Handwashing & Water Insecurity in COVID-19

Sarina Chaiken

~Note~

In this video, I will not address the profound inequities in water insecurity that exist within the United States. This is an immensely important issue that I urge you look into when you have the capacity.

Handwashing and Water Insecurity Before COVID-19

• 40% households worldwide lacked water for handwashing¹
• 4 billion people spend at least 1 month per year in severe clean freshwater deficit ^2,3
• Weather patterns, such as droughts and floods that contaminate water both cause and exacerbate this issue
• When freshwater is available, people cannot obtain it or allocate it to handwashing ⁴
• Soap is expensive, which limits its use for handwashing globally ⁵

Who is most impacted?

Handwashing Prevents the Spread of COVID-19

• Frequent handwashing is key to fighting COVID-19 ^6,7

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• Per the CDC, soap and “ the cleanest water possible” are ideal - 60% ethanol solutions are a great alternative if soap and water are not available ⁷

Access to Handwashing in the Time of COVID-19

• Those who experience water insecurity may already be more vulnerable to other health-disparities, including susceptibility to COVID-19 ⁸
• Those who lack water access for handwashing and cannot follow guidelines are more likely to spread and catch COVID-19, exacerbating pre-existing inequities ⁹

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Access to Handwashing in the Time of COVID-19

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• School closures have affected 90% of children worldwide, which has caused many to lose access to their primary source of water for handwashing.^10,11
• Due to COVID-19 handwashing campaigns and resources, in some areas handwashing rates have improved.

Ongoing Research

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• The preexisting Joint Monitoring Program �(a combined WHO and UNICEF initiative) �continues to monitor the global state of �Water Access, Sanitation, and Hygiene (WASH) ¹⁰
• WASH measures access to clean water among schools and households and uses these data to execute interventions
• Others continue to examine methods of behavioral change from a framework of “cultural embeddedness”¹²

Solutions and Current Efforts to Increase Handwashing

• Due to COVID-19, the WASH is accelerating its initiatives to increase access to water for handwashing in schools¹⁰
• UNICEF has provided global guidelines for schools reopening which would additionally provide increased water access for children at school ¹³
• The success of increased wells, temporary water tanker trucks, and distribution of hand sanitizer has prompted its expansion among other countries¹⁴
• A CDC study examined the use of handwashing stations in Ekurhuleni, South Africa and determined that they improve handwashing ¹⁵
• While temporary solutions abate issues in COVID-19, stable infrastructure and policy is needed to abate water insecurity in the long-term³

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References

• UNICEF, W. (2019). Progress on Household Drinking Water, Sanitation and Hygiene 2000–2017. UNICEF Report.
• Mekonnen, M. M., & Hoekstra, A. Y. (2016). Four billion people facing severe water scarcity. Science advances, 2(2), e1500323.
• Hannah, D. M., Lynch, I., Mao, F., Miller, J. D., Young, S. L., & Krause, S. (2020). Water and sanitation for all in a pandemic. Nature Sustainability, 3(10), 773-775.
• Young, S. L., Boateng, G. O., Jamaluddine, Z., Miller, J. D., Frongillo, E. A., Neilands, T. B., ... & Stoler, J. (2019). The Household Water InSecurity Experiences (HWISE) Scale: development and validation of a household water insecurity measure for low-income and middle-income countries. BMJ global health, 4(5), e001750.
• Freeman, M. C., & Caruso, B. A. (2020). Comment on “Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries”. Environmental Health Perspectives, 128(9), 098001.
• WHO SAVE LIVES: CLEAN YOUR HANDS IN THE CONTEXT OF COVID-19. (n.d.), https://www.who.int/infection-prevention/campaigns/clean-hands/WHO_HH-Community-Campaign_finalv3.pdf
• Handwashing. (n.d.). Retrieved November 21, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/global-covid-19/handwashing.html
• Schaider, L. A., Swetschinski, L., Campbell, C., & Rudel, R. A. (2019). Environmental justice and drinking water quality: are there socioeconomic disparities in nitrate levels in US drinking water?. Environmental Health, 18(1), 3.
• Fact Sheet: Lack of Handwashing with Soap Put Millions at Increased Risk to COVID-19 and Other Infectious Diseases. (2020). https://www.unicef.org/press-releases/fact-sheet-lack-handwashing-soap-puts-millions-increased-risk-covid-19-and-other
• UNICEF and WHO, & WHO, U. (2020, August 01). Progress on drinking water, sanitation and hygiene in schools. Retrieved December 07, 2020, from https://www.unicef.org/reports/progress-on-drinking-water-sanitation-and-hygiene-in-schools-focus-on-covid-19
• Amegah, A. K. (2020). Improving handwashing habits and household air quality in Africa after COVID-19. The Lancet Global Health, 8(9), e1110-e1111.
• Manjang B, Hemming K, Bradley C, et al. (2018). Promoting hygienic weaning food handling practices through a community-based programme: intervention implementation and baseline characteristics for a cluster randomised controlled trial in rural GambiaBMJ Open, 8, e017573.
• New guidelines provide roadmap for safe reopening of schools. (2020, December 04). Retrieved December 07, 2020, from https://www.unicef.org/press-releases/new-guidelines-provide-roadmap-safe-reopening-schools
• Schmidt, C. W. (2020). Lack of Handwashing Access: A Widespread Deficiency in the Age of COVID-19. Environmental Health Perspectives, 128(6), 064002.
• Mobile handwashing stations launched to fight COVID-19. (2020, October 09). Retrieved December 07, 2020, from https://www.cdc.gov/globalhealth/stories/2020/covid-mobile-handwashing-stations.html

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