Sanitation nation: how Covid created a home hygiene boom

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In the depths of the pandemic last spring, half of the world’s population was asked or ordered to stay at home. As people were trapped indoors, they made every effort to keep the novel coronavirus out, stocking their homes with an arsenal of cleaning products and emptying supermarket shelves as a result.

Jeffrey VanWingen was one such person. A video of the soft-spoken family doctor from Grand Rapids, Michigan, explaining how best to sanitise groceries went viral in March last year. In the 13-minute tutorial, which has been viewed more than 26m times on YouTube, VanWingen squirts Lysol disinfectant spray on a packet of crisps and bathes bags of apples and oranges in soapy water. 

“Amid all the fear over Covid-19, the home became a fortress, a sanctuary,” VanWingen tells the FT, “and I think our desperation to make every inch of it feel safe drove a lot of commerce.” 

Worldwide sales of household disinfectant grew by 47 per cent to $4.1bn in 2020, according to market research company Euromonitor, and are set to grow further still to $5.6bn by 2025. Demand has also soared for soaps and antibacterial gels. Meanwhile, a panoply of new products has gone mainstream thanks to the pandemic: air purifiers, carbon dioxide monitors and UV sterilisers, among others. 

But public health messaging about how Covid-19 is transmitted — whether via surfaces or through the air — has often lagged behind the scientific consensus, meaning demand for certain products has been misplaced. 

Reams of scientific research have now linked superspreader events with airborne transmission, but there is scant evidence directly demonstrating a link between surface transmission and outbreaks. Yet the UK government took until March this year to add “fresh air” to its “hands, face, space” guidance before dropping it altogether last week.

The World Health Organization and the US Centers for Disease Control and Prevention also prevaricated, only acknowledging that minuscule, airborne particles were the main route of transmission in spring 2021. 

As vaccines raise hopes that an end to the pandemic may be in sight, what, if any, of the often pricey paraphernalia associated with our newfound love of home hygiene are worth keeping as the world learns to live with Covid-19?

There is plenty of historical precedent for commercial crazes being birthed by public health crises. The phenomenon has been termed the “germ sell” by Nancy Tomes, a history professor at Stony Brook University. In the wake of the Spanish flu pandemic of 1918-20, companies used the virus to market everything from fridges to vacuum cleaners to toothpaste.

“Whether this marks the entry of the epidemic or not, the fact remains that ‘Spanish’ influenza is here and is a serious menace,” read a Colgate advert from 1918. “Remember the Three C’s . . . Clean Mouths, Clean Skins, Clean Clothes.” When memory of the Spanish flu faded, the same methods were applied to the Hong Kong flu epidemic, according to Tomes.

“It’s the same old, same old,” Tomes says. “Reappropriating the fear of the germ to sell household cleaning products. It traces its origins all the way back to amulets to protect against the plague. Many of them are useless but they help us feel in control.”

Professor Sally Bloomfield, chair of the International Scientific Forum on Home Hygiene, is thankful that the Covid pandemic has “refreshed our collective memory” about the need for good hygiene, but she worries people have picked up as many unnecessary new habits as helpful ones. 

© Matthew Billington

Much of the hygiene promoted during the pandemic has amounted to “nothing more than theatre”, according to Bloomfield. She says all too often companies took advantage of the public’s conflation of hygiene and cleanliness. “Marketeers will market,” says Bloomfield. “If the public erroneously believe that if something looks clean it’s free of harmful germs, we end up in a self-defeating circle where admen offer them products that achieve just that.”

In extreme cases, the effort to dispel these claims has led to advertising regulators banning product ads, or online marketplaces such as Amazon purging their listings. However, a confusion over the risk of Covid-19 spreading through surfaces and the actions necessary to mitigate against this risk has become far more pervasive. 

A torrent of scientific studies showing coronavirus could survive on cardboard for up to 24 hours, plastic for up to 72 hours and banknotes and phone screens for up to 28 days put people on high alert about surface, or fomite, transmission. But, according to Emanuel Goldman, a microbiology professor at Rutgers University, these studies examined a “humongous” amount of virus particles under “unrealistic” conditions, skewing the results. 

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“The amounts of virus studied could never realistically be produced by a few coughs or sneezes,” explains Goldman. If “a more realistic amount of virus” had been used in the studies, the particles would have “disappeared” and not been a threat after a matter of hours, he says.

In a paper published in the medical journal The Lancet, Goldman concluded the likelihood of surface transmission was “very small”, and scientific consensus has shifted unequivocally towards seeing coronavirus as an almost entirely airborne virus.

But, aping William Shakespeare, Goldman says: “What’s done cannot be undone. Everyone was whipped into a frenzy about surface cleaning by those early studies, and that hasn’t really gone away.”

Professor Clive Beggs, an infectious disease expert at Leeds Beckett University, agrees. He thinks people reached for the bleach bottle or the cleaning wipes because they were the “lowest hanging fruit”. “It feels real and comforting to scrub a table-top or a shopping bag, but for the effort expended, the gain in protection from coronavirus is low,” he says. 

Instead, both scientists think people should double down on the tried and tested hygiene practice of handwashing. “Everything else is irrelevant,” says Goldman. The age-old public health intervention was trumpeted into the British people’s heads by prime minister Boris Johnson in March last year, who recommended “[washing] your hands for the length of time it takes to sing happy birthday twice”. 

However, even hand hygiene has fallen over the course of the pandemic, with 84 per cent of Britons telling the Office for National Statistics in July that they always or often wash their hands after getting home, compared with 96 per cent in June 2020. This drop-off in basic hygiene practices suggests the “more extravagant measures . . . will fall by the wayside”, according to Beggs. 

FT readers, what about you? Have you changed your hygiene routines as the science around Covid-19 developed, or have your original pandemic habits become engrained? If you’ve been vaccinated, has that changed anything? Share your thoughts and experiences in the comments below.

Ian Bell, head of home care research at Euromonitor, says the pandemic has not just given rise to a “home hygiene boom” but has spurred innovation. “The emphasis has shifted from chemicals to gadgets and appliances,” he adds.

Home appliance brand Beko has not only mass-produced an ultraviolet-light disinfectant cabinet, retailing for nearly £200, but has also integrated UV lights into a range of other products, including fridges and tumble dryers. Before the pandemic, UV cleaning appliances, which have been proven to kill coronavirus particles, were the preserve of industry and rarely found in homes. 

At the more expensive end of the scale, Samsung’s AirDresser, which is priced at nearly £2,000, promises to eliminate bacteria from clothes by blasting them with up to 70C steam. In April this year, rival LG Electronics released its CLOi robot, an autonomous device that criss-crosses the house cleaning frequently touched surfaces with UV rays. 

But Jose-Luis Jimenez, a professor of atmospheric chemistry at the University of Colorado at Boulder, says these products, despite having “a futuristic appeal”, are “largely pointless”. “It’s like every football player on a team man-marking one player. We’ve put all our efforts towards targeting coronavirus on surfaces, and let airborne transmission in for easy goal after easy goal,” he says.

© Matthew Billington

Instead, he thinks products that successfully marshal aerosol particles, the microscopic droplets of liquid that carry the virus, are worth spending money on, but he concedes it’s often difficult for consumers to work out which ones do what they claim. Jimenez says that a colleague often tells him that 50 per cent of air purifiers are not worth having. “I think that’s a very modest estimate,” he adds.

There are two options, Jimenez says: devices that remove the virus from the air or devices that leave it in the air but render it non-infectious by damaging the protein coating used to bind to human cells. HEPA filters take the first approach by pushing the air from a room through minute fibres with distances of around a micron, in the process removing 99.7 per cent of contaminants, including Covid-19 particles, from the air, according to the CDC. 

Prices vary from about £150 to as much as £1,000, but Linsey Marr, a professor of environmental engineering at Virginia Tech university, says a lot of the add-ons for more expensive versions are “unnecessary”. “Once the virus particles have stuck to the filter, you don’t then need to apply UV or an ioniser to them, they’re not coming back, unless you start waving the filter around,” says Marr. 

The Belgian government has recently joined Taiwan in mandating the use of carbon dioxide monitors in certain public spaces to help in the fight against Covid-19. As people emit CO2 when they breathe out, such monitors are a helpful corollary for the likely spread of coronavirus particles in a poorly ventilated room, according to Jimenez.

Jimenez suggests such devices could be switched on at dinner parties and social gatherings to allow people “to keep a watchful eye” on the level of ventilation in a room. The Airthings Wave Radon detector, which is priced at €199, connects to an app on your phone and alerts you whenever CO2 levels are above 800 parts per million, encouraging you to open the window.

But Rachael Wakefield-Rann, a researcher who specialises in health and the built environment at the University of Technology Sydney, believes the changes wrought by Covid-19 to people’s homes could be more far-reaching. “It’s not just about the products we buy, but the homes we build,” she says. 

In the UK, a government-commissioned report by the Royal Academy of Engineering showed that the way buildings are designed and operated has all too often overlooked ventilation and called for greater investment in the area. The report hinted at the need for wider-scale transformation in architecture and design, based on infection control, echoing how increased understanding of tuberculosis in the late 19th century transformed interior design. 

Robert Koch’s discovery that TB was a contagious pathogen rather than a genetic disease in 1882 birthed the sanatorium as a treatment centre for the disease, which in turn bled into the way town houses were designed in Europe. Staples of Modernist design, such as terraces, balconies, sunroofs and whitewashed rooms, all owe their popularity to the effort to prevent TB, according to Wakefield-Rann. 

“We’ve come to notice air as a really important quality of space, but design could go one of two ways,” she says. “We could let more fresh outdoor air in or it could go the other way where we bubble ourselves off.”

VanWingen’s patients in Grand Rapids are still curious about the best way to protect themselves from Covid as the third wave begins. “I think it’s taken a while for the general public to catch up with the science on what works and doesn’t,” he says. “I imagine some appliances will start to gather dust over the years to come.”

“Whenever [my patients] ask about how to stay safe I generally say, ‘Get vaccinated and open the window,’ ” he adds.

Inconsistent, confusing, vacuous: government messaging on Covid

Chris Whitty, chief medical officer for England
Chris Whitty, chief medical officer for England © POOL/AFP via Getty Images

The government is dropping its Covid-advice slogan “hands, face, space” in favour of a new mantra designed to reflect the easing of lockdown measures: “keep life moving”, writes Kristina Foster. Accompanying the phrase is a set of guidelines focusing on the importance of ventilation and meeting outdoors — which has been seen as a late response to criticism that it failed to emphasise the importance of such measures earlier on.

Many countries rolled out their own health slogans during the pandemic, with mixed results.

France’s “Dedans avec les miens, dehors en citoyen” (Inside with my own, outside as a citizen) attempted to separate private and public Covid measures, but ended up reading like a philosophical riddle.

Germany went for the strong acronym “AHA”, standing for distancing, hygiene and daily face covering, which was expanded to “AHACL” in September to include the coronavirus app and “Lüften” — or airing out a room. 

The UK, whose Covid-19 messages have changed several times in the past year, began by appealing to the collective sense of responsibility: “Stay home, protect the NHS, save lives”. This evolved into “Stay alert, control the virus, save lives” and eventually into clearer directives of washing hands and wearing face masks.

The latest guidelines on ventilation outdoors echo Tokyo governor Yuriko Koike’s sanmitsu or “3Cs” policy, which warned against “closed places, close conversations, crowded spaces”. The slogan was so popular it was declared buzzword of the year at the end of 2020. 

Helen Ward, a professor of public health at Imperial College London, is critical of the UK government’s messaging during the pandemic. She says earlier slogans overlooked those who were unable to work from home and also missed out the critical issue of testing.

“ ‘Stay alert, control the virus, save lives’ [was] the most vacuous, and it was embarrassing to see public health professionals advocating this on government briefings,” she says. “It failed the basics of health advice, providing no practical actions for people or organisations. ‘Keep life moving’ is the same — an empty slogan.”

Oliver Barnes is an FT health and science reporter

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Autore dell'articolo: Redazione EconomiaFinanza.net

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