Now the CDC wants to shut down ‘hygiene theater’

Editor’s Note: Kent Sepkowitz is a CNN medical analyst and a physician and infection control expert at Memorial Sloan Kettering Cancer Center in New York. The views expressed in this commentary are his own. View more opinion at CNN.

Remember when we all thought we had to wash our vegetables to remove possible contamination from the novel coronavirus? A year ago, this was a hot topic of discussion; when asked by friends (and I frequently was asked by friends) how to both eat and live safely, I referred them to this well-done video that shows the best clean-your-box-of-pasta approach.

Kent Sepkowitz

It seemed logical at the time. In those frantic early months of the pandemic, routes of transmission of the virus were not well-characterized. Everything and anything seemed a potential danger, from touching a countertop to eating an apple to walking in the street.

In response, the most germophobic behavior suddenly made perfect sense. Hand sanitizers proliferated at every store entrance, in pockets and at home. Indeed, hand sanitizer sales in 2020 jumped 600%.

But now we actually know a great deal about how the coronavirus is and is not transmitted. It turns out that airborne transmission of the virus is much more likely than transmission from surfaces, especially porous ones.

So, the apple you washed and scrubbed and let sit overnight to make sure all the maybe-virus had died could have been bitten into after a quick rinse, just like you used to do when all you worried about were toxic chemicals and salmonella.

In fact, we are so confident of transmission routes that the US Centers for Disease Control and Prevention (CDC) has just declared that the constant cleaning of surfaces and food and chairs is not part of the solution at all, but rather threatening to become part of the problem.

Sure, the “high-touch” surfaces, like doorknobs and faucet handles, need attention – and in households with a Covid-19-positive individual, disinfecting surfaces in the house can lead to lower viral transmission rates – but the rest, according to Vincent Hill, chief of the Waterborne Disease Prevention Branch of the CDC, is protecting no one and is, in fact, nothing more than “hygiene theater.”

Even worse, such an approach may be harmful in two distinct ways. First, scrubbing and scrubbing may lead to a false sense of security, the misplaced confidence that if the place is spick-and-span, Covid-19 transmission cannot occur – so you need not tell your coughing uncle who came over for dinner to cover his cough or better yet, go home.

Healthcare workers tend to a patient with Covid-19 who is having difficulty breathing in a Covid holding pod at Providence St. Mary Medical Center in Apple Valley, California on January 11, 2021.

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Second, there is the often-overlooked fact about soap and other cleaning products such as bleach and quintenary ammonia: They are not harmless. Indeed, Hill points out that calls to poison centers increased in 2020. This may have been related to the overenthusiastic use of cleaning products and other dangerous practices in the name of preventing illness.

The problem with the CDC adjusting its message, especially this far into the pandemic, is that the agency is less than forthcoming about how and why everyone went into such a cleaning frenzy.

It – the CDC – did not dissuade people from the sort of over-sanitizing that can be dangerous. In its cagey gov-speak, the exact declarative statement, “sanitize every surface you touch, every time you touch it!” never appears. But, with little known about the risks of everyday behaviors in the dark months of spring 2020, the advice on how to avoid contracting Covid-19 often felt unclear.

Plus the collective worry was enhanced by the initial medical literature, which was chock-full of super-scary lab findings showing that the virus could last hours and hours on surfaces. Many logically concluded that a contaminated apple might be a real thing.

As the first wave of the pandemic was settling last summer and the country was catching its breath, the CDC inched in the direction of telling people not to worry in their June 2020 guidance, writing that “it may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.” (“This is not thought” by whom, exactly?)

But this sort of non-declaration declaration serves only to allow the CDC plausible deniability. They are giving “take it or leave it” advice, not strong and helpful direction similar to some of their recent guidance.

A healthcare worker records a vaccination with the AstraZeneca Covid-19 vaccine on an additional Covid-19 vaccinations card to the International Certificate of Vaccination or Prophylaxis (ICVP), also known as the Carte Jaune or Yellow Card, by the World Health Organization (WHO), at the university hospital in Halle/Saale, eastern Germany, on February 12, 2021. (Photo by JENS SCHLUETER / AFP) (Photo by JENS SCHLUETER/AFP via Getty Images)

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That’s why the current cheerful revision feels like a bit of a bait-and-switch operation.

The CDC, of course, is in the very unenviable position of needing to scare people into action when a threat appears but then turning around the very next week or month or year to now assure the exact same people that there is nothing to be afraid, that it is safe to go back into the water.

An impossible task. Better, though, to admit that consensus has changed; that new evidence is available, and we changed our minds after reviewing the data. Instead, we get the usual robotic tone that ignores past missteps and, if anything, points to overly energetic cleaning as ill-advised, perhaps whacky and in no way a normalish response to the terrifying early days of the pandemic when cleanliness was next to godliness and the more the better.

Getting the tone right might sound like a ridiculous quibble at a moment of such heightened excitement and concern regarding the pandemic.

But it matters a great deal: the Biden CDC and other governmental experts have done a good job winning back the trust of much of the population, but the confidence in any government endeavor is extremely fragile. Witness the intense criticism of their appropriately cautious “pause” of vaccination with the Johnson & Johnson Covid-19 vaccine.

Throughout the pandemic, the CDC and the World Health Organization and every Covid-19 talking head, myself included, have made countless mistakes as all have tried, in good faith, to prepare people for what’s ahead.

Trustworthiness, though, is not based on the percentage of predictions and bits of advice a person or agency gets right; rather, it’s owning up to mistakes and changes of direction with clarity and bluntness.

Or, stated more clearly and bluntly, for people in need of public health advice, the road to hell is lined with evasively worded guidelines.