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 & COVID-19
Video

Global Basic Drinking Water Services in 2019 10

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

  1. UNICEF, W. (2019). Progress on Household Drinking Water, Sanitation and Hygiene 2000–2017. UNICEF Report.

  2. Mekonnen, M. M., & Hoekstra, A. Y. (2016). Four billion people facing severe water scarcity. Science advances, 2(2), e1500323.

  3. 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.

  4. 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.

  5. 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.

  6. 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

  7. Handwashing. (n.d.). Retrieved November 21, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/handwashing.html

  8. 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.

  9. 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

  10. 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

  11. Amegah, A. K. (2020). Improving handwashing habits and household air quality in Africa after COVID-19. The Lancet Global Health, 8(9), e1110-e1111.

  12. 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.

  13. 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

  14. Schmidt, C. W. (2020). Lack of Handwashing Access: A Widespread Deficiency in the Age of COVID-19. Environmental Health Perspectives, 128(6), 064002.

  15. 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