COVID-19: Urgent actions, critical reflections and future relevance of “WaSH”: Lessons for the current and future pandemics

Guy Howard*, Jamie Bartram, Clarissa Brocklehurst, Jack Colford, Federico Costa, David Cunliffe, Robert Dreibelbis, Joseph Eisenberg, Barbara Evans, Rosina Girones, Steve Hrudey, Juliet Willetts, Caradee Y. Wright

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

59 Citations (Scopus)
133 Downloads (Pure)


The COVID-19 pandemic placed hygiene at the centre of disease prevention. Yet, access to the levels of water supply that support good hand hygiene and institutional cleaning, our understanding of hygiene behaviours, and access to soap are deficient in low, middle and high income countries. This paper reviews the role of water, sanitation and hygiene (WaSH) in disease emergence, previous outbreaks, combatting COVID-19, and in preparing for future pandemics. We consider settings where these factors are particularly important and identify key preventive contributions to disease control and gaps in the evidence base. Urgent substantial action is required to remedy deficiencies in WaSH, particularly the provision of reliable, continuous piped water on-premises for all households and settings. Hygiene promotion programmes, underpinned by behavioural science, must be adapted to high risk populations (such as the elderly and marginalised) and settings (such as health care facilities, transport hubs and workplaces). WaSH must be better integrated in preparation plans and with other sectors in prevention efforts. More finance and better use of financing instruments would extend and improve WaSH services. The lessons outlined justify no-regrets investment by government in response to and recovery from the current pandemic; to improve day-to-day lives and as preparedness for future pandemics.
Original languageEnglish
Article numberjwh2020162
Number of pages18
JournalJournal of Water and Health
Publication statusPublished - 21 Jul 2020

Structured keywords

  • Covid19
  • Water and Environmental Engineering


  • COVID-19
  • coronavirus
  • hygiene
  • pandemics
  • WASH
  • water


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