Keep washing your hands!

Hello, dear readers, and welcome to this month’s letters column. In the midst of so much turmoil and uncertainty, we’re more grateful than ever for this chance to communicate with you.

-- Several of you wrote about the frustration of seeing someone exit a public restroom without washing his or her hands. “I find this upsetting at the best of times, but during the COVID-19 outbreak, I am more concerned than offended. What can be done?” a reader asked. Unfortunately, you can’t force people to practice good hygiene.

However, you can take steps to protect yourself from the effects of their bad habits. Push swinging doors open with a shoulder, elbow or knee. Use toilet paper or a paper towel to protect yourself from any surfaces that you have to touch, such as the lock on the stall door, faucets on the sink and the door handle on the way out. Don’t rest personal items, such as a purse, on a public bathroom countertop. Be sure to dispose of the used barrier paper safely in a trash can. And, of course, wash your hands.

-- On the topic of hand-washing, we received a lot of mail asking about the effectiveness of hand sanitizers. The short answer is that 20 seconds of thorough hand-washing with soap and water is the preferred method of protecting against all types of germs and microbes. However, when this isn’t possible, an alcohol-based hand sanitizer of at least 60% concentration is a good alternative. The problems arise when people fail to use a large enough volume of hand sanitizer, or when they wipe the product off of their hands before it has completely dried. The takeaway here is to use the properstrength products and read and follow the directions.

-- In that same vein, some of you told us you are confused that hand sanitizers, which are marketed as antibacterial, are being recommended for use during a virus outbreak. The answer is that hand sanitizers do not target a specific microbe; they work by damaging the exterior membranes of a wide range of organisms. This includes bacteria and some viruses. Although not all viruses have an exterior membrane, the coronavirus does, so hand sanitizers are useful at this time. However, as we noted, the proper alcohol concentration is crucial to the work of destroying the membrane, so use the right product and follow the instructions.

Thank you to everyone who has written with kind words. Knowing that these columns are useful means a lot to us. (And to Glenda in Tulsa, who just turned 83, your note about who you want to be “when I grow up” made us laugh out loud.) We appreciate the time and care you all put into your letters and emails, and we will revisit some topics with your thoughtful suggestions in mind. We look forward to our next batch of mail and to seeing you here again next month. Please take care of yourselves -- and stay safe.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.