DISINFACTS | Issue 2/2020

Painstaking work: stay diligent! False notions about the effectiveness of alcohol-based hand disinfection on the new coronavirus and other pathogens are also circulating. Simply dismissing these reports as fake news or the result of sloppy editorial work would be the wrong way to handle them. We should take such misunderstandings seriously and diligently expose them as fake news – with both feet firmly planted on the ground of evidence-based science. The scientist Alexandra Peters (University Hospitals Geneva Clinic, Switzerland) has shown the approach to take: together with Didier Pittet she dissected a study in November last year (well before SARS-CoV-2!) that was published in mSphere, the journal of the American Society for Microbiology. The study called into question the effectiveness of established hand hygiene measures against influenza viruses and therefore also attracted the attention of the mainstream media (5). Following a detailed analysis of the study, the verdict of the two experts was damning: it is not just the conclusion that is incorrect. The study had serious flaws in the experimental design and also had no clinical relevance because the authors neglected to consider the considerable mechanical effect in hand hygiene due to rubbing respectively. All in all, the authors showed a lack of understanding of clinical practice, current hand hygiene recommendations and the current professional literature as Peters and Pittet pointed out in a detailed letter to the editor that was also published in mSphere (6). They ended the letter by making it clear that alcohol-based hand disinfection is extremely effective against influenza viruses and helpful against non-spore-forming organisms, including non-enveloped viruses. Distorted headline The finger cannot always be pointed at a study’s authors or its expert reviewers. This is demonstrated by a similar case that was also opposed by Peters and Pittet (7): in a letter to the editor of the eminent journal The Lancet in 2018, they, together with another colleague, turned their attention to a study published The World Health Organization is busting myths about the novel coronavirus on a website specifically created for this purpose. There are graphics with questions and answers on every topic for downloading and sharing. More information at: Common myths about SARS-CoV-2 and COVID-19: 1. Spraying alcohol or chlorine inactivates coronaviruses that have already entered the body? No. 2. A hot bath protects against SARS-CoV-2? No. 3. Rinsing your nose with saline solution prevents a SARS-CoV-2 infection? No. 4. Hand dryers are effective against SARS-CoV-2? No. 5. Eating garlic protects against SARS-CoV-2? No. WHO website busts myths www.who.int/emergencies/diseases/novel-coronavirus-2019/ advice-for-public/myth-busters in the journal about the supposed development of tolerance of Enterococcus faecium to isopropanol. After analysing the study, they blamed the publisher’s press department, above all, for the spread of the fake news. The reason was that the press release on the study had been headed ‘Hospital superbugs becoming resistant to alcohol disinfectants’. A distorted statement, according to the experts, considering that ‘alcohol-based hand rub is on the WHO essential medicines list and saves millions of lives worldwide every year’. Sources: 1 Süddeutsche Zeitung. Forscher geißeln Gerüchte um das neue Coronavirus. 19 February 2020. Link: https://www.sueddeutsche.de/gesundheit/covid-19-coronavirus-labor-1.4805658 2 Süddeutsche Zeitung. Fake News über Whatsapp. 15 March 2020. Link: https://www.sueddeutsche.de/digital/coronavirus-whatapp-fake-news-1.4845355 3 Medizinische Universität Wien. Angebliche Forschungsergebnisse der „Wiener Uniklinik“ rund um das Covid-19-Virus sind Fake News. 14 March 2020. Link: https://www.meduniwien.ac.at/ web/ueber-uns/news/detailseite/2020/news-im-maerz/angebliche-forschungsergebnisse-der- wiener-uniklinik-rund-um-das-covid-19-virus-und-ibuprofen-sind-fake-news/ 4 Federal Office of Public Health (BAG). Is ibuprofen dangerous with an infection with the coronavirus? 15 March 2020. Link: https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/ news/news-06-03-20201.html 5 Hirose R et al. 2019. Situations leading to reduced effectiveness of current hand hygiene against infectious mucus from influenza virus-infected patients. mSphere 4:e00474-19. https://doi .org/10.1128/mSphere.00474-19. 6 Peters A, Pittet D. 2019. Influenza and alcohol-based handrub: the danger of ignoring clinical relevance. mSphere 4:e00719-19. https://doi.org/10.1128/mSphere.00719-19 7 Pidot SJ et al. Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. Aug 1, 2018. http://stm.sciencemag. org/lookup/doi/10.1126/scitranslmed.aar6115 8 Peters A, Pittet D et al Enterococcus faecium tolerance to isopropanol: from good science to misinformation. https://www.thelancet.com/action/showPdf?pii=S1473-3099%2818%2930542-5 KNOWLEDGE DISINFACTS 2/20 page 13

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