page_title: Hand sanitizer
section_title: COVID-19 pandemic
hierarchical_section_title: Hand sanitizer / Production / COVID-19 pandemic
caption_attribution_description: English: A notice at a CVS Pharmacy about hand sanitizer shortages, because of during 2020 coronavirus pandemic in North Carolina, as well as a limit on purchases.
context_page_description: Hand sanitizer is a liquid, gel, or foam generally used to decrease infectious agents on the hands. In most settings, such as the current COVID-19 pandemic, hand washing with soap and water is generally preferred. Hand sanitizer is less effective at killing certain kinds of germs, such as norovirus and Clostridium difficile and unlike soap and water, it cannot remove harmful chemicals. People may incorrectly wipe off hand sanitizer before it has dried, and some are less effective because their alcohol concentrations are too low.
  In most healthcare settings alcohol-based hand sanitizers are preferable to hand washing with soap and water, because it may be better tolerated and is more effective at reducing bacteria. Hand washing with soap and water; however, should be carried out if contamination can be seen, or following the use of the toilet. The general use of non-alcohol-based hand sanitizers has no recommendations.
  Alcohol-based versions typically contain some combination of isopropyl alcohol, ethanol, or n-propanol, with versions containing 60% to 95% alcohol the most effective. Care should be taken as they are flammable.
context_section_description: In 2010 the World Health Organization produced a guide for manufacturing hand sanitizer, which received renewed interest in 2020 because of shortages of hand sanitizer in the wake of the COVID-19 pandemic.  Dozens of liquor and perfume manufactures switched their manufacturing facilities from their normal product to hand sanitizer. In order to keep up with the demand, local distilleries started using their alcohol to make hand sanitizer. Distilleries producing hand sanitizer originally existed in a legal grey area in the United States, until the Alcohol and Tobacco Tax and Trade Bureau declared that distilleries could produce their sanitizer without authorization.
  In the beginnings of the pandemic, because of hand sanitizer shortages due to panic buying, people resort of using 60% to 99% concentrations of isopropyl or ethyl alcohol for hand sanitization, typically mixing them with glycerol or soothing moisturizers or liquid contain aloe vera to counteract irritations with options of adding drops of lemon or lime juice or essential oils for scents, and thus making DIY hand sanitizers. However, there are cautions against making them, such as a wrong measurement or ingredient may resulting in an insufficient amount of alcohol to kill the coronavirus, thus rendering the mixture ineffective or even poisonous.
  Additionally, some commercial products are dangerous, either due to poor oversight and process control, or fraudulent motive. In June 2020, the FDA issued an advisory against use of hand sanitizer products manufacture by Eskbiochem SA de CV in Mexico due to excessive levels of methanol – up to 81% in one product. Methanol can be absorbed through the skin, is toxic in modest amounts, and in substantial exposure can result in "nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death". Products suspected of manufacture by Eskbiochem SA with excessive methanol have been reported as far away as British Columbia, Canada.
  The FDA expanded the list of dangerous hand sanitizers.
caption: A notice about hand sanitizer coronavirus shortages at a CVS Pharmacy on 17 March 2020
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