Sawbones: A Marital Tour of Misguided Medicine - Hand Sanitizer

Episode Date: July 19, 2022

Around the early 1900s, it was discovered that a high percent of ethanol was useful for killing germs, and worked great if there was no available soap and water. Dr. Sydnee and Justin go through viral internet stories and odd patents to explain how we eventually landed on the hand sanitizer we know and love today. Hey, if you can, though, wash your hands.Music: "Medicines" by The Taxpayers https://taxpayers.bandcamp.com/

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, of Miscite Medicine. for the mouth. Wow. Hello, everybody, and welcome to Solbombs, a marital tour of misguided medicine.

I'm your co-host, Justin McRoy. And I'm Sydney McRoy. I'm Serp, just I keep checking my mustache. Why do you keep checking your mustache? For it, because you make sure it's there. To make, you may fund me, because I got a little bit of cream in there. You just made fun me, because I got a... You just cream in there. You may fund me because I got a...

You just made yourself this little fancy coffee drink just in the middle of the day. It's nice coffee. Well, you made it ice coffee, but then you put a nice little swirl of whipped cream, a fanciful swirl of whipped cream right on the top. I love that. I love injecting some whims into your day. Sydney, I have a suggestion for you. Once a day, get yourself a present.

Just give yourself a plan for it. Don't wait for it. Just give yourself a present. Today, you might a little present to me. A little drop of whipped cream. I thought of my coffee drink. But now I'm worried it's stuck in my mustache. So I'm having to wipe it off. It's not.

My hands, I've made my hands all sticky with whipped cream that I've scraped out of there. And I don't know how to get them clean. This is my husband, his hands are sticky with whipped cream. My hands are sticky with whipped cream, like some sort of bear in a can't ground. He is an adult. Like a bear that got into the marshmallow. But his hands are sticky with whipped cream. My hands aren't sticky.

Smirral, I've opened the door for you. It's a segue, all right? Sheesh. I was trying to make it. Is that the present you got me in segue? I wish, I wish we had segue money. Keep hitting those sponsors and your maximum fund dollar or first-lash join and just get that money rolling in.

It's like I can finally get my wife, the one thing she's ever wanted, a segue. That's not true, by the way, I don't actually, I would definitely fall off. I don't want a segue. Well, Justin, if your hands are sticky, you might need some hand sanitizer. Yeah, that would...

That's actually not the best solution. Washing your hands would be better, but this episode is about hand sanitizer and not washing your hands, so. I see where you set me up there, but like, think about it. If, when your hands are sticky, if you squirt hand sanitizer on them, does that always like do the whole job for you? No, it's not as you might just live with alcohol, strewn sticky hands. That's not good. They've disinfected sticky hands. Yeah. We've talked about hand washing. Yes. That's done.

We did that. Or Dr. Simmelvice, who did cleanliness. That it's true. We did that one early in the pandemic because it was relevant because people suddenly became aware of hand washing. So glad we're over that by the way. Yeah.

Gross. You know how much I was spinning on soup. No, we are not over that, and we still should be washing our hands, but we didn't talk about hand sanitizer, and we should, because not so much now, but throughout the pandemic, it's been a hot item, a hot ticket item.

The earlier one, when everyone who could make hand sanitizer was like, I think Tito's the vodka, people, they're like, we're using our extra capacity to make hand sanitizer was like, I think Tito's the vodka people, they were like, we're using our extra capacity to make hand sanitizer. A lot of alcohol companies converted that, then there were a lot of DIY, we'll get into that. But hand sanitizer became a hot commodity, and it was hard to get, people were stockpiling it.

Oh yeah, like a house. Oh yeah, that in toilet paper. But you know, it's interesting to think about, did we always love hand sanitizers so much? Where did it come from? Who came up with it? And was it always the hot commodity that it is today? So we figured out hand washing.

We talked about that. We loved that. And we all got excited about it, but there was an obvious limitation in order to wash your hands with soap and water Need hands Yes, this is one but you also you have to have soap and water yeah, and soap was maybe less of a limitation in the sense that like Well, you can make soap pretty cheaply and easily eventually a variety of forms and you can get that out to people. It's shelf-stable. You can rend an animal, right? Isn't that what you do? You render the animal.

There's fat involved. There's fat involved. It's not pretty. But it is. I don't want to get in. It is available. We've all seen fight club. However, it does require water, and without water, you don't have a great option, well, prior to this, to clean your hands, right? Because you've got soap, but we're just gonna rub the dry soap all over your hands. Come on. Do real.

Also, I don't know if this is like a healthcare worker problem or if other lines of work, you have this common thing where in a room, in an exam room, it is not uncommon to have a hand sanitizer dispenser and a soap dispenser that look identical, except for if you read where they say either hand sanitizer or soap. And sometimes there's a slight colored difference

in what you can, so a visual, I have so many times put soap on my hands and then stood there talking to a patient while I just continually rub soap all over my hands and thought this is not hand sanitizer, this is not hand sanitizer. But now this patient isn't gonna take me seriously if I say, excuse me, I've just put soap on my hand.

I'm a real doctor. I wasn't pretending. But even when you have access to water and soap, it also takes time. And that was another problem they found pretty quickly. And maybe if you're prepping for a surgical scrub, you've got the time to do a full, you know, real deal. Cause that's a big time hand washing or deal that you go through before a surgery. But if you're in like a busy ER, they're crashed, they're crashing. Yeah.

Get in here. It's just like that. My hands are dirty. It doesn't matter. No, it doesn't. So we needed a way to clean your hands without soap and water and we needed a way to do it fast. The idea of alcohol being sort of the vehicle for that is an older one. If you think about on this show stuff we've talked about throughout medical history that we've used to clean wounds, we've been using alcohol on wounds for a long time, without really knowing why, right? Well, it's nice because it burns when you drink it, and it's one of those rare times where it feels like

what it's like, you could intuit that. This is burning my throat. I bet it would burn the germs away. When we didn't even know about germs. I know. But. And now. But it's similar. We used to cauterize wounds. We used to literally burn wounds.

So I not dump some wine or brandy or whatever on them. And maybe that was doing something. And it may be it was, if there was enough alcohol content, it would have been doing something, even though we didn't understand that yet. In the same period of time where we were kind of understanding sanitation, we're talking about after some of us told us to wash our hands, we're in the lister and past

juror era where all of a sudden we were starting to understand germs and how to kill germs and the concept of antisepsis and why that would matter and why that would keep you from getting sick. Like of having a work surface or area or OR or hands or something that is free of germ cause disease causing bacteria or viruses or germs, right? That whole concept was was coming to light. This is a same period of time where Dr. Leonid Buchholz discovered that a form. I can't say that one more time just because it was very cute. Buchholz. Okayuccolds.

Okay. Buccolds. Buccolds. Okay, you're getting there. Discovered that a form of alcohol, specifically ethanol, was a useful antiseptic. It killed stuff. E208, right? Yeah.

Hey, very good. Oh, thank you. Now, he figured that out and everybody was like, well, that's kind of cool. We don't quite know what to do with that information yet. That's nice. We know that now. We need to know how do you apply it to things, just dump it, and then also what concentration about call, right?

I mean, we understand that beer, verse wine, verse vodka, those are all different concentrations of alcohol. Similarly, how much alcohol do we need in this liquid to do something? So you see all these studies, especially like late 1800s, early 1900s where they're kind of comparing different amounts of ethanol and like dumping them on germs and saying like did it kill the bacteria, did it kill the virus, it's like what did it do? And what they kind of found is that it seems like somewhere between 50 and 70% was the sweet spot.

There was a thought for a while that if you went much higher, it would actually have a negative effect, which wasn't necessarily true. I don't know how that, but anyway, at least they knew this is where we need to hit, especially that 70%. We need to hit that in order to kill germs effectively. Now, a lot of times in medicine, when we find that something works for one thing, we kind of try to do it for everything. It's very excited. Right. Exactly. And so, when we figured out alcohol, ethanol, could kill some microorganisms, we decided like, well, then it must kill all of them. And it's actually set it back for a while

because they found that it wasn't very good for fungus. Oh. And so there was this thought, like, well, it's not if it can't even kill fungus. Why? Not that cool. Why are we chasing this down? Like, why are we continuing to investigate it as this possible antiseptic if it doesn't even kill fungus?

Who cares? Yeah. It took a while. Research persisted, but it wasn't until 1936 that you see the next breakthrough where we switch from ethanol to isopropyl alcohol as a better way, as a more effective form of alcohol to kill germs. But at this point, again, it's still like, we're so stupid liquids on stuff, right? I mean, like, how else are you going to apply these alcohols?

And I know it's not that expensive, but there is some waste there. Right. You're dumping alcohol. It's a great alcohol that someone could use. And you're just sloshing a lot of it down the sink. Yes. And like, if you think about like, if you just dump a big bottle of ice purple alcohol on your hands, it will dry on its own.

But like, if you're in a hurry, you still got to dry it. So this wasn't gonna catch on. And especially at that point, handwashing it really, like the idea of the proper surgical scrub. So before a surgeon and everyone else involved in the OR, not just the surgeon, but everyone else who's going to assist, performs a surgery, they do a full scrub.

Do you know what the difference is between that and like hand washing? Where do you scrub in and you are clean, but you can't touch things afterwards. You have to keep your hands free of them. I was seeing them walk around their hands here. Do you remember in the NICU, they had that sink with the little sponges set up

that you had to wash your hands at when you came in and out? Yeah. It's similar, but more so. They're specialized, like if you go into an OR now, a modern OR, you're gonna have like a big sink and you've got these little scrubs, these little sponges with a sponge on one side and like a bristled brush on the other.

So you can really like, you're gonna wash all the way up to both elbows, thoroughly wash like every square inch of hands all the way up to the elbows. You have the brush with bristles that you can use, but you also get this little like pick thing to clean out from under each nail as you go. So you do all of that and rinse everything and then that's a full surgical scrub. That concept had already been introduced by now. So like we kind of have this gold standard that we're up against of like,

this is how to become clean. Yeah. Prayer. The story of how we get from, we understand alcohol can do this. We are still washing our hands, but we need something better, we're not better, but something

that would work in a pinch. The story of how we get from there to hand sanitizer is it's funny, I found this like mentioned several places on the internet and then at the same time that I found this like, where did hand sanitizer come from? Where I found this answer, I found immediately people saying, oh, we don't think this is true. So this story is probably apocryphal. I say probably because

there's always a chance we'll find something out. But the story that you may have seen, because I think it was like tweeted around at early in the pandemic, like if you're wondering who to thank for hand sanitizer, here's a tweet thread that tells you who to thank. And this probably wasn't so. But the story was that in 1966, there was a nursing student in Baker'sville, California named Lupe Hernandez, who came up with this idea that if we took alcohol, which we knew could disinfect, and we take some sort of gel and combine them, then that would be like the perfect thing to quickly cleanse your hands, in busy hospital settings.

What's the gel doing? What's the gel's role? It's the vehicle for it. It's better than a liquid you gotta dump on your hands, right? And it could also be easily dispensed to people if it was in a gel. At this point, we had gels. We had things like squirt bottles and things that, you know, you could see where that, if we could use that as a vehicle for something that cleaned your hands,

wouldn't that be convenient. The story goes that Lupi contacted like a pat, like called some sort of number inventions hotline to try to get this thing patented. Nobody really ever knows what came of that. And then I think like what we would assume is the industry stole it. The big the big cats. The big cats of the sanitization game stole this idea. Did you guys hear about this? There's some lady who didn't get a patent on something. We heard about it. I'm a friend of a friend. We actually don't know the gender of this nursing student. Okay. Man or woman is still not a question. Not a question. Not have assumed. The original story said it was a woman, but then there were other evidence

that said maybe it was man, and then there's other evidence. And that's part of the problem with the story is that, because it was reported in the Guardian in 2012, and I'm not sure, I was reading this, like there's a historian named Joyce Betty, who works for the Smithsonian, who tried to chase down like, where did the Guardian get this story? And where is, like, can we find this human? Can we go through like the records of the hospital

where they supposedly worked and find any patients registered to this nurse? Can we call, like, and they were in contact with a historian in Baker'sville who was like, I've been trying to figure this out too. I saw the same tweet thread like, where did this come from? And all of this got revitalized interest in 2020 because of the pandemic.

And so all of these people were trying to track down the origins of this. Is this true? Where is this person? Did they really get deprived of credit for their invention? You know, is this really something that happened? And we've never been able to find any proof that this person existed and that this really is where we came up with hand sanitizer.

I'd love to be, where do I sign out to be the kind of reporter that just looks at the stories other people did? And they're like, ah, ah, ah, ah, not so fast. I got you. I wanna be that one who's like right behind your shoulder, like, oh, well, interesting. Is that true? Did you make it up?

You gotta feel kind of bad for this reporter who like in 2012 wrote this story that sounds very compelling. And suddenly, they must have gotten it somewhere. I don't know where it came from originally, but certainly they got it somewhere. And they made this from a whole cloth, but certainly they got it somewhere. Let me raise this from a whole cloth,

but like sometimes in the journalism industry, you hear a story that's really good, and you're like, I've heard this from a couple sources now. Let's go with it. And I will tell you as a researcher, it is hard. I have had, and I mean, we've talked about it on the show, various times where I found a story, I found it other places, I felt like I've talked about it on the show. Various times where I found a story, I found it other places,

I felt like I corroborated it, I felt like I found enough, like initial primary research that proved like this is real, and then only to have like a listener say, actually, that's not true. And then I've had to dig deeper and find that there was like, a root, like falsehood, where all of these branches of false information came from and I didn't realize it because I found so many

corroborating false branches, it's hard. It's hard to do. So, and I mean, maybe there is some grain of truth in this, but as it stands, you'll find this story out there on the internet if you Google where did hand sanitizer come from, who invented it. And as of yet, we don't know that that's actually, I don't have any evidence that it's true. I'm not saying it sounds plausible, it sounds certainly possible. Can't prove it. But I can tell you about all the people who did come up with what we know today

as hand sanitizer. But first I got to take you to the billing department. Let's go! The medicines, the medicines, the escalate my car before the mouth. In the briefest time, I feel like we got to know each other. Bro, I appreciate you so much for that. Do you read minds or what? It's really a very sacred space you've created here. Ha ha ha ha! Bullseye! You've hit the Bullseye, baby! Bullseye! Interviews with creators you love and creators you need to know

from MaximumFun.org at NPR. Hey! Did grad school ruin your reading habits? Oh my god, all those books you had to read for grad school. To becoming a parent, destroy your ability to focus on a book. To the pandemic, tank the number of novels you can get through in a year. Ugh, that happened to everyone and we're reading glasses and we're here to help. We'll get you out of a book slump, dismantle all that weird reader guilt,

which we know you have a lot of, but most importantly, we'll help you fall back in love with reading. Reading glasses every Thursday on Maximum Fun. Sydney, you're about to introduce me to the heroes of Sanitization. So a lot of patents have been filed since the early 1900s for things that were sort of like hand sanitizer.

I don't really have evidence that they made anything. I guess you can just file a patent and then not make it, right? Yeah, if you got free time. Sure. I don't want to do this, but I do want credit for it. But he does do. There's a, in 1908, a Hans Kusel files a patent for Alka Jell's. A better name. Which sounds like what you would expect. That should be the initial hand sanitizer. Or just a way, a very convenient way of getting drunk on the go. Alka Jell. At the time of these clumsy glass bottles, they're always shattering.

Why don't reach for a packet of Alka Jell. It at the time of these clumsy glass bottles, they're always shattering. Why don't we reach for a packet of Alcajel? It's the drunk of the future. Weee! In 1936, William Moore sort of built on that and registered a patent for disinfectant that could be used on skin and was based on this Alcajel kind of idea. Like reference this old patent. Like we know that alcohols exist because there was a brand of love's alcohol.

I don't know that the alcohols did exist, but in 1941, there's another one for germicide file, which again, similar ideas without like, there is no like product history I have here. There is no substance that came from this that was sold widely or given to hospitals or whatever or however it would have been used. It's like some we have the idea but not necessarily into mass, what's where in production.

Yes, exactly. In the 1940s, the first thing we see that's similar is when a couple named Goldie and Jerry Lipman have the idea for this hand cleanser, a waterless hand cleanser. Now this is different because, and they start mixing this stuff by the way, in a washing machine in Goldie's parents' basement, in Akron, Ohio. So they start making big batches of mineral oil, petroleum jelly, and 5% alcohol.

So not enough. Yeah, not enough to get the job done. No, not enough to be disinfecting, but enough to, like, if you talk about hands that look visibly dirty, this would work very well to clean them. Like, they would look visibly cleaner. And this wasn't aimed at disinfecting as much as people who worked in, like, rubber plants, people who had hands that were covered in grease and oil that needed like a good waterless cleanser to get that off, that is really what they were aiming to do. They weren't trying to kill germs. They were trying to get all that grease and dirt off.

Because a lot of people who worked in those kinds of lines of work would use toxic like caustic substances to try to get all this stuff off their hands. And the idea was, this is safe. You can put this all over your hands, you can put it on your skin, it's not gonna harm your skin, and it will remove all that visible grease and dirt. And they called it Gojo. Gojo?

Yeah, Goldian Jerry. Oh, okay. Gojo. So they made this stuff, they called it Gojo. I believe it's still sold today. I believe it's still out there. Yeah, and the Gojo company, okay. Gojo. So they made this stuff. They called it gojo. I believe it's still sold today. I believe it's still out there. Yeah. And the gojo company definitely can to continue as you'll see. But they called it gojo and they sold it out of the trunk or their car. They would mix up these giant batches of it in the washi machine and then put it in pickle jars and then sell it in in pickle jars to anybody who worked in an industry where their hands

would get dirty like that. Yeah, good job, still thing. I was kind of surprised you hadn't heard of it. Why? Well, you work with your hands now. What? You got into that? Yeah, that's true.

I just have dirty hands. I don't I just kind of Don't care. I don't leave the house lot. So yeah, I have a special 3M paint cleaning soap that I use but Well, and you can see where this gets us on the right direction like this this is close This isn't it. This isn't gonna do what our modern hand sanitizers do because there's not enough alcohol in it But we're getting there. We have something that's waterless that cleans your hands quickly and effectively. There are some patents filed in the 50s and 60s for some, again, some concepts of hand sanitizers that would be very cool,

although I don't know that they ever actually existed. They're not substances as much as like the delivery method, because those are the two things you need, right? Like, what is going to clean your hands and what is the delivery method of this? There's one for a rapid hand sanitizer, which, and these are fun, this is like a box with holes in it, and you would just stick your hands in the holes. That I love. That's convenient. And you can see where like, stick your hands in the holes. That I love.

That's convenient. You can see where like these are filed in the 50s and 60s. So if you start thinking about like the futuristic kind of obsession. You would just have one of these outside of a cafeteria or, you know, and on your way out you just stick your hands on. And the idea for this one is an electrically operated fine spray device and a hot air blower dryer, which would clean your hands in just a few seconds. The compound would have lannolin, pure grain alcohol, perfume, and maybe some sort of disinfectant.

Obviously, they didn't know what was going to be in it, but you stick your hands in a box, they're sprayed with something and then dried very quickly and you take them out and they're clean. Perfect. Which sounds very jettison. That's great. Like you can see where this was like, this is a very jettison. That's a big great thing. You probably get there.

If we would, would it spend a little more focus on it? There was another one, the same idea for a hand sanitizer. Again, a box with an opening where you could just stick your hands in. Now this was a sanitizing fluid where you would just immerse your hands in this sanitizing fluid in a box. And you would like, there'd be a ding or something. Some sort of time that said, like, you're done and you take your hands out and they're clean.

But this still doesn't give us like what's in there? What is the substance? We need the thing that cleans your hands. These are cool boxes, which by the way, so you can just patent like a box with holes in it. I guess. Yeah. No, you don't actually have to make anything. You can just patent it. Wait for the money to start rolling in. For a box with a hole in it. Come with it. Yeah. Why not? It's box with holes in it. Anything you put in that box, you owe me five cents. One time in fifth grade, my friend and I drew an invention, which And it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know,

it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know,

it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know, it's like, you know want. Yeah. In our example, it was a pizza. It was what we presented to the class. You type in pizza, and then it would spit out a pizza. Please remember, when I was in fifth grade, computers were very new. Yeah, but I will say this, that it's basically 3D printing. It was.

It was basically a minute 3D printing. I invented 3D printing. I'd said a 3D printing. It was. It was basically a minute 3D printing. I invented 3D printing. I've set a 3D printing anything. Email my wife a quarter. Please. You owe her. How much I had patented it. Of course you should have. I mean, I was 50. A computer that could print anything. It's like, did you pat that? That's a 50, 50 split with my friend Stacey. She gets the other 50. All right. Okay. Okay. Fine. So since she's 12.5 cents and since it needs 12. a half cents, anytime

you three, you print something. I don't know. We use my fifth grade teachers class and materials. So maybe this one gets a cut too. I don't know. I love that. I love that gift. Yeah. It's a classroom and kind of an incubator. Like, that's a loft space, which means I made the kids sleep under their desk while they invent things for me. I get 5% of the bad ones and 10% of the good ones. Okay, so this still we're not at a compound yet. Now in 1965 in Hamburg, Germany, there is Peter Koma, who works in a hospital and creates something called

sterileum, which is a much bad name. It's a bad name. It's a rough name. Alcohol based, no water needed. You rub it into your hands. Here we go. Now we're in business. Now we've created hand sanitizer.

It's called sterileum. The pictures I saw of it look like it was just in like a big bottle. So like the thing that, meanwhile, that Gojo had done, the advantage of Gojo, is they had patented that like the dispense mechanism, the idea of like a single serving dispenser for their product. And that was huge, because you can

see the convenient factor. And the first thing I said is we have to make this smaller. Why did we make it huge? This is so inconvenient. And so, but like again, no major manufacturers are doing anything with this. Like nobody is, this is not widespread. A lot of these things that they are making are just being used maybe in a hospital or in a lab somewhere or something like that, but you're not, nobody is selling this stuff to the public.

Because I think at this point, you would also wonder like, does anybody want to... We've made it this far. By this. Yeah. Is there a market for, do people worry enough about cleaning their hands to want to buy something like this? Yeah, but maybe we should make them more.

Well, that's always the key, right? You got to make them afraid. So in in in 1988, Gojo actually did go ahead and make a 70% alpha, alpha alcohol based hand cleaning gel. So they did make it like that early. There was no, they didn't bring it to the market. There were probably people using it, but it was not being marketed at all.

Like that existed though as far back as 88. You don't see it enter the market until 97. So that's how, that's really how recent, which is weird if you think about it. I don't remember, I have pretty clear memories of like Starting to see hand sanitizer like it seems like An overreach at first I think like you'd start to see people like well you must be a real

Well, the content was always your like a germaphobe. Yes, like start when it came out It's like oh, you're somebody who's like, super, super worried about germs all the time. It was like the pocket protector of its day. It was, it was definitely not something that you would commonly carry with you, or that you would have seen in all the ways that you do today in like, with like, I always think of places like Disney

where they have all the fun character, little holders for bottles of hand sanitizer. You certainly wouldn't see that kind of thing back then. So in 97, Gojo launched their version of hand sanitizer, you certainly wouldn't see that kind of thing back then. So in 97, Gojo launched their version of hand sanitizer. You may know it. It's called Purell. And it was a viscous, isopropyl alcohol-based hand sanitizer. It's got antimicrobials and chemicals that will make it gentle.

It's fine for your skin because that was always part of it too. You need a cleanser that's safe for your skin. So this was released in 97 and you know what came out that same year was Germax. Wow. So like the two major players in the hand sanitizer industry, Purell and Germax come out, which I think even to this day are like number one and two come out in that same year. But they're still not being sold that much yet. Like they're a release in 97, like you said,

there were definitely people who started to use them. And you could see a shift pretty quickly because a couple of things happened. First of all, in 2002, the CDC, that's when they first released their official statement that they had enough research to say, alcohol-based hand sanitizers are a reasonable alternative to hand-washing. released their official statement that they had enough research to say alcohol based hand sanitizers are a reasonable alternative to hand washing.

That was kind of like what they, you know, in a situation where you don't have access to soap and water readily, this will work. This is fine. You can do this. It's safe. It's effective. The CDC endorses it. And this was huge because it allowed it to be promoted in certain settings where something

cost-cutting and time-saving like this would be especially useful. So like you saw the US military immediately adopt the use of hand sanitizer. Hospitals very quickly adopted the use of hand sanitizer. And I feel like I can remember seeing the like shift in hospitals from soap dispensers next to sinks to those ubiquitous hand sanitizer dispensers everywhere right those things I can't tell you how many times of their motion sensing at the hospital Mm-hmm. I can't tell you mean times have been in a patient room And I just like lean back on a wall and it's the hand sanitizer wall and I just totally goosh my back

You do you do and a lot of them are like a foam. So then you're good. You're just a foam. But and they found they did studies at the time that found things like an ICU nurse could save an hour out of their shift by using hand sanitizer instead of washing their hands in two patients. And so you can see where in a setting where you're trying, where time is money, you would immediately want to switch to this. So that was a big moment. In 2002, the CDC said, yes, we can use that. And so you started to see it in like these institutional settings.

And the other big thing that happened in 2009, well, first of all, the World Health Organization echoed the CDC in 2009 and said, yeah, we agree about hand sanitizer. There's another thing that happened in 2009. What? Well, it may be hard to remember, but there were other pandemics. Is that swine flu? H1N1. Oh, okay. Yep, swine flu. So... It's a bit of merit. It's either the swine flu or the burr flu. Those are the ones we... And you saw with H1N1, you saw sales of hand sanitizer just shoot through the roof. Because all the sudden people became aware

that they should be washing their hands more, but they can't if they're on the go. There are all kinds of settings where washing your hands aren't convenient. And so hand sanitizer jumped in to fill that void. And that is really where we see, it's only been since 2009 that it has been so common to see hand sanitizer everywhere

you go, plus people carrying it as like a normal common thing for people to do. And not as you said, as it would have been seen previously, as kind of like a germaphob type thing. Since then, Purell has gotten to trouble periodically. If you can picture some of their packaging, you probably, like they say, they're 99.9% effective at killing disease-causing germs. Yeah. They've made claims about things like Ebola before. And you've got to be careful when you make claims like that. If you haven't actually done a study to see if it kills Ebola.

Oh, yeah. I would assume that's a big issue. So they've periodically gotten in trouble with the FDA for making claims that they can't completely, I mean, it's hard because we have like decades and decades and decades of research on alcohol and germs. But that doesn't always mean that, as we've talked about on the show before, just because alcohol and a petri dish kills germs, doesn't mean that the way a person might interact

with a hand sanitizer dispenser to clean their hands with hand sanitizer would decrease the germ burden enough to prevent infection with that germ that you have to do that study to see. Because you also have like real life use. Yeah, right. One of the big things with hand sanitizer is you've got to let it dry. How many people before COVID

would just sort of rub it on their hands and move on touching things before letting it dry? How many of you will put their hands on it to dispenser and you can't really hear it or see it, but you think some came out and then you just sort of rub your hands together. And you just rub in your dirty hands together for no reason.

Yeah. But the pandemic really solidified like the presence of these things in our life. I mean, like that, I don't think it will ever go away now. I think since 2009, they were more popular. I think because of COVID, you see them everywhere. And certainly an explosion of like, do it yourself. There were a lot of early on in the pandemic, a lot of like TikToks and YouTube's about how to make your own hand sanitizer, a lot of small business-based

products. A lot of people argued that this is a market that's really right for disruption, but I don't know, I don't know, but I don't think that way. So of course, I wouldn't like, what else do you need? Like what how, you know. What do you, if you would ask, if Ford had asked Sydney what she wanted, she would have said a faster horse. Just, you know. Yeah, I mean, yeah. Well, there are a lot of problems came with cars to be fair.

You mentioned Tito's, Tito's actually had to release a statement early in the pandemic to say You cannot use our vodka as hand sanitizer because it's 40% not 70% But midnight midnight grandpa the bottom shelf whiskey was like yeah, absolutely We're fine. We're yeah, we got you covered So and while all this is great like obviously hand sanitizer has found its place as a an alternative to hand washing when soap and water are inaccessible to disinfect your hands to an extent right like we know that yeah And and I mean I carry hand sanitizer wherever I go. I use it in the hospitals most of the time

When I am seeing patients I am going to use the hand sanitizer just been through on the wall and I'm not going to go find a sink and stop and wash my hands. Because it's just good, it's washing hands. Well, it's quicker, it's more efficient, it's easier. Yes, it is what I'm going to do. It's what I'm going to do. However, washing your hands is still better because it's a mechanical action. So when you think about like, I guess if you've already given your hands a good scrub to continue on throughout your day with hand sanitizer

is somewhat the same. But if you have like dirt and debris or oils or things on your hands, especially if you've been outside, like think about like when I've been out gardening. If I only use hand sanitizer on my hands when I'm done gardening, my hands will still look dirty, right? And while that visible dirt isn't the same as looking at germs, obviously, all of those large particles are great places for germs to hide. And I can't guarantee that I've gotten that alcohol substance in and around and all over all of those little particles of dirt and debris and oil and whatnot on my hands. Which is why at the end of the day, like the mechanical action of soap and water scrubbing

your hands is ideal. Hand sanitizer is okay if you can't do that, but you know, especially if you can see visible to bring your hands. Wash them. Yeah. Cindy, thank you so much. And thank you so much. And thank you, Hansan Tizer.

We took you for granted and then we really realized that you were there when you needed you. No, it is not effective. I've said this before in the handwashing. Hansan Tizer is not effective for CDIF, Closteroidium difficile, which is an infection that causes diarrhea and you have to use soap and water if you've been in contact with it. It seems like a pretty big gap. It's like they should fix that. It's not, I mean, hand sanitizer has its place. And I think especially we're all out in the world, we're all interacting a lot,

we have this very contagious virus. Obviously, it has its place, but it's always great to wash your hands. When you done going to the bathroom wash your hands when you're gonna eat something wash your hands Wash your hands wash your hands. Thanks so much for listening to our program Thanks to taxpayers for the use of their song medicines is the intro announcer of our program and Thanks to you for for listening. We really appreciate it and we hope that you Are having a nice life and we hope that you are having a nice life. And we hope that you'll join us again next week for Salmons. Until then, my name is Justin McRoy. I'm Sydney McRoy.

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