The London School has a long and established history of research on the very basics of preventive care – around water, sanitation, hand hygiene, risk screening, and environmental hygiene – and particularly poignant today – the art and the science of epidemic modelling. These collectively represent the core of the H in the London School of Hygiene and Tropical Medicine.

Added to this is recent work in crowded healthcare facilities in low-&-middle-income countries, and particularly maternity and neonatal units, which yields sobering lessons from the often-neglected frontline workers who face incredible risks – cleaners.

There is strong evidence showing how high-risk hand touch sites are central to the pathway to infection. No amount of hand hygiene – practised however effectively – can work if the surfaces surrounding patients and providers are constantly re-contaminated. We need to calmly and decisively insert “vigilant cleaning”* of surfaces into the stream of actions which must be taken to mitigate COVID-19  – in healthcare environments and beyond.

Although there are no universal guidelines for cleaning, many countries have national specifications (such as 4) & updates for the COVID-19 context. The School has also co-produced a package to train cleaners – TEACH CLEAN – in low-resource settings which has been acknowledged by WHO, & CDC & ICAN.  This package can be accessed here.

As WHO emphasized long before COVID-19 – clean care is safe care. So, let’s value those who help to keep us safe – cleaners.

*Vigilant cleaning of surfaces means:  ensure regular cleaning schedule is maintained in healthcare facilities (including appropriate frequency, technique & use of correct cleaning fluids); consider additional measures for highest frequency hand-touch sites (such as door handles, hand rails, and taps); & ensure cleaners are properly protected with relevant PPE as they carry out their work.

See also: http://bit.ly/LSHTMBASICS