Steam inhalation (tuob) and COVID-19 in the Philippines

By Hanna Trexie V. Tinio

(The author is a fourth year BA Sociology-Psychology student of UP Visayas)

COVID-19 and traditional medicine

When the Coronavirus disease 2019 (COVID-19) started with its first suspected case last January 2020 here in the Philippines, different agencies of the government reacted by imposing several measures such as usage of face masks and face shields, community quarantine, class suspensions, and travel restrictions (Armero et al., 2021). However, the said measures were not enough to contain the virus. The measures are said to be palliative, and people tend to ignore them after a few days of isolation, mainly done by those disadvantaged and vulnerable communities which could not function without daily income (Silveira et al., 2020). Soon enough, the health care resources here in our country, such as its facilities and equipment, exceeded its capacity due to the overwhelming amount of patients that were rushed every day. Thus, due to the lack of hospital beds, lack of health care supplies, and the overly expensive cost of COVID-19 treatment in hospitals, Filipinos infected with the virus choose to stay at home and turn to alternative treatments.

Common symptoms of COVID-19 were also alike the common symptoms for flu such as dry coughing, fever, and fatigue. Hence, people were quick to turn to traditional medicine, such as the use of herbs, as treatment to the symptoms of the virus. But then, one of the most headlined traditional medicine treatment that caused a ruckus on the different social media platforms last year was the alleged usage of steam inhalation or tuob to cure the COVID-19 patients.

Steam Inhalation

Steam inhalation, better known as tuob here in the Philippines, has long been used as a traditional home remedy and adjunct in the treatment of a number of respiratory conditions (Aro et al., 2020). According to Namoto (2020), this healing tradition was first documented in the 16th century at the start of the Spanish colonization and this traditional Filipino medicine takes a holistic view of the individual, including environmental factors that affect a person’s physical, mental, emotional, and spiritual well-being. To perform the tuob, it involves the sick person to be wrapped in a blanket or cloth, sitting over a jar heated by coal, or hovering above a steaming pot and is rubbed with essential oils. Such treatment is said to have several benefits such as detoxification, cleansing the skin, muscle relaxation, increasing body metabolism, boosting the immune system, keeping mucous membranes from drying, and relieving comfort from asthma, allergies, and arthritis (Namoto, 2020)

On June 2020, Cebu Governor Gwendolyn Garcia made headlines when she claimed that tuob, which she further explained as the practice of inhaling steam from a basin of infused water while covering one’s head, is a cure or medication for COVID-19. In her Facebook live, knowing that the common symptoms for the virus was fever and cough, she claimed that “Sometimes for flu, you just drink paracetamol, because there is already a medicine for flu, there is already a vaccine. So, there’s already a medicine for COVID-19, tuob”. She also repeatedly promoted the practice of tuob in her several videos uploaded on her Facebook page. Adding to that, she also signed a memo in her office to include tuob as part of a wellness program for the provincial government employees in Cebu (Rappler, 2020). Reportedly her office spent 2.5 million pesos worth of steam inhalation kits and was set to institutionalize steam inhalation within the province. And this was done despite several forewarnings from the local medical societies and the Department of Health (Armero et al., 2021)

Tuob has said to have helped some Filipinos who have been infected with the virus before. Several reports said that an overseas Filipino worker got cured from COVID-19 and with the use of the steam inhalation, it helped her cope with the respiratory symptoms of the virus. Also, a couple vlogger claimed and shared on their social media that tuob, indeed, also helped them alleviate their symptoms and helped them cure from the virus (Malasig, 2021). However, even with these claims, neither the World Health Organization (WHO) nor the Department of Health recommend this treatment for preventing COVID-19.

According to DOH, Tuob does not kill SARS-CoV-2, the virus that causes COVID-19. DOH Undersecretary Maria Rosario Vergeire also said that there is no scientific evidence that proves that steam inhalation or inhaling steam with salt, lemon, and other ingredients, can kill the virus that causes the disease COVID-19. She also added that the practice may cause accidents like burning of the skin. The World Health Organization also released a statement that says “While some western, traditional, or home remedies may provide comfort and alleviate symptoms of mild COVID-19, there are no medicines that have been shown to prevent or cure the disease. WHO does not recommend self-medication with any medicines, including antibiotics, as a prevention or cure for COVID-19” (Rappler, 2020).

Several doctors also further explained why steam inhalation or tuob is not a cure for the virus. Dr. Earl Louis Sempio, a pulmonologist and biochemist, said that while doctors understand that tuob can provide relief to nasal congestion, it shouldn’t be considered as a specific treatment for COVID-19 since it does not directly kill the virus. He added that camphor or menthol, which are ingredients that some people infuse in the steam inhalation treatment mixture, can trigger the excretion of mucus or even inflammation if inhaled in excess (Malasig, 2021). But even with the statements from the WHO and DOH, a lot of people still do tuob when they show symptoms of the virus such as coughing and cold because of the limited access to conventional and modern medicine, because it is affordable and for some, because they find this health care alternative to be more congruent with their own tradition, values, and beliefs toward health and life.

Summary and Conclusion

Philippines is one of the countries that has a weak healthcare system which can be seen from how the government responded to the ongoing pandemic. Also, the country is known to have a diverse culture that have strong beliefs in traditional medicine, even choosing these over scientifically sound treatment options. Due to these reasons, we cannot blame the Filipinos as to why they turn to traditional medicine, specifically tuob, for the treatment of the said COVID-19 symptoms.

However we must note that scientific studies have proven that the risks of using steam inhalation or tuob as a treatment for COVID-19 outweigh its benefits (Baartmans et al., 2012 & Belmonte et al., 2015). While steam inhalation alleviates the symptoms of nasal congestion, physicians have stressed that it is definitely not a cure nor it does not address the virus that caused it.

Hence, steam inhalation or tuob is not an alternative nor a complementary medicine to address COVID-19. Tuob is mainly a remedy to the symptoms but is also not recommended by physicians because patients did not undergo the diagnosis and treatment of professional doctors in line with the modern medicine that we know today. Thus, when it comes to addressing medical concerns especially in these times of pandemic, we should seek a health professional’s opinion because they know better on how to address the virus.

Lastly, it is important to understand that although many herbal or treatments come from natural sources, ‘natural’ does not always mean that a product is a safer or better option for our health (National Center for Complementary and Integrative Health, 2021)

References

Armero, M., Belotindos, J., Dalanon, J., Delos Reyes, C., Fabillar, J., Locsin, R., Matsuka, Y., Okura, K., Redoble, R., Suzuki, Y. (2021). Adequate knowledge of COVID-19 impacts good practices amongst health profession students in the Philippines. Retrieved from https://www.biorxiv.org/content/10.1101/2021.02.18.431919v1.full.pdf

Aro, S., Aro, S., Uy, E., Uy, T. (2020). Should steam inhalation be used in the treatment and prevention of COVID-19?. Retrieved from https://www.psmid.org/wp-content/uploads/2020/07/Steam-Inhalation-for-COVID-Full-Report-14JUL2020-V1-TU-MM-SA-EU-LFD.pdf

Baartmans, M., Kerkhof, E., Vloemans, J., Dokter, J., Nijman, S., Tibboel, D., & Nieuwenhuis, M. (2012). Steam inhalation therapy: severe scalds as an adverse side effect. British Journal of General Practice, 62(600), e473–e477. doi:10.3399/bjgp12x652337

Belmonte, J. A., Domínguez-Sampedro, P., Pérez, E., Suelves, J. M., & Collado, J. M. (2015). Severe burns related to steam inhalation therapy. Anales de Pediatría (English Edition), 82(2), 95–99. doi:10.1016/j.anpede.2014.03.002

LeQuang, J., Magnusson, P., Pergolizzi, J., Varrassi, G. (2021). Traditional, Complementary and Integrative Medicine Approaches to COVID-19: A Narrative Review. Retrieved from http://www.lidsen.com/journals/icm/icm-06-03-021

Malasig, J. (2021). ‘Tuob’ as cure or prevention vs COVID-19? Here’s what health experts are saying. Retrieved from https://interaksyon.philstar.com/trends-spotlights/2021/04/12/189423/tuob-as-cure-or-prevention-vs-covid-19-heres-what-health-experts-are-saying/

Namoto, S. (2020). Indigenous Filipino Healing Practices. Retrieved from https://coldteacollective.com/indigenous-filipino-healing-practices/

National Center for Complementary and Integrative Health (2021). In the News: COVID-19 and “Alternative” Treatments. Retrieved from https://www.nccih.nih.gov/health/in-the-news-covid-19-and-alternative-treatments

Rappler (2020). FALSE: Tuob is a cure for COVID-19. Retrieved from https://www.rappler.com/newsbreak/fact-check/tuob-cure-covid-19

San Juan, R. (2020). Doctor warns against steam inhalation as COVID-19 treatment. Retrieved from https://www.philstar.com/lifestyle/health-and-family/2020/12/01/2060714/doctor-warns-against-steam-inhalation-covid-19-treatment

Silveira, D., Prieto-Garcia, J. M., Boylan, F., Estrada, O., Fonseca-Bazzo, Y. M., Jamal, C. M., … Heinrich, M. (2020). COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy? Frontiers in Pharmacology, 11. doi:10.3389/fphar.2020.581840