Hugs and Corona Virus

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Hugs and Corona Virus
Doctors by doing physical examination-tender 
touch, soothing words and empathy transfers
sense of tranquility in the patients
Prof. Emeritus Lt. Gen. Mahmud Ahmad Akhtar
Former Surgeon General/DG Pak Armed Forces

Hug is an important way to express emotions. Hugs are given to express love, bonding, sympathies, happiness etc. On ceremonial days like Eid people exchange hugs to express happiness. Sometimes while hugging they start crying or screaming on unhappy, sad moments which takes more time. This could also be hazardous, and can transmit infections/pathogens.

Hug is practiced all over the world in different cultures and in different ways. A new born is immediately placed over the mother’s chest for bonding. Hugging produces oxytocin also called love hormone which causes bonding.

In this era of social distancing and depressing news, a hug could be soothing-helpful. There have been recent studies on the mechanism of the hug and the correct and safe way to hug. A team from Japan’s Taho University measured the calming effect of hugs of different pressures and when given by strangers compared to the parents. By monitoring the heart rates of the infants and using pressure sensors on the adult’s hands, the researchers assessed each baby’s reaction to just being held, a hug with medium pressure and in a tight hug. According to the results, published in the Journal Cell, babies were soothed more by a medium pressure hug than by just being held but the calming effect decreased during a tight hug. The researchers kept the length of the hug to 20 Seconds as it was almost impossible to avoid infant’s bad mood during a one minute or a longer hug, they concluded in their paper. Unsurprisingly the calmer effect was greater when receiving a hug from a parent than from a female stranger. So the perfect hug is considered to be medium pressure. Parents also exhibited significant signs while hugging their children. Some people have the habit of deep uncomfortable rather painful pressure of hugging and hand shaking. They should be made aware of its harmful effects.


Lt. Gen. (R) Mahmud Ahmad Akhtar

In the present Quarantine, social distancing, not only do we miss hugs, we need them. Physical affection reduces stress by influencing our sympathetic nervous system, which during times of worry releases damaging stress hormones into our body. In one series of studies, just holding hands with a loved one reduces the distress of a sad episode. Doctors by doing physical examination-tender touch, soothing words and empathy transfers sense of tranquility in the patients.

Holding an old lady’s hand creates a lot of soothing effect. These have healing effects. Necessary qualities for a doctor to acquire and practice- called ‘human touch’. Humans have pathways that are specifically dedicated to detecting affectionate touch. Affectionate touch is how our biological systems communicate to one another that we are safe, that we are loved and that we are not alone.

To learn the safest way to hug during the viral outbreak, Linsey Marr, an aerosol scientist at Virginia Tech and one of the World’s leading experts on airborne disease transmission explained about the risk of viral exposure during a hug. Based on mathematical models from Hong Kong study that shows how respiratory viruses travel during close contact. Dr Marr calculated that the risk of exposure during a brief hug can be surprisingly low, even if you hugged a person who was unaware of being infected and who happened to cough.

“We don’t know how many infectious viruses it takes to make you sick — probably more than one,” said Dr. Marr. “If you don’t talk or cough while hugging, the risk should be very low.” Here’s why. We don’t know the exact dose required for the new coronavirus to make you sick, but estimates range from 200 to 1,000 copies of the virus. An average cough might carry anywhere from 5,000 to 10,000 viruses, but most of the splatter lands on the ground or nearby surfaces. When people are in close contact, typically only about two percent of the liquid in the cough — or about 100 to 200 viruses — would be inhaled by or splashed on a person nearby. But only one percent of those stray particles — just one or two viruses — actually will be infectious.

There is a tremendous variability in how much virus a person sheds, so the safest thing is to avoid hugs but if you need a hug, take precautions. Wear a mask. Do not hug someone who is coughing or has other symptoms and remember some hugs are riskier. Older persons beyond the age of 60 have lower immunity, therefore more susceptibility to infections and complications.

It is important to point faces in the opposite direction. Do not talk or cough while hugging and do it quickly. When done, do not linger, back away so that you do not breathe into each other’s face. Wash your hands afterwards. Try not to cry. Tears and runny nose increase the risk of coming into contact with more fluids that contain the virus.

There is a real challenge for the older people who worry that they would not be able to touch or connect with family for the rest of their lives keeping hugs brief is particularly important because the risk of transmission increases with more prolonged hug. The prolonged hug is also uncomfortable. Here are the dos and don’ts of hugging based on the advice of Dr. Marr and other experts.

Do not hug face to face: When a shorter person hugs a little taller, looks up the exhaled air because of its warmth and buoyancy travels up into taller person’s face who is looking down, there is opportunity for the huggers exhaled and inhaled breaths to mingle.

Skip cheek to cheek too: This position with both huggers looking in the same direction which makes you directly breathe each other’s exhaled particles, wear a mask.

Face in opposite direction: For a safe full body hug turn face in opposite direction which prevents you from directly breathing each other’s exhaled particles, wear a mask.

Let the children hug your waist: Hugging at knee or waist level lowers the risk for direct exposure to droplets and aerosols because faces are far apart. There is potential for the child’s face and mask to contaminate the clothes. Consider changing clothes and wash hands after a visit that includes hugs. The adult should also look away, so as not to breathe down on the child.

Touch/kiss only the back of the heads: In this scenario, the adult is minimally exposed to the child’s exhaled breath. The child could be exposed to taller person’s breath so kiss through a mask. Hold your breath- important precaution.

Most hugs last less than 10 Seconds, one should be able to manage this. Then back away to at least two meters separation before talking again to allow them to catch their breath at a safe distance. Holding breath stops exhaling any virus into their breathing space, if you are unknowingly infected- and stops you from inhaling any virus from them.

Yuguo Li, a university of Hong Kong engineering professor said that “hugs probably pose less risk than a longer face to face conversation”. “The exposure time is short unlike conversation which can be as long as we like” he said “But no cheek kissing”. Dr. Li said the risk of viral exposure may be highest at the start of the hug. When two people approach each other and could breathe on each other and at the end, when they pull part wearing a mask is important, as is hand washing because there is a low risk of picking up the virus from another person’s hands, skin or clothes. The risk of a quick hug with precautions is very low but not zero, people should choose their hugs wisely. Marie Kondo approach “The hug has to spark joy”. During the last Eid people did not take precautions to prevent the spread of Covid-19. There was a huge surge in Corona virus infection.

During festive occasions like Eid there is need to take strict precautions to contain the pandemic. Use of masks, maintaining social distance, frequent washing of hands should be done with perfection. Hugging is done as a part of Eid Celebration. It would be prudent not to hug. If hugging is done it should be done by taking all precautions mentioned in the write up. Already there is a wave of fresh cases. Every endeavor should be undertaken to avoid further surge in Covid 19 Cases. The media (all types) must advocate people now to be careful about wild hugs, prolonged hugs, face to face hugs, speaking hugs, coughing hugs, sneezing hugs and crying hugs on Eid ul Azha to mitigate spread of Corona Virus in the masses.