One of the best things you can do to protect yourself from the threat of COVID-19 is to separate the facts from the myths. Infectious disease expert Dr. Jonathan Quick, author of The End of Epidemics, joined Ask Science to tell you how.
Today I have with me Dr. Jonathan Quick, who is a Senior Fellow at Management Sciences for Health, a nonprofit that works to build strong locally-led health systems in some of the world's poorest places. He has worked as a family physician and the director of essential medicines at the World Health Organization. He has published many articles in leading medical journals.
Dr. Quick is also the author of The End of Epidemics: The Looming Threat to Humanity and How to Stop It, a book he published in 2018, which is, of course, chillingly topical right now. He is an expert in pandemic threats and health systems innovation.
Basic facts about the SARS-CoV-2 coronavirus and COVID-19
Thank you so much for being here Dr. Quick.
I want to thank you for having me.
There's a lot of misinformation out there. So what do you think are some of the basic facts about COVID-19 that people really need to know?
It's an entirely new coronavirus that we have only known for two months. So there's a lot we know; there's a lot we don't know. It's the third really deadly coronavirus to go global. The first one was the SARS virus in 2003. The second one was out of the Middle East—the MERS virus. And then this is the third.
Like with the seasonal flu, one out of a thousand people die with [seasonal] coronaviruses. This [SARS-CoV-2] coronavirus, it's about one out of 50. And if you have risk factors, it's one out of 10.
What's worrying about [SARS-CoV-2, the virus that causes COVID-19] is the spread—it's more contagious than the other two—and also the fatality rate. The MERS virus has a 60 percent fatality rate, the SARS virus 10 percent, [and] this one to two percent. But they're just putting that into perspective. What it means is, like with the seasonal flu, one out of a thousand people die with coronavirus. This [SARS-CoV-2] coronavirus, it's about one out of 50. And if you have risk factors, it's one out of 10.
So, it's deadly, and it is spreading globally and doubling every few days. That's what's concerning.
You mentioned the different fatality rates. We've been seeing a lot of reports that the symptoms can be different for different ages or different groups. Do we understand why the same virus can affect different people so differently?
Well, the symptoms tend to be fairly similar [to the flu] in terms of fever and respiratory congestion. What's really distressing is the differences in the fatality rate. We know now, from a recent study that the Centers for Disease Control published, that for people over 85, their case fatality rate was 10 to 25 percent. Whereas in the younger ages—under 40—it was under 1 percent.
In [a recent CDC] study, half of the people who ended up hospitalized [in] intensive care units were under 65.
So, the big difference between the ages is how susceptible they are. And it's basically elderly people and people with medical problems that are much more susceptible to the worst cases. That said, in this study, half of the people who ended up hospitalized at intensive care units were under 65. So, although the risks are higher in the older age ranges, there still are risks even in the tribe of adulthood.
Dispelling common coronavirus myths
As I mentioned, we see a lot of misinformation. What are some of the most dangerous myths you've come across that you can dispel for us?
Well, let me say a couple words first about why myths are a problem and what's the consequence of a myth. One consequence is that it can lead you to conclude that this is no big deal and [cause you to] be complacent in your behavior, as [with] the Spring Break partiers. And the Boston biotech company that didn't worry so much about it and had a conference anyway and 130 people were subsequently infected. Or first responders who announced that they don't believe in or protect themselves. And so, it can lead you to put yourself at risk. It can also lead you to rely on measures that don't work. They do little or nothing or even increase our risks. Either way, the consequences are you're risking getting sick yourself.
[Myths] can lead you to conclude that this is no big deal and [cause you to] be complacent in your behavior. ... The consequences are you're risking getting sick yourself.
But because so much of [the time, COVID-19] doesn't cause symptoms, if, through casual behavior, you get yourself sick, you can unintentionally infect others. You don't know, just looking at somebody, whether the person that you're sitting next to [has] got some medical problem, whether they are immunosuppressed from cancer. So if you get yourself infected, you can unintentionally infect someone else who's at risk and lead to serious illness, intensive care, or even death [for that person]. So there's, there's a consequence to not getting the facts.
Some of the strange and dangerous myths—dangerous because they lead you not to protect yourself—are things like 'breathing through baby wipes will protect you' or 'garlic will protect you.'
Oh, I hadn't heard those.
Yeah, yeah. No. As a matter of fact, there are lists. Pretty much any mainstream media—New York Times, BBC—they all have the lists of different myths.
Wow. Well, that explains why I can't find baby wipes for my baby's actual bottom.
Yeah! And they don't work. The other thing is those don't substitute for [hand sanitizer] gel.
But through three common myths that are creating some problems—one is that a regular everyday face mask will protect you, a surgical face mask. And, and it really doesn't. It doesn't filter out the viruses.
If you get yourself infected, you can unintentionally infect someone else who's at risk and [that could] lead to serious illness, intensive care, or even death [for that person]. So there's, there's a consequence to not getting the facts.
And the other thing is, and I watched this vividly, a person across the aisle on a plane, he was drinking a soda. And normally, you just take the top off, drink the soda, your hand wouldn't touch your face. But he had to take the facemask down, get the soda, put the face mask back up, and adjust it. And actually, you may end up—because the hand-to-face is so important—you may end up infecting yourself. So that's, that's one common myth that's causing confusion.
The CDC recently added the following update regarding cloth face coverings: "In light of new data about how COVID-19 spreads, along with evidence of widespread COVID-19 illness in communities across the country, CDC recommends that people wear a cloth face covering to cover their nose and mouth in the community setting. This is an additional public health measure people should take to reduce the spread of COVID-19 in addition to (not instead of) social distancing, frequent hand cleaning and other everyday preventive actions. A cloth face covering is not intended to protect the wearer, but may prevent the spread of virus from the wearer to others." —CDC.gov
The other one is, you know, 'It's like the flu, so why worry?' And we've already talked about that … that it's not [like the flu]. I mean, it's not like the symptoms aren't similar, but the disease is very different.
The third—which is to-be-determined—is that the virus will die out in the warmer weather. There's some evidence suggesting that it may go down in the warmer weather. [But] I don't think very many virologists agree that anything will make it go away at this point, [so] we can't plan on [the virus dying out in warmer weather]. Hopefully, that'll happen and give us a little bit of break, but we won't really know until the virus tells us.
Does recovering from COVID-19 make you immune?
And speaking of a break, if you got [COVID-19] and you recovered, do we have any ballpark estimate? Are you immune? Does that immunity last forever? For a year?
Because we only have some people that have recovered, we don't have any longterm [information] with this virus. We know that with the seasonal coronaviruses—so, I talked about the three global coronaviruses, but they've also got their sort of weaker cousins, the four seasonal viruses—and the immunity doesn't really last very long with those. So again, we won't know until we have enough experience with this virus.
How to spot fake COVID-19 news
Is there anything else you'd like to share with us?
One thing on the issue of misinformation that I think is really important, is actually knowing how to identify misinformation. The fact-checking organizations actually have put together eight things that you should look at to see if something is likely to be fake news.
One of them is to look at the source. Where's this coming from? What kind of a site is it and what's the mission of the organization? Who's the author? Do they seem to have any credentials? Are there any supporting sources?
I always go to the source. When something is suspect or seems unusual, go to the source.
I always go to the source. When something is suspect or seems unusual, go to the source. If there's a lot of hyperbole in the way that it's said. So if there's a lot of hyperbole, then the fact is that fake news uses much more dramatic language, and then check other sources. You know, if you see something like 'garlic will protect you', look at two or three other sources. So, there are a few habits that you can use to filter out.
The other thing that I would say is social media is an important source of ideas and information about what's out there, but when you're going to make a decision that affects the health of yourself and your family, go to a reliable source.
And people are hearing this over and over again—cdc.gov is the US Centers for Disease Control. They're a world-renowned organization and their sole mission in life is to protect the health and wellbeing of the American people. They have no other goal but that. So, if you go to the CDC website, you'll see the basic measures—hand-washing, limiting exposure, keeping away three to six feet times a year with people, reduced hand-to-face touching—and a lot of answers to a lot of different questions around coronavirus and pregnancy, coronavirus and travel.
Use social media to get ideas and see what's happening. But when it comes to making decisions that matter for you and your family, go to unbiased, updated evidence-based sources.
So again, the principle—use social media to get ideas and see what's happening. But when it comes to making decisions that matter for you and your family, go to unbiased, updated evidence-based sources.
How to protect yourself and your family from coronavirus
That's really great advice. Thank you. And on the topic of advice, I wonder if you have any advice for those of us out there who are considered essential employees who are still going out. So, I am an academic. I'm sitting at home, but my husband is an essential employee. Many of my dear friends are doctors or essential employees working in places like grocery stores. Do you have any advice for how essential employees can go out and do the brave work that they do and then come home and be safe with their families?
So, the basics work for everybody—frequent hand washing and making sure that you [do that] several times a day. With soap, two verses of Happy Birthday, do it long enough and get the fronts and backs and between your fingers and your nails and all that really is important.
Staying, to the extent possible, three to six feet away from people—that closeness is a problem. I heard one expert say that if you could smell what they had for lunch, you're too close.
[laughs] Probably in other times, too.
Yeah. Limiting the time. So, if it's places that are crowded, where you'd be standing in a big line and all, try to go [to] less crowded places.
Keep your surfaces clean. We're just learning about this virus, but we know from other coronaviruses, and evidence so far, that this can linger on surfaces.
And keep your surfaces clean. We're just learning about this virus, but we know from other coronaviruses, and evidence so far, that this can linger on surfaces. If you have surfaces where people are frequently there with their hands, like a kitchen [countertop] or meeting tables where people are sort of all over it, as it were, or the tray tables on airplanes—and all the airplanes are doing a good job—but no surface is... Until we know more, treat them as potential places of exposure.
Right. Because we don't know how long it lasts on surfaces yet, do we?
Yeah, no. I mean, we know that other coronaviruses—the SARS virus—can last from hours to several days. Okay. But being on the surface does not necessarily mean it's still able to infect you. But vigilance is the word.
[Staying healthy] is up to each of us individually and all of us collectively.
This has been really informative. I appreciate you taking the time. I know you're in super high demand right now, so I appreciate it. My listeners appreciate it. Thank you.
Well, thank you, Sabrina. I really appreciate the interest, and people's interest in staying healthy during this. It's up to each of us individually and all of us collectively.
Thank you. And since I now am locked inside, I will definitely be checking out your book!
To learn more from Dr. Jonathan Quick, you can follow him on Twitter.
Dr. Quick has also left us with some tips for how to spot fake news, whether related to coronavirus or otherwise. When it comes to getting the highest quality, most accurate news related to the coronavirus. Dr. Quick recommends getting the latest public health information from the CDC, and the latest research on coronavirus from the NIH.
When you're trying to sort out fake news from real news, Dr. Quick, also highly recommends FactCheck.org, where they break down coronavirus and other myths. In particular, see their article on how to spot fake news.