Campaigns Needed to Reinforce Handwashing Even as We Get Vaccinated

Handwashing is still one of the best ways to reduce risk and prevent the spread of the virus that causes COVID-19. It is recommended by the Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO), and other public health agencies to prevent the spread of COVID-19 and other viruses. Of course, handwashing as a disease prevention measure is not new, but the COVID-19 pandemic has prompted us to remember the importance of effectively and consistently practicing this behavior. 

As the COVID-19 pandemic has progressed, campaigns to promote handwashing and disease prevention have been featured on both traditional and social media channels. These campaigns were critical to reminding the public of the need for handwashing and proper handwashing techniques. A few examples of media handwashing campaigns included Sesame Street on Youtube and Gloria Gaynor's TikTok videos, among many others. Messages conveyed common themes of:  

  • handwashing is important and prevents disease transmission,
  • proper handwashing should include soap and water, and
  • people should wash their hands for 20 seconds or more for handwashing to be effective.

Data on Public Handwashing Behaviors and Knowledge 

Early in the pandemic, RTI captured data on the U.S. population’s handwashing behaviors in response to COVID-19. In April 2020, RTI conducted a nationally representative web panel survey (April 10-13, and April 17-20, 2020, n=2,279, to assess the U.S. population's knowledge and behavior adoption related to COVID-19.

Among other questions, we asked respondents to indicate how effective they thought handwashing was in:

  • protecting "you and your family from getting the Coronavirus,"
  • "protecting people in your community from getting the Coronavirus," and
  • "reducing the number of people who die from Coronavirus infection." 

Response options included very effective, effective, somewhat effective, ineffective and don't know. A majority of the respondents indicated that they perceived handwashing to be effective or very effective at "protecting you and your family from the Coronavirus" (86.8%), "protecting people in your community from getting the Coronavirus" (86.6%), and "reducing the number of people who die from Coronavirus infection" (81.6%).

We asked respondents to indicate which actions they were "currently taking to protect themselves from the Coronavirus" and "washing my hands with soap and water more often" was one of the actions they could select. Encouragingly, 94.8% of respondents indicated they were washing their hands with soap and water more often.

To determine if respondents had accurate knowledge about how long to wash their hands, we asked them to indicate if the following statement was true, false, or if they did not know: "For handwashing to be effective at killing the Coronavirus, you should wash your hands with soap and water for at least 10 seconds." About 40% of respondents incorrectly said this was “true” and 3.8% reported they did not know.

When we conducted a crosstabulation of self-reported handwashing behavior and knowledge, we found that 53.5% of respondents who reported washing their hands more often had accurate knowledge about how long to wash their hands (x2 = 11.85, P = 0.0027). On the other hand, 38.0% of respondents were washing their hands more often but did not indicate the correct answer for how long to wash them.

Handwashing Survey Results
SURVEY QUESTIONS   Which of the following actions, if any, are you currently taking to protect yourself from the Coronavirus?  
  SURVEY RESPONSES Not washing hands more often Washing hands more often Totals
For handwashing to be effective at killing the Coronavirus, you should wash your hands with soap and water for at least 10 seconds. Incorrect Response 2.2% 38.0% 40.2%
Correct Response  2.5% 53.5% 56.0%
Don't Know 0.5% 3.3% 3.8%
  Totals 5.2% 94.8%  

This gap in knowledge concerning handwashing techniques could have implications for disease spread. These data were gathered early in the pandemic when messaging about the importance of handwashing was being consistently promoted. Since then, the main messages for COVID-19 prevention have evolved and now focus more on wearing masks, social distancing, and vaccination.

Continue to Prevent the Spread

As we enter the second year of the pandemic, it is essential that we not become complacent and dull our defenses in the fight against COVID-19. With the emergence of new variants, we must remain vigilant in our preventative practices and not allow fatigue to hinder our progress. While this guidance may seem implicit in the National Strategy, health communications and campaigns must continue to promote these fundamental practices—wear your mask, wash your hands, and watch your distance—and also ensure that Americans know how to effectively wash their hands to prevent the spread of COVID-19.

Learn more about RTI's COVID-19 research and response.   

Disclaimer: This piece was written by Alicia M. Frasier (Senior Research Survey Scientist), Christine Bevc (Research Public Health Analyst), Lauren McCormack (Senior Vice President, Communication Practice Area), and Linda Squiers (Senior Health Communication Scientist) to share perspectives on a topic of interest. Expression of opinions within are those of the author or authors.