Myths & Facts: COVID-19

It’s been three years since the start of the COVID-19 pandemic. And while President Biden officially declared on Sept. 20, 2022, in a “60 Minutes” broadcast that the pandemic is over¹ due to the falling rates of COVID-19 infections and deaths, the SARS-CoV-2 virus still poses a serious threat. So serious, in fact, that as of this writing, each day an average of more than 37,000 new cases are diagnosed, more than 300 people die and more than 3,200 people are hospitalized due to the virus.² The good news is that over two-thirds of the U.S. population is considered fully vaccinated,³ so there is a much lower chance of individuals developing severe disease or needing hospitalization. The bad news is that many people who are unvaccinated are ending up hospitalized — or worse — and these COVID-19 cases allow the virus to mutate, resulting in more variants.

Unfortunately, misinformation about COVID-19 continues to spread online and in communities, which poses a real challenge for healthcare professionals as they try to combat it and increase vaccine confidence. According to a Kaiser Family Foundation COVID-19 vaccine report, based on a survey of more than 1,500 vaccinated and unvaccinated U.S. adults, “a substantial number of people either believe or are unsure about several common misconceptions about COVID-19 and the vaccines used to prevent it. This includes statements about the vaccine’s effects on pregnancy and infertility, and statements that the federal government is lying about the number of deaths caused by COVID-19 vaccines and by the disease itself.”⁴

“Misinformation is widespread and is a recognized public health crisis,” said Sarah Coles, MD, chair of the Academy’s Commission on Health of the Public and Science, and an assistant professor in the Department of Family, Community and Preventive Medicine at the University of Arizona College of Medicine — Phoenix Family Medicine Residency. “Family physicians are key to combating misinformation for our patients and communities.” Indeed, it is paramount for providers on the frontline of healthcare to provide the facts about COVID-19 so that, as Dr. Coles explains, patients know what to believe and what not to believe.⁴

Separating Myth from Fact

Myth: COVID-19 is no worse than the seasonal flu.

Fact: While the SARS-CoV-2 virus is similar to the influenza virus since they are both contagious respiratory diseases and some symptoms are the same, the viruses are different and they affect people differently. Symptoms of COVID-19 generally appear two to 24 days after exposure, while symptoms of flu generally appear one to four days after exposure. COVID-19 is always more contagious and spreads more quickly than the flu. In addition, people infected with the SARS-CoV-2 virus may lose their sense of taste and/or smell, and severe illness such as lung injury is more frequent than with the flu. COVID-19 also causes different complications than the flu such as blood clots and multisystem inflammatory syndrome in children, as well as higher death rates.⁵

Myth: The data surrounding COVID-19 infections and deaths cannot be trusted.

Fact: This myth stems from flawed reasoning about data collected by the Centers for Disease Control and Prevention (CDC) that show most people who died of COVID-19 had multiple causes, mostly other pre-existing conditions such as heart or lung disease, weakened immune systems, severe obesity or diabetes. But, these people would have lived far longer had they not contracted COVID-19. “For deaths with conditions or causes in addition to COVID-19, on average, there were 2.6 additional conditions or causes per death,” said a statement by CDC.⁵

Also, since the SARS-CoV-2 virus was novel, information concerning it changed as scientists learned more. Unfortunately, this led many people to mistrust the reliability of the data and information. On top of that, partisan differences led to a great deal of mistrust.⁵ A study published in The Lancet showed that this lack of trust, as well as government corruption, “are strongly correlated to higher COVID-19 infection rates around the world.” What’s more, “high levels of government and social trust, as well as lower government corruption, were all associated with higher vaccine coverage.”

The study evaluated data from 177 countries, with findings suggesting “that if all societies had trust in government at least as high as Denmark, which is in the 75th percentile, the world would have experienced 13 percent fewer infections. If social trust (trust in other people) reached the same level, the effect would be even larger: 40 percent fewer infections globally.”⁶

Myth: COVID-19 tests can’t distinguish between the SARS-CoV-2 virus and the flu or a cold.

Fact: The mostly widely used COVID-19 tests originally could detect only the SARS-CoV-2 virus; they could not detect cold viruses or the flu.⁷ However, in July 2021, CDC began using a new test that can check for both influenza and COVID-19 simultaneously, known as the “multiplexed method,” which caused many to believe that the original tests couldn’t distinguish between the SARS-CoV-2 virus and the influenza virus. But, according to pathologist and microbiologist Jana Broadhurst, MD, PhD, “The original test could detect the presence of SARS-CoV-2 with very high specificity.” Specificity means the test is designed to detect only one type of virus. “The PCR test is validated against many different coronaviruses and common respiratory viruses, including influenza so that it would not give false-positive results,” explained Dr. Broadhurst. In fact, when subjecting the PCR test to many different samples to see if it would give the wrong result, it correctly identified SARS-CoV-2 out of all of these samples. CDC switched to the multiplexed PCR test since it can diagnose both viruses at the same time.⁸

Myth: Only a COVID-19 PCR test can diagnose whether someone has the SARS-CoV-2 virus.

Fact: PCR tests are considered the “gold” standard for diagnosing COVID-19. However, rapid tests provide a diagnosis in minutes rather than days, which can be helpful to determine whether someone is contagious and can spread the virus to others. The main difference between PCR tests and rapid tests is that PCR tests are based on detecting the genetic material inside the coronavirus, which means it can detect an infection in the earliest stages, often days before symptoms start. Rapid tests look for a protein found on the surface of the virus (an antigen). The more virus found in someone’s nose, the more likely they are to have a positive rapid test and be capable of spreading the virus.

“Having a positive rapid test indicates that you are infected with high enough levels of the virus to be contagious to others,” said Emily Somers, PhD, an epidemiologist at Michigan Medicine who has advised school districts and public health agencies on the use of rapid testing to steer quarantine and isolation guidance. “If you’re negative on a rapid test, you may not be infected, or you might be in the early or late stages of an infection, before or after the contagious period.”⁷

Myth: Natural immunity to the SARS-CoV-2 virus is better than immunity from the COVID-19 vaccines.

Fact: There was some truth to this myth in the beginning when individuals infected with COVID-19 had greater protection against the Delta variant with natural immunity. But when the Omicron variant emerged, which has been responsible for the largest surge in COVID-19 cases, that was no longer the case. Now, the COVID-19 vaccines provide greater protection. “Omicron has a large number of mutations that all appeared at once. It’s very different from previous versions, including Delta,” explains Lisa Maragakis, MD, MPH, senior director of infection prevention at Johns Hopkins Medicine. “It has over 50 mutations, many in the spike protein, which is how it gets into our cells in the first place. The spike protein is also one of the most prominent exterior features of the virus that our immune system recognizes, responds to and uses to develop antibodies. Unfortunately, Omicron is a perfect storm: Mutations gave it the ability to escape weak immune responses and become more transmissible from person to person.”⁹

One main difference between natural immunity and vaccinations is that natural immunity from a past COVID-19 infection varies greatly, whereas vaccine-related immunity has been studied in-depth and is relatively consistent. The COVID-19 vaccines provide safer, better and longer-lasting protection against serious illness than an infection. It’s much safer to get vaccinated than it is to risk a potentially severe bout with COVID-19 that can leave lasting effects.⁷

Myth: Since herd immunity will end the pandemic, vaccines aren’t necessary.

Fact: Also referred to as “community immunity,” herd immunity is a public health term used to describe a case in which the potential for person-to-person spread is significantly reduced due to the broader community’s resistance against a particular pathogen. High levels of herd immunity have enabled the United States to largely control polio and measles, which are caused by viruses that have not undergone significant evolution. However, achieving herd immunity with respiratory viruses such as influenza, which continually mutate, has been less successful.

According to Anthony S. Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), David M. Morens, MD, senior scientific advisor to the NIAID director, and Gregory K. Folkers, chief of staff to the NIAID director, “achieving classical herd immunity against SARS-CoV-2 is unlikely due to the virus’ ability to continually mutate to new variants; asymptomatic virus transmission, which complicates public health control strategies; the inability of prior infection or vaccination to provide durable protection against reinfection; suboptimal vaccination coverage; and adherence to nonpharmacologic interventions.”¹⁰

According to virologist Sabra Klein, PhD, MS, MA, co-director of a the National Cancer Institute Center of Excellence, immunity from natural infection starts to decline after six to eight months, whereas immunity after being fully vaccinated lasts for a year or longer. But that’s the puzzle: While it’s not known why vaccines lead to better immunity than natural infection, it is known that infected individuals’ immune systems have been trained to target all parts of the virus, whereas vaccines target just the spike protein — the part of the virus essential for invading cells. So, the assumption is that natural immunity would provide better protection, but it doesn’t. “It’s like a big red button sitting on the surface of the virus. It’s really sticking out there, and it’s what our immune system sees most easily,” says Dr. Klein. “By focusing on this one big antigen, it’s like you’re making our immune system put blinders on and only be able to see that one piece of the virus.”
On the flip side, current vaccines recognize the COVID-19 variants and induce excellent immunity against them. Yet while previously infected individuals’ immune systems will recognize the variants, it is unknown what level of immunity against a specific variant or how degraded the immune response will be. It’s possible these individuals might actually be susceptible to reinfection with one of the variants.¹¹

Myth: mRNA vaccines are not really vaccines.

Fact: mRNA vaccines may be different from other types of vaccines since they are manufactured using a new methodology, but they still obtain the same results by triggering an immune response inside the body. The difference is that mRNA vaccines work by teaching cells in the body to make a harmless piece of a spike protein found on the surface of the virus that causes COVID-19. Once made, the cells then display this spike protein on their surface, and since the immune system doesn’t recognize it, it responds by producing antibodies against the virus to get rid of it. This differs from many other vaccines that use a piece of, or weakened version of, the germ that the vaccine protects against, which is how the measles and influenza vaccines work. When that germ is introduced into the body, the immune system produces antibodies to fight the germ since it doesn’t recognize it.¹²

Also, it’s important to understand that the mRNA technology is not new; research and development of this type of vaccine has been underway for years.

Myth: The COVID-19 vaccine ingredients are dangerous.

Fact: According to CDC, there is nothing dangerous about the COVID-19 vaccine ingredients: They don’t contain eggs, gelatin, preservatives, pesticides, tissues (such as aborted fetal cells), antibiotics, medicines, latex or metals, so they cannot make people magnetic. They also don’t contain microchips or any live virus, so they can’t make people sick with the SARS-CoV-2 or monkeypox viruses.^12,13

The ingredients in the Pfizer-BioNTech and Moderna vaccines are very similar. They both contain mRNA (messenger ribonucleic acid), which is the only active ingredient in the vaccines, lipids to protect the mRNA and to help deliver it to the cells, salts and sugar. The Moderna vaccine also contains acetic acid and acid stabilizers. The Johnson & Johnson vaccine contains a modified and harmless version of a different virus (Adenovirus 26) that delivers a DNA gene sequence to produce the coronavirus spike protein, as well as acids, salts, sugars and ethanol. The Novavax vaccine contains a SARS-CoV-2 recombinant spike protein made from moth cells; an adjuvant that contains saponins, a soap-like substance derived from the soapbark tree; salts; food additives (disodium hydrogen phosphate dihydrate and sodium dihydrogen phosphate monohydrate); cholesterol; phosphatidylcholine (a chemical found in many foods such as eggs and soybeans); and water for injection.¹⁴

Myth: COVID-19 mRNA vaccines can alter DNA.

Fact: The rumor that mRNA vaccines can alter a person’s DNA is simply not true. The mRNA vaccines never enter the nucleus of the cell, where a person’s DNA is stored. Instead, after injection, the mRNA from the vaccine is released into the cytoplasm of the cells, and once the viral protein is made and on the surface of the cell, mRNA is broken down and the body permanently rids itself of it, therefore making it impossible to change a person’s DNA.¹⁴ In short, all of the vaccine ingredients are discarded after the body produces an immune response because they are no longer needed by the cells.

Myth: COVID-19 vaccines can affect people’s fertility.

Fact: There is currently no evidence that COVID-19 vaccines cause fertility problems in women or men. In fact, several studies evaluating the safety and efficacy of vaccines on fertility and pregnancy have all shown that the COVID-19 vaccines are safe for people who are pregnant, or who want to have a child in the future. For instance, data from v-safe and from eight U.S. healthcare systems show COVID-19 vaccines do not prevent people from becoming pregnant, which is confirmed by an in vitro fertilization study that showed people who had been vaccinated against COVID-19 were just as likely to get pregnant as people who had not been vaccinated or recently had COVID-19. Another study that compared sperm before and after vaccination with an mRNA COVID-19 vaccine (Pfizer or Moderna) found vaccination did not affect how much sperm men had or how it moved.

It’s unwise for women who are pregnant not to get a COVID-19 vaccine since getting infected with the SARS-CoV-2 virus when pregnant can cause preterm birth, stillbirth and other pregnancy complications. And, it is known that vaccination either before conception or early during pregnancy is the best way to reduce maternal and fetal complications. In the largest study of its kind, researchers found mRNA COVID-19 vaccines are highly effective at protecting pregnant and breastfeeding people against COVID-19. And, two other studies (published in the Morbidity and Mortality Weekly Report and American Journal of Obstetrics & Gynecology) showed that babies received protection through the vaccinated parent’s placenta and milk.¹⁵

Myth: COVID-19 vaccines don’t protect against the variants.

Fact: There is no evidence that shows the COVID-19 vaccines don’t protect against variants, and boosters are now being designed to target the latest variants. In a study that evaluated a third and fourth COVID-19 vaccine dose, researchers found they offered substantial protection among adults with healthy immune systems who were eligible to receive them during Omicron variant evolution in early 2022. The study, conducted from mid-December 2021 through mid-June 2022, examined VISION Network data on more than 214,000 emergency department/urgent care visits and more than 58,000 hospitalizations with a COVID-19-like illness diagnosis in 10 U.S. states. Findings showed:

• When BA.1 was the predominant variant, vaccine effectiveness (VE) was 61 percent for two doses against COVID-19-associated hospitalizations, and VE increased to between 85 and 92 percent after receipt of a third/booster dose.
• When BA.2/BA.2.12.1 became predominant, vaccine effectiveness with two doses was 24 percent against COVID-19-associated hospitalizations and increased to 52 to 69 percent after a third/booster dose.
• Patterns were similar for emergency department and urgent care encounters, with lower VE during BA.2/BA.2.12.1 predominance and higher VE with three or four doses compared to VE with two doses.
• Among adults ages 50 years and older during BA.2/BA.2.12.1, vaccine effectiveness against COVID-19-associated hospitalization was 55 percent more than four months after a booster/third dose and increased to 80 percent more than a week after the fourth dose.

Importantly, stopping the spread of the SARS-CoV-2 virus decreases the ability for the virus to mutate, which helps prevent the emergence of any other variants. Vaccines remain the single most important tool to protect people against serious illness, hospitalization and death — even as variants continue to emerge.¹⁶

Myth: COVID-19 is not really dangerous anymore because treatments are widely available.

Fact: There are treatments available for COVID-19, but again, the best way to avoid severe illness, hospitalization and death is by getting vaccinated against the SARS-CoV-2 virus. Currently, there are two FDA-approved treatments: the intravenous antiviral drug Veklury (remdesivir) for adults and certain pediatric patients and the immune modulator Olumiant (baricitinib) for certain hospitalized adults. There are also other treatments authorized by FDA’s emergency use authorization, including several monoclonal antibodies for the treatment, and in some cases prevention (prophylaxis), of COVID-19 in adults and pediatric patients, as well as two oral antiviral pills, Paxlovid and Lagevrio (molnupiravir), authorized for patients with mild-to-moderate COVID-19, with strong scientific evidence they can reduce the risk of progressing to severe disease, including hospitalization and death. However, most monoclonal antibodies must be taken within a few days of infection, and antivirals need to be taken within the first five to seven days of infection.¹⁷

Myth: There are other treatments that can prevent or cure a COVID-19 infection.

Fact: There is one treatment, Evusheld, that can help protect some people from COVID-19 before they are exposed to the SARS-CoV-2 virus, but CDC emphasizes that it is not a substitute for a COVID-19 vaccine. Individuals who may be eligible for this long-acting antibody treatment are those who:¹⁸

• Are at high risk for serious COVID‑19
• Have not tested positive for COVID‑19
• Have not been recently exposed to someone who has tested positive for COVID‑19

However, a great number of myths are being spread about the use of other treatments to prevent or treat COVID-19, including the use of antibiotics, exposure to cold weather, taking vitamin D supplements, drinking water, ingesting highly toxic products and even taking medicines approved for animals.

Antibiotics can only treat a bacterial infection, not a virus, so antibiotics should not be used to prevent or treat the SARS-CoV-2 virus. There is no evidence whatsoever that cold weather can kill the SARS-CoV-2 virus or that vitamin D supplementation can prevent or treat COVID-19. While it’s important to hydrate, drinking water will not wash the virus down a person’s throat and into the stomach where it will be killed by stomach acid, and water won’t prevent the virus from entering the lungs or making a person sick.

The final two treatment myths are the most dangerous. Disinfectants, bleach and rubbing alcohol should not be ingested or rubbed on the body because they are toxic substances. And, while many people believe taking Ivermectin, a medicine that controls parasites in animals and humans, will prevent or cure COVID-19, this is false. In fact, the formulas reported to FDA that humans are taking are different than for people and can be very toxic to humans.¹⁸

Myth: There are no long-term effects of COVID-19.

Fact: While most people who contract the SARS-CoV-2 virus recuperate within a few weeks, there are individuals whose symptoms last for a long time afterward. There are a variety of names for this, including post-COVID-19 syndrome, post-COVID conditions, long COVID, long-haul COVID-19 and post acute sequelae of SARS COV-2 infection.

With long COVID, individuals experience new, returning or ongoing symptoms that last more than four weeks after contracting the virus, and for some, these symptoms last for months or years, causing disability. According to the latest research, one in five people ages 18 to 64 years has at least one medical condition that can be attributed to COVID-19, and among those age 65 and older, one in four individuals has at least one medical condition attributed to the virus. Most common symptoms include fatigue, symptoms that get worse after physical or mental effort and fever and lung (respiratory) symptoms, including difficulty breathing or shortness of breath and cough. But other more serious symptoms include:¹⁹

• Neurological symptoms or mental health conditions, including difficulty thinking or concentrating, headache, sleep problems, dizziness when standing, loss of smell or taste, pins-and-needles feeling and depression or anxiety
• Joint or muscle pain
• Heart symptoms or conditions, including chest pain and fast or pounding heartbeat
• Digestive symptoms, including diarrhea and stomach pain
• Blood clots and blood vessel (vascular) issues, including a blood clot that travels to the lungs from deep veins in the legs and blocks blood flow to the lungs (pulmonary embolism)
• Other symptoms such as a rash and changes in the menstrual cycle

Myth: The COVID-19 pandemic is over.

Fact: Yes, President Biden did declare that the pandemic is over¹ due to the falling rates of COVID-19 infections and deaths. However, it’s too early for individuals to let their guard down due to ongoing hospitalization and death rates. According to Harvard T.H. Chan School of Public Health experts, as of Oct. 7, 2022, “Some parts of the U.S. are seeing an uptick in COVID cases and hospitalizations, although experts are unsure whether the increases foretell a winter surge in the U.S. If more people get the new bivalent vaccine, it could keep numbers down, but so far only eight million out of 200 million eligible people have gotten them. And uptake of previous boosters has already been sluggish.”²⁰

Dispelling the Myths Now

The COVID-19 pandemic has caused many hardships — both economic and personal. After almost three years, it’s safe to say that the public is in a state of pandemic fatigue, causing many to let their guard down. But while we would all like to return to life as normal, it is important to understand the facts about this deadly virus that has killed more than six and a half million people worldwide.

According to Robert M. Califf, MD, commissioner of the U.S. Food and Drug Administration (FDA), “The distortions and half-truths of misinformation and disinformation pose enormous dangers to the effectiveness of science and to public health itself through the negative impact it has on individual behavior. That’s why I’ve made combating misinformation one of my priorities. Providing factual info is the key to helping people make the best informed decisions about their health.”

FDA recommends individuals, especially providers, take three easy steps to prevent rumors from spreading: 1) Don’t believe the rumors, 2) Don’t pass them along and 3) Get health information from trusted sources such as FDA and its government partners: usa.gov/health, coronavirus.gov and vaccines.gov.¹³