Is better hygiene here to stay?

BELFAST, Northern Ireland — The new coronavirus has created an uptick in better hygiene habits — particularly around the frequency and duration of hand-washing — yet water, sanitation, and hygiene experts question whether such practices will last beyond the pandemic. Washing hands is one way to reduce the risk of contracting not only COVID-19, but also a multitude of other illnesses, including diarrheal diseases, respiratory infections, and cholera, as well as neglected tropical diseases such as trachoma, schistosomiasis, and leprosy. “You would argue that this boost of efforts that’s being placed specifically on better hygiene promotion will have an implicit effect on other continuously occurring outbreaks like cholera,” said Marielle Snel, senior global humanitarian WASH specialist at Save the Children. “You would logically think this is something that would be further picked up.” After all, doing something for two weeks turns it into a habit, said Pritha Hariram, water and sanitation specialist at FMO, the Dutch development bank. The first case of COVID-19 was declared late last year in Wuhan, China, and almost all populations for several months have been aware of the subsequent need for increased hand-washing. But the human mind forgets very quickly, Hariram said. “Without a dedicated and deliberate effort, it’s likely that any increase in hand hygiene during the COVID-19 outbreak will be short-lived,” agreed Robert Dreibelbis, associate professor in the department of disease control at the London School of Hygiene & Tropical Medicine. To address the long-term determinants of hand-washing behaviors, any changes beyond the pandemic would require specific strategies to build new habits and create environments that make hand-washing convenient, he added. That means increased investment in hygiene, which experts say is so far lacking in donor commitments to tackle the coronavirus. Last month, Sanitation and Water for All called on leaders to prioritize WASH, highlighting its importance in building resilience to future crises. According to WaterAid, only eight out of 53 major donor commitments to COVID-19 mention hygiene. Kelly Bridges, senior associate at Global Water 2020 — an initiative focused on water access and security — said that there is also a gap in public and private finance for WASH in other health spaces, such as neglected tropical diseases, with water access and hand-washing essential in limiting or breaking the transmission cycle for 16 of 20 NTDs, she said. “Without a dedicated and deliberate effort, it’s likely that any increase in hand hygiene during the COVID-19 outbreak will be short-lived.” --— Robert Dreibelbis, associate professor, London School of Hygiene & Tropical Medicine According to Snel of Save the Children, better integration between the WASH and public health spaces, as well as other thematic areas, would yield better health outcomes, but such areas have historically remained siloed. COVID-19 provides an opportunity for more conscious efforts, she said. “We are really making progressive steps, and this unfortunate outbreak has created a possible further level of consciousness on how interlinked we all are and how important it is to get our health infrastructure well-aligned and working effectively — not just for the immediate term, but for the medium and long term and, as such, link that up with adequate WASH services,” Snel said, adding that she is hopeful this will happen. But it cannot just be the WASH sector making all the noise, Bridges said. “The demand for WASH really needs to come from the health sector,” she argued. Hariram of FMO said nongovernmental organizations need to push governments to include WASH on the priority agenda — not just for COVID-19, but as part of their plans for achieving the United Nations’ Sustainable Development Goals.