Abstract
The COVID-19 pandemic placed hygiene at the centre of disease prevention. Yet, access to the levels of water supply that support good hand hygiene and institutional cleaning, our understanding of hygiene behaviours, and access to soap are deficient in low-, middle- and high-income countries. This paper reviews the role of water, sanitation and hygiene (WaSH) in disease emergence, previous outbreaks, combatting COVID-19 and in preparing for future pandemics. We consider settings where these factors are particularly important and identify key preventive contributions to disease control and gaps in the evidence base. Urgent substantial action is required to remedy deficiencies in WaSH, particularly the provision of reliable, continuous piped water on-premises for all households and settings. Hygiene promotion programmes, underpinned by behavioural science, must be adapted to high-risk populations (such as the elderly and marginalised) and settings (such as healthcare facilities, transport hubs and workplaces). WaSH must be better integrated into preparation plans and with other sectors in prevention efforts. More finance and better use of financing instruments would extend and improve WaSH services. The lessons outlined justify no-regrets investment by government in response to and recovery from the current pandemic; to improve day-to-day lives and as preparedness for future pandemics.
Highlights
Rosina GironesDepartment of Genetics, Microbiology and Statistics, University of Barcelona, Barcelona, Spain Steve HrudeyFaculty of Medicine and Dentistry, University of Alberta, Alberta, Canada Juliet WillettsInstitute for Sustainable Futures, University of Technology Sydney, Sydney, AustraliaCaradee Y
The world in 2020 has been gripped by a pandemic of a novel coronavirus, severe acute respiratory syndrome coronavirus 2, cause of COVID-19.1 Starting in China in late 2019, by the end of July 2020, this had spread to virtually every country in the world, with global cases escalating past 15 million and over 600,000 deaths at the time of writing
We explore how the importance of adequate WaSH services is reinforced by evidence from other outbreaks and pandemics of contagious and infectious disease
Summary
Rosina GironesFaculty of Medicine and Dentistry, University of Alberta, Alberta, Canada Juliet WillettsCaradee Y. We explore how the importance of adequate WaSH services is reinforced by evidence from other outbreaks and pandemics of contagious and infectious disease.2 We address the roles, strengths and weaknesses of WaSH by analysing the three necessities for sustained handwashing (availability of sufficient flowing water, availability of soap and hand sanitisers where used and behaviours practiced by individuals) and consider WaSH in settings of specific concern.
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