COVID-19 research briefs: handwashing reduces transmission of respiratory infections

Daily POEMs

Published: 2020-04-18 © 2020 John Wiley & Sons, Inc.

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Clinical question
Can advice to wash hands frequently reduce the transmission of respiratory infections?

Bottom line
A brief online handwashing intervention reduced respiratory infections. (LOE = 1b)

Little P, Stuart B, Hobbs FD, et al. An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial. Lancet 2015;386(10004):1631-639.

Study design: Randomized controlled trial (nonblinded)

Allocation: Concealed

Setting: Population-based

Research Brief #4 (Little, 2015) A UK trial randomized 20,066 persons living in households with others to receive either access to a brief online handwashing intervention or no access. The primary outcome - the likelihood that a participant had a respiratory tract infection during a 4-month period - was decreased in the intervention group (51% vs 59%; P < .001; number needed to treat [NNT] = 12). The intervention also decreased the number of gastrointestinal infections (21% vs 25%; P < .001; NNT = 25) and the number of respiratory infections in a household member (44% vs 49%;P < .001; NNT = 20). The intervention has been updated for COVID-19 and is freely available at

Mark H. Ebell, MD, MS
University of Georgia
Athens, GA

Copyright © 2020 John Wiley & Sons, Inc.