Coronavirus: Obsessing about not touching your face can make matters worse, say experts
It's been quite a few months since the novel coronavirus started and there is no vaccine or treatment for it. The best way to prevent illness, therefore, is to avoid being exposed to this virus.
Accordingly, the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) have a bit of prudent advice for everyone — avoid touching your eyes, nose and mouth, and of course, wash your hands.
“Every human being spontaneously touches its eyes, cheeks, chin and mouth manifold every day. These spontaneous facial self-touches are elicited with little or no awareness and are distinct from gestures and instrumental acts. Self-touch frequency has been shown to be influenced by negative affect and attention distraction and may be involved in regulating emotion and working memory functions,” says a 2019 study.
And while it is a natural habit, it is a major and common way a person can pick up infections like COVID-19. The reason: Throughout the day, people touch many surfaces — chairs, doorknobs, ATM or elevator buttons, subway poles — where viruses, including that of COVID-19, can linger for days.
“Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick,” says the WHO.
The WHO is not certain how long the virus that causes COVID-19 survives on surfaces but says that it seems to behave like other coronaviruses.
“Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment),” says the WHO.
But simple as it may sound, this advice of not touching the face is far more difficult to follow through than you can imagine.
During the influenza A (H1N1) pandemic, face-touching behavior in the community was commonly observed with individuals touching their faces 3.3 times on an average per hour, say experts.
Hands are also considered a common vector for the transmission of healthcare-associated infections and have been implicated in the transmission of respiratory infections.
“Eyes, nose, mouth — all those mucous membranes are the portal into the body for a virus, like COVID-19 or SARS. I was in a conference yesterday watching people, and in just about two minutes I counted a dozen times that I saw someone touching mucous membranes,” Dr. Mary-Louise McLaws, professor of epidemiology, health care infection and infectious diseases control at the University of New South Wales in Sydney, Australia, tells the New York Times.
She adds, “It is a very common practice. We rub our eyes, scratch our nose, touch our mouth — the general community needs to be aware of how often they are touching their face.”
Some experts say each person may touch their face 23 times per hour. This is according to a 2015 study, in which a total of 26 medical students were observed making 2,346 touches to the face over 240 minutes.
The researchers found a high frequency of mouth and nose touching — 4 times per hour on average for mouth touching, and 3 times per hour on average for nose touching.
“Of all face touches, 44% (1,024/2,346) involved contact with a mucous membrane, whereas 56% (1,322/2,346) of contacts involved non-mucosal areas. Of mucous membrane touches observed, 36% (372) involved the mouth, 31% (318) involved the nose, 27% (273) involved the eyes, and 6% (61) were a combination of these regions,” says the study.
Dr. McLaws, who was one of the authors of the 2015 study, says: “By touching your mucous membranes, you’re giving a virus 11 opportunities every hour if you’ve touched something infectious.”
Don’t obsess, say experts
Be aware, but do not overthink, say experts. Thinking about not touching your face or rubbing your eyes can only make things worse.
Dr. Kevin Chapman, founder and director of the Kentucky Center for Anxiety and Related Disorder, tells Business Insider that being hard on oneself will not help because “suppressing thoughts doesn't typically help people curb their habitual behaviors.”
“Rather than telling yourself, ‘I will not touch my face at all in public today,’ tell yourself, ‘I need to be more aware of touching my own face today’,” he says.
Stew Shankman, a professor of psychiatry and behavioral sciences at Northwestern University tells the New York Times that he would advise people to try to reduce their stress as opposed to worrying constantly about what they touch.
“Stress impacts your immune system, and the more you’re stressed, the more you’re reducing your body’s ability to fight off infection,” he adds.
Also, changing any habit takes a lot of time, so tell yourself that.
“It took years to form so expecting to quit cold turkey is not only impractical, it sets us up for failure. Expect to reduce it over time. If you touch your face five times an hour, make it two or three... until it becomes two to three times a day,” Sanam Hafeez, a psychologist in New York, tells Huff Post.
Identify your triggers and set reminders
The key to kicking an old habit is to identify triggers. Take a moment to figure out what is causing you to bite your nails, for example, in the first place — and then take action against it.
“It is key to spend a day noting time and place for touching your face. This may be when you are reading, driving, zoning out, under stress, etc.,” Paul DePompo, a clinical psychologist and founder of the Cognitive Behavioral Therapy Institute of Southern California, tells Huff Post.
Dr. Raabe of NYU Langone Health tells New York Times that keeping a note of compulsive behaviors can help. “If you find yourself rubbing your eyes because they are dry, use moisturizing drops. If you are using your hand as a chin rest or to adjust your hair, be aware of that,” he says.
Setting reminders on your phone or post-its on your desktop, or places where you frequently go in your house, could also be helpful, say experts.
Keeping your hands busy with a stress ball, for example, can also be helpful as long as you do not forget to clean the ball.
To break the face-touching habit, a box of tissue can also be of help. If you need to scratch an itchy nose or rub your chin or adjust your glasses, use a clean tissue instead of your hands.
Glasses could create a barrier between your eyes and your hands. Dr. Justin Ko, a clinical associate professor of dermatology at Stanford Health, says he tells patients who wear contact lenses to consider wearing glasses instead so that it can discourage them from rubbing their eyes.
Most importantly, keep your hands clean
While much attention has been given to the diagnosis and management of the disease, experts have been urging one key thing: wash your hands frequently. They are clean only till you touch the next object or surface.
Hand washing is a scientifically proven preventive strategy that reduces the likelihood of transmitting both viral and bacterial borne diseases, according to experts. Hand hygiene is also an inexpensive preventive method.
“It may seem like a low-cost — and incredibly simple — intervention. But not emphasizing it would be a huge missed opportunity,” write experts in The Conversation.
A recent MIT study found that improving handwashing at all of the world’s airports could have a massive benefit. The study says that if 60% of travelers have clean hands at any given time, it could potentially slow global disease spread by almost 70%.
The team estimates that on an average, only about 20% of people in airports have clean hands — meaning that they have been washed with soap and water, for at least 15 seconds, within the last hour or so. The other 80% are potentially contaminating everything they touch with whatever germs they may be carrying.
The CDC recommends that people must wash their hands often with soap and water for at least 20 seconds, “especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.”
“If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty,” says the CDC.
The WHO has also been promoting handwashing on social media and has a page dedicated to the basic protective measures one can take to combat COVID-19.
Also, clean your cellphones
We use our mobile phones throughout the day and they too touch multiple surfaces. The surface of your smartphone too can be an avenue of infection.
According to an analysis of 22 studies, human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses can persist on inanimate surfaces like metal, glass or plastic for up to 9 days.
“They can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute," say experts.
On Good Morning America, a medical expert said that it is wise to clean your phone as many times as you wash your hands. The expert recommend wiping the mobile phone with alcohol wipes, such as Lycol.