At this stage of the COVID-19 pandemic, what we’re seeing in the Philippines and many other countries is the paradox of people being extremely fearful of low-risk situations, while taking for granted conditions that are truly high-risk.
People can get confused because we have too many rules, laws, and prohibitions that are not adequately explained. Add on the infodemic of fake news. In cases where information is given out, messages might not be clear, or do not address questions people have.
I’ve been working with Gideon Lasco, a physician, fellow medical anthropologist, and Inquirer columnist, on an article about local concepts of infectiousness (hawa, nakakahawa) and resistance (resistensiya), and we feel perhaps the biggest cognitive barrier we have toward understanding COVID-19 risk is the idea that the virus is transmitted through “hangin,” in the wind. Even President Duterte has used the term and doctors themselves frequently use “airborne” rather than “aerosol” or “droplets,” which are more precise descriptions of how the COVID-19 virus is transmitted. “Airborne,” unfortunately, is translated as “nasa hangin.”This fear of hangin results in neighbors fearing neighbors, pitting barangays against barangays and provinces against provinces. A concrete example of the hangin misconception: A UP faculty told me some time back that an ambulance had picked up his neighbor. He was worried that if the neighbor had COVID-19, would the virus spread through the air (hangin again) into his house? I explained that if indeed the virus can travel long distances through hangin, we would see people dropping dead in the streets.
But then our quarantine rules end up propagating this “airborne” concept by practically forbidding people in barangays with COVID-19 infections from coming out of their houses. Not only that, even in modified general quarantine, the rule is that children and senior citizens still cannot leave their homes. Implicit in these prohibitions is the idea that the virus is in the hangin, in the air.
It’s not just us Filipinos. The last few weeks, governors and mayors, as well as health ministers in the US and Canada, have appeared on television to scold their constituents for going out to beaches and parks to enjoy the weather. The authorities had dire predictions that there would be a surge of infections from the beach and park groups, but it hasn’t happened.
The reality is that studies are finally coming out from different countries showing that most infections occur indoors: in hospitals, in residences, in restaurants and bars, in dormitories, work places, and places of worship. The largest study so far was an analysis of 1,245 cases in China for patients diagnosed in January and February 2020, and with good contact tracing (investigation of who infected whom, and under what conditions). The researchers found that the most frequent place of infection was inside homes, followed by transport vehicles. Only two infections were acquired outdoors.
(I worry about transport vehicles coming in second in the Chinese study, which should not be surprising. I’d be more worried about air-conditioned transport than the jeep or tricycle with natural ventilation.)
All over the world there are similar findings: nursing homes for the aged in New York City, homes in Italy where people of different generations tend to live under one roof, much like in the Philippines.
I suspect that if we analyzed our reports of infections, we will find the infections happening mainly in homes, too, and in hospitals.
Culture also needs to be taken into consideration when trying to track the infections. We’ve had clusters reported from “sabong” (cock-fighting), and from attending large religious gatherings. I don’t know if our contact tracers ask about karaoke, which tends to make people congregate.
Should we then allow all businesses and schools to open again?
Nope, the numbers of new infections are still high enough to warrant limiting the movement of people and having enough space for physical distancing. Especially in a country with such a large population as we have in the Philippines, it is easy to create crowds in confined places like malls, LRT/MRT stations, and in the places I mentioned earlier.
Let’s not fear the hangin and the outdoors. Go out for fresh air and the sun, get some exercise, but do that with adequate protection and practice physical distancing. We use 1 meter here, but westerners tend to go for 2 meters. Again, if the virus indeed goes through hangin, then you would require much greater distancing to be safe.
mtan@inquirer.com.ph