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It is the friction of rubbing your hands with soap and the running water that help remove most of the germs. They go right down the drain.Hand gel is 60% alcohol no good only soap and water cos effective because of the friction of hand washing. And yet it is deemed a suitable replacement for constant hand washing in the hospital. Foam in foam out.
When I took Micro, out instructor proved to us how much bacteria was in hand sanitizer. He said using good old soap & water was the best. I never buy HS. Duh. Before hand sanitizer was soap and water. I only use hand sanitizer when I can’t get to a sink right away. Hand sanitizer have your hands sticky. I rather use soap and water. When I was an IP, I taught my staff to foam in and out of rooms along with hand washing. I used the analogy where if you had a fly or a bug or something on your hands, you squashed the bug. Bug is dead but guts are still on your hands, ie using hand sanitizer. Kills most of the bugs but does not get them off of your hands. Washing with soap and water will remove the guts of the bugs from your hands. I taught my employees to wash hands after every 3 to 4 uses of sanitizer. It may be silly but it worked