Photo by Patrick Mansell

As soon as this is over…

Stop washing your hands

After SARS, Hong Kong turned into one big hospital, with hand sanitizer everywhere. Now Covid-19 might push the world to follow suit. Bad idea, says Nadine Voelkner: viruses are not our enemy. ‘It’s about living in harmony with the microbial world.’
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Door Christien Boomsma

14 April om 15:30 uur.
Laatst gewijzigd op 22 November 2020
om 16:15 uur.
Avatar photo

By Christien Boomsma

April 14 at 15:30 PM.
Last modified on November 22, 2020
at 16:15 PM.

When Nadine Voelkner went to Hong Kong in 2017, she was shocked. The international relations researcher, who specializes in political ecologies of global health, lived there from the age of four until she was eighteen and knows the city well. But upon her return, she felt her city had completely changed. 

People were wearing face masks. Free hand sanitiser was provided everywhere, from libraries to subway stations. Elevator buttons and even escalator handrails bore signs informing passers-by of regular cleaning measures and every single store was selling tiny bottles of hand gel.

What had happened? The Hong Kong she’d grown up in had always been aware of the risk of disease, as the warm, damp climate provides the perfect circumstances for infections to emerge. The millions of people packed together in the city are a perfect breeding ground for the spread of viruses. ‘But that was always just a part of living there’, she says, ‘in spite of serious, near-pandemic infections that emerged in the 1960s and 70s, like the Hong Kong flu.’ 

One big hospital

Now, however, the city resembled one big hospital. ‘People were constantly telling me to wash my hands, to disinfect.’ She laughed it off at first – ‘I felt that I grew up there, I never had to do that, so why do it now?’- but after a week or so, she found herself washing her hands just like everyone else and teaching her children to do the same. 

Children learn early on to wash their hands regularly

The event that changed everything was the 2003 SARS outbreak. This coronavirus killed almost three hundred people in the city and 774 worldwide. The government declared war on viruses in general and one of its most important strategies was to make citizens responsible. ‘They raised awareness and taught kindergarten-aged children to wash their hands regularly. There was a lot of “social cleansing” and the whole of society was made aware how to prepare for another epidemic, because the question was not whether there would be another one, but when and what kind.’

Personal protection

Smart thinking, you might say. With COVID-19 spreading practically everywhere around the world, Hong Kong has still only had four deaths. The measures that Hong Kong and similar places like Singapore or Taiwan have put in place have been copied all over the world: social distancing, personal protection, disinfection and washing, washing, washing.

Voelkner questions the Hong Kong approach, though. She fears that in the long run, it might not keep people safe, but actually weaken them. That’s why, in an article in International Political Sociology published only weeks before COVID-19 hit, she advocates for a completely different approach to virus control. One in which we see viruses not as our enemy, but as entities that we are deeply connected with and even depend on.

She wants to get one thing straight. ‘I don’t question the measures that are put in place to battle corona at this moment. Those are clearly necessary. But they’re a short-term solution.’ 


However, the constant fear of viruses and bacteria, the rigid killing off of everything that might live on or in us completely denies recent insights in science, she says. ‘It’s a very exciting, emerging field that studies our microbiome. And part of that microbiome is the virome.’  

All these creatures that live within us serve a purpose 

Just as there are many bacteria living on and in our bodies, doing all kinds of necessary things like defending the skin against other, harmful bacteria or helping us digest our food, there are many viruses doing the same thing. Together, these viruses make up our virome. ‘They infect or kill harmful bacteria, spur changes in our genetics… We are really deeply viral ourselves’, says Voelkner. ‘And all these creatures that live within us serve a purpose within the whole. If you change that balance, you’re also changing your susceptibility to certain diseases, and your response to certain medication, like antibiotics and antiviral medicine.’

She realises, of course, that there are viruses that can kill us and that epidemic surges will happen. We should fight those harmful viruses using vaccines and other treatments. ‘But it’s about living in harmony with these viruses while also knowing how to act towards those who are more virulent towards us.’


At this point, we are killing species that are vital for our own existence, she says. ‘We assume that we can battle them and kill them, but in doing so we’re contributing to increased adaptation and mutation. And we are running out of weapons. There is an increasing number of bacteria and viruses that no longer respond to some antibiotics and antivirals, like is happening with for example HIV, or influenza A.’

She wants to prompt people to start thinking differently about virus control, both socially and politically, and start thinking about long-term prevention. Because what Hong Kong is doing right now – the cleaning, the hand gel – will probably take root in many other countries after COVID-19 has been suppressed. ‘I’m really afraid that it will become the new normal.’  


To find a solution, Voelkner draws on Chinese philosophy: Daoism. Western philosophy sees reality as unchanging, which defines how we intervene in the world. ‘But Daoism sees reality as something constantly mutating and dynamic. As a consequence, even if you have a plan, it probably won’t work, because the situation has changed.’

Even if you have a plan, it probably won’t work 

Daoism also views all species and living things as being connected. ‘We’re part of a space in which everybody plays a part. If you take out one thing, you change the dynamics. For Daoist thinkers, intervention has less to do with killing things as they come along and more with how to prevent things from emerging in the first place.’ 

In this light, we should not try to kill the germs, but intervene before something like COVID-19 can emerge. ‘We need to something about our lives and the way in which the human population operates within this big world ecology.’

Microbial city

She advocates for the so-called ‘microbial city’, a kind of eco-city that focuses on ecological issues and in which architects and developers make room so our microbial world can flourish. 

Eco-cities are cities with more natural spaces, like wooded areas that make room for natural life. Children play in the dirt and people sit in the grass without feeling compelled to take out their hand sanitiser every few minutes and clean their hands. 

‘It’s also about the way we interrelate with the animal world, the way we treat cattle, eat meat’, she says. ‘We need to realise that we are all part of this bigger system.’ 

She’s no fool. She knows we are deeply connected. She knows people will keep travelling and that it is not possible to create a disease-free world. ‘There will always be a virus that will endanger the human population. But we can minimise the risk’, she believes. ‘And we need to adopt the knowledge of the natural sciences into the social world and vice versa.’

So, when all this is over… at least stop washing your hands.


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