Once upon a time there lived a Hungarian doctor named Ignaz Semmelweis. In 1846, he was appointed as an assistant at a Vienna hospital with two maternity clinics for training doctors and midwives. Similar to other hospitals around the world at this time, many admitted mothers were dying of a mysterious illness called child-bed fever. Semmelweis discovered a disturbing trend where its doctors’ clinic had an average mortality rate of 9.9%, which was significantly higher than that of its midwives’ clinic (3.9%).
Semmelweis was determined to identify the cause of this noticeable difference between the two clinics. At the time, there was no notion of germs or infections so he considered a variety of potential causes such as bad ventilation, overcrowding, delivery methods, and even religion. An unfortunate event triggered Semmelweis’s eureka moment. When a close friend at the hospital was conducting an autopsy, he was accidentally poked by a student’s scalpel and later died from the wound. As Semmelweis performed the difficult post-mortem examination, he noticed a strong similarity in the pathology of his friend’s illness and that of the women who died of childbed fever.
At the Vienna hospital, it was common for the doctors to perform autopsies in the morning and then spend the rest of their day attending patients in the maternity ward — without ever washing their hands. Unlike the doctors, the midwives performed no autopsy work and were not in contact with any corpses. Semmelweis hypothesized that some kind of poisonous particles were being transferred by the doctors from the cadavers to the patients in the maternity clinic. He found a chlorinated lime solution was strong enough to remove the putrid smell of the autopsy tissue from the doctors’ hands and determined it would be ideal for removing these deadly contaminants.
Two months after the death of his friend, he introduced a new handwashing policy for the doctors to use the chlorinated lime solution after any autopsies. When he launched the new policy, the monthly mortality rate was 12.2% in the doctors’ clinic. Semmelweis’s new policy had an immediate impact, and the death rate was lowered to 2.2% (an 82% decrease). After several months of significantly lower mortality rates, he still observed student doctors who were not following the policy. After introducing stricter controls on the negligent doctors, Semmelweis was able to lower the mortality rate even further with two months where no mothers died of childbed fever.
Semmelweis’s data met three key criteria — it was truthful, valuable and actionable — but he ultimately failed to see his ideas adopted in his lifetime as he couldn’t scientifically prove why his handwashing policy worked. As an example of the prevailing sentiment of many mid-nineteenth-century doctors, American obstetrician Charles Meigs is attributed with saying, “Doctors are gentlemen and a gentleman’s hands are clean.” Due to their social status, physicians were unaccustomed to being reproached—especially by one of their own. Ignaz’s data was ignored, his life-saving ideas were rejected, and he was sadly discredited by his colleagues.
Eventually, in the mid-1860s, Louis Pasteur discovered the germ theory of disease. Yet the ironic truth was the doctors did have more than 18 months of statistical data showing Ignaz’s handwashing approach worked and that such practices could have saved many more lives of expectant mothers.
In the wake of COVID-19 pandemic, we are experiencing a deja-vu from Ignaz’s time. The world health communities have declared the 3 S of COVID-19 prevention -
a. Sanitizer usage b. Soap handwash c. Social Distancing
Although this list was just alphabetically ordered, the global citizen seems to have taken this quite literally as more importance is being placed on use of Sanitzers rather than our humble Soap, as per the consumer buying pattern and shortage of sanitizers. Now, the science community is in loss of words while explaining that it is the Soap that is more effective, not the fancy spraying sanitizers.
Technically, it is the very structural nature of soap molecule, that makes it an effective enemy to corona family of viruses. Going back to school level chemistry, Soap molecule have a hydrophobic tail (that loves to attach with oil, grease and germ fat/lipids) and a hydrophilic head (water lover) making it an amphiphilic.
While the basic structure of Corona virus that cause COVID-19 consist of an RNA strand encapsulated within a thick lipid membrane which has spike proteins protruding outside the capsular surface resembling a crown, hence the name corona.
So, when we are rinsing our hands with soap water for 20 seconds or more, the soap’s molecular tails get attached to this lipid membrane of the virus and once the water falls on the rinsed hand, the head of the soap molecule rushes towards the water molecule, tearing up the virus into shreds.
The fatty membrane of the virus is basically getting detached from our skin and getting attached to the foamy froth of the soap, which later gets washed away while rinsing with water, even if we spend less that 20 seconds to wash our hands. This is what makes soap more powerful than sanitizers as we can’t dab a lot of latter due to its “high price”. More over, the alcohol of the hand sanitizer that actually helps in breaking the membrane of virus, evaporates rapidly leaving an incomplete job done, that might sometimes be more harmful in hindsight. Even the famous Metcalf experiment done by a primary school Teacher revealed the long term effects of soap-water on touching food.
So, what are you waiting for? Go ahead, and wash your hands. Go Soap-ing, Stay safe!!
1. A History Lesson On The Dangers Of Letting Data Speak For Itself, Brent Dykes, Forbes, Feb 9, 2016
2. WHO directives on COVID-19 Preventive measures
Article originally published in VGSoM IITKGP Executive MBA Digital Interaction Platform.