How risky is using a public restroom during the COVID-19 pandemic? Minnesota experts weigh in

Luggable Loos. SheWees, GoGirls and Tinkle Belles.

Suddenly, portable camping potties and female funnels have become must-have products, selling out at camping stores and back-ordered online.

"We have seen a noticeable uptick in hygiene and sanitation categories," said Melissa Paul, a merchandising manager at REI, where sales of the Luggable Loo and Go Anywhere portable toilets are double what they were last year.

These devices are pandemic bestsellers because even though Minnesotans are increasingly venturing out, there's one place we remain eager to avoid: the public restroom.

Travelers are rejecting gas stations and wayside rests in favor of draping a sheet over the windshield and setting up a portable toilet in the back of their SUV or even purchasing or renting RVs just for the private potty on wheels.

Is this call-of-nature caution warranted?

"A multi-stall bathroom that lots of people go in? Worst place you could go," said Dr. Gregory Poland, an infectious disease expert and head of Mayo Clinic's Vaccine Research Group. "The reason being, you have the highest density of people and the smallest amount of real estate."

Dr. Craig Hedberg, a professor who researches infectious disease outbreaks at the University of Minnesota School of Public Health, agrees, but with a caveat.

"If there are several people who are all in the facility at the same time, then that creates a crowding situation that might foster some respiratory contact," he said.

However, a pit stop likely carries less risk for catching COVID-19 than a night inside a packed bar.

"We've seen transmission now in a number of bars," Hedberg said. "The longer you stay in indoor air environments with opportunities for respiratory transmission, the greater the likelihood of transmission is going to be. And so I think that (a bar) is a more likely scenario than the use of bathrooms—but there certainly are things that I would want to watch out for."

There are several risks associated with using public restrooms, the primary one is being in close respiratory contact with other people who are sharing a tight indoor space.

A lesser risk factor (but a slightly grosser one) involves feces, which have been demonstrated to contain virus particles, and toilets that either have no lids or have their lids raised when flushed.

"That's another potential source of exposure, if you have somebody flushing a toilet and there were virus particles that are being aerosolized," said Hedberg.

In addition, there are all those surfaces—toilet and sink handles, countertops, soap and towel dispensers. (One study Poland worked on found that there was less fecal bacteria in the toilet bowl water than on surfaces like light switches and doorknobs.)

But washing your hands or using sanitizer can mitigate that risk, making it of less concern than breathing in virus particles directly.

"Environmental contamination is much lower on our risk for transmission to occur because you've got to get the virus off the surface and then put that virus into your respiratory tract," said Hedberg. "If you are washing your hands at the end of your bathroom process you should be able to remove virus particles."

And some public bathrooms are riskier than others.

Because they are used by only one person at a time, portable bathrooms have emerged as a more attractive option, as long as it's possible to wash or sanitize your hands thoroughly afterward. Portable potties, however, tend to be cleaned less often than restrooms.

And while peeing behind a tree is an option, public restrooms exist for a reason.

"We don't want to encourage people to be discharging waste in an unsanitary manner into the landscape," said Hedberg. "We don't want to create more problems than we're solving. One of the great public health interventions that we've benefited from in the last century was the development of sanitary sewers and safe water supplies."

Bathroom ninja routine

Some businesses, park centers and beaches are trying to make their restrooms safer by closing every other sink, stall or urinal to encourage social distancing, as well as increasing the number of cleanings. Some are closing large, multi-stall bathrooms and putting in porta potties instead.

"The first concern people might have when thinking about going to a restaurant is, 'Geez, how are you going to do social distancing?' and then the second question is, 'What if I need to use the restroom?'?" said Steven Soifer, a social work professor at the University of Mississippi and president of the American Restroom Association.

Soifer has some suggestions.

"We've always advocated for single-stall, gender-neutral, floor-to-ceiling enclosed water closets, which, in an ideal world, would be the best way to protect one from the coronavirus and lots of other things," he said. "These designs are popular in Europe, for sure."

Until individual water closets are popular in the U.S., many of us are trying to balance our risk tolerance with the need to go when we're on the go.

The Mayo Clinic's Poland said he and his wife have developed a method for visiting a single-stall public bathroom:

They bring Clorox or Lysol wipes, using one to open the door. (Paper towels also work in a pinch). They use a wipe or paper towel on the flush handle (do not flush wipes, as they clog) and then wash their hands properly. Then they use a fresh wipe or towel to turn the faucet off and open the door.

"And ideally, you wear a mask because you don't know who was in there hacking away five minutes ago," Poland said. "It's nicer if there's a ventilation fan, and if there is I use that ventilation fan, whether you need it or not just because you're improving airflow."

Before the coronavirus, Poland was a bit self-conscious about his public bathroom routine.

"You always wonder, the people that see me doing that must think I'm a nut, or a germaphobe," he said. "Now you see a lot more people doing it. It's become a little more, so to speak, socially acceptable."