Consistent handwashing, or hand sanitising when water and soap aren’t readily available, is one of the primary Covid-19 prevention strategies promoted and popularised by the World Health Organisation (WHO). The global health body recommends hand sanitiser with alcohol content of at least 70%, but there are just as many alcohol-free sanitisers on the market, some of which contain benzalkonium chloride, an antiseptic and disinfectant, as an alcohol substitute.  

While alcohol-free hand sanitisers may reduce the number of pathogens on your hands, they are less effective than alcohol-based sanitisers and not recommended for use against Covid-19.  

“This is why we strongly recommend alcohol-based sanitisers. It works fast and effectively if it is at 70% concentration, as recommended. We simply cannot vouch for the any other type of sanitiser because they haven’t been tested and no standard is in place for now,” says Emmah Monyanga, inspections manager at the National Regulator for Compulsory Specifications (NRCS), the government body that oversees product standards relating to human health, safety and the environment.  

Currently, there is no regulatory standard for hand sanitisers in South Africa, but discussions are currently underway to ensure that all hand sanitisers on the market are up to scratch. 

“We were caught off-guard with the coronavirus. There are no compulsory regulations, only voluntary standards for alcohol-based hand sanitisers, so we have started discussions with the South African Bureau of Standards to see if we can get new regulations legislated that conform to international standards,” confirms Monyanga. 

Alcohol, at 70% or higher, destroys the envelope protein surrounding some viruses, including coronavirus. This protein is essential for the virus’s survival and multiplication. Alcohol in sanitisers may be labelled as ethanol, isopropyl alcohol or ethyl alcohol, and it has been found effective in killing numerous types of bacteria, including  MRSA and E coli, as well as many viruses including influenza A, rhinovirus, hepatitis A, HIV and Middle East respiratory syndrome coronavirus (MERS-CoV). 

Gold standard of hand hygiene 

In the meantime, public awareness is the only safeguard against hand sanitisers which fall through the cracks of effectiveness against Covid-19. Most important to know is that along with alcohol-free sanitisers, those with less than 60% alcohol are least effective.   

“Hand sanitisers reach a maximum reduction rate of Log 3 (the rate at which pathogens are killed), which means the number of germs left after using it is 1 000 times smaller. Disinfectants on the other hand, must reach a reduction rate of Log 6, which means the number of germs left after use is 1 000 000 times smaller. This is why disinfectants, not sanitisers, are used in hospitals,” explains Brink Heinemann, international agent for ADI, a SABS approved and internationally accredited surface disinfectant. 

The gold standard for hand hygiene and preventing the spread of coronavirus, however, remains washing with warm water and soap.  

“Sanitisers are a convenience when you’re out shopping, but washing your hands is not only effective, it avoids skin irritation that might be caused by alcohol-based products,” says Monyanga. 

Tips:  

• When using hand sanitiser, apply the product to the palm of one hand and rub it all over the surfaces of your hands until they are dry. Spread all over your hands, including between your knuckles, palms, wrists, back of your hands and fingernails. 
• Use hand sanitiser as an alternative when you don’t have access to soap and water. Soap is better at penetrating dirt and grease, which harbours germs. 

• Avoid making DIY hand sanitiser, as there is no verifiable information about the methods used or and whether they are safe for use on human skin. 
• Wash your hands with warm water, not cold water. Rub the soap in for at least 20 seconds. 
• You should wash your hands before and after preparing food, before eating food, before and after using the toilet, after blowing your nose, coughing or sneezing, after touching an animal or animal feed, and after touching waste.