Ecolab has been a busy behind-the-scenes player in many of the most powerful health care scenes since COVID-19 hit the U.S., from COVID-19 units to N95 mask sterilization.

It has helped factories with sanitization needs in this new era.

As the U.S. death toll from COVID-19 surpassed 100,000 last week, the $15 billion St. Paul-based giant is also helping hotels and restaurants safely reopen as it continues its work in hospitals.

Examples include helping New York City's Mount Sinai Hospital set up its COVID units and update other areas by installing 2,000 hand-sanitizing stations in one weekend. Ecolab helped the nearby Four Seasons Hotel improve its sanitization so it could become a temporary home for worn-out EMTs and hospital workers tending to coronavirus victims.

"We have been in situations where we had to redo hospitals because they wanted to overprotect," said Ecolab CEO Doug Baker. "We have huge spikes in demand in all antimicrobial products. It's monstrous."

Because Ecolab has helped sanitize hospitals for 50 years, hospitals turned to it during the pandemic — causing sales for disinfectants and other necessary products to spike, even as revenue from cruises, hotel, restaurants and concert halls sagged amid coronavirus stay-at-home orders.

In weeks, hand-sanitizer sales jumped fifteenfold, the company said. Surface-disinfectant sales are five times higher as Target, grocers and factory customers began sterilizing shopping carts, counters, machines and doors nonstop.

Ecolab has added extra shifts, reallocated workers from its slower restaurant chemicals business and doubled the number of plants to 35 where its alcohol-based hand sanitizers are now made.

Still, it can't keep up with demand, Baker said.

Some of Ecolab's 130 global factories aren't equipped to help make the extra hand sanitizer needed during the pandemic. For example, some were not built to handle hazardous materials, he said. So extra production was shoehorned into some of its plants in Illinois, Texas, California, Washington state, Canada and Europe.

Mairs & Power investment manager Justin Miller said growth at Ecolab's health care division has been hampered for years as hospitals struggled, consolidated and only tentatively embraced some of Ecolab's more innovative offerings such as an automated monitor that alerts patients if a doctor fails to wash hands before approaching.

Hospitals have "just been a very difficult market for [Ecolab] to get a lot of traction, which is a head scratcher for me when you weigh the risk of infections," Miller said.

But that could change because of the coronavirus, he said.

"When you look longer term, [opportunity] should be accelerated for them when you think about the greater need for compliance around [patient and] food safety, around hand washing and cleanliness."

One of the places that called Ecolab during the past few months was the University of Oxford's Jenner Institute, which needed help expanding its COVID-19 vaccine lab. Ecolab provided the antimicrobial disinfectants and clean room consultants.

"Ecolab has been a true partner, and we are all very impressed with the team that has been putting in huge efforts to help us manage this important work," said Cathy Oliveira, the GMP production manager at Oxford's Clinical Biomanufacturing Facility.

Early last year — before coronavirus was a household word — Ecolab paid $178 million for Bioquell PLC, a U.K. company that uses hydrogen peroxide vapor to disinfect pill-making chambers inside pharmaceutical plants.

When the coronavirus struck, U.S. fire departments and hospitals needed a way to quickly disinfect ambulances. And doctors and nurses desperately needed a safe way to reuse N95 respirator masks because new masks were so hard to find as the virus disrupted supply chains.

Under pressure, Ecolab raced to get more of its new Bioquell sterilizing equipment shipped from England, but airlines had halted international flights due to the pandemic.

"Getting the equipment from the U.K. here has been a challenge," forcing Ecolab "to break through enormous obstacles," said Beth Simermeyer, president of Ecolab's $1 billion Healthcare and Life Sciences division.

Today the Bioquell vapor sterilization units are in 70 U.S. hospitals. Last month, Ecolab partnered with Ohio-based Battelle, which put the Bioquell units in vans that travel to hospitals and nursing homes sterilizing used N95 masks.

With the new technology, hospitals can decontaminate a mask 20 times before it becomes brittle, Simermeyer said.

"I feel incredibly proud of our team and our ability to help during this crisis and support our hometown heroes," she said.

The new vapor sterilization won't make Ecolab rich. But that's not the point.

"This is not material to our earnings. But it is very material to the safety of workers and health care workers," Baker said. Heightening public safety is key. "We have 50,000 employees and we are not immune from the virus."

CFRA Research equity analyst Matthew Miller said Ecolab's efforts today could be long-lasting.

"When the world emerges to the new normal after the current health pandemic, we think ECL's products and services, [especially those] focused on hygiene, antimicrobial, and sustainability, will experience strong secular demand growth," he said.

To ensure that happens, the 97-year-old Ecolab is working quietly behind the scenes to help other businesses reopen safely in a post COVID-19 world.

Two weeks ago, Kris Kielsa, general manager of Ecolab Institutional North America, sent a team to help Pala Casino Spa and Resort in California restart idled dishwashers, washing machines and spa equipment and to train workers on new cleaning protocols, which upgraded from general cleaners that remove stains and stickiness to hospital-grade disinfectants.

He is doing the same for large restaurant chains who are calling, asking Ecolab to service about 200 reopening restaurants in Texas and 100 in Louisiana.

Gianni's Steakhouse in Wayzata had Ecolab come in to assess its reopening strategy, including switching to hydrogen peroxide cleaning chemicals that disinfect faster.

In recent weeks, Ecolab food scientists and public health experts also visited car factory customers plus Marriott, Wyndham, American and Choice Hotels to put in place new cleaning protocols, provide faster disinfectants and explain that they should stop hiding cleaning efforts from public view.

"It is not business as usual with the hotels. They have to do a different job to make guests understand that they should feel comfortable" venturing out during a pandemic, Baker said.

"Customers want to see people [frequently] wiping down high-touch surfaces," he said. "One significant factor that businesses need to account for, now more than ever, is cleanliness. There will likely be anxiety among employees and customers regarding their health."

Dee DePass • 612-673-7725