Cruising and sanitizing -- bad advice from Rick

I agree with sanitizing hands upon returning to the ship and before entering the dining room(s.)
Those ships turn into giant petrie dishes.

Dick,
I agree with you totally. The cruise ships (even the very high-end small ones) push the hand sanitizing dispensers. I trust their medical advisers to know what helps to prevent the spread of various germs/illnesses. I also trust that the cabins/suites are cleaned a little more carefully than many hotels.

If Rick's staff is reading this, I'd suggest he edit his comments.

Dick, as a retired health professional, I will disagree with your complaint and side with Rick and the nurse you quoted. The ships push the Hand sanitizers because too many people are too lazy or ignorant to wash their hands properly. Hand washing with plain soap and water negates the need for any hand sanitizer. And I'd like to point out that the stuff they supply, while an antibacterial, are not effective against norovirus. So Rick is not wrong, providing that he washes his hands, which I'm sure he does.

Hand sanitizer has its place - primarily in those situations where plain soap and water are not available. I haven't seen that this problem exists on any ship I've cruised on.

If you want to see massively long and hotly debated threads on the virtues/overuse of hand sanitizers, where the germaphobes extol the ridiculous (and ultimately useless) lengths they go to, I highly recommend just about any of the forums on Cruise Critic. It's interesting to see that the majority of germaphobes seem to be Americans. Try as you might, you can't sterilize the world. Nor should you try.

If you would like to know actual FACTS about hand sanitizing and hand washing, I suggest you have a look at what your own CDC has to say on the matter. They have the information online.

As C. Jean of Canada suggest, the American CDC advice would seem to support Rick's thoughts that a little squirt of Purell could be counterproductive. The CDC recommends proper hand washing with alcohol based hand sanitizer being an extra precaution. Studies reported by the National Institute of Health goes as far as concluding that hand sanitizers may increase norovirus risk: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3168661/

Alcohol-based hand sanitizers may not be the panacea for hand hygiene
they were once supposed, as mounting research indicates they may not
be effective substitutes for soap and water, and in some cases may
actually increase the risk for outbreaks of highly contagious viruses
in health care settings.

In addition to frequent hand washing with soap and water, don't shake hands (bow, fist or elbow bump) or high five. If you are really concerned, use a napkin to handle the buffet serving utensils and avoid touching your face.

Outside of the cruise lines installing a row or two of sinks at the entry to all dining facilities on board and only admitting those who wash their hands with soap, I still hold that the Purell dispensers definitely serve their purpose.

So you wash your hands personally, what's the big deal ? That's good, as I do. But, between leaving one's suite, there are handrails, elevator buttons, door knobs, others who shake hands with you, etc. And, there are lots of people who don't even wash their hands after using the restroom..........so do you want THOSE people handling the serving utensil for the salad bowl right before you pick them up? While it might not be perfect, I would still feel better knowing such people were encouraged to first use the Purell dispenser. Not 100% perfect, but it definitely helps.

It is not just Novovirus that is the risk; it's the common cold, intestinal bugs, and on and on. And, of course, I acknowledge that some germs are airborne, too.

If you are on a ship for 7 days, use the Purell dispenser, and do your part for whatever good that does. And, I hope Rick will, too.

After long overseas flights, often with some loss of sleep, it pays to take some extra precautions when a couple of 100 people (or 1000s of people in the case of the mega ships) may have their resistance a bit compromised. I remember years ago, when we went on our first Silversea cruise (I think it was 2007 or 2008) the ship's doctor was taking the temperature of every single passenger before they were admitted. I asked: If someone had a fever of concern, it would be evaluated, and if admitted, they would have been isolated in their cabin and monitored. Temps were not taken when we cruised again with Silversea last year.

I think most of us here agree about the overuse of antibacterial products, but unfortunately Rick, who has a large following, is vague describing what he does. Does shun mean he takes a squirt though he winces and dislikes it, or does it mean he waits until Mr. Washy-washy turns his back and then sneaks past? A squirt is standard procedure, so what exactly does he mean?

We have been on a couple of cruises where the norovirus either hit some passengers or the prior cruise passengers. The cabin stewards just went crazy with the antibacterial spray in our cabin. My wife had a reaction to this stuff, perhaps an allergic reaction and we told the stewards to back off with the spray. They did and my wife's reaction went away.

I don't mind getting my hands cleaned with this stuff prior to a meal, but the spray by the cabin stewards can go over the top.

I am generally pro-sanitizer. But I have read in the New York Times that these products have little or no effect on viruses, as opposed to bacteria. Is that correct or incorrect?

Hand sanitizers aren't 100% effective, especially when you do a less-than-thorough job of it. BUT not washing at all is 0% effective. So please do it. Since a large percentage of adults don't bother to wash hands at all after using the toilet, you're getting pretty good exposure to bad germs all the time. Most of the things that cause serious outbreaks are not things to which you build immunity.

I agree with the other posters that said you should be washing your hands thoroughly before and after dining (not to mention many other times when appropriate) and not relying on antibacterial hand sanitizers. The only time I use them is when washing with soap and water is not available - that does not include cruise ships.

And I agree with the OP's last sentence - wouldn't a RS cruise be a blast?

Thanks for that last comment, Stan, and to all for this thoughtful dialogue. Thanks to Edgar for the links he provided to the CDC and the Canadian Medical Association Journal. Those links don't support rejecting the sanitizers cruise lines offer.

The CDC says sanitizers are not preferable to hand washing. I think we all agree with that. The CMA Journal article is about use of sanitizers in health care settings like hospitals and nursing homes, where infection control is at least as challenging as on a cruise ship. It reports studies showing "an association between the preferential use of alcohol-based hand sanitizers for routine hand hygiene with an increased risk for outbreaks of norovirus" (emphasis supplied). It also notes the tradeoff between the convenience of sanitizers and the greater effectiveness of hand washing with soap. It quotes a CDC expert: "The use of alcohol-based hand sanitizers has greatly increased adherence to hand hygiene in health care settings, says Kate Ellingson, another epidemiologist with the CDC’s division of health care quality promotion. 'Hand sanitizer is promoted so widely because it’s efficient, accessible and takes relatively very little time to use. There’s potentially a large tradeoff in switching back to soap and water in the health care setting, where workers have to wash their hand many, many times per shift, or even hour, depending on what they’re doing.'"

Cruise ship passengers and crew (apart from food preparation) probably don't need to be as sanitation-conscious as health care workers. And I agree that everyone should wash their hands with soap frequently when cruising, as the cruise lines encourage, and as I'm sure Rick does. But for those who don't, and for all of us whose hands might have been exposed to, say, a stair rail or elevator button since washing, that lady with the spritzer chanting "washee washee" provides an extra layer of protection for everyone and from everyone else. I'm sorry Rick doesn't take advantage of that extra protection, not only for his sake but for that of his fellow passengers.

I have no idea what's right or best regarding the use of hand sanitizers. I assume there's no harm in using these products. However, I think the harm could come when people think these products are an acceptable substitute for thorough hand washing. If the cruise ships push these on their passengers, and as a result passengers become blase about washing their hands, that can't be good.

I don't go on cruises (at least I haven't so far), but I would think reminders of the importance of hand washing would serve a better purpose than squirting Purell on everyone's hands.

I wonder if they do it so that if there's an outbreak on board, they can say they took every precaution.

I’m of the school of thought that sanitizing everything with
antibacterial products just makes you less resistant and is
counterproductive — so, I shun the squirts."

Sounds like he hasn't visited anyone in a hospital lately? The "squirt" stations are EVERYWHERE and it's requested that you use them when entering the building, when entering a patient's room, when entering examining rooms, and exiting all of the same. I guess if they didn't think they were resonably effective, they wouldn't spend the money?

I'll admit to not using the stations at my local Target store but I probably would on a cruise - in addition to hand washing, that is - where I really didn't want to get sick.

Actually, I think the washee-washee is CDC required on cruise ships. If anyone gets a case of diarrhea caused by anything including their own gluttony, it must not only be reported to the CDC, but the passenger and roommate are both quarantined until 24 hours after the episode has passed. Roommate can order anything from room service, but said glutton gets a CDC diet of toast, broth, and other yukes. Personal testimony. Don't pig out and don't forget the Pepto. CDC is serious, which leads me to ask again about the so-called shunning.

Ugh, sounds dreadful, all of it. I'm even more convinced to skip cruising.

Sadly he's right. There's a reason healthcare workers use real soap and water. And even when they use sanitizer it's not the quick spurt you get from a cruise line employee gave you

But to claim anything that Rick Stevee says is healthcare advice indicates that there's a certain disconnect here. Why would you ever assume he's a qualified healthcare provider to give you health care advice?

This got me wondering how the US Navy (and others) avoid the norovirus problem. After all, an aircraft carrier is just as packed with people (maybe more so ) than a cruise ship. I found this article among others: http://www.cnn.com/2014/02/11/health/navy-norovirus/index.html. And then I found this: http://www.straightdope.com/columns/read/3160/is-disease-much-of-a-problem-in-the-u-s-navy. So, sounds to me like even the US Navy is not perfect and strict daily monitoring & cleanliness are a must. And I don't see how the issue on airplanes can be much different. It's just that the passengers on any given flight are not in proxmity long enough to see who got sick.

Best wishes for all travelers and don't laugh at me for washing my hands so much.

I would observe that military Basic Training produces extremely reliable good behaviors. Young veterans often wipe down a public sink area after they use it. I'm sure they wash their hands.

My husband is retired Navy. This reminds me of a joke. Army guy sees Navy guy leaving bathroom without washing hands. Army guy says, "In the Army, they teach us to wash our hands after using the latrine." Navy guy says, "In the Navy, they teach us not to p!$$ on our hands."

Washing hands before and after dining room is great.. but NOT enough.. I am sorry ,,, not everyone washes their hands .. and then they pick up the ladles to serve themselves from buffets.
You go then with your "clean" hands and pick up ladle. Now you have their crap on your hands, and then you pick up your bun to butter it..or use your hand to eat your fries or fried chicken etc.. so all your hand washing benefit is gone.

I wash my hands with soap and water before eating but I ALSO use hand santizer BEFORE I eat and AFTER I have served myself.

Pat (above) and Dick...........

........and don't we wish everyone (including Rick) does, too.

I just wear white gloves all the time. Problem solved.
:-)

As celeste commented - now I'm REALLY uninterested in going on a cruise!

Ha Ha!! I went on a two week cruise this last summer, Barcelona to Athens. I noticed most people did not wash or use sanitizing products. So, I would get my food and then set it down on the table and go wash again before I started eating. I was very aware (working in healthcare) about infection control so it didn't use stair rails, etc. But, what do you know....both me and dad ended up with pneumonia! Dear old dad was hospitalized for 4 days after arriving back home! I wasn't big on cruises anyway, now even less interested.

I always wash my hands BEFORE I pee.

Stan from Kansas City wrote:
"Since a large percentage of adults don't bother to wash hands at all after using the toilet, you're getting pretty good exposure to bad germs all the time."
Ugghh! (Faint) That is just horrible. I would guess I wash my hands 40 times a day. If I am preparing food in the kitchen, I wash at every step. If I put my hands on the handles to the refrigerator door to go in and get something, I wash before touching the bread for a sandwich or any food I am preparing. I don't even want to put germs from the fridge door handles into my food, even though I regularly wash and sanitize the handles.

Which has me thinking.....I agree with all the talk about germs on the handles of serving utensils at the buffet on the cruise. Making people use the hand sanitizer is one step the cruise lines can take. But no one has mentioned......what about the kitchen staff? In theory, they are supposed to wash hands after a bathroom break, but how can we know if they do or not? My theory is that a lot of norovirus or various germs are possibly being passed on by kitchen staff handling salad, food or plates with unclean hands. Or sneezing or coughing near food. We can't be sure what goes on back there. I would still use hand sanitizer before and after going through the buffet line. But what if food is contaminated before it is served? We can't protect against that.

Rebecca, I wasn't just making that up - I have read research reports on this behavior. I can't remember the numberss but they're significant, higher for men, and the percentage who do wash goes up when there's another person in the public restroom. But that's not specific to cruises - its true everywhere. That's why all those restaurants in the US have those signs in the restrooms saying "employees must wash hands before returning to work". When you do hear about an outbreak tied to a restaurant worker, well, thats what they're talking about.

@ Celeste, Nicole, Susan, Monte, and others -- Concern about norovirus and other nasties is certainly one reason not to cruise. There are many other reasons too. Concern about disease transmission is a reason not to travel at all, but we on this board have decided to travel for lots of good reasons, and we manage the risks in various ways, like frequent hand washing and, in addition, sanitizing when that's available. I don't use sanitizers at home because I understand that the "good" bacteria on my hands help me resist some of the bad stuff in my community. But overseas, or in an airport or cruise ship or other travel settings, especially internationally, I may be exposed to other germs and viruses that accompany people from all over the world. So I wash a lot, from when I start at SeaTac until as soon as I get home. But if you don't want to go cruising, that just leaves more room for the rest of us on those big ships! ;-)

@ Rebecca -- I've cruised on only one line (Norwegian), which seems to have a better record on these issues than others we read about (though I'm sure not perfect). They push the hand washing and sanitizing very hard. I've been in some of the galleys and amazed at the widespread use of gloves, separation of different kinds of food, signage about washing, and such measures. No system is foolproof at sea any more than on land, but I think cruise lines are very careful -- outbreaks hurt their bottom line, after all. The weakest link is the passenger who comes down with something and doesn't report it. That person can set off a shipboard epidemic, or a precautionary regime that makes eating and other pursuits much harder for everyone. ("Want salt with that? Let me shake some over your plate while wearing rubber gloves.")

Thanks for all the thoughtful comments and also the Navy anecdotes.

I will add something different to this discussion. The use of gloves. People like to think this makes everything so much more sanitary when in reality, it makes it worse, a lot worse. Staff wears the same gloves all day, they never get washed and they are the real culprit when it comes to spreading germs. Coming from a culinary background, and old school kitchen work, we never wore gloves, but we washed our hands 100's of times per day or made sure to use tongs, napkins, etc. to pick up food. Now, if we had to wash our hands that many times, you would need to change your gloves that many times per day too. Think about it for a while.

How many times have you seen that fast food worker or bakery employee make your order and then take your money too? yummy! This is an organization problem though, either you make food or you handle money.

For that reason, I am totally against the use of gloves in the food business. It gives a completely false sense of hygiene and it is spreading disease faster then it ever was when workers just washed their hands all day.

That said, I don't ever use hand sanitizer except when visiting a hospital or dr. office. I don't use those wipes either. They aren't common to use here in Germany and we seem to be a lot healthier without them.

I am a former health care professional. When we were in India, our group all kept healthy with bottled water and frequent use of hand sanitizer, since opportunities to wash with soap and water were infrequent and the water itself could be suspect. No one got sick.
It is important to recognize how hand sanitizers work. They are basically nothing but alcohol, and they dehydrate microorganisms, including both viruses and bacteria, thus killing them on your skin. This has absolutely nothing to do with antibiotic resistance, which is a serious global health problem caused in large part by overuse of antibiotics. Hand sanitizers are NOT antibiotics.
The main point the CDC makes is that if you have the opportunity, wash your hands with soap, and if you don't, use hand sanitizer. Don't use nothing or you will spread infection or become infected.