It takes more than a pandemic to make good handwashing habits stick
Jason Tetro doesn't like it, but he understands. The Canadian microbiologist and handwashing evangelist said the COVID-19 health crisis helped focus people's minds on proper hand hygiene, but even as early March 2020 he was predicting a backslide once the immediate threat of a new virus faded.
Surveys on handwashing trends suggest Tetro was right.
"I feel vindicated, but at the same time it's really depressing," he said.
Tetro, who wrote The Germ Cod e and The Germ Files, said high-touch surfaces like door handles, shared office equipment and cellphones still carry the risk of microbes, so people should wash their hands or at least use sanitizer after touching them.
"Unfortunately, a lot of people simply are choosing not to do that because they don't think that there's any COVID there, so they're not going to do it anymore," he said.
A pre-pandemic study from the International Journal of Epidemiology yielded the nauseating statistic that only about 51 per cent of people in wealthy countries with greater access to handwashing facilities wash their hands with soap after "potential fecal contact."
While there hasn't been a comparable study, a recent National Foundation for Infectious Diseases (NFID) survey in the U.S. found 48 percent of adults admitted to forgetting or choosing not to wash their hands at key moments, like after visiting grocery stores, restaurants or health-care facilities.
While the methodology used in that survey was different, you might take some relief from the fact that 69 per cent of American adults reported they wash their hands after using the bathroom. But even after the world ground to a halt over a contagious respiratory virus, only one-third report washing their hands with soap after coughing or sneezing.
The NFID's campaign says handwashing can help prevent 80 per cent of infectious disease.
That message was amplified with signage, social media posts and hand sanitizing stations during the pandemic, but Tetro said it's now common to find those hand sanitizing dispensers empty.
"Those nudges were fantastic during the pandemic, but when you take those nudges away you're inadvertently saying that maybe hand hygiene isn't important anymore," he said. "If you're not going to fill them, then take them off the walls."
A Canadian survey in 2021 reported more than 90 percent of participants were washing their hands more frequently due to the pandemic, with 63 percent strongly agreeing with that statement.
A hospital's handwashing helper
Even health-care workers weren't immune from waning hand hygiene, according to a study of Ontario hospitals published in the Canadian Medical Association Journal. Tetro said more recent studies have shown a net improvement among health professionals.
To shore up those gains, The Ottawa Hospital's Civic campus is using 3D imaging sensors installed in the ceiling of their transitional care ward to keep up those nudges, and it's led to a sustained increase in handwashing.
The artificially intelligent monitoring systems (AIMS) platform has been programmed to recognize proper handwashing technique.
"There's a light, it's that reminder and it just triggers something in your brain," said Sybile Delice-Charlemagne, clinical manager in the hospital's transitional care unit where the "nodes" have been installed for nearly six months.
"As I'm washing my hands, I wait for the light to turn green."
The nodes are networked to track handwashing as busy staff move from room to room, allowing them to scrub with sanitizer while they walk.
"They have an abundance of things to do," said Scott Delaney, CEO of Lumenix, the Ottawa-based company behind AIMS.
"Our ability to provide assistance along the way is what is providing that sustained change," he said.
Delaney said the system has dramatically slowed potentially deadly outbreaks wherever it's installed.
"We've been able to decrease hospital-acquired infections or outbreaks in the wards we're installed [in] by greater than 90 per cent, as well as deliver a 41 per cent increase in hand-hygiene compliance," said Delaney.
Delaney said the technology will soon be adopted by the McGill University Health Centre, and will be expanded at The Ottawa Hospital — all while preserving the privacy and anonymity of the people it monitors.
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