Wednesday, 27 May 2020

COVID-19 Mythbusting

God damn it, here we go again. Another goddamned rabbit hole, and another goddamned long-ass post that no one will likely read, care about, or both. In case you don't know exactly what I'm talking about, I went about busting 76 of the most common vaccine myths I see on social media just over a year ago, so if you haven't read that post, I'd strongly suggest ignoring it completely unless you enjoy bashing your head against a wall repeatedly, because reading that would probably hurt quite a bit more.

Anyway, if you think this post strongly resembles that one, there's a very good reason for that, and it sounds something like COPY PASTE. I have no intention of reinventing the wheel, and that one seems to have worked out rather splendidly, so here we are with a lookalike (and possibly soundalike) post.

Let us begin.

If you've landed on this page, one of two things has happened:
  1. You've been a loyal reader, got an email notification, and you excitedly clicked the link thinking you'd finally get your first stupid patient story in over 6 months, or 
  2. I or (hopefully) someone else referred you here from Twitter (or (hopefully) elsewhere) because you propagated some stupid myth or outright bullshit lie about COVID-19. 
If it is #1, then I apologise in advance for your current state of profound disappointment. However, if it's #2, there is at least a 99.91% chance (I calculated it) that you have already clicked back over to Twitter or Facebook or Natural News or greenmedinfo or Children's Health Defense or Infowars or whatever your source of conspiratorial bullshit may be. And if that is the case, then why the hell am I still talking to you.

But on the off chance that you are still reading, and I sincerely hope you are, then please do read on to find out exactly why your myth is a myth.

I was temporarily suspended on Twitter at the end of April for reasons only known to Twitter. I had been in the middle of explaining why the #FilmYourHospital trend was bullshit (more on that later) when Twitter decided to shut me down, because apparently they don't care about medical misinformation being strewn about. At least that's what I think happened, though I have no proof since Twitter didn't bother to explain why my account had been suspended. I appealed (of course), and after about three weeks I got this reply:

Which, of course, explains exactly fuck all. In those intervening three weeks, I missed out on a lot of bullshit peddlers peddling their bullshit, so without further ado, please allow me to bust some bullshit COVID-19 myths.

Unlike my usual mythbusting, there may be some opinion here. Unfortunately SARS-CoV-2 is still a new virus and COVID-19 is still a new disease, so while scientists have discovered plenty, the information coming out is often confusing, contradictory, or both.

Once again I will place a handy alphabetised and clickable table below with all the bullshit I'll be busting.

5G Bill Gates Boost immune system
COVID name Death certificates Emergency doctors
Empty hospitals Event 201 Fake
Flu shot increased risk Hand sanitiser Hydroxychloriquine
Jesus Just the flu Lockdown worse than disease
Manufactured virus Masks don't work Media panic
Only old & sick die Oxygen Plandemic
Rights Stanford study Sweden
Temperature kills virus Weakens immune system World Health Organisation

And with that out of the way, let's get started. 

1) The virus doesn't exist.
Yes, we'll start with the one that should be easiest to correct: it's all completely fake and there is no virus.

WRONG. Hey look, here it is!
And here is a transmission electron micrograph of it!
Science! The virus has been isolated, sequenced, and extensively studied including how it infects cells

It fucking exists.

2) Ok, the virus exists but it's basically just the flu.
It would be incredibly easy to just say "No it isn't just the flu", but that would never satisfy you. Actually, nothing will actually satisfy you, but fuck it, I'll go through the motions anyway.

Unfortunately many smart and/or famous people made this same comparison, including Dr. Drew Pinsky (who retracted, corrected, and apologised) and paediatrics and vaccine expert Dr. Paul Offit, who also notably minimised COVID-19 in mid-March when there were fewer than 100 deaths in the US (now just about 100,000).

To start, COVID-19 is far more infectious than the flu. Unfortunately I'll have to pause this explanation by explaining R0. It is an infectious disease's infectiousness, the average number of people who will contract a disease from someone who has it. As an example, measles (the most highly infectious infectious disease) has an R0 of 12-18, meaning on average 12-18 non-immune people who come into contact with someone with measles will catch measles. For influenza, the R0 is about 1.5. For COVID-19, it is between 2 and 3. This means that COVID-19 is up to twice as infectious as flu.

So fucking what? you say? Well the lower the R0, the higher the likelihood the outbreak will burn itself out. That's why flu epidemics tend to fizzle, but also why Ebola outbreaks die out (people tend to die quickly before getting the chance to infect others).

What, not enough? Then let's also compare death rates, shall we? For influenza, the most recent H1N1 pandemic in 2009 had a case fatality rate (CFR, defined as number of deaths divided by number of cases) of 0.01-0.08%, which means that of every 10,000 people who had H1N1, between 1 and 8 died. Compare this to COVID-19, which has an estimated CFR of 1.3%, which is approximately WAAAAAAAAAAAY GODDAMNED HIGHER than even the upper estimate of the 2009 swine flu pandemic at 0.08%.

COVID-19 spreads more easily and kills more people. It is NOT the fucking flu.

3) But that number is inflated! Stanford study!
I'll give this one a C- for accuracy, because there definitely is some validity to this argument, though not nearly as much as you hoped. The currently reported case fatality rate will almost certainly fall as more tests are done, because it is known that there are many asymptomatic cases that haven't been factored in. The "Stanford study" essentially offered volunteers free COVID antibody tests (when such tests were scarce), and based on their results the authors claimed that there are so many asymptomatic patients that they estimated 50-85 times as many people who had been tested actually had been infected. This theoretically means the death rate should be 50-85 times lower.

Well, no. Not really. There are so many things wrong with this paper (which as of this writing is still in pre-print and has not been peer reviewed), all of which are detailed by this Columbia statistician here. If you think about it another way, the current number of deaths (again as of this writing) in New York City is over 16,000. If every single New Yorker had been infected, this would be a case fatality rate of 16,000 divided by 8.4 million (the current population of NYC), which would be 0.19%. Again, that would be the CFR IF EVERY PERSON IN THE CITY HAD GOTTEN IT. Which they have not. Yet.

So is the CFR 6% as it stands right now? Of course not. But is it higher than flu? Yes, much higher. How much higher will not be known for quite some time, perhaps even years.

4) Ok, it isn't just the flu, but it isn't that dangerous. It's all just media panic
The easiest way to explain that it isn't just all panic is by showing how many more people are dying compared to the expected number of deaths.

In case you can't read or understand the graph, the red area is the number of deaths over the historical average in France, Spain, UK, Netherlands, New York City, Lombardy, Belgium, Sweden (more on Sweden later), Istanbul, and Austria. Notice anything striking? Yeah - lots more people are dying all over the world. There are similar graphs for other countries in South America and Southeast Asia, but hopefully by now you get the point - people are dying of this disease. Lots of them. Hundreds of thousands of them.

There are a few other related claims, like BUT HOSPITALS ARE EMPTY, which I will cover below.

5) Yeah! Hospitals are empty!
Some of them, sure. Like this one, for example. Does this prove you're right?
No. This was an idle cruise terminal that had been transformed into a makeshift hospital at a time when hospital utilisation in the city was incredibly high, including over 3,000 patients in intensive care. The city was preparing for the worst, and fortunately efforts to contain the disease finally began to be successful, and new cases began to fall, rendering the temporary facility unnecessary. All this proves is that the city was prepared. If your smoke alarm battery dies because it never went off, do you consider the smoke alarm useless? If your airbag in your car never goes off because you don't get into an accident, do you consider them a waste? No. It's called preparedness, and it is generally a Very Good Thing.

Now if you're talking about the #FilmYourHospital movement, slow the hell down and use your damned brain. People were walking through empty hospital corridors or filming outside hospitals and shouting about the lack of business. As someone who has walked through many hospital corridors over many years, I can tell you that patients aren't treated in the hallways, they are treated in treatment areas. Those people typically walking in the halls are visitors. Nearly all of them. And these people were filming these hospitals at a time when they were closed to visitors. Parking lots were empty because there were no visitors allowed. Cafeterias were closed because . . . that's right, no visitors allowed. And hospitals were generally slow during that time anyway because elective surgeries were cancelled to make room for COVID-19 patients. At my hospital, for example, 2/3 of the hospital wards were converted to COVID only, and they were full. The ICU was full of COVID-19 patients. The hospital was NOT empty.

If your local hospital is slow or relatively empty, then consider yourself lucky that the virus hasn't hit your area very hard. But claiming that that means the pandemic is a hoax is like saying that global temperatures aren't rising (they are) because it's cold at your house.

6) But doctors are inflating the death numbers so hospitals get paid more!
This is a two-pronged myth: 1) doctors are putting COVID-19 on the death certificate no matter what the cause of death was, and 2) hospitals are getting paid more if they say a patient has COVID-19. The source of this was a doctor and US state senator Dr. Scott Jensen, who said,
"Right now Medicare has determined that if you have a COVID-19 admission to the hospital, you’ll get paid $13,000. If that COVID-19 patient goes on a ventilator, you get $39,000, three times as much. Nobody can tell me after 35 years in the world of medicine that sometimes those kinds of things impact on what we do."
Interesting. The problem is that Medicare, the US federal insurance program for people 65 and older, pays hospitals to care for patients, and the amount paid for respiratory ailments with comorbidities in 2017 was . . . $13,000. And Medicare pays more for more complicated cases, ie need for a ventilator.

Oh, and it gets worse. In a later interview, Jensen "clarified" his statement:
"Do I think people are misclassifying? No."
The problem he had was that the CDC guidance on classifying deaths constituted, as he put it, "less precise standards". Well let's just look at the CDC guidance, shall we?
It says quite clearly that COVID-19 should be listed as "probable" or "presumed" if the patient was presumed to have it within a a reasonable degree of certainty. It does not say "Just fucking put COVID on there no matter what, whatever fuck it". Anyone who has filled out a death certificate (as I have) without a solid cause of death knows how difficult it can be to put a diagnosis on there without being sure. We do the best we can with the information at hand, and that sometimes means being wrong. But your argument that doctors can just put COVID-19 as the cause of death even if the patient died in a car accident is 1) unfounded, and 2) assumes the doctors caring for these patients around the world would act unethically. In other words, it just doesn't hold water.

What is more likely is that deaths are being undercounted.

7) It was manufactured by China
This one just smacks of racism, though I reserve the right to be wrong. Though considering the current geopolitical landscape (yes, I just used the term "geopolitical landscape" in my stupid blog"), I am not at all surprised to see it rear its very ugly head.

Anyway, the genetic sequence of SARS-CoV-2 has been extensively studied by people who understand viral genetics much better than you and I, and their conclusion is so fucking difficult to misinterpret that I feel no need to elaborate: No credible evidence supporting claims of the laboratory engineering of SARS-CoV-2. The author further states that there is no evidence the virus escaped from the lab in Wuhan either, so you can put that bullshit away too.

Another claim that the virus was man-made because it has HIV sequences in it, but this was also roundly destroyed by an HIV virologist. Once again, the title of the paper is impossible to misunderstand: HIV-1 Did Not Contribute to the 2019-nCoV Genome.

8) It doesn't matter, because hydroxychloroquine something something cures it something something game changer.
Hydroxychloroquine is a very old (first synthesised in the 1940's), very cheap, very safe, and very effective drug which is used to treat various autoimmune diseases (such as lupus and rheumatoid arthritis) as well as malaria. It also has been shown to have some antiviral and anti-inflammatory activity, which prompted its investigation into the treatment and/or prevention of COVID-19. The first report was written by French microbiologist Didier Raoult regarding the supposed "100% cure" of 80 patients. There were several, ah, problems with this:
  • no control arm
  • 92% of patients had mild disease
  • only 15% of patients had a fever, which is a hallmark of COVID-19
  • only 15% of patients required oxygen
In other words, the overwhelming majority of the patients had mild disease and would have recovered anyway. Add no control arm, and this is a small, poorly done study. I won't even go into Raoult's track record of academic fraud, but feel free to look it up.

Once that study was produced and a certain demagogue promoted it as a "game changer", hydroxychloroquine became the go-to medicine (with or without azithromycin (an antibiotic) and zinc), mostly because clinicians had no other real treatment. A few small trials showed some promise, but more recent larger trials, including a multinational registry analysis of over 96,000 patients in over 600 hospitals on 6 continents have shown 1) no positive effect of hydroxychloroquine, and 2) increased risk of death. I have chosen to strike through rather than delete the link to this possibly fraudulent study, because I believe it is important to highlight bad science as well as good.

Regardless, a recent randomised placebo-controlled study showed that hydroxychloroquine was not effective as post-exposure prophylaxis. Another study of over 1400 hospitalised patients showed no efficacy of hydroxychloroquine in relation to intubation or death. Randomised trials are underway, but the results have not yet been published as of this writing.

In short, hydroxychloriquine does not appear to work, and it appears to increase the risk of death due to the well-known side effect of QT prolongation of both hydroxychloroquine and azithromycin. We want it to work - we want something, anything, to work - and any claims that we don't are preposterous.

9) But those two emergency doctors say COVID isn't so bad!
You're referring to Drs. Dan Erickson and Artin Massihi who made a viral video claiming that COVID-19 is no worse than the flu. They based their conclusions on the tests they had performed in their walk-in clinic that they own. Oh, you thought they were emergency doctors working in a hospital? Nope. They own and operate several walk-in clinics in California, and they were testing people who literally walked into their clinic. Concluding the seriousness of a disease based on the symptoms of people who are well enough to walk into a clinic is like concluding the endurance of all people by testing the riders at the Tour de France.

In fact, Erickson and Massihi's statements were so outrageous ludicrous that it prompted the American College of Emergency Physicians and American Academy of of Emergency Medicine to release a joint statement:

10) Only the old and sick are dying.
First of all, fuck you for not caring about the elderly or infirm. Second and more importantly, while it is true that 1) the overwhelming majority of deaths are people over age 65 and/or people with co-morbidities, and 2) cases in children tend to be mild with fewer symptoms, there are previously healthy children and young adults who have died of COVID-19. One of the techs with whom I've worked for over a decade, who helped me take care of hundreds if not thousands of my trauma patients and was young and completely healthy, is now dead, having caught COVID-19 from a patient.

There are now multiple reports of children with a multisystem inflammatory syndrome similar to Kawasaki disease has now been described in multiple countries around the globe. It is still quite rare, but at the same time quite worrisome.

The bottom line is that who the virus is killing matters less than the number of people who are dying, which is about 350,000 so far.

11) But lockdowns don't work and are making everything worse. The 'cure' is worse than the disease! Open up!
Do lockdowns work? Well let's take a look at a tale of two cities in Italy, which saw its first case on February 21, that treated this a bit differently. Lodi went into lockdown two days later, the same day Bergamo, another city in the same region, reported its first case. However, unlike Lodi, Bergamo waited to enforce a lockdown until March 8. Just over a week later, Lodi (locked down) had fewer than 1400 cases while Bergamo had over over 3700. Though Bergamo has a population almost 3 times that of Lodi, their curves look very different indeed - Lodi leveled off rather quickly while Bergamo's cases continued to rise just as quickly:

Still not conviced? The chart below (from Financial Times) plots the daily death toll for various countries around the world at their point of lockdown versus 10 days after their 50th death. As you can see, the longer countries wait to impose a lockdown, the higher their death toll tends to be.
Studies out of both China and Hong Kong have shown the same thing - lockdown = fewer cases, and taking a look at countries around the EU, the data again seems clear - waiting longer to lock down means more deaths.

Is that definitive evidence that lockdowns work? No. There are other studies that show lockdowns do work, and others that say they don't. There are also opinion pieces by economists that seem to waver somewhere in between. My take on this issue of lockdowns is quite simple: we don't know yet, but the hypothesis and early evidence certainly seems to support the idea.

The next question deals with the economic aftermath of such lockdowns. Germany has already entered a recession, and the US economy has taken a decided and harsh downturn. I have heard the argument that more people will die of starvation because of the lockdown than would have died of COVID-19 had the lockdown never happened, but this is of course impossible to prove unless you happen to have a TARDIS or specially equipped DeLorean handy. However, if these strict measures had not been put in place and the disease had been left to spread unabated, there is a very good chance that hospitals and indeed entire countries' medical systems could have been overwhelmed, leading to even more deaths. And when medical systems collapse, that leads to even more poverty and even more deaths. The main point was to flatten the curve, not necessarily to bring the pandemic to an end.

So is it true that the treatment is worse than the disease? Maybe, but maybe not. Though I doubt it I have no real definitive answer, and neither do you.

12) But Sweden is different!
The myth here is that Sweden didn't lock down, and they have fewer cases and fewer deaths. Unfortunately for you (and more so for Sweden), that just isn't true.

The only portion of this myth with any truth is that Sweden didn't lock down as tightly as many other countries. Schools, bars, restaurants, and gyms remained open (though with distancing in place), the Swedish government issued recommendations on hand washing and social distancing, and people were recommended to work from home if possible, though gatherings of more than 50 people were banned. The hypothesis was that herd immunity would eventually kick in, mitigating the threat. And that worked, right?


As of today, Sweden, with a population of 10.2 million, has over 34,000 cases and over 4,100 deaths. Their per capita death rate is among the worst in Europe, and far worse than their Nordic neighbours. In fact, Sweden's death rate per million (392) is worse than the US (300), and far worse than neighbours Denmark (93), Finland (53), and Norway (44). The Swedish experiment has failed.

13) The flu shot increases risk of COVID-19.
Another load of bullshit. There is no evidence that this is true in any way. Unfortunately, this myth persists, and it comes from a January 2020 study from the US regarding the 2017-18 flu shot, which looked at 6000 people who had or had not had that particular flu shot. It found no difference in general in infections from other non-influenza respiratory viruses between vaccinated and unvaccinated Department of Defense personnel, but there was a slightly higher risk of contracting certain cold viruses, including metapneumovirus and coronaviruses.
Nope. The data from this study were collected two years before SARS-CoV-2 was even known to exist, and the coronaviruses mentioned in this study are the garden variety coronaviruses which just cause the common cold, not SARS-CoV-2 which causes COVID-19. There are literally zero studies which show that the flu shot (or any other vaccine) increases the risk of contracting SARS-CoV-2. None. Zero.

This claim is pure, unadulterated fear mongering and pure, unadulterated antivax bullshit.

14) This is all just a ploy by Bill Gates to do something nefarious.
Ok, here we go. This is the first myth that I can more accurately categorise as a conspiracy theory, and this one is DEEP. Not deep as in profound, but deep as in knee-deep in bullshit. There are several components or iterations of this conspiracy theory:
  • Bill Gates created SARS-CoV-2 in order to create a mandatory vaccine.
  • The mandatory vaccine would make Bill Gates $200 billion in profit.
  • The mandatory vaccine will include a microchip to track everyone's vaccine status and/or location.
  • Bill gates owns a patent on SARS-CoV-2.
  • Event 201
Lest you think I'm making any of this up, prepare to be amazed (or not).
There are two iotas of truth here - Event 201, which I will discuss later, and a vaccine "chip".
Slow down there, sparky. You're not nearly as correct as you think. The "microchips" are nothing remotely resembling actual microchips, which are all far too large to fit through a vaccination needle anyway. But I guess you didn't consider that little nugget of information, did you.

The technology is called biocompatible near-infrared quantum dots, and they more closely resemble an invisible tattoo that would be delivered along with a vaccine through a dissolvable needle (which is some pretty goddamned fancy science). Thus the person would carry a record that s/he had received that vaccine. Though this may sound like an evil method of ensuring everyone gets every vaccine ever conceived (or tracking your movement), the real purpose is useful and quite benign: in many places around the world there is no standardisation of record keeping, which makes tracking coverage difficult. Besides, if The Government (which one, by the way?) wants to track your movement, they'll just use your phone that you keep in your pocket or next to your bed 24/7.

Anyway, as for the Gates Foundation owning a patent on SARS-CoV-2, that's just a malicious lie. Such a patent does not exist.

Bill Gates does not stand to profit on this situation. At all. He has donated billions of dollars (and has promised to donate tens of billions more) and has said on record (back in 2019 before COVID-19 even existed, by the way) that the "profit" received from his philanthropy is through economic return:
"Helping young children live, get the right nutrition, contribute to their countries — that has a payback that goes beyond any typical financial return."
No, Bill Gates is not a doctor or a scientist. No, he has no formal training in virology or immunology. No, Bill Gates is not profiting from his philanthropy. All he does is donate tens of billions of dollars to people who do so that they can improve the world, and he is being demonised for it. And that is one of the saddest things I've ever heard.

15) But Event 201 proves they knew about this!
Let's be quite clear here: Event 201 happened.
Before you start celebrating, think for one second. Just think. If this were some kind of super-secret planning meeting to create a worldwide pandemic to bring the population of Earth to its knees and usher in a New World Order, would they splash the entire thing all over the internet, including the entire 3+ hour video? Nothing is hidden, nothing is censored, and nothing is held back. You can watch the entire 5 video series here (which I'm sure you won't) in case you don't believe me, which I'm sure you don't.

Event 201 on October 18, 2019 was a joint exercise in world readiness for just this type of pandemic among the Johns Hopkins Center for Health Security, the Gates Foundation, and the World Economic Forum. There are approximately 200 infectious epidemics worldwide each year, and fortunately few of them reach pandemic proportions. Considering the recent SARS (2003) and MERS (2012) epidemics, epidemiologists and other health experts thought it would probably be a good idea to make sure the world was ready for something bigger. They modeled a fictional coronavirus pandemic after SARS and MERS (which were also both coronaviruses) and assessed the impact it would make on the world. This was simply an effort to come up with ways to protect both lives and livelihoods in such a disaster. You can read their conclusions and recommendations here.

Oh, and this was far from the first meeting designed to identify a public health risk before it happened, such as this meeting in 2018. Epidemiologists have been warning about and planning for this sort of thing for a long, long time.

Unfortunately the timing of Event 201 stinks, which is what prompted this conspiracy theory. But again, the entire meeting is freely available to watch, so knock yourself out if you really are looking for something evil. Good luck finding any heinous crime being committed or planned.

16) You can't trust the WHO because they keep changing their minds.
This virus is new. Let's just get that out of the way. This isn't measles or rotavirus which are well known, well described, and well understood. SARS-CoV-2 is brand new, and absolutely nothing was known of it when it started circulating in Wuhan, China at the end of 2019. With this in mind, nothing was known at the beginning of how (or even if) it was spread from person to person, nothing was known of its deadliness, how contagious it was, nothing. So on January 14, 2020, just over a month after the first patient became ill, the World Health Organisation stated that there was "no clear evidence of human-to-human transmission".
This tweet has aged incredibly poorly and looks downright egregious in hindsight. But at the time, that statement was true - the evidence of human-to-human spread was not yet clear. Keep in mind that the virus had only been identified as a coronavirus two weeks before, and the virus isolated and genome map made public less than a week before. Officials in the Wuhan Health Commission seem to have seriously fucked this whole thing up, and this study suggests that had they acted just a few weeks earlier, this whole thing may have been mitigated or stopped before it ever began.

Once more information began coming in, the WHO changed their recommendations based on new data, just as they have done with social distancing, masks, hydroxychloroquine, and everything else having to do with this disease. Has WHO been perfect? Absolutely not. But it's almost like the process of science where new information makes old information obsolete, and people change their minds and what they say based on prevailing evidence, right?


17) Masks don't even work.
Well that's a rather complicated statement. What kind of mask do you mean? And what do you mean by "work"?

This issue is admittedly much more complicated and much less clear than I would like. What is clear is that N95 respirators are very effective at preventing the contraction of respiratory illnesses. There is some evidence that regular masks are also effective at preventing infection, though certainly less so compared to N95. There is also evidence that both N95 and surgical masks are effective at preventing spread of respiratory viruses from infected people.

This systematic review of mask use concludes,
"The evidence suggests protection of masks in high transmission settings such as household and college settings, especially if used early, if combined with hand hygiene and if wearers are compliant. If masks protect in high transmission settings, they should also protect in crowded public spaces, including workplaces, buses, trains, planes and other closed settings."
"In summary, there is a growing body of evidence supporting all three indications for respiratory protection – community, healthcare workers and sick patients (source control). The largest number of randomised controlled trials have been done for community use of masks by well people in high-transmission settings such as household or college settings. There is benefit in the community if used early, and if compliant. They also found no evidence of efficacy of hand hygiene or health education, suggesting mask use is more protective than hand hygiene."
Cloth masks are most likely less effective than surgical masks, but depending on the fabric and the method of manufacturing, they can be effective.

My take is that masks probably work to varying degrees, and even if they aren't terribly effective they certainly couldn't hurt.

18) But wearing a mask decreases my oxygen and increases my carbon dioxide!
Nope. This has actually been studied by looking at the oxygen saturation of surgeons of various ages wearing surgical facemasks while performing surgery. The study showed a significant decrease of oxygen saturation from . . . are you ready? 97% to 96%. That's it, even after 3-4 hours of stressful surgery. Normal oxygen saturation is anything above about 93%, so wearing a mask for 15 or 20 minutes while you pick up groceries will not affect you, unless you have a pre-existing lung condition. If you do, have someone bring your groceries to you.

As for N95 masks, they are much more tight fitting and have much smaller pores to filter out much smaller particles, including viruses. They can certainly restrict breathing much more than surgical or cloth masks, and they can make even healthy people feel like they can't breathe. They have also been shown to increase CO2 rebreathing. And this is why they are not recommended for the general public.

19) Ok, fine but being forced to wear a mask violates my constitutional rights!
All this proves is that you've never actually read your constitution. It doesn't even matter to which constitution you're referring (though if you made this argument, there is a 98.482% chance you mean the US Constitution), because no constitution on the planet says anything about face masks. If you could please point out where in this document it states that Congress shall make no law restricting your right not to wear a mask (or anything even close), please feel free to comment below.

But before you do, perhaps you should consult a constitutional law lawyer. Oh wait, this author already did, and you're wrong. If a restaurant can enforce "No shoes, no shirt, no service", then a grocery store can enforce "No mask, no shop". And if you still disagree, then you're still just wrong. But hey, you too still have the right to be wrong.

20) High temperatures and sunlight kill the virus.
Nope. Ok, maybe. Well probably not.

It is true that heat will kill the virus, but only if you get it up to 56°C (133°F) for 90 minutes or 75°C (167°F) for 30 minutes, and I don't suspect your sauna gets that high, nor would I suggest you try it. Radiation will also kill the virus, if you're willing to undergo UV radiation for 60 minutes. Which you're not, because then you'd be very dead.

As for "injecting" UV light, you mean this?
Yeah, that's just bullshit despite its rather high-profile mention by the same demagogue. Ultraviolet blood irradiation was invented in the 1920's and had some popularity in the 1940's before antibiotics. However, there is simply no evidence that it is or could be effective in treating COVID-19, nor is there any physiologic mechanism whereby it could work.

21) The quarantine is weakening our immune systems since we aren't getting exposed to nature.
First of all, even though I've never seen where you live, I guaran-damn-tee you have plenty of antigens inside your home, especially if you open a window. There is plenty of opportunity for your immune system to be stimulated regularly.

Second, really? Are you never going outside? While decreased sunlight exposure can decrease your vitamin D level (which can actually weaken the immune system), are you never going outside? And while decreased exercise can also weaken the immune system, are you NEVER going outside?

Seriously, get the fuck outside. Grab a mask, get your ass outside, and go for a run. Climb a mountain. Or just take a walk. If there is no one around, take your damned mask off, especially if you're alone in your car. Seriously. Don't do this.

There is no reason whatsoever for you to stay inside your home 24 hours a day.

Oh, and while I'm on the subject, if you're wearing gloves to shop, take them off before you get into your car and touch everything. If you never take off your gloves, all you're doing is spreading contaminant onto every single damned thing you touch.

22) I'd rather boost my immune system naturally.
No you wouldn't, because that would mean you have an autoimmune disorder. And as someone who has one of those, trust me, you don't fucking want it.

It doesn't matter how many vitamins you take, how many acai smoothies you drink, or how many herbal supplements you buy, you can not "boost" your immune system. You can support it by eating well and exercising, and if you are deficient in a nutrient you should absolutely take that supplement, but any other product or technique that supposedly "boosts" your immune system 1) doesn't, 2) drains your bank account, and 3) creates very expensive urine.

23) Hand sanitiser can catch fire and explode if left in a hot car.
Fortunately this isn't a dangerous myth, but one that should still be corrected.
The viral pictures do not show a car that was damaged by a bottle of hand sanitiser that spontaneously caught fire, it was taken from a different accident that had nothing to do with hand sanitiser. While hand sanitiser is indeed flammable, it would have to reach temperatures of around 370°C (700°F) to combust, and cars' interiors on a hot summer day only reach about about 47°C (116°F).

24) "COVID-19" stands for the 19th strain of Chinese Originated Viral Infectious Disease
Nope, that's just a stupid, racist backronym. COVID-19 stands for "COronaVIrus Disease", and 19 stands for 2019, the year it was discovered, not that it's the 19th strain.

But while we're on the subject of misnomers, COVID also does NOT stand for 666, the mark of the beast. Yes, we're now going from stupid, provably wrong bullshit to plain silly bullshit. However, I've seen this sort of meme shared too many times to ignore it.
Ok, I'll admit I just added this for comedic value. But some people do seem to believe it, so I don't feel bad at all for laughing at them.

25) Plandemic!
Oh boy, I saved the worst for last. This is the idea that this pandemic is all planned and therefore a "plandemic". Ha! Such a clever portmanteau, right? It's so clever that a supposed movie by that name purportedly starring Dr. Judy Mikovits will be released in the summer of 2020. A 26 minute "preview" in the form of an interview with Dr. Mikovits was released May 4, 2020 to great (ha) fanfare, and you fell for it. How very sad.

I will not be debunking the entire video, because it has been done many, many, many times already. The best bullshit busting I've seen was by, not coincidentally, Science, which published (and then retracted) her seminal (not really) paper. I'll just give a few lowlights of the bullshit claims and why they are bullshit:
  • Mikovits' 1991 doctoral thesis revolutionised the treatment of HIV/AIDS.
  • - It didn't.
  • Mikovits published a blockbuster article in Science.
  • - That study purported a link between a mouse retrovirus and chronic fatigue syndrome, a link that was later proved false, Mikovits' paper was retracted by Science, and she admitted no link exists, though she retracted her retraction later.
  • Mikovits: "And they’ll kill millions, as they already have with their vaccines. There is no vaccine currently on the schedule for any RNA virus that works."
  • - Wrong, wrong, wrong, wrong, and wrong. There is less than no evidence that vaccines have even killed thousands, let alone millions of people. There is myriad evidence, however, showing that they have saved millions of lives. And there are many vaccines for RNA viruses, including measles, mumps, rubella, influenza, and Ebola.
  • Mikovitz hints that SARS-CoV-2 was distributed in Italy in an influenza vaccine made using dog cell cultures, and "dogs have a lot of coronaviruses".
  • - No evidence to support this claim exists.
  • Mikovits: Wearing the mask literally activates your own virus. You’re getting sick from your own reactivated coronavirus expressions, and if it happens to be SARS-CoV-2, then you’ve got a big problem.
  • - There is no evidence whatsoever to support this claim.
  • Beaches should be open because the ocean contains "healing microbes".
  • - I can't even bring myself to respond because this is such deep bullshit.
She also propagates several of the myths above, which I won't rehash here. There are many other claims she makes regarding her failed career as a researcher and her arrest (yes, really), but I won't get into those since that isn't what this is really about. What it is about is Mikovits promoting and drumming up interest in her new book, to which I will also most assuredly not link.

There is a similar video of an interview with professor Dolores Cahill from University College Dublin (to which I will also not link), where Dr. Cahill repeats the same myths again, including boosting the immune system, masks decrease oxygen, hydroxychloroquine, manufactured virus, and social distancing decreases immunity, as well as various generic bullshit antivax claims which I've already discussed previously. But she makes one new one:
  • “SARS virus circulated [since] 2003 and essentially every three or four years since, so that people are immune—so that everybody practically in the world is immune.”
  • HAHAHA! No but seriously HAHAHAHAHAHA! If this were even partially true, then millions of people around the world wouldn't be sick or dead. I have no idea how she said that with a straight face, but she should be ashamed. Both she and Mikovits are disgraces and a stain on medicine and science.

    26) Jesus will protect me from COVID-19.
    That's right, a bonus myth! Huzzah!

    Wait wait wait, I'm sure many of you think I'm just making this one up. Sadly, I am not.
    Unfortunately this is a very real claim, but even more unfortunately Jesus will not save you: I take absolutely no joy whatsoever in finding and listing these stories. None. But there are some true believers who misguidedly think their lord and saviour will protect them, and it is my duty to inform you that you are not protected any more than anyone else.

    27) 5G causes/activates COVID-19.
    I nearly forgot this one, which is rather shocking since it was the ridiculous myth that prompted me to write this stupid post. Once again, this is a very simple "NO". There is no evidence whatsoever that 5G is causing COVID-19 or similar symptoms, nor is there any mechanism by which high frequency radio waves could "activate" a virus or cause such symptoms. It's just pure bullshit. Unfortunately that hasn't stopped several True Believers from burning down 5G towers. But if that isn't good enough, then please watch this very detailed (and chock-full-of-fucking-science) video by electrical engineer Mehdi Sadaghdar on exactly why 5G isn't dangerous in any way.


    That's all I have. I'm sure there are many fringe myths that are slightly too whackadoodle to address, so I apologise for ignoring them with alacrity. If I made any glaring errors or omissions, please comment below.

    And most importantly no matter what you believe, no matter whom you believe, no matter which way you align politically, keep yourselves, your loved ones, and everyone around you, safe.



    1. Thank you so much for doing this. I cant tell you how badly I needed this! Many people I know - smart, well-rounded individuals - are still falling for these conspiracy theories. There are just so many that people habe started assuming there must be some truth to them, even if they make no sense. I'm going to share this as much as I can.

    2. Mate u are a serious legend.

      I live in Adelaide South Australia snd we have had just 1 case in 19 days now. We have knuckled down and did the right thing and now we are starting to re open businesses and are able to have more interaction tho with modifications. It works and looking at what is happening in the US makes my head hurt... facepalms allround. I hope you get thru to the public but something tells me they are too stupid to care.


    3. Excellen. Shared with my med students. The only way to counteract the bullshit that's out there is to spread the facts. Yes, these may change as we gain knowledge. But if you're suprised this happens then you bloody don't know how science works.

    4. When I share this on Facebook it decides that the only possible usable image is the "suspended Twitter account" one. Maybe because it's first? So maybe you should edit this to put a different image up higher for easier sharing...

      1. I did exactly that. I didn't realise that would be a problem. Hopefully this solves it.


    6. Shared this on Facebook and within minutes I had the expected "I can refute every point but I don't have time" comment. Amazing how few understand basic science.

    7. Nice summary and post. I think you should change a bit lock down section. Lodi is roughly 1/3 of Bergamo. and,_Lombardy which makes ratios almost identical. Better argument is eastern europe versus western europe. Due to history of communism people in east tend to accept orders regulating their perceived freedoms much better than in the west. So even when my town had strong earthquake (Zagreb 2020) people went out and did socially distance together with masks result is extramly low case and fatality ratios in our part of the world. Unfortunately now people started to eat this bullshit propaganda and myths and have become careless - but the first 6 weeks were really spot on version of lock-down - stronger and more respected then what my friends in the western countries reported to me.

      1. Thank you for pointing this out. I failed to fact check that appropriately, but now I have. Despite the difference in population, the rate of increase of cases was vastly different between the two cities. I have updated the text accordingly.

    8. Yay you're back!

    9. What a fantastic read, makes a change to hear sense 👍

    10. my county slammed the doors, closed the beaches and went into total lockdown in the second wave of lockdowns - mening we were at total lockdown when many plces were only at social distancing.
      to date, we have 7 county residents confirmed to have COVID-19. one of the 7 has not been in the county at any time during the outbreak.

      not spreading the disease works, IF you actually do it.

    11. GREAT job, thank you. Enjoyed reading as well!

    12. You are a moron, most of your arguments are easily disproven and the true ones are irrelevant

      1. Okay, disprove them. Please cite all peer-reviewed sources.

      2. Excellent. I’ve seen several such responses, none which actually go on to disprove anything.

        Shall I wait?

      3. Troll. Many of us love Doc and have missed him. If you think he is a moron, why do you bother to follow him?

      4. Still waiting. Any idea how long it will take you to compile your rebuttal?

    13. if i only had the time to rebut SOME of your points - certainly, not all of them - and have an adult exchange, it would do us both a world of good. in the interim, until i find such time, i can only suggest you drop the attitude. it doesn't help your case, your standing as an impartial observer (not that you claimed not to have your own biases) or to "win over converts"...if you are interested in such and not just interested in preaching to the choir...attitude...

      1. you're new here aren't you???

        Frankly I trust Doc B (who I most likely have never met really don't want to given what he does for a living) and what he presents over some fool trying to claim the moral high ground.

      2. Is that you, John? Long time, no see. As always, you know more than an actual doctor and other experts. What extraordinary hubris you possess!

      3. Please- enlighten me. Give me peer reviewed credible sources as he has. Give me an ounce of evidence to believe you.
        I will wait. I have the patience of stone.

      4. Quite frankly my dear, I don’t give a fuck what you think about my attitude.

        That’s what Rhett said to Scarlett, right? Perhaps I’m paraphrasing.

        You see, what you just did is come into my house and tell me you don’t like the decorations. My attitude means fuck all here - it’s all about the evidence. I didn’t write this to convert anyone, rather for people to use as a reference when shutting down these myths.

        Now if you’d like to refute anything, I’ll be waiting right here. Now that you know the house rules, I suspect you won’t return.

    14. Solid read, thanks Doc B

    15. This is great, glad to see a new post!

    16. Glad to see you are back Doc
      I will say when this started (prequarantine when it had just barely hit the USA) people asked me what i thought of it all.
      I said "Ive seen bird flu, swine flu, sars, measels down the block from me and even the black plague in my town (im serious). I think this is gonna blow over in a couple weeks."
      A couple weeks later....and suddenly everything was shutting down and i shut my god damned mouth.
      Though i did have a fight with my sister when she said Los Angeles was gonna be as bad as New York when thats a completely different animal. 8 million people in an extremely dense city with low quality sanitation and other factors vs los angeles which geographically is the largest city in the world with a population of 4 million. She went on and on that Los Angeles was days away from being as bad as New York!
      Well she was thankfully wrong.
      I know this disease is horrible but I know we will get through it. Eventually.

      1. Los Angeles also didn't have a mayor and a governor having a pissing match.

    17. YASSSS! The ol' Bastard is back! And debunking the "G5-causes-Covid-virus" fucktards who have gotten on my last good nerve over the past month. Thankseverso for this. Hope you & yours are all well.

    18. I appreciate many of your perspectives, but not #11.
      We DO know what happens when people transition to poverty- annual mortality increases by about 2% overall (Bernstein SF et al. Poverty dynamics, poverty thresholds and mortality: An age-stage Markovian model. PLoS One. 2018;13(5):e0195734.) Pre-Covid, around 14% of Americans lived below the poverty threshold; with shutdown, the figure is now 30%. In the developing world, it is way higher. Poverty has both higher prevalence and higher case fatality rate than Covid-19.
      So lockdown IS worse than the disease. It’s just other people who are dying, people you don’t know.

      1. well, researched, civil, wrong. it ignores the massive cost of healthcare for those who DO make it into hospitals, even in countries that DON'T have America's predatory for-profit healthcare system; plus the cost of disposing of windrows of corpses.

        costs of treating COVID are estimated in the range of 500 billion dollars over two years. to put that in perspective, that is about the cost of 5,000 F-35 raptors, or 48 nuclear aircraft carriers. or 13,000 years' rent for a nice one bedroom apartment in New York City, or a year's wages for 33,000 minimum wage workers.

        all coupled the false premise that a pandemic with an estimated death rate of 5% if the healthcare system is overwhelmed WON'T cause the economy to collapse.

      2. Oops, I deleted my comment by mistake while nuking some bots.

        I had said thank you for the civil and well-researched response, Jonathan. However, the main purpose of the lockdown was to flatten the curve and prevent the world's medical system from collapsing due to being overwhelmed. That would have led to even more death and poverty, both from the disease and the aftermath. I meant to include that originally but forgot, so I have updated the text accordingly.

      3. Ken... I apologize for correcting you on this, F-35s are Lightning IIs that are still more or less in the production stage. F-22s are Raptors that are currently in service. I know this has nothing to do with the article, so Doc feel free to delete this if you feel so inclined haha. I just like people to have as much knowledge as possible, even about trivial things haha.

      4. gotcha. I checked, and it the F-35 I priced.

    19. I have mostly just stayed inside my studio since mid-March as I have pivoted to online work... I am now recategorising that behaviour as paranoiac not prudent and will mask up and go out. It's easy to get mental if you live in a busy area.

      1. lucky you. I managed to squeeze in a week of self quarantine s there had been a possible exposure a week before our stay home order started - and the Mrs had developed a cough. after that, the demands that I was essential became too strident to dismiss.

    20. Hello! I'm a writer for my school's blog. I want to use your article as a reference. Since I don't live in the US, the content will obviously be different. I want to 'borrow' your arguments in point 1, 2, 4, 8, 10, 16, 20, and 21. How should I credit you? Thanks!

      1. You can call me "DocBastard" or simply refer to me as an anonymous trauma surgeon. Your choice, and I thank you for sharing.

    21. Good content. I live in the US and all those myths are so prevalent its embarrassing. Its impossible to spread real information when the president spouts conspiracy theories from the bully pulpit on a regular basis.

    22. I live in New Zealand. Our government followed the science and ignored the myths and bullshit. We had a total of 20 deaths from a population of 5 million. Science works. Great myth busting article. Thanks

    23. Great article overall, but one nitpick: "this study suggests that had they acted just a few weeks earlier, this whole thing may have been mitigated or stopped before it ever began". Keep in mind that the first recorded patient resented in hospital on Dec 16th, and China enacted their first shutdowns on Dec 31st - 2 weeks later. The study talks about action being taken 1, 2 or 3 weeks earlier - which seems to indicate shutting down on the same day as the first patient presented in hospital, or a week earlier than that. This seems like a bit of an unrealistic expectation, especially given that the first death wasn't until Jan 9th.

      1. the US didn't shut down until april. a month after China admitted it was a real problem. three weeks after WE found out China admitted it was a real problem. TWO weeks after the GOP politicians finished selling off their stocks and admitted it was a real problem.
        Australia - country pretty close to our size - shut the doors March 19. they required citizens to quarantine and didn't allow non citizens in. they started widespread testing and contact tracing. Australia had less CASES than the New York City had deaths.

      2. Australian here. We did do travel bans better. And testing. And contact tracing. But we don't have cities anywhere near the density of New York or with an equivalent number of international tourists. And yes same size but so so so many less people 24 million only in Australia - so 3 times the pop of New York spread across a country similar to the size of the United States.

    24. Great article - thanks. Conspiracy theories driving me nuts on this. Only nitpick was cars definitely get hotter than 47 degrees in an Australian summer day but definitely not over 300 degrees yes 😉

    25. I might be missing something here but your data seems to undermine your point in number 11.

      Bergamo has 3 times the population of Lodi, and after not entering lockdown clearly has fewer than 2.5 times the number of cases compared to Lodi, suggesting a no lockdown strategy worked better.

      Plus it had fewer cases for nearly 2 weeks despite the first cases in both places being 2 days apart.

      Although the growth of Bergamo cases clearly increases faster towards the end of the graph, there is nothing to indicate whether this keeps on increasing wildly or flattens out below 3000.

      1. Someone else has pointed this out to him and he did apologize

    26. Hey Doc.

      Seems like more research/information is coming out about the possibility of the virus leaking out from a lab in Wuhan, so it is not the case that 'No credible evidence supporting claims of the laboratory engineering of SARS-CoV-2. The author further states that there is no evidence the virus escaped from the lab in Wuhan either, so you can put that bullshit away too.'


      1. it's always good to know your sources:

        I'd classify their publications as long on theory, maybe bit short on the investigation end. youe opinion may vary.

      2. Efnisien - there is a world of difference between "escaped from a lab" and "was manufactured by a lab". One implies simple negligence, the other gross malfeasance. I never make any reference to the possibility that it escaped from a lab, simply the unfounded claim that it was manufactured.

    27. Regarding hydroxychloroquine, you seem overly confident based on the evidence supplied. Zinc seems to be a crucial part of the treatment. Possibly because zinc is used by the immune system, and pretty much only has value if it is inside the cells, and it seems hydroxychloroquine helps the uptake into cells. The smaller (tiny?) studies which showed promise used zinc, but large study linked did not even once refer to zinc as far as I can tell by searching it. Why would you discard a hypothesis that says 'hydroxychloroquine + zinc helps the immunesystem fight COVID-19', with reference to evidence where zinc was not used? I don't think that helps the willingness and open-mindedness of people. It is difficult enough as it is to be open-minded, with all the medias 'screaming' and countries that lock down on free debate.

      Also I think its worth mentioning that while it truly is a tiny study of 80 people, those might not all have survived without the hydroxychloroquine + zinc (H+Z). H+Z is reported to work best when given early in the onset of the disease, and have effected the process of the disease. Many 'mights' here, the art is to see evidence neither stronger or weaker than it is. I think it still fair to say that its promising, and the collection of further evidence would be valuable.

      1. maybe because in the only side by side test, the survival rate of patients not given hydro was one patient higher than the survival rate of patients given hydro.

      2. I've seen many people claim "HCQ only works if you give zinc!", but the evidence (other than a tiny study) to support such a claim does not seem to exist.

        If you have any, please share it. Otherwise it's just a hypothesis.

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    31. hey, doc. this lawsuit just got filed in Florida.
      based on the claims in it, I can only conclude that somewhere there are documented statistics on how many healthcare workers die from wearing masks on the job. do you know where I could find those numbers? I hate to think of all the brave doctors and nurses who are risking their lives by wearing a mask every day.

      on the other hand, it's a bit gratifying to think of all those bank robbers who are killing themselves by wearing masks, so I guess it balances out.


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