Debunking Misinformation About COVID-19

00:04 Narrator: We live in a connected time. The information age has brought with it unparalleled access to other people through telecommunications, email, social media, and so on. Someone half a world away can post something on their social platforms and you can see it almost instantly, wherever you are. This access can be an amazing resource. On the flip side, instant access to people's thoughts and opinions can sometimes skew toward rumor or gossip, and upend rigorously research truth. Fake news is a term we are all very familiar with these days, and more than just being a source of confusion or hurt feelings, misinformation can actually cause huge problems. And this has been made painfully apparent during the COVID-19 pandemic. There are so many opinions on the subjects floating around on the internet that it can be hard to know what to trust. Yet the cost for acting on wrong information during a pandemic can be tragic. Today, we'll clear the air a little bit by taking a look at some of the more popular misconceptions and questions about COVID-19 from a public health standpoint.

Hello and welcome to Population Healthy, a podcast from the University of Michigan School of Public Health. This episode is part of a series of special editions of our podcast focusing on the ongoing coronavirus pandemic. Abram Wagner is a Research Assistant Professor of Epidemiology at the University of Michigan School of Public Health. He studies the predictors of vaccine preventable disease incidents with a particular focus on vaccine hesitancy. We presented him with several misleading but popular statements about the COVID-19 pandemic to get his response as a scientist and researcher. We’ll start with a couple of common questions.

01:54 Speaker 1: How is COVID-19 actually transmitted?

01:58 Wagner: So when we think about COVID-19 transmission, there's been evidence that it can be transmitted in multiple different ways. Mostly we think that it's transmitted through close contact, and by close contact we mean that somebody who has COVID-19 exhales and then somebody else inhales within 3 to 6 feet of somebody else, and especially if you're not wearing masks, it's much more efficient for you to breath in the virus. It could also be transmitted in other ways, through surfaces, for example. If somebody coughed, breathed or sneezed on a surface and then you touch that surface and then touch your face, that could be one additional way that you could acquire it.

There is some, but less evidence for airborne transmission. By airborne transmission, we mean that somebody might cough or they might sneeze or sing or talk really loudly, and then the virus just hangs in the air. And then that original person could leave and somebody else could come into that same space and potentially get infected. There's less evidence for that, but there have been some circumstances of what we call “super spreading events”. This has been documented in choirs, like somebody singing, and so an individual person with COVID-19 might be able to spread rapidly in a sort of larger geographical region, and this has probably been tied to aerosolization of the virus. So mostly, we think the virus is being transmitted through close contact, but in some circumstances, it might be able to be transmitted over a longer distance, over a longer period of time.

03:32 Speaker 2: Are children extra likely to spread COVID-19 when they're infected?

03:36 Wagner: There's been some mixed evidence on this front. There was one study out of the Children's Hospital of Chicago, which found that younger children had a higher count of viral particles than older children and adults. Now, this doesn't mean that they're transmitting it more, it just might mean that their immune response is such that they produce more viral particles in their own bodies. And in my own studies, I haven't found much evidence that children are huge vectors of COVID-19, meaning that they don't transmit it as readily as some older adults. On this question, there's just sort of mixed evidence. And right now, a lot of children are heading back to school, so in the coming months we will see first off, if having viral counts is a case in a larger population, and then also, if having these higher viral counts does lead to enhanced transmission of the disease.

04:32 Narrator: Let's switch gears now and get Wagner's thoughts on several of the more prevalent misconceptions about COVID-19 that have been circulating online.

04:42 Speaker 3: Wearing a mask and gloves protects me from COVID-19.

04:47 Wagner: So when we think about wearing a mask, we're predominantly thinking about protecting other people. If we're infected with COVID-19, we don't know it, we could be exhaling droplets which could carry the virus. And having a mask on, that protects other people. It's possible that wearing a mask could also protect us from other people sort of exhaling droplets, but predominantly wearing a mask is for protecting other people from any virus that you might be carrying. And on that note, I think it's important to wear your mask correctly, you know, have it cover your nose and your mouth. Masks which are multiple layers, which have cotton and polypropylene are best for really stopping the spread of COVID-19.

I like to think of wearing a mask and all these other social distancing measures as part of the Swiss Cheese Metaphor, which we've been talking a lot about at the University of Michigan, where one slice of swiss cheese will have a hole in it, but if you add another slice of swiss cheese on top maybe that hole will be covered or partially covered. Then if you have multiple three, four slices of swiss cheese, then looking down on the swiss cheese you're probably not gonna see a hole all the way to your table. Wearing a mask is kind of like one slice is cheese. There might be literally a hole in your mask, or you might not have the highest quality mask,  might not be wearing it correctly. So that's one slice of swiss cheese. Social distancing is another slice. Keeping your hands washed, that's another slice. So doing all these things and limiting your contact with other individuals, those add up. Individually, they're effective, but all together, they're very effective.

06:21 Speaker 4: It’s important to disinfect my groceries when I get back from the store.

06:25 Wagner: The FDA has put out some guidelines on grocery shopping and what you should be doing with your groceries once you get home. Certainly while you are in the store, it could be important to wipe down your cart or basket, make sure you're washing your hands before you go out shopping, after you come back. Right now, there's no evidence of people becoming infected with COVID-19 based on touching groceries. But for people in certain high risk groups, I think that there's no harm in wiping down your groceries and trying to disinfect them prior to putting them away.

06:57 Speaker 5: If I don't have a cough or fever, etcetera, then I'm not contagious.

07:01 Wagner: So a lot of people are wondering about when somebody might be contagious with COVID-19. But there already has been mounting evidence that if you are pre-symptomatic or asymptomatic, meaning that you don't show any symptoms now but maybe you will in the future, you still could be passing on the virus. And in some research that I've been doing with some colleagues at the Shanghai CDC, we've been looking at when people are contagious or not, and even really minor symptoms, like having a sore throat, like a really mild sore throat, can be associated with passing the virus on to somebody else. So it doesn't take having a cough or a fever or sneezing a lot to be contagious, it can be something much more mild and that and you could even pass it if you didn't have any symptoms at all.

07:51 Speaker 6: If I've already had COVID-19 or tested positive for antibodies, then I am immune and don't need to worry about getting infected again.

07:59 Wagner: There's recently been a report coming out of Hong Kong, and there was one case who was infected in Hong Kong in the spring, and then he was traveling around in Europe more recently and was re-infected with COVID-19. So we do have empirical evidence at this point in time, that somebody might be able to get re-infected multiple times with COVID-19. This was a sort of a special case. They were able to isolate multiple strains of COVID-19 and they were able to show that there was sort of a difference in the strain that the case was infected with in the spring and what the case was infected with in the summer. So at this point in time, we don't know what the long-term implications of this are. It could be the immunity wanes after a few months, it also could be that the virus has different strains or that is mutating, so that in the future, people just will be exposed to a different enough virus that their immune system hasn't encountered before. So right now, really the evidence is that even if you had COVID-19 in the past, we can't say for certain that you will be protected against COVID-19 in the future.

09:06 Speaker 7: If I'm young and I don't have any other risk factors, I don't have anything to worry about.

09:11 Wagner: Certainly we've been seeing that among younger individuals, often they will have milder illness. But we've also seen cases of extensive  lung damage, and there's something called multi-system inflammatory syndrome in children which has been associated with COVID-19, and these are pretty serious conditions. So even if you are young, even for children who don't have any high-risk conditions, there could be some serious complications which result from COVID-19.

09:41 Speaker 8: People either die from COVID-19 or are completely fine.

09:45 Wagner: Right now, we don't yet know about lifelong complications from COVID-19. You know it's only been spreading in the United States for six, seven, eight months. So we really only have that many months of data for how long somebody might have complications. And what we've seen is that many people recover just fine, but fighting the disease can be very taxing on the body and there have been many cases who over several months have had decreased lung function and who have had shortness of breath and who've not been able to attain the quality of life that they had prior to getting COVID-19 even though they are quote unquote recovered. So I think we will see in the next few months and over the next few years, whether these individuals are able to fully recover or if they will be in some state of disability.

10:34 Speaker 9: The death count is the only statistic that really matters.

10:39 Wagner: So right now, we're talking a lot about death, and of course that's important to look at because it's very devastating for a family, and also our surveillance systems are pretty good at picking up deaths here in the United States. But I would argue that we should also be thinking about if there is any sort of long-term disability associated with COVID-19 like decreased lung function, chronic heart information, things like that. In the short term, we should also be thinking about ICU or hospital capacity, because if the hospital is filled up with COVID-19 cases, that means that they have decreased capacity to respond to individuals who sort of have parental concerns, like have a stroke or a heart attack or some other acute event. So what is the excess mortality going to be like in the United States if we're spending so much on COVID-19 and don't really have the capacity to be responding to other health concerns as well.

11:36 Speaker 10: Groups less than 10 are safe, but more than 10 are unsafe.

11:39 Wagner: Certainly, I would say overall, the fewer people that you're exposed to, the better. It's probably more important to think about what the distance is between you and other people. I'd be much more comfortable with 20 other people if everyone was six feet apart or more, versus with five people but everyone was crowded into an elevator or something like that. A related question is how many people should we be socializing with right now. For a long time, the messaging has been socializing within a household, so maintaining a quarantine bubble in your household. I think that it's okay to expand the bubble, so to include your neighbor or to include close family members into your what’s sometimes referred to as a quarantine pod or a quaranteam or a social bubble, something like that. And the reason is that as long as a couple of families come together and as long as they are still social distancing from other people, this can be a good way to share child care, it can be a way to have a bit more normal social functions than what you can have with just your immediate family members. The important thing with this is that you need to have conversations with other families and be sort of explicit in what your expectations are for them, because you don't want to quarantine pod with five other families and have no other expectations for them, and then they go off and quarantine with another five or six families, that doesn't make sense. It really has to be a closed bubble, but those bubbles could be important for social interactions and especially for younger children.

13:22 Narrator:  This has been a special edition of Population Healthy, a podcast from the University of Michigan School of Public Health. During the ongoing coronavirus pandemic, we’ll work to bring you analysis from our community of experts to help you understand what this public health crisis means for you. To stay up-to-date in between special edition episodes, be sure to check out our website publichealth.umich.edu, subscribe to our Population Healthy newsletter at publichealth.umich.edu/news/newsletter and follow us on Twitter, Instagram, and Facebook @umichsph.