Imperfect mask-wearing, lemons and other COVID-19 myths, addressed

CADILLAC — If you've spent anytime online over the past three months — and you've probably spent a fair amount, since so many businesses were closed — you've probably read some claims about mask-wearing, home remedies and other tidbits about keeping yourself safe from the coronavirus.

Some of those things are myths, not good advice, or overlook important considerations.

The Cadillac News talked to Dr. James Whelan, interim chief of medicine at Cadillac Munson Hospital, who is also in private practice, about some of the claims we've seen making the rounds recently.

Claim No. 1: Imperfect mask-wearing from others means wearing masks is a waste of time.

The Cadillac News has seen some variation on this claim in several places. Generally, this refers to people who take masks on or off in a way that is different from the sterile technique used by healthcare providers. The claim also sometimes references people who take the same mask on and off multiple times.

This myth seems to stem from the idea that wearing homemade cloth masks will protect the wearer from contracting coronavirus.

That idea is wrong.

Wearing a mask is something you do to prevent spreading the novel coronavirus to somebody else. You may have the virus without knowing it.

"A plain cloth mask that people are making homemade primarily protects others from droplets created by the wearer during normal speech or if they cough or sneeze," Dr. Whelan said. "It doesn't protect the wearer from anything they're breathing in. The virus is so tiny that it passes easily through a cloth mask. So if they were in a room where someone coughed without a mask, and they were wearing a cloth mask, it wouldn't really provide any protection."

So why do cloth masks work one way but not the other? If the virus is so tiny that it can come in the mask, isn't it so tiny that it could go out the mask?

It's about reducing the amount of virus that goes out into the air.

"It only works partially the one way by capturing large droplets," Dr. Whelan said. Still, if you were to sneeze while wearing a cloth mask, "a very significant portion of that would be captured."

Cloth masks don't protect the wearer, but they protect the people near the wearer by reducing the amount of virus that goes into the air.

What about people that take their masks on and off multiple times without washing it, tossing it in a purse or bag and only bringing it back out when they're around others?

That's totally fine, because you only need to wear a mask when you're within six feet of non-household members. And taking it off when you're alone (or at home) may make it easier to tolerate wearing the mask when you're in public.

As for re-wearing the same cloth mask, the current recommendation is to launder the mask when it's visibly soiled (such as from the oils on your face or from dust or dirt). If the maks gets damp from moisture on your breath, let it dry out before re-using it.

Claim No. 2: Masks reduce the amount of oxygen in your blood.

The claim we've seen goes something like this: wearing a mask reduces the amount of oxygen in your blood and could lead to your death.

It depends on the kind of mask you're wearing.

If you're wearing the kind of mask that's intended to be effective against contracting COVID-19, you could have reduced oxygen levels.

But homemade cloth masks don't have the same effect.

"Say you're wearing an N95 mask, and had some other medical conditions, especially things like COPD, it could lead over time to fatigue with breathing and lower oxygen levels," Dr. Whelan said. "A regular cloth mask, While uncomfortable, would not significantly reduce your oxygen level to even moderate lengths of time."

Claim No. 3: The virus can't survive outside a pH range of 5.5 to 8.5, so just change the PH in your mouth or body and you'll kill the virus.

The specific claim the Cadillac News saw on this claim was that drinking lemon juice or water would kill the novel coronavirus.

While it's true that, in a lab, the virus doesn't survive outside a certain pH range, you shouldn't try to chang the pH of your body.

"It is essentially impossible to change the pH inside of your body," Dr. Whelan said.

If your pH varied even just a little bit, it would be a sign that you were very sick.

"If our body loses its ability to maintain its neutral pH, then, almost certainly it's because something severe is already wrong inside of us. If you drink—let's say a gallon of—lemon water in rapid succession, literally at no point would your blood pH change."

Some might argue that they might change their mouth pH, if not their blood pH, by following a certain diet.

But your mouth isn't the only possible route for the virus to follow.

"Any mucous membrane is a vector for the virus," including the nose and nasal passages, eyes, mouth and upper respiratory tract.

You couldn't change the pH of those body parts "without extraordinary discomfort. No one would put lemon water in their eye. It would hurt," Dr. Whelan said. "And so, the pH thing is misleading. It's true that the virus, in a lab doesn't survive outside that pH. However, you can't physically, through dietary or supplements, you cannot change your body's pH, nor should you want to."

A variation on this claim—that lemon water could kill the virus before it reaches your lungs—fundamentally misrepresents how the virus works.

"The virus doesn't enter into our lungs. It enters through our mucous membranes—the lining of our nose, our cheeks, our eyes— it gets into the bloodstream directly that way. It does not need to get all the way into our lungs to get into our bloodstream," Dr. Whelan said. "Once it's in our bodies, it attacks the lungs. But that is not how we become infected, by breathing it down into our lungs."

Claim No. 4: We need lots of people to get COVID-19 so we develop herd immunity.

Some have argued that herd immunity is the only way to build resilience to the virus and that social distancing delays that goal.

Herd immunity is a goal, said Dr. Whelan. But that immunity should be built through a vaccine, not through infection.

Immunity built through high infection rates means people will die.

"We will not be able to relax about overwhelming our healthcare system or eliminating daily new cases aross the broad population, until we have herd immunity," Dr. Whelan said. Hopefully that will happen via vaccination. "If we gain herd immunity by infecting vast number of people, approximately one out of every 20 of those people will die."

According to estimates, 40 to 70% of the population would have to be infected before we would have herd immunity. That could mean the deaths of 6.6 million people, Dr. Whelan said, pulling out a calculator got estimate the number.

Masking and social distancing are attempts to slow the spread until a vaccine can be developed.

Early in the pandemic, it was estimated a vaccine would take 18 months. It could be sooner.

"The pace of the vaccine studies is ahead of that 18 months timeframe," Dr. Whelan said. Additionally, the federal government is paying companies with experience making vaccines to make 100 million doses of their experimental vaccines.

"We can immediately begin mass immunization, which otherwise would have been delayed four to six months while those doses were manufactured," Dr. Whelan said.

Claim No. 5: There are so many symptoms, anything could be COVID-19.

Though there have been anecdotal reports of somewhat unusual COVID-19 symptoms, for most people, the symptoms are fairly consistent.

A recent report from an organization that's tracking cases across the state found that in the 1,500 cases, the vast majority of the symptoms were ones doctors already know about, Dr. Whelan said.

The most common were cough, fever and shortness of breath. The next most common were sore throat. Approximately 20% had nausea, diarrhea or vomiting along with a fever.

The much-discussed loss of taste and/or smell, however, remains anecdotal.

"But the prevalence of that symptom anecdotally is so high that many people believe it is a significant symptom," Dr. Whelan said. "

Claim No. 6: It makes no sense to wait for a vaccine. After all, the flu vaccine doesn't even work.

It's true that the effectiveness of the flu vaccine varies from year to year. That's because vaccine researchers have to try to figure out which flu strain is going to infect the most people every year.

"On average, one out of every seven years, that prediction is inaccurate, and the strain that circulates in the United States is not included in the vaccine," Dr. Whelan said.

But there's only one known strain of SARS-COV-2, the novel coronavirus that causes COVID-19. 

"It will be much more like the polio vaccine in that, if the tests show that it's safe and effective, it will be effective—meaning that it will not miss the virus, like the flu (vaccine), can, periodically," Dr. Whelan sad.

Claim No. 7: I probably already had coronavirus, so I'm fine now and don't need to worry about getting it again.

You probably did not already have the virus if you lived in this part of northern Michigan during the start of the pandemic.

Though there is some evidence of "antibody positivity" in southeast Michigan, where there were more widespread cases, that's not the case near Cadillac.

Antibodies are evidence that a person has been sick.

When the Cadillac News spoke to Dr. Whelan last week, he said his own office had tested dozens of people for the COVID-19 antibodies, and nobody had them. Those people had been sick earlier in the pandemic but didn't qualify for testing at the time due to the low supply. The absence of COVID-19 antibodies indicates they were sick with something other than COVID-19.

Should you get tested for the antibodies?

There's not a lot of benefit to it, Dr. Whelan said. 

That's because we don't know yet whether you can get re-infected.

"We don't know that those antibodies would mean you are immune from getting infected," Dr Whelan said.

Cadillac News