Covid infection rate affected by water access

Covid infection rate
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Xue Zhang of Cornell University outlines how a lack of access to water results in a higher Covid infection rate and deaths.

Handwashing is one of the most effective ways to prevent the spread of infection. The COVID-19 pandemic has proven how crucial good handwashing practises are for reducing the risk of transmission. Studies have shown that handwashing approximately reduced COVID-19 cases by 53%.1

However, handwashing as a method to reduce Covid infection rate may not always be possible due to a lack of access to water. Although access to water and sanitation are recognised as human rights by the United Nations, the US government has not yet joined other nations in ensuring that people have a right to access clean, running water. As levels of unemployment soared throughout the pandemic, more and more people were at risk of losing their access to water due to unpaid bills.

Having access to clean and affordable running water is not just a problem which stemmed from the pandemic, as prior to the pandemic, rising water prices resulted in millions of Americans falling into water poverty. In 2016, it was estimated that 5% of households in the US were disconnected to their water services due to unpaid bills.2

Across the US, moratoriums on water disconnections were put in place at the start of the pandemic. This necessary measure to enable access to clean, running water, and subsequently prevent infection, was not enacted for very long. It was reported that by August 2020, 115 local moratoriums on water disconnections were left to expire, even as the pandemic continued.2

A recent collaborative study by Cornell University and Food & Water Watch showed that a nationwide moratorium on water is essential to prevent the spread of Covid infection.3 To find out more about this study, Health Europa spoke to Cornell University’s Xue Zhang about the findings, and discussed what the US Government can do to ensure water equity.

How has the COVID-19 pandemic exacerbated the pre-existing water affordability crisis in the US?

Equitable access to water is a basic human right, as recognised by the United Nations, but the US government has not taken action to affirm it. Before the COVID-19 pandemic, no state had a moratorium on water shutoff for low-income households who could not pay. But with the onset of the pandemic, 34 states enacted moratoria on water shutoffs for at least some water utilities, so that people could access clean water to drink and wash their hands. A nationwide moratorium on water shutoffs could have protected millions of people from the risk of losing access to water.

Your study has stated that a nationwide moratorium on water shutoffs in the US might have prevented half a million people from becoming infected with the COVID-19 virus. Can you explain the link between water equity and COVID-19 daily infection growth rate?

This study shows that having a water shutoff moratorium in place significantly lowered the Covid infection daily growth rate by 0.235%. In addition, a comprehensive moratorium covering all water systems (public and private) significantly lowered the infection growth rate by 0.169%. We used the percentage to estimate how many people could be protected if there was a nationwide moratorium. We argue that a comprehensive approach to water equity can protect the health and safety of all communities.

Are there any particular groups or demographics that may be more vulnerable to infection due to water shutoffs?

Essential workers and minority groups are some of the most vulnerable populations in the COVID-19 pandemic.

Has the COVID-19 pandemic had a significant impact on public awareness of personal hygiene as a means of preventing infection?

The need to ensure access to safe drinking water for handwashing, sanitation, and public health is highlighted in the context of the coronavirus disease 2019 (COVID-19) pandemic. Since March 2020, one of the US Centers for Disease Control and Prevention’s top recommendations to help stop the spread of the novel coronavirus is thorough and frequent handwashing.

What can policy makers do to ensure water equity?

With the ongoing pandemic and millions of people losing the protection of water access, this study shows the need for state and national leadership in protecting equitable access to water. Federal legislation can contribute to public health by funding programmes for low-income households and providing support long-term for water utilities to help address systemic inequalities and create stronger, more resilient, and more equitable communities.


  1. Effectiveness of public health measures in reducing COVID-19 incidence (
  2. Millions in US face losing water supply as coronavirus moratoriums end | US news | The Guardian
  3. Zhang, X., Warner, M. E., & Grant, M. (2021). Water Shutoff Moratoria Lowered COVID-19 Infection and Death Across US States. American journal of preventive medicine.

Xue Zhang
Postdoctoral Associate
Department of Global Development

This article is from issue 20 of Health Europa Quarterly. Click here to get your free subscription today.


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