During this COVID-19 pandemic a lot of posts on social media are being forwarded. Some of it are blatantly fake, some half truths and some twisted statistics to show the desired conclusion rather than the actual truth. In this write up, have tried to put forth some facts and information regarding various angles and perspectives related to the COVID pandemic.
Right now there is a flood of misinformation on social media about covid. This is mainly due to a few people who have little belief in their country’s systems. They feel that their systems are corrupt and have always misguide them, telling lies with some ulterior motive. Working in a system I can say that no system is perfect. But it does work with a purpose and tries to achieve its goals even though lot of pulls and pressures try to derail it. One needs to understand that if there is no system there will be a free for all and an infinite chaos. So whatever rules regulations about allowing specific industries to work, restricting movement of people, etc., are all taken with the greater common good in mind. These decisions may hurt a few, irritate a few, may not affect a lot or help a big chunk of society. Sometimes a tiny minority might use them for their benefit legally or illegally. Overall the aim is to reduce the spread of covid and limit the long term damage to the society and the economy.
- There are many posts quoting false mortality statistics of various pandemics without context and stating that COVID-19 is a much milder or in other words a much hyped pandemic.
Mortality rates of a few pandemics for comparison
- SARS : 5-10%
- H1N1 Swine Flu: 1-3%
- Spanish Flu(1918): 1-3%
- COVID-19: 1.5-5%
- Seasonal Flu: 0.001-0.003
The above mortality rates gives a very different picture in isolation. Showing SARS as the worst pandemic. But we have to look at the mortality rates in context of the death toll.
Below is the death toll due to various pandemics.
- Spanish Flu: 40-50 million
- MERS: 850
- SARS: 770
- Swine Flu H1N1: 200,000
- SARS COV or COVID-19: 2,700,000 till March 16, 2021
Spanish Flu : Death toll has to be taken with context of modern medicine, improved research, development of medicines and vaccines and vastly improved current health infrastructure in most countries. During the 1918 Spanish flu pandemic there were no antivirals, no antibiotics nor the advance medical care that we are used to now.
SARS infection: It was easy to control because of the comparatively shorter incubation period and severe symptoms due to which cases could be easily identified and isolated. Also somehow SARS didn’t have the ability to survive in the human body for long and hence the virus went out of circulation and the SARS pandemic slowly fizzled out. The total deaths in the world due to SARS were 770.
Swine flu H1N1 was not highly contagious as the COVID-19 virus is and was better controlled. With the advent of vaccines it was controlled. Now the H1N1 virus has become endemic.
Against seasonal influenza virus effective vaccines are available and also many people have a residual immunity from past infection.
Case and death reporting : The vigorousness of testing and different methods and protocols of contact tracing may lead to different estimates of prevalence and mortality due to COVID-19 in different countries and even in different regions in the same country. Also every country has a different way of defining COVID-19 related deaths and the parameters may keep on changing in an evolving pandemic. Due to this the number of cases and deaths reported by different countries may not actually reflect the exact burden of disease in those countries. Though it may be nearer to the actual figures. This also confounds the calculation of deaths due to COVID-19 in any given country.
2. One needs to keep in mind that apart from mortality the morbidity is very high in Covid -19 cases. People recovering from ICU are suffering from :
- Oxygen Dependency
- Severe Lung Damage
- Neurological sequelae
- Extreme fatigue lasting for 1-6 months
- Severe myopathy or frailty due to prolonged ICU stay leads to patient becoming dependent for their normal day to day activities for quite a long time.
3. There are a lot of social media posts claiming that the number of people dying due to other diseases like HIV, Tuberculosis, malaria is actually higher. Most of the figures quoted in such posts are exaggerated and are fake. And even assuming that they are true, people dying due to these diseases don’t suddenly die in 1-2 months resulting in overburdening of the health infrastructure. These deaths are spread out evenly over the year. And that is the most important difference between Covid deaths and deaths due to these diseases. That doesn’t mean that we should take other diseases lightly but a lot of programmes and plans are already in place in most of the countries to handle these diseases.
4. One more issue that is discussed in various posts is that mortality is higher in older populations or people with comorbid illnesses like diabetes, hypertension, kidney diseases, etc,. so rest need not worry. Meaning without saying that let this group of people fend for themselves.
Yes agree. But is all older population sitting at home doing nothing and being a burden on the family, society and the nation ?
No !! People nowadays are working well into their seventies and some even in their eighties because of family responsibilities, economic reasons, dedication to work, etc., Also there a lot of older but active people who hold a wealth of knowledge and experience gathered over years in their field and therefore are an asset to the society. So should these people be left to die?
Again people with comorbid conditions like diabetes, hypertension, etc., are living comfortable and productive lives. They are not a burden on the society. So should these people be left to die? Rather the question should be, are we defining who should be allowed to die and who should not be allowed to die ?
5. Another myth being propagated is that if there is no treatment for Covid then why are patients being admitted to hospitals. COVID affects a lot of systems and organs of the body like lungs, vascular system (blood vessels and blood) liver, heart and kidneys. Sometimes more than one organ is affected. In the hospitals what health professionals do, is try to maintain the affected organ with external support with the help of equipments and/or medicines and wait for it to recover from damage due to infection. For example if lungs are affected Oxygen and ventilators are used. Most of the times patients recover, support can be withdrawn gradually and patient can be sent home. But not all are so fortunate. A small minority succumbs because the damage caused by the virus is so extensive that the organs don’t recover from it.
6. Reasons for varied symptoms of covid-19 like fever, cough, loss of sense of smell and taste, body ache, fatigue , weakness, etc. : Research done by Dr. Sreekala Nampoothiri found that the hypothalamus and the regions of brain regulating the cardiorespiratory function, smell, or taste expressed the viral receptor ACE2 and TMPRSS2. The hypothalamus and connected regions could thus be infected by the virus, Many of the functions affected in severe COVID-19 patients – temperature control, hydration, cardiorespiratory function, the senses of smell and taste were coordinated or transmitted by the hypothalamus. Besides, many of the risk factors for severe COVID-19, including male sex, metabolic diseases such as obesity, diabetes or hypertension, and even old age, also involve hypothalamic cell networks.
7. Why a few people are affected more than others:
- Every individual varies. Even a simple illness like common cold can affect different individuals differently. The symptoms as well as duration of common cold may vary to great degree in different individuals. So individual variance is one explanation for different levels of severity in Covid-19.
- There is also another important explanation. The initial amount of virus that infects a person or in other words the infecting dose of virus. If the initial or infecting dose of virus entering the body is small then it may give rise to a milder illness. Provided there are no other severe comorbidities. Conversely if the initial infecting dose(amount) of virus entering the body is large it may give rise to more severe symptoms. And if there are associated comorbidities then it can cause severe covid illness requiring admission to a hospital.
8. Why only certain nations or some specific areas in on country are affected more than others : Covid-19 is a typical urban phenomenon. It spreads like wild fire where people density is very high. Especially large cities and towns where people live and work in close quarters. Where the bulk of population uses public transport. Where economic and/or industrial development is high due to which there is a lot of intermingling of people for work, social and recreational reasons.
9. Health workers are suffering: The rate of infection and mortality rates among the health workers is very high. And this because of the carelessness of people leading to increased admission in hospitals.
10. Waves of Covid infection and their effect: The question is not only about the spread of the disease but also about its huge waves. That leads to collapse of the health infrastructure. During the waves, finding a hospital bed or an ICU bed becomes extremely difficult. Right now at the place I live, there is a wait list for admission to most of the hospitals. And it can extend from 5-100 depending on the hospital. This may lead to delay in initiation of treatment and thus increasing mortality and morbidity.
11. The conspiracy theory about the the media and the governments acting together to destroy the financial system. Their aim being to pull the stock market down and then buy cheap stocks in bulk or cause acquisitions and mergers.
- One really needs to just look around and see that all the governments in the world irrespective of their political system, level of democracy, level of social welfare, level of economic development, ideology , etc, are using the same measures to fight Covid. These governments and nations who never can agree on many other smallest and simplest of matters are agreeing on the measures to handle Covid. How is that? Are all the government in cahoots together and have formed some sort of cabal to destroy the economy and every human being on the earth ? This is quite far fetched and the creation of an idle and fertile mind.
- About conspiracy theories in general : Covid has been a huge crisis. People want to make some sense of it. But they might feel that they don’t have complete information about it. There may be lack of information or the information may conflict with their own beliefs hence they may discard it. Conspiracy theories appeal to the closely held rational/irrational beliefs of people. They are widely speculative and broadly based involving multiple protagonists from varied backgrounds who are portrayed a villains. There is no proof in these theories just wild conjectures. But then the lack of proof itself is portrayed as the tremendous power of the villains implicated in the conspiracy theories. It’s better to stay away from these for ones own mental well being.
12. Spread: It is mostly due to undiagnosed asymptomatic patients. These patients have not been tested or don’t want to be tested for the fear of quarantine and loss of income. Some also have a misplaced confidence that due to their robust health Covid will not affect them. Such people move around in the society and spread the virus to unsuspecting vulnerable people. Thus increasing the disease burden and increase in number of cases.
13. Importance of Nose: The Covid-19 virus enters the human body through the nose. The nasal epithelium has the highest concentration of ACE2 and TMPRSS2 receptors. The virus attaches itself to these receptors with the help of its spike protein and gains entry in the cells. From the above it is clear that the virus gains entry into the body through the nose. Hence it is extremely important to cover the nose, when one is out of the safety of their home. At public spaces, at their work places or recreational places where a lot of people mingle. The mask should cover the nose, mouth and the chin. And air should not leak from the sides/edges. This simple measure can control the spread of the virus.
14. One more myth being propagated is that masks cause decrease in levels of oxygen leading to fainting and unconsciousness and even death. Health workers working in dedicated Covid hospitals use double sometimes triple level of protection counting the PPE suit. With layers of masks covering their nose and mouth, they work in eight hour shifts everyday. They don’t face any problems, then why should others. Research has also proved that wearing N95 or any other masks doesn’t reduce the oxygen level in the blood.
15. One more myth being propagated is that why are children not getting affected even though their immunity is weak? Again the answer lies in the scientific fact that the ACE2 & TMPRSS2 receptors are not present or present in very small amounts in the nasal epithelium of the children. They are also present in lesser amounts in women. Hence the rarity of complications in children and lesser complications in women.
16. Reinfection: At present it is not very clear for how many days does the immunity provided by natural infection lasts. It may last a minimum of 3 months. A few patients may not gain any immunity at all probably due to use of steroids during their hospital stay. So it is dangerous to assume that once one is infected he or she may become immune to the virus. Hence remaining vigilant and using safety precautions like mask is very important till the end of pandemic. Irrespective of the status of previous infection with Corona virus.
17. Mutations : Mutations add to the chaos because the immunity provided by natural infection due to one variant may not be completely useful against another mutated variant. Research is still going on and we may receive some information about it in the coming days. Hence remaining vigilant and using safety precautions like mask is very important till the end of pandemic. Irrespective of the status of vaccinations.
18. One really needs to understand that any amount of infrastructure, any number of health professionals and any number of measures the governments(state as well as Central), may undertake, they will never be enough to overcome the insane levels of stupidity and callousness among the common people. COVID-19 cannot be completely curbed by the governments and neither by the health workers. It can be controlled only by the general public. In that sense it has now transformed from a medical problem to a social problem. And the blatant lies and half truths being circulated in the social media are adding to the burden by confusing the general public.
19. Yes economy has to go on. But that can be done easily if everyone wears masks properly. But since the pandemic has started, we are seeing that after a wave subsides people become careless and casual. At all the shops, malls, working places and other public places masks and social distancing is seen to a very less extent. And even those wearing masks wear it improperly. And this virus which cannot survive outside the human body, keeps alive by jumping from person to person and then acquires a critical mass to cause another big wave.
20. The answer to this is pandemic is not false bravado. The answer is to be afraid of the personal, social, economic and national consequences and take appropriate measures like masks and social distancing to avoid getting infected and spreading the infection to others.
21. Masks have to be worn properly. Mere hanging it on the face will not serve the purpose. One needs to understand that whatever air a person breathes has to be filtered through the material of mask. Air may leak in from the sides of mask due to loose or improper fit on the face. This air is not filtered and may contain virus which can infect that person. Hence wearing a proper mask whose sides fit snuggly on the face throughout the mask perimeter is very important. Improperly fitted masks act only as show pieces and give false sense of security.
- On individual level it is one of the method to avoid falling sick or getting severe covid.
- On a societal level it may help in reducing the spread but most importantly it will reduce the number of severe cases of covid. This will reduce the number of hospitalisations thus reducing the load on the health infrastructure.
- Once the load is reduced health care will become more available, more timely and more effective for those who may need it.
- There are different types of vaccines available in different countries and all are effective.
- Please take the vaccine if you are eligible to receive it depending on the rules and regulations of your country of residence.
- Remember that the current vaccines may not prevent infection. But they certainly prevent the severity of covid by 80-90% depending on the vaccine.
- A vaccinated person can get a milder covid infection and though he may not suffer the extreme consequences of it, he or she can easily pass on the infection to other vaccinated or unvaccinated people. In this event the unfortunate unvaccinated person may suffer from severe covid infection.
- The conclusion is that even after receiving vaccination, face masks and social distancing should not be abandoned.
23. Social Media
- Lastly a few words about social media forwards: Every one nowadays is an expert on Covid. Anyone with a mobile phone and an opinion can broadcast his or hers opinion all over social media. Unmindful of the damage he or she may cause. Because for them its chance to shine in the limelight which they would rather not loose.
- Should we consider well made videos by sincere looking people, with a good command over language but without any core competency in the medical field as authentic ?
- On similar lines should we believe in written words on social media just because they have been forwarded multiple times and written in a compelling language ? These forwards are created very intelligently by antisocial elements, mixing half truths, selective facts and frank fiction in such an effective way that it tends to appeal to your emotional side which is already in a flux due to the pandemic. The main aim of such people is to create doubts and distrust leading to more chaos.
- Medical field similar to any other professional or academic field is not very simple nor small. It has huge amount of information and facts. Requires a lot of skills. It is also continuously evolving. Keeping in touch with the best practises and new research is not very easy even for those working in medical fields. It’s very difficult for people from other backgrounds to claim expertise in this field but which a lot of so called experts, rather social media influencers do. Hence don’t fall for fake forwards and videos on social media. If you have any medical issue please consult your doctor.
- Lastly, don’t forward fake social media posts and add to the confusion and chaos.
24. Humans have evolved over a very long time. May be millions of years or more. Humanity has overcome many roadblocks in their path of evolution. Has overcome many adverse events beyond the grasp of imagination to be where humanity is standing right now.Right now we are facing a pandemic but we will overcome this pandemic like many before us and come out of it stronger. But there is a caveat. Right now we face two pandemics at the same time. One is virus and the other is misinformation. Especially misinformation on social media. One cannot control the misinformation but one can learn to neglect it. And we will have to neglect it if we have to come out of the covid pandemic unscathed. Use social media but only as a means of communication and entertainment and not as a source of authentic information.
25. All the information above can be condensed into just two lines:
- Properly worn masks and social distancing can prevent Covid as well as keep the economy running and make our lives better in the coming days.
- Staying away from the misinformation on the social media will also prevent the rising numbers of cases of COVID-19.
Congratulations on discussing an important issue, you have touched upon all the important aspects about covid ! It’s implications on the public ,health sector, economy and the burden on the government. The role of gossip mongers and social media in spreading panic and wrong statistics
So proud of you
Thanks Dr Dudhgaonkar for long awaited views, explanations with a scientific approach based on research. Logic, language & presentation is a piece of a commendable article. Bhelke
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Excellent write up
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very nice message.Elaborate information is given.Thank you.
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