Water, sanitation, hygiene (WASH) and waste management for the COVID-19 virus: Technical Brief

World Health Organization. (2020). Water, sanitation, hygiene and waste management for COVID-19: technical brief, 03 March 2020 (No. WHO/2019-NcOV/IPC_WASH/2020.1). World Health Organization.

Review written by:

Nazneen Ali, edited by Elizabeth Harty

Green - WHO briefing

The provision of safe water, sanitation and hygienic conditions is essential to protecting human health and prevention of human-to-human transmission of SARS-CoV-2. Based on current knowledge, transmission occurs by respiratory droplets and contact. There are no reports of fecal-oral transmission to date. . The risk to water supplies is low (guidance provided for places where centralized water treatment is not available). SARS-CoV-2 is an enveloped virus, which means that it is expected to be less stable in the environment. Survival time on surfaces has varied in studies and depends on a number of factors (type of surface, temperature, relative humidity).

Proper hand hygiene is one of the most important measures to prevent the infection against the SARS-CoV2 virus. WASH practitioners and providers should work to enable more frequent and regular hand hygiene by improving the functionality of facilities and using proven behavior change techniques.

Hands should be cleaned with soap and water, or an alcohol-based hand rub in healthcare settings, as per the instructions of the “My 5 moments for hand hygiene”. The five moments include 1) before putting on PPE and after removing it, 2) when changing gloves, 3) after any contact with a patient who has a suspect or confirmed COVID-19 infection or their waste, 4) after contact with any respiratory secretions, 5) before eating and after using the toilet. Hand hygiene in non−health care settings is one of the most important measures that can be used to prevent COVID-19 infection. In homes, schools and crowded public spaces—such as markets, places of worship, and train or bus stations—regular hand washing should occur before preparing food, before and after eating, after using the toilet or changing a child’s diaper, and after touching animals.

WHO guidance on the safe management of drinking-water and sanitation services applies to the COVID-19 outbreak. Extra measures are not needed. In particular, disinfection will facilitate more rapid die-off of the COVID-19 virus. Currently, WHO recommends using: 70% ethyl alcohol to disinfect small areas between uses, such as reusable dedicated equipment (for example, thermometers) and sodium hypochlorite at 0.5% (equivalent to 5000 ppm) for disinfecting surfaces in hospitals. Many co-benefits will be realized by safely managing water and sanitation services and applying good hygiene practices. Such efforts will prevent many other infectious diseases, which cause millions of deaths each year.

Review Notes

1. The technical brief establishes baseline protocols that will require incorporation of location specific practices.

3.  The WHO continues to monitor the situation closely for any changes that may affect interim guidance. Should any factors change, WHO will issue a further update.  Otherwise, this technical brief document will expire 2 years after the date of publication.

4. This document is a supplement to the WHO’s Infection Prevention and Control documents. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/infection-prevention-and-control.

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