The Importance of Sanitation During Covid-19

The introduction of Covid-19 has irrevocably changed everyday life. While scientists work to determine a vaccine, it is vital that centers of public traffic work hard to combat the spread of the virus by taking steps to increase sanitation. There will be new laws written and increased expectations from consumers that their health is a priority for businesses, schools, transportation hubs, and other public places.

Most states and countries are beginning to ease restrictions and lift lockdowns that have been in place since early in 2020. After months of reading and watching news about the virus, there will be a period of adjustment that will have to be made as people begin to return to work, school, and their regular routines. It is essential that they feel safe enough in a given place to relax and feel comfortable. Businesses will be making an effort to visibly show the changes they are taking to increase sanitation. Such as installing multiple hand sanitiser stations through a store or at checkouts and doors.

Over the past decade, there have been numerous research studies on the efficacy and uses of hand sanitiser in the public and private sectors. The results provided by them should help to give a more definite sense of what steps will need to be taken by businesses, schools, and workplaces once the lockdowns are fully lifted.

Every facet of daily life has been impacted in some way by Covid-19, and the need for communities to work together to stop the spread of the virus has never been stronger. One way of doing that is by providing ample sanitising options. In February alone, there was a 255% increase in hand sanitiser  sales. That has already doubled and is expected to continue to rise throughout the rest of the year.

Not all hand sanitiser provides the same level of protection against viruses, and some dispensers are more cost-effective than others. This article will explain the various types of hand sanitiser types and dispensers to provide an educated understanding of which would be most useful in certain situations and locations.

Changes to Expect When Lockdowns are Fully Lifted

Most stores and essential businesses have already implemented safety features into their floor plan, including new hand sanitiser stations at doors, checkouts, and throughout areas. Each location will have to find the right balance between cost-effective safety features and ensuring sanitisation standards meet the new guidelines provided by the Center for Disease Control (CDC).

Below is a list provided by the CDC on their website as a reminder of some of the most touched surfaces that will require additional sanitisation. Having hand sanitiser near these areas will help to keep the possible transmission of Covid-19 to a minimum. (1)

• Tables
• Doorknobs and handles
• Light switches
• Countertops
• Desks, phones, and keyboards
• Gas pump handles
• Touchscreens and ATM machines

Reopening guidelines for business, schools, and workplaces include making sure that you have a plan in place for keeping all areas regularly cleaned. In addition, the CDC recommends “frequently washing hands or use alcohol-based (at least 60% alcohol) hand sanitiser when soap and water are not available”. (1) When providing hand sanitiser for your visitors, it is vital to keep the alcohol content at or above the recommended percentage; otherwise, it may not give the intended effect. (2)

Kinds of Sanitiser Dispensers

There are multiple forms of hand sanitiser dispensers currently available on the market that range from a simple bottle to standing automated stations with multiple distributors attached for areas with a high volume of traffic. Once a sanitation plan has been set up for a business, school, or workplace, then they will be able to decide which option would work the best for their needs.

Below are a few of the most common hand sanitiser dispensers being used for commercial and private business locations.

• Hands-free portable dispenser stands
• Portable dispenser stands
• Anchored hands-free dispenser stands
• Hands-free wall-mounted dispensers
• Pump bottled Dispensers (e.g., for receptionist desk, customer service counters, office cubicles)
• Countertop hands-free dispenser stations
• Countertop pump dispenser stations
• Personal use small bottle (e.g., for purse, car, or desk)

Consumer Expectations of Public Sanitisers

Consumers will be highly concerned with the ability of locations to keep them safe. They will expect physical changes to sites and visible indications that CDC and local health guidelines are being followed for their protection. (3) The most crucial single step to stopping the spread of Covid-19 is keeping hands clean.

Research by Arizton on the use of hand sanitiser revealed a considerable boom in the expected use of hand sanitisers. “Buoyed by the growing demand for hand sanitizers during the ongoing COVID-19 pandemic, the market revenue will reach over $11 billion in 2020, registering YOY growth of over 600% from 2019.” (4) They also found that “in the US, the price of a liter of hand sanitiser exceeded the price of a gasoline liter in March 2020.” (4)

This shows clearly that the general public is highly concerned about the cleanliness of their environment and that they are invested in being able to sanitise their hands at a moment’s notice. Consumers will expect this need to be met while they are shopping, working, and attending classes.

Laws Regarding Cleanliness in Public Places

There are national guidelines provided by the CDC on their website, which goes over in detail how to make a plan for keeping your public space clean and sanitised. State regulations and guidelines will also be used for the foreseeable future as each state finds the best path forward. Each state will balance the lifting of restrictions with public health in the way that they see best.

Communities will be expecting their businesses to provide clean and secure environments for them to shop, learn, and work in. To that end, making educated decisions about which sanitiser base is most effective and which dispensers are least likely to continue the spread of Covid-19 will be an essential part of every public spot post-lockdown. Appearances are equally crucial since public perception often drives community action. Showing a dedication to sanitising your business or school will give people a reason to trust in that brand.

The Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) that was passed in March of 2020 included regulations to “amended the tax code to provide a temporary exception from excise tax for alcohol used to produce hand sanitiser and to exempt this alcohol from any requirements related to labeling or bulk sales.” (15)

There will also be federal safety guidelines for schools and businesses that will need to be adhered to in the following months. The best way to keep a location ahead of the curve and in line with any laws or regulations that may apply is by watching for local, state, and federal updates to the Covid-19 response.

Gel vs. Liquid-Based Hand Sanitiser

Scientific research has shown that gel-based hand sanitisers are not as effective as those with a liquid base. (2) There are several reasons that gel hand sanitisers are seen as inferior. They take twice as long to become active, which increases the likelihood that users will be compliant with the proper hand rubbing time frame for their hands to get truly sanitised.

Gel-based sanitisers also do not pass the European Standard (EN 1500) test, which is used to determine the “efficacy of a hygienic hand rub by measuring the number of viable bacteria remaining on the fingertips after contamination and hand rub exposure.” (5) Liquid sanitizers do pass the EN 1500, have higher antimicrobial performance, and are also able to reach more surface area than gels. (3)

Environmental Factors

There is a significant adverse environmental impact when gel hand sanitisers are used. The Cary Institute of Ecosystem Studies reported the detection of “triclosan in 58% of 85 rivers and streams tested in 30 states.” (6) In addition, there are also millions of bottles added to the plastics polluting our planet. Most users are also unaware that “alcohol-based hand sanitising fluids are flammable liquids at room temperature.” (7)

Wastage

Due to the fact that gel hand sanitisers are flammable and often their containers are not entirely emptied out before being thrown away, they must be disposed of as hazardous waste. The fact that so much of the content is being left in the container is usually due to the fact that it is harder to empty the last layer of gel out of any plastic container when compared to liquid-based sanitiser. It is less cost-effective and also takes more effort to dispose of properly. (7)

Cost-Effectiveness

As mentioned in the previous section, liquid-based hand sanitisers are more cost-effective because they are easier to access in most dispensers making it less likely that waste will be accumulated. (7) There is also less chance of users taking too much of the sanitiser at once because the liquid is easier to spread during hand rubbing. Gel-based sanitisers generally drop more than needed and are not always appropriately used, necessitating more than one attempt. (8)

Alcohol Concentration

The Food and Drug Administration (FDA) guidelines recommend hand sanitiser that contains a minimum of 60% to 95% ethanol or isopropanol to remain effective against bacterial and viral agents. A study by East Tennessee State University found during their tests that “despite a label claim of reducing �germs and harmful bacteria’ by 99.9%, we observed an apparent increase in the concentration of bacteria in handprints impressed on agar plates after cleansing.” (9) They were testing several forms of gel sanitiser and found that most were not strong enough for antibacterial properties to be meaningful.

Ingredients

In 2016, a study by the FDA found that some ingredients in certain hand sanitisers were harmful to children and pregnant women. They banned these ingredients, but there are still three ingredients that are not yet banned: benzalkonium chloride, ethyl alcohol, and isopropyl alcohol. The FDA will be making determinations on these three ingredients of gel-based sanitisers in 2020.

Dispensers for Hand Sanitiser

There are many designs for dispensing hand sanitiser. We listed several previously and will go into more detail on each here. There is nothing inherently wrong with any of these dispenser types. However, some are more advantageous than others in specific settings. When looking at purchasing options for your school, workplace, or business, it is crucial to think about how customers or employees will perceive them. For example, a walkthrough booth might be impractical for a workplace where people will need to sanitise their hands throughout the day repeatedly.

Pumps

Pump bottle dispensers are the easiest because most hand sanitiser – even large industrial size containers – already come with a pump installed. This makes for easy access and also gives no need for transfer to another vessel, which could waste some product. Some bottles are even sold off the shelf with multiple colors and styles so they can be directly placed in high traffic areas.

Locations that desire a more aesthetically pleasing appearance can have counter pumps or wall pumps installed. These are sometimes seen as less hygienic because they necessitate many people touching the same pump. They can be less effective if children or other users touch the pump and then do not use proper hand rubbing techniques, which could leave Covid-19 on their palms and fingers where it can then be spread.

Button Push Dispensers

Push-button dispensers have more moving parts and a higher tendency to break down and require maintenance when compared to both pump and automated machines. The need to touch the button is also sometimes undesirable for the same reason that people may prefer not to use pump action dispensers. Most touch-based dispensers will have the same issues of not giving proper protection if the sanitiser is not handled correctly.

Booths

Booths provide perhaps the most all-encompassing option for anyone worried about the spread of Covid-19 in their workplace. These are large box-shaped devices that a person steps inside of, and then they are sprayed with disinfectant. The benefit of a booth is that it can come with multiple built-in tools, such as a way to check an individual’s temperature. These are mostly being seen in airports and businesses where it is vital not to bring in any contaminant.

Automatic Dispensers

Unlike touch systems, automatic dispensers completely eradicate the possibility of picking up a virus or bacteria from the device itself regardless of the efficacy with which the sanitiser is then utilized. They are safe, effective, and easy to use. There are also fewer moving parts, so they require less maintenance when compared to other dispensers. In addition to possibly being a source of contamination, non-automated dispensers are also cost-effective and can be either anchored or portable.

Expectations for Availability of Hand Sanitiser

The safety of consumers and the general public is paramount during this time of year when summer is starting to heat up, and people will be going out more as lockdowns ease. Ensuring that they have easy access to sanitisers is one way of showing community consciousness. Each kind of public area will need to keep in mind the expectations of visitors while balancing cost and effectiveness. The following industries will need to work hard to show people that they have the safety and health of the public in mind.

Schools

A surprising study conducted by the American Journal of Infection Control showed that absenteeism in schools went down by over 19.8% when hand sanitiser was made available to students and teachers. (10) That was well before Covid-19 appeared on the scene, which makes it likely that the percentage would be much higher if the same study were to be done today. This is one benefit of hand sanitiser in schools.

The CDC guidelines for reopening schools after the lockdown involves making hand sanitiser with at least 60% alcohol available for teachers and students. Although they do not specify a dispenser in their guidelines, it is known that automatic dispensers have a higher chance of stopping the spread of contaminants.

The University of Michigan’s Department of Environment, Health, and Safety have narrowed down the following areas as places where hand sanitiser dispensers should be readily available to staff, students, and visitors. This is an excellent planning tool for any school that is looking to reopen.

• Dining facilities
• Shared equipment spaces (computer labs)
• Residence halls
• Athletic facilities
• Transportation buses
• Child care centers
• Public spaces/lobbies entrance areas
• Meeting rooms
• Lounges and staff kitchen areas

There are some state regulations that may be enforced in regards to how hand sanitiser is used in classrooms post-lockdown. For example, the West Virginia Poison Center instructed that teachers in classrooms make sure that “hand sanitizers for personal [are] kept in their original, fully labeled containers.” (11) One reason for rules like this is so that the alcohol content can be checked to make sure it fits with the CDC strength guidelines. When in doubt, it is always best to read local and state notices involving changes to how schools should utilize hand sanitiser.

Restaurants

The Environmental Health Studies (EHS) did research to see when and how restaurant workers were more likely to clean their hands. What they found was that when a handwashing station or hand sanitiser dispenser was within view, they were more likely to wash their hands regularly. (14) Restaurants have been highlighted as places where the spread of germs and viruses is incredibly simple when proper precautions are not enforced.

There are also changes that can be made to the way in which food is prepared to cut down on possible cross-contamination. The same study gave the example of ” a sandwich-making process [that] could be revised to lower the number of times a worker has to handle raw meat. This would lower the number of handwashings needed and should increase the odds that workers will wash their hands as needed.” (14) Prioritizing cleanliness with restaurant workers and customers alike will decrease the likelihood of closure due to someone testing positive for Covid-19.

Bars and Pubs

It has already been shown in areas where the lockdowns have been lifted that drunk people are less likely to follow social distancing rules. This makes it even more vital to have hand sanitiser readily accessible for patrons of bars and pubs. Depending on local health advisories, there might be specific regulations involving when and where and sanitisers are required. For example, all exits and entrances might need to have some form of sanitiser available. This will depend on local and state enforcement.

Automated sanitiser stations and portable pump bottles will probably be the most commonly seen within pubs and bars as they will be easier to maneuver around based on occupancy. Bathroom dispensers should also be updated if they are not currently available so that liquid-based sanitiser can be made available using automated wall-mounted or countertop dispensers.

Public Transport

Bus drivers are being urged by the CDC to use hand sanitiser with 60% alcohol when hand washing is not possible. Public transportation is currently one of the most dangerous industries for employees. Nearly 100 bus drivers and other public transportation workers have been killed by Covid-19 so far in 2020. Drivers face an even greater possibility of being infected now that there is such a high level of unemployment. Public transportation will be replacing services like Uber and Lyft while people try to save money. Hand sanitiser dispensers on buses and at terminal stops can help fight against the spread of Covid-19.

Airports and Airplanes

Most airports are adopting full-body decontamination processes for travelers. This could involve a booth dispenser or some other form depending on the location and if international flights are included. A notice sent out by the Transport Security Administration (TSA) stated that “TSA is allowing one liquid hand sanitiser container up to 12 ounces per passenger in carry-on bags until further notice.” (12)

Automated hand sanitisers in public areas of airports have been the norm for a while. Still, with Covid-19, it will be more important than ever to stop incoming or outgoing contaminants before they can reach the plane or outer areas of the airport. Portable automatic hand sanitiser stations are an easy and affordable way to add another layer of protection.

Hotels

A Market Research study in 2015 revealed that 70% of hotel guests saw cleanliness as an important factor when choosing a hotel, and 82% had a more favorable impression of locations that offered hand sanitisers. (13) Due to the easing of lockdowns throughout the country, there will be an influx of travelers, which will mean more overall use of disinfectants for rooms. The CDC recommends that hotels work with their local and state health officials to determine the best course of action for cleaning and sanitising hotel rooms. There may even be a need for isolation if someone arrives, showing symptoms of Covid-19.

Customer satisfaction in hotels is going to depend significantly on how visibly the chain is working to keep them healthy and safe during the pandemic. Setting up portable automatic hand sanitiser stands at all exits and entrances as well as within lobby and dining areas will help to keep people feeling secure while cutting down on the possibility of contamination.

Other Public and Business Spaces

At the very least, a pump bottle of hand sanitiser with an appropriately high alcohol content should be available for both customers and employees at all times. When handwashing is not an option this will help stop the spread of the virus. For areas with larger floor space, such as car showrooms, portable hand sanitising stations can be used.

Create a Safe Post-Lockdown Environment

To create a post-lockdown environment that will keep your community safe and show them your invested interest in their continued health, it is vital to find the right product. Visual presentation and proven ability to combat viruses like Covid-19 will need to be considered. Peace of mind will keep customers coming back.

To keep Covid-19 from spreading every industry and individual business must do its part. It is almost impossible to find a grocery store that does not have several automated hand sanitiser stations beside each entrance and exit as well as throughout areas like the produce and meat departments. Research has clearly shown that people are more likely to use hand sanitiser if it is placed in a clearly visible spot.

Transportation terminals, schools, grocery stores, workplaces, and even drive-through restaurants have already started introducing more considerable numbers of hand sanitiser dispensers for their customers to use. This trend is only going to grow as more people come out of self-isolation, and life returns to some semblance of normal.

It is easier than ever to make the right choices with all of the research available to pinpoint precisely which sanitisers and dispensers are most impactful for stopping the spread of Covid-19 and other transmittable illnesses. Creating a safety plan and following will keep communities safe and businesses thriving.

Resources:

1. https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html
2. https://www.sciencedirect.com/science/article/pii/S014067360208426X
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206535/
4. https://www.infectioncontroltoday.com/hand-hygiene/survey-reveals-americans-expectations-hand-sanitizers
5. https://vivotesting.com/information/en-1500-hygienic-handrub-method
6. https://www.caryinstitute.org/news-insights/media-coverage/why-you-shouldnt-use-hand-sanitizers
7. https://www.safety.rochester.edu/envcompliance/pdf/Disposalofalcoholbasedhandsanitizer.pdf
8. https://www.prnewswire.com/news-releases/the-global-hand-sanitizer-market-to-grow-over-600-due-to-impact-covid-19-in-2019—market-research-by-arizton-301041017.html
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3291447/
10. https://pubmed.ncbi.nlm.nih.gov/11029132/
11. http://wvde.state.wv.us/healthyschools/documents/SafeHandSanitizerUseinSchoolsWVPoisonCenter.pdf
12. https://www.tsa.gov/travel/security-screening/whatcanibring/items/hand-sanitizers
13. https://www.gojo.com/en/Markets/Hotels-Hospitality
14. https://www.cdc.gov/nceh/ehs/ehsnet/plain_language/food-worker-handwashing-restaurant-factors.htm
15. https://www.steptoe.com/en/news-publications/federal-support-for-hand-sanitizer-production-fda-and-ttb-guidance-impact-of-the-cares-act.html