Researchers estimate that the impact of flu-like viruses, including the fast-spreading coronavirus, could shrink by 24% to 69% if travelers washed their hands properly at all airports.
By increasing hand washing at only 10 major airports, the risk of a pandemic could drop by 37%, said the researchers, who hail from the Massachusetts Institute of Technology and the University of Cyprus.
“Our study concludes that population engagement with proper hand hygiene could be a simple and effective solution for preventing transmission of infections and reducing the risk of massive global pandemics,” they wrote, noting that viruses transmit easily at airports and during flights.
The study was published in the Risk Analysis journal on Dec. 23 before news about the coronavirus in China broke.
But Christos Nicolaides, senior author and a fellow at MIT, said Tuesday the coronavirus appears to follow the same “rules” of transmission of flu-like illnesses and, therefore, applies to the study.
The coronavirus, officially named “covid-19” by the World Health Organization on Tuesday, has killed more than 1,000 people and sickened about 42,000 worldwide. Most of the cases and deaths have been reported in mainland China. Twenty-four other countries confirmed 393 cases, as of Tuesday.
Since the outbreak began in December, officials have implemented drastic measures involving air travel.
Multiple airlines have canceled flights to China amid warnings from the State Department urging passengers to not fly to China. The Trump administration has barred entry of foreign nationals who recently visited China with few exceptions. Hundreds of Americans evacuated from the Asian country are being held under mandatory 14-day quarantines.
The fast, far-ranging human travel and crowded, confined spaces with usually poor hygiene make air transportation a perfect hub for contagious illnesses.
But proper hand washing, considered the most efficient and cost-effective line of defense against diseases, could play a significant role in stemming the spread of infections and mitigating possible health crises, according to the study.
“Proper hand hygiene is essential because people touch their face multiple times with their hands and provide a route of entry for many different pathogens,” said Dr. Amesh Adalja, a senior scholar for Johns Hopkins Center for Health Security who was not involved in the study. “It’s hard to come up with an absolute quantification of what the decrease in infections will be with proper hand hygiene, but we know that it is sizable.”
The researchers used world air-traffic data from September 2017, which included more than 1.9 million flights, for their study. They also established the “status quo” level of hand cleanliness of 20%, the amount of people that have “clean hands” in an airport at any given time.
If the “status quo” increased to 30% at all airports, the impact of a disease worldwide declined by 24% and decreased even further to 69% if hand cleanliness ticked up to 60%.
Achieving such measures at so many airports could be costly and impractical, but the researchers conclude that a large reduction in disease spread could be reached by improving hand cleanliness at only 10 major international airports: London Heathrow, Los Angeles, John F. Kennedy, Charles de Gaulle in France, Dubai, Frankfurt, Hong Kong, Beijing Capital, San Francisco and Amsterdam.
“The trick is to sanitize your hands in the first place,” said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University. He said people can also practice proper cough etiquette and try to avoid people who are coughing and sneezing.
Health professionals say people should wash their hands with soap and water for 15 to 20 seconds, cleaning their palms and the backs of their hands.
To encourage hand hygiene, Mr. Nicolaides said airports could increase touch-free hand-washing devices, especially outside of restrooms.
Dr. Adalja added airports can make sure they have enough alcohol-based hand sanitizers that are properly stocked and conveniently located.