By Dr. George Jacob

Kochi, May 1, 2020: Gloves form one among an array of armamentarium used to protect oneself from the Corona Virus. Gloves find itself alongside the mask, alcohol-based hand sanitizer, the good old soap and running water, the more elaborate Personal Protection Equipment (PPE) used by health workers, and many kinds of faceguards, a lot of them improvised.

Use of gloves has curiously escaped directives from organizations like the WHO, ICMR, and governments, both central and state, unlike the mask. The Kerala government has made use of mask compulsory, like some European nations. Flouting the directive has been made punishable with stiff fines. The WHO was not enthusiastic about the use of mask in the early days of COVID-19. This was probably because considerable confusion reigned regarding the safety provided by different kinds of masks available.

Later, the WHO advised use of the mask for:
• People with symptoms of COVID-19, irrespective of results of viral testing,
• Healthcare workers attending on patients who have tested positive for the virus, and,
• People who are in close contact with those who have tested positive for the virus, and those with travel history to regions declared viral ‘hot-spots’.
arguments against the use of masks were:
• Tendency of the mask wearer to touch the face, as the mask is being adjusted to keep it in place,
• the false sense of security the mask would confer on the user. It was argued that the mask wearer tended to disregard other important measures to be observed to prevent viral transmission viz; frequent washing of hands or the use of hand sanitizers and physical distancing. Later, aye-Sayers for the mask argued that the mask physically prevents people from publicly spitting and blowing the nose, and also prevents viral transmission while coughing, thus inculcating healthy respiratory etiquette among the public, something which a country like India badly needed. The big concern of community spread of the virus also won over supporters for the mask. The possibility of suspended particles in badly polluted air transmitting the virus also favored use of the mask

However, gloves remain the lesser talked about among the various physical barriers employed against the Corona Virus.

Gloves, in the current pandemic must be worn ideally by

• healthcare providers tending to patients who’ve tested positive for the virus, or those with travel history to viral hotspots, and those with history of contact with those who have tested positive for the virus, and those involved in surgical procedures and sampling
• sanitation workers to prevent possible fomite transmission of the virus. However, two groups of people are seen to use the gloves extensively for protecting themselves from contracting the virus while interacting with people. These are the policemen doing lockdown duty on the roads and shopkeepers. These two groups of people come in physical contact with a large group of people during interaction and transactions. This happens when the former examine declaration forms and ID cards, and the latter while transacting business.

The gloves undoubtedly do protect the wearer from contracting the virus. But, those using the gloves tend to use the same pair of gloves for the good part of the day, or sometimes for the entire day, across numerous transactions and interactions. In doing so, they transmit the virus across a vast number of people while they remain protected themselves.

The ideal would be to change gloves between interactions. This is impractical due to shortage of gloves and the inconvenience involved in changing the pair of gloves frequently.

This being the reality concerning use of gloves, people are to be advised against using gloves without bothering to change them between interactions. They pose immense threat to the society in the current situation as they contribute to viral transmission in a big way.

Instead of using gloves, people should be advised to either wash their hands with soap and water between interactions. (This might be practically not feasible as soap and water might not be available for use at close quarters), or to use hand sanitizers between interactions. They could be encouraged to carry a small bottle of the sanitizer for personal use, that can be used between interactions. Random use of gloves by people, must therefore be banned.

(Doctor George Jacob is a consultant Surgical Gastroenterologist at Lakeshore Hospital in Kochi, Kerala.)