Germophobia Doesn’t Pay, But It Does Sell

Germophobia Doesn’t Pay, But It Does Sell
by Steve Templeton at Brownstone Institute

The following is an excerpt from Steve Templeton’s book, Fear of a Microbial Planet: How a Germophobic Safety Culture Makes Us Less Safe.

As I discussed in the first two chapters, much of what germophobes do has little effect on their ability to avoid getting sick and might even be counterproductive. Studies of antimicrobial products have shown they don’t provide any advantage over soap and water. The antimicrobial triclosan, which for years was incorporated into a deluge of products from toys to toothpaste to cosmetics, was found to induce microbiome disruption and colonic inflammation and exacerbated colon cancer in animal models. In humans, urine and blood levels of triclosan were highest in children with allergies and asthma. Yet triclosan wasn’t targeted by the US FDA until 2016 and was gradually removed from antiseptic products in the following year.

Hand sanitizers might be better than nothing, but not much better. A 2011 study of nursing homes showed preferential use of hand sanitizer among the staff was associated with a significantly higher rates of norovirus infection, which causes acute gastroenteritis, more commonly known as the stomach flu, when compared to facilities that more often used soap and water. Hand washing with soap and water was also shown to be superior to hand sanitizer alone in inactivating influenza viruses. A systematic review of multiple studies of hand sanitizer use in daycares found only a small, and likely insignificant benefit of hand sanitizers in reducing absenteeism in school children.

However, articles reporting the lack of efficacy of hand sanitizer received very little recognition in the media. No one wants to hear that something they’ve been doing is ineffective, so why tell them? Instead, CNN, Reuters, USA Today, and People magazine all reported on a single study of a daycares in Spain that reported benefits of hand sanitizer use on absenteeism and antibiotic use in addition to washing with soap and water. The study had all sorts of red flags, including behavioral interventions that included stories and songs about hand hygiene and infection (could introduce bias), a higher proportion of immigrant families in the soap and water only group (groups weren’t matched demographically), and lack of monitoring for compliance. In other words, the potential for bias was difficult to control and the effectiveness of their interventions on actual behaviors wasn’t observed, yet only a weak correlation remained. But that was enough for multiple news outlets to report the authors’ conclusions as gospel.

Media outlets love the “Ten things you can do to prevent _____” listicles, because people love to read them. People have exquisite control over their environments these days and they always want more. The media is happy to give it to them. Quoting an expert that agrees with the premise of the article gives an added layer of authenticity. For many years the media’s favorite go-to expert in disinfection has been Dr. Charles Gerba, a professor in the University of Arizona’s Department of Environmental Science. Gerba is famous for his studies cataloging the mass of deadly bacteria that can be found in almost any home environment and how to kill them. He never met a germ he didn’t attempt to eradicate.

In a profile article in Good Housekeeping titled, “How a Microbiologist Keeps His Home Clean to Avoid Spreading Germs,” Gerba tossed some serious irradiated red meat at germophobic readers with quotes like, “I use hand sanitizer about four or five times a day,” and “I won’t let my grandchildren go into playgrounds…Playgrounds are essentially public toilets for birds, and you’ll never see, say, a soccer ball without E. coli on it. Anytime we have little kids over we make them use hand sanitizer—we’ve tested kid’s hands and they all have E. coli on them.” Not mentioned is the fact that most normal kids’ hands have E. coli on them; it rarely matters unless it’s an especially pathogenic strain, and pointless to assume it’s always disease-causing—occasional hand-washing takes care of most bacteria and hand sanitizer doesn’t do much more. Not surprisingly, Gerba has voiced skepticism of the hygiene hypothesis, likely because it doesn’t agree with his kill-or-be-killed microbial absolutism, “Even if it were true, I can’t recommend exposing people to disease-causing organisms that could make them seriously ill or kill them.” Just because something is possible, doesn’t make it likely, but that distinction is lost on most germophobes.

Fortunately, as I discussed in Chapter 2, the tradeoffs to living in a completely disinfected environment are becoming clearer, and by early 2020 a wave of germophobia had crested and passed. But unfortunately, as I will cover in great detail in Part II, shortly thereafter a tsunami of germophobia hit the developed world with the SARS-CoV-2 pandemic, from which we are still recovering.

Germophobia Doesn’t Pay, But It Does Sell
by Steve Templeton at Brownstone Institute – Daily Economics, Policy, Public Health, Society