safety measures?

“Out damned spot!” Thanks to Covid-19, we’ve had more than a year now of compulsive sanitisation – gels, hand washing to the national anthem, masks, Perspex screens and deep cleaned surfaces. 

Nobody in their right mind wants to catch the virus. When the pandemic began, it was reasonable to take all of what seemed to be sensible precautions – even if the UK authorities bafflingly and wrongly insisted that masks wouldn’t be much good. It was reassuring to feel that we were doing what we could to protect to protect ourselves.

We know the virus much better now. It’s probably worth reassessing what works to stop its spread and what amounts to “hygiene theatre”, as some sceptics term it. Most people yearn to return to pre-pandemic normality, but there may also be some potential long-term behavioural changes that will protect us from Covid and other threats to our health. 

Fomites should be top of the list for reconsideration. Fomites are contaminated surfaces that, when touched, were thought likely to infect many people with Covid. This fear prompted the deep cleaning regimes in offices and shops, while many people at home quarantined their groceries for at least two days as well as wiping them down.  

The US Centers for Disease Control (CDC) concluded; “The principal method by which people are infected with SARS-CoV-2 is through exposure to respiratory droplets carrying the infectious virus. It is possible for people to be infected through contact with contaminated surfaces or objects (fomites), but the risk is generally considered to be low.”

Under lab conditions with the virus known to be present, the CDC puts the chances of infection from touching hard surfaces at 1 in 10,000, stating: “There is little scientific support for routine use of disinfectants in community settings, whether indoor or outdoor, to prevent… transmission from fomites. In public spaces and community settings… risk is low – compared with risks from direct contact, droplet transmission or airborne transmission.”

The CDC finds that the virus can stay alive on hard surfaces such as plastic glass and metal for around three days – it is absorbed by porous materials much more quickly. But the chances of it being present in sufficient quantities for infection on your Ocado delivery are remote. The likelihood of your transferring it in sufficient quantities to your mouth and nose is less likely still.

Businesses have engaged in an arms race to see who could offer their workers the deepest and most frequent cleaning. The CDC is now suggesting that this is a waste of effort except in locations, such as hospitals, where there is already a great deal of infection present.

As governments and regulators reached for the most draconian measures, some experts have been monitoring developments to see what really works and what amounts to sanitation gesture politics. “The Nerdy Girls” have built up a following of millions on their Dear Pandemic site on social media. Its founder, Professor Jennifer Dowd of Oxford University’s Leverhulme Centre for Demographic Science, explained that she and an interdisciplinary panel of academics, who all happen to be women, set out to explain to each other what their families needed to be doing to stay safe.

Dr Dowd is not opposed to the government’s “Hands Face Space” messaging, although she thinks it is unfortunate that hands have a prime place since they are less important in fighting the disease than masks and social distancing. She says the authorities have been slow to react to mounting evidence and relax specific restrictions. Only in the past few days have American regulators recognised that transmission out of doors, for example, is not a major factor in contagion. The greatest danger zone comes from close contact in poorly ventilated indoor spaces – especially if there is singing and shouting. 

Crowded trains, buses and planes can quickly become just such environments. Not surprisingly, governments have discouraged people from travelling and using public transport during the pandemic. As the lockdowns are lifted, the new challenge is convincing passengers to get back on board. Masks may become a sensible feature permanently, but there should not be too much worry about hanging on to iron bars. 

There are few silver linings to the pandemic, but I visited a company, D&G, which is developing an innovative, automated way of cleaning buses and the air in them. The company operates in partnership with V-Stop, a tech start-up backed from Singapore. When all is quiet in the depot in the dead of night, nozzles spray out a mist of cleansing aerosol particles. 

Each cleansing costs just £1.50 and replaces human cleaners. Fitting the system is more expensive at £3,500 per bus. The system is being installed first on the buses serving routes, including hospitals. In most circumstances, the systems will be important in reassuring passengers although the threat of contagion is slight. In ambulances or vehicles with known exposure to infected people, regular spraying could be a clinical godsend.

Another bonus of Covid has been that 2020/21 flu epidemics have been minimal around the globe. This is not due to any vaccine, but because of the restrictions, we have all placed on our social contacts. After Covid, societies will have to reach an agreement of what modifications of behaviour are worth keeping in place. We know it can be done; Korea, Taiwan and Vietnam are among Asian countries which contained Covid successfully, in large part because they had previous experience of SARS and MERS, unlike the West. 

There are adverse consequences to too much hygiene theatre. Bugs are also part of our life cycle; without ‘good’ bacteria, we would die. Office managers are discovering that the rules make a return to the workplace problematic even on a part-time “hybrid basis” and IT departments are complaining that too much deep cleaning is jamming up keyboards and fuzzing screens.

If we want a rational and orderly return to normality, it’s time for a critical review of the pandemic theatrics – and in the words of Lady Macbeth once more, warning against “letting ‘I dare not’ wait upon ‘I would’.”