SINGAPORE, Feb 7 — In some households, Chinese New Year celebrations can be boisterous, but under the shadow of Covid-19, Dr Leong Hoe Nam will be doing a “very quiet” one this year.
The infectious diseases specialist who practises at Mount Elizabeth Novena Hospital said that he will scale back home visits by limiting them to his parents and in-laws, and stick to small gatherings with just one or two relatives.
“I will use the time to chill and reflect on how kind God has been to us (so far during the pandemic). Life could be very different,” he said, referring to the coronavirus situations in other countries in the region.
With the Covid-19 pandemic claiming more than two million lives worldwide to date, the usual traditions will look different this year as Chinese households usher in the Year of the Ox on Feb 12.
After a period where there were no transmissions within the community, Singapore saw an increase in the number of community cases last month, some of which had no known source of infection and resulted in clusters.
To further mitigate the risk of large community clusters, the Ministry of Health released new rulings last month. Among them was that each household should only receive up to eight visitors a day and people should visit at most two households a day.
People dining out have to do away with the usual noisy tradition of shouting auspicious phrases during lohei — the tossing of yusheng or raw fish salad — and replace it with a silent version while remaining masked up.
Of course, there may not be enough people patrolling and enforcing these rules and when no one is watching, some habits may be hard to break.
Explaining why some people find it challenging to adhere to the restrictions during the festive season despite the potential risks of infection, sociologist Tan Ern Ser from the National University of Singapore (NUS) said that people are creatures of habits and tend to choose to live what they consider to be a “normal life”.
“When caught up in the excitement of festivities among people they know, they are likely to throw caution to the wind,” Associate Professor Tan said.
Besides, there is a low probability of being caught not keeping a safe distance, especially in the privacy of a private residence, so people may not adhere to the rules, he added.
To help families stay safe this period, the experts suggest applying a few other good practices at home and when visiting relatives.
1. No air-conditioning, keep your home well-ventilated
Keep your windows open during house visits, Dr Leong advised. Doing so makes it less conducive for the coronavirus to thrive in places with stagnant air.
For people who can, Dr Leong advised holding family gatherings outdoors. While the evidence shows that the Sars-CoV-2 virus, which causes Covid-19, can be transmitted in all areas and types of weather, higher heat and humidity is thought to slow its spread — unless no one practises safe distancing.
“Within the house, you can keep the 1m to 2m physical distancing. We are already used to it while queuing up and in supermarkets, what harm is there in doing a bit more?” Dr Leong asked.
He added that those with family members who have just returned from overseas should be even more vigilant in adhering to physical distancing since the last few positive cases were individuals in whom the virus incubated for more than 14 days.
2. The mask should stay on
Restrain yourself and try not to shout “pohng” at the mahjong table when you have three tiles of the same suit and number.
When engaging in hearty bantering over a meal or games session, Dr Leong said to mind plosive words that start with P and B because they spread the virus better than those starting with other consonants.
A study by researchers from Princeton University in the United States found — through experiments and simulations — that air emitted during the use of such plosive words leads to significant transport of the virus.
This highlights the importance of masking up even during house visits.
“Remember, the virus is adapting. Many individuals who acquire the disease now are asymptomatic,” Dr Leong warned.
“When you need to speak, wear a mask before speaking. The mask comes down when you eat or drink but it goes back up when your cup’s bottom is down (on the table).”
If the person sitting next to you is eating, remain masked up because this will protect him, he added.
Dr Leong does not think that families need to do away with the usual traditions of games, but said that there should be safety rules and everyone must adhere to them:
● People feeling unwell should not be playing or even visiting their relatives
● Wear a mask at all times
● If you need to drink, eat or touch your face during or after the session, wash your hands thoroughly. Have alcohol-based sanitisers on standby
Another word of caution from Dr Leong: If you think that it is safer to play under ultraviolet light as a means to decontaminate surfaces, you will regret it.
“It’s a sure way of growing cataracts in your eyes,” he said.
Ultraviolet light sterilisers can be a danger when used improperly, and there is insufficient published data to show that those marketed for home use are fully effective in eliminating viruses in the home and casual settings.
3. Consider the bubble approach
One expert recognised that it would be impossible to maintain a perfect track record of masking up all the time due to the human need to connect and socialise.
In an email interview with TODAY, infectious diseases expert John O’Horo from the Mayo Clinic in Minnesota, US, suggested using a “social bubble” approach.
This means that you maintain a small and selected group of people with whom you can “let down” your guard and vice versa.
“Most people, whether they realise it or not, have a bubble in their household as few people mask up around their immediate family. A social bubble extends that concept to include other (selected) households,” he explained.
When an infection occurs to one member in the bubble, the entire bubble is at risk. However, Dr O’Horo said that this will allow better awareness and more effective self-isolation should an infection occur.
He emphasised that this only works if it is a “closed bubble” and everyone in the group has a common understanding of safety measures and expectations to disclose symptoms and potential exposures honestly.
Referring to Singapore’s recent tightened measures for the Chinese New Year period, Dr O’Horo said: “If you visit two households one day, and each of those (households) visit two different houses the next and so forth, this can create a chain for transmission.
“The bubble of only visiting a defined group of family members can limit the amount of spread.
“While people within the bubble may not mask up around one another, the wearing of masks when interacting with others (outside the bubble) is important. If you are not certain that everyone in your bubble is doing everything to keep you safe, they should not be in your bubble.”
4. Keep up hygiene when serving food, giving money and oranges
Even without a pandemic, communal-style dining practices such as the sharing of food and double-dipping are a source of germ transfer.
With the Sars-CoV-2 lurking around, it is best to use serving tongs or cutlery and retire your communal serving plates. For people who are extra cautious, clean the tongs or cutlery after each use.
“Separate (and scoop) the food onto each individual’s plates. Once the food lands on the plate, finish it. Share the food, not the virus,” Dr Leong said.
This applies to snacks typically served on a common platter. They should be covered and there should be separate serving spoons or cutlery when there is a need to refill plates.
Technically, the virus can survive on inanimate objects and pass from person to person, although money has been changing hands freely all this while with few links to Covid-19 transmission, Dr Leong said.
Wash or sanitise your hands thoroughly before packing and giving out money in red packets or hongbao, or consider digital hongbao as a safer and more environment-friendly option this year.
The same rule should apply when giving out mandarin oranges.
5. Lay down the ground rules
Assoc Prof Tan from NUS said that society is made up of a complex web of social networks, so having closed groups (such as the bubble approach) may be a neat solution conceptually, but it can be hard to put into practice.
Despite one’s best efforts, there may still always be that one or two relatives or friends who are not on the same page on what is safe or not.
A practical approach would be to make sure the precautionary measures are in place.
Stepping up on enforcement may not be a practical solution, Assoc Prof Tan said.
“My view is that we should keep emphasising (via media) that it is still possible to live a (somewhat) ‘normal’ life but with new helpful habits like stepping up on personal hygiene, masking up and practising safe distancing. Since people have acquired these new habits, they should try not to backslide to their old ways.
“Another important theme is to emphasise that backsliding could mean a return to lockdowns, pay cuts and job losses,” he said.
To avoid unpleasant incidents and social minefields during the festive celebrations, Assoc Prof Tan advised setting ground rules at the start of the event or gathering. Consider assigning some young family members to “police” the rules.
“This may help enhance compliance among the young and ensure older members toe the line for fear of being shamed by the younger members for not showing a good example,” he said.
Dr Leong reminds people who have received their Covid-19 vaccine that there is no room for them to relax either. To date, more than 150,000 people have received the first of two doses of the vaccine.
While vaccination is effective in preventing a serious or life-threatening infection, its efficacy for the asymptomatic or milder form of the illness is poorer, he said.
“If these individuals relax, they are putting their loved ones at risk.” — TODAY
