Proper handwashing could save a million lives a year, according to an expert — and yet many people are doing it improperly, often due to misconceptions surrounding the practice.

Doctors recommend washing with soap and water for at least 20 seconds to reduce the spread of infectious diseases.

The NFID 2025 State of Handwashing Report, recently released by the National Foundation for Infectious Diseases, provides details on Americans' handwashing habits (and mistakes).

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The report is based on a survey of 3,587 U.S. adults, conducted in November and December 2024 and March 2025."We have to recognize that there are a number of important infections that hand sanitizers are not effective at preventing," Hopkins said.
One example is norovirus, a highly contagious stomach virus that is common on cruise ships and is also spread seasonally.

The virus cannot be killed with hand sanitizer, but is "easily destroyed" with soap and water, according to Hopkins.Certain viruses are "encapsulated" and can be destroyed with either soap and water or hand sanitizer, the expert said. However, there is also an "unencapsulated" type of virus, which has an outer coat that does not break down from the alcohol in hand sanitizer.

Using soap and water is a more effective way to kill the germs, the doctor noted.

2. Just coughing into your sleeve
When people cough or sneeze into their sleeve, they could still spread germs afterward.

"If you cough into your sleeve … go ahead and wash your hands with soap and water as well," Hopkins advised.

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"We also have to recognize that we often bring our hands up close to our face, touch our nose, our glasses, other parts of our face," noted the doctor, who is based in Arkansas.

"If we have bacteria or viruses on our hands, we can introduce them into our mucous membranes, where we can get infections."