How Safe is it to Use a Public Toilet Post-Lockdown?

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23 July 2020 | Updated 28 July 2020

The UK government’s message is clear, they want the public to start safely resuming normal social activities. But some will be understandably nervous about using shared public facilities, such as toilets. 

As restaurants, leisure facilities and shopping centres reopen, so will public amenities such as washrooms. In early July, the Managing Director of the British Toilet Associaton (BTA), Raymond Martin commented that publicly accessible toilets had always played a vital role in our nation’s health and well-being, social inclusion and equality.

But never has their maintenance and cleanliness of these services been so prevalent in the public’s mindset. Hygiene anxiety will be a barrier for some individuals when it comes to visiting public spaces, but are these worries justified in terms of COVID-19 risk?

What’s the Advice for Reopening Public Toilets in England?

In late June, Local Government Minister Simon Clarke and Environment Minister Rebecca Pow wrote to councils setting out the government’s position on public access to municipal public toilets.

Their guidance for councils reopening public toilets is as follows:

• Use signs and posters to build awareness of good handwashing techniques, the need to increase handwashing frequency and to avoid touching your face, and to cough or sneeze into a tissue which is binned safely, or into your arm if a tissue is not available
• Consider the use of social distancing marking in areas where queues normally form, and the adoption of a limited entry approach, with one in, one out (whilst avoiding the creation of additional bottlenecks)
• Consider making hand sanitiser available on entry to toilets where safe and practical, and ensure suitable handwashing facilities including running water and liquid soap and suitable options for drying (either paper towels or hand driers) are available
• Set clear use and cleaning guidance for toilets, with increased frequency of cleaning in line with usage. Use normal cleaning products, paying attention to frequently hand touched surfaces, and consider the use of disposable cloths or paper roll to clean all hard surfaces
• Keep the facilities well ventilated, for example by fixing doors open where appropriate
• Putt up a visible cleaning schedule
• Provide more waste facilities and more frequent rubbish collections

Can Toilets Promote COVID-19 Transmission?

A recent study from the journal Physics of Fluids posed the question: “Can a toilet promote virus transmission?” The paper outlines the potential dangers of inhaling droplets arising from a flushing toilet. 

It concluded that 0-60 per cent of the total number of particles can rise above the toilet seat to cause large-area spread, with the height of these particles reaching 106.5 cm from the ground. Even in the post-flushing period (35 s–70 s after the last flushing), the upward velocity of the diffused particles can reach between 0.27-0.37 cm per second.

The authors of the study advocate several procedures to adopt when using a toilet, including putting the lid down before flushing, cleaning the toilet seat before using it and wash hands carefully after flushing, since particles may be present on the flush button and door handle.

No Current Evidence to suggest Faecal−Oral Transmission of COVID-19

Faecal–oral transmission is a common transmission route for many viruses, but whether this is true for COVID-19 still remains to be explored. 

According to the World Health Organisation (WHO) there is some evidence that COVID-19 infection may lead to intestinal infection and be present in faeces. However, to date (report updated as of 9 July 2020) only one study has cultured the COVID-19 virus from a single stool specimen. There have been no reports of faecal−oral transmission of the COVID-19 virus to date.

Using Public Toilets Safely

William Schaffner MD, Professor of Medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine, had his guidance for using public toilets safely published in WebMD. His suggestions prioritise proper handwashing, mask-wearing and social distancing:

• Wear a mask
• Scope out the bathroom ahead of time to see how congested it is and wait to use it until it is quieter if necessary
• Try to keep your distance from people. For those using urinals, keep your distance from the nearest person
• Aim to use larger restrooms to avoid close contact with people and toilet sprays
• Don’t use seat covers, it is better to keep contact with objects to a minimum
• If you wish, carry wipes into the toilet with you and wipe off the toilet seat before sitting down
• Toilets with lids should be closed before flushing to avoid the plume. If they don’t have lids, back away and exit the stall as quickly as possible
• When approaching the sink for hand-washing, pay attention to the number of people already using the space. If you can, wait until the area is clear
• If you are going on a trip, try to avoid using a public toilet altogether and go before you leave the house

Picture: A photograph of a toilet sign

Article written by Ella Tansley | Published 23 July 2020

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