Abstract
Transmission of SARS-CoV-2 – the causative agent of COVID-19 – can be prevented through non-pharmaceutical interventions such as observing proper hand hygiene using alcohol-based hand rubs/sanitisers (ABHRs) as recommended by the WHO and local health authorities. However, this recommendation has led to high demand for ABHRs and proliferation of sub-standard products, which do not contain the recommended amount of alcohol. Fifty products of different origins and formulations obtained off-the-shelf and in public places in and around Pretoria (South Africa) were analysed for their alcohol content using gas chromatography. Ethanol was the most common alcohol used in the products, followed by isopropanol. Only 21 (42%) of the products analysed contained at least 70% alcohol; of these only 14 (28%) met the WHO recommended 80±5% alcohol content to have a virucidal effect on SARS-CoV-2. Of the 41 commercial off-the-shelf products analysed, 27 (66%) contained less than 70% alcohol in comparison to 13% of homemade products. Only 18% of gel products contained 70% alcohol, compared with 47% for liquid-based products. Most of the products did not contain the appropriate or correct declaration as recommended by the South African National Standards (SANS 289 and 490). The proliferation of substandard ABHRs is of great public health concern and calls for stricter regulations and enforcement in order to protect consumers, their rights and well-being during and post the COVID-19 pandemic period. However, in the interim, formulation of ABHRs using the WHO guidelines should be mandatory, as such formulations, when made correctly, do have the required virucidal effect against SARS-CoV-2.Significance: Commercial, off-the-shelf and public hand sanitisers were analysed to determine whether they contained enough alcohol to be efficacious virucides as recommended by the WHO. The majority of the products analysed were substandard, did not contain the recommended amount of alcohols and were not labelled correctly according to local and international standards. Homemade products conformed to a greater degree to the WHO standards for alcohol-based hand sanitisers. It is evident from these results that there is a need to monitor the manufacture of off-the-shelf products to ensure compliance and to assure consumers that products offer the required protection against SARS-CoV-2.
Highlights
In December 2019, an infectious disease named COVID-19 caused by a novel coronavirus (SARS-CoV-2)[1] was first identified in Wuhan, Hubei Province, China[2]
A direct rapid and reproducible gas chromatography method for the determination of alcohols in hand-based sanitisers that can be used for the quality control of ABHRs was developed and optimised
Most of the commercial alcohol-based products sold and made available to consumers in public places are sub-standard and do not contain the required amount of alcohol to be classified as effective virucides, especially against SARS-CoV-2, the causative agent of COVID-19
Summary
In December 2019, an infectious disease named COVID-19 caused by a novel coronavirus (SARS-CoV-2)[1] was first identified in Wuhan, Hubei Province, China[2]. Interrupting the chain of virus transmission using non-pharmaceutical interventions such as observing physical distancing, wearing of a face mask and maintaining good hand hygiene (washing hands with soap or the use of alcohol-based hand rubs/sanitisers (ABHR)) as recommended by the WHO and national health agencies remain the primary prevention options, especially given the slow pace of vaccination and the emergence of genetic variants of SARS-CoV-2. This demand drove the global hand sanitiser market valued at USD2.7 billion in 2019 up to USD3.3 billion in 2020, which is projected to reach USD13.7 billion by 2027.5 In South Africa, production facilities for the raw materials needed to make hand sanitisers experienced a nearly 400% increase in demand, opening the door to the introduction of substandard products, exploitation (inflated prices) and corruption leading to estimated overpricing to the level of ZAR66 million.[6]
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