We unconsciously touch our faces – a scratch here or a chin rest there. Now we hear with the spread of novel coronavirus that prevention steps include stopping that finger’s swipe across an eye, nose, mouth.

And how easy is that? Doesn’t reading a story about how not to touch your face give you an uncontrollable urge to touch your face?

Spokane health professionals offer strategies they use and share with their patients. The tips might help slow the spread of COVID-19, doctors say, but each of their ideas go in tandem with regular handwashing.

“It can be totally natural to want to touch your face, so I tell patients it’s OK to touch your face, just wash your hands first with soap and water for 20 seconds,” said family physician Dr. David Ward, who is based at Kaiser Permanente’s Lincoln Heights Medical Office.

Consider the reasons, too, added Dr. John McCarthy, a family medicine doctor at the Native Project clinic. We’re trying to prevent the transfer of pathogens picked up by our hands that get into the body through mucous membranes – via eyes, nose and mouth.

“Our hands will pick up bacteria and viral particles from anything we touch,” said McCarthy, also Okanogan County’s public health officer and an assistant dean for University of Washington School of Medicine. He encourages people to be more aware of face-touching.

“It’s totally unconscious, and I catch myself doing it,” he said. “When I do, I grab the bottle of Purell and say, ‘OK, I touched a doorknob. If my nose itches, I’ll use the back of my hand.’

“I challenge everybody to pay attention to how often we touch our eyes or have a tickle on the nose. It’s the mucous membranes we want to stay away from.”

Dr. Dan Getz has daily reasons to avoid touching his face. He works as chief medical officer of acute care with Providence Sacred Heart Medical Center and Children’s Hospital.

“The mantra is handwash, handwash, handwash,” Getz said. “Beyond that, I am using my nondominate left hand to open all doors or reach for things on my desk, which may give me a little protection if I inadvertently reach to my face with my right hand.

“I have been trying to interlock the fingers of both hands prior to addressing the urge to touch my face,” he said. “This brief act of mindfulness helps give my brain a split second to interpret the act and perhaps choose a different movement to address the behavior.”

Tissues and sanitizer

Keep clean tissues nearby along with small bottles of hand sanitizer. The tissue can be used as a barrier to scratch a tickle near the nose or eyes.

“That’s totally good as long as it’s a fresh tissue that hasn’t been in your pocket and as long as you keep contaminated away from uncontaminated,” McCarthy said.

“Don’t flip the Kleenex from front to back because in using it, that can put viral particles on the tissue.”

He also suggests hand sanitizer if you can’t wash your hands but must touch your nose or eyes.

Triggers and behaviors

Jami Hoff is a Providence Sacred Heart occupational therapist with a degree in behavior analysis. She said people can think about identifying why they’re touching the face.

“Are there certain times of the day that you’re touching your face?” Hoff said. “Are you chewing on your fingers when you’re anxious talking to your boss? So it’s looking at the environment or situations that are triggering you to touch your face more.”

It’s bringing awareness and breaking the chain of behavior – to stop and think – beforehand, she said. In recognizing triggers, perhaps instead you grab that tissue or sanitizer first.

Face-touching as a behavior likely is linked to comfort and sensory input, Hoff added. “There’s not a lot you can replace touching your face with because it gives you automatic reinforcement. If you have an itch on your face, you want to scratch, and it makes you feel better.

“We’re not consciously aware of it unless we try to be.”

Ward suggested people be aware of physical triggers, as well.

“Identify a list of triggers, like a runny nose or the urge to sneeze, so then if you have a tissue nearby, you can grab it, or if you’re going to sneeze, aim your sneeze into your elbow,” he said.

“If you’re a contact-lens wearer, that might irritate. If you’re touching your eyes a lot, you might go with glasses during this time instead.”

Busy hands

People also can find ways to keep their hands busy, Hoff suggested.

“If you’re fidgeting because you’re bored, can you put your hands in your pocket?” she said. “If you find yourself trying to touch your face during something that causes anxiety, can you have a stress ball, a coin in your hand or a stone to rub?

“Maybe you can fidget with jewelry so you’re touching things other than your face or even engaging in an activity such as coloring.”

Ward also brought up that tools in the hand can help. “Use a stress ball, worry beads, fidget spinners that might keep hands busy and out of your face.”

Scents and visuals

A scented environmental cue can help you stop before fingers reach the face, Hoff said. “If you have a perfume or lotion or an essential oil, that would give you the cue to stop.”

Ward has heard of people putting a ribbon or rubber band around a finger as a visual reminder to avoid touching the face, but he agreed it’s often unconscious anyway.

“Yes, it is. This is why you can see politicians and city officials touching their faces right after they tell people not to touch their faces. You can find all those videos online.

“Some people have talked about using a smelly hand sanitizer or lotion because the smell might remind them.”

Calm and common sense

McCarthy said that in recent weeks, he has avoided touching high-contact surfaces such as step handrails.

“When I wash my hands and leave the restroom, I use the paper towel to touch the doorknob,” he said. “These are things I do.”

Lately, McCarthy has attended health meetings where he says doctors are avoiding handshakes. “I’ve stopped shaking hands the past couple of weeks,” he said.

Ward also has ditched the practice of hand-shaking recently.

“It’s long been a strong social custom when I come into an exam room to shake the patient’s hand. Do we need to rethink that permanently in another socially acceptable way to extend trust and human connection?

“Again, I wash hands before I go into any exam, but I haven’t been shaking hands all week in clinic.”

However, Ward said the overall prevention strategies against infections are practical to use all the time.

“I don’t know that we should obsessively worry or stress about this,” he said.

“I think we should wash our hands frequently, but every year we’re facing dangerous viruses. The key is to eat healthy, rest, exercise, take natural immune boosters like zinc and Vitamin C and wash hands for 20 seconds.

“These are all pieces of the formula we come back to every year multiple times.”

McCarthy also returned to good hygiene and flu-season strategies as COVID-19 threatens. That includes being mindful of potential viral particles both in the air and on surfaces, he said.

The Centers for Disease Control and Prevention says COVID-19 is thought to spread mainly through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby, or possibly be inhaled.

The agency says it is possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

“I don’t think we’re going to eradicate this – we’re just going to slow the progression” of COVID-19, McCarthy said.