Targeted hygiene: The catalyst for a safe return to school this fall

As schools across the U.S. have welcomed students back for the fall semester – many at full capacity for the first time in over 18 months – how can they ensure they meet the increased hygiene standards students, parents, and staff now expect? A solution lies in partnering with hygiene experts to develop a tailored, science-based approach to cleaning, disinfection, and hand hygiene protocols.

Schools can be a focal point for virus transmission, with germs spreading via surfaces and via the hands of students and staff. When 15 or 20 students spend long periods of time in one room together sharing equipment and desks, germs spread faster than they do in many other environments. A recent survey commissioned by Reckitt, maker of Lysol, found that moms and teachers in the U.S. were equally worried about the return of in-person learning, with two-thirds of both groups saying they were concerned.^[1] In another survey that examined consumer comfort levels around engaging in various day-to-day activities, less than a third of people indicated that they were comfortable with sending their kids to school.^[2]

With cases of the Delta variant of SARS-CoV-2 on the rise, the CDC warning^[3] about an outbreak of the RSV respiratory virus, and an uncertain cold and flu season looming, the time for schools to get serious about targeted hygiene to help protect their students and staff is now.

 A complex challenge

Although respiratory viruses can spread directly via aerosols and droplets, they also can be passed on indirectly via contaminated hands to eyes, nose, and mouth. Respiratory viruses may survive on hard, frequently used surfaces such as school desks for several hours to days, while intestinal viruses, such as rotavirus, norovirus, and hepatitis A virus, can also survive for days to several weeks. The result is a complex challenge that requires a science-based, targeted approach to hygiene.

Amongst the many respiratory viruses that can spread in schools via desks and other surfaces, RSV is a particular concern because it is a common cause of bronchiolitis and pneumonia in young children.^[4] While flu cases in 2020-21 were historically low, likely due to a range of non-pharmaceutical hygiene interventions (e.g., masks), and behaviors that were put into place to slow the spread of SARS-CoV-2, the CDC advised doctors and other healthcare providers in June 2021 to be on alert for increased interseasonal RSV activity across parts of the Southern U.S. this year.^[5]

There are differing opinions amongst experts on how severe the impending cold and flu season will be, but schools can still be prepared for any eventuality by proactively stepping up their hygiene game. This is especially critical because children are often the carriers of these viruses to others in the community, making schools a primary location to focus the fight against the transmission of both flu and RSV.^[6]

Science-based protocols

So, what measures can schools take to help minimize contamination of commonly touched surfaces effectively and efficiently? A solution lies in targeted hygiene.

Targeted hygiene means focusing hygiene practices at the times and in the places that matter most to help break the chain of infection and reduce the transmission of germs. Hygiene intervention includes not just cleaning and disinfection, but also hand hygiene (washing or sanitizing), which should be carried out when it is most needed, such as when arriving at school, before lunch, after breaks, and of course after using the bathroom. Hand sanitizer is useful where sinks are not readily available.

Schools should base cleaning and disinfection on risk-based protocols that are created by scientists with the specific school environment in mind and rigorously assessed.

Timing is key

Once cleaning and disinfection protocols are established for high contact touchpoints at a school, the critical element to reducing the potential for germ transmission is the frequency of cleaning and disinfection.

Schools can focus their precious resources on what really matters. So, if desks are used only by the same student every day, the requirements for cleaning and disinfection will be less onerous than if a student moves from one classroom to another – essentially “hot desking.” In the first case, cleaning and disinfection of desks and chairs may need to be weekly but in the latter case, cleaning and disinfection of all student desks and chairs every day may be more appropriate.

However, there may be other parts of school environments that have been neglected previously – and now is the time to refocus on high-touch points in cafeterias (tables, chairs, counters), restrooms (door handles, taps, toilet flush handles, cubicle locks), locker rooms (door handles), gyms (equipment), and buses (grab handles, seat arms, and seat belt buckles). All these high-touch areas need to be cleaned and disinfected at key times to assist in breaking the chain of infectious disease transmission.

In summary, schools seeking to establish best practices in hygiene could consider the following: 

• Timely cleaning and disinfection of surfaces and objects that are touched often, particularly if by many different people, such as chairs, desks, countertops, doorknobs, bannisters, computer keyboards, hands-on learning items, faucet handles and phones.
• Immediately cleaning surfaces and objects that are visibly soiled.
• Ensuring that policies are in place for cleaning up and disinfecting in situations such as where surfaces or objects are soiled with body fluids or blood.
• Following label directions on cleaning products and disinfectants so they work correctly and are safe to use.
• Ensuring that everyone washes their hands when they arrive at school, before lunch and after breaks, before returning to the classroom.

A school program of targeted, enhanced environmental hygiene protocols should be carried out routinely by trained custodians using appropriate products, and supported by teachers and other school staff. Together with careful adherence to hand hygiene, this will pay dividends to help to break the chain of transmission of infectious diseases.

By choosing a hygiene partner with the right combination of effective products and deep scientific expertise, schools can help turn the tide against the spread of illness-causing germs more effectively as we head into the winter months.

Chartered Environmental Health Practitioner, RSPH Professorial Fellow, and Winston Churchill Fellow Dr Lisa Ackerley has a background in local and central government, academia, private sector strategic consulting and has offered support and advice on hygiene to industry stakeholders, government and directly to consumers through mass media engagement. Lisa is passionate about developing practical, easy to follow messaging to help promote public health.