Hand sanitation after a half-year of COVID: any safety measures worth holding on to?

As the revamp of my webpage reaches its completion, I must consign myself to brief little “spurts” of writing while the domain transfer process rolls out and we iron out any remaining kinks.  It has long been a goal of mine to publish more frequent, brief articles (much like my Halloween one) but it is often easier said than done: what seems like a quickie all too often requires an extensive analysis to make sense of things, and, before too long—lo and behold—I’ve created a Russian haiku of 1,200+ words.  (Like this article!)  Let’s hope the next few posts will remain brief (by my standards) and will seem as whimsical as I like to think they are.

Needless to say, I’ve covered the influence of COVID-19 on the built environment for quite some time, particularly the efforts to mitigate the spread through measures that promote distancing and sanitation.  These measures, usually directed by state and local government entities, have resulted in considerable confusion across jurisdictional lines and a furious spitting contest to determine which jurisdictions are achieving the best results, using the day-to-day change in case loads (per capita) or accumulated death rate (per capita) as the closest metrics.  From these raw statistics, partisan bickering has grown increasingly heated over whether a more or less draconian lockdown is appropriate, gauging the low caseload in state X with stringent and long-term lockdowns versus the higher load in state Y that exercised few restrictive measures, or vise versa: that is, a state U with persistent lockdowns that still had high cases/deaths versus state V that remains low but with little to no lockdown. 

Now, a staggering eight months after the declaration of a global pandemic, it’s hard not to see the shift in views around localized efforts to “flatten the curve”: what used to be clinical intrigue has morphed to wry bemusement.  But this cynicism has less to do with an awareness of the disease’s contagion (but relative lack of virulence) and more about the inconsistency and lack of clarity to visible mitigation policy.  What about hand sanitation?  Take this example, seen in the restrooms of the Denver International Airport (DEN) in the late summer:

While this isn’t my first sighting of specific measures taken in restrooms to help promote social distancing and disease transmission, it’s the first to anathematize the conventional restroom hot-air hand dryer.  Long recognized as a more ecological substitute to paper towels, hot-air dryers have come under scrutiny in recent years, it seems, for harboring particularly troubling concentrations of bacteria that they suck up from the air—a sort of miasma elicited after flushing a lidless toilet aerosolizes fecal microbes.  Yuck.  Contrast this drying mechanism with conventional paper towels, and the latter win for hand sanitation, a practice already widely known among management in high-risk settings like hospitals and clinics.

So why do we still use hot-hair hand dryers throughout so much of the country?  I suspect that, for many businesses, it’s less about concern for the environment and more about the day-to-day cost of paper towels.  Hand dryers require little to no management, while paper towel dispensers require constant stocking of inventory.  And if the dispenser uses a roll to be torn—rather than individually, progressively folded single-use towels—it may impel the user to be more economical with towels, but the device is more likely to break or jam.  The internal mechanics of a hot-air hand dryer are complicated, but the use is quite simple for the customer…though I’ve always wondered if the energy consumption required from this high-BTU hand sanitation device nullifies the ecological benefit of paper reduction.

Regardless of those distinctions, it appears that disabling hot-air dryers is the preferred long-term solution for hand sanitation at DEN, at least in the era of COVID.

But this is clearly not a national solution, since I’ve been to numerous other public restrooms that retain the air dryers for customer use.  Then again, the very approach to disaster relief in the United States generally follows federalist principles, giving the states and even municipalities wide berth in devising the most suitable mitigation tactics.  We should therefore expect inconsistency across jurisdictions, though it begs the question if cultural differences impart greater perceived efficacy to certain solutions, in the same way that they interpret the seriousness of the disease differently.  Using Colorado again as the example, it’s hard not to notice another idiosyncratic solution, manifested once again through cautionary signage:

I encountered this policy in the small resort town of Crested Butte, but I saw indicators elsewhere that it is a statewide law for indoor dining.  Essentially it’s requiring customers to remain masked when entering and exiting a business, but person can obviously remove the mask to eat.  The fallacy in the law, of course, is that it treats “standing” and “eating” as mutually exclusive activities, when they obviously are not.  What if, as is frequently the case, a person is sitting but not yet eating, as when they’re waiting to order or for the food to arrive? 

I’ve seen no evidence of enforcement under these circumstances, but technically it would be a violation of the law.  And, if a person is standing and eating at a bar or counter, must he or she remain masked?

The attempt here at crafting a simple sanitation policy appears almost self-defeating: while more complicated regulations are more difficult to enforce (the violator may be ignorant of specifics), they at least apply a level of nuance that reduces the ambiguity that often frustrates the general public and jeopardizes the credibility of the enforcement agent.  I understand that these sort of laws serve as an implicit truce between public health experts and the restaurant/hospitality industry: the former wants to reduce transmission but the latter needs social gatherings to stay in business.  But from a virological perspective, I can’t believe it makes any sense.  If masks are so good at preventing the spread of COVID, why would we even want to give a single reprieve for people dining together, sitting at a table with less than six feet of separation, laughing and talking and salivating with those masks off?  If the interest of stopping the spread were paramount, wouldn’t we just have to eliminate all restaurant dine-in settings altogether?  For that matter, shouldn’t we just close most public toilets, if we want to reduce risk from improper hand sanitation?

The absence of an answer to these questions is, I suspect, beginning to shift public sentiment further away from the “spitting contest” over which countries/states are best at fighting COVID, to be replaced by a shared fatigue for how cavalier and downright silly some of these solutions appear.  We can’t all expect to attend music concerts in little hermetically sealed plastic space bubbles.  (Though I guess if it’s a Flaming Lips concert, they probably would have tried them out even if we never heard of a novel coronavirus.)