Editor's note: this article originally appeared on Greater Greater Washington and is republished here with permission.
In pre-coronavirus days, about a third of all public restroom users only used the facility to wash their hands. Many others did not wash their hands at all. That wasn’t good enough then and it really isn’t good enough now. During this pandemic, we all need to be washing our hands, often!”
The problem we have now is a lack of public facilities to wash them, even though workers at establishments deemed essential—like hospitals, grocery stores, food delivery places—still have to work. Not to mention people who are out, while still practicing social distancing practices.
Access to public restrooms has diminished
In December I wrote an article on about the need for more restrooms and more accessibility for the diverse people within the region. I never imagined how relevant this topic would become during this pandemic.
WMATA closed the facilities in many Metro stations years ago. Elsewhere, there is a constant lack of public restrooms. Many businesses, during normal times, shut their restrooms off to non-customers. The opportunities we do have are often poorly maintained, under-staffed, and under-cleaned bathrooms long ignored by public agencies. Even interested parties often struggle to gain budgetary and staffing allowances to maintain public restrooms. So our hands often go dangerously unwashed.
People experiencing homelessness, immunocompromised people, trans and non-binary folks, people with disabilities, and older adults are especially impacted. And the public bathrooms that do exist are often inaccessible physically or due to socially-instituted barriers. Trans and non-binary people often cannot use gendered restrooms, or cannot use them safely. Public restrooms are often an infection risk for immunocompromised people, even during normal times. Most bathrooms are inaccessible for people with disabilities and many older adults.
Businesses and institutions often demand payment before restroom use as a mechanism to exclude people experiencing homelessness. Not only does this mean that many people lack adequate opportunities to use the toilet, which leads to health issues, but also that members of these communities have fewer opportunities for hand hygiene.
Furthermore, some of these communities may be at greater risk from the coronavirus, due to the virus’ biology, common comorbidities, and limitations in accessing healthcare.
We already know that the majority of deaths from the virus are among older people and immunosuppressed people. Barriers to accessing healthcare are especially large for people with disabilities, trans and non-binary people, and especially people who are homeless.
Members of the last group often suffer from other health conditions that are potentially deadly when combined with coronavirus. Besides, barriers to healthcare are likely to surface in barriers to testing, or the ability to get a test at all, much less treatment. If people in these groups are unable to wash their hands, they are at greater risk to contract a virus that poses more of a threat to their well-being than for other people. This situation could be different.
What other countries are doing
In other countries, transit stations and interchanges offer frequent opportunities for handwashing. In Seoul and Dubai, most transit stations have restrooms with stocked and supplied sinks—as does much of the system in Istanbul. Pretty much every transit interchange in Japan and Australia has restrooms of some sort—including large bus stations. Many places also encourage hand washing and sanitizing throughout one’s day.
On Twitter, Michael Twitty recently observed a wide availability of hand sanitizer and opportunities to wash one’s hands in Senegal, with the encouragement and assistance of local leadership. In its most recent edition, The Economist noted that bus stops across the Indian state of Kerala were also providing hand washing basins.
In my own experiences in Jewish communities in the United States and Israel, the stand-alone sinks that are used for ritual hand washing are frequently used for hygienic hand washing too, even by people who are not observant of halakha.
What could we do here?
Reopening restrooms in Metro stations is a start. At the very least, these facilities—when maintained—offer a place for passengers to wash their hands, a habit that I hope continues after this pandemic. Also, making hand sanitizer regularly available throughout the WMATA system would be beneficial.
Adding restroom capacity at major interchanges would be helpful too. The restrooms installed in the 1970s probably do not meet the needs of a system that is currently far more heavily trafficked.
A program to install public restrooms and hand-washing stations across the region would be of great long-term benefit, especially for people who cannot afford to pay for services to which business restrooms are often tied.
Funding, staffing, and protocols would all need to be considered.
I am distinctly aware that installing these facilities costs a lot of money; the cost for adding a restroom facility is often about $250 to $300 per square foot. For a typical 56 square foot accessible bathroom, that comes out to between $14,000 and $16,800 - and that’s before labor costs, the cost of maintenance, and the cost of supplying toilet paper, water, and soap. The Portland Loo, a commonly-touted but ultimately problematic solution to restroom access, runs at about $90,000 per unit.
Installation costs are not the only expenditure: additional staff would be needed to make sure restrooms stay safe, in working order, and maintained. By and large, the reason public restrooms in many countries are usable is that resources are allocated to keep them that way. Workers would need to be properly paid, and provided the materials to keep bathrooms clean, and the time to do so regularly.
It is likely that additional protocols will need to come into place to keep restrooms clean and safe. One example might be automatic faucets or soap dispensers, which are already called for by the United States Access Board.
Yes, this will cost a lot of money and time, and maybe the political will won’t be there. But that is where our activism comes in. Funding choices are political and not choosing to allocate resources to essential things like hand hygiene is a conscious choice that can have drastic consequences. Besides, after the pandemic, we will all need to rejig our priorities to ensure health and safety in our public spaces.
As we move forward, let’s make sure that includes restrooms and the ability to wash our hands, as needed. Also, take other hand hygiene precautions: cough into your elbow, avoid shaking hands, and use your sleeves or elbow to touch surfaces when possible. After all, you don’t know when you’ll next be able to wash your hands.
