Health officials have noted that in addition to fighting the COVID-19 pandemic, the world is also fighting an “infodemic,” which they described as an excessive amount of false information about a problem which may be viewed as a detriment to its solution.
In a conference call with The Enterprise on Tuesday, St. Mary’s Health Officer Dr. Meena Brewster and MedStar St. Mary’s Hospital Senior Vice President Dr. Stephen Michaels addressed some of these rumors, which have arisen greatly online amid the pandemic.
• Rumor: Hospitals, or local health departments are receiving financial incentives from the government to declare more COVID-19 cases.
The rumor is connected to a provision of the federal CARES Act signed into law in late March, which grants hospitals treating patients on Medicare for COVID-19 an additional 20 percent “add-on” to diagnosis-related group rate payment, according to a bulletin from the American Hospital Association.
“What you’re talking about, is essentially fraud,” Michaels said. “There is no financial benefit for us to declare a case COVID or non-COVID.”
Michaels added that MedStar is a not-for-profit company, and that the pandemic is a “significant financial challenge” to the hospital.
“The insinuation that there would be some kind of fudging of the numbers, there is no evidence of that,” he said.
“The idea of a profit [off the pandemic] is atrocious,” Brewster said. She said the health department makes no financial gain from COVID-19 cases.
“We make sure our data is accurate and up to date,” she said.
Similarly, Del. Matt Morgan (R-St. Mary’s) dispelled the rumor at a restaurant owners’ meeting last week, noting that hospitals “are actually dying on a limb right now” due to COVID-19.
• Rumor: COVID-19 death numbers are being inflated by marking uncertain deaths as COVID-19 deaths.
Before COVID-19, determining a cause of death has never been “100 percent clear,” Michaels said, but determining a COVID-19 death is often “not as big a challenge as other times when it’s less clear,” Michaels said.
Brewster said when signing a death certificate, a physician is tasked with determining the immediate cause of death and going through “almost a chain reaction of what led up to the death” using intermediate or underlying causes, and comorbidity, or the simultaneous presence of two diseases or conditions in a patient.
The coronavirus is not the final piece in that chain, Brewster said, but the consequences of the COVID-19 disease, such as pneumonia or respiratory distress, often are.
Deaths are counted as a COVID-19 death if the disease was “involved in the sequence leading to that death,” Brewster said.
Death which occurred prior to large-scale COVID-19 testing may be more difficult to determine, Brewster said, as some who died of the disease may have not been tested, so some of those cases are sent to the office of the chief medical examiner in Baltimore for an autopsy, where postmortem COVID-19 testing is performed.
• Rumor: COVID-19 only kills the elderly.
Brewster said while the disease is definitely more likely to kill individuals who are older, and who have chronic medical conditions, “There have been documented COVID-19 fatalities in healthy, younger people.”
Although St. Mary’s death count is so low that deaths cannot be quantified in age ranges due to privacy reason, as of last Thursday, those who have died of COVID-19 in the county were in their 60s through their 90s, according to a health department spokesperson.
In Maryland, as of Wednesday, one person in their teens has died of a confirmed COVID-19 case, 11 people in their 20s, 28 people in their 30s, 66 people in their 40s, 153 people in their 50s, 358 people in their 60s, 563 people in their 70s, and 1,030 people over age 80. Probable deaths similarly rise with age.
• Rumor: Masks aren’t proven to stop the spread of COVID-19.
“So that’s false,” Brewster said.
Although no mask has shown to be 100% effective, all masks have a different level of effectiveness.
Cloth face coverings, which can be made out of old fabric or T-shirts, have demonstrated to be “more effective” in preventing the spread of asymptomatic COVID-19 coming from the wearer, Brewster said. The cloth face coverings help prevent spread from subtle actions like the wearer talking and breathing, rather than coughing from someone who is symptomatic.
Medical-grade masks help to prevent spread from somebody else to the wearer, Brewster said, and effectiveness is based on the type of material as well as proper sealing of the mask.
As no type of mask is completely effective, Brewster said the best practice is to combine mask wearing with other social distancing measures.
• Rumor: If I wear a mask, I can get within 6 feet of you; if I stay 6 feet away from you, I don’t have to wear a mask.
Masks should be worn “if you’re around other people, especially if you’re around people you’re not living with, or in a place where you can’t ensure social distancing,” Brewster said. “Just to be on the safe side, wear a cloth face covering or face masks.”
Researchers are still learning about the virus and determining if 6 feet is the safest distance to avoid respiratory droplets before they settle, Brewster said, and a greater distance may be needed.
Those under the age of 2, or those with medical issues which prevent them from wearing face coverings, are the only people who should not wear them in public, she said.
• Rumor: New research says the coronavirus cannot be spread through surfaces.
While the CDC did recently edit its website to say the new coronavirus does “not spread easily” from surfaces, the organization noted in a news release last week that the change did not reflect a change in the institute’s views of how the virus spreads or new science, but rather a clarification of other ways the virus can spread.
The CDC has since changed that page again to say it “may be possible” to contract the virus from touching surfaces and then their own mouth, nose or eyes.
“It’s not the main way we think the virus spreads,” Brewster said, as respiratory droplets have always been seen as main method of exposure. But it is still possible.
“There is still evidence that someone can get coronavirus by touching a surface with the virus on it” and then touching their mouth, nose or eyes, she said. The virus does not last long on surfaces though, and may be a lower risk on certain surfaces, like food packaging.
“The science is still evolving,” she said. “But at this point, it would be premature to reduce those precautions.”
• Rumor: Hospitalizations are low, the experts were wrong in warning of a catastrophic health event.
Michaels said the rates of hospitalizations varies throughout the country, and are very high in some areas, particularly urban centers.
In St. Mary’s, he said, hospitalizations are lower, and the low rates “may have to do with population density and compliance with measures.”
“I would disagree that this was not a catastrophic health event,” Michaels said, adding that over 100,000 people have died in the United States over the course of ten weeks, more than in the Vietnam War “and other conflicts.”
“I think it would be foolish to ignore the fact that this is a pandemic,” he said.
Brewster agreed that there is evidence to suggest social distancing measures “helped to decrease the spread of COVID, and saved us numerous hospitalizations.”
“We are not out of this yet, we have months to go, and we must press on,” she said.
• Rumor: Coronavirus sits dormant in your throat before you contract the disease. Gargling salt water or vinegar can kill the virus before symptoms show.
Brewster said she has not seen any science that shows gargling salt water kills the virus, but did say physicians will sometimes suggest patients gargle saline to reduce congestion.
“It may make you feel better,” she said.
• Rumor: Gov. Larry Hogan (R) has permitted local jurisdictions to reopen on their own terms.
While the governor did allow for jurisdictions to forego moving into the first phase of his Roadmap to Recovery plan earlier this month, local jurisdictions do not have the authority to be less restrictive than the governor’s orders, Brewster said in a previous email to The Enterprise.