The Thanksgiving Advent Calendar, Day Fourteen: Hand Sanitizer

There was this one time I was on a book tour, and I shook hands with someone in San Diego, and the next thing I knew I was in Minneapolis. Which would be fine, except somewhere in there I was also in Phoenix. I gotta tell you, I have almost no memory of being there, due to one of the gnarliest cases of 24-hour stomach virus that I had ever encountered. I mean, I must have been in Phoenix, and I must have done an okay job when I was there because I didn’t hear of anyone complaining about me. But, yeah. Really, just a blur.

That’s when I joined the cult of the Hand Sanitizers.

Look: I do a lot of travel. And I do a lot of travel to events where I am in close contact with a whole bunch of people, like conventions and bookstore events and conferences and book fairs. And when I am there, I am touching books that other people have handled, pens other people have handled, and hands attached to people. Sometimes people want hugs and sometimes when they ask for pictures they put their hands on me — not in a weird grope-y way, mind you, but still, there’s some physical contact. Some of these people — not you, of course — have colds or something worse. Some of these people — definitely not you — have questionable hygiene.

And thus I would often find, having gone to a convention or other event, that I would come home with a low grade something, and occasionally a high grade something. In the case of the latter, I would be out of commission for at least a couple of days. In the case of the former, I would feel like crap for at least the same amount of time. Mind you, it’s not just me and my oh-so-delicate immune system. This sort of thing happens enough that there’s a name for it : “Con Crud.” No, it’s not that science fiction fans are dirty, germy people. Well, it is, actually. But they are no more dirty or germy than anyone else. When you get any large group of people together for several days, they’re going to swap viruses like business cards. And because I belong to the class of people at conventions/conferences/book fairs/etc who constitute the entertainment, I come into direct contact with more people than most other folks.

I don’t want to get sick every time I go to an event. At the same time, I don’t want to keep myself distant from the folks who have come out to see me; aside from my own gregarious nature it’s just not good business. So these days, after book signing or other event where I’m socializing and touching people and things (and vice versa), out comes the hand sanitizer, and there’s a thorough rubbing of my exposed surfaces. Yes, that sounds a little dirty, doesn’t it. But in fact it’s the opposite of dirty, which goes to my point.

I and some other of my friends in the same position in terms of the public are aware sometimes people get offended if they see the hand sanitizer come out. This is one reason why I try to wait until I’m done socializing. But beyond that, here’s the thing. If you see me or someone else pull out the Purell or Germ-X when we’re having contact with you, it’s not that we’re saying you’re dirty. We’re saying that all that personal contact we’re having adds up. You’re going to like us better a) if we’re not sick and b) not passing along a petri dish worth of germs that we’ve gotten from everyone else at the event. We’re doing it for you. And for us. Mostly for us. But for you too.

Does it work? Yes it does. I’ve been using hand sanitizer pretty religiously for a few years now and I’ve noticed my incidence of being laid out by illness after an event has gone way down since I have. It doesn’t always work; for example, I got sick when I was Germany despite hand sanitizer. But then I was at the Frankfurt Book Fair, in close proximity to hundreds of thousands of people. A dab of alcohol-based gel can only be expected to do so much. Otherwise, yes. The stuff usually works.

Which I’m thankful for. I don’t like to get sick when I see people. I don’t like to make other people sick when I see them. A little hand sanitizer goes a long way to avoiding both scenarios. Everybody walks away happy, or at least not virus-laden.

39 thoughts on “The Thanksgiving Advent Calendar, Day Fourteen: Hand Sanitizer

  1. Amen, brother! I spent years working in medical and psychiatric emergency rooms before this stuff came about, and I can’t tell you how chapped my hands (and those of my co-workers) got after all the washing we did. (Although the little cartoon germ characters on the poster above the sink in one particular ER have remained with me until this day.)

    The advent of hand sanitizer was a real blessing in a lot of ways. For instance, you can’t always run off to wash, but you can get a squirt of sanitizer out of the little bottle that hangs around your neck/at your waist. It’s much easier to be discreet about using hand sanitizer than about washing one’s hands. And fewer chapped hands, thank heavens!

  2. John, let me give you the benefit of my biochemistry background. Sanitizers will work great for bacteria; not so great for most viruses. A good UV or “backlight” should be in your traveling kit also. If not for viruses at least to check your room for bodily fluids.

    Yes, I have a little bit of Adrian Monk in me.

  3. Sounds like a smart thing to do. Seems silly that anyone would be offended.

    We go through many fluid ounces refilling our portable-size bottles that we use after handling grocery carts, touching bus & subway seats & handrails; restrooms at work & just about everywhere & elsewhere in public places. (at home we wash our hands like rabid raccoons)

  4. Ha. Try teaching elementary school. I practically bathe in hand sanitizer some days.

    Best part is that I’m perpetually on an immunosuppressant medication for a chronic medical condition. I love refilling the prescription every month just so I can read the disclaimer that those using this drug “should avoid contact with anyone who might be contagious.” Uh, yeah, right. I’ll work on that.

  5. The tv show “Monk” managed to eradicate any offense I might have had at someone whipping out a hand sanitizer.

  6. I became a believer when I was spending the week caring for my dad (down the road a couple of counties from you) in the family home. He caught the bug that was roaring through the care center where my mom was. It was gruesome, and I had a 9-hour drive back to Wisconsin facing me on t he weekend, so I used hand sanitizer every 20 minutes. And I did not get sick. Now I carry it in my purse.

  7. “But then I was at the Frankfurt Book Fair, in close proximity to hundreds of thousands of people.”

    …99% of whom were surely, already immune to bugs that your lymphocytes could hardly recognize.

  8. Yeah, I used to cop something after every single con. Now I sanitize as often as I can get away with it and I’m usually fine for 2 shows out of 3. If you have to take a flight, chances of getting sick go up a lot.

    I’ve read that a long haul flight (and, living in Australia, I do a lot of these) the chances that any given passenger will pick up something nasty runs about 25%.

  9. I reached a point where I ended up sick every time I had to travel so bought and wear an “ionic air purifier” which seems to have made a big difference. If the hand stuff helps, great; nothing for people to get techy about.

  10. I have avoided con-crud for the past several years by consuming a cocktail of Emergen-C and Airborne at least twice a day, and if it seems like a lot of people are coughing/ sick at the con, adding extra echinacea to that mix. I also avoid air travel like the plague (or like a known vector).

  11. Canyon42: My mother taught elementary school music for nearly 25 years. During most of that time, as you may be aware, such a thing as “hand sanitizer” did not exist. She’d get sick at least twice a year.

    As soon as sanitizer became available, she started buying it in bulk at Sam’s Club, and keeping the giant jar in her classroom. She’d still get sick, but the intensity/duration of her illnesses significantly decreased.

    christy: My mother took about a decade-long break from teaching, during which time she worked as a unit clerk in the local ER. Even in the days before sanitizer, and even though we were living in Chicago at the time (she taught music here in Houston), I don’t recall her getting sick nearly as often working in a hospital as she did working in a public school setting.

  12. I work at a university advising students. Along with the sanitizer, I found that keeping a separate jar of pens for students prevents a lot of problems.

  13. You get a lot of the same problems mentioned above in a call centre, especially one that practices “hot swapping” of desks. Not as bad as an elementary school, but if one person gets sick it can spread quick. Alcohol wipes swiftly become your friend in those situations.

  14. They should do Andromeda Strain-style decontamination — six levels of burning the clothes and scrubbing with disinfectant — on everyone entering a convention. For SF fans I bet it’d really be a hoot.

  15. @Jennifer:
    I can sympathize with the school thing too – I’ve been a foster parent for several years, and granted that’s no comparison for a class-full, we got a full bombardment of pathogens.

    I will say that elementary school gave the metro regional ER a run for its money, at least in my case. I’m just glad that we never had to deal with day-care! My sister has been sick for about five years straight…or at least it seems that way.

  16. Let me recommend fish oil pills for improving your immune system. We all know fish oil is good for us because of the Omega 3 fatty acids which many of us do not get enough of. I have read lots of studies about how it is good for your heart, your brain, your joints but I have not seen much about its effects on the immune system. Yet since I started taking fish oil every day I have hardly had a head cold, let alone influenza, whereas before I used to get at least one bad virus a year. Now, even if I get a cold it’s not with me long enough for me to even make a dent in my sick time. The last one started Friday afternoon and was gone by Monday morning. Give it a try!

  17. I was never in the hand sanitizer camp until I had a child with severe epilepsy. Even then, I wasn’t too paranoid until we realized that a simple stomach bug that would make the rest of us sick a few times would put him in the hospital because it triggered more problems than his seizure meds could handle. The same goes for strep. Now we sanitize every time we get in the car after being in a public place, and if we have been somewhere like Target or the preschool hall at church, or God forbid a play area at McDonald’s, we follow up with a hot shower and a good scrub down. I constantly get looks from people when we whip out the Purell, and if one more person tells us that I “should let them be exposed to build their immune systems” i may just slap them. Been there, done that, have the hospital bills to prove it.

    So, I too am thankful for hand sanitizer.

  18. Hand sanitizer ++. There must be a half-dozen bottles open here. Sadly, I haven’t completely gotten to the state of always using it.

  19. I work in a hospital and let me tell you, those little dispensers are everywhere, and it’s a good thing they are. We have a rule that you sanitize going into a room and when coming out, and that is if it’s standard precautions. Viral, respiratory or contact precautions up the ante considerably. Any way you look at it, hand sanitizers lessen the chance of an infection spreading.

    Whoever invented that stuff deserves a Gold Star and a cookie.

  20. I use sanitizer when I travel or attend mass events like football games or conventions but I don’t at home and in my everyday community because unlike Rebecca above, I don’t have immune issues and I find it I get less sick trying to isolate myself from germs as I do letting my local germs have their way with me. I do get a flu shot though.

  21. I’m a flight attendant…if I could sheep-dip myself in the stuff, I would…you’d be amazed how many people blow their noses into their napkins and then hand it to me…

  22. This will strike many people as nerdy beyond belief, and it is, but in the last few years I picked up the habit of carrying and frequently using prepackaged hand-sanitizing wipes…not out of health concerns but because I’d begun depending on touchscreen-based mobile devices, and I can’t stand to use them if my fingertips are anything other than extremely clean. Additionally, as a guitarist, I’ve always been a little obsessive about clean hands, and unlike in 1975 it’s now possible to always have a small quantity of antibacterial wipes stashed in a pocket.

    But as a side effect to this small outbreak of (manageable! honest!) OCD, I do indeed seem to be getting fewer colds, and recovering more quickly from the ones I get. So compulsiveness + science FTW.

  23. Imagine if you will the germ fest that is the public library.
    “The doctor says little Tommy has the chicken pox. We stopped to get him some books”

    I was always sick when I was working there.

    Now, working at an academic library, we only see the crud racing thru the building at the beginning of the semester, when the students come back from where ever it is they go to get a fresh supply of exotic maladies.

    Hand sanitizers and Lysol ftw.

  24. I am so glad to see no one praising antibacterial soaps in this comment thread! Not only do those run the risk of selecting for antibiotic resistance (only the strong bugs survive), but there’s plenty of evidence that they have no health benefit whatsoever.

    The alcohol-based, stuff, on the other hand, has no risk of resistance. And works against more things (not only bacteria, but also some viruses, like flu) than antibacterial soap.

    I’m still puzzled why the students in my microbiology course have no trouble believing these things (despite the evidence that they don’t often pay attention to me), and yet I can’t get my mom to stop buying the triclosan-laden soap!

  25. It isn’t always easy to find non-antibacterial soap.

    It’s never seemed like a good idea to me to use the stuff casually, and we avoid buying it, but I’ve always wondered whether there was actually any credible risk of resistance.

    Kristy, are you saying that there good reason to worry about resistance, or are you saying that in the absence of evidence that the stuff actually helps, there is no reason to run a risk of resistance.

    I suppose that if one actually sings happy birthday twice while washing then the washing will probably be more effective than any benefit from the antibacterial agent.

  26. Just so long as you’re using the alcohol based stuff and not the triclosan stuff. Triclosan is from the devil.

  27. Mike: There is evidence that triclosan (the most common active ingredient in antibacterial soap) promotes resistance to antibiotics in the laboratory. While we don’t have a clear view of real-world impact, the laboratory studies suggest that selection for resistance is pretty likely, and not worth the risk given that there’s no evidence that they are any more useful than regular soap. I wish this was more common knowledge so that there wasn’t such demand for non-antibacterial soap, making it hard to find the non-drug-laden stuff!

    Lab studies showing cross-resistance to triclosan and antibiotic drugs:
    Copitch, Whitehead, Webber (2010) International Journal of Antimicrobial Agents 36:247 [http://www.ijaaonline.com/article/S0924-8579%2810%2900200-1/abstract]
    Lucia Birošová and Mikulášová (2009) Journal of Medical Microbiology 58:436 [http://jmm.sgmjournals.org/content/58/4/436.short]

    I’ll also note that triclosan has the same target as isoniazid, a common anti-tuberculosis drug (Aiello, Larson, and Levy (2007) Clinical Infectious Diseases 45:S137 [http://cid.oxfordjournals.org/content/45/Supplement_2/S137.full]). So if bacteria become resistant to triclosan, isoniazid is likely going to be off the table, too.

    A really well-done study showing no benefit of antibacterial products in the home: Larson et al. (2004) Annals of Internal Medicine 140(5):321 [http://www.annals.org/content/140/5/321.full]

    Finally, antibacterial soaps are going to kill good bacteria on your skin as well as potential pathogens. Those good bacteria help protect you from disease-causing ones by competing for space and nutrients. Ordinary soap, on the other hand, is good for mechanical removal of microbes, but affects pathogens more than normal microbes (because the normal ones are usually more tightly associated).

    (Apologies for diving into the moderation queue with all the links: I’ve taken this quest beyond the classroom)

  28. John, the road runs both ways. Anyone shaking your hand (or passing you a Coke Zero, or a pen to autograph their copy of Zoe’s Tale) appreciates that you are making an effort not to be a vector as well.

  29. I noticed that once I had retired from public service, my sick time went WAY down. When I did work I always held on to my own pen and handed the client a “service pen” with the encuse “I have a slight cold”. My most vicious colds seemed to be caused by fellow employees coming in when they were sick to “save” their sick leave.

    But cons are very dangerous…

  30. I am currently sick as a dog. Not a good way to start winter.

    Anyways, out of curiosity, I’m wondering if it is possible to limit the bug to me and not give it to my wife, short of checking into a hotel for several days and ordering room service.

    Sleep in different beds? use different bathrooms? Get those UV lights they have in emergency rooms (Do those work?)? buy a contamination suit, and wear it to keep the germs on the *inside*? Hose everything down with bleach on a regular basis?

    Or is it really, “check into a hotel?”

    I think it might be too late this time around, since she’s starting to get a cough. But it seems like its impossible for one of to get sick without the other one. And I’m wondering just how hard it would be to firewall the bacteria/virus to one person in the same house.

  31. I dramatically reduced my own instances of picking up the Con Crud by never eating anything in the con suite that isn’t either wrapped or which I didn’t see them just put out.

    There’s a con I regularly attend where they usually put out bagels and big tubs of cream cheese in the morning (with knives and stuff so you can serve yourself), and on more than one occasion I’ve watched someone take a bite from a bagel, swoop it straight through the entire tub, take another bite, swoop, etc. Ick!

  32. Suzanne: watched someone take a bite from a bagel, swoop it straight through the entire tub, take another bite, swoop, etc

    No double dipping the cream cheese!!! That should be in the con’s rule book somewhere.

  33. Sociology at work: one year at Macworld Expo (about 30K attendees) there was a vast outbreak of post-Expo Crud. The next year, it became completely socially acceptable to whip out the hand sanitizer, use it, and offer it to people at the end of an encounter.

  34. My organization is in the emergency healthcare and preparedness field, including (but not limited to) preparedness for mass outbreaks of influenza and the like. So, what I’m about to relate has that information behind it.
    Every quarter, we have a membership assembly, which gathers all our stakeholders, including doctors, nurses, paramedics, etc. And it is always catered. And we (the administrative staff) set out fresh bottles of hand sanitizer within sight of the food tables…

    …I noticed after the most recent meeting that NOT ONE of the bottles was used by the end of the meeting. And this is why I get my portion of lunch before the rest of them come in, and do not touch it after they’ve descended upon it. Uck.

  35. Wash your hands (or use sanitizer), but just as important is that you stop touching your face! Just because the mucous on that doorknob get on your hand doesn’t mean that your should introduce it into your mouth.

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