dr. roach

DEAR DR. ROACH: Everyone knows that they are supposed to wash their hands after using the toilet, but does that advice only apply when using a public toilet? Since whatever came out of the person is technically theirs, do they need to wash their hands at home if they live alone? And can you also address whether it makes sense to wash your hands before using the toilet and then afterward, too? Thank you! I’ve never seen these points addressed. — J.A.H.

ANSWER: Yes, you absolutely should wash your hands after using the bathroom each time. Studies clearly show that you get bacteria on your hands while using the bathroom. Washing hands every time reduces the risk of diarrheal illnesses, colds and foodborne illnesses. It’s poor hand hygiene that leads to most outbreaks of gastrointestinal illnesses.

Put more directly, you risk infecting others or reinfecting yourself if you don’t wash carefully after using the bathroom.

You should wash your hands before using the bathroom if your hands have been someplace where you might contaminate yourself later. This includes preparing food, such as raw meat, or if you have touched somebody who might be sick. Frequent handwashing dramatically reduces the likelihood of getting infections, especially respiratory and gastroenterological infections.

DEAR DR. ROACH: I was catching up on my reading when I came across a column in which you described the early use of hydroxychloroquine as the standard of care for rheumatoid arthritis. Wasn’t that the drug the medical community was up in arms about, since it’s supposedly dangerous when it comes to COVID?

Meanwhile, have there been any conclusions from the clinical trials using the hydroxychloroquine cocktail and/or ivermectin during the early days of COVID — or the many doctors who saw success using them, claiming reductions of hospitalizations and deaths by 70% or more? — W.S.

ANSWER: Yes, I think there is a clear scientific consensus that neither hydroxychloroquine nor ivermectin have any benefit in treating or preventing COVID. The initial anecdotal reports that seemed to show benefit have been showed to be flawed or fraudulent. High-quality studies haven’t shown a benefit in reducing either hospitalizations or deaths. (No responsible scientist ever suggested a reduction of 70%, however.)

Hydroxychloroquine does provide benefit with several conditions. It is indicated for use in malaria and in treatment for lupus, and is used off-label for other rheumatological conditions. Even when used correctly, it has the potential for serious complications to the eyes, heart, skin, bone marrow and other organs.

In a serious disease like rheumatoid arthritis, the benefits outweigh the risks for many patients. However, when there are no proven benefits, despite a large number of studies, even a small risk is not worth it, and the risk from hydroxychloroquine is not small.

Similarly, ivermectin is an effective drug for certain parasites and, when used correctly, is very safe. The problem is that early on during the COVID pandemic, the drug was not always used correctly, with people taking veterinary products at incorrect dosages and sometimes ingesting products only intended for external use.

Again, when there is unlikely to be any benefit to taking a drug, any potential for harm is too much. Further, taking an ineffective medicine often keeps people from being treated with an effective one, such as Paxlovid.


Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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