Rosie, my mom, called me all the way from Australia recently–where she, like most of us, is thankfully following physical distancing rules. She called me up to remind me to do “tuob” or “suob” as a way to ward off a COVID-19 infection. This refers to a practice that has been trending at least in Cebu and over on social media.
Let’s try to be more mindful about this practice and discuss it. When we research on the internet, the common element in all the different tuob methods is steam and the requirement to inhale it. One method requires standing above a steaming pot of water while draping a blanket over one’s entire body and the pot. This allows the steam to fll the blanket. You inhale the steam and you get hot and sweaty in the process; yes, as though you’re in a sauna.
There’s also a version of tuob that lets you sit down and crouch over a steaming pot or basin of water, with a blanket or a tower big enough to cover your head and shoulders. Some recommend putting ginger, lemon, herbs, salt, etc. in the boiling water to be used for steaming.
Tuob trended recently because it was recommended by the Cebu Provincial Government as 1) A way to prevent a full-blown COVID-19 infection; or 2) As a remedy for mild COVID-19 symptoms. According to Cebu Governor Gwen Garcia, preventing or remedying COVID-19 at home will help keep Cebu hospitals from getting overwhelmed by COVID-19 cases.
The Provincial Health Office of Cebu already sent a memorandum “enjoining” government employees to practice tuob inside their offices. In a news feature interview, Garcia recommended other health practices along with tuob to help boost immunity against the novel coronavirus (SARS-Cov 2) that causes COVID-19.
Tuob vs COVID-19: Does it work?
Let’s point out that soon after Garcia and the health office enjoined government workers to do tuob during office hours, the Department of Health issued its own warning, telling people that: a) tuob does not kill SARS-Cov 2; b) steam inhalation may cause scalding and burns on the skin; and c) practicing tuob in groups runs the risk of spreading the virus to others.
The idea that the steam from tuob can kill the virus is supported by one doctor quoted in the earlier news feature we mentioned. Dale Pasco, who is chairman of the Matias H. Aznar College of Medicine Department of Surgery, said that he believes that SARS-Cov 2 dies “at a temperature of 27 degrees Celsius and humidity of over 40 percent.”
Pasco’s basis for this belief is, according to him, an experiment done by the U.S Department of Homeland Security (USDHS). The exact experiment Pasco refers to is not linked anywhere in the news feature (so that we can verify it) but there is one experiment discussed in the Declan Herald that was conducted by the USDHS on COVID-19.
That experiment, however, apparently does not really support Pasco’s belief. First of all, the experiment was more concerned about finding out how long the virus could survive outdoors in the sunlight. This is an experiment that would reasonably be conducted by an agency such as the USDHS, which is concerned with homeland defense: for example, in case terrorists would start spraying deadly viruses outdoors at people. Essentially, this was not an experiment on steam inhalation.
Scientifically speaking, if this is the experiment Pasco refers to, then his conclusion is not a valid one. You simply cannot apply the findings of the USDHS experiment to steam inhalation–because the experiment itself is not concerned with steam inhalation. The variables and conditions of the experiment are completely different.
Furthermore, the USDHS experiment found that when SARS-Cov 2 is exposed to environmental temperatures of “[21 to 24 degrees Celsius] with 20 percent humidity on a non-porous surface” its half-life is reduced. This means that for example, if there are 100 viruses on a steel (non-porous) surface, 50 of them will die when exposed to an ambient temperature of 21 to 24 degrees Celsius.
Good news for steam inhalation? No. That’s because in the USDHS experiment, it took 18 hours of exposure to 21 to 24 degrees Celsius for half of the viruses to die. And even if half the viruses died, there’s still the other half that can infect you.
Also, if you are to apply these findings to steam inhalation, then maybe you’d have to do tuob for 18 hours straight! And then after 18 hours, only 50 percent of the viruses are dead. So what then? Tuob again for 18 hours more? Thirty-six hours of tuob–good luck.
Burns and viral spread
Water boils at 100 degrees Celsius, and the steam rising from the boiling surface is roughly, or a bit hotter than that. Such temperatures are enough to cause serious burns that require surgery. According to the American Burn Association, human skin can start to burn at 48 degrees Celsius. However, the burns do not happen right away; it takes about five minutes before skin starts burning.
At higher temperatures, skin burns more quickly. When exposed to 68 degrees Celsius, skin burns in just one second. Now imagine exposing skin to 100 degrees Celsius. But wait, I have done tuob many times and have not burned myself–well, that’s because I’m careful when I do it.
Steam from tuob is hottest at the surface of the water; as the steam rises, it gets cooler because it mixes with the unheated air above. So what you do is position your face so that you can inhale the steam from a height where the steam still feels warm or slightly hot.
However, the longer the steam hits your face, the greater risk of getting burned, so you simply have to pull your face away when it gets too hot. It takes getting used to and yes, if you make a mistake you can burn your face or at least just your nose.
Will steam from tuob kill the COVID-19 virus? According to the World Health Organization, SARS-Cov 2 dies at 56 degrees Celsius (much higher than the 27 degrees mentioned by Dr. Pasco). That’s still higher than 48 degrees Celsius required to burn your skin after five minutes. You might burn your face first during tuob before you can kill the virus.
Another serious concern is whether tuob can help spread the COVID-19 virus. Experiments have shown that SARS-Cov 2 is not spread so widely over the air as the measles virus, which can stay in the air, dangerously infectious, for hours and hours. However, certain conditions can make it travel through the air and potentially infect someone. These conditions include:
- Coughing and sneezing
- Speaking, especially speaking loudly
- Breathing heavily (when doing strenuous activity especially indoors)
- Breathing too closely to someone (if you don’t stay at least 1 meter apart)
- Not wearing a mask
During tuob, the steam will trigger our nasal cavities to produce more secretions. These secretions can potentially make us cough or sneeze. Imagine doing tuob in the office and you start coughing and sneezing, and it turns out you are Covid-infected; that would really make your co-workers love you.
So should you do tuob? Yes! If you have a cough or cold symptoms, tuob can bring you great relief and help you recover. However, there’s no solid evidence that it will prevent or cure COVID-19. If you do tuob, better do it in your own house and have everyone else keep their distance while you’re at it.