Using Public Restrooms Safely during the Coronavirus Pandemic
This article presents recommendations on using public restrooms safely during the coronavirus (COVID-19) pandemic. These include classic infection control measures, such as good hand hygiene, as well as strategies unique to avoiding the coronavirus, including wearing face masks to avoid its transmission through airborne droplets.
As we venture out of our homes on necessary excursions during the coronavirus pandemic, the need to visit a public restroom is likely to arise at some point. We offer the following recommendations on using public restrooms as safely as possible during the pandemic.
Tried-and-true Infection Control Measures
First, the fundamentals of personal infection control still apply. Hand hygiene remains critical for everyone. Wash your hands thoroughly for at least 20 seconds after using the public toilet. Dry your hands too, as wet hands can more easily transfer pathogens to surfaces than dry hands.
Keep your hands away from your face and refrain from applying makeup in public restrooms (your mask is covering about half of your face anyway and it should stay in place during your visit). Automatic doors to restrooms, touch-less faucets and soap dispensers, and automatic toilet flushing mechanisms can help prevent your contacting pathogens on restroom surfaces.
Where touch-less features are not available, we recommend you place a paper towel between your hand and the surface you need to touch, for example, the sink basin faucet after washing hands and the door handle when leaving the restroom. But don’t count on all public restrooms to be well-stocked with paper towels. Tuck a few of these in your pocket, purse, or backpack before leaving home. If paper towels are not available, you can sometimes use your elbow to push open or close doors. A small bottle of hand sanitizer is another essential item to carry and use frequently when out of the house. It may be all you have to clean your hands with if the public restroom sink faucets are inoperable.
Strategies for Use with Coronavirus in Mind
As social distancing is a significant strategy for avoiding coronavirus, try to avoid crowded restrooms. Although it may be difficult to maintain a social distance of six feet in a public restroom, the more space you can put between yourself and others, the better. If you are waiting in a queue to enter a public restroom, try to maintain a social distance from others.
Public health experts strongly recommend everyone over the age of two wear a face mask to help avoid inhaling or exhaling infected respiratory droplets and fine mists. Importantly, leave your face mask on when you use a public toilet and do not touch or adjust it. A face mask is effective only if it fits snugly over your nose and mouth. We have probably all seen variations on wearing masks that do not meet the “gold standard” of proper coverage. Touching your mask and rearranging it frequently is counterproductive and potentially could spread pathogens. And remember, a face shield is not a substitute for a properly fitted face mask.
Researchers believe the coronavirus is transmitted primarily through the air when infected people cough or sneeze. Coughing and sneezing release virus-laden droplets of diameter greater than about 5 microns1 from the human respiratory tract; these droplets may be deposited on, or inhaled by, people in the vicinity of an infected individual. Another possible airborne route of exposure to the virus is through microscopic “bioaerosols,” consisting of the solid residue of evaporated respiratory droplets released into the air when infected people breathe or talk. Because of the very small diameter of bioaerosol particles (less than 5 microns), they may remain airborne for many hours. While studies of bioaerosols are ongoing, it bears repeating: Wear your mask when you are in a public place or with others not in your immediate circle.
Toilet flushing can potentially produce a fine mist of the contents of a toilet bowl. In the past, we have recommended closing the lid (if there is one) before flushing. Studies have shown flushing can spread pathogens to nearby surfaces, including contaminating toothbrushes stored in residential bathrooms. Some automatic public toilets flush repeatedly during a single use which, while ensuring the user does not make physical contact with the flushing mechanism, could expose the user repeatedly to a bioaerosol from the toilet. These toilets likely waste water too.
Researchers continue to study the coronavirus and its transmission. Currently, the virus is not thought to be spread via the feces of infected individuals as is norovirus, for example. But the coronavirus is not our only public health concern during the pandemic. A general, prudent approach to flushing public toilets is to turn your back on the toilet immediately after flushing, and leave the toilet stall as quickly and safely as convenient. If you are helping a child, usher her out of the stall ahead of you. And at the risk of providing “Too Much Information,” but in the interest of avoiding exposure to an unknown bioaerosol, if possible, refrain from flushing a lidless public toilet that has been obviously used by someone else who has not flushed.
We hope this information helps you navigate public restrooms safely now, during the pandemic, and well into the future.
1One micron is one-millionth of a meter. For perspective, the diameter of human hair ranges from 17 to 181 microns.