On our Swinefeld episode of WCBA, I suggested that getting people to cough into their sleeve to stop H1N1 transmission was a bit like asking school kids to "duck and cover" to save themselves from a nuclear blast.

I was rebuked by some of you for eschewing a motherhood suggestion of public health experts. Now comes word that another "motherhood" tip may be just as useless as coughing into your sleeve.

The Canadian Medical Association Journal has an article today which states that there's no evidence that good hand hygiene practices prevent influenza transmission, that according to a 2007 Council of Canadian Academies report commissioned by the Public Health Agency of Canada (PHAC).

Astonishingly, despite those 2007 findings, the agency still recommends hand washing as the primary preventive measure against flu transmission.

The CMAJ article has this comment from College of Family Physicians of Canada President Dr. Sarah Kredentser.

"The average family physician is confused and that's partly because there is a lot of conflicting evidence and things change day by day. " The absence of any kind of national guidelines or strategies "makes it tough for physicians in practice. In this kind of situation, physicians actually want to be told: What do I do? How do I triage patients? What steps do I take to keep the office open?"

Read the article and judge for yourself. And listen to the podcast of our Swinefeld episode on September 19, 2009.