In a banner year for uncertainty, it feels like an impossible task to imagine what will come after the COVID-19 pandemic. While it is hard to think of the future beyond the day-to-day, our ability to keep people safe may depend on thinking a step ahead.
The road to ending this pandemic will likely be a longer and more winding one than we would want. Creating and distributing a vaccine for sustained herd immunity will be very challenging. It is heartening that Pfizer-BioNTech, Oxford University-AstraZeneca, and Moderna have all announced positive preliminary trial results. Even with positive initial results, though, the earliest that truly large-scale distribution could happen would be between mid to late 2021.
In the meantime, the pandemic stretches on and, as it does, our behaviours are changing. These changes may be permanent.
Habits can take anywhere from 18 to 254 days to form, making the COVID-19 pandemic lengthy enough to instill deep habits. While researchers are speculating whether we will ever go back to shaking hands or whether mask-wearing will continue post-pandemic, there is evidence that frequent, thorough handwashing is becoming habitual. In one study, ninety percent of Americans said they are washing their hands more frequently, with 77 percent washing their hands for at least 20 seconds. The jump from pre-pandemic levels is eye-opening; survey participants who washed their hands six or more times per day increased from 37 percent last year to 78 percent this year. Participants believed that these new habits would persist after the pandemic by an overwhelming majority of 88%. 
Previous outbreaks led to similar, sustained vigilance. A study of people who were quarantined in Toronto during the SARS outbreak found that they reported continued conscientious handwashing and crowd avoidance. Just as disgust with public spitting and uncovered coughing or sneezing became the the norm after the 1918 influenza pandemic, we may see that our higher standards of hand hygiene are here to stay.
The influenza pandemic of 1918 also spurred on the creation of public health agencies in many nations and the first instance of socialized healthcare. It is hard to underestimate the impact this has had for the quality and length of life in the following century. We may see more historic shifts following the COVID-19 pandemic, including the accelerated embrace of a host of transformative technologies.
Touchless, powered by the future
The pandemic has seen the rapid increase in the adoption of touchless technologies. At OPHARDT, touchless products have increased from 20% of our dispensing business to 55%. These devices will outlast the pandemic, and people’s new preference for the convenience and safety of touchless technology will likely as well.
At OPHARDT we think about three key areas that are crucial for improving hand hygiene: access, compliance, and monitoring. The issue of access is particularly important when it comes to touchless dispensers.
While touchless dispensers have an obvious hygienic advantage to manual dispensers, that advantage means nothing if the dispenser’s batteries are not replaced on time. OPHARDT creates smart dispensers that help solve this problem by alerting staff when batteries are low, but we want to make battery replacement a thing of the past. We are currently developing dispensers that are powered by fuel cell technology that runs on the isopropanol found in disinfectant. This always-on, battery-less dispenser would have more than enough power to drive the dispenser motor and transmit data. Beyond the hygienic and time-saving advantages, this innovation will help institutions reduce their environmental impact by eliminating the need to use disposable batteries.
Smart devices and artificial intelligence
Like the issue of access, hand hygiene compliance will also be transformed by new innovations.
“New technologies will play a very important role in increasing good hand hygiene,” Dr. Andreas Glöckner, OPHARDT’s Chief Medical Officer shared with us, “We need smart technologies to measure the most important criteria of hand hygiene compliance, including when there’s a hand hygiene event (HHE), the amount of disinfectant or soap used, and the duration of the HHE. New technologies will help us bring relevant information quickly to the point of care so that healthcare workers get electronic feedback on a nearby screen or direct feedback on the dispenser.”
On device feedback is still in its nascent stage. The ingo-man SmartNose gives feedback when the recommended amount of disinfectant has been used. Future dispensers may include reminders of the different stages of handwashing or disinfecting, timers, and even provide feedback from biosensors (like hand temperature). Real-time feedback will be crucial to improving compliance for healthcare workers and encouraging healthy habits for the public
Increasing access and compliance will be hard to do without improving monitoring. Without accurate and comprehensive monitoring, many institutions are flying blind.
Small events, big data
The use of smart systems in both healthcare and public spaces has increased because of their ability to dramatically increase both health outcomes and customer satisfaction. OPHARDT’s Hygiene Monitoring System (OHMS) has been able increase disinfectant consumption by 31% and help decrease hospital-acquired infections by 28%. These solutions, while very effective, are still relatively niche, a situation that we expect to change in the coming decade.
Currently, much of the data that is collected using connected hygiene systems stays in a silo and is not connected to other data sets within the hospital and the region. However, Josh Geurts, a software developer at OPHARDT, sees a world of possibilities opening up when improved monitoring data is combined with other data sources and artificial intelligence.
“One thing that will be helpful will be the ability to update the feedback on the dispenser to meet a target that meets the changing needs of a hospital. So, say we typically light up the green feedback LED on the dispenser after two dispenses. But imagine we’re seeing higher than usual transmission rates for infectious diseases in the area or maybe an increase in the use of antibiotics in a hospital. Using artificial intelligence in this scenario, we’ll be able to update the dispenser to require three dispenses before flashing the green LED. Dynamic dosing feedback is one way that artificial intelligence paired with big data will be helpful.”Josh Guertz, Software Developer at OPHARDT Hygiene
This could be a crucial tool in controlling the outbreaks of tomorrow.
Pandemics: the new normal?
Calling the COVID-19 pandemic a once-in-a-hundred years pandemic is accurate, but it might not remain accurate for long. Researchers are predicting an increase in the severity and frequency of pandemics, as climate change and sprawling exurbs bring novel interactions between humans and wildlife which may lead to cross-species infection transmission. The high use of antibiotics leads epidemiologists to suggest that future pandemics might be caused by “superbugs” which have mutated to be resistant to antibiotics, leaving us few tools to combat their spread.
The role of handwashing to stop the spread of future infectious diseases will be crucial. Our hands will remain one of the chief ways that diseases can be spread, responsible for helping spread 80% of communicable diseases, so proper hand hygiene will remain one of the most accessible and necessary tools to stop widespread loss of life.
 Anderson, R., Vegvari, C., Truscott, J. and Collyer, B., 2020. Challenges in creating herd immunity to SARS-CoV-2 infection by mass vaccination. The Lancet, 396(10263), pp.1614-1616.
 Lally, P., van Jaarsveld, C.H.M., Potts, H.W.W. and Wardle, J. (2010), How are habits formed: Modelling habit formation in the real world. Eur. J. Soc. Psychol., 40: 998-1009. https://doi.org/10.1002/ejsp.674
 Survey: How Coronavirus Turbocharged Our Hand Washing Habits, 2020. Bradley Corp. [online] Available at: <https://thewashfountain.bradleycorp.com/post/survey-how-coronavirus-turbocharged-our-hand-washing-habits> [Accessed 24 November 2020]
 Cava, M.A., Fay, K.E., Beanlands, H.J., McCay, E.A. and Wignall, R. (2005), The Experience of Quarantine for Individuals Affected by SARS in Toronto. Public Health Nursing, 22: 398-406.
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