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An End to Pandemic Precautions?

photograph of masked man amongst blurred crowd

I feel like I have bad luck when it comes to getting sick. Every time there’s a cold going around, I seem to catch it, and before I started regularly getting the flu shot, I would invariably end up spending a couple of weeks a year in abject misery. During the pandemic, however, I have not had a single cold or flu. And I’m far from alone: not only is there plentiful anecdotal evidence, but there is solid scientific evidence that there really was no flu season to speak of this year in many parts of the world. It’s easy to see why: the measures that have been recommended for preventing the spread of the coronavirus – social distancing, wearing masks, sanitizing and washing your hands – turn out to be excellent ways of preventing the spread of cold and flu viruses, as well.

Now, parts of the world are gradually opening up again: in some countries social distancing measures and mask mandates are being relaxed, and people are beginning to congregate again in larger numbers. It is not difficult to imagine a near-future in which pumps of hand sanitizer are abandoned, squirt bottles disappear from stores, and the sight of someone wearing a mask becomes a rarity. A return to normal means resuming our routines of socializing and working (although these may end up looking very different going forward), but it also means a return to getting colds and flus.

Does it have to? While aggressive measures like lockdowns have been necessary to help stop the spread of the coronavirus, few, I think, would think that such practices should be continued indefinitely in order to avoid getting sick a couple times a year. On the other hand, it also doesn’t seem to be overly demanding to ask that people take some new precautions, such as wearing a mask during flu season, or sanitizing and washing their hands on a more regular basis. There are good reasons to continue these practices, at least to some extent: while no one likes being sick with a cold or flu, for some the flu can be more than a minor inconvenience.

So, consider this claim: during the course of the COVID-19 pandemic, we have had a moral obligation to do our part in preventing its spread. This is not an uncontroversial claim: some have argued that personal liberties outweigh any duty one might have towards others when it comes to them getting sick (especially when it comes to wearing masks), and some have argued that the recommended mandates mentioned above are ineffective (despite the scientific evidence to the contrary). I don’t think either of these arguments are very good; that’s not, however, what I want to argue here. Instead, let’s consider a different question: if it is, in fact, the case that we have had (and continue to have) moral obligations to take measures to help prevent the spread of coronavirus, do such obligations extend to the diseases – like colds and flus – that will return after the end of the pandemic? I think the answer is: yes. Kind of.

Here’s what this claim is not: it is not the claim that social distancing must last forever, that you have to wear a mask everywhere forever, or that you can never eat indoors, or have a beer on a patio, or go into a shop with more than a few people at a time, etc. Implementing these restrictions in perpetuity in order to prevent people from getting colds and flus seems far too demanding.

Here’s what the claim is: there are much less-demanding actions that one ought to take in order to help stop the spread of common viruses, in times when the chance of contracting such a virus is high (e.g., cold and flu season). For instance, you have no doubt acquired a good number of masks and a good quantity of hand sanitizer over the past year-and-change, and have likely become accustomed to using them. They are, I think, merely a mild inconvenience: I doubt that anyone actively enjoys wearing a mask when they take the subway, for example, or squirting their hands with sanitizer every time they go in and out of a store, but it’s a small price to pay in order to help the prevention of the spread of viruses.

In addition, while in the pre-corona times there was perhaps a social stigma against wearing medical masks in public in particular, it seems likely that we’ve all gotten used to seeing people wearing masks by now. Indeed, in many parts of the world it is already commonplace for people to wear masks during cold and flu season, or when they are sick or are worried that people they spend time with are sick. That such practices have been ubiquitous in some countries is reason to think that they are not a terrible burden.

There is, of course, debate about which practices are most effective at preventing the spread of other kinds of viruses. Some recent data suggest that while masks can be effective at helping reduce the spread of the flu, perhaps the most effective measures have been ones pertaining to basic hygiene, especially washing your hands. Given that we have become much more cognizant of such measures during the pandemic, it is reasonable to think that it would not be too demanding to expect that people continue to be as conscientious going forward.

Again, note that this is a moral claim, and not, say, a claim about what laws or policy should be. Instead, it is a claim that some of the low-cost, easily accomplishable actions that have helped prevent the spread of a very deadly disease should continue when it comes to preventing the spread of less-deadly ones. Ultimately, returning to normal does not mean having to give up on some of the good habits we’ve developed during the course of the pandemic.

To Clean or Too Clean? The Problem of Over-Cleanliness

Photograph of a hand drier and a hand sanitizer dispenser attached to a tiled wall

Rubbing hands with hand sanitizer is a frequent habit for many, but are we becoming too clean for our own good? By extension, are we inadvertently creating an environment which is dangerous for children’s developing immune systems? Exploring the ethics of the rise of sanitizing products in our society is necessary in order to determine a healthy balance between taking advantage of antibacterial advancements without overusing these products and limiting our bodies’ exposure to bacteria, and preventing the development of superbugs.  

Over the past few years the discussion surrounding over-cleanliness has risen in prominent news organizations including The New York Times, NBC News, and NPR. Scientists have been researching the effects of taking long showers, changing clothes frequently, and washing hands regularly on our overall health. Microbiologists such as Mary Ruebush are emphasizing that our stringent hygiene routines are having a negative effect on our health, by increasing the risks of developing allergies and weakening our immune systems. This of course, does not mean that by taking a shower every day you are bound to get ill, but rather that the combination and overuse of too many antibacterial products both on your body and in your living environment can wipe out even beneficial bacteria, resulting in a possible compromise to your health.

Over-cleanliness is especially harmful to young children and can be explained using the “Hygiene Hypothesis” developed by epidemiologist David Strachan in 1989. This hypothesis as described in a BBC article, states that exposure to infections early in life provides a strong defense against allergies into adulthood.  Unbeknownst to this knowledge parents are getting stricter about the environments they exposure their children to, unlike previous generations of parents who were more lenient. In August of 2016, a study published in the New England Journal of Medicine compared the immune profiles of both Amish children growing up on small family farms to those of Hutterite children who grew up on large industrialized farms. The Amish children lived in a microbe rich environment and due to their increased exposure to factors such as barn dust, had relatively low incidences of asthma. Hutterite children on the other hand, did not display the same low incidence of asthma, illustrating that exposure to diverse microbe populations is beneficial to children’s overall health.

Beyond the benefits of exposure to dust, Jack Gilbert a co-author on the New England study as well as author of the book Dirt is Good argues in an NPR article that parents should allow children to get dirty more frequently. Gilbert’s primary concern is with the immediate sterilization of children after playing outside or with animals. A common example is, “if they’re interacting with a dog, and the dog licks their face, that’s not a bad thing. In reality, that could be extremely beneficial for the child’s health.” In order to minimize his concerns regarding over-cleanliness in modern children’s home environments, Gilbert suggests that parents should protect children by encouraging them to “eat more leafy vegetables, a diet rich in fiber as well as reducing the sugar intake, but generally allowing your kids to experience the world. As long as they are properly vaccinated, there shouldn’t be any threat, and they will actually get a stronger and more beneficial exposure.”

In a world where bacteria are demonized, and products promise to eliminate 99.9% in one quick swipe, parents must become well informed on the adequate amounts of antibacterial soaps, sanitizers, and wipes to use. Firstly, it is essential to remember that not all antibacterial products are harmful for children or adults. An article published in the Chicago Tribune by Brian Sansoni seeks to remind us of the various ways in which antibacterial soaps can be used safely and beneficially by consumers. These soaps, as emphasized by Sansoni, “eliminate bacteria that can lead to skin infections, intestinal illnesses, or other commonly transmitted diseases;” these products are essential in instances of close contact with highly infectious individuals as well as settings of food preparation, particularly in schools. This article is a useful tool in reminding parents, school teachers, and especially health care professionals that responsible use of these products is highly advisable, and the complete dismissal of these important advancements could result in increased disease transmission particularly in places where there are vulnerable individuals.

Finally, understanding the relationship between consistent use of antibacterial soaps and increasing antibacterial resistance is key to the prevention of superbugs. An article from Science in The News at Harvard University explains antibiotic resistance in reference to the additive Triclosan (which is present in most consumer hand soaps and toothpastes). Triclosan has not been proven to be harmful to humans, but there is evidence to suggest it may be contributing to increasing risk of drug resistant bacteria. (For a clear explanation of how Triclosan works, this link provides a helpful diagram.) As a widespread issue this could become harmful if bacteria populations are exposed to Triclosan repeatedly and soon develop mutations to survive the exposure, this could influence the effectiveness of antibiotics prescribed by doctors as well. As this article describes, “limiting the use of Triclosan to only products where it will be most effective could be very important.”

Overall, creating an environment for children where the mantra “Dirt is Good” is counterbalanced by an appreciation for healthcare advancements utilized responsibly is the most effective path to encourage parents to use these antibacterial products sparingly.