In Lexington, Kentucky, this week, two public-health experts took to the pages of the local newspaper to address readers who have been worrying about the spread of the coronavirus, which has infected patients in China and beyond, killing roughly 1,300 people. “While coronavirus is serious and its headlines are scary, the current threat level for this illness in Kentucky is low,” wrote R. Brent Wright, president of the Kentucky Medical Association, and Ben Chandler, CEO of the Foundation for a Healthy Kentucky. “Influenza is a much greater, deadlier virus that is already widespread.”
Their advice, boiled down: Get a flu shot and wash your hands a lot. But human psychology is working against their efforts to persuade. Were humans more rational, the Discovery Channel would dedicate weeks of programming to heart disease and road safety. Instead, there’s Shark Week. More unlikely killers often loom largest in our fears.
Occasionally, however, despite our imperfect brains, opportunities arise to prevent many deaths by taking what we know logically and building it into the design of modern life.That brings me to my proposal: a change to airport security that could easily save hundreds of thousands of lives while proving no more onerous to passengers than the status quo.
A study in the journal Risk Analysis inspired the idea. As David L. Chandler of MIT News puts it, its authors estimate “that improving the rates of handwashing by travelers passing through just 10 of the world’s leading airports could significantly reduce the spread of many infectious diseases. And the greater the improvement in people’s handwashing habits at airports, the more dramatic the effect on slowing the disease.”
They estimate that roughly 20 percent of travelers have clean hands. And if that rate could be tripled, they found, the spread of disease could be slowed by nearly 70 percent.
“Deploying such measures at so many airports and reaching such a high level of compliance may be impractical,” Chandler writes, “but the new study suggests that a significant reduction in disease spread could still be achieved by just picking the 10 most significant airports based on the initial location of a viral outbreak. Focusing handwashing messaging in those 10 airports could potentially slow the disease spread by as much as 37 percent.” What’s more, “even small improvements in hygiene could make a noticeable dent. Increasing the prevalence of clean hands in all airports worldwide by just 10 percent, which the researchers think could potentially be accomplished through education, posters, public announcements, and perhaps improved access to handwashing facilities, could slow the global rate of the spread of a disease by about 24 percent.”
Normally, I’m averse to central planning and coercive nudges. But assuming that washing hands would be even half as effective as the authors estimate, this is an exception. Airports already put travelers through all manner of intrusive and cumbersome security theater in the name of guarding against vanishingly rare terrorist attacks. I’ve waited in line for hundreds of hours, forgone the ability to carry liquids, and subjected myself to uniformed government employees prodding my genitals in search of weapons.
Meanwhile, pandemics are orders of magnitude more dangerous than terrorists on planes. And commercial air travel is obviously one of the ways that they spread around the world.
So here’s the pitch: For a long while, I removed my shoes every time I went through security, an inconvenience I am spared now that I’m enrolled in TSA PreCheck, as if a terrorist with enough resources to build a shoe bomb couldn’t infiltrate that massive program.
In U.S. airports, let’s put hand-washing stations at security and let travelers leave their shoes on if they wash their hands for the 15 to 20 seconds that doctors recommend. In bathrooms, make people pay a dollar to use the facilities if they don’t wash their hands. Put sinks at the gate, too, where people who won’t wash their hands must board last. We go to far more trouble at airports for measures that are more intrusive and burdensome and that save far fewer lives. As for the infrastructure costs, communicable diseases aren’t going away, and this onetime expense would pay dividends indefinitely.
Airports with abundant hand-washing stations—and sticks and carrots to encourage their use—would make far more sense as a focus of secure air travel than the system we have today.
So let’s trade some security theater for actual clean hands.