Analysis, Noel Munzabwa 

ARE you using the proper and effective hand sanitiser?

This is the big question given the Covid-19 pandemic that has infected hundreds of thousands, claimed thousands of lives.  The uninformed choice of a hand sanitiser — a product flying off the shelves in recent weeks — could leave many penniless and improperly protected.

On Tuesday last week minutes after President Emmerson Mnangagwa had addressed the nation on the pandemic, I walked into a large supermarket and right at the entrance I noticed some noble yet clumsy effort to help fight the spread of the novel coronavirus.

I call it noble in the sense that it was premised on the worldwide reaction to the virus but minutes after I realised the clumsy side of that coin – what the supermarket was purportedly using was a simple and ordinary hand sanitiser which was either a hand liquid soap or moisturiser.

First the pharmacy technician side of my mind probed on the effectiveness of these purported efforts with the journalist half of me triggering me into research mode on what sanitiser types could be very effective because I didn’t think that just any sanitiser would work effectively against the coronavirus.

Luckily there have been several scholarly articles that have been published with much insight such as the one titled “Coronavirus: not all hand sanitisers work against it – here’s what you should use” authored by University of Westminster’s Manal Mohammed, which easily lessened my burden.

As a pharmacy technician, there was a moment when I served as a hand rub focal person which entailed ensuring availability through production and one of the seminars I attended was emphatic that not all hospital alcohol percentages were effective and further stated that alcohol based sanitisers were effective in infection control.

Since the outbreak of Covid-19, sales of hand sanitisers have risen. It’s become such a sought-after product that pharmacies and supermarkets have started limiting the number that people can buy at one time.  

Though hand sanitisers can help reduce our risk of catching certain infections, not all hand sanitisers we are seeing around are effective against coronavirus, hence the need to be much more informed as to the right choice of an effective one.

In the first place it must be known that washing with warm water and soap remains the gold standard for hand hygiene and preventing the spread of infectious diseases. Washing your hands with warm water (not cold water) and soap removes oils from our hands that can harbour microbes.

But in the absence of a washing basin, soap and water in such places as our supermarkets the option becomes the hand sanitisers which for years painted class and were elevated to a luxury that most ordinary residents never considered. The Covid-19 has made them almost a necessity.

As with other viral respiratory infections – like the common cold and flu – the novel coronavirus (called SARS-CoV-2) is mainly spread when virus-laden droplets from a person’s mouth or nose are transferred to other people. 

Aside from inhaling droplets, you can also get respiratory viruses including SARS-CoV-2 by touching anything contaminated with the virus and then touching your face, in particular your mouth or nose. We touch our faces a lot without even realising it. 

A study from New South Wales found that people touch their faces about 23 times an hour hence in the advent of the pandemic it is a necessity to regularly wash one’s hands with warm water and soap.

But hand sanitisers can also protect against disease-causing microbes, especially in situations when soap and water aren’t available. They’re also proven to be effective in reducing the number and types of microbes.

There are two main types of hand sanitisers: alcohol-based and alcohol-free. Alcohol-based hand sanitisers contain varying amounts and types of alcohol, often between 60% and 95% and usually isopropyl alcohol, ethanol (ethyl alcohol) or n-propanol. Alcohol is known to be able to kill most germs.

Alcohol-free hand sanitisers contain something called quaternary ammonium compounds (usually benzalkonium chloride) instead of alcohol. These can reduce microbes but are less effective than alcohol.

Not only are alcohol-based hand sanitisers found to be effective at killing many types of bacteria, they are also effective against many viruses, including the influenza A virus, rhinovirus, hepatitis A virus and Middle East respiratory syndrome coronavirus.

Alcohol attacks and destroys the envelope protein that surrounds some viruses, including coronaviruses. This protein is vital for a virus’ survival and multiplication. But a hand sanitiser needs to be at least 60% alcohol in order to kill most viruses.

Hand sanitisers with less than 60% alcohol were also found to be less effective at killing bacteria and fungi and may only reduce the growth of germs rather than killing them outright.

And even hand sanitisers containing 60% alcohol can’t remove all types of germs. Studies have found that hand washing is more effective than hand sanitisers at removing norovirus and with shortages leading some people to try and make their own hand sanitisers. It’s also important to know these might not be as effective as commercially available products.

Washing hands for 20 seconds with warm water works best. 

If hands are visibly dirty, hand washing with soap and water is more effective than using alcohol-based hand sanitisers. Research has found that the detergent effect of soap and the friction of washing work together to reduce the number of microbes on our hands, as well as the dirt and organic materials.

Sneezing or coughing into your hands also requires more than just a pump of hand sanitiser to disinfect them. This is because if your hands are contaminated with mucous, the hand sanitiser might not work as well because mucous acts to protect microbes.

As a result, the best and most consistent way of preventing the spread of the coronavirus — and reducing your risk of contracting it — remains washing your hands with soap and water as a first choice, and avoiding touching your face as much as possible.

But alcohol-based hand sanitisers (with at least 60% alcohol) are a practical alternative when soap and water aren’t available. If you are using hand sanitiser then, just like when washing with soap and water, you need to make sure you cover your hands (including between your knuckles, wrists, palms, back of your hand and your fingernails) fully, rubbing it in for at least 20 seconds so it’s truly effective.

Next time you look for a sanitiser kindly check if it is alcohol-based to try and maximise on the effectiveness lest you be left with unwashed liquid soap or merely moisturised hands. — @NoelMunzabwa