Recommendations to Member States to improve hand hygiene practices to help prevent the transmission of the COVID-19 virus. Interim guidance, 1 April 2020
World Health Organization
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Recommendations: Member States to improve hand hygiene practices widely to help prevent the transmission of the COVID-19 virus by: 1. Providing universal access to public hand hygiene stations and making their use obligatory on entering and leaving any public or private commercial building and any public transport facility. 2. Improving access to hand hygiene facilities and practices in health care facilities. Background: Current evidence indicates that the COVID-19 virus is transmitted through respiratory droplets or contact. Contact transmission occurs when contaminated hands touch the mucosa of the mouth, nose, or eyes; the virus can also be transferred from one surface to another by contaminated hands, which facilitates indirect contact transmission. Consequently, hand hygiene is extremely important to prevent the spread of the COVID-19 virus. It also interrupts transmission of other viruses and bacteria causing common colds, flu and pneumonia, thus reducing the general burden of disease. Although awareness of the importance of hand hygiene in preventing infection with the COVID-19 virus is high, access to hand hygiene facilities that include alcohol-based hand rubs as well as soap and water is often suboptimal in the community and in health care facility settings, especially in low-and middle-income countries. WHO and UNICEF estimate that globally 3 billion people lack hand hygiene facilities at home and two out of five health care facilities lack hand hygiene at points of care.1 Further, access has become increasingly challenging as a result of stock-outs of supplies. When hand hygiene is provided free of charge and is made obligatory by public health authorities, acceptability and adherence to hand hygiene best practices are improved, including in public health emergencies of international concern.2,3 Hand hygiene is the most effective single measure to reduce the spread of infections through multimodal strategies, including access to the appropriate supplies.4 Therefore, this guidance is relevant for all countries and is recommended particularly for areas without ready access to hand hygiene locations.