As an infection preventionist, it’s a weird sentiment to spend your life trying to instill basic infection control measures, like hand hygiene, air filtration, cleaning and disinfection, only now to face the notion of hygiene theater.
Routine cleaning and disinfection is important and isn’t unique to COVID-19. Comments like “you can put the bleach away” intend to explain to people why excessive cleaning isn’t beneficial against COVID-19, but the communication of this extreme behavior often goes to the opposite end of the spectrum.
The extremes that we went to at the beginning of the pandemic may have been too much, but what we were doing before the pandemic was not enough.
Yes, you don’t need to excessively disinfect to prevent COVID-19, but that doesn’t mean throwing away all of your cleaning products and forgetting about hand hygiene. Our actions established during this pandemic should reset community-based interventions for health that frankly, we should’ve been doing all along.
Those interventions – masking, distancing, vaccines, ventilation, hand hygiene, and cleaning and disinfection have all helped to reduce other infections. Norovirus infections have dropped nearly 50% in the U.S. and the world saw historically low cold and flu seasons. As the country began opening up, we saw an increase in cases of common viruses like rhinovirus, which causes the common cold and CDC recently issued health advisory for extreme, out of season spikes for RSV in southern parts of the U.S. Moreover, with the highly transmissible Delta variant continuing to rise in parts of the country, the CDC has revisited masking guidelines to curb the spread.
It’s important that we harness the awareness for public health and infection prevention we’ve recently gained and utilize them for broader public health. Consider if interventions were more normalized – masking in the winter, frequent hand hygiene, attention to ventilation, more robust vaccine programs, and cleaning/disinfection on a routine basis – we could be facing a very different Cold & Flu season or dreaded travel bugs could become more infrequent.
We shouldn’t trade one extreme for another, but rather push for a more measured approach to cleaning, disinfection, and hand hygiene that can be sustained into the future. Afterall, this pandemic is not the only infectious disease we face and to admonish people for cleaning without providing a more pragmatic approach is myopic and short-sighted.
It’s not all in or nothing
In response to a better understanding of SARS-CoV-2 transmission and awareness for excessive cleaning and disinfection, there were several news sources going from one extreme to the other – from telling people to disinfect their packages to stopping disinfection overall.
Response to any pandemic requires a certain amount of “flex” – the ability to pivot and evolve guidance as we learn more about the pathogen we face.
At the beginning of the COVID-19 pandemic, it seemed that overnight, the fear of this novel pathogen was compounding and people were taking to extremes. Those of us working in infectious disease stressed pragmatism, reiterating that coronaviruses are not that environmentally hardy and tend not to live on surfaces for very long; and that cleaning is important but should be part of a holistic approach.
These basic infection control measures quickly manifested into excessive practices. The mistakes were apparent – too much time and resources were being invested into singular interventions, like excessive fogging or disinfecting practices, and not enough into the additive layers of risk reductions, such as ventilation or reduction in occupancy.
In the U.S., we are fortunate to have access to several effective vaccines and the privilege of a robust healthcare and public health infrastructure. What we cannot afford to do is create false dichotomies within the science of COVID-19 response.
The lessons of COVID-19 are not only a reminder of the importance of responding to disease, but also ensuring equitable public health. Communicating science in a way that is not short-lived, but rather a cultural shift to instill sustained health interventions that are holistic, pragmatic, and evidence based.
Now more than ever, we must reinforce the foundation of public health with general infection prevention efforts rather than calling for extremes.