PROVO — Since the pandemic began, many people in the U.S. have operated under the assumption that for a hand sanitizer to be effective at combating the novel coronavirus, it must contain at least the CDC recommended 60% alcohol.
However, a new study published by a team of Brigham Young University researchers in the Journal of Hospital Infection puts those assumptions under question, as it shows that sanitizers using certain alcohol alternatives are just as effective as those that contain alcohol.
The team of researchers tested four commercial disinfectants, three of which are completely alcohol-free, and discovered that each was effective at stopping the virus.
"They all worked beautifully," said Benjamin Ogilvie, a graduate student at BYU and one of the lead researchers on the paper.
For their testing, the researchers first mixed the novel coronavirus in with the various cleaning agents one at a time and then, after 15-30 seconds, introduced the virus to living cells.
Each solution deactivated the virus, even after the researchers added mucus and blood proteins into the solution mix, which sometimes distract cleaning agents and cause them to be less effective.
"Our goal was to see even if your hands are a little dirty, would this still work? And it did just fine," Ogilvie said.
Perhaps the most noteworthy of the successfully tested solutions is benzalkonium chloride, an ingredient that is used in many hand sanitizers and other cleaning products.
Ogilvie, who has spent years studying disinfectants, said he was not surprised by the results.
"Enveloped viruses like SARS-CoV-2, like the flu virus, they are very wimpy; they are very easy to kill, and this agent pretty much always kills enveloped viruses pretty well," he said.
Prior to COVID-19, benzalkonium chloride was the primary ingredient in many popular hand sanitizers.
Now, people tend to shy away from products that use it.
"People were already using it before 2020," BYU professor and co-author Brad Berges said in a press release. "It just seems like during this pandemic, the nonalcohol-based hand sanitizers have been thrown by the wayside because the government was saying, 'We don't know that these work,' due to the novelty of the virus and the unique lab conditions required to run tests on it."
Ogilvie said he thinks the widespread belief about alcohol-free disinfectants being less effective at stopping COVID-19 stem from a review paper published early in 2020.
"Overall, it is a great article. It is very widely cited, in part because it was early and in part because it was really thorough," he said. "The authors of that paper said that they thought benzalkonium chloride, which is the active ingredient in alcohol-free hand sanitizer and the only one approved by the FDA, they said that that chemical was probably less effective against SARS-CoV-2. I think that really set the stage for everything."
Since the paper was published, multiple other articles have been written expressing concern over the assertion that benzalkonium chloride is not as effective as other disinfecting agents.
Ogilvie hopes that his team's research will help provide needed evidence supporting the pushback.
"It hasn't really gotten a ton of press coverage yet, in part because nobody had any scientific results to back it up until now," he said.
If nonalcohol-based hand sanitizers become more widely used, it would also help solve myriad supply chain problems, he added.
"They work at a very low concentration," he said of benzalkonium chloride sanitizers. "That makes it a lot easier to ship places. So shipping 10,000 gallons of alcohol is kind of a pain, but shipping 20 gallons of benzalkonium chloride is a lot easier."
It is important to note that both the Centers for Disease Control and Prevention and the Food and Drug Administration recommend the washing of hands with soap and water as the best way to prevent the spread of COVID-19.