July 2, 2020 -- With dirty door handles, heavily trafficked toilet bowls, and proximity to strangers, public restrooms can be a germophobe’s worst nightmare. But the COVID-19 pandemic adds a new layer of risk, and infectious disease doctors are urging people to be cautious ahead of the holiday weekend.
A recent study published in Physics of Fluids outlines the potential dangers of toilet plumes -- clouds of droplets that can rise 3 feet from a flushing toilet and be inhaled by an unsuspecting user. Aside from the obvious ick factor, simulations found that coronavirus remnants in a person’s stool can make their way onto other surfaces or linger in the air nearby.
But there are things people can do to avoid the dangers of restrooms.
“What’s the most hazardous part of using a public restroom? It’s the people in it,” says William Schaffner, MD, a professor of medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine. “It’s not necessarily the inanimate environment.”
Wear a mask, of course. Scope out the bathroom ahead of time to see how congested it is, Schaffner says, and wait to use it until it has cleared out a bit. If it is urgent, try to keep your distance from people -- for men, stay a couple of urinals away from the nearest person. Aim to use larger restrooms to avoid close contact with people and toilet sprays.
Though it may be tempting to use seat covers, it is not recommended -- they could be covered with their own germs, and it is smart to keep contact with objects to a minimum.
“If you want, you can carry wipes into the bathroom with you and wipe off the toilet seat before sitting down,” Schaffner says.
Toilets with lids can be closed before flushing to avoid the plume. If they don’t have lids, back away and exit the stall as quickly as possible. And when approaching the sink for hand-washing, Schaffner says, pay attention to the number of people already using the space. If you can, wait until the area is clear.
Although studies have shown that high-powered air dryers can blow harmful particles around, infectious disease experts say those machines and paper towels have similar risks. In fact, Schaffner says, the air dryers might be safer.
“I think air dryers help rather than hurt -- they move air around,” he says. “If there happens to be a person next to you that's infected, the air dryer will disperse the air, and you're much less likely to get an infectious dose of the virus.”
According to Aaron E. Glatt, MD, chairman of medicine at Mount Sinai South Nassau, the risk of contact with bodily fluids pales in comparison to the dangers of close gatherings. After all, there is always a chance of plume contamination with viruses and bacteria like E. coli.
“Bodily fluids are always a concern, regardless of COVID,” he says.
Glatt’s main advice? Be smart and use common sense. If you are going on a trip, try to avoid using a public restroom altogether and go before you leave the house.
The bigger concern, Glatt says, is the potential spike of COVID-19 cases after fireworks displays and barbeques bring large groups of people together.
“People aren't being careful. We're seeing it across the country right now,” he says. “This is a formula for disaster.”
As long as people are mindful of “the big three” -- masks, hand-washing, and distancing -- the country can avoid a post-holiday spike, Schaffner says.
“There is still plenty of room for people to enjoy themselves,” he says.