COVID-19 and restrooms: 11 things you better know

By Page Leggett, Novant Health

Aug. 14. Many of us had an aversion to public restrooms long before COVID-19 turned mundane moments  — like touching a doorknob — into risky business.

Amy Braden, a Novant Health infection preventionist based in Winston-Salem, has recommendations on ways to mitigate those risks.

Amy Braden

Public restrooms are just plain gross, right? Should we avoid them at all costs?

Well, they are notoriously not the cleanest places. But if you’re doing the things we’re supposed to be doing – wearing a mask and limiting the things you touch – they should be fairly safe.

There are some caveats, though. There’s some evidence that you can find COVID in stool, but we don’t yet know if you can become infected that way. Other viruses – the norovirus, for instance – can be spread through stool.

I’ve read about “toilet plume” – the water droplets that can spray up from the toilet bowl when you flush – being risky. True?

There could be a remote risk in that aerosolized water, but the people you encounter in public pose a bigger risk. In a public restroom, the biggest risk points are touching the door handles, the security lock on the door and the toilet paper holder. I’m much more concerned with what I touch than with toilet plume – and that was true even before COVID.

What do you do these days when you have to go into a public restroom?

The first thing I do, always, is scan the restroom to see if paper towels are available. You’re going to need one to dry your hands, turn the sink off and open the door as you’re leaving.

And if there are no paper towels, do you walk out?

 I’ve had to use toilet paper in place of paper towels. It falls apart when it’s wet, but at least it’s a barrier between you and a sink or you and a door handle.

If there’s no soap, I’ve rinsed my hands off with water and then used hand sanitizer as soon as I can.

What if you’re a parent with kids and you have to take them into a public restroom with you?

First, make sure everyone is masked. Touch the least number of things possible, and make sure your kids do the same. Tell the kids to hold their hands together and interlock their fingers. I do that myself. It’s an impossible-to-ignore reminder not to touch anything.

Are hand dryers germ spreaders?

I am not a fan of hand dryers. I haven’t seen any data on the new, fancy Dyson ones. But in general, I steer clear of them. I mean, you press a button, and it blows some warm air out. A moist environment with heat is the perfect environment for bacteria to grow.

Your hands are actually dirtier after you’ve used a hand dryer than before. I never, ever, ever use them. I will walk out of a bathroom with wet hands before I’ll use one. That is my No. 1 infection prevention tip.

Using a hand dryer defeats the purpose of washing your hands.

Now, let’s talk about when we’re actually in the stall. What safeguards should we take?

The germiest part of a toilet isn’t the seat; it’s the handle. You should close the lid before you flush and then flush with your foot, if you can. If not, use toilet paper as a barrier between your hand and the handle. And of course, your mask should be on the whole time.

Lots of public restrooms don’t even have toilet lids. There’s just a seat. What do you do then?

Work quickly. Flush in the safest way you can, turn your back and get out of there.

Ideally, we shouldn’t even be in situations now where we need to use public restrooms often. If you need to go to the mall, don’t stay for hours. It’s safest to avoid unnecessary trips to a public bathroom.

Right. But what about a family that leaves town for a day to, say, go hiking?

Yes, you have to live life and get out of your house. I went hiking on Pilot Mountain recently with my niece and nephew and used a public restroom. I wore my mask and washed my hands afterward. You have to always be asking yourself: What’s the risk? How can I minimize it? And then plan accordingly.

Again, the people you come in contact with at a restaurant, convenience store or rest stop are a bigger risk than a public restroom.

Do you need to put on a new mask when you leave the public restroom?

The rule of thumb is to change your mask when the outside is soiled. Also, you should not be touching your mask. Each time you touch it, you should wash your hands.

You don’t necessarily need to put on a new mask when you leave the restroom unless it’s soiled. But if you do put on a new one, you shouldn’t put the soiled one directly into your purse or pocket. Have a Ziplock bag with you, and put it in that.

What about purses? What do you do with it when you’re in a public restroom?

You should be leaving home with as little as possible these days. If you have to carry a purse, a small crossbody one is a good choice. You don’t ever have to take it off. If I take my purse to the grocery store, I don’t set it down in my cart. I leave it on my shoulder.

This isn’t one of the biggest risks out there, but it’s smart to avoid placing it on any surface if you can help it.

Courtesy of Novant Health