Confronting Three Pieces of Misinformation

Three Things Thursday

Three Things Thursday highlights three things I am paying attention to as an epidemiologist each week.

This week this article — COVID conspiracies return in force, just in time for 2024 — caught my attention. And two quotes have been swirling around in my mind throughout the week…

1. “We’re only at the tip of the iceberg for how bad this is going to get,” said Mike Rothschild, a conspiracy theory researcher.

2. Rothchild continues, “Misinformation about COVID is probably pretty constant. There’s new variants of COVID that seem to ebb and flow … but the conspiracy theories about what they think is happening with COVID are very constant — and they’re constantly at a high, fever pitch.”

Back in April, I wrote in a post titled What Is Keeping Me Up At Night in it I wrote —

“The past three years have been plagued by an unimaginable amount of medical and public health misinformation. Misinformation is epidemic. Misinformation is killing people.”

Given that misinformation is epidemic, today’s three things are myth-busters. I’m going to break down three myths/sources of misinformation — #1) the evolution of the SARS-CoV-2 virus and vaccine effectiveness; #2) the similarities and differences between COVID and (just) the flu; and #3) the harm done when we each “do our own research.”

Hoping this post helps to educate and empower you
to be healthy and create healthy communities.

The Evolution of SARS-CoV-2 & Vaccine Effectiveness

Yes, the SARS-CoV-2 virus continues to evolve. This is NOT a surprise.

We are seeing new subvariants of the Omicron lineage of the virus quite regularly.

Omicron was initially identified in Botswana and South Africa in November 2021. The EG.5 subvariant (of Omicron) arrived earlier this summer (2023). And then in August another Omicron subvariant, BA.2.86, unofficially nicknamed “Pirola,” started making headlines. There are relatively few reported cases of COVID caused by Pirola, but it has been identified in several countries.

The Fall 2023 COVID booster (which contains the mRNA of the XBB1.5 subvariant of Omicron) is NOT an exact match for EG.5 or BA.2.86, BUT each of these subvariants are close relatives. Earlier this month, Moderna announced that clinical trials showed that the new booster shot effectively targets both the EG.5 and FL 1.5.1, another subvariant that is circulating. Data presented at the Advisory Committee on Immunization Practices meeting (about two weeks ago) showed that the fall booster shot did exactly what we want — it generates a robust immune response (against all of the subvariants, including BA.2.86).

The fall booster was created with the sole purpose of helping our immune system to recognize and prepare to attack newer versions of the SARS-CoV-2 virus.

The fall booster is effective at preventing severe illness, hospitalizations, and deaths caused by the newest subvariants of the virus.

The fall booster shot is needed because the virus is evolving.

Getting the booster shot this fall will quite literally boost/assist/aid your immune system so that it can better fight the latest subvariant of the virus.

Compare/Contrast COVID and Influenza

Let’s start some simple truths…

There is not such thing as just the flu. And COVID is NOT just the flu.

Both influenza and COVID are upper-respiratory viruses that can cause severe disease. Many of the symptoms are the same for both diseases (fever, cough, fatigue, sore throat, body aches); a few symptoms (pink eye, loss of taste/smell, skin rash) appear to be unique to COVID. And both diseases are contagious (meaning they both spread person-to-person).

We have separate vaccines to prevent severe illness caused by each disease.

And we have different antiviral medications that can be used to treat an individual who has been diagnosed with each of the diseases.

But they are distinct illnesses. Caused by two different viruses.

It is possible to get one disease and then immediately get the other. It is also possible to have both at the same time.

There are a lot of similarities between the two diseases. BUT they are not the same.

And if you become symptomatic — with either disease — you should stay home until you have been symptom-free for at least 24 hours. For most of us, this will mean staying home for 4-5 days in order to get better AND stop the spread of disease to others.

At the end of the day, we need to STOP saying that COVID is just the flu.

And we need to stop thinking that just the flu is a thing.

Flu is no joke. When you are infected, it is awful; no fun; a lousy situation.

When you have the flu, your body is rocked. You have virus swirling around in your lungs, esophagus, nasal passages, and throat/mouth. You are sick; sometimes really sick.

There is no such thing as just the flu.

We need to respect the flu and COVID as contagious respiratory diseases. They are caused by two different viruses, both have the potential to make us very sick (or to land us in bed and feeling really yucky for several days).

There is not such thing as just the flu. It is a serious infection. And can cause serious illness.

We need to stay home when we are sick.

Get vaccinated to protect against severe illness.

And we should seek out antiviral treatment following a diagnosis.

There is NO such thing as JUST THE FLU.

Doing Your Own Research Does NOT Make You An Expert

The myth that you can just do your own research in order to be an expert of your own health is killing people, literally. Googling a question about vaccines, disease severity, disease risk factors, or treatments for a disease is NOT research.

I want to repeat that — googling is NOT research.

Research is so much more than a google search.

In order to get my PhD in Epidemiology (with a masters in biostatistics), I had to first complete a MPH (master of public health program) and then four more years of study. In addition to two years of course work and a thesis, my MPH program required a 200 hour internship, where I got hands-on experience designing health studies, collecting and analyzing data, and communicating the findings.¹ Following my MPH program, I spent four more years studying to become an epidemiologist. These four years included weekly journal clubs where we read, discussed, and learned from the latest research. I took a three-day long comprehensive exam (which included a 24 hour data analysis project — my only all-nighter during grad school). I worked as a research assistant and teaching assistant to learn more and apply what I already had learned. (Oh…) And I completed a dissertation, which investigated the genetic and environmental risk factors for bladder cancer.

Since graduation I have taken additional classes, done intensive trainings, and gone to conferences to continue to learn.

I have coordinated studies — in the community and in clinical settings — and published my work (which includes a grueling process of review from other epidemiologists and statisticians).

Three advanced degrees. Six years of graduate education. Published books. Published papers. And hours and hours of practice, applied experience, and time being mentored and coached by clinicians, epidemiologists, and statisticians.

THIS IS RESEARCH.

Google is NOT research.

Cherry-picking one article online is NOT research. Nor is reading a few abstracts from a research studies. And until you understand epidemiological study designs, power calculations, null vs. alternative hypotheses, p-values, confidence intervals, estimation, probability, generalization, bias, validity, and the strengths and limitations of a cohort vs. case control study, among other things — you really cannot understand the research.²

In order to improve our individual health, the health of our communities, and the healthcare system, we need a real health researchers who can understand all of those things, explain them to the public, and answer questions that individuals may have.

Google is a tool. It can help us to generate questions to ask an expert. It can connect us to health research experts. It can show us what it takes to become an expert.

But googling something does NOT mean you are doing or that you understand research. Nor does it make you qualified to decide on your own what is healthy or what makes a healthy community.

On top of that — google does NOT (necessarily) allow anyone to see the big picture. Google may answer a question about your health, but it does not connect your health with that of your community. Google does NOT help you to think through systems of power, access to care, health inequalities, or how the decision you are making about your health may impact the health of your neighbor.

This type of systems thinking comes from years of study, experience, and application.

We can NOT improve our health or the health of our communities by thinking we are doing research and becoming a healthcare provider by googling one health question at a time.

We need to recognize that research is more than asking a single question online.

Health research is the culmination of years of work.

Individuals with training and experience and expertise are needed.

Claiming you know what is best for you (and your family) if you are just googling a question here and there, reading a few articles, or skimming a few abstracts is insulting to me (there, I said it).

And, more importantly, it is harmful to you, your family, and our communities.

The COVID pandemic has had a deep and meaningful impact on all of us. There are big feelings, strong beliefs, and a lot of misunderstandings. For me, the pandemic opened my eyes to the reality that health research, public health realities, and my expertise are needed beyond the research lab, the walls of the hospital where I work, and the classroom where I teach.

The knowledge I have gained from 20+ years of education and experience are needed by YOU — the public.

I am here to share what I know, to listen to your questions, to help you understand.

Please use me, and other experts, to help you build a healthier life and create healthier communities.

Do not rely on google. Do not minimalize the complicated fields of medicine and health research and think you can master them with a quick internet search.

The epidemiologists and public health experts are here. Here for you.

Ask us questions. Listen to our advise. Trust our expertise.

My goal is to create healthy communities for all of us.

Ask me a question. Engage in a conversation. Recognize that my expertise can help you to make healthier decisions and create healthier communities.

1. I did this at the Delta Airlines Corporate Safety Office. I examined water samples from the airplane bathrooms to see if they were safe to drink (they weren’t). I designed studies to determine if flight attendants were suffering from hearing damage on different sized airplanes.

2. The ladies from The Unbiased Science Podcast said it best —