‘Sanitisation theatre’: Not only pointless but gives a false sense of security

Organisation: Position: Deadline Date: Location:

People are engaged in a frenzy of disinfecting anything and everything they touch, despite science telling us that surface cleaning to prevent COVID-19 is largely pointless, writes Maura Judkis in The Washington Post. But such “sanitisation theatre” is not the harmless pursuit it might seem.

Judkis writes that despite initial reports warning people that the novel coronavirus can be transmitted from contaminated surfaces, the US Centres for Disease Control and Prevention has told Americans in no uncertain terms that the virus is primarily transmitted person-to-person, through breathing, speaking, shouting and singing. While it may be possible to catch the coronavirus from a doorknob or a package, it’s a long shot, and “not thought to be the main way the virus spreads,” says the agency. (It still recommends disinfecting high-touch surfaces.)

Yet, six months into the pandemic, Americans seem determined to Clorox their way to absolution. They’re wiping down soccer balls, Lysoling beach chairs, touching PIN pads with “touch tools” and gloves, and cleaning bags of Tostitos with diluted bleach. Which seems harmless enough, provided they’re using their cleaning products safely, but the most important things that will help them avoid catching the virus? Wearing masks, staying more than six feet apart, avoiding enclosed spaces.

There are the things we do to stay safe, and there are the things we do just in case. Just to be sure. What can it hurt?

The report says the term “security theatre” went mainstream post-9/11 to describe the anti-terrorism measures that didn’t do much to prevent terrorism at all. Things like making mothers dump out bottles of breast milk at airport security checkpoints, or random bag checks on the Metro, which did not thwart any attacks. The whole show of it seemed part of the idea – possibly the main part.

Now, the report says, the pandemic has given that show a sequel, and a new term: “sanitisation theatre.” Sanitisation theatre is real but tricky to discuss for people who understand both the real threats posed by the virus and the prevalence of denial and misinformation about those threats. Why criticise the extra-vigilant, the doubly cautious?

“The surfaces are not really the problem,” says Emanuel Goldman, a microbiology professor at Rutgers New Jersey Medical School. Sanitising surfaces has “been done to excess. And that excess actually gives people a false sense of security. And what they really should be doing is focusing on the main routes of transmission of this disease, which is breathing.”

Among what Goldman considers to be on the theatrical side of the spectrum: New York’s Metropolitan Transportation Authority shuts down the subway every night from 1 a.m. and 5 a.m. to conduct a deep cleaning — at a cost expected to reach $500m a year, according to Politico. There are cities abroad that sent cleaners into public squares to spray disinfectant outdoors, where we’re the safest. And there’s one particularly vexing source of sanitisation theatre: The Disinfection Tunnel, which requires people to walk through a mist of chemicals. A team of scientists published called them “a wasteful expenditure of scarce resources.” Many people became familiar with it when a video of the Denver Broncos going through one before a practice went viral.

“Walking through a fine mist for a few seconds… I don’t think it probably does any good, and if it does any good, it’s very small,” says Peter Raynor, a professor at the University of Minnesota School of Public Health.

Sanitisation theatre is real but tricky to discuss for people who understand both the real threats posed by the virus and the prevalence of denial and misinformation about those threats. Why criticise the extra-vigilant, the doubly cautious?

Goldman gets it. He also knows microbiology well enough to read critically reports of the coronavirus living on “fomites” (the scientific term for objects and surfaces that could transmit disease). Goldman argued that prior experiments were based on concentrations of virus that “have little resemblance to real-life scenarios,” he writes. “I do not disagree with erring on the side of caution, but this can go to extremes not justified by the data.”

Some businesses have begun to cut back on more laborious measures. Southwest Airlines has announced it will no longer disinfect the seat belts before boarding, a move that will reduce the time planes spend on the ground between flights.

The report says the National Institute of Allergy and Infectious Diseases – Anthony S Fauci’s own office – no no longer does a temperature screening at the door. “We have found at the NIH, that it is much, much better to just question people when they come in and save the time, because the temperatures are notoriously inaccurate,” Fauci said recently.

But, the report says, businesses everywhere are investing in touchless thermometers and going full-throttle on the deep-cleaning, which makes some experts concerned. Those measures may be more about making people feel safe than they are about actually doing what it takes to ensure their safety. If the table looks clean, people may be more likely to let their guard down about the preventive measures that actually matter. If no one has a fever, they might think it’s okay to sit closer.

That kind of reassurance is high in demand. A report from Deloitte urges frequent, visible cleaning as a way to build consumer trust. “There’s definitely a decision that’s been made to have that overt sanitation be part of the norm,” says Anthony Capozzoli, whose official title at Restaurant Associates, a company that manages eateries for institutions and museums, is COVID-19 safety czar.

Capozzoli knows ventilation and distancing – which the company is also addressing – are the most important. For customers, there “is a delicate and necessary balance between the perceived safety and the actual safety,” of any measures taken, says Capozzoli. “I think this level of sanitation is here to stay.”

A showily thorough disinfection regimen – like wiping door handles every 30 minutes – could reinforce the idea that surface transmission is how people should be worried about getting sick.

Still, COVID-19 or not, all that Lysoling isn’t in vain.

“A lot of the stomach viruses that cause stomach flus – those horrible, gut-wrenching stomach flus we go through in the winter times – you know, many of those are transmitted through the contact route,” says Susy Hota, a clinician investigator specialising in infection control at the Toronto General Hospital Research Institute. Really, the amount of cleaning we’re doing now only serves to illustrate how much we weren’t doing before.

“The concept of washing your hands is something we always should have been doing all along,” says Hota. “Maybe the silver lining for this pandemic is we’re going to raise a generation of children who grow up knowing that this is the norm.”

The Washington Post writes that sanitisation theatre arose out of the confusion in the early days of the pandemic. Experts believed in good faith that objects and surfaces were vectors of transmission, and urged thorough cleaning, while de-emphasising masks. By the time that thinking reversed, for some, the habits were set.


Full report in The Washington Post

Receive Medical Brief's free weekly e-newsletter

Related Posts

Thank you for subscribing to MedicalBrief

MedicalBrief is Africa’s premier medical news and research weekly newsletter. MedicalBrief is published every Thursday and delivered free of charge by email to over 33 000 health professionals.

Please consider completing the form below. The information you supply is optional and will only be used to compile a demographic profile of our subscribers. Your personal details will never be shared with a third party.

Thank you for taking the time to complete the form.