Airborne ≠ ‘nasa hangin’

Much has been said about how the COVID-19 pandemic has been aggravated by an infodemic or an epidemic of misinformation, including fake news.

But we often forget that in many cases, there may be no intention to spread misinformation and disinformation, and that the problem comes with inaccurate translations of key terms needed to explain how COVID-19 spreads and how it can be controlled.

The world has about 7,000 languages, with about 170 in the Philippines. We’re not even counting dialects (e.g. Batangas Tagalog versus Metro Manila Tagalog), slang and jargon, almost esoteric terms found in each profession and even in specializations.

Just one example: You may have heard about “cough etiquette” as one of the methods to prevent COVID-19 transmission. The term is problematic for three reasons. First, it applies not just to coughing but to sneezing. Second, more than politeness, it can be life-saving, because if you are infected, you don’t want to be coughing or sneezing into your hands, and then touching someone with those hands. Finally, the usual explanation of this maneuver is to cough into your elbow. Try it and you’ll find you can’t. The correct explanation should be “cough or sneeze into the crease of your elbow.”

Now how do you translate that into our local languages?

For some time now, I’ve been worried about the use of the term “airborne transmission” for COVID-19, a term that various health authorities, including the World Health Organization, has been careful to avoid.

“Airborne” has connotations of very high contagion, the disease-causing germs perceived by lay people as spreading with the wind across long distances. In Filipino, it sounds even more ominous when translated as “nasa hangin.”

Tuberculosis is airborne, the bacteria spread when an infected person talks, coughs, or sneezes, sending out droplets. The risk is prolonged with “droplet nuclei,” tiny parts of a droplet that stay suspended in the air for several hours in a confined space (a room, a vehicle) and can infect the people inside that space, and not any further.

Yet, Filipinos of several generations, including myself, will remember how our parents would tell us “Don’t breathe” whenever we drove past Quezon Institute, a sanitarium for TB patients. The buildings were about 200 meters away from the main road.

What’s happening now is that some 200 aerobiologists (yes, still another specialized field) have signed a statement urging WHO and other international bodies “to recognize the potential for airborne spread of COVID-19,” citing “inhalation exposure to viruses in microscopic respiratory droplets (microdroplets) at short to medium distances (up to several meters, or room scale)…”

Note “several meters, or room scale.” We’re not talking about the viruses spreading in the air outdoors from one community to another. (That’s another problematic term: community transmission, which actually means people within a community infecting each other, and not one barangay infecting another barangay.)

This matter of aerosols and droplets is not new. I’ve been using it in my columns and lectures after watching, in March, a Japan Broadcasting Corporation (NHK) documentary featuring research from Toho University, using laser photography to graphically demonstrate how microdroplet transmission occurs, and how the risks are increased inside a room with poor ventilation. The Japanese recommend opening windows and doors to allow these droplets to disperse. (A video clip has been posted on YouTube: https://www.youtube.com/watch?v=H2azcn7MqOU)

It seems even President Duterte may have seen that NHK documentary, or something similar, because, in one speech back in April, he mentioned watching how the virus is transmitted, using laser photography. He then used the Filipino “nasa hangin” to describe that transmission.

Which is problematic, because people then begin to think of transmission like TB germs from the Quezon Institute. It is this “nasa hangin” perception that has led to exaggerated fears on the part of many local governments, banning the return of their own townmates just because they came from Manila or overseas. The crazy thing is that while we try to control this “nasa hangin” virus, we forget it’s still close contact that’s the main danger, the contact that comes with sharing karaoke microphones, or attending birthday parties and even sports events.

Even more ironic is our failure to understand that “hangin,” in terms of outdoor air and winds, is actually good, helping to reduce risks of transmission.

Let’s avoid terms like “airborne” and “nasa hangin” and instead advise people to avoid the 3C’s that the Japanese government first proposed: crowds, confined spaces, and close distances (between people).

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