Just washing your hands properly can save lives

Practising proper hand hygiene at the appropriate times can help save millions of lives worldwide from infections. — AZLINA ABDULLAH/The Star

The cumulative number of positive Covid-19 cases in Malaysia exceeded 400,000 on April 28 (2021), compared to 113,010 on Dec 31 (2020).

On May 1 (2021), Malaysia’s ranking in the global league of cumulative confirmed cases was 43, a jump from a ranking of 85 on Nov 18 (2020).

Vaccination progress has been slow with just over 500,000 having been fully vaccinated at the time of publication.

Individual measures like hand hygiene are vital in preventing the spread of infection from microorganisms, including the SARS-CoV-2 virus, which causes Covid-19.

The transmission of microorganisms from one person to another through the hands involves the following sequence:

  • A person has the microorganisms present on their skin and/or has shed them onto inanimate objects in their immediate vicinity.

  • The microorganisms are transferred onto the hands of another person through touch.

  • They survive for several minutes on this other person’s hands.

  • This person either doesn’t wash or sanitise their hands properly, or at all, or the soap or sanitiser used for hand hygiene is inappropriate.

  • The contaminated hand or hands of this person comes into direct contact with another person or with an inanimate object that will come into direct contact with another person.

There is substantial evidence that hand antisepsis reduces the transmission of microorganisms and the incidence of healthcare associated infections (HAI).

Improvement in hand hygiene practices may reduce the spread of microorganisms by half.

Annual awareness

The World Health Organization (WHO) has had an annual campaign on hand hygiene called “Save Lives: Clean Your Hands” on May 5 since 2009.

The rationale of the campaign is that hand hygiene is at the core of infection prevention and control (IPC).

The theme of this year’s campaign is “Achieving hand hygiene at the point of care” and the slogan is “Seconds saves lives – clean your hands.”

The campaign is directed at:

  • Healthcare professionals (with the message: Now more than ever - clean your hands at the point of care!)

  • IPC practitioners (Be a champion and mentor for clean hands at the point of care.)

  • Facility managers (Ensure hand hygiene supplies are available at every point of care.)

  • Policymakers (Invest now to ensure hand hygiene for all.)

  • Patients and families (Help us to help you: please clean your hands.)

  • Vaccinators (Clean your hands with every vaccine.)

The campaign objectives are to engage multiple audiences, highlighting their role in achieving effective hand hygiene action at the point of care, according to the WHO multimodal hand hygiene improvement strategy; and to support implementation of the WHO 2020 recommendation for universal hand hygiene and of the WHO/Unicef Hand Hygiene for All initiative in healthcare facilities.

The WHO recommendation on the improvement of hand hygiene to prevent the spread of Covid-19 includes the provision of universal access to public hand hygiene stations and making their use obligatory on entering and leaving any public or private commercial building and public transport facility; and that healthcare facilities improve access to, and practice of, hand hygiene.

Give them a wash

Handwashing is a simple and effective way to prevent the spread of microorganisms and infections.

The exact contribution of hand hygiene to the reduction of direct and indirect spread of Covid-19 is currently unknown.

However, handwashing removes microorganisms, including the SARS-CoV-2 virus, when done correctly and thoroughly (see infographic below).

Handwashing to prevent Covid-19 should be done every time after:

  • Blowing the nose, coughing or sneezing

  • After being in a public place, and

  • Before and after caring for a sick person.

In order to stay healthy, handwashing should be done:

  • Before, during and after preparing food

  • Before eating

  • After using the toilet

  • After cleaning up a child who has used the toilet

  • After touching garbage

  • After changing diapers, and

  • After touching an animal, animal feed or animal waste.

If the hands are not soiled or potentially contaminated, an alternative is sanitising your hands with an alcohol-based hand rub (ABHR), which contains 65-90% alcohol.

They are useful if water or a sink are not available.

There is better compliance with ABHRs than with soap and water.

Hand hygiene at the right time saved, saves and will continue to save millions of lives globally.

It is a quality indicator of safe healthcare systems as infections can be stopped by good hand hygiene practices.

The WHO estimates that harm to patients and healthcare professionals can be prevented by spending less than US$10 (RM41.22) on hand hygiene and that ABHRs can prevent HAI and millions of deaths annually.

It is the belief of healthcare professionals that hand hygiene will continue to be an effective tool to stay safe from the SARS-CoV-2 virus even after vaccination.

Carry on for protection

Non-pharmaceutical interventions are necessary to prevent the spread of Covid-19.

They include frequent handwashing; the use of face masks; physical distancing; and the avoidance of crowds, confined spaces and close contacts.

These will all still be vital even when larger numbers of the population have been vaccinated.

As per WHO’s message to everyone during the 2021 hand hygiene campaign: Make clean hands your habit – it protects us all!

Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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