# Some quick notes on hand hygiene

I always wash my hands but typically not very well; I never worked in healthcare and never got trained. Given the [current situation](https://en.wikipedia.org/wiki/2019%E2%80%9320_Wuhan_coronavirus_outbreak) I decided to actually research how to do it properly.

Different sources differ slightly in their recommendations but the basic gist is the same. Some takeaways:
- Washing your hands should take ~ 20-30 seconds. If it's taking you much less you're not doing it right.
- Make sure you actually get all your hand surfaces, including your nails and between your fingers. The [WHO guide](https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf) has a good protocol that's probably worth memorising.
- If possible, try to dry your hands with a single-use towel, or air-dry somehow; not much point washing your hands and then drying them on a dirty towel.
- Good hand sanitiser (>60% alcohol) is a good substitute if your hands aren't visibly soiled, but you *still have to do the all-surfaces routine* and it should still take ~20 seconds.

For those of you who use [Anki](https://apps.ankiweb.net/), ankifying this is probably among the most valuable things you could ever use it for. Especially in the early days of a maybe-pandemic! Ditto for those of you who use TAPs. My read of the various health authorities is that good, regular hand-washing is way ahead of gloves and masks in terms of keeping you and your loved ones safe.

Other things that now would be a good time to hammer into your head if (like me) you didn't already: coughing into your elbow, sanitising your doorknobs and light switches, and not touching your face. These are all a good idea anyway during flu season, but you should use the impetus of the current situation to *actually do them* , rather than just vaguely intending to learn how to do them like everyone else.

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In the interests of reducing the number of people who read this, nod, vaguely intend to get better, and do nothing, here's an itemised checklist of concrete things you can do.

1. Read the The [WHO guide](https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf) and memorise/Anki the hand-cleaning/sanitation. [Here](https://drive.google.com/file/d/1yKSmq88I4qIbf63Ob82rIsoUXVFbFhOW/view?usp=sharing) is a little minideck of cards I made for my own practice.
2. Go to Walgreens/Boots/some other drug store and buy lots of little bottles of hand sanitiser (with alcohol!). Failing that, buy some big bottles [off Amazon](https://www.amazon.com/NATURALS-Advanced-Sanitizer-Conditioners-Essential/dp/B01BXYP4DE/ref=sr_1_4) and aliquot them into smaller containers for use on the go.
3. Order some alcohol in a [spray bottle](https://www.amazon.com/gp/product/B07MVPHTN1/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1) you can use to clean your light switches and doorknobs (I have no particular opinion on isopropanol vs ethanol for this, if somebody does then please comment and let me know).
3. If you have trouble touching your face, order some of that [anti-nail-biting stuff](https://www.amazon.com/Onyx-Professional-Biting-Sucking-Deterrent/dp/B005HGWH26/ref=sr_1_2_sspa) people use to train their kids and use it until your brain gets the message. Chili powder might work even better; if people try either of these (or something else) and it works well for kicking the habit I'd love to hear about it.

If anyone on here disagrees with any of this, please do comment and let me know. Other than the [WHO](https://www.who.int/gpsc/5may/Hand_Hygiene_Why_How_and_When_Brochure.pdf), you can also find guidance from the [CDC](https://www.cdc.gov/handwashing/show-me-the-science-handwashing.html), the [Mayo clinic](https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/hand-washing/art-20046253) and the [NHS](https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/), among others. And [here](https://foreignpolicy.com/2020/01/25/wuhan-coronavirus-safety-china/) is some other guidance on staying safe in outbreaks (though note that the author's position on both gloves and masks is somewhat controversial).

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ETA: Some more quick notes on *when* to wash/sterilise your hands. Broadly, the answer seems to be "much more often than you're probably doing it". Whenever you use the toilet, before you ever eat food, after touching dirty things, and after coughing/sneezing/blowing your nose are good TAPs to install (though note that you should not be coughing/sneezing into your hands). If you wash your hands super-often you're likely to have issues with your skin, but this is much less true of hand sanitiser, so use that to fill in the gaps.

This part is a little crude but probably important. I've previously gotten into a couple of arguments about whether you should always wash your hands after peeing, given that (i) your junk probably isn't that dirty and (ii) there's lots of things in your house / around town that are more dirty that you don't wash your hands after touching. I think argument (ii) is valid but more of an argument for cleaning your light switches/bathroom surfaces than for not washing your hands. It's also important to note that when you pee, and especially when you flush, you create a fine mist of very-much-not-clean toilet water that covers everything in the bathroom, including your hands.

But probably the strongest argument for always washing/sterilising your hands thoroughly after peeing is that you probably pee fairly regularly and don't wash your hands enough, and so instantiating a "wash your hands after peeing" TAP ensures you're washing your hands at least that often.