Busting coronavirus myths found on social media

You’ve likely seen some of these coronavirus myths on social media, or maybe you’ve heard them from friends or relatives.

I’d like to say that the amount of misinformation out there is “shocking,” but, well... if you’re still surprised by misinformation in 2020, you haven’t been paying attention.

One post being passed around this week conveniently put a lot of these myths in one place. It’s hard to know where this list originally came from — I found it on Facebook from Afshine Emrani, a right-wing doctor in Los Angeles, as well as on the Instagram of Ben Tapper, a right-wing chiropractor in Omaha. Still, it’s been shared thousands of times in various screenshots.

Let’s go through each of the 12 points on the list, and separate fact from fiction.

1. Was Sweden right?

Sweden garnered a lot of attention for its unusual approach to the coronavirus. Rather than locking everything down, Sweden made only a few legal changes — closing schools for those 16 and older, turning all restaurants and bars to table service, banning nursing home visits, and banning gatherings over 50 people.

Everything else was accomplished through public information campaigns and a high social safety net. Half of all Swedes began working from home and 93% of those over 70 years old said they followed public health guidelines asking that they see fewer people. And in Sweden, employees receive an automatic 80% of their salary on days they miss work while sick, for up to 14 days.

How you think Sweden performed is highly dependent on which country you compare them to. If you compare them to the U.S., Spain, Italy or the U.K., Sweden looks better. If you compare them to Nordic neighbors Finland, Norway, and Denmark — which underwent lockdowns — things look a lot worse.

Looking at these graphs, it’s hard to argue Sweden “was right.” I mean, sure, their pandemic results were better than what we’ve seen in the United States, but we’ve made numerous mistakes. Sweden’s stats are significantly worse than Finland, Norway, and even Germany — including an increase in deaths by a factor of 10. If we’re going to say any countries were right, those would be ones to point to. If someone is excited about what Sweden has done during the pandemic, they’re trying to sell you something.

2. Are 95% of infected people asymptomatic?

No. According to a World Health Organization analysis of 94 different studies where they actually examine patients, only 20% of people infected with SARS-CoV-2 remain asymptomatic throughout the infection.

U.S. Centers for Disease Control and Prevention scenarios have estimated anywhere between 10% to 70% of infections are asymptomatic. Their current best estimate is 40%. It’s definitely not 95%. That’s just crazy talk.

3. Do asymptomatic people rarely infect others?

That WHO analysis found that asymptomatic people are about 35% as contagious as everyone else with COVID-19 — in other words, significantly lower. The CDC scenarios have estimated anywhere from 25% to 100%, though say their current best estimate is 75%.

So, it depends on your definition of “rarely.” I’d still be worried about hanging out with an asymptomatic person, personally.

But remember: there’s a difference between asymptomatic and pre-symptomatic. Asymptomatic people never see symptoms, whereas pre-symptomatic people do eventually. And at any given point in time, we don’t know whether someone without symptoms is asymptomatic or pre-symptomatic.

Pre-symptomatic people are very contagious. Those CDC scenarios have planned for anywhere between 30% to 70% of all transmission happening from pre-symptomatic people, with a best guess of 50%.

4. Is herd immunity ‘real’ at 20%?

Generally, if you want to calculate at what point herd immunity alone will turn coronavirus growth into coronavirus decline, you need to focus on the initial transmission rate, our old friend R0. That’s the average number of people a sick person infects.

The CDC’s estimates of R0 for the coronavirus have ranged between 2 and 4, and 2.5 is considered their best estimate. That means we’d need between 50% and 75% of the population contracting the virus to “reach herd immunity,” with 60% being the best estimate. And of course, that’s if we did nothing else differently — no social distancing, tens of thousands of people at sporting events, etc.

Now, there are researchers who argue that the percentage is still too high. Because some people are more social than others, for example, one study suggested a herd immunity threshold of 46.3%. Sure.

We’re not close to that, though. A Stanford study released last week found that 9% of people in America have been infected with the coronavirus. So pick your favorite herd immunity rate: 20%, 46.3%, 60%. Any of them are well off in the future.

5. and 6. Are 80% of people immune already? Do many people have T-cell immunity from other coronaviruses?

This point does reference a really positive finding: many people do have T-cell reactivity to this coronavirus, meaning a piece of their immune system kicks into gear because this virus is in some ways similar to past ones. The BMJ looked at six studies that reported between 20% to 50% of people have T-cell responses to COVID-19 despite never having had it.

T-cell responses aren’t perfect — they usually don’t prevent you from contracting the disease because T-cells act to kill already infected cells. In particular, it’s very possible and even likely that some of those who have coronavirus T-cells are still contagious.

But those with the right T-cells tend to have more mild symptoms and a less severe disease. Which is great news!

So, these points hint at true-ish things, but are exaggerated. Many people do have helpful coronavirus T-cells. But it’s unlikely that these mean full immunity, and 80% is wildly too high of an estimate for those who are fully or partially immune. In fact, one study released Tuesday hypothesized that T-cell benefits are already “baked in” to epidemiological models.

7. Do the number of cases matter? Or only hospitalization and death?

I mean, of course cases matter.

People getting sick is bad, even if they don’t go to the hospital. Sick people frequently can’t go to work, which is bad for their family and their economy. Sick people are more susceptible to further and future health consequences. Sick people are unhappy.

But cases also matter in terms of future growth — each case represents a person who can spread the virus to other people. The more people who are possible spreaders, the more spread is likely to occur.

I can’t believe I had to waste two paragraphs explaining to two social media doctors that sickness is bad.

Now, are cases a flawed statistic? Of course! Changes in testing can have huge impacts on the number of cases we find out about. But whenever we’ve seen an increase in cases, we’ve seen an increase in hospitalizations, and then a few weeks later, an increase in deaths. Is it always a perfect correlation? No. The demographics matter, and we’ve simply gotten better at treating the virus. But are cases a leading indicator of hospitalizations and death? Yes.

8. Does an increase in cases at the end of a pandemic lead to increased hospitalizations and deaths?

Yes. Here’s Utah’s data, just because it’s the dataset I’m most familiar with.

Cases went up first. Hospitalizations followed about a week later. Then deaths came about two to three weeks later. It’s exactly what you’d expect.

The idea that the end of the pandemic (and let’s hope we are nearing the end of the pandemic) means that cases somehow don’t lead to hospitalizations and deaths just doesn’t make sense.

9. Do lockdowns hurt people and increase deaths by exacerbating other illnesses?

Clearly they do. I wrote a whole article about the secondary effects of the pandemic.

Do the secondary effects hurt more than the disease itself? It’s not clear.

In terms of death, not yet. In America, we’re at about 285,000 excess deaths over the course of the pandemic, and about 210,000 of those are COVID-19 deaths. While more will die from COVID-19 moving forward, secondary deaths will increase too — people will die from cancers or other long-term illnesses they didn’t find out about due to the pandemic.

Now, there are other non-death negative effects. How do millions of COVID-19 illnesses compare to the impact of millions of children missing school? I’m not sure how you begin to answer that. Maybe a philosophy degree would be most helpful.

But yes, lockdowns have negative secondary effects, and it’s hard to know whether the primary COVID-19 goals achieved are worth it.

10. Is reinfection very, very rare?

So far, yes. We’ve seen several confirmed cases, but you can count them on two hands. It’s exceedingly rare.

However, we may see more reinfection cases in the months and years to come, as antibodies to the virus degrade over time. One study found that antibody quantities fall by about 50% after three months, but even the small amount of antibodies that remain should provide pretty good protection. But after a year or multiple years, we don’t know.

Still, I’d say that this point is accurate, so far.

11. For most people of working age, is the coronavirus like the flu?

This is also a statement that President Donald Trump tweeted Tuesday morning: that the coronavirus was like the flu for most.

It’s just not true.

Here are several estimates for the fatality ratio of coronavirus vs. the CDC estimates of the fatality ratio of influenza over various years, when adjusted for age:

Note that the above graph has a logarithmic scale, in this case, each dash is 10 times higher than the one below it. And you can see, there are significant differences between the fatality rate of influenza and coronavirus for anyone 20 or over. For younger adults, COVID-19 is about 2 to 5 times more deadly, and for older adults, it’s 10 to 15 times more deadly.

If you look at other non-death metrics — hospitalization percentage, number of symptoms, length of symptoms — you find the same thing: on average, COVID-19 is significantly worse than the flu. Part of this is because we have many vaccines and treatments for the flu, but few for the coronavirus.

12. Are children immune from COVID-19?

Clearly no.

From March 1 to Sept. 19, there were 277,285 children confirmed to have the coronavirus in the United States, according to the CDC’s survey. Just over 1% of those were hospitalized (3,240 kids), while 404 of them went to an intensive care unit and 51 of them died.

Even among those who weren’t hospitalized, 58% of school-aged children with confirmed coronavirus reported at least one symptom.

Let’s be clear, it’s obvious that the rates of severe disease and death from COVID-19 are significantly reduced in children. Those percentages are much better than their adult counterparts. And there is some thought that an active thymus, where we find T-cells, might be part of the protective circumstances involved.

But yes, kids get sick from COVID-19. They are not immune.

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The willingness of people to both share and believe this misinformation is discouraging, because the fight against COVID-19 has to be a collective one. If a large share of the population takes different action because they believe one or all of these lies, it hurts all of society, not just themselves.

So yes, as Jonathan Swift said, “Falsehood flies, and the truth comes limping after it.” But if we shoot those falsehoods down, the truth is all that still can move forward.

Andy Larsen is a data columnist who is focusing on the coronavirus. He is also one of The Salt Lake Tribune’s Utah Jazz beat writers. You can reach him at alarsen@sltrib.com.