Coronavirus facts & misconceptions: More questions answered

Here are some of the most common misconceptions about COVID-19 and the coronavirus in Israel and around the world.

A patient suffering from coronavirus disease (COVID-19) wears a full-face Easybreath snorkelling mask given by sport chain Decathlon and turned into a ventilator for coronavirus treatment (photo credit: REUTERS/BENOIT TESSIER)
A patient suffering from coronavirus disease (COVID-19) wears a full-face Easybreath snorkelling mask given by sport chain Decathlon and turned into a ventilator for coronavirus treatment
(photo credit: REUTERS/BENOIT TESSIER)
Since our previous article on common misconceptions about the coronavirus, we have received an outpouring of interest from the community about addressing additional myths and misconceptions surrounding COVID-19 – too many to fit into one additional article, so here is another. Here are some of the most common misconceptions about COVID-19 and the coronavirus in Israel and around the world.
Mortality Rate vs. Death Outcome
 
Expert estimates for the mortality rate of COVID-19 seem to range from 1% to 6% depending on the source and how the data is interpreted. However, by April 16th, world reports show that 21% of reported cases ended in death. Does this mean that COVID-19 is much deadlier than we expected?
  
Answering this question requires a brief epidemiology lesson. First, there is a difference between Mortality Rate and Case Fatality Rate. Mortality Rate refers to how many people have died out of all cases. Case Fatality Rate refers to how many people have died out of all cases that have had an outcome (ie: closed cases, meaning recoveries or deaths). Closed cases always lag behind the number of reported cases and deaths since it may take up to 6 weeks to recover and be discharged from the hospital, causing the Case Fatality Rate to look higher than we expect. Moreover, mild cases that test positive and recover are rarely reported as such, while the vast majority of deaths occur in hospital and must be reported, inflating the number of known deaths relative to the number of known recoveries.
It is likely that the mortality rate is actually on the lower end of the spectrum, closer to 1%, as between 50 and 90 percent of cases are thought to be asymptomatic. That being said, the Mortality Rate of COVID-19 is higher for different age groups and across countries depending on the strength of their healthcare systems, so numbers can vary widely. Regardless, one percent is still a huge number of deaths, and we should take every precaution to avoid this worst-case scenario: 1% of the world population is 75 million, roughly the population of Germany or half the population of Russia who would be at-risk of dying in a widespread COVID-19 pandemic. It is around the estimated number of deaths from the deadly Spanish Flu Pandemic of 1918, and a third more than the number of people who died in the Black Death, a plague that devastated Medieval Europe.
Gloves Off
 
Do gloves protect? What we already know from years of medical research is that even when wearing gloves, people still tend to touch their faces, and gloves are only as effective as the people using them. The only difference is that you can’t re-sanitize gloves with soap or hand-sanitizer, making them even more risky. In an ideal world, touching everything with sterile gloves, not touching your face, and regularly changing them would reduce transmission, but right now gloves are in such short supply that even healthcare workers cannot change gloves as often as their work protocols demand.
 
Our limited supplies of gloves and other protective equipment like facemasks and goggles are best left to the front-line workers who need them most, with the one exception being for someone who is taking care of a relative or loved one who has tested positive for the coronavirus. To safely remove gloves, turn the first glove inside out by removing it at the wrist with the second glove, making sure the second glove doesn’t touch skin or clothing. Then, remove the second glove with the inside-out first glove, making sure your skin doesn’t touch the surface of the second glove. Then, immediately after disposal, wash or sanitize your hands thoroughly.
 
Homemade Masks
 
Since personal protective equipment is in short supply, would a homemade mask help? Cloth masks will not filter out viral particles in the air since these particles are small enough to fit through the holes between cloth fibers. However, they may reduce the number of droplet particles inhaled from another person’s cough or sneeze and might prevent you from touching your mouth. In the Czech Republic, the virus appears relatively contained compared to the other European countries, although this may be due to lack of widespread testing. The country has attributed its low infection rates to widespread wearing of masks, including homemade masks. Although homemade masks are far from ideal, they are better than nothing if you absolutely have no access to proper surgical or N95 masks. Here is an informative video from the Czech Republic about their strategy and why they believe it is working.
 
COVID-19 Lifespan
 
Inside the human body, the coronavirus is capable of incubating (without showing symptoms) for 1-14 days, and if the illness shows symptoms, they may last for 2-6 weeks. It is therefore essential to quarantine or self-isolate for 2 weeks if you have been exposed to someone with COVID-19. Coronaviruses similar to COVID-19 were shown to live up to 72 hours on hard, shiny surfaces like stainless steel or plastic, and up to 24 hours on cardboard, paper, and fabrics. Although less research has been conducted on COVID-19 because of how novel it is, its lifespan outside the body is likely similar to other coronaviruses. Using hand sanitizer frequently, spraying surfaces down with cleaning solution and avoiding touching railings and doorknobs with bare hands can help reduce the spread when you interact with potentially contaminated items.
 
There have been reports of folks avoiding purchasing items or food online due to fears that they may be contaminated with the coronavirus; this is highly unlikely. Most packages are paper or cardboard and spend more than 24 hours in circulation before arriving at your door, and the majority of postal workers already take precautions, but, if in doubt, spray all packages down thoroughly with a bottle of standard cleaning solution and leave them in a safe place for 24-72 hours or until you are comfortable opening them.