President Obama has formally declared the swine flu a national state of emergency.  This means he has given his health chief the power to let emergency rooms have a place offsite to keep infected and non-infected patients separate.  This allows hospitals to speed up the treatment process and protect other patients who are not infected with the H1N1 virus.  While close to 1000 adult Americans and almost 100 children have died from this flu virus, "Many millions" of Americans have had swine flu so far, according to an estimate that CDC Director Dr. Thomas Frieden gave Friday. The government doesn't test everyone to confirm swine flu so it doesn't have an exact count. While it sounds scary, there is no reason to be frightened.  There preventative steps in what you can do to keep you family healthy. 

Wash, wash, wash your hands, then wash them again.  Simple and basic hygiene and sanitation is going to keep you from getting sick all of the time.  Nearly 2/3 women do not wash their hands after they use the bathroom (less do after a diaper change) and 1/3 of men do not either.  And if you think that is bad, ABC News 20/20 revealed on Friday, October 23, Studies have shown that hospital personnel wash or disinfect their hands fewer than half the times they should," Levitt and Dubner write. "And doctors are the worst offenders, more lax than either nurses or aides." In fact, one Australian study reported a hand washing compliance rate of only 9 percent.  Makes one think twice before you shake your doctor's hand.  Local Freakonomics experts says, the neckties that doctors wear carry the most germs.  A study from New York Hospital showed that almost half of doctors' neckties carried germs, and one out of four carried potentially harmful staph bacteria. In fact, the United Kingdom's Department of Health has banned doctors from wearing neckties, watches and jewelry.  The US is questioning whether the same rules should be implemented here. 

The history of handwashing.  This history of handwashing is quite interesting.  During the 19th century, women in childbirth were dying at alarming rates in Europe and the United States. Up to 25% of women who delivered their babies in hospitals died from childbed fever (puerperal sepsis), later found to be caused by Streptococcus pyogenes bacteria.  As early as 1843, Dr. Oliver Wendall Holmes advocating handwashing to prevent the spread of childbed fever.  While this idea was looked down upon, later in the 1840's, Dr. Ignaz Semmelweis, an assistant in the maternity ward in Vienna observed the death rates of mothers were three times higher those assisted by medical students than those assisted by midwives.  In fact, childbirthing mothers were scared of the medical students.  Dr. Semmelweis observed the medical students were coming straight from the autopsy rooms to working on the delivering mothers without washing their hands, while midwives were washing their hands in between each patient.  He postulated medical students were carrying infections from their dissections and spreading it to the mothers.  He ordered all medical students and doctors to wash their hands in chlorinated solution.  Thus dropping the death rates to less than one percent.  It was the beginning of a long road to enforce handwashing in the healthcare environment. 

Skip the antibacterial soaps, they don't work.  Anti-bacterial soaps do kill bacteria and microbes -- but so do plain soap and water (if you are washing for 20 seconds). A U.S. FDA advisory committee found that use of antibacterial soaps provides no benefits over plain soap and water.  The active ingredient triclosan has been found to be toxic and on the top 7 list of chemicals for kids to avoid, according to the Environmental Working Group. 

Something so elementary and simple is hard for the majority to do.  When you think about the process of going to the bathroom or working from patient to patient, it is down right disgusting.  Using only water does not get any germs off of your hands.  According to the CDC clean hands, this is when we all should be washing our hands:

Before preparing or eating food
After going to the bathroom
After changing diapers or cleaning up a child who has gone to the bathroom
Before and after tending to someone who is sick
After blowing your nose, coughing, or sneezing
After handling an animal or animal waste (even petting your pet) 
After handling garbage
Before and after treating a cut or wound

Makes you think the Chinese are onto something when they bow to each other as a formal greeting.  Perhaps try the elbow jab instead.

What about hand sanitizers?  Unfortunately, not all are created equal.  According to 27 studies reviewed by the University of Michigan School of Public Health, found the best way to prevent infections is to use plain, regular soap. Worse, they may also decrease the effectiveness of some antibiotics. If you are in a bind and cannot wash your hands, the next best thing is to use an alcohol-based hand sanitizer.   These waterless cleansers are nice and convenient, but are designed to kill bacteria -- not to remove dust and dirt, which is often how chemicals migrate. Washing with soap and water, on the other hand, kills bacteria and more thoroughly removes grime from hands to reducer any toxic exposures.  The problem with handsanitizers is they contain alcohol, which can be toxic when putting them on the hands of infants and young children.  Want the best of both worlds?  Check out Clean George(R) Hand Purifier  has no harsh chemicals, alcohol or synthetic antibacterials.  It is made with Tea Tree Oil a natural antiseptic, germicide, antibacterial, and fungicide. You may be seeing its uses in shampoos, skin care products, but has many other beneficial uses. Tea tree oil is being used to help topical skin conditions including eczema, acne, staph infections such as MRSA according to PubMed. Tea tree oil is toxic when swallowed and is only meant to be used externally.

We would be a less sick world if we all just did the simple steps of washing our hands and teaching our kids to do the same. 

For More Info:

The swine flu:  How to keep you family healthy

Chicago Pregnancy Examiner:  Back to school does not mean back to germs

Environmental Working Group:  Choosing Safer Soaps

See more of ABC's 20/20 Freakonomics segment on handwashing and how doctor's ties are making you more sick, click here