When the pandemic begin in the United States, public health officials understood little about how this particular virus spread from person to person. Many presumed it could be spread easily through contact with surfaces such as counters, tables, and plastic and cloth items such as reusable grocery bags. Deep cleanings of schools, hospitals and homes with bleach and other hard-to-find disinfectants became the norm. People who almost never washed their hands began hoarding hand sanitizer and these little bottles of clear gel began cropping up as ubiquitous swag. Places such as California—which had seen less cluttered beaches, parks and landfills as a result of its single-use plastic bag bans—saw the sudden return of the vexatious plastic pest as front line workers refused to touch their customers’ presumably unhygienic personal totes. These products pose may pose some risk to human health—especially when misused—as well the physical environment.
At present, as more is known about how the virus spreads through inhalation from infected droplets, surface transmission has receded somewhat as a focal point of concern. Public reliance on chemical products targeted at reducing exposure through these means is likely to ebb and flow through the findings of ongoing research and the emergence of new viruses and variants that behave in different ways.
Current understanding of SARS-CoV-2 virus exposure
According to the Centers for Disease Control (CDC), exposure to the SARS-CoV-2 virus occurs in three principal ways: “(1) inhalation of very fine respiratory droplets and aerosol particles, (2) deposition of respiratory droplets and particles on exposed mucous membranes in the mouth, nose, or eye by direct splashes and sprays, and (3) touching mucous membranes with hands that have been soiled either directly by virus-containing respiratory fluids or indirectly by touching surfaces with virus on them.” (See Scientific Brief: SARS-CoV-2 Transmission, updated May 7, 2021, SARS-CoV-2 is transmitted by exposure to infectious respiratory fluids)
Scientists now understand that inhalation is the principal mode of transmission and infection. At this time, the number of infections actually achieved through surfaces such as clothes, utensils and furniture is unknown. Case reports suggest one can get the virus from directly touching one’s nose, mouth or eyes after touching a surface such as a doorknob or countertop on which an infected person has recently coughed or sneezed. It is understood that the virus is capable of living on surfaces such as plastic and stainless steel for up to two-to-three days. At this time, medical professionals recommend cleaning and disinfecting all counters, knobs, and other surfaces touched by humans regularly several times a day.
During the pandemic period compared with the pre-pandemic period, the frequency of cleaning (69.3%) and the amount of cleaning product usage (74.2%) increased significantly and the frequency of problems related to the use of cleaning products was found as 46.9%.
The EPA’s List N: Disinfectants for Use Against SARS-CoV-2 (COVID-19) has 545 products that have been shown to be effective against the virus. These products contain quaternary ammonium compounds (QACs), hydrogen peroxide, bleach (sodium hypochlorite), alcohols (ethanol and isopropanol), acids, and phenolic compounds as the active ingredients. Bleach is the active ingredient in 75 products.
Bleach (sodium hypochlorite) is commonly used as an ingredient in household, public space and hospital cleaners. Bleach has been linked to chronic and acute negative health outcomes. Bleach and bleach-based disinfectants have been suggested to increase risk of Chronic Obstructive Pulmonary Disease and increased asthma symptoms at high-level exposures, though further study is needed. Due to its oxidative nature, bleach reacts with biological tissues, denaturing proteins and causing irritation and cell death. Many people are unaware that bleach should never be mixed with other household chemicals such as toilet bowl cleaners, ammonia and detergents, as chlorines may be released into the air. When chlorine gas comes into contact with moist tissues (eyes or lungs), hydrochloric acid, a digestive molecule, is produced which can damage airways, cause asphyxiation, and death.
Misuse of bleach has become common during the pandemic. An American Association of Retired Person (“AARP”) report found that 39 percent of respondents reported engaging in at least one “high- risk practice” in the prior month to prevent the transmission of COVID-19, including:
- Rinsing fruits and vegetables with bleach (19 percent)
- Washing hands or skin with household cleaning and disinfectant products (18 percent)
- Misting the body with a cleaning or disinfectant spray (10 percent)
- Inhaling vapors of household cleaners or disinfectants (6 percent)
- Drinking or gargling diluted bleach solution, soapy water, and other cleaning and disinfectant solutions (4 percent each)
Hand hygiene is a barrier to surface transmission and has been associated with lower risk of infection. Most alcohol-based hand sanitizers are effective at inactivating enveloped viruses, including coronaviruses.
In a recent private manufacturer poll, 65% of respondents stated that they use hand sanitizer as often now as they did during the beginning of the pandemic; 33% say they use it more than once an hour, and 49% say they use it every couple of hours.
Yet there are some dangers with hand sanitizers, particularly to little children. Per the CDC, hand sanitizers should have at least 60% alcohol in order to be effective. Thus, these products can be deadly to children if swallowed, particularly for products containing methanol. From January to September 2021, there were over 17,000 poison control calls in the U.S. involving disinfectants, nearly 23,000 about hand sanitizer and around 30,000 on bleach through September 6, respectively up 23%, 58% and 7% from the same period in 2019.
According to the American Academy of Dermatology Association (ADA), constant use of alcohol-based sanitizers can cause dry skin that can flake, itch, crack and bleed. This can cause open wounds on the skin surface that can allow in bacteria and other germs and increase the risk of infection. The ADA recommends using hand cream or ointment immediately after sanitizing.
Single-Use Plastic Bags
Over the last fifteen years or so, there has been a push at state and local levels to cut down on or eliminate single-use plastic bags, which can litter parks, get stuck in trees or wind up in landfills.
In 2007, San Francisco became the first jurisdiction in California to ban single-use plastic bags. . Washington, D.C. prohibited non-recyclable plastic carryout bags in 2009.
California, which had been using 500 million bags a month, was the first state to ban the bags. Proposition 67 (a veto voter referendum of the legislation enacting the ban) was designed to prohibit large grocery stores and pharmacies from providing plastic single-use carryout bags and ban small grocery stores, convenience stores, and liquor stores from doing so the following year. Proposition 67 allowed single-use plastic bags for meat, bread, produce, bulk food, and perishable items. The measure required stores to charge 10 cents for recycled, compostable, and reusable grocery bags. Revenue from the charge was intended to cover the costs of non-plastic bags and educate consumers. Proposition 67 exempted consumers using a payment card or voucher issued by the California Special Supplemental Food Program from being charged for bags. The measure provided $2 million to state plastic bag manufacturers for the purpose of helping them retain jobs and transition to making thicker, multi-use, recycled plastic bags. The measure passed with 53% of the vote.
But, as the pandemic struck, people stockpiled food, cleaning supplies and toilet paper. Grocery stores installed plexiglass to protect cashiers, labeled one-way aisles to encourage social distancing, and returned plastic bags to all stores, requesting customers keep reusable ones at home. The pandemic disrupted some retailers’ efforts to reduce use of non-recyclable plastics, from grocery bags to plastic forks. Some states postponed intended enforcement of bag bans.
In this context, California Governor Gavin Newsom’s executive order in late April 2020 gave the Golden State bags a second life for 60 days. Some believed the executive order temporarily lifting the ban was driven by uncomfortable front line workers who did not want touch customers’ personal items, not by science. Environmentalists hailed the measure because they decry the single-use bags’ indestructibility as “horrible.”
A compromise provision in the measure allowed retailers to sell reusable plastic bags for a minimum of 10 cents each. The legislation also states the bags must be capable of being recycled in California. This provision has recycling advocates arguing for better enforcement by the state. In practice, converting soft plastics such a shopping bags and packaging films into new products is so cost-prohibitive that recyclers say no market exists for this material. Thus, these items are not widely accepted in curbside recycling programs across California. For that reason, advocates say that they should not be labeled “recyclable.”
Proponents of continuing the ban believe reusable grocery bags help to reduce the amount of litter in California and should be used in accordance with the hygiene and cleaning practices recommended by public health officials. Cal/OSHA has issued guidance for the grocery industry regarding the use of reusable bags.
As we move into the third year of the pandemic, the science about the spread of the virus and its prevention is developing. As long as people continue to be infected and there is some evidence that surfaces can be a source of those infections, cheap and widely-available chemical products that arguably help reduce that spread are likely to be an inevitable part of American life for the foreseeable future.