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7 dangerous myths about the COVID-19 coronavirus pandemic

Robert Pearl, MD
Conditions
March 20, 2020
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The coronavirus (COVID-19) is the single-most important topic on the minds of Americans, and it remains the subject of regular updates from health officials. And yet, despite the abundance of scientific facts and guidance surrounding the disease, misinformation abounds as confusion persists.

Avoiding many of the worst consequences and doomsday predictions will depend, in part, on the ability of Americans to act according to the facts. This article outlines and dispels seven of the most dangerous myths that remain about the coronavirus.

1. The coronavirus is comparable to seasonal influenza 

In a March 9 tweet, President Donald Trump compared the death total of COVID-19 to that of the seasonal flu.

So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on. At this moment there are 546 confirmed cases of CoronaVirus, with 22 deaths. Think about that!

— Donald J. Trump (@realDonaldTrump) March 9, 2020

As we now know, the coronavirus is far more lethal than the president first indicated. According to the best available estimates, the disease could cause hundreds of thousands of deaths.

Trump’s tweet was intended to downplay the threat of the coronavirus, but he nevertheless shined a light on an important contradiction: The American public routinely overlooks the threat of seasonal flu, even though it infects millions and kills tens of thousands each year.

Unlike COVID-19, seasonal influenza has never caused stock-market volatility, never grounded air travel, and never disrupted the nation’s news cycle. In fact, Americans pay so little attention to seasonal influenza that 45% of U.S. adults don’t even bother to get an annual flu shot.

2. Social distancing doesn’t apply to young and healthy Americans

Not long after the Centers for Disease Control and Prevention (CDC) recommended canceling all “mass gatherings” of 50 or more people on March 15, the Trump administration went a step further, suggesting everyone avoid congregating in groups larger than 10.

Both messages fell on selectively deaf ears. In Chicago, New York City, and other urban hubs, restaurants, and nightclubs overflowed with people in their twenties and thirties just the night before statewide closures took effect. Meanwhile, chopper footage over Clearwater Beach in Florida this week showed spring-breakers packed elbow to elbow along the waterfront.

It’s a statistical fact that young people are less likely to die from the coronavirus. Global mortality figures confirm that the elderly are at greatest risk, along with those who have multiple chronic conditions, including diabetes and heart disease.

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However, the problem with ignoring public-health guidance is this: Everyone is a potential source of infection. When younger people catch the disease, they probably won’t die from it, but they can easily transmit it to vulnerable populations. That means all of us need to maintain social distancing (of at least six feet) and avoid mass gatherings.

3. The problem will go away as soon as we have a vaccine 

In the 2011 box-office hit Contagion, a scientist helps end the global epidemic in a matter of weeks thanks to the speedy development of a new vaccine. That timeline is pure fiction.

This week, U.S. researchers administered the first test shots of an experimental coronavirus vaccine, an important first step. But even if tests prove effective early on, the vaccine must undergo several rounds of safety verification before production can begin.

Dr. Anthony Fauci, a leading expert on infectious diseases, estimates the vaccine won’t be available for widespread commercial use for another 12 to 18 months. That won’t help curb the current health threat, though it could spare us the next round in 2021.

4. People don’t need to be tested unless they’re very sick 

Early this week, the White House task force confirmed coronavirus testing had ramped up. As of this morning, an estimated 82,000 tests have been completed thanks to new commercial technologies that enable “drive-thru” testing and processing within hours, not days.

But aggressive testing should have happened in the United States over a month ago. Instead, faulty kits and burdensome regulations hampered public health efforts and set back the nation’s coronavirus response. Nearly two months after the first COVID-19 case was confirmed in the United States, fewer than 10,000 tests had been completed on American soil.

By comparison, South Korea has been testing 10,000 people per day since late February, despite having a population one-sixth the size of the United States (and discovering its first coronavirus case around the same time we did).

Universal testing of every American who may have COVID-19 is important for three reasons.

First, testing helps people protect others around them. Individuals with the virus must self-quarantine to avoid further spreading the disease to family members and friends. And the only way for people to be certain they don’t have COVID-19 is through aggressive and accurate testing as soon as they experience a sore throat, runny nose, and fever.

Second, testing can help prevent a national disaster. Some nations that have tested aggressively managed to slow the growth of new cases. Others, like Italy, were too late to the table and saw hospitals quickly overwhelmed with patients. The experience of other nations teaches us that reliable testing and immediate results tracking are vital for identifying outbreaks and limiting surges of patients who require simultaneous ICU care.

Finally, expedited testing helps hospitals and health officials get ahead of the problem. Whereas statistics on hospitalization and death rates are retrospective (telling us what the problem looked like two or three weeks ago), results of COVID-19 testing can help medical responders understand the breadth and severity of the problem in real-time.

Impossible as it is to believe, scientists still aren’t sure how deadly this disease is—now more than two months into the global pandemic. The estimated mortality (case-fatality risk) ranges from less than 0.5% to upwards of 4%. Without knowing the exact percentage of infected people who will require inpatient treatment, hospitals can’t project staffing or prepare to meet the needs of patients with non-emergent problems.

5. With the right actions, the virus can be quickly contained 

Without a vaccine, the second-best way to end a viral pandemic is through containment. This method requires immediate identification of all new cases early in the process (when total numbers are low) so that infected persons and their recent contacts can be quarantined.

Our nation successfully deployed this strategy to corral two other strains of the coronavirus: SARS in 2003 and MERS in 2015. It’s also how officials in Hong Kong and Singapore are successfully managing the COVID-19 problem today.

In the U.S., however, that opportunity is long gone. Already, there are more than 7,000 confirmed cases with the actual number of infected persons estimated to be five to 10 times higher. It is therefore impossible for U.S. health officials to identify and isolate all potentially infected individuals—who now likely number in the hundreds of thousands.

Had the CDC provided enough test kits—or had the government allowed private laboratories to distribute them—back in early February, health officials could have, theoretically, pursued containment.

But now, recognizing the impossibility of it, California announced it would no longer trace or quarantine people exposed to the virus.

The lone approach that offers hope now is trying to slow the spread of the disease so as reduce the total number of people infected at any one time. The now-ubiquitous “flattening the curve” graph is part of an effort to slow the rate of infection so as to avoid a rush on critical-care units. A flattened curve could help ensure there are enough beds, respirators, and health care professionals available for coronavirus patients who go on to develop pneumonia.

If worst-case estimates come true—and 160 million to 214 million Americans become infected—the only way to manage hospital demand will be to spread out the infection timetable across six months rather than one or two. Even though this curve-flattening approach would prolong school and restaurant closures, it’s our nation’s best hope for saving lives.

That’s why all people should adhere to recommendations from the CDC, World Health Organization (WHO), and local health departments, even if they are unlikely to need a critical care bed, themselves.

6. Doctors and nurses are adequately protected from COVID-19 

All clinicians need to be protected from the coronavirus and its harmful effects. Right now, they’re not.

An unimaginable situation is playing out in medical facilities across the country. Doctors and nurses are running out of the protective (N95) masks they need to greatly lessen the chances of being infected by COVID-19. For about the cost of running an ICU for one day, every hospital in the country could have purchased and stockpiled an ample supply of masks. They didn’t, and now many physicians and nurses must work at an unnecessarily heightened risk.

When health care workers are at risk, so are their patients. Much has been made about the shortage of supplies, ventilators, and space. But hospitals can always convert their cafeterias into treatment areas or set up tents to house critically ill patients. And while some U.S. cities might have an insufficient supply of ventilators, as is the case in Italy, manufacturers can ramp up production in a relatively short time period.

Training highly skilled doctors and nurses, however, takes years. Without them, the beds and machines add limited value. When clinicians become ill, they remain contagious for up to 14 days. If we combine many more patients with fewer staff, our nation’s medical care challenges will increase dramatically.

7. When scientists say “we don’t know …” it means things are worse than we thought 

The first cases of COVID-19 were reported to the WHO less than three months ago. As a result, there’s still a lot we don’t know about the biology of this virus.

Scientists can’t be sure whether its intensity will diminish once the weather gets warm. They don’t know for certain how fast it will mutate, although early evidence suggests it lags behind other viruses. And they don’t fully understand why children seem to be relatively immune, unlike with the H1N1 and seasonal flus.

On my new podcast, Coronavirus: The Truth, I stressed to listeners that when scientists and doctors say “we don’t know,” that’s what they mean.

The natural human inclination, especially among the general public, is to assume that officials are hiding the truth and that things are much worse than meets the eye. Not so. “We don’t know” means “we don’t know.” The results could be worse than expected, the same or better. As a nation, we need to be prepared for all possibilities, but we shouldn’t panic over what’s still unknown.

Rather than focusing on what we don’t know, people should act on what we do. We should socially distance ourselves. We should self-quarantine and call our doctor at the first sign of symptoms (rather than driving to the ER). We should wash our hands with soap before reaching for the hand sanitizer.

Perpetuating myths will only make our health care challenges worse and lead to unnecessary harm. This is a time for all of us to educate ourselves through credible sources while trying to remain healthy and calm.

Robert Pearl is a physician and CEO, Permanente Medical Groups. He is the author of Mistreated: Why We Think We’re Getting Good Health Care–And Why We’re Usually Wrong and can be reached on Twitter @RobertPearlMD. This article originally appeared in Forbes.

Image credit: Shutterstock.com

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