Covid-19 is truly a terrible and devastating attack against humanity and indeed all efforts must be employed to fight and eradicate it from our mist.

Due to the fast transmission rate of Covid-19, the World Health Organisation  (WHO) has given preventative measures and advise to the global community and the most important of these measures are regular washing of hands with soap under running water; and regular sanitizing or disinfecting the hands with an alcohol-based sanitizers.

As result, public health officials, government officials, medical doctors, non-governmental organizations (NGOs) etc around the world have happily taken up WHO's preventative measures and advise and generally, robustly forcefully and indiscriminately imposing such measures onto their citizens without considering the medical consequences of some of these measures and advise provided by WHO.

My concern is not about the washing of hands with soap under running water, but rather my worry is the overuse of the 70% alcohol sanitizers which is been trumpeted by WHO and those medical officials whom I expected to know better by considering the deleterious effects of this product when it is used on the skin for a long time, and sadly they did not provide any guideline or amelioration to combat any damaging effects that may arise from the overuse of the sanitizer let alone even talk about the fact that or warn that the over usage of the alcohol sanitizer could damage the skin.

Can over usage/overuse of alcohol-based hand sanitizer damage the skin?

Yes, the overuse of the alcohol-based hand sanitizer can cause damage to the skin and possibly to internal systems too (inside the body). Thus, the following can occur:

1. Skin sensitivity

2. Irritate the skin

3. Itching and burning sensations

4. Cracks to skin texture

5. Dryness

6. Damage to skin integrity

7. Disturbance to skin DNA which may result in dermatological consequences including possible skin cancer, hardening of the skin (skin coagulation), etc.

8. Destruction of the skin microflora or resident microorganisms that supposed to protect our skin, as a result, would expose the skin to serious infections.

9. Possible effects and damage on skin melanin.

Effects of regular alcohol inhalation

Alcohol is a volatile substance and diffuses rapidly in the presence of air hence, In addition to the above consequences, apart from those that may be absorbed into the blood through the skin, there is the tendency to inhale a copious amount of the alcohol into the body which may cause ocular irritation, abdominal discomforts, conjunctivitis, coughs, respiratory discomfort, oral irritations etc. Such outcomes can be more prevalent to those that are alcohol intolerance and those that may be allergic to the alcohol and these allergic reactions  (hypersensitivities) could be serious.

Although the body can produce minute amounts of blood alcohol by itself, from the website of WHO, they do admit that the alcohol sanitizer can be absorbed into the blood but said the amount is insignificant.

But my point is that this will only be insignificant when the application is not overused but it will surely be significant and dangerous to the body if the sanitizer is overused particularly to children and those with weak skin textures; unfortunately, currently, the whole world is abusing and overusing the alcohol-based sanitizers per official advise by WHO and health officials worldwide saying that everybody must use alcohol-based hand sanitizers timelessly without any guidelines on how many times per day that must reasonably be used and also a failure by officials particularly WHO to give warnings on the consequences of the over applications of their recommended product.

It must be noted and added that individuals such as some from the Asian communities having non-functional aldehyde dehydrogenase  (ALDH) gene may have oxidative metabolism of alcohol-based compounds. Furthermore, this "free for all" abuse and overuse of the alcohol sanitizer could affect children (dermal compatibility issues) greatly because of lack of full functional metabolism (Patrick Boshell, 2018, info@debgroup.com).

The tendency of microbial resistance

It must be pointed out that microorganisms can develop resistance to any antimicrobial substance when it is overused against their killing (inactivation) and when such resistance occurs such microorganisms would now become infectious and pathogenic and difficult to kill/destroy and one of the ways for microorganisms becoming resistant due to the overuse of an antimicrobial such as alcohol sanitizer is DNA mutation, and a typical example currently is the mutation that has taken place in COVID 19, as a result, causing devastating effects against humanity.

Although, it must be clarified here that it is not suggesting or confirming the mutation resulted in COVID 19 was due to the over usage of alcohol but microorganisms can mutate under different conditions including harsh conditions, climate change, overuse of antibiotics/disinfectants  (antimicrobials) etc.

Another example of a mutation that led to resistance is the methicillin-resistant staphylococcus aureus (MRSA) which happened as a result of the overuse of methicillin antibiotics which for some time now has been causing serious nosocomial infections  (hospital-acquired infections) in many hospitals around the world especially in Europe.

It must, therefore, be clarified with strong emphasis that the overuse of the alcohol-based hand sanitizers have the tendency to cause resistance to the skin microflora thus the good microorganisms that are naturally living on our skins to protect the skin, as a result, render them more dangerous and pathogenic.

From WHO's website, they said that there is no evidence of likely resistance of microorganisms to alcohol-based hand sanitizers. I challenge WHO that the overuse of the alcohol sanitizer could cause resistance and may lead to another serious public health issue apart from damages to the skin.

A study has shown that the more the use of the hand sanitizer routinely, the greater the likelihood of microbes may become tolerant of the alcohol. Thus, it was shown that after subjecting Enterococcus faecium to 70% alcohol severally, the organism became resistant to the effects of the alcohol as a result of mutation of the genes involved carbohydrate uptake and metabolism (Sacha J. et al  2018, Science Translational Medicine, Vol. 10, Issue 452). This study confirms the overuse and over applications of the alcohol sanitizers could lead to serious skin microflora resistance and expose the skin to serious microbial attacks and attacks from other sources such as the sun, ozone etc due to lack of natural protection to our skin.

Recommendations

1. To fight Covid-19 pandemic as a measure of prevention, the focus must be more on routinely washing of hands with soap under running water. Since the soaps are washed off from the hands with water, the soaps do not leave any residue on the hands to cause any damage.

2. Alcohol-based hand sanitizers, if it should be used, must be used very little and the hands must immediately be moisturised just after using it on the skin with natural shea butter, cocoa butter or any other good natural moisturisers.

3. Natural lemon juice can also be used as hand sanitizers and natural moisturisers should be used to rub the hands after use.

4. Using only one type of sanitizer and overusing it could cause resistance to the good microorganisms that protects our skin and could cause problems to the skin, so at least two different types of sanitizers could be used interchangeably thus alcohol (minimally) and non-alcohol-based sanitizers (preferably natural type).

5. Household and working environments must be routinely disinfected with at least two different types of disinfectants to be used interchangeably. Such disinfectants could be normal households chlorine and hydrogen peroxide-based disinfectants.

6. Apart from cleaning of hands, it must be added that if possible routine washing of the face with face soap and water would be useful since one could touch the face inadvertently with a contaminated hand. A face cream may be applied after face wash with soap to avoid dryness.

7. The use of alcohol-based hand sanitizers must not be used on children (0 -16 years) rather children soaps must be used to routinely wash their hands under running water and under parental/guardian supervisions.

Children must not be allowed to have full access to it as the tendency of abusing it including drinking it is high.

8. Should you have to use the alcohol-based hand sanitizers, rub your hands away from your chest and nose to avoid inhalation directly or indirectly.

9. 70% alcohol-based hand sanitizer is highly combustible and flammable hence if they are used or stored close to a fire could cause fire outbreaks. This must be stored away from fire and from places such as kitchens etc.

8. If by using the who's recommended alcohol-based hand sanitizers and you are experiencing problems on your hands as indicated above of some of the problems, you must stop using the product and focus on regular handwashing with soap under running water and could use lemon juice to sanitize your hands as well or visit your local skin specialist for further advice.

Conclusion

It is clear public health officials around the world including WHO have been overwhelmed with the current global pandemic and in their desperate measures to help us all to protect ourselves and to overcome the situation, desperate directives too have been provided to the global community without carefully looking into other serious damaging consequences that such directives could later on bring about which may cause further morbidity and economic repercussions.

This overuse of the alcohol sanitizers are not just been applied by adults alone but indiscriminately been applied routinely on children and the very old people without any precautional advise. The authorities must urgently provide guidelines.

Briefly, the disinfestation programmes that is ongoing in public places such as markets, trains, buses, etc must not use only one type of disinfectant alone as this could lead to resistant to environmental microorganisms. It is generally known that chlorine-based disinfectant is been used for this public places disinfestation, however, other environmentally friendly disinfectants such as hydrogen peroxide must be used alongside the chlorine-based disinfectant.

WHO and public health officials leading this Covid-19 fight must consider and establish control measures to curb the overuse of the alcohol-based hand sanitizers to avoid another global dermatological catastrophe as well as other related morbidities.

In my previous article, I hypothesized and suggested that this mutation of this COVID 19 and its related speed and fierce rate of transmission may have been a laboratory-based manipulation of the virus intended to be used against humanity for global economic dominance by a particular nation; or it may be a bioterrorist act etc, and somebody somewhere including WHO may have a clue but pretending they do not know anything about this virus.

We Africans must not live in this world as orphans and anything that is thrown at us should be accepted. This is a global pandemic and we must equally investigate and ask questions so we can also find solutions because if informed steps are not taken the uphill consequence of the effects of this viral burden cannot be contained on this continent.

African knowledge must be collectively mobilised and utilised now. And this is an opportunity to collectively build this continent. My next article will focus on this matter extensively thus bioterrorism and genetic manipulation.

We shall overcome.

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Dr. Michael Boateng works with Agropharm West Africa Ltd, Tema. He can be reached on email at editors@myjoyonline.com