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Popularizing the hydroalcoholic gel formulation twenty-five years ago earned him the nickname Doctor Clean Hands. Infectious diseases and epidemiologist working in Switzerland, cleaning expert at WHO, Didier Pittet was also commissioned by Emmanuel Macron with the autopsy of the management of the Covid crisis in France.
His final report is scheduled for December but, already, the doctor is worried about a drop in hand hygiene, “breast” according to him to prevent the epidemic.
What makes you say we’re letting our guard down?
PROFESSOR DIDIER PITTET. The latest statistics from Public Health France show growing support for wearing a mask. All the better, but at the same time we see that the French who say they wash their hands regularly have gone from almost 80% during the first birth to less than 70% for the second. A figure to be halved to get closer to reality: when we self-evaluate, we double our hygiene practices. The problem is that when they hide, people say to themselves: Okay, you’re done! They artificially feel like they are totally protected and protect others. 85% of the population said they respect the distance of one meter in spring, compared to only 54% on the eve of the second birth. This is very concerning and shows that behavior changes are not integrated.
In your book * you write that the mask is not “the first line of defense” …
The two parts of preventing the transmission of the virus are hand hygiene and physical removal. The mask is a great additional ally, but alone it is not enough. With your hands you touch the other directly, or indirectly, through a table, a handle, an elevator button where the virus can stay for two to three hours, then you put your fingers close to your face. But the importance given to washing has diminished since June. As proof, in Geneva, we offer hydro-alcoholic solutions on Saturdays in popular places. At the beginning of the school year we were only able to distribute six times less than after childbirth. In the absence of a truly sufficient campaign, people have forgotten everything over the summer.
But what is the caliber for the hydroalcoholic gel?
Every Frenchman should use – at least – one bottle of 100 to 150ml per week. That is why the gel must be given away or sold at extremely low prices. You need to rub it on your hands, starting with your fingertips. However, Swiss data shows that we consume less than 5% of what is needed. There is no reason why the French are different, and Europeans in general, except those from the north, who are more sensitive to hand hygiene.
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How to record this practice in our long-term memory?
That’s the whole difficulty, as it was getting people to agree to wear seat belts in the car. Since behavioral changes are a real science, sociologists and specialists must help us. It will take important campaigns. The more informed we are, the better we follow the instructions. There is no need to complicate it. As soon as the restaurants reopen, not only the hydroalcoholic gel will have to be at the entrance, but everyone will have to run inside! The mimicry effect also plays a role. I sent my son to the supermarket to do the experiment: if you rub your hands in front of a person, nine times out of ten they will imitate you. And if you don’t, neither does she, almost in the same proportion. If I ran a business, I would give a 1 euro voucher to anyone who washes their hands upon entering.
Hands, condition for a successful deconfinement, when a first peak is reached?
Yes, this is totally part of it, with an efficient test system and above all the insulation that follows. De-confinement is an art where learning to wash your hands is not optional. At Christmas you will probably need to have the glass of champagne in one hand, the hydroalcoholic solution in the other. The risk is clear: if we do not respect it durably, we will have a third and then a fourth wave.
* “Overcoming epidemics – from awareness to life-saving actions”, by Didier Pittet and Thierry Crouzet, Hugo Doc Editions, 232 pages, 16.95 euros.
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