The Atlantic

2022-07-09 08:58:38 By : Ms. Selina WiViTouch

America can’t quit hygiene theater.

Two weeks into the pandemic, a box of Cheerios sent me into an existential tailspin. I’d just returned from an unnerving trip to a New York City supermarket, where bandanna-masked customers with carts full of toilet paper dodged one another like bandits. As I unpacked my groceries, I was gripped by fear. If I don’t Lysol the living daylights out of this cardboard, I wondered, will I die?

I kept up the cleaning for weeks. My garbage bin, like so many in America, turned into a disposable-wipe repository. It took until May 2020 for the CDC to confirm that the coronavirus is rarely transmitted by touching things. My Cheerios boxes became markedly less soggy, but even then, other, more public surfaces—elevator buttons, subway poles, shopping-cart handles—remained in a continuous wash cycle. I knew this because signs everywhere told me they had recently been cleaned.

Today, it’s well understood that because the coronavirus spreads through the air, good ventilation and air filtration are far more effective at disrupting transmission than wiping down surfaces. Best practices for avoiding infection during a surge include opening a window when gathering indoors, opting for outdoor dining, and masking. In March, the Biden administration made air quality a pillar of its COVID response (finally). Meanwhile, study after study has found that the risk posed by lingering virus on surfaces is low compared with the threat it poses in the air.

Which raises the question: Why in the world is so much cleaning still happening?

Although most people are no longer disinfecting their groceries, signs flaunting cleanliness are still all over the place. Public bathrooms tout regular spray-downs with disinfectant. Elevators advertise self-cleaning buttons. At my local Marshalls, the cashier sanitizes the credit-card reader after every use—even if I use Apple Pay! A recent issue of United Airlines’ in-flight magazine was “treated with an antimicrobial process,” according to its cover. Signs lining the queue for a Delta flight in June read, cryptically: Certified by Lysol Pro Solutions .

It’s not just the cleaning, either. Months after mask mandates have lifted and vaccine requirements have eased—meaningful interventions that do protect people—you’ll still come across QR-code menus, floor stickers placed six feet apart (has anyone ever used these correctly?), temperature screening, and hand-sanitizing stations. In 2020, The Atlantic’s Derek Thompson dubbed such measures “hygiene theater”: precautions that are far more performative than useful at stopping the spread of the coronavirus. Somehow, in 2022, the show goes on.

Some places hardly bothered with pandemic protections, theatrical or otherwise, in the first place. Among those that did, some of the pushy signs and other small measures you might still find are likely vestiges of a more cautious time—the flimsy plexiglass shield that no employee has bothered to remove, the long-empty dispenser of hand sanitizer. Perhaps in some cases, like the constant wipe-downs at Marshalls, performative cleanliness has simply become part of the employee script, like asking customers to sign up for a credit card.

But hygiene theater also continues to rear its useless head in much more deliberate ways, lingering in offices, airports, and shops, often proudly touted as a service to patrons. Joseph Allen, an associate professor at the Harvard T. H. Chan School of Public Health, told me that he recently stayed at a hotel where the remote control was sheathed in a disposable wrapper that said it had been sanitized. Just another day in pandemic-era travel.

One simple explanation for hygiene theater’s enduring appeal is that some Americans who remain pandemic-cautious (and the businesses that cater to them) still don’t understand that this virus primarily spreads through face-to-face airborne transmission. Though the messaging on this point is now abundantly clear, confusion is understandable. At the beginning of the pandemic, studies did detect potentially infectious remnants of the coronavirus on surfaces in cruise ships and hospitals, and the health messaging at the time reflected those findings. The idea stuck. “I don’t blame the public at all,” Allen told me. “The science has changed every day for two years.”

A related reason might be that some people who do understand how the virus spreads see no harm in erring overwhelmingly on the side of caution. Though it’s irrational, they feel more secure knowing—or better yet, seeing—that their surroundings have recently been cleaned or that attempted safety protocols are in place. As customers have come to expect a higher level of visible hygiene, some businesses might feel as though they have no choice but to supply the theatrics. They’re left with an inflated standard that they don’t dare to burst.

If we’re talking about actual safety, it would make more sense to ask both customers and employees to simply wear good masks when infection rates are high. But America has never been especially prudent about effective COVID interventions, and hygiene theater has the perk of shifting the perceived burden of safety onto other people, implying that protection against COVID is a service to be provided rather than a personal act of self-preservation and community good. This seems to add to the pressure on businesses that want to remain pandemic safe, even if they already have good COVID hygiene protocols in place.

At Voance Salon in New York City, standard protocol is for masked and vaccinated staff to sanitize stations and tools between clients, who are required to wear masks when a CDC recommendation or mask mandate is in effect. But the salon also provides additional measures upon request, such as heavy cloth dividers between stations to wall off other guests, Voance’s owner, Rasheda Akter, told me. Precautions like these give customers “confidence to get their hair done,” she said.

Meanwhile, in Santa Barbara, California, “sanitation captains” roam the dining area of a restaurant called the Lark, cleaning surfaces. The restaurant also employs the R-Zero, an ultraviolet-light-powered disinfection system that looks like a human-size lamp on wheels. There is good evidence that UVC light inactivates the coronavirus, but perhaps the device’s bigger draw is that it’s noticeable. It’s “one of the ways we tried to bring comfort and visible safety,” Skyler Gamble, the director of people and culture at Acme Hospitality, the restaurant group that owns the Lark, told me. Gamble added that the company’s strict hygiene protocols are as much for guests as they are for staff, many of whom are worried about being unable to work. “We’re asking our employees what would help them feel safe and comfortable coming to work,” he said. “For us, it’s for peace of mind.”

Peace of mind can go only so far, however. The Lark is fortunate: It operates in perpetually sunny and warm Southern California, where open windows and outdoor seating can significantly bolster the safety of restaurant dining. But in general, with or without sanitation captains, dining indoors is always going to be a higher-risk pandemic activity. The same is true for traveling on cruise ships, where some of the largest early COVID-19 outbreaks occurred, and where hygiene measures—useful and otherwise—are now especially prevalent. Most major cruise lines require the majority of guests to be vaccinated, but masking policies and COVID-19 protocols vary widely. In a number of cases, cruise ships’ measures have been insufficient. In May, for example, an outbreak on a fully vaccinated Carnival Cruise forced many passengers into quarantine and prompted a highly publicized CDC investigation.

No wonder so many ships feel the need for hygiene overkill. Variety Cruises, an international line based in Greece, maintains a vaccine requirement and asks employees to wear masks at all times and guests to do the same when indoors. It also screens guests for body temperature and blood oxygen content, disinfects all luggage before boarding, and steam-sterilizes the ship’s upholstery, cushions, and curtains daily, according to Constantine Venetopoulos, Variety’s PR and communications manager. Research shows that temperature checks are useless for diagnosing COVID, and some people with COVID do not have altered blood oxygen levels. Furthermore, although pulse oximeters may be more helpful than thermometers for detecting illness in the elderly, they have been found to be unreliable when used on Black, Hispanic, and Asian COVID patients.

A related and more nefarious reason hygiene theater persists is that good ventilation and filtration, great measures at cutting back infection, are invisible. For companies aiming to demonstrate their concern about COVID, these practices can have less payoff because they’re harder to flaunt (or at least, they’ll seem to have less payoff until the staff has a COVID outbreak and business stalls out). Instead of a wrapped and sanitized remote control in his hotel, Allen told me, “what I would have loved to have seen was a note on my bed that said they’ve upgraded the filters and increased the ventilation rate. The other stuff is just silly.” Maybe so, but plastic-wrapping a remote is a lot easier and cheaper than installing a suite of HEPA filters and convincing people that they’re there.

And thus, the theater continues. Jim Dudlicek, the director of communications and external affairs for the National Grocers Association, told me that his organization expects grocery stores’ “enhanced sanitation procedures to be permanent, as consumers will continue to look for that assurance when they choose where to shop.”

At its best, hygiene theater is benign—albeit time-consuming, wasteful, and expensive. It’s never a bad idea to keep places clean or to insist on hand-washing; clean hands and surfaces are a cornerstone of public health. (Hotel-room TV remotes might not give you COVID, but they are pretty gross.) Hygiene theater becomes a serious problem, however, when it falsely reassures people that an environment is safe, giving them permission to relax their expectations and behavior. A hotel that sanitizes its common areas with hospital-grade disinfectant isn’t safe if guests are unmasked at the bar during a surge. Neither is a restaurant that uses QR-code menus but doesn’t filter its air or open its windows. The real dangers posed by hygiene theater are that it perpetuates unscientific thinking about coronavirus transmission and takes time, attention, energy, and resources away from the measures that are effective against COVID.

While visibility is keeping hygiene theater alive, perhaps it will also be its downfall. Those who understand how ridiculous hygiene theater is may get into the habit of using it as a barometer for outdated standards. There are already signs that more people and businesses are updating their beliefs: Trade associations representing the banking, hospital, restaurant, and airline industries told me that they’ve shifted their recommendations for members toward improving air quality, signaling a change in consumer expectations. Maybe, eventually, plastic barriers and floor stickers will go the way of disinfected cereal boxes—humorously obsolete trash.