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Only 23 Percent of Mainland Chinese Wash Hands After Using Toilet: Survey

Children wash their hands with soap in the western German city of Pfungstadt on August 8, 2009. Washing hands is advised to curb the spread of 2009 H1N1 influenza. AFP PHOTO DDP / THOMAS LOHNES GERMANY OUT (Photo credit should read THOMAS LOHNES/DDP/AFP via Getty Images)

News Analysis

As the novel coronavirus continues to infect more people in China and spread to other countries, experts say hand hygiene is an effective method in preventing the spread of the infectious disease. However, a Gallup/WIN study found that only 23 percent of people in mainland China wash their hands with soap after using the toilet. China’s low rate of handwashing makes it the most susceptible to infectious disease outbreaks, which could explain why the coronavirus was able to spread rapidly inside the country.

The Worldwide Independent Network and Gallup, together with 75 of the largest international study institutes, surveyed 63 nations to determine the proportion of people who wash their hands automatically with soap after using the toilet. Saudi Arabia had the highest rate of 97 percent; the United States near the middle with 77 percent; and China with the lowest rate of 23 percent.

The study found that some Asian countries tended to have a low percentage for automatically handwashing with soap after using the toilet, including South Korea with a 39 percent rate, and Japan with a 30 percent rate.

The very low rate of handwashing in China is directly related to the fact that the vast majority of public restrooms do not stock soap. Travel advisory organizations also warn that China’s public restrooms often do not have any toilet paper or, sometimes, stall doors. Foreign travelers are advised to always carry hand sanitizer and toilet paper.

The United States Centers for Disease Control and Prevention (CDC) cites“handwashing as the single most effective way to prevent the transmission of disease.” CDC studies have found that “hand hygiene is the single most important intervention for reducing healthcare associated infections and preventing the spread of antimicrobial resistance.”

The World Health Organization (WHO) has designated May 5 as World Hand Hygiene Day to improve healthcare provider adherence to hand hygiene recommendations; address the myths and misperceptions about hand hygiene; and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands.

The Henry the Hand Foundation highlights that scrubbing hands with soap for a minimum of 15-30 seconds and drying with paper towels is the most effective method to reduce the number of microbes and germs on hands. Although alcohol-based hand sanitizers can quickly reduce the number of microbes on hands in some situations, “they are not as effective as soap and water when it comes to removing and inactivating dangerous gastrointestinal illness-causing germs such as cryptosporidium, norovirus and clostridium difficile.”

The WHO updated its “Health Emergency” response to the novel coronavirus (2019-nCoV) on Feb. 5 by stating that the outbreak is not a pandemic. But WHO emphasized it needs $675 million to fund a preparedness and response plan for February through to April 2020. WHO added that: “There are no known effective therapeutics against this and WHO recommends enrollment into a randomized controlled trial to test efficacy and safety.”

China’s Wuhan City is the epicenter of the coronavirus outbreak. The Chinese regime continues to be the hotbed for the spread of emerging infectious diseases due to the spectacular rise of its export-led economy. The newest global risk is the outbreak in China’s Hunan Province of a highly pathogenic strain of avian influenza, H5N1.

According to China’s Ministry of Agriculture and Rural Affairs, the “highly pathogenic” disease has already killed 4,500 chickens in Hunan alone and the government has culled almost 18,000 chickens to prevent its spread.

Bird flu generally does not infect people, but WHO warns that influenza viruses constantly undergo genetic changes. If H5N1 virus mutates to become transmissible among humans, prior zoonotic outbreaks have had about 61 percent mortality rate in humans. That is on par with the mortality rate for Ebola.

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