At the beginning of the current coronavirus outbreak, we were inundated with guidelines that caused confusion, like if you should wash your hands with soap and water, and if hand sanitisers are less effective. And what do you do if you can’t get to a basin with soap and water?

Now, an international research team headed by Professor Stephanie Pfänder from the Department of Molecular and Medical Virology at Ruhr-Universität Bochum (RUB) has confirmed that alcohol-based hand disinfectants are effective against the new coronavirus, according to a recent news release.

This research was published in the journal Emerging Infectious Diseases.

Must be used correctly
The researchers exposed the new coronavirus to the WHO-recommended disinfectant formulations for 30 seconds.

Then the team analysed how much of the virus remained infectious after being exposed to the hand sanitiser.

“We showed that both WHO-recommended formulations sufficiently inactivate the virus after 30 seconds,” said Prof Pfänder.
She states that this doesn’t only apply to those sanitisers strictly formulated according to the WHO guidelines, but to any sanitiser that has high concentrations of the main components, i.e. alcohol, ethanol and isopropanol.

What is in the WHO formulation?
There are two formulas for disinfectant currently recommended by the WHO.
Disinfectant I recommended by the WHO consists of 80 volume percent ethanol, 1.45 volume percent glycerine and 0.125 volume percent hydrogen peroxide. Disinfectant II consists of 75 volume percent isopropanol, 1.45 volume percent glycerine and 0.125 volume percent hydrogen peroxide. Practise stringent hygiene

Health24 emphasises that regular hand washing is crucial, especially when returning home after going to the shops.

The science behind plain old soap and water might be simple, but it’s effective against viruses. If you don’t have access to hand washing facilities, use hand sanitiser – which contains 60% or more alcohol – and rub your hands together for at least 30 seconds. Also let the solution dry properly.

Updated 17 March 2020
“Simply wash your hands,” experts say. Why are soap and water so effective in protecting against the coronavirus?

“Simply wash your hands,” experts say. But what is the science behind this simple protective measure?

As people raid the shelves for protective masks, toilet paper and hand sanitiser, experts are punting a very simple piece of advice – regularly and thoroughly wash your hands with soap and water.
Are we following your advice? And what is the science behind washing your hands?

What exactly is soap?
Soap has been used for many centuries and is essentially a mixture of fat or oil, water and an alkali or a salt base. These ingredients go through a chemical process called saponification, which results in soap.

How does soap work?
Here’s a shocker – soap doesn’t actually kill germs on our hands – it simply removes them. As our hands get sticky, dirty or sweaty during the course of the day, nasty things on the surfaces of desks or our phones, bathrooms, or from other people’s hands stick to our hands and can enter our bodies when we touch our eyes, noses or mouths.

But when we wash our hands under running water, it removes these germs clinging to the surface. The soap molecules bind with both water and oil and allow both to be washed off our hands.
In the case of the new coronavirus, the virus spreads through liquid droplets expelled into the air, through coughing or sneezing. These droplets stick to people’s hands when they cover their mouths.

For people who are infected with the virus, leaving hands unwashed results in the droplets remaining on your hands – and being transferred to the objects and people you touch.

But this applies to people who are not infected too – thoroughly washing your hands could potentially stop you from contracting the virus, if you have potentially come into contact with somebody who is infected, or objects that have been contaminated by somebody who has been infected.

The risk of you the touching your face with contaminated hands would be high, and the virus could enter your body through your nose, mouth, or eyes.

A thorough hand washing will remove these droplets – and the virus – from your hands, and curb the spread.

What about hand sanitiser?
While the World Health Organization (WHO) suggests soap and water as your best protective measure, hand sanitiser is a good backup – but only if the alcohol content is 60% or higher.

Hand sanitiser, unlike soap, doesn’t wash away germs. It kills bacteria and germs on the surface by breaking down their protective membranes. Some viruses, such as the norovirus which causes stomach ailments, are coated by a protective cap that isn’t always killed off by hand sanitiser.
There is no harm in carrying hand sanitiser if you aren’t close to a tap and soap, but make sure that the alcohol content is high enough.

How (and when) to wash your hands?
The WHO recommends washing your hands when they are visibly dirty or soiled with blood or bodily fluids, or after using the bathroom. You should wash your hands even more frequently when you are taking care of the vulnerable and ill.

Will hand sanitiser clean my hands properly?
Hand sanitiser is a no-brainer when it comes to waterless hand hygiene. But how effective is it really?

You should wash your hands at least six times a day on average. It may seem like a lot, but think about how often you use the bathroom, prepare food, eat, sneeze, cough, and touch things…
Hand hygiene goes a long way toward preventing illness – and can reduce the risk of communicable diseases by up to 59%.

But how do you keep your hands clean when there is a drought and you’re urged to save water?
The most common solution is to reach for the hand sanitiser. But how effective is it and does it need to contain alcohol?

Going waterless
Research shows that alcohol-based hand sanitisers may not offer complete protection against harmful germs. Experts say that good old-fashioned soap and water is still the best way to keep your hands clean.

According to an article on Emerging Infectious Diseases, the FDA recommends a concentration of 60-95% ethanol or isopropanol (kinds of alcohol) when used in a healthcare environment. However, for those of us in non-healthcare settings, they do not specify the appropriate concentration of alcohol.

When it comes to preventing the common cold, however, a study published in the Antimicrobial Agents and Chemotherapy journal shows that hand sanitisers that contain ethanol are more effective at removing the rhinovirus from hands than soap and water. Sanitisers with ethanol or organic acids were able to reduce the spread of the virus effectively.

“The ethanol-containing hand disinfectants were significantly more effective than hand washing with water or with soap and water for removal of detectable rhinovirus for the hands in this study,” the researchers said.

“Furthermore, a formula containing organic acids and ethanol resulted in residual activity that significantly reduced virus recovery from the hands and rhinovirus infection for up to four hours after application.”

What does this mean for hand hygiene?
According to the World Health Organization, alcohol-based hand rubs should be used in “resource-limited or remote areas with lack of accessibility to sinks or other facilities for hand hygiene (including clean water, towels, etc.)”.

Recently, Capetonians were restricted to 50l of water per person per day. Under the guidelines from the City of Cape Town, 3l are allocated for daily hygiene, which includes hand washing. So you don’t necessarily need to forgo the water and soap – just don’t leave the tap running while you wash. Wet your hands (close the tap), add soap and scrub for 20 seconds, then rinse and dry.

How to use hand sanitiser:
Although you might want to make every effort to save water, there are instances where you cannot use hand sanitisers. If your hands are visibly dirty or you’ve handled chemicals, you need to use soap and water instead.

If you are using hand sanitiser, make sure you use it correctly. People often make the mistake of not using enough – you need at least a dime-sized amount (18 mm in diameter or about the size of a contact lens) i.e. at least 3 – 5 ml.

Put it in the palm of one hand and then rub your hands together. Make sure you cover every surface of your hands – get between your fingers, around your fingertips, nails and wrists.

Rub your hands together for about 30 seconds before the sanitiser dries/evaporates. Avoid touching food or surfaces until your hands are completely dry.