With the talk of CORONAVIRUS and its daily toll on persons globally, knowing how to protect yourself must be a priority. Dr MILTON LUM has given some clear guidelines to follow if we are to stay safe.
"The Covid-19 outbreak brought into sharp focus the
need to keep hands clean by handwashing with soap and water, or the use of
alcohol hand sanitisers.
Clean hands, not masks, are more vital in the
avoidance of illness and spreading microorganisms to others
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To ensure your hands are rid of harmful
microorganisms, scrub your hands for at least 20 seconds, or as long as it
takes to sing the Happy Birthday song twice. — Photos.com
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Many infectious diseases are spread by not washing
hands with soap and clean running water.
How they spread
There are various ways in which microorganisms can
get onto human hands and cause illness.
The faeces of humans and animals often contain
microorganisms like Escherichia coli and Salmonella, which cause
diarrhoea.
In addition, faeces can also spread some
respiratory infections like adenovirus, and hand, foot and mouth disease, in
children.
These microorganisms find their way onto our hands
after we go to the toilet or change a diaper.
It can also occur after the handling of raw animal
meats that can have invisible amounts of animal faeces on them.
Microorganisms can also find their way onto our
hands if anyone touches an object that contains microorganisms on it.
This occurs as a result of an infected person
coughing or sneezing on the object, or another contaminated object touching the
object.'
When microorganisms on the hands are not washed
off, they can be passed from one person to another, thereby spreading and
causing illness.
A healthcare-acquired infection (HAI) is an
infection acquired by a patient during healthcare delivery in a hospital or
other healthcare facilities, which was not present or incubating on admission.
It is the most frequent adverse event in
healthcare and affects patients in any care setting during and after discharge.'
A HAI leads to prolonged hospital stays;
antibiotic resistance; disability; high costs for individuals, their families
and health systems; and unnecessary deaths.
It can also lead to infections in doctors, nurses,
other healthcare professionals or caregivers attending to patients.
From hands to face
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French tennis player Benoit Paire clutches his
face during a match at the recent Australian Open tournament. Touching our face
with hands that have picked up harmful microorganisms is one way we can get
infected. — AFP
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The washing of hands prevents illness and spread
of infection(s) to others.
When hands are washed with soap and water, there
is removal of a substantial number of microorganisms from their hands.
There are several ways in which handwashing
prevents infections.
Microorganisms from unwashed hands can get into
drinks and food during preparation or consumption.In addition, microorganisms can multiply in some
types of drinks or foods under certain conditions, then cause illness.
They can cause illness when they get into the
human body through the eyes, nose and mouth.
People often touch their eyes, nose and mouth
without realising it.
A study of medical students at the University of
New South Wales in Australia, published in 2015 in the American Journal of
Infection Control, reported that the subjects touched their faces 23 times per
hour.
“Of all face touches, 44% involved contact with a
mucous membrane, whereas 56% of contacts involved non-mucosal areas.
“Of the mucous membrane touches observed, 36%
involved the mouth, 31% involved the nose, 27% involved the eyes, and 6% were a
combination of these regions.
Another study, published in 2014 in the Journal
of the American Board of Family Medicine, observed hand hygiene and face
touching in family doctors and their staff in Cincinnati, United States.
The participants touched their eyes, nose and
mouth a mean of 19 times in two hours (a range of zero to 105 times) with
family doctors doing so significantly less often than their staff.
Microorganisms from unwashed hands can be
transferred to other objects like door knobs, table tops, hand rails etc, then
transferred to other people’s hands.
The transmission of healthcare-associated
microorganisms from one patient to another through caregivers’ hands involves
the following sequence:
- Microorganisms are present on the patient’s skin
or have been shed onto inanimate objects in the patient’s immediate vicinity.
- The microorganisms are transferred onto the hands
of caregivers, where they are capable of survival for several minutes.
- Handwashing or antisepsis by the caregivers is
inadequate or omitted, or the agent used for hand hygiene is inappropriate, and
- The contaminated hand or hands of the caregivers
come into direct contact with another patient or with an inanimate object that
will come into direct contact with a patient.
Protection against infection
There is substantial evidence that widespread
handwashing significantly reduces the incidence of diarrhoeal illnesses,
particularly in those with weakened immunity, as well as the incidence of
respiratory infections in the community.
Handwashing with soap can protect about one out of
every three young children with diarrhoea, and almost one out of every five
young children with respiratory infections like pneumonia.
Handwashing can prevent about 30% of
diarrhoea-related illnesses and about 20% of respiratory infections, both of
which are often prescribed antibiotics.
The reduction of these infections helps prevent
antibiotic overuse, which is the single most important factor that leads to
antibiotic resistance globally.
Handwashing can also prevent antibiotic-resistant
infections that are difficult to treat.
There is substantial evidence that hand antisepsis
reduces the transmission of healthcare-associated microorganisms and the incidence
of HAI.
Improvement in hand hygiene practices may reduce
transmission of microorganisms by half.
In short, the removal of microorganisms through
handwashing helps in the prevention of diarrhoea and respiratory infections,
and may even prevent skin and eye infections in the community setting.
In the healthcare settings, handwashing reduces
HAIs significantly.
Hand hygiene at the right time has saved, saves,
and will continue to save millions of lives globally.
It is a quality indicator of safe healthcare
systems as infections can be stopped by good hand hygiene practices.'
The World Health Organization (WHO) estimates that
the harm to patients and healthcare professionals can be prevented by less than
US$10 (RM42.25) and that alcohol-based hand sanitisers, which cost about US$3
(RM12.67) per bottle, can prevent HAIs and millions of deaths annually.
How to wash hands
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Hand sanitiser provided for the public at an ERL
counter. Alcohol-based hand sanitisers should be used only when your hands are
not visibly dirty, otherwise, handwashing with soap and water is a must. — ERL
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WHO recommends frequent handwashing with soap and
water, or the use of an alcohol-based hand sanitiser, if your hands are not
visibly dirty, as one of the basic protective measures against Covid-19
infection.
The US Centres for Disease Control and Prevention
(CDC) spells out the details of handwashing for the general public in five
steps: “Wet your hands with clean, running water (warm or cold), turn off the
tap and apply soap.
“Lather your hands by rubbing them together with
the soap. Lather the backs of your hands, between your fingers and under your
nails.
“Scrub your hands for at least 20 seconds. Need a
timer? Hum the Happy Birthday song from beginning to end twice.
“Rinse your hands well under clean, running water.
“Dry your hands using a clean towel or air dry
them.”
WHO has guidelines for hand hygiene in healthcare
too.
Handwashing with soap and water must be used when
the hands are visibly soiled or potentially contaminated with body fluids, and
when caring for patients with vomiting or diarrhoeal illness, regardless of
whether or not gloves have been worn.
A hand sanitiser containing 70%-95% alcohol is
used for hand decontamination in healthcare settings, as it is better tolerated
than handwashing with soap and water.
Non-alcohol-based hand sanitisers are not
recommended.
The message on clean hands in the Covid-19 outbreak
should be carried forward into the cultivation of frequent handwashing as a
daily habit for everyone.
This will also reduce diarrhoeal diseases and some
respiratory diseases in the medium to long term.
In summary, clean hands not only protect against
infections, but also saves lives."