Water, sanitation, hygiene, and waste management for the COVID-19 virus - Interim guidance (23 April 2020)

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This interim guidance supplements the infection prevention and control (IPC) documents by summarizing WHO guidance on water, sanitation and health-care waste relevant to viruses, including coronaviruses. It is intended for water and sanitation practitioners and providers, and health-care providers who want to know more about water, sanitation and hygiene (WASH) risks and practices.

The provision of safe water, sanitation and hygienic conditions is essential for protecting human health during all infectious disease outbreaks, including of coronavirus disease 2019 (COVID-19). Ensuring evidenced-based and consistently applied WASH and waste management practices in communities, homes, schools, marketplaces, and healthcare facilities will help prevent human-to-human transmission of, the virus that causes COVID-19.

This guidance was originally published in March 2020. This first update provides details on hand hygiene, sanitation, protecting WASH workers and supporting the continuation and strengthening of WASH services, especially in underserved areas. This additional information has been prepared in response to the many questions that WHO received about the prevention and control of COVID-19 in settings where WASH services are limited and where there is emerging evidence on the presence of viral fragments in excreta and untreated sewage.

The most important information concerning WASH and the COVID-19 virus is summarized here.

  • Frequent and correct hand hygiene is one of the most important measures to prevent infection with the COVID-19 virus. WASH practitioners should work to enable more frequent and regular hand hygiene by improving access to hand hygiene facilities and using multimodal approaches (refer to Hand hygiene practices) to support good hand hygiene behaviour. Performing hand hygiene at the right time, using the right technique with either alcohol-based hand rub or soap and water is critical.

  • Existing WHO guidance on the safe management of drinking-water and sanitation services applies to the COVID-19 outbreak. Water disinfection and sanitation treatment can reduce viruses. Sanitation workers should have proper training and access to personal protective equipment (PPE) and in many scenarios, a specific combination of PPE elements is recommended.

  • Many health co-benefits can be realized by safely managing water and sanitation services, and by applying good hygiene practices.

Currently, there are no studies on the survival of the COVID19 virus in drinking-water or sewage. The morphology and chemical structure of this virus are similar to those of other coronaviruses for which there are data about both survival in the environment and effective inactivation measures. This guidance draws on the existing evidence base and current WHO guidance on how to protect against viruses in sewage and drinking-water.