Handwashing & Water Insecurity in COVID-19
Sarina Chaiken
Handwashing and Water Insecurity Before COVID-19
Prior to the COVID-19 pandemic, approximately 40% households worldwide lacked water for handwashing1
This was partially due to the scarcity of fresh water; about 4 billion people spend at least 1 month per year in severe clean freshwater deficit 2,3
Weather patterns, such as droughts and floods that contaminate water both cause and exacerbate this issue
Even when freshwater is available, this water is often needed for other uses, such as cooking
When freshwater is available, it is often too expensive or physically challenging for families to acquire4
Soap is also a cost-heavy resource that limits its use for handwashing globally5
Handwashing Prevents the Spread of COVID-19
The WHO states that frequent handwashing is key to fighting COVID-19 6
Handwashing should occur after going out in public, coughing/sneezing, and before and after caring for someone who is ill.7
Per the CDC, soap and “the cleanest water possible,” is the best option. 60% ethanol solutions are a great alternative if soap and water are not available 7
Access to Handwashing in the Time of COVID-19
Those who experience water insecurity may already be more vulnerable to other health-disparities, including susceptibility to COVID-198
Those who lack water access for handwashing and cannot follow guidelines are more likely to spread and catch COVID-19, exacerbating pre-existing inequities9
School closures have affected 90% of children worldwide, which has caused many to lose access to their primary source of water for handwashing.10,11
Due to COVID-19 handwashing campaigns and resources, in some areas handwashing rates have improved.
Many African governments quickly implemented water tankers, bore holes, and mobile hand washing stations to aid in COVID-19 relief, which has substantially increased handwashing in these areas in 202011
What ongoing research exists?
A plethora of scientific research is currently examining changes in handwashing practices and accessibility in the wake of COVID-193
The preexisting Joint Monitoring Program (a combined WHO and UNICEF initiative) continues to monitor the global state of Water Access, Sanitation, and Hygiene (WASH)10
WASH measures access to clean water among schools and households and uses these data to execute interventions
Others continue to examine methods of behavioral change from a framework of “cultural embeddedness,” looking at the impact of cultural norms on handwashing practices 12
Solutions and Current Efforts to Increase Handwashing
Due to COVID-19, the WASH program is accelerating its initiatives to increase access to water for handwashing in schools10
UNICEF has provided global guidelines for schools reopening which would additionally provide increased water access for children at school13
The success of increased wells, temporary water tanker trucks, and distribution of hand sanitizer has prompted its expansion among other countries14
A CDC study examined the use of handwashing stations in Ekurhuleni, South Africa and determined that they improve handwashing15
While temporary solutions abate issues in COVID-19, stable infrastructure and policy is needed to abate water insecurity in the long-term3
Citations
UNICEF, W. (2019). Progress on Household Drinking Water, Sanitation and Hygiene 2000–2017. UNICEF Report.
Mekonnen, M. M., & Hoekstra, A. Y. (2016). Four billion people facing severe water scarcity. Science advances, 2(2), e1500323.
Hannah, D. M., Lynch, I., Mao, F., Miller, J. D., Young, S. L., & Krause, S. (2020). Water and sanitation for all in a pandemic. Nature Sustainability, 3(10), 773-775.
Young, S. L., Boateng, G. O., Jamaluddine, Z., Miller, J. D., Frongillo, E. A., Neilands, T. B., ... & Stoler, J. (2019). The Household Water InSecurity Experiences (HWISE) Scale: development and validation of a household water insecurity measure for low-income and middle-income countries. BMJ global health, 4(5), e001750.
Freeman, M. C., & Caruso, B. A. (2020). Comment on “Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries”. Environmental Health Perspectives, 128(9), 098001.
WHO SAVE LIVES: CLEAN YOUR HANDS IN THE CONTEXT OF COVID-19. (n.d.), https://www.who.int/infection-prevention/campaigns/clean-hands/WHO_HH-Community-Campaign_finalv3.pdf
Handwashing. (n.d.). Retrieved November 21, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/handwashing.html
Schaider, L. A., Swetschinski, L., Campbell, C., & Rudel, R. A. (2019). Environmental justice and drinking water quality: are there socioeconomic disparities in nitrate levels in US drinking water?. Environmental Health, 18(1), 3.
Fact Sheet: Lack of Handwashing with Soap Put Millions at Increased Risk to COVID-19 and Other Infectious Diseases. (2020). https://www.unicef.org/press-releases/fact-sheet-lack-handwashing-soap-puts-millions-increased-risk-covid-19-and-other
UNICEF and WHO, & WHO, U. (2020, August 01). Progress on drinking water, sanitation and hygiene in schools. Retrieved December 07, 2020, from https://www.unicef.org/reports/progress-on-drinking-water-sanitation-and-hygiene-in-schools-focus-on-covid-19
Amegah, A. K. (2020). Improving handwashing habits and household air quality in Africa after COVID-19. The Lancet Global Health, 8(9), e1110-e1111.
Manjang B, Hemming K, Bradley C, et al. (2018). Promoting hygienic weaning food handling practices through a community-based programme: intervention implementation and baseline characteristics for a cluster randomised controlled trial in rural GambiaBMJ Open, 8, e017573.
New guidelines provide roadmap for safe reopening of schools. (2020, December 04). Retrieved December 07, 2020, from https://www.unicef.org/press-releases/new-guidelines-provide-roadmap-safe-reopening-schools
Schmidt, C. W. (2020). Lack of Handwashing Access: A Widespread Deficiency in the Age of COVID-19. Environmental Health Perspectives, 128(6), 064002.
Mobile handwashing stations launched to fight COVID-19. (2020, October 09). Retrieved December 07, 2020, from https://www.cdc.gov/globalhealth/stories/2020/covid-mobile-handwashing-stations.html