From hygiene and ventilation through to seizing the educational moment, there are some basic steps worth taking, writes Dr Mike Bedford, a specialist in health and wellbeing in early childhood education settings.

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Hygiene – get the basics right

It’s a good idea to have children wash their hands as soon as they arrive at school or ECE. This can help to break transmission from surfaces or people they have been in contact with. For ECE, also get children to wash hands before they leave in addition to normal hand wash routines. For schools, hand washing before leaving may not be practical. Forget about antibacterial hand soaps. Some antibacterial soaps use antibiotics such as Triclosan, which won’t do anything to a virus (and really shouldn’t be sold anyway).

All you need is ordinary soap and running water (never shared water, and warm water is more effective). Use liquid soap rather than bar soap. When you are about three years old and just learning to wipe your bum, sometimes you’re not very accurate, and gross contamination of soap can happen.

In ECE, songs can help encourage hand washing (please not Happy Birthday!) but as each child may wash their hands five times a day or more, you need to protect your sanity! Songs with actions can be good, so their children can do the actions without having to sing the song 30 to 35 times a week. Another great idea is to make “soap gloves” – soap all over the hands before washing off. A 20-second hand wash is recommended, but any hand wash with soap and running water is better than no hand wash.

Hand drying is also important. Paper towels are the most practical option for most situations, but in small ECE centers, single-use-before-wash cloth towels can be good if you can manage that. For paper towels try the ‘paper towel scrunch’. Wipe hands both sides, and each finger, then scrunch up the paper towel and roll it around between your hands. Try to make it into the tiniest ball you can (which can get competitive!). This maximises contact and reduces a lot of mess.

The Nanogirl soap-in-water-with-pepper demo on YouTube is also great – just make sure children get the right explanation. For ECE, explain, “soap helps the water to clean things”, and in schools use the explanation about water tension with the original video.

Disinfection and cleaning

I was using computer dictation for this, and it gave me “some fiction and cleaning”. Very apt! This is where we need to rely on what we know, more than what we think might help. The first thing is that we know cleaning really helps. Soaps and detergents work well to remove viruses, so focus on frequent cleaning.

Chlorine-based sanitisers give you the best practical surface disinfection, after you clean. Other products, such as normal supermarket disinfectants (like benzalkonium chloride) or advanced surface-residual disinfectants like Zoono may help, but for human coronavirus there remain some questions.

For example, Zoono, which is a quaternary ammonium silane, works well on bacteria and has been tested as effective on some coronaviruses, but could be slow acting. All disinfectants work best on clean surfaces, so just clean! Anything that can go through a dishwasher should go through a dishwasher. 

Heating and ventilation

Unlike bacteria, viruses die off quicker in warmer room temperatures. The New Zealand minimum indoor temperature of 16 degrees for ECE is too low (it’s the lowest regulatory ECE minimum temperature in the world). You should aim for a minimum of 18 degrees – warmer is better.

The other important consideration is ventilation. Most ECE centres have their doors open to outside frequently, so main activity room ventilation isn’t much of a problem. However, there can be a problem with infants’ rooms and especially with sleep rooms. Please make absolutely sure that these rooms are well ventilated. If your ventilation is open windows, then open them. Please note that heat pumps do not provide any ventilation; they are only heating air that is already in the room. If a sleep room has no ventilation, it should not be used.

Activities

In ECE, there has been debate about whether to stop water play or play dough. Balancing risk against need, I’d say yes, stop these activities for now. They will increase risk and children can live without them for a while.

Education – stop the silly language of “bugs” and “germs”.

This situation has shown that most New Zealand adults don’t know even the most basic science of microbes. They don’t know the difference between bacteria and viruses, which is like not knowing the difference between a cow and grass. That’s why dumbed-down advertising like “kills 99.99% of germs” sells. Kills 99.99% of what? Bacteria? Viruses? Just some, not others? Practically, it means nothing – it’s just marketing. It’s why people still buy antibacterial soap for a viral outbreak.

Even health sector information still uses the language of “bugs” and “germs”, instead of accurate words. Recently we’ve had a You Tube clip zipping around showing “bacteria” growing on bread wiped with hand sanitiser. Actually, it was mould – just mouldy bread, and mould really likes moist, bacteria-free bread. But people believed it was bacteria.

My Covid-19 challenge for schools especially (and as far as you can in ECE) is to grab the moment and teach the basic science. What are bacteria, fungi and viruses? How do they work? What’s the difference? Why doesn’t an antibiotic kill a virus? What’s the difference between soap, an antibacterial, and a biocide? How does soap or detergent cut water tension and improve wetting? How does marketing exploit people’s fears and lack of knowledge (think of the Protex TV ads)? It’s really easy and interesting to teach, and a great opportunity to learn.