When I was starting out in my career, back in the last century, an advertising campaign for Lemsip was running on public transport. “What sort of person goes to work with the flu?” asked the posters, with the take-no-prisoners answer, “The person after your job. Stop snivelling and get back to work.”
That time now feels like ancient history – an era when even those of us with comfortable, keyboard-bound jobs couldn’t work remotely even if we didn’t have hard-as-nails jobseekers biting at our heels. Back then, I was one of those people who would go to work with a cold. I thought it showed grit and determination. Soon afterwards I sat next to a colleague who had cystic fibrosis, and it belatedly dawned on me that I wasn’t so indispensable as to have to risk other people’s health. Two decades later, the Covid-19 pandemic made sure everyone knew that. There’s nothing like watching deaths from an airborne respiratory illness climb to more than a thousand a day to ram home the message about keeping your germs to yourself.
Now, though, that trend seems to have reversed. We’re currently at the height of the colds and flu season, and a fellow commuter openly sneezed at me yesterday. She looked up from her phone, held it at arm’s length and did a huge “atichoo!” right into my face. Just before Christmas, I was shouted at for wearing a mask on the London Underground. “It’s people like you who are fucking us all over,” said a woman on the Piccadilly line. “Slave to the government! Sheep!”
In the week running up to Christmas there were 942 patients with flu in hospital in England each day, and 3,631 in hospital with Covid-19 over Christmas week – the latter up 57% from the same point in November. Cases of norovirus were also up 61% from the same period last year. This was all on my mind as I sat on a packed train for two and a half hours next to a man who repeatedly wiped his nose on the palm of his hand and then on to the table. It wasn’t deadly – at least, it wasn’t for me – but it was gross.
What people seemed to understand before Covid, but seem reluctant to accept now, is that coughing and sneezing in public without covering your mouth is – at the very least – really bad manners. Have we been so traumatised by enforced mask wearing and staying indoors that we can’t bear to carry the burden of responsibility any longer? Has the availability of LFTs convinced us that a cough that hasn’t tested positive as Covid doesn’t count? Or is it from the sheer joy of being alive that some people so bountifully share their snot with their fellow travellers? It seems particularly obtuse when protecting others is so easy. If people really must go to work with a cold (and some people must), they can at least sneeze into their elbow, or a tissue, or anywhere that isn’t someone’s face.
According to Adrian Martineau, professor of respiratory infection and immunity at Queen Mary University of London, such simple precautions do work. There is good evidence that hand-washing reduces the risk of influenza infection, for instance. His other top tips for avoiding spreading colds, flu and Covid-19 this winter are: getting flu and Covid-19 jabs if you are eligible; working from home and reducing social contact if you have respiratory infection symptoms – especially if you may be in contact with someone who is particularly vulnerable; and wearing a face mask.
Trish Greenhalgh, professor of primary healthcare sciences at the University of Oxford, adds that the best evidence shows that masks work to reduce transmission of all respiratory pathogens – flu, measles, TB, Covid and even the common cold. Of course, they only work when worn, and worn properly. “This sounds silly, but some of the controversy about masks stems from studies where people were advised to wear masks but few actually did,” she said.
I’m still quite blase about catching a cold myself; despite starting my career in the 1990s I’m relatively young and healthy, and a week of nose-blowing won’t kill me. But the people I want to spend Christmases with are clinically vulnerable: one family member has pulmonary fibrosis; another has to take immunosuppressant medication. If I passed on an infection that sent them to hospital, could I forgive myself? And, if you gave me that infection in the first place, do you think I would ever forgive you?
My parents remind me that when they were young, adverts and public health campaigns carried the information: “Coughs and sneezes spread diseases. Trap the germs in your handkerchief.” I wish we could go back to the public-spirited hygiene messages of the 1940s or 2020, and not be stuck with the revolting sneeze-sharing of the 1990s and now.
Katy Guest is a Guardian Opinion deputy editor
