We all know that poor hygiene within dense populations is a breeding ground for diseases. On the other hand, we know that some kind of medium level of exposure to infectious agents on a daily basis is strengthening immunity and keeps it alert.
The big question is what happens when we start to use sanitizers en masse within whole populations?
Hospitals have special procedures aiming at the rotation of chemically-based sanitizers to avoid the rise and promotion of drug-resistant bacteria and viruses.
How is this problem addressed within whole populations? This seems to be important to know right now during the COVID19 outbreak.
Use of hand sanitizer is very pivotal to combat current covid-19 pandemic. It's going to imply a positive impact in such a highly contagious disease.
You raised a very good question and this issue is of special concern as an existing threat of human health. Over use or miss use of sentiseizers will have negative impact on human health due to emerging of resistant microorganisms. A weaken and inert immune system will be a serious consequences that maximize the likelihood of infection that might have the ability to exert its severity due to failure of immune system to counteract this infection.
Use of hand sanitizer is very pivotal to combat current covid-19 pandemic. It's going to imply a positive impact in such a highly contagious disease.
Dear Jiri,
you posted an intriguing question. Although preventing drug-resistance is reasonable and scientifically accurate, this very moment is delicate and we have to fully enforce hand sanitizing. Whole world population is now in a real dangerous time; scientific community has to promote public hygiene as hard as possible. In my opinion, sanitizers rotation is a very clever way to manage this emergency, and it should be encouraged.
Good luck with your work,
Dave
Narjes Alfuraiji, Md. Israt Hasan, Davide Frumento, Dear Colleagues,
The question what is given here is very complex and the correct answer to it and implementation of these answer requires unpreceded coordination of medical doctors, hospitals, countries' health systems, disinfectant producers, sale business, and whole populations within countries and across the whole globe.
I would like to see what can be done in this direction. Incorrect implementation of disinfection procedures can lead to collateral infections and hence unwanted diseases and even deaths.
This question was raised to stimulate discussion on the complexity of the consequences of from-the-first-sight quite simple solutions to various kinds of threats to our health.
The question is very interesting and the discussion can be very complex. Undoubtedly, the use of hand sanitizer is very important to combat the current situation. However, prolonged use of hand sanitizers or extra hygiene can lead to allergic reactions. The normal microflora of our skin is important in many ways. It protects us from harmful skin infections and there are high chances of getting skin fungal infections if we keep sweeping normal microflora of skin using these sanitizers. Secondly, exposure of our body to microorganisms of the environment is very important to develop acquired immunity and extra hygiene may hinder the development of acquired immunity.
The concept is beautifully explained by
Wills-Karp, M., J. Santeliz, and C. L. Karp. 2001. The germless theory of allergic disease: revisiting the hygiene hypothesis. Nature Rev. Immunol. 1:69.
Mass disinfection of hands will help to develop greater resistance of bacteria, of which there are many on the hands. Including conditionally pathogenic, or saprophytes. They will acquire new properties that will make them more resistant to disinfectants, possibly more virulent to the body. As an example of the formation of nosocomial infection. On the other hand, the constant effect of disinfectants on the human skin will adversely affect its protective properties.
1.One important issue has been already pointed out by David: the public needs clear messages and high adherence to hygiene is necessary to combat current COVID-19 epidemic.
2. All evidence we have points out that introduction of hygiene measures (starting with Semmelweis in early 19th century) had very favourable effects in public health and has enormously reduced mortality.
Before introduction and knowledge of hygiene, infectious diseases were nr. 1 reason for death and greately influenced average life expectancy. While antimicrobial resistance might be an issue in certain environments, I believe it is less likely to happen in general public, where people usually use diversity of disinfectants. Thus, the pressure of a single disinfectant towards development of resistance is smaller.
Nonetheless, it is sensible to have surveillance systems in place (most public health systems do have them) that report most common occurrence of resistence in microbes and watch carefully for trends.
Unfortunately, even in this discussion, some people make predictions with certainty that does not exist. The effects of stepping up hygiene measures to the extent as we observe now are not fully understood. What is also certain is that it would be foolish and counterproductive to warn people against disinfecting their hands, as the benefits most certainly outweigh the risks. The question is whether we will need public collaboration and adherence on “rotation programmes”, but as I said, I believe it is very unlikely this will be necessary.
Dear Irena Jakopanec, Thank you for your exhaustive answer. It fits perfectly with what is expected to exist. Forgive us, non-specialists, the following silky question: "Are those surveillance systems used to locate drug resistance passive (just collecting data) or pro-actively searching within the society for new drug-resistant bacterial strains?"
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