Washing your hands for 20 seconds in the approximately 10 -15 times a day, as recommended by the CDC, is unnatural. As a physician who washes his hands anywhere from 30 to 60 times a day (yes, I have counted), you can take it from me, it is an unnatural exercise. But for me, it is a habit. For the general public, it needs to be learned and learned fast. Anyone who works in the health care field in any capacity knows that handwashing is not always done as directed by hospital policy, common sense, and sound studies. So now we are expecting the general public to follow the standards of what we do in the medical field.
The military is an excellent environment for studies that involve telling people what to do. If we order a soldier to do something, the order will more than likely be followed, or there are immediate consequences. It turns out; there have been multiple studies on handwashing and the prevention of disease done in the military setting (1,2,3). The bottom line is that handwashing, when appropriately done, is associated with marked reduction of illness. Well, that is a big “DUH.” But it also turns out, even in the ideal military setting of telling people what to do and expecting them to follow, it remains a challenge to maintain consistent positive behavior.
So if handwashing is unnatural, it turns out that touching your face is the most natural thing to do. In one observational study of medical students, it was found they touched their faces on an average of 23 times…….per hour! With almost half of those times touching a mucous membrane (4). We touch our faces. Remember the public health official speaking on national news and her reflex to touch her face? Even when you KNOW not to do something, and it is a natural reflex, you CAN’T HELP IT! Be aware of that natural habit and minimize the face touching as best as you can. That is what I tell my patients every flu season, and it is what I tell my medical students and resident physicians all the time. We know proper hand hygiene is the key to countering the natural habit of touching your face. Count how many times and where you touch your face in one hour. Think about all the objects you touched before you rubbed your eyes, scratched your nose, moved the hair off your forehead.
So sing the “Happy Birthday” song twice (I sing “You are my Sunshine”) and slow down the nose-picking. It just may save your life.
- Ryan MA, et al. Am J Prev Med. 2001 Aug;21(2):79-83. doi: 10.1016/s0749-3797(01)00323-3
- Guo N, Ma H, Deng J, Ma Y, Huang L, Guo R, Zhang L.Medicine (Baltimore). 2018 Dec;97(51):e13144. doi: 10.1097/MD.0000000000013144.
- Tam CC, et al. Am J Trop Med Hyg. 2018 Oct;99(4):1089-1095. doi: 10.4269/ajtmh.18-0219.
- Kwok YLA. Am J Infect Control. 2015 Feb;43(2):112-4