Guide to Hygiene and Sanitation in Aviation for COVID-19

Hygiene and sanitation play a vital role in preventing infection from the environment. One risk is posed by the potential for microbial contamination of aircraft water by an animal or human excreta. This contamination may originate from source waters or may occur during transfer operations or while water is stored onboard the aircraft.

The most important information on hygiene concerning WASH and COVID-19 are:

  •  Frequent and proper hand hygiene is one of the most important prevention measures for COVID-19. 
  •  Existing WHO guidance on the safe management of drinking-water and sanitation applies to COVID-19. 
  •  Many co-benefits will be realized by safely managing water and sanitation services and applying good hygiene practices. Such efforts will prevent many other infectious diseases, which cause millions of deaths each year.

COVID-19 transmission 

There are two main routes of transmission of COVID-19; respiratory and contact.

  • Respiratory droplets are generated when an infected person coughs or sneezes. Any person who is in close contact with someone who has respiratory symptoms (e.g., sneezing, coughing, etc.) is at risk of being exposed to potentially infective respiratory droplets. 
                                                           Wash your hand after sneezing
                                                         Wash your hand after sneezing

Droplets may also land on surfaces where the virus could remain viable and thus the immediate environment of an infected individual can serve as a source of transmission (known as contact transmission)

Keeping water supplies safe 

The presence of the COVID-19 virus has not been detected in drinking-water supplies and based on current evidence the risk to water supplies is low. While laboratory studies of surrogate coronaviruses taking place in well-controlled environments indicate that the virus can remain infectious in fecally contaminated water for days to weeks. 

A number of measures can be taken to improve water safety starting with source water protection, treatment of water (at point of distribution, collection, or consumption), and safe storage of treated water in regularly cleaned and covered containers at home. Furthermore, conventional, centralized water treatment methods that utilize filtration and disinfection should inactivate the COVID-19 virus. 

 In places where centralized treatment and safe piped water supplies are not available, a number of household water treatment technologies are effective in removing or destroying viruses, including boiling, high performing ultra- and nano-membrane filters, solar irradiation, and in non-turbid waters, UV irradiation and appropriately dosed free chlorine.

In places where centralized treatment and safe piped water supplies are not available, a number of household water treatment technologies are effective in removing or destroying

Safely managing wastewater and/or fecal waste

Hand hygiene
                                          Hand hygiene to protect yourself properly

 There is no evidence to date that the COVID-19 virus has been transmitted via sewerage systems, with or without wastewater treatment. Furthermore, there is no evidence that sewage and wastewater treatment workers contracted SARS, another type of coronavirus that caused a large outbreak of acute respiratory illness in 2003. As part of an integrated public health policy, wastewater carried in sewerage systems should ideally be treated in well-designed and well-managed centralized wastewater treatment works. 

Hand hygiene practices Hand hygiene is extremely important. Cleansing of hands with soap and water or alcohol-based hand rub (ABHR) should be performed according to the 5 moments for hand hygiene. The preferred method is hand hygiene with ABHR for 20-30 seconds, using the appropriate technique, if hands are not visibly soiled. When hands are visibly soiled they should be washed with soap and water for 40-60 seconds, using the appropriate technique.

 Toilets and handling feces

 It is critical to conduct hand hygiene when there is suspected or direct contact with feces (if hands are soiled soap and water are preferred to alcohol-based hand rub). If the patient is unable to use a latrine, excreta should be collected in either a diaper or a clean bedpan and immediately and carefully disposed of into a separate toilet or latrine used only by COVID-19 confirmed or suspected cases. In all health care settings, including those with suspected or confirmed COVID-19 cases, feces must be treated as a biohazard and handled at a minimum.

 Cleaning practices 

Existing recommended cleaning and disinfection procedures in health care facilities should be followed consistently and correctly. Laundry and surfaces in all environments in which COVID-19 cases receive care (treatment units, community care centers) should be regularly (at least once a day and when a patient is discharged) cleaned. There are many disinfectants, that are active against enveloped viruses, such as the COVID-19 virus, including commonly used hospital disinfectants. 

 Safe management of health-care waste

Best practices for safely managing health care waste should be followed including assigning responsibility and sufficient human and material resources to dispose of such waste safely. 

There is no evidence that direct, unprotected human contact during the handling of healthcare waste has resulted in the transmission of COVID-19. All health-care waste produced during the care of COVID-19 patients should be collected safely in designated containers and bags, treated, and then safely disposed of and/or treated, preferably on-site.

Considerations for WASH practices in homes and community

Hand hygiene

 Hand hygiene in non-healthcare settings is one of the most important measures to prevent COVID-19. In homes, schools, and crowded public spaces such as markets, places of worship, train/bus stations, etc regular hand washing should occur before preparing food, before and after eating, after using the toilet and changing a child’s nappy, and after touching and handling animals. 

Treatment and handling requirements of excreta 

Best WASH practices, particularly handwashing with soap and clean water, should be strictly applied and maintained as these forms an important additional barrier to COVID-19 transmission, and to the transmission of infectious diseases in general (WHO, 2002). Consideration should be given on how to safely manage human excreta through the entire sanitation chain starting with access to regularly clean, accessible, and functioning toilets or latrines to the safe containment, conveyance, treatment, and eventual disposal of sewage. 

Note on document development and background 

The content in this Technical Brief is based on the information currently available for the COVID-19 virus and the persistence of other viruses in the coronavirus family. It reflects input and advice from microbiologists and virologists, infection control experts, and those with practical knowledge about WASH and IPC in emergencies and disease outbreaks.

Generally, the aircraft drinking-water supply and transfer chain consist of four major components: 

  1. the source of water coming into the airport; 
  2. the airport water system, which includes the on-site distribution system. It may also include treatment facilities if the airport produces its own potable water; 
  3. the transfer point (sometimes referred to as the watering point), including the water transfer and delivery system. It is typically a temporary interconnection between the hard plumbed distribution system of the airport (e.g. at a hydrant) and the aircraft water system, by means of potable water vehicles and carts, refillable containers or hoses. This water transfer process provides multiple opportunities for the introduction of contaminants into the drinking-water;
  4. the aircraft water system, which includes the water service panel, the filler neck of the aircraft finished water storage tank, and all finished water storage tanks, including refillable containers/urns, piping, treatment equipment, and plumbing fixtures within the aircraft that supply water to passengers or crew.  

Water requirements 

The water storage capacity required for all purposes onboard aircraft is based on the number of occupants (passengers and crew) and the duration of the flight, while being limited by weight, aircraft design, and other practical considerations.  

Source: Brief of WHO

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