False information in the time of corona

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These trying times of the novel coronavirus have made us susceptible to more than just social isolation and economic uncertainty: false stories and information are running rampant. When the truth sometimes seems unreal, it’s easy to believe a lie. The Examiner will take a look at some of the rumours that have been circulating in social media feeds and messaging apps, in an effort to clear up, or at least explain the complications involved, in some of the stories.

Let’s start off with some low hanging fruit:

Will garlic help fight coronavirus? No.

The World Health Organization has a great list of “myth busters” that I highly recommend everyone check out. It includes cute shareable graphics, to help you spread the good word.  And the word on garlic vs. coronavirus is:

Can you test yourself for coronavirus by holding your breath for ten or thirty seconds? No.

Snopes is another great place to check for coronavirus related misinformation. It has identified this rumour as something akin to following:

The new Coronavirus may not show signs of infection for many days. How can you know if you are infected? By the time you have fever and/or cough and go to the hospital, the lung is usually 50% fibrosis. Taiwan experts provide a simple self-check that we can do every morning: Take a deep breath and hold it for more than 10 seconds. If you do this successfully without coughing, without discomfort, stiffness or tightness, there is no fibrosis in the lungs; it basically indicates no infection. In critical times, please self-check every morning in an environment with clean air.

This rumour is not just wrong, it’s really wrong, as Snopes’ Alex Kasprak writes:

The “simple self-check” hinges on two central and unsupported assertions: First, that early COVID-19 infections include as a symptom a condition known as pulmonary fibrosis; and second, that the ability to hold your breath for 10 seconds is an accurate indicator of fibrosis. Neither is the case.

Can we wash away coronavirus by drinking lots of water? No.

Let’s head over to the BBC Future to tackle this one. Writer Zaria Gorvett speaks to a clinical epidemiologist who sounds like she may have spit out her coffee the first time she heard this rumour.

“This is just so simplistic, I can’t even get my head around it,” says Kalpana Sabapathy, a clinical epidemiologist at the London School of Hygiene and Tropical Medicine.

Sabapathy explains that infections often begin after we’ve been exposed to thousands or millions of viral particles, so sweeping a few down the oesophagus is unlikely to have much of an impact. “One gaping hole in it is the likelihood that you managed to flush all of them down into your stomach,” she says. “You would probably have already got them in your nostrils by then, for example – it’s not fool proof,” she says. And here lies another of the main flaws in the idea. Even if the virus hasn’t already managed to find its way inside the cells of your respiratory tract, it can also get into the body in other ways. While some people might become infected by touching their mouth with contaminated fingers, it can also enter the body by touching the nose or eyes.

Will summer be a saviour? Probably not.

The idea that warm weather will slow down transmission of the coronavirus has been circulating, thanks in part to Donald Trump’s repeated, hopeful references to the possibility. Sometimes the rumours get very specific, like “it can be killed if the heat is over 26 degrees,” the rumour reported to me.

The World Health Organization rains on this parade, stating there’s no reason to think that summer will save us:

From the evidence so far, the COVID-19 virus can be transmitted in ALL AREAS, including areas with hot and humid weather. Regardless of climate, adopt protective measures if you live in, or travel to an area reporting COVID-19. The best way to protect yourself against COVID-19 is by frequently cleaning your hands. By doing this you eliminate viruses that may be on your hands and avoid infection that could occur by then touching your eyes, mouth, and nose.

One of the reasons people are hoping that this new virus will slow down in the summer is that it’s a coronavirus, and other coronaviruses that have been with us a long time, like the common cold, do tend to be seasonal. And the common influenza virus, which is also endemic (ie, here to stay), is seasonal. But unfortunately, as Marc Lipsitch, director of Harvard’s Center for Communicable Disease Dynamics writes, that doesn’t mean this new virus will be.

Seasonal viruses that have been in the population for a long time (like OC43 and HKU1) behave differently from viruses that are newly introduced into the population.

There’s not really a scientific consensus on what makes these common viruses seasonal, explains Lipsitch. The factors that are considered to contribute to seasonality include humidity levels (drier conditions have been shown to be favourable to influenze transmission, though not necessarily coronaviruses), human behaviour changes (like congregating more inside), the condition of our immune systems (which may be worse off in winter), and the normal cycle of an epidemic (the curve that we are all hoping to flatten.)

Lipsitch concludes,

For the novel coronavirus SARS-CoV-2, we have reason to expect that like other betacoronaviruses, it may transmit somewhat more efficiently in winter than summer, though we don’t know the mechanism(s) responsible. The size of the change is expected to be modest, and not enough to stop transmission on its own.

BBC Future’s Richard Gray has an in-depth piece on the seasonal/warm weather debate, citing ongoing research that may indicate the new virus is at least somewhat affected by climate patterns, and quoting this virus expert, who draws a distinction between behaviour of endemic versus pandemic stage viruses:

“Eventually we would expect to see Covid-19 becoming endemic,” says Jan Albert, a professor of infectious disease control who specialises in viruses at the Karolinska Institute  in Stockholm. “And it would be really surprising if it didn’t show seasonality then. The big question is whether the sensitivity of this virus to [the seasons] will influence its capacity to spread in a pandemic situation. We don’t know for sure, but it should be in the back of our heads that it is possible.”

Snopes.com also tackles the claim that “warmer weather will inhibit the spread of the new coronavirus,” and finds it unproven.

To sum up: There’s still a lot we don’t know about COVID-19. While it’s possible that the spread of this disease will be dampened by warm weather, it won’t simply go away due to a change of season. COVID-19 can spread in all climates and in various regions of the world, and people should take precautions regardless of the current temperature.

Can you make an effective hand sanitizer at home? With the right ingredients, yes, but soap and water washing is the way to go.

Since hand sanitizer, along with toilet paper, is the stress-induced purchase of choice these days, leaving shelves somewhat empty, people have turned to making it on their own. So the question is, can you make an effective one at home?

First things first: everyone, everywhere recommends soap and water hand washing first, as the gold standard for getting rid of the new coronavirus on your hands. Why is proper soap and water washing so good? For two reasons:

First, soaping up and rinsing under running water mechanically removes the virus from your hands, as explained in this Harvard Health Letter from back in 2007, long before this coronavirus even considered making the jump to humans.

Secondly, as University of New South Wales chemist Palli Thordarson has explained in a very long Twitter thread, soap “dissolves the fat membrane [which surrounds this coronavirus] and the virus falls apart like a house of cards.”

“The skin is quite rough and wrinkly which is why you do need a fair amount of rubbing and soaking to ensure the soap reaches [every] crook and nanny on the skin surface that could be hiding active viruses,” writes Thordarson.

But if soap and running water are not available, the alcohol in hand sanitizer will also work the same magic on the membrane layer of the coronavirus (just without the added benefit of also washing the virus away.)

And since commercially produced hand sanitizers have become such a hot commodity, it’s worth looking into whether we can make a useful hand sanitizer on our own.

Biologists Shobana Dissanayeke and James McEvoy from Royal Holloway university in London evaluate a common homemade recipe in The Conversation, and find it somewhat up to the task. The recipe they looked at calls for two parts rubbing alcohol (99% isopropyl alcohol) and one part aloe vera gel, which leaves the mixture with roughly 66% alcohol concentration. “Mixtures of 60%-80% alcohol by volume kill microorganisms, so the 66% alcohol concentration in the recipe looks about right if pure rubbing alcohol (also known as “surgical spirits”) is used,” write Dissanayeke and McEvoy, warning the rubbing alcohol may be sold in more diluted forms so checking labels is a must. Even so, they point out, the World Health Organization, which has published its recommended hand-rub formulations, calls for 80% ethanol or 75% isopropyl alcohol by volume.

The homemade products may not be strong enough to inactivate the virus quite as effectively as the WHO formulation. On the other hand, some commercial hand sanitisers contain as little as 57% alcohol, so these homemade products would be better than that.

In our opinion, if you want to make a homemade hand sanitiser you should go with a modified version of the first recipe, upping the rubbing alcohol to the WHO-recommended concentration: three-quarters of a cup of isopropanol and a quarter of a cup of aloe vera gel. You could even substitute glycerol for the aloe vera gel. It’s cheaper, but it won’t smell as nice.

Popular Science’s Sara Kiley Watson also came up with no objections to homemade hand sanitizer, but warns against using recipes calling for other non-medicinal sources of alcohol, such as vodka, which are just not strong enough to pass muster, but which have been unfortunately recommended widely online, including from seemingly reputable sources like Good Housekeeping.

Does ibuprofen make COVID-19 worse? It’s complicated.

Last Saturday, none other than France’s health minister tweeted out: ““The taking of anti-inflammatories [ibuprofen, cortisone … ] could be a factor in aggravating the infection. In case of fever, take paracetamol. If you are already taking anti-inflammatory drugs, ask your doctor’s advice,” as reported (and translated) by the Guardian’s Kim Willsher on March 14.

This unleashed plenty of discussion among medical professionals, and also rumour-mongers online.

The BBC’s Reality Check team has a story from March 17 about false stories spreading via WhatsApp claiming that patients are suffering more after using anti-inflammatories or ibuprofen, or that the drugs are even the cause of the rapid spread of the virus. Though all false, the same story does report that the UK’s National Health Service has moved to recommending paracetamol (aka acetaminophen) over ibuprofen:

Speaking to the BBC, medical professionals said that ibuprofen is not recommended for managing coronavirus symptoms.

The NHS says that, while “there is currently no strong evidence that ibuprofen can make coronavirus (Covid-19) worse, until we have more information take paracetamol to treat the symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you.”

Those already taking ibuprofen for other conditions should not stop without consulting a doctor, though.

Both paracetamol and ibuprofen can bring a temperature down and help with flu-like symptoms. But ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) are not suitable for everyone and can cause side-effects – especially for people with asthma, heart and circulatory problems.

On the other hand, the Canadian Pharmacists Association (CPA) released a memo on its website on March 17th, referring to NSAIDS (non-steroidal, anti-inflammatory drugs, like ibuprofen, naproxen and aspirin), and stating:

This Snopes article by David Mikkelson does a great job summarizing the “mixed reactions” to France’s warning. Here’s how NHS doctor Dr. Amir Khan explained the issue, as reported by Snopes:

Despite all of their beneficial effects, it has long been known that anti-inflammatories can have a depressive effect on parts of our immune systems.

When it comes to taking them to help ease the symptoms of the common cold, we do not really have to worry about this slight but important reduction in the strength of our immune systems: We are very unlikely to develop complications from the common cold, let alone die from it.

But we need our immune system in top working order in order to battle the coronavirus and win.

If that seems like it could wrap up the issue for you, there’s one more thing to consider.  As pointed out in the CPA memo, and explained in this video by Dr. Roger Seheult, NSAIDS have also been found to have anti-viral properties that might actually help guard against coronaviruses.

At this point in time, it’s probably best to leave this package unwrapped, like the CPA has:

The COVID-19 situation is evolving and data collection is ongoing. The NSAID evidence will be reviewed as it becomes available and this statement will be updated accordingly.

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