Prevention is always better than waiting .
- The focus on stopping the immediate spread of the coronavirus should remind us about the importance of always maintaining a healthy immune system.
- The most at-risk population are those with immunodeficiencies and respiratory problems.
- Eating a diet high in fruits and vegetables, exercising regularly, and not smoking keep your immune system strong.
Wash your hands. Don't touch your face. Maintain a distance of at least six feet.
Wash your hands. Don't touch your face. Maintain a distance of at least six feet.
Wash your hands. Don't touch your face. Maintain a distance of at least six feet.
You might have seen these instructions here or there (or everywhere) lately. They're certainly important at this moment in time. Immediate actions must be taken; your best protection is prevention.
But there's a larger issue at play. Humans are reactionary animals. Americans seem particularly primed to react rather than foresee. We tend to respond only when necessary. As we're finding out, kicking the can down the road in regards to our health is not the wisest decision.
There is plenty of discussion about the dangers of COVID-19 on people with immunodeficiencies. The conversation also needs to focus on maintaining a healthy immune system so that when disasters strike, you're as prepared as possible to withstand the ravages of disease.
Your entire body is effectively your immune system. Specifically, the parts that play a role include your lymphatic vessels and lymph nodes, bone marrow, spleen, appendix, adenoid, thymus, and Peyer's patches (gut-associated lymphoid tissue). While geographically widespread, this team unites for a single purpose: to protect you against disease.
As you age, your immune system weakens. This is why cancers are more prevalent in older populations and infections that you shrugged off earlier in life can end up taking your life. Recovery periods from seemingly minor insults are extended. As it stands, respiratory infections, pneumonia, and influenza are among the top causes of death in seniors over age 65 around the world. This makes COVID-19 especially dangerous to older populations.
Maintaining a healthy immune system should be important to all of us at every age. At some point, you and I and everyone will experience the final insult that leads to death. Living a healthy lifestyle means you are not only increasing your chances for living longer, but you'll also live better at every step. Below are eight methods for keeping your immune system strong.
3 Immunity Boosters You Should Know About
You've heard it a million times, but let's repeat it again: regular movement is one of the most important factors for keeping your immune system in top shape. Exercise alleviates mental health issues, helps lift depression, and reduces the effects of anxiety disorder—all cognitive issues that add stress to our lives, and chronic stress destroys immune systems.
On the physical side, humans were born to move. Denying yourself this birthright proves detrimental to fighting disease. Load your body, engage in cardiovascular activity, stretch—just get moving. The most important aspect of exercise on your immune system appears to be increased circulation, so even regular walking is a boon. Ideally, you push your heart rate up regularly and load your body at least three times per week.
Eat well, especially fruits and vegetables
While movement is essential, nothing affects your immune system more than your diet. Those who live in poverty or are malnourished (or both) are more susceptible to infectious diseases than other populations. Regardless of economic status, your risk for immunodeficiencies increases if your diet is high in sugars and carbohydrates.
Those lacking vitamins such as zinc, iron, folic acid, copper, selenium, and vitamins A, B6, C, and E might also experience immune problems. The answer is simple: eat a lot of plants and fruits and lower your intake of processed and sugary foods. Make sure dessert is what it was intended to be: an occasional treat. Stop eating dessert for breakfast.
Watch your weight
In December, it was reported that half of Americans will be obese in 10 years if interventions are not put into place. Even more alarmingly, a quarter of Americans will be severely obese—over 100 pounds overweight. An animal that, for 350,000 years, has survived thanks to nutritional scarcity has fallen victim to caloric excess. The negative health effects of obesity cannot be overstated. Trouble fighting disease is only one of the many consequences of not maintaining a healthy body weight.
Anxiety levels are skyrocketing. Most people have not been infected by this coronavirus nor will fall seriously ill due to it, yet fear and panic are overriding our calmer instincts. Added stress increases the likelihood you'll experience more dire effects if you are infected; chronic stress is more detrimental to overall health than the occasional stressor.
Numerous anxiety reduction techniques exist—parasympathetic breathing techniques, meditation, listening to music, conversing with friends, and many others. We need a mass cognitive reframing right now. Though the worst is probably ahead of us, this epidemic too will pass. Keeping this in mind is important as you navigate this new terrain.
Greek Lentil and Spinach Soup With Lemon.
Tom McCorkle for The Washington Post via Getty Images; food styling by Lisa Cherkasky for The Washington Post via Getty Images
Drink in moderation
Alcohol stunts the immune response. While a little bit might prove relaxing, moderation is key. Drinking daily or getting drunk to distract yourself from the virus (or anything else) increases the likelihood that your body will be incapable of fighting off the disease if you become infected. Be smart about your drinking and try not to use it as a coping mechanism.
Sleep deprivation reduces your body's ability to produce essential proteins that keep your body healthy. Still, the National Sleep Foundation estimates that 47 million Americans don't get enough shuteye. It is estimated that 70 million Americans suffer from a sleep disorder. Chronic lack of sleep leads to both mental and physical health problems, including a compromised immune system. In fact, the number one remedy for most illnesses is sleep (along with hydration). Basic, of course, but basics are essential.
The best way to not get sick is to avoid situations in which you can get sick. Wash your hands. Don't touch your face. Maintain a distance of at least six feet. This is always good advice, but critical now.
Throw out the cigarettes
Cigarette smokers are especially susceptible to COVID-19 given that it's a respiratory disease. We've known about the deadly consequences of smoking for a century, even though it took public health officials some time to catch on. In the long run, nothing good comes from it. Don't wait for another epidemic to kick this habit.
The Black Death skipped certain parts of Europe - and that could be a lesson for today's coronavirus epidemic
- Calm down, we're not comparing COVID-19 to the Plague.
- Well, not literally. But this map raises an interesting question: Why were some parts of Europe spared of the Black Death?
- And can that tell us something about where the coronavirus will or won't spread?
The doctor will see you now
Engraving of 'Doctor Schnabel' ('Dr. Beak'), a plague doctor in 17th-century Rome, wearing the typical mask with which caregivers sought to keep the 'bad air' at bay that they held responsible for the spread of the disease.
Image: Paulus Fürst, ca. 1656 - public domain
The Black Death was a ruthless killer – and, if you were lucky, a swift one. Its more fortunate victims "ate lunch with their friends, and dinner with their ancestors in paradise," wrote Giovanni Boccaccio, who lived through the initial wave of the Plague as it struck Italy in the 1340s.
What does that have to do with the coronavirus? Not a whole lot, fortunately. Except that the brief of this little corner of the internet is to look for strange maps, and one map led to another.
The Plague was brought from China to Europe in the 1330s by rodents hitching rides with traders. The infection with the Yersinia pestis bacterium was typically transmitted to humans by fleabites. The Plague's three manifestations were bubonic (causing painful swellings), septicemic (infecting the bloodstream) and pneumonic (choking off breathing, and transmittable via coughing). Left untreated – as was necessarily the case in the Middle Ages – bubonic plague had a mortality rate of about 50%, for the other two, it's virtually 100%.
Bocaccio's Italy was hit hard by the epidemic. Cities like Venice and Pisa lost three-quarters of their population. The disease followed the traditional trading routes north, racing forward each spring as a new generation of fleas was ready to spread the infection.
The Plague afflicted most of Europe in a relatively brief period. It's estimated that it killed as many as 25 million – a third of Europe's population at the time – in just five short years.
Absent explanations and remedies, Europe's populations turned to God for hope, and victimized outsider groups as scapegoats. Some of Western Europe's worst anti-Jewish pogroms before WWII took place during outbreaks of the Plague.
In just a few years, the Plague had moved from its entry points on the Mediterranean as far north as Scandinavia.
Image: Andy85719 - CC BY-SA 3.0
This map shows the progress of the Plague, from its arrival in the Mediterranean:
- First afflicted (in 1347) were Asia Minor, and the islands of Sicily, Sardinia and Corsica, with just small bridgeheads on the European mainland: Marseilles and environs, Calabria (the tip of Italy's shoe), and the southern shore of what is now Turkish Thrace (i.e. European Turkey).
- By the next year (1348), the disease had achieved a firm foothold in Europe, reaching as far as the gates of Toledo and Paris.
- In early 1349, the Plague had overwhelmed London and Frankfurt, and was poised to pounce Vienna and Bucharest. Later that year, it reached as far as Ireland and Norway.
- Its relentless march north continued. In 1350, it hit Lübeck and Copenhagen, reaching high into Norway. In 1351 and thereafter, it swept further north, touching the entire continent.
But as this map indicates, the Plague spared certain areas (marked green on the map) on march of destruction:
- an area in Italy centered on Milan;
- small, contiguous parts of Spain and France, on either side of the Pyrenees;
- an area in the Low Countries around Bruges;
- a large area in Eastern Europe, stretching from Magdeburg to beyond Warsaw, taking in most of present-day Poland, plus some surrounding areas.
Why? First off, the map is slightly misleading. Green does not mean 'safe', just 'less deadly'. Milan, for example, only lost about 15% of its population. Horrific by today's standards, but a mere trifle compared to the almost wholesale extinction of Italy's other cities. In Poland and the other 'green' areas too, people did die of the Plague, albeit in much lower numbers than elsewhere.
Blues vs. Greys
Interconnected equals infected, and vice versa.
One main reason why Poland escaped relatively unscathed, was the decision by Poland's king, Casimir the Great, to close the country's borders – and set up internal quarantines.
This increased Poland's natural isolation, both from the outside world and between the settlements within the country – generally smaller and less connected than elsewhere in Europe. Prague to Krakow took eight days on horseback. People infected took between 24 to 72 hours to get sick. So the issue would 'resolve' itself well before the danger reached the Polish border.
Isolation plus quarantine certainly helped spare Poland from the worst of the epidemic. One more spurious explanation is that Poland had more cats than other parts of Europe, and thus less disease-carrying rats…
Milan's significantly lower mortality rate may also be down to the city's stricter quarantine measures: The houses of infected families were simply bricked up (with the infected left to die inside).
Like Poland, the French-Spanish area, corresponding to the then-kingdom of Navarre, may have benefited from its relative isolation. Why the area around Bruges – then a thriving port with connections to the Mediterranean – might have been spared, is more of a mystery.
So, what's the lesson, if any? Isolation definitely helps against infectious diseases. But that's about the only advantage of being isolated. Take this map of the spread of COVID-19 as of 11 am on 5 March. If you had to divide the world into 'fun' and 'no fun' halves, they would correspond quite well with the blue and grey zones on this map, respectively.
For example, one sure-fire way to limit your exposure to the outside world is to have a bloody civil war – see Yemen, Libya and Syria. Another is to be a destination as out of the way and unconnected as Paraguay, the Central African Republic or Mongolia.
If it's the price of living in an interconnected world, then perhaps there are worse things than having to fight off a slightly deadlier iteration of the flu. Praise globalization and pass the hand sanitizer – with your elbows, please!
Strange Maps #1014
Got a strange map? Let me know at email@example.com.
Information is the best armor against panic.
- For most people, getting the coronavirus is not life-threatening.
- Those most at risk are the elderly with pre-existing conditions.
- Things may change as the virus replicates, but here's what you need to know about the risks right now.
As we anxiously watch coronavirus, COVID-19, touch our shores and begin what seems an inexorable march across the United States — as it has been doing across the globe — many of us are naturally wondering, "Just how scared should I be?"
Unfortunately, there's no definitive answer. First of all, the closest you can get is a statement of your odds of dying from COVID-19. Second, viruses mutate, so the best information only reflects what's been seen prior to now. Most of what we know so far comes from the virus' impact in China, where it began.
As of the first week of March 2020, the odds of dying from COVID-19 on average are 2.3%, though that number varies depending on your age.
Your odds of contracting the disease, however, are much higher and dependent on where you are and how much interpersonal contact you have. For the vast majority of people, COVID-19 is not life-threatening. According to one first-hand account published by The Washington Post, having the virus may be an easily tolerated experience. Still, it's best to avoid it altogether if you can.
As of this moment, here are the groups with the greatest risk of dying from COVID-19.
The elderly illCHINA WUHAN COVID-19 HOSPITAL
Image source: Barcroft Media/Contributor
Based on China's experience with the coronavirus, your chances of acquiring a fatal case of COVID-19 have a lot to do with your age:
- Age | Death Rate
- 80+ | 14.8%
- 70-79 | 8.0%
- 60-69 | 3.6%
- 50-59 | 1.3%
- 40-49 | 0.4%
- 30-39 | 0.2%
- 20-29 | 0.2%
- 10-19 | 0.2%
- 0-9 | no fatalities
Older people with pre-existing conditions such as high blood pressure, heart problems or diabetes are at even higher risk. A study of deaths in Wuhan, China where the disease originated breaks down more interested facts:
Most of the death cases were male (65.9%). More than half of dead patients were older than 60 years (80.5%) and the median age was 72.5 years. The bulk of death cases had comorbidity (76.8%), including hypertension (56.1%), heart disease (20.7%), diabetes (18.3%), cerebrovascular disease (12.2%), and cancer (7.3%).
GenderWedding Ceremony In Leishenshan Hospital
Image source: China News Service/Getty
As noted above, COVID-19 is more fatal for men than women, based on a study of Chinese statistics. This may be influenced by the greater incidence of smoking — which may also increase one's susceptibility to COVDI-19 — among Chinese men.
That being said, special precaution is also good idea for women who are or are planning to be pregnant. The CDC says:
We do not have information on adverse pregnancy outcomes in pregnant women with COVID-19. Pregnancy loss, including miscarriage and stillbirth, has been observed in cases of infection with other related coronaviruses SARS-CoV and MERS-CoV during pregnancy. High fevers during the first trimester of pregnancy can increase the risk of certain birth defects.
What to watch out for and what to doConcerns COVID-19 Cases Are Going Unreported In Southeast Asia
As you wait for your local store to re-stock their supply of hand sanitizer, you'll want to keep an eye out for possible COVID-19 symptoms:
- Shortness of breath
Though COVID-19 tests are still not widely available, if you think you could be sick, contact your physician immediately.
If you have coronavirus, follow the CDC's guidelines:
- Stay at home except to get medical care.
- Separate yourself from other people and animals in your home.
- Call ahead before visiting your doctor.
- Wear a face mask.
- Cover your coughs and sneezes.
- Wash your hands often.
- Avoid sharing personal household items.
- Clean all "high-touch" surfaces every day.
- Monitor your symptoms.
When the virus passes, the CDC recommends extending the period of isolation just to be safe.
Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low. The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.
The video fragment only shows increase in COVID-19 cases, reversing the video's original message to induce panic.
- A terrifying graph shows how the spread of coronavirus overtakes previous epidemics like Ebola, SARS and MERS.
- However, the clip is only part of a longer video – and conveniently cuts off before swine flu surpasses COVID-19.
- The wider context: the coronavirus outbreak remains relatively small and is comparatively non-lethal.
How to lie with statistics
This video, posted on Twitter on 22 February, shows how the coronavirus (COVID-19) epidemic compares to that of other recent outbreaks. Terrifyingly, the line for the coronavirus skyrockets, leaving those for SARS, MERS, ebola and swine flu far behind.
Alarming? Yes. But not the whole story. As Mark Twain once said: There are three kinds of untruths: "Lies, damned lies and statistics." If he were around today, he might add a fourth: video edits. The 30-second clip is part of a 10-minute video with exactly the opposite message: Do not panic!
When the video was posted, the coronavirus was less than two months old, and had already travelled from its ground zero—a so-called 'wet market' in the Chinese city of Wuhan—across several continents, infecting more than 40,000 people. It had just killed its 1,000th victim.
The no-panicking message still holds, even half a month and more than double the number of cases later. As of 1 March, we've passed 86,900 people infected, with just under 3,000 deaths reported. Why? Because context is everything.
Virus speed comparison
Mexican police officer wearing a face mask during the swine flu outbreak of 2009.
Image: Eneas De Troya, CC BY 2.0
First, the standalone clip, which has been seen more than two million times. It compares the speed of the coronavirus outbreak to that of a few other recent ones:
- SARS (started in Hong Kong in March 2003),
- swine flu (started in Mexico in March 2009),
- ebola (started in Western Africa in March 2014), and
- MERS (started in South Korea in May 2015).
- At first, Ebola is the scary one. Not only had it infected the most people after just one day, it had killed two thirds of those.
- By comparison, SARS killed its first victim only after three days (out of 38 people infected).
- By Day 10, SARS had overtaken Ebola as the most infectious of the outbreaks (264 vs. 145 patients), but the latter was ten times more lethal (91 dead from Ebola vs. 9 from SARS). At this time, the coronavirus had infected 39 people, killed none, and was still playing in the same minor league as the swine flu and MERS.
Day 262: swine flu dwarfs the other epidemics.
- Day 20, and SARS cases are skyrocketing: 1,550 people are ill, 55 have died. That's a death rate of 3.5%. Ebola has affected only 203 people by now, but killed 61.6% of them, a total of 125. Meanwhile, the coronavirus has taken Ebola's second place, but is still far behind SARS (284 infected). At this time, the coronavirus has claimed the lives of just five people.
- But now the coronavirus cases are exploding; by Day 30, the new virus has infected 7,816 people, killing 204. That's far more infected than any other virus (SARS comes a distant second with 2,710 patients), and significantly more killed (Ebola, though still just 242 people ill, has killed 147, due to its high fatality rate). Meanwhile, MERS is stuck in triple digits, and the swine flu in double digits.
- Day 40: coronavirus cases (40,553) dwarf those of SARS (3,550). The swine flu (369) has overtaken ebola (243), at about the same level as MERS. Also in terms of fatalities, coronavirus now far supersedes SARS (182), ebola (164) and the swine flu (5).
About here, the clip cuts out. The editing aims to focus the attention on the exponential rise in coronavirus cases. But as the longer version goes on, the story changes.
The FULL video of that viral Twitter snippet
- By Day 60, it's the swine flu cases that have exploded, to more than 60,000 people ill and 296 people killed—surpassing Ebola (183), if not SARS (513).
- The swine flu numbers keep growing exponentially: by Day 80, they've passed 362,000 cases (and 1,770 deaths), far surpassing any of the other diseases.
- Day 100: swine flu cases are approaching 1 million, deaths have surpassed 5,000. That's far more than all the other diseases combined—they have merged into a single line at the bottom of the graph.
- By Day 150, swine flu hit 5.2 million patients, with 25,400 people killed. By the time it was declared over, a year later, the outbreak would eventually have infected more than 60 million people and claimed the lives of almost 300,000.
Swine flu was caused by the H1N1 virus, which also caused the Spanish flu. That outbreak, in 1918/19, infected about 500 million people, or 1 in 3 people alive at that time. It killed at least 50 million people. It was the combination of extreme infectiousness and high fatality that made the Spanish flu such a global, lethal pandemic.
None of the other infectious diseases comes close to that combination. The swine flu, although more infectious than other diseases, was less infectious than the Spanish flu, and also less deadly (0.5%). Unlike COVID-19 or its fellow coronaviruses SARS and MERS, Ebola is not spread via airborne particles, but via contact with infected blood. That makes it hard to spread. Ironically, it may also be too lethal (39.6%) to spread very far. And COVID-19 itself, while relatively lethal (2.4%), is well below the deadliness of the Spanish flu, and does not seem to spread with the same ease.
WHO dashboard on the spread of COVID-19.
Image: World Health Organization.
Providing further context to the relatively small danger that the coronavirus poses to your personal health, the video ends by comparing the virus's most deadly day so far (108 people killed on 10 February) to the average causes of death worldwide for that day.
On average 151,600 people die every day. On 10 February, the coronavirus killed a lot less than people were killed by
- Influenza (650, in the US alone)
- Drowning (877),
- Homicide (1,095),
- Suicide (app. 3,000)
- Car crashes (3,287)
- Stroke (13,689)
- Heart disease (24,641)
- Cancer (26,283).
- focus your attention on beating more likely causes of death by eating well, exercising enough and driving safely.
- beat the coronavirus by staying informed and cautious rather than obsessed and panicked.
Strange Maps #1013
Got a strange map? Let me know at firstname.lastname@example.org.
As the new coronavirus epidemic spreads, more and more people are wearing surgical masks—despite their questionable effectiveness. An anthropologist explores the reasons why.
On the day the first case of the new coronavirus was confirmed in the Philippines, a surreal sight greeted me on the streets of Manila.
Half the people were wearing face masks—from the disposable surgical variety to heavy-duty N95 respirators, which many had purchased just weeks before to protect themselves from ash erupting out of the Taal volcano.
Traveling to Thailand the same week, I was met by a similar scene. All the flight attendants and half the passengers on the plane from Manila to Bangkok had donned masks.
On January 30, the World Health Organization declared that the “unprecedented outbreak" of the novel coronavirus (2019-nCoV) was a global health emergency. As of that date, 7,834 cases of the flu-like disease had been confirmed, and 170 people had died. Nearly 99 percent of cases occurred in China, where the virus first appeared in December before rapidly spreading to 18 other countries.
As a result, masks are selling out around the world, making them one of the most sought-after commodities of our time. A recent cover of The Economist depicts a giant surgical mask wrapped around the Earth.
However, the science on how well masks protect the public is complicated.
Surgical masks are designed to protect health care providers and patients from cross-transmitting large droplets such as blood and saliva. So, they can be somewhat effective when worn by sick people to prevent spreading disease through coughing. But surgical masks provide minimal protection from contracting viruses. And they offer little to no protection from air pollution, since gases such as nitrogen dioxide from vehicles easily pass through, while poor fit and movement allow larger particles to leak in.
Filtering facepiece respirators such as N95s are highly effective in protecting people from inhaling viruses and environmental pollutants. But respirators can make it very difficult to breathe, and they're only effective if worn properly.
People's motivation for wearing these masks goes far beyond simple considerations of medical efficacy. Cultural values, perceptions of control, social pressure, civic duty, family concerns, self-expression, beliefs about public institutions, and even politics are all wrapped up in the "symbolic efficacy" of face masks.
Face masks first became widespread during the 1918 influenza pandemic, which infected 500 million people and killed an estimated 50 million worldwide. The public was advised, and in some places required, to wear gauze face masks. "Obey the laws and wear the gauze," Americans were warned. Masks became "an emblem of public spiritedness and discipline" that helped boost morale, wrote historian Nancy Tomes. However, the masks were typically homemade (some women even fashioned them out of chiffon), so, not surprisingly, studies on their efficacy were mixed.
After the 1918 pandemic abated, use of the masks subsided in many parts of the world. Yet they remained part of the hygiene culture in Japan, where they became increasingly common due to a succession of epidemics and disasters, including severe acute respiratory syndrome (SARS) in 2003, avian flu in 2004, swine flu in 2009, and the Fukushima Daiichi nuclear disaster in 2011.
Scholars have proposed various additional explanations for the popularity of face masks in Japan. Some say the practice conforms with the country's notions of cleanliness and purity. One study suggested Japanese society has lost trust in public institutions in recent decades, prompting people to become more self-protective. In another survey, Japanese people said they primarily used masks to protect themselves but that the practice also demonstrates consideration for others and a respect for etiquette. For many, masks are a kind of "safety blanket," and the simple act of putting them on is a "risk ritual" that provides comfort and quells anxiety.
In a sign that the culture is constantly evolving, young Japanese people today are sporting masks as fashion statements, expressing their personal style through anime designs or army camouflage patterns. (Ditto in Australia, where bushfires have inspired companies to fashion attractive respirator masks infused with eucalyptus scent.) Some people are even strapping on masks to prevent others from bothering them or to hide their emotions.
In China, too, people's motivations for wearing masks are muddled with culture. When SARS broke out in Hong Kong, wearing a face mask expressed collectivist values, and declining to do so was met with public censure, noted sociologist Peter Baehr. By putting on a mask, "people communicated their responsibilities to the social group of which they were members," he wrote. "By disguising an individual's face, it gave greater salience to collective identity."
Peer pressure certainly plays a role in some people's decision to don a mask. When two researchers flew to Bangkok during the SARS epidemic, they observed travelers who, after encountering the sight of masked crowds, rushed to buy their own masks. This was despite the fact that no cases of SARS transmission had been reported in Thailand, they had received no clear information on mask wearing, and the surgical masks offered minimal protection. What's more, many people who wore masks practiced poor hygiene, taking them off to cough, sneeze, wipe their nose, and rummage through the communal bread basket. (Many experts say washing hands is the best way to fend off viral illnesses.)
Nevertheless, these scholars stated that mask wearing "can assist the management of major communicable disease incidents by empowering the general public and strengthening perceptions of personal control."
Perhaps this is what Singapore's government had in mind in its response to the novel coronavirus outbreak. On January 30, Prime Minister Lee Hsien Loong simultaneously announced that "we only need to wear a mask if we are sick" and that all 1.37 million households in Singapore will be given four masks each. On the day of the announcement, only 13 cases of the disease had been confirmed in Singapore.
Perhaps the perception of control also informs the narratives of Filipino people I have spoken with about their decision to wear masks. "I don't want to infect my children," Fely (a pseudonym), a mall worker in Quezon City, told me. "Even if doctors say it's not necessary, I will wear it anyway because my family is at stake."
"I feel uneasy when I see others wearing masks and I'm not," said Justine (a pseudonym), a college student in Manila, adding that "there's nothing to lose" by wearing them.
"When [people] saw me, they began to discreetly wear masks. They think all Chinese are contagious," a Filipino Chinese colleague told me.
There may be nothing to lose, but that doesn't mean face masks are always a neutral or benign device.
As concerns over the new coronavirus are spreading around the world, face masks are playing a role in the act of "othering." A Filipino Chinese colleague recently recounted to me: "When [people] saw me seated in the restaurant, they began to discreetly wear masks. They think all Chinese are contagious."
Disease epidemics set off an "epidemic of explanation," in which societies search for a cause of the contagion, according to medical sociologist Philip Strong. At the same time, outbreaks heighten preexisting fears of societal dangers, which can cause flare ups of racial, social, and economic prejudices. The subsequent symptoms can include stigma, exclusion, and what cultural anthropologist Mary Douglas calls a politicized "blaming system."
In late January, news broke out that 3 million face masks had been shipped from a Philippine factory to China, at a time when Filipinos were struggling to buy masks due to shortages and overpricing. The public response was mixed—and telling.
Some Filipinos were outraged and criticized the Chinese for a variety of related and unrelated harms, saying that their own people must come first. Some pointed out that China had previously offered aid to the Philippines, so it was right to return the favor. Others focused purely on the fact that China needed the masks more.
Anthropologists have explored these varying responses. In times of scarcity, some groups become more selfish. Others uphold reciprocity, a powerful and universal human value. And many communities practice "need-based transfer"—based on the idea that, in times of trouble, people help because they assume others would do the same for them.
Following the eruption of the Taal volcano in the Philippines, face masks became the currency not just of greed but also of goodwill. One of the most iconic images of the crisis is a photo of a man distributing free masks to help protect people from inhaling ashfall.
Face masks are likely to become increasingly common as the climate crisis exacerbates wildfires and other natural disasters, as air pollution worsens in many cities, and as global connectivity heightens the risk of pandemics. As masks become more integrated into everyday life, they will continue to reveal facets of human cultures as much as they conceal our faces.