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Hand hygiene, cough etiquette, cleaning and laundry - Advice and information to the general public
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How to prevent transmission
The SARS-CoV-2 virus that leads to COVID-19 disease is spread primarily via droplet and contact transmission, when the virus is transmitted from the respiratory tract of an infected person to a healthy person. Therefore, good hygiene is an important measure to limit transmission in the population.
Cough etiquette and social distancing are crucial to limiting droplet transmission, while hand hygiene, and especially avoiding touching the face with unclean hands, is important to prevent indirect contact transmission.
- Facts about coronavirus: The virus, transmission and disease
- Facts about infection control measures during the COVID-19 outbreak
Avoid touching your face with unclean hands. This will prevent stop transmission via the hands to the eyes, mouth and respiratory tract.
When should hand hygiene be performed?
- Before cooking or eating food
- After using the toilet (or changing nappies)
- With visibly dirty hands
- After contact with bodily fluids (e.g., after wiping the nose)
- After contact with animals
- When you arrive at work / childcare centre / school
- After touching contact points in areas used by many people, including work / childcare centre / school
- Before putting on a face mask and immediately after removing it
Hand wash or hand disinfection?
Both hand washing and alcohol-based hand disinfection are, in most cases, effective methods of hand hygiene.
Alcohol-based hand disinfection is less effective when hands are wet, visibly dirty or soiled with organic matter such as food or bodily fluids. Therefore, washing with soap and water is normally recommended as a method outside the healthcare service.
However, during the COVID-19 pandemic, hand hygiene is performed more frequently than usual. Alcohol-based hand disinfection is easily available and less irritating to the skin on the hands. Therefore, it can be a good alternative to hand washing when your skin is dry and not visibly dirty.
For the best effect, follow the manufacturer's recommendations for how much to use and how long it takes to work.
NB: There is no need to perform both hand washing and hand disinfection – one is sufficient.
Effective hand washing, step by step:
Choice of disinfectant
It is important that the products used are both effective, safe and skin friendly.
The Norwegian Institute of Public Health, like WHO and ECDC, primarily recommends alcohol-based hand disinfection, based on ethanol or isopropanol. Ethanol is less irritating to skin, eyes and mucous membranes and may therefore be preferred as a main ingredient. The alcohol concentration should be between 70-90 per cent v/v.
Alcohol-based hand disinfectants have been used by the healthcare system in Norway for several decades. Even though some react with irritated skin, experience shows that alcohol-based disinfection is effective and is gentle to skin on the hands.
Hand disinfectants must comply with the requirements of the biocide regulations managed by the Norwegian Environment Agency.
Hand disinfectants with active ingredients other than alcohol are also available. In order to be sold in Norway, these products, like alcohol-based hand disinfectants, must comply with the requirements of the biocide regulations. They must show documented effect according to ES-NS-1500. There is limited experience with clinical use of these products.
How should you dry your hands after washing them?
You can dry your hands with disposable paper towels or warm air hand dryers. It is important that hand dryers are kept clean. They should be designed so that water does not collect at the bottom and then be blown out during use.
Hand towels can be used in private homes but should be changed regularly.
Warm air hand dryers should not be used in healthcare institutions. Read more about drying hands in the national hand hygiene guide in the health service.
How to prevent dry and sore hands?
Here is some advice to prevent dry and sore skin on the hands due to frequent hand hygiene:
- Use skin-friendly soaps (perfume-free, pH <5.5) and use good quality paper towels to reduce drying out of the skin. At home, clean towels are a good option.
- Wash your hands in lukewarm water, not hot water.
- Wet your hands before applying soap.
- Rinse your hands thoroughly after washing so that all soap suds are washed away.
- Pat your hands with the paper towel / towel until they are completely dry, avoid rubbing hard.
- Use hand cream to prevent dry and sore skin, as often as needed (e.g., after hand washing).
- When using shared tubes (other than by people in the same household), it is important to ensure that the tube opening does not come into contact with skin or objects during use, to avoid contaminating the cream.
Film about skin-friendly handwashing in several languages
See these animated films in several languages from the Psoriasis and Eczema Association (PEF).
The film is intended to promote skin-friendly handwashing during the coronavirus pandemic.
The film is available in these languages:
Use of disposable gloves
Transmission by hands wearing gloves happens in the same way as for hands without gloves. Therefore, we do not recommend the general use of disposable gloves, see Routine use of gloves for shop employees and customers is not recommended.
Precautions with use of hand disinfectants
- Alcohol-based hand disinfectants are flammable. Do not store or use at high temperatures or near open flames.
- Hands must be dry after using hand disinfectant before activities that may involve contact with heat, sparks or open fire (normal drying time is 20-30 seconds). Cases have been reported where hands that are damp with alcohol-based hand disinfectant have been set alight after close contact with open flames, for example, when lighting a candle or lighting a fire in a stove.
- Hands must also be dry before touching nearby objects because of the risk of static electricity. Sparks can arise. Cases have been reported where hands that are damp with alcohol-based hand disinfectant have touched metal objects, causing sparks.
- Alcohol-based hand disinfectants can be harmful if swallowed or if they come into contact with the eyes. Consider safe use and placement in areas where children, people with mental disorders or who are mentally impaired or other groups are at increased risk of accidental ingestion.
- Avoid coughing or sneezing directly onto others.
- Try to cough / sneeze into a paper tissue (carefully disposed of afterwards), or into the crook of your elbow if you do not have tissues available.
Laundry and home cleaning
- In households where coronavirus infection has not been confirmed, normal cleaning can be performed.
- In households where infection has been confirmed: Clean surfaces that are touched by both the infected person and others daily, such as bathroom sinks, toilets, door handles and kitchen worktops. Ordinary detergents can be used. Towels and bedding used by the sick person must be washed on a minimum of 60 degrees, other textiles at the highest possible temperature. Clothes and textiles that have been in contact with the infected person should be kept separately from other objects before washing. Wash your hands after handling the used textiles.