Beginning in early 2020, the spread of COVID-19 disrupted lives all around the planet. In the United States, what started as a distant concern quickly turned into a health emergency as the virus spread to the states and case numbers rose, leading to the indefinite closure of nearly every public space and unprecedented stay-at-home orders. Tens of millions of people lost their jobs, and more than five hundred thousand Americans lost their lives in the course of one year.
Most Americans agree that the United States, despite being home to the world-renowned Centers for Disease Control and Prevention (CDC), was unprepared for the pandemic. Although there’s nothing that we can do to erase the grief and disruption that COVID-19 caused, there are many lessons we can learn. We have a unique opportunity not only to better prepare for the next pandemic but also to address public health issues that were present long before COVID-19 came to the United States—issues that will, unless we change our behavior, remain after the virus subsides.
This white paper argues that it’s time to reevaluate who should be responsible for cleaning, disinfecting, and sanitizing in public spaces. The truth is that the job is too big for sanitation workers and cleaning crews alone; instead, we all must accept responsibility for keeping public spaces free of dangerous pathogens through a concept we call “cooperative cleaning.”
What is cooperative cleaning, and why is it necessary?
Cooperative cleaning is the name we have given to the shared responsibility for cleaning and disinfecting public spaces and for washing and sanitizing one’s own hands in public. We aren’t sure exactly what this shared responsibility will look like: it could involve individuals playing a more robust role in disinfecting spaces that they occupy, ensuring schools and businesses have the resources to hire enough staff to provide multiple daily cleanings, or a combination of both. One thing is clear: we need a real and lasting change in attitudes and behaviors. This may seem like an enormous undertaking, and in many ways it is. But the good news is that many Americans are prepared and even eager to adjust their behavior to improve public safety.
A September 2020 poll from the Pew Research Center found that about half of Americans assume their lives will change in major ways after the pandemic. Another poll from The Ohio State University Wexner Medical Center found that 72 percent of Americans said that they plan to continue wearing masks in public after COVID-19 stops spreading and that 90 percent will maintain frequent handwashing and sanitizer use. However, intentions and actions are different things. One of the challenges to making cooperative cleaning a reality will be convincing people to remain vigilant—and in the correct manner—after the danger of COVID-19 decreases.
Shifting the focus from COVID-19 to other health risks
Though the COVID-19 pandemic has brought a higher awareness of public health issues at large, we should be careful not to tailor our thinking and behavior to preventing the spread of COVID-19 alone. There will still be many other threats to public health after COVID-19 subsides, and the measures we take to prevent the spread of COVID-19 won’t necessarily be adequate for avoiding these threats.
For example, because research suggests that there’s a low risk of contracting COVID-19 via fomites (contaminated objects or surfaces), the CDC has recently relaxed its guidance on cleaning and disinfecting said surfaces. The agency now says, “In most situations, cleaning surfaces using soap or detergent, and not disinfecting, is enough to reduce risk.” This may be true for COVID-19, but plenty of other pathogens are more prone to fomite transmission. In addition, this guidance is focused on specifically preventing the spread of COVID-19—this nuance may be lost on the general public, who may see it as justification to avoid disinfecting surfaces altogether. COVID-19 should remain an area of focus for as long as it poses the single most urgent risk to public health, but it’s important to remember that it’s not the only challenge we face. For these other challenges, we believe we must embark on a cultural shift toward cooperative cleaning.
Health risks in a pre- and post-COVID-19 world
Tens of thousands of people have died from the flu every year over the past decade, including an estimated sixty-one thousand people during the 2017–2018 flu season. Nearly one hundred thousand people die every year from health care–associated infections (HCAIs). These deaths haven’t received the same attention or sense of urgency as deaths from COVID-19, but they were and are no less tragic and no less preventable.
Granted, COVID-19 dominated health-related news in 2020 and 2021, but there has long been a general lack of public awareness of these and other preventable health crises—even a sense of acceptance that these deaths are somehow inevitable or simply the cost of living in an otherwise prosperous society. The hope behind cooperative cleaning is that we can use the recent surge in public health awareness to fuel action toward preventing preventable illnesses. But before we can explore the practicalities of cooperative cleaning, it’s important to look at the current state of cleaning and disinfecting.
How we currently approach cleaning and disinfecting in public spaces
The COVID-19 pandemic ushered in an intense examination of the way the public perceives cleaning, and for the most part, we have been found wanting. In a survey from the American Cleaning Institute, 42 percent of respondents didn’t know how to disinfect properly. A handwashing survey from the Bradley Corporation showed that most people formed good handwashing habits during the height of the pandemic but have begun backsliding as of January 2021.
Most schools, restaurants, offices, and other frequently occupied spaces have in-house or third-party cleaning crews come in after hours to clean or disinfect once a day or week. However, even a daily cleaning regimen is inadequate. Although daily cleaning and disinfecting are better than none at all, spaces need to be disinfected multiple times per day—ideally between each person who occupies a given space—in order to more meaningfully reduce the spread of harmful diseases. And since it’s not practical to expect in-house or third-party cleaning crews to provide this level of frequent cleaning and disinfecting, the responsibility must fall on all of us. In short, we need a more comprehensive and cooperative approach to cleaning and disinfecting public spaces.
Defining terms: Cleaning versus disinfecting versus sanitizing
Because cooperative cleaning will require broad knowledge of and comfort with cleaning and disinfecting, it’s necessary to make sure readers understand what we mean when we use terms like cleaning, disinfecting, and sanitizing.
Potential benefits of cooperative cleaning
The central goal of cooperative cleaning is to reduce the impact that preventable disease has on our society. Above, we discussed the number of people who succumb to the flu and HCAIs every year—a tragedy that a nationwide push toward more robust cleaning could avoid. Here are a couple more benefits of cooperative cleaning.
Reduced absenteeism from work. A 2018 report from the Integrated Benefits Institute estimates that workers covered for sick time, workers’ compensation, disability, and medical leave are absent about 893 million days per year due to illness and incur the equivalent of 527 million lost workdays due to impaired performance. The nearly 1.4 billion lost days of productivity cost employers an estimated $530 billion per year. This doesn’t cover many freelance or gig economy workers, who make up an increasing share of the United States workforce and who don’t have the luxury of taking paid time off and may feel obligated to work while sick. By reducing the spread of everything from the flu to the common cold, cooperative cleaning could have a profound impact on the US economy and on the health of our nation’s workers.
Reduced absenteeism from school. Looking at the years 2013–2015, the CDC estimates that 3.9 percent of boys and 4.3 percent of girls missed more than ten days of school within a twelve-month period because of illness or injury. Not only do missed school days affect the child’s academic performance, but a parent may have to stay home with a sick child or even contract the illness themselves, which leads to absenteeism from work. Instituting cooperative cleaning in US schools—often breeding grounds for common illnesses—can go a long way toward reducing the impact of illnesses on education and its accompanying effects.
Challenges to cooperative cleaning
Bringing about a cultural shift toward cooperative cleaning won’t be easy or happen overnight. There are a number of challenges involved with convincing people of the necessity of cooperative cleaning as well as figuring out the logistics of cooperative cleaning itself. It’s important that we openly discuss these challenges and how to overcome them to make cooperative cleaning work and save lives.
Education. Getting accurate information to the public is perhaps the single most challenging aspect of making cooperative cleaning a reality. Because cleaning and disinfecting have long been the purview of professional cleaners, most people aren’t familiar with the ins and outs of cleaning and disinfecting. As discussed above, many people don’t understand the difference between cleaning and disinfecting or the concept of “dwell time”—the time a disinfectant must remain wet on a surface before it can be wiped away. It will also be critical to ensure that people understand that different disinfectants are rated for different uses.
Supply. Shifting the responsibility of cleaning and disinfecting from the few to the many will, at least initially, lead to shortages of both cleaning supplies and the personal protective equipment that is needed to safely use many of these products.
Logistics. Encouraging the public to add a task to their daily routines could prove to be a big ask. Though many hands make light work, it may prove difficult, for example, for a restaurant to wait out a twenty-minute disinfectant dwell time before seating new patrons.
Safety. Disinfectants aren’t just dangerous to pathogens; they can also be dangerous to people if used improperly. Schools, for example, may need to develop measures and protocols to keep supplies away from small children.
Environment. There must be an open discussion about the impact that more cleaning products and personal protective equipment might have on the environment in terms of sourcing for production, runoff, and other factors.
Complacency. A big challenge to cooperative cleaning is convincing people to combat an unseeable threat even after the danger of COVID-19 has decreased. As disruptive as COVID-19 was, there’s a chance that many will revert to their prepandemic behaviors.
Although adopting a concept like cooperative cleaning may seem challenging for a lot of reasons, it’s important to remember that society has undergone many similar shifts in thinking and behavior. For example, many people alive today can remember a time when seat belts were rarely used or weren’t even present in passenger vehicles. It wasn’t until 1964 that it became mandatory for all new passenger cars to have some form of seat belt. In the 1970s, seat belts were used only about 10 percent of the time. New York enacted the first seat belt use law in 1984, and many more states adopted similar laws in the following years. Many people resisted, but eventually seat belt use became second nature to most drivers and passengers: the National Highway Traffic Safety Administration reports that the national use rate was 90.7 percent in 2019 and that seat belt use in passenger vehicles saved an estimated 14,955 lives in 2017 alone. There are obviously many differences between the widespread use of seat belts and the proposed shift toward cooperative cleaning, but this comparison illustrates that it’s possible for a society to shift attitudes and behavior for a larger social good—to accept minor inconvenience to save lives.
Being more mindful of cleaning in public spaces isn’t the only change that should happen in a post-COVID-19 world, and it may not even be the most pressing, but it is nonetheless a critical one that demands robust discussion and action. We encourage anyone reading this to absorb the points we make here and think about what they can do to advance the conversation. We welcome any and all commentary about the concept of cooperative cleaning, including correcting anything we say here, pointing out further challenges not enumerated here, or proposing solutions to challenges. In the months and years to come, we expect and welcome more white papers, research, panels, and other endeavors to help move the needle toward more proactive public safety measures.
The COVID-19 pandemic brought profound disruption and tragedy. It’s a time in our lives that we won’t soon forget. Still, we can’t assume that we’re now prepared for another pandemic. As we adjust to a new normal, we must be sure we adopt new strategies and mindsets not only to help us avoid another pandemic but also to avoid preventable deaths resulting from a lack of cleanliness in public spaces.