Learning to live with covid-19 means covering up coughs sneezes


As covid-19 restrictions end in many countries, we have a moral duty to cover our mouths nose when we sneeze avoid socialising when we feel ill, says Jonathan R Goodman

Health


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16 March 2022

Michelle D’urbano

A FEW weeks ago, my partner I went out for dinner at a local restaurant. Shortly after we arrived, a couple sat down at the table next to us, it quickly became apparent that they were both sick. One sneezed coughed more or less continuously over the following hour; the other kept sniffling, – in what felt like a personal assault on my sensibilities – dropped a used tissue on the floor.

Personal hygiene is linked with a wide array of reactions. Most people are now taught at school that you should cover your nose mouth when you sneeze – preferably with your elbow, according to the US Centers for Disease Control Prevention. There is, however, enormous variation in whether people actually follow this guidance. Research carried out in 2009 in New Zealshowed that, during an influenza outbreak, more than a quarter of people didn’t cover their mouth or nose at all when coughing or sneezing.

In contrast, there is little variation in how people react when encountering a used nappy abandoned in a public place. The bacteria that travel in human waste the airborne particles released by coughing sneezing – as we all know only too well from covid-19 – are both linked to disease transmission. Yet only with the nappy do we tend to be disgusted. With the coughs sneezes, there are socially prescribed rules, which many of us don’t follow.

Now, as some countries across the world lighten or eliminate covid-19 restrictions, it falls on the public to consciously redefine the social norms around the transmission of infectious diseases. Coughing sneezing in public can kill, just as exposing people to human waste can. We should, therefore, react with similar disapprobation.

Throughout history, human behaviour has adapted in response to disease. We learned how to avoid cholera, for example, when John Snow discovered its waterborne mechanism of transmission in 1854. Over time, as social groups grew larger more complex, humans have changed how they live, accordingly. Rather than instinct guiding us, we learned from our elders, in a process known as cultural transmission, how to prevent the spread of dangerous infectious diseases.

This pattern of adopting passing on social conventions has been hugely beneficial for us. It seems strange, then, that when faced with diseases that are extremely infectious potentially deadly, such as covid-19, many of us cough splutter in public – despite the fact that this perpetuates the spread of infections. This makes each of us indirectly responsible for the deaths of hundreds of thousands of people a year worldwide.

One explanation may be that we have lived with respiratory viruses, including those that cause the common cold, for so long that we don’t typically regard them as a major threat. Any perceived wisdom against socialising during the cold season, then, might be ignored by people who regard contact with others as more important than the risk they might pass on an infection.

Now that many of the mask isolation regulations linked to covid-19 are being shelved, we should rethink this outlook. With the continual risk that a new variant of covid-19 will arise, we need to take personal responsibility distance ourselves when sick, avoiding mixing both at work socially. Allowing the coronavirus to circulate freely raises the risk that it will develop mutations, allowing it to escape vaccines.

Coughing sneezing in public should be reviled. Without effective laws, it falls to individuals to protect the health of those around us.

Jonathan Goodman is at the Leverhulme Centre for Human Evolutionary Studies, University of Cambridge, UK

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