Understanding the importance of true cleanliness in infection control

The recent COVID-19 / Coronavirus pandemic has brought hygiene back to the forefront of the mind. We now all know that we must wash our hands more frequently, and that we must regularly seek to remove germs from touchpoint surfaces and any surfaces with bodily fluids present.

 

But there are some large misconceptions about what this actually means. Even the government advice can be slightly misleading.

 

Analogy: cleaning a floor at home vs in a commercial building

Were you to ask 100x people on a high street how to clean a floor, 99% would probably reply “with a mop”. This is because it’s how they do it at home. And at home that’s probably effective.

 

But imagine if you had hundreds or thousands of people a day in your home. All of a sudden, swilling a mop around isn’t going to be an effective way of removing that level of contamination.

 

Clean vs sanitise vs disinfect

You should know that there is a difference between cleaning, sanitising and disinfection.

Cleaning is the removal of soiling, whether visible of invisible, from a surface.

Sanitising is the reduction of bacteria and germs.

Disinfection is the removal of bacteria and germs.

 

You can sanitise a surface without necessarily cleaning it first, or indeed you can have one product or process which does both (e.g. your Dettol spray at home). But you cannot disinfect without thoroughly cleaning first.

 

Disinfection requires a clean surface

“Disinfection is a process that reduces the number of micro-organisms to a level at which they are not harmful and is only effective if the surface is thoroughly cleaned with a detergent solution beforehand” (NHS)

 

Since the COVID-19 outbreak we have seen countless videos and photos of sanitising wiping (either spray and wipe or using wipes) taking place. But is this effective? It is clear that you need to ensure that the surface is thoroughly and effectively cleaned first before germs can be removed.

 

Killing germs at home vs in a commercial building

Whilst in a domestic setting, where contamination does not build up to significantly, spray and wipe sanitisers can play an effective role in helping to remove build-up of germs, in a commercial setting, with much higher usage and therefore much higher levels of dirt on surfaces, the process needs to be:

  1. Clean
  2. Disinfect

 

Sanitiser sprays or products claim to both clean and remove germs. It could be that these are effective, but don’t assume.

 

 

Even after disinfection, the next time a surface is used it could have germs on it again

 

It is possible to leave a residual effect on a surface following disinfection which repels any germs, keeping them airborne where they will swiftly die out. However, if that surface gets soiled or has too much abrasion on it, it can become a landing place for bacteria again.

 

Many disinfection processes do not even leave that residual effect, so as soon as the first person with the virus on their hands touches a door handle, that is contaminated.

 

Disinfection is not a one-and-done; you need constant maintenance.

 

 

So, what should you do, practically, to reduce risk to yourself and others?

 

If you are running a business that is still operational, I’d recommend a weekly deep clean and disinfection clean is done professionally. This can include a residual effect which lasts for up to 8 days (though note as mentioned above that touch points will need regular cleaning and sanitisation between this). On a day-to-day basis, concentrate on sanitising your high frequency touch points such as door handles as much as you can.

 

If you are travelling to work on public transport, I would have my own spray or pack of wipes with me and I would be cleaning and then disinfecting any surfaces before I touched them. Note that if you have alcohol-based wipes, for example, the alcohol will almost certainly be used up cleaning the surface so then will have nothing left to kill germs – you need a double process.

 

At home, you shouldn’t need to worry quite as much because germs will be more contained within your family unit. If you need to go out to work, I would strongly advise taking off clothes as soon as you get home, then either washing them or putting them somewhere and leaving them for 72 hours (long enough for any of the virus that may have been deposited onto them to be killed off. Then, give your hands and any exposed skin areas a thorough wash with soap.

 

 

And, of course, wash your hands and don’t touch your face!

 

Interestingly, cases of Norovirus are dramatically down this year because people clearly are washing their hands more than they would have done before. Hopefully we can all stick to this higher level of hygiene when the world returns to normal.