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Coronavirus outbreak: Divided by face masks, united by handwashing

The one thing virus experts are united on is the importance of clean hands. There might be debates about what kind of face mask to use, or whether masks should be bought at all, but about handwashing there are no doubts. The virus lingers on surfaces that hands then touch and transfer it to mouths and noses. So, wash hands regularly and thoroughly.

, ET Bureau|
Last Updated: Mar 07, 2020, 07.43 AM IST
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A view of a sign for a hand sanitising station.
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Mumbai: In February last year, Pete Hegseth, a host on the rightwing Fox News TV channel in the US, made a startling admission: He hadn’t washed his hands in over 10 years. “Germs are not a thing,” he asserted. “I can’t see them, therefore they are not real.”

Hegseth, an ex-military man who prides himself on his toughness, seemed to imply that overall health was more important than clean hands. While Fox News later clarified he was joking, Hegseth gave a less apologetic response, talking about the need to take risks, like riding bikes without helmets and sneering at people who walk around with bottles of alcohol-based hand sanitiser gel in their pockets.

Not surprisingly, Hegseth hasn’t been touting this wisdom as the coronavirus threat explodes. Instead, like many others on Fox, he’s now trying to find ways to blame the outbreak on President Donald Trump’s opponents in the Democratic Party. Someone might also have pointed out to him that Trump is a noted germophobe and probably a copious user of hand sanitiser.

The one thing virus experts are united on is the importance of clean hands. There might be debates about what kind of face mask to use, or whether masks should be bought at all, but about handwashing there are no doubts. The virus lingers on surfaces that hands then touch and transfer it to mouths and noses. So, wash hands regularly and thoroughly. If sanitiser isn’t available, then plain soap and water will do, and might even be better.

This might seem obvious and in Katherine Ashenburg’s book, Clean: an Unsanitised History of Washing, where she traces the often rather minimal human history of hygiene, hands were the one part of our bodies that were usually washed: “It was a sensible practice when food was still eaten with the hands, without forks, but its point was also symbolic, as a mark of civility that dated at least to Homer’s day.”

The symbolism of handwashing was reinforced by stories like Pontius Pilate washing his hands of Christ’s death in the Bible, or Lady Macbeth’s incessant, near insane attempts to wash her hands of the guilt of King Duncan’s murder. In places like the Middle East, the formal offering of a jug of water and basin to wash hands before a meal is a mark of respect, always starting with the most important person in the room.

And yet, in parallel with this, there has always run a kind of defiant dirtiness, like Hegseth’s macho posturing about the problems of being too clean. Far from being seen as wrong, ‘getting your hands dirty’ has positive connotations, of being willing to deal with problems in a real way. Excessive cleanliness was seen as effete, while griminess signalled being genuine, the sign of a true working man.

This could have tragic consequences, as with the case of Dr Ignaz Semmelweis, a young Hungarian doctor who started working in the maternity ward of Vienna’s General Hospital in 1946. Childbirth was very dangerous at that time, with many mothers dying of infection after birth, but Semmelweis noted something odd. Mothers who gave birth with the help of midwives generally did well, while those examined by doctors often died.

Semmelweis had to struggle to find reasons, but finally he concluded that it was linked to the fact that many doctors also did autopsies on dead bodies, and often came to see their patients straight after. Since the concept of germs was still not known, Semmelweis could not find the precise cause, but he felt that doctors were transmitting infections from the corpses to the mothers, while the midwives were comparatively clean.

Semmelweis got his staff to start cleaning their hands with chlorine before examining patients, and found a dramatic drop in deaths. But his fellow doctors, all male, were furious at the idea that they were contributing to casualties and refused to clean their hands. Semmelweis was ridiculed and harassed and finally forced out of his job, suffering a breakdown and being sent to a mental asylum where he died, tragically, of an infection.

Among the bitter ironies in this story is the fact that the midwives were cleaner than the doctors. In the history of hygiene, it has been common for women, servants and, in India, lower castes to be accused of being unclean simply because the work forced on them involved cleaning. In reality, being directly faced with dirt was more likely to make them mindful of being clean, in contrast with the insouciance of the powerful who romanticise dirt.

Hygiene is also dependent on access to clean water and cleaning materials and this again has historically been easier for the rich. Ashenburg, in her book, notes that good soap was hard to get before the 18th century when the invention of techniques “that produced soda ash from salt rather than wood ash also reduced the price of soap and made a product that was harder and milder, unlike the gelatinous and irritating soap made from wood ash.”

International trade in the 19th century also brought vegetable oils like olive, palm and cottonseed that made better soaps than the heavier ones made in the past from animal fats. This also enabled the growth of manufacturers, like Proctor & Gamble, which could bring soap to mass consumers, not least by advertising its benefits to them.

Hygiene has always been a major preoccupation in India, partly because of our obsession with purity, caste and contamination, but also because we still eat with our hands. It is still common to find washbasins in dining rooms in Indian homes, to allow people to wash without having to go to the bathroom or kitchen. In cities like Chennai this can still be so imperative that landlords have to install them if they want their flats rented.

Restaurants also need to have easily accessible washbasins, and this can be a problem for fine dining restaurants that want to serve Indian food. Providing finger bowls doesn’t really work since that doesn’t really remove the grease. At Parsi weddings, the Middle Eastern tradition is followed of a proffered jug and basin, with soap and towel, if needed, but while elegant, it is labour intensive. One possible option is to combine finger bowls, towels and hand sanitisers to deal with the grease.

One restaurant that tried an innovative solution is the legendary Mavalli Tiffin Rooms in Bengaluru. Many years back, it tackled the problem of how to turn on a tap with greasy fingers and still leave the tap clean. Their neat solution was to have a foot-operated wash basin, with the tap controlled by floor paddles. Unfortunately, this confused customers and the paddles kept breaking, so the innovation was discontinued. Motion-sensitive taps now take care of the touch problem, but with the irritation of not delivering continuous water, foot-operated wash basins still seem like a solution worth trying.

Handwashing has caused problems sometimes. In 2009, the Times of India (ToI) reported on villagers in Gidigere near Mangaluru who panicked after finding microchips embedded in bars of soap. Some thought they were bombs and took them to the police, while others panicked that “the chip was actually a camera that takes pictures of people in their bath”. ToI traced the chips to a project by Hindustan Unilever under its Lifestyle Swastya Chetna programme to track soap usage in the field.

One area in which India has shown particular enthusiasm for handwashing is in setting records on Global Handwashing Day, which is observed on October 15. In 2015, Madhya Pradesh set a Guinness record when 1.28 million students across the state washed their hands at the same time. This smashed an earlier record of 740,870 in three countries — Argentina, Peru and Mexico. In 2018, Salem in Tamil Nadu set another record for the largest hand-hygiene lesson with 4,024 people (which sounds like it could be easily beaten).

Most of these lessons involve just soap and water, but now hand sanitisers are an option as well. They have had a slightly complicated history in India. But this virus epidemic might be the one event that cements their place in the marketplace. Overseas, they have already gone from being a product for use in institutions such as hospitals or restaurants to being a pocket imperative product mocked by Hegseth.

It’s a remarkable transformation for a product that was invented by a young nurse, Lupe Hernandez, in California in 1966, when she realised that an alcohol gel could deliver a cleaning product in situations where soap and water wasn’t easily available.

Hernandez has hardly been acknowledged for this, possibly because the use of alcohol itself as a cleaning product goes back centuries, and other cleaning fluids were in use by the 1950s, and it was manufacturers of these products, like Purell, who really created the hand sanitiser market. But it offers a neat counterpoint to macho opponents of hand cleaning, like Hegseth, for a woman to have invented such a product.

This Sunday, on International Women’s Day, when hand sanitisers, and hand cleaning in general, is so much in the news, it would make sense to acknowledge how much human health through history has depended on the practical work of so many millions of women in keeping our hands clean.
(Catch all the Business News, Breaking News Events and Latest News Updates on The Economic Times.)

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