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How to make your own hand/surface sanitizer to share

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Date:
Authors: Dr. Kate Hurley
Document Type: Information Sheet
Topics: Infectious Disease
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Dr. Hurley shares her technique for creating small bottles of hand and surface sanitizer using Rescue (accelerated hydrogen peroxide), as well as some guidelines about using proper hand sanitation to slow the spread of coronavirus.

(Caveat: I am a shelter veterinarian, not a human infectious disease specialist or epidemiologist. This is my best interpretation of methods to prevent spread of disease based on what I’ve learned working with disease outbreaks in animal shelters. THIS IS NOT A SUBSTITUTE FOR FOLLOWING STAY-HOME OR SHELTER IN PLACE RECOMMENDATIONS. See this link for more: https://sites.google.com/view/stayhomesavelives/home. Hand/surface sanitation is a method to mitigate risk for those times when you do need to go out and for use on an ongoing basis even after such recommendations have been lifted. The basics are in the first section, with more detail on the how and why in the second section below if you are interested.)

When you must go out, either because you work in an essential function or for necessary trips such as groceries or doctor’s visits, breaking the chain of transmission between your face (especially nose/mouth/eyes) to surfaces that will be touched by others and from there to other people’s faces (and vice versa), may be the most important and practical thing you can do to lower risk of coronavirus spread for yourself and everyone else.

Although the recommendation is out there to wash your hands and avoid touching your face, the reality is that hand washing stations are not present in many of the locations where we are likely to touch contaminated surfaces, and touching our faces is a common and often unconscious habit. So do follow those recommendations at every opportunity, and also use hand and surface sanitizer frequently when hand washing is not available and in case you do touch your face (or whenever you notice that you have done so).

Make this easy for yourself by having hand sanitizer in strategic locations: in your pocket whenever you are out and about, in your purse/backpack/toolbag, in your car, close to your door at home etc. Because our phones especially are contaminated frequently by our hands, spray bottles of disinfectant can be more practical even than the squirt gel of hand sanitizer as it’s easier to spray phones, car keys, grocery cart handles and other frequently touched surfaces.

It has gotten hard to find hand sanitizer and many cleaning chemicals, but luckily coronavirus is easy to inactivate. It is an “enveloped virus”, which means it is surrounded by a lipid envelope which is relatively easy to disrupt. Even good ol’ soap not only removes virus but can damage that lipid envelope and help inactivate it. You can find lists online of effective disinfectants including accelerated hydrogen peroxide, bleach at 1:50, 70% alcohol, and other compounds that work well including quaternary ammonium disinfectants (these generally have the suffix -onium somewhere in their ingredient list). All disinfectants must be applied correctly for the required contact time.

Because accelerated hydrogen peroxide (AHP) is non-toxic, rapid acting, reliable against coronavirus and even has good activity in the face of organic matter (so if your hand isn’t perfectly clean at the time of application it is still likely to work), I have been using this to make spray bottles for my family, friends (and their family, friends and coworkers), staff at my local grocery store, delivery drivers and pretty much everyone I can find who needs them. The concentrate is effective when diluted at 1:64 in 5 minutes and sanitizes in 30 seconds when diluted at 1:16. There is also a “ready to use” version which sanitizes in 30 seconds without dilution. Because in hand sanitation situations speed of action is often important, I’ve been using the 1:16 ratio.

As of this writing, AHP was no longer available on amazon but could still be found elsewhere on the internet such as at pet supply distributors. Just try googling “accelerated hydrogen peroxide disinfectant”. Note that plain hydrogen peroxide is NOT the same, so if you don’t find the brand name Rescue or Accel, check to be sure it really is accelerated hydrogen peroxide. The makers of accelerated hydrogen peroxide also have information on the various names under which it is marketed and where it can be found: https://virox.com/covid-19-updates/. One gallon of concentrate will make 16 gallons diluted at 1:16 so don’t over-order please – get what you need to make enough to share and there will more likely be enough to go around 😉.

Sanitizer does not have to be in an official container. Just put correctly diluted disinfectant into spray or squirt bottles in convenient sizes and in convenient locations. For instance I ordered these on amazon: https://www.amazon.com/gp/product/B07ZGB9JLL/ref=ppx_yo_dt_b_asin_title_o04_s00?ie=UTF8&psc=1 (1 ounce for pocket use) and these https://www.amazon.com/Bekith-Pack-Clear-Spray-Bottles/dp/B07BRNVLXC/ (~3 ounce to have in car, by door, on desk etc.). Orders may be limited per person, but if we each fill 30 bottles and share them freely every week, that will go a long way.

Gloves and safety glasses are indicated when working with the concentrate as it can be a contact irritant. Also if you spill it, wipe it up quickly so it doesn’t eat into the finish on your kitchen table. I used a squirt bottle, like for condiments or salad dressing, to dilute and dispense the disinfectant into the little bottles. These slightly higher end bottles are really nice because the lid is sturdy, they don’t leak and they have the ounces marked on the side so it’s easy to do the dilution. https://www.amazon.com/gp/product/B076PT3BD8/ref=ppx_yo_dt_b_asin_title_o02_s00?ie=UTF8&th=1. Get the 16 ounce size – there is room at the top for one more ounce of the AHP so it’s perfect.

I fill one condiment bottle with the full strength AHP concentrate, then fill another with 16 ounces of water and added 1 ounce (2 tablespoons) of AHP from the bottle of concentrate. Then I use the bottle of diluted AHP to fill all the little bottles. Make sense? That way I don’t have to mess around much with the gallon of concentrate as it’s kinda unwieldy to get two tablespoons out of there at a time. I just use the smaller bottle of concentrate to refill the other bottle as needed.

The high end condiment squirt bottles are really nice when you’re in production mode and filling lots of bottles because they don’t leak or spill, but when I want to give someone enough to refill their own little squirt bottles (like for a family or group at a workplace that is still in operation), I make up a cheaper condiment bottle with the 1:16 solution to give them to refill. You can get these for about 50 cents each. https://www.amazon.com/gp/product/B0845NSNB4/ref=ppx_yo_dt_b_asin_title_o03_s00?ie=UTF8&psc=1.

I made labels to put on the bottles of 1:16 AHP. I used Avery mailing labels, sheets of 30: https://www.amazon.com/gp/product/B001SN8ITI/ref=ppx_yo_dt_b_asin_title_o00_s00?ie=UTF8&psc=1. Here is a link to the sheet which you can print either onto the premade labels or just onto a piece of paper and cut and tape. https://www.dropbox.com/s/x3mwrzmy2idu5ur/homemade%20AHP%20sanitizer%20labels%203.docx?dl=0. Here is the text I put on the labels if you want to make your own.

Accelerated hydrogen peroxide: 1:16 dilution, safe on hands and most surfaces but test sensitive surfaces in small area first to make sure there is no discoloration. Allow 30 seconds contact time. Avoid inhaling spray as it can be irritating. https://virox.com/resources/safety-data-sheets-sds/ for more info.

I also added stickers to some bottles because, well, stickers! For wiping stuff, I bought a bunch of lens cleaner cloths and have them handy along with sanitizer spray (I use a different color for my glasses and actual lens cleaner). For example these: https://www.amazon.com/gp/product/B00A7OTO74/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1. But really any little rags or tissues will do. Just get enough so they are in all your pockets and bags conveniently. And that’s it! If you want to know more about the WHY behind hand sanitation read on, but otherwise you’re good to go. Oh, and let me know if you have questions or suggestions.

Do-It-Yourself hand and surface sanitizer

Optional additional reading: Hand and fomite/surface sanitation considerations to slow the spread of COVID-19

Something we think about a lot in animal shelters is a concept called “dose effect”. No pathogen (bacteria, virus, etc.) causes illness with just a single unit of infection. No matter how hot the virus, it still takes some amount to cause infection (including subclinical) and more to cause manifest illness. In general with higher exposure dose, the incubation period will tend to be shorter and the disease will tend to be more severe. This has been documented for animal coronaviruses (e.g. https://www.ncbi.nlm.nih.gov/books/NBK92442/).

However, importantly, dose effect gives us a fighting chance. Below a critical threshold, exposure does not equal infection. This is good news because even where it is not possible to completely eliminate potential exposure, lowering the dose we’re exposed to in the environment will give our immune systems a fighting chance, while lowering the dose we spread in the environment will do the same for others.   

The intention of the broad stay-at-home or shelter-in-place orders is to dramatically lower the dose of exposure for everyone. This is so important acutely to slow the spread and allow time for systems to ramp up. Please follow all orders and recommendations to the very best of your ability, not just for you but for everyone, especially those in the health care sector and all the immunocompromised and older people who will be most impacted.

However, for those in essential job functions or for those times you do need to go out for groceries and necessary appointments, you can still meaningfully decrease the risk you experience and create for others by paying attention to hand and surface sanitation. (This is for asymptomatic people. If you are AT ALL symptomatic, even mildly, follow even stricter precautions. More on self-isolation here: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html).

When we are really careful in animal shelters about preventing close contact between sick and susceptible animals and interrupting the chain of exposure between sick animals to surfaces like hands, clothing and equipment that come into contact with those animals, and susceptible animals, we are often successful in containing even highly contagious diseases. We even have an advantage as humans, in that we don’t lick our bodies all over like animals do. That means we really just have to worry about keeping our hands clean before touching common surfaces, and keeping them out of mouths, eyes and noses when they are dirty. Bottom line, if we effectively interrupt the chain from mouth/eyes/nose to surface (doorknob, checkout counter touch screen, elevator button etc.) to another person’s mouth/nose/eyes, we will substantially slow transmission.

So here is the super high yield habit we can all develop to reduce dose: have lots of bottles of hand sanitizer or tiny spray bottles of any of the number of non-toxic disinfectants that kill coronavirus, and use them freely. Make it really convenient and easy on yourself. Focus on when you come home, get back to your car from being out and about, get to your office in the morning or back from lunch or a meeting, after you’ve been grocery shopping, etc. Any time you’ve been out in the world touching elevator buttons, grocery cart handles, payment touch screens (that’s why they’re called “touch screens” :-0), doorknobs, hands, money, etc.

Also focus on immediately before and immediately after touching your face and especially your mouth, nose and eyes – before to protect yourself, and immediately after to protect others. However, remember that touching our faces is a very common and automatic thing for most people, so err on the side of sanitizing your hands immediately after touching a high contact surface. That way, if you do happen to touch your face, you will already have broken the chain of transmission (additionally, spray the high contact surface, like the handle of your grocery cart, if it’s something you’ll be in contact with more than just briefly).

Remember also that for many people your phone is almost an extension of your hand; we touch them so often. So when you sanitize your hands, consider spraying down your phone at the same time. It does no good to sanitize your hands and then immediately touch your phone if you’ve been handling the phone with your dirty hands previously.

Also wash your hands whenever the opportunity presents, and do it right (don’t just moisten and not clean and dry, as moisture can enhance the ability of viruses to survive and translocate onto mucous membranes). But remember all those other surfaces – if you were walking around the grocery store touching stuff and playing with your phone, then still spray your phone or anything else you handled a lot and didn’t wash, so you don’t re-contaminate your fresh clean hands.

In between sanitizing your hands and when out and about at places like grocery shopping, at work, doctor’s office (!!!) or anywhere else where lots of people are around and touching surfaces, try really hard not to touch your face with your hands. Use a tissue or the inside of the top of your shirt or something to rub an itch if you must – something that will not come into contact with surfaces. In fact you might try and develop this habit at home too so it will start to feel strange to touch your face with your bare hand.

(A note though about using sleeves to cover your hand when opening doors and such – just remember that you won’t be able to sanitize your sleeve as readily as your hand, and may touch your face, rub your nose etc. with your sleeve. So if that’s something you tend to do, it might be better to just use your hand and then sanitize.)

Remember that this IS a habit, one that will serve us all well over time. How do YOU do best to develop new habits or strengthen existing ones? Would it help to think of every squirt of sanitizer as an act of love for yourself and the world? Would it help to leave your phone in your backpack or purse so you don’t mindlessly touch it when you’re out and about? Don’t be embarrassed to use visual cues for yourself – putting rubber bands on your hands, drawing big NO signs on your hands, wearing something that covers your mouth and nose so you remember not to touch (this doesn’t need to be a face mask and shouldn’t be as those should be reserved for sick people and the health care workers who need them). A bandanna or a cloth face mask that you got back during some kind of smoke event (familiar to Californians) works just fine as a cue to not touch (but don’t fool around with it with dirty hands, that’s counterproductive).

Also think about how you can set up your office/home/car/wherever you commonly land after being out and about to cue the right behavior. Put a sign up on your front door or where you set down your car keys, put a bottle of hand sanitizer/spray in obvious places. Keep a couple in your car and if you find you went into a store without it, go back and get it.

Take extra care when you are going to be in a prolonged situation where you will be surrounded by high risk surfaces (those that are contacted by many peoples’ hands). It’s harder obviously to remember to be careful for hours or days than on a quick trip to the grocery store. For instance if you do end up needing to travel or you work in a situation where exposure is possible, that might be the time to break out the hard core visual cues and even set a timer reminder to sanitize your hands regularly.

If you do this – really solidly interrupt the chain between frequently touched surfaces and your own respiratory mucous membranes – that will lower your potential exposure dose greatly as well as the dose you put out there if you happen to be preclinically shedding when out in public.

And P.S. if this needs saying again: follow shelter in place/stay at home orders and self-isolate when you’re sick according to guidelines! Together we can all help slow this down and protect the most vulnerable, the folks on the front lines and truly all of us. Thanks!!!