So with yes/no questions, a 5: Tie indicates something inconclusive about the question or outlook, and worsens your character’s situation somehow.
Harm is a separate, abstracted thing. (Also it’s possibly hard to see the words in this section). Essentially if bad stuff happens to your character and it makes sense in context, you can decide they suffer a point harm. Or you can ask a yes/no question to decide if they suffer harm.
If they get to 5 points of harm, they perish. Your fingers on one hand are a good way to keep track of this.