Abstract
Background: Hand hygiene may mitigate the spread of COVID-19 in community settings; however, empirical evidence is limited. Given reports of similar transmission mechanisms for COVID-19 and seasonal coronaviruses, we investigated whether hand hygiene impacted the risk of acquiring seasonal coronavirus infections. Methods: Data were drawn from three successive winter cohorts (2006-2009) of the England-wide Flu Watch study. Participants (n=1633) provided baseline estimates of hand hygiene behaviour. Coronavirus infections were identified from nasal swabs using RT-PCR. Poisson mixed models estimated the effect of hand hygiene on personal risk of coronavirus illness, both unadjusted and adjusted for confounding by age and healthcare worker status. Results: Moderate-frequency handwashing (6-10 times per day) predicted a lower personal risk of coronavirus infection (adjusted incidence rate ratio (aIRR) =0.64, p=0.04). There was no evidence for a dose-response effect of handwashing, with results for higher levels of hand hygiene (>10 times per day) not significant (aIRR =0.83, p=0.42). Conclusions: This is the first empirical evidence that regular handwashing can reduce personal risk of acquiring seasonal coronavirus infection. These findings support clear public health messaging around the protective effects of hand washing in the context of the current COVID-19 pandemic.
Highlights
The expanding global outbreak of Coronavirus Disease 2019 (COVID-19) demands an evidence-based public health response
This study aimed to assess the relationship between hand hygiene and the risk of contracting seasonal coronavirus infection in an English community cohort
Moderate-frequency handwashing was associated with reduced overall risk of coronavirus infection
Summary
The expanding global outbreak of Coronavirus Disease 2019 (COVID-19) demands an evidence-based public health response. The balance of evidence suggests small but significant reductions in rates of influenza and influenza-like-illness, likely impacted by the specific community context[12,13,14]. Trial outcomes reflect both the effectiveness of the intervention at altering behaviour as well as the relationship between the behaviour and risk of subsequent illness. Conclusions: This is the first empirical evidence that regular handwashing can reduce personal risk of acquiring seasonal coronavirus infection These findings support clear public health messaging around the protective effects of hand washing in the context of the current COVID-19 pandemic
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