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By Dr. Sanjay Mehta, MDCM, FRCPC
Founding Board Member, Eternal PHriend, Treasurer & Past-Chair, PHA Canada
Director, Southwest Ontario PH Clinic, London, ON

As a respirologist/lung specialist, you can imagine how many emails, texts, private messages, and telephone calls I am getting! Sadly, there are many false ideas which are complicating peoples’ discussions and actions regarding COVID-19. Most people spreading these falsehoods and critical comments do so out of ignorance, but some clearly do so out of cynicism regarding society/government, and possibly even maliciousness. So, here I will address some of the most common myths and misconceptions I’m encountering about COVID-19.

Myth #1: “This is a hoax; this is overblown by the media, government, health system, etc.”

Truth: This is real. This could be very serious. This could be the most serious public health issue we see in our lives.
It may seem like we only have about 300 cases in Canada, but these are the cases that have tested positive. The number of COVID-19 infections which are mild – that is infected people that have no symptoms or only mild symptoms of a cold/flu-like illness – and are never tested – is anywhere from 3-20 times greater than the number of people tested. If we use an average of about 10 times, it is more likely that there are already 3,000 cases in Canada.
Best estimates suggest ½ of all Canadians may likely get COVID-19 (anywhere from 30-70%), but most of these (at least 80% of all infections) will be mild, as described above. You may have seen the major impacts COVID-19 has had initially in China, then Italy, and now other European countries (e.g. Spain, UK). If we cannot slow the spread of COVID-19 in Canada, many Canadians will get ill, many will die, and the country will be overwhelmed.
There are 3 potential “victims” of COVID-19 in Canada:

1. Individual Patients 
This especially applies to people who are elderly and/or who already have other serious medical illnesses.These people are at high risk of dying if they get COVID-19. Underlying serious illnesses include significant lung disease (COPD, lung fibrosis/scarring), heart disease (heart failure), liver/kidney disease, or illness/medication that weakens your immune system (transplant, cancer, steroids, chemotherapy, etc.).
PH patients: You have a lung disease that is different from these lung diseases listed above, but you may also commonly have heart failure. Thus, you are increased at risk: risk which may not be as high as those who are elderly and/or have other serious illnesses, but clearly higher than the average, healthy person.
2. The Healthcare System 
We can look after sick patients; however, if there is a mass influx of very sick, critically ill patients who need intensive care unit (ICU) treatment – such as being on a respirator or ventilator – then our system can and will be overwhelmed, exactly as it happened in Italy. The consequences will be:
  • Staff working non-stop 24-hour shifts until getting infected/collapsing
  • Not enough equipment, such as respirators, to treat all patients
  • Situations of ethically impossible decisions to treat some critically ill patients and not treat others, leading to deaths
If you follow public health recommendations – isolation for those who are sick (flu, cold) but not sick enough to need hospitalization, voluntary quarentine (self-isolation) and monitoring for those potentially/actually exposed (but who have no symptoms), and reduced social contact/social distancing for others – we can slow down the spread of COVID-19 and the number of seriously ill patients needing hospital/ICU care, so that we can look after them and reduce the number of patients who die.
3. Society
We are already feeling the impact on society/community, with cancellation of schools, sports and social events, lack of ability to travel, less social interaction, panicked buying, loss of courtesy, people taking financial advantage of desperate people, etc. If we don’t slow down the rate of COVID-19 cases in Canada, life will change further, as it did in China and Italy, where they have experienced the closure of all public spaces and businesses, quarantining of all people at home, loss of social services, and looting for food/medicine. 

Myth #2: “I am young/healthy, and don’t need to worry.”

Truth: You may not get very sick (or sick at all) if you get COVID-19, but you will spread it to others, who could die (your older family/friends and those with underlying serious illness), and contribute to the major issues outlined above.

Myth #3: “Social distancing (isolation, quarantine, less social contact) will have no benefit.”

Truth: This is one of the effective measures in reducing spread of an infectious contagious illness like COVID-19. This worked to abbreviate the severity/course of the epidemic in China, Korea, and Singapore. It is being put into place in places such as Italy, Spain, etc. Follow public health recommendations to reduce social contact, including less socializing (especially in crowds), working at home if you can, etc. This is especially important IF you are a person at high risk (elderly, underlying illness), or if you are a close contact (partner, family, friend) of a high-risk person.

Myth #4: “We can prevent and/or treat COVID-19 infection.”

Truth: There is no vaccine, treatment, or medical way to prevent COVID infection.
Most people who are infected with COVID-19 will have mild symptoms and will recover spontaneously. Some will need hospitalization and some who are very sick will need critical care. For very sick patients, treatment is to support the vital functions of the body (oxygen, breathing, blood pressure, heart function, etc.), and to recognize/treat complications (e.g. another/different infection, worse lung disease/heart disease/kidney failure, etc.).

The only way to prevent COVID-19 infection is to follow public health recommendations. If we slow down the number of cases, we can then do our best to look after all ill patients with COVID-19. It is still likely many will get infected, but more slowly over many months or longer, and not as quickly as happened in China and Italy.

COVID-19 and Kids 

1. Children can absolutely get COVID-19.
There have been fewer children than adults reported ill with COVID-19, especially in China and Italy, which have provided us with the most information about ill COVID-19 patients. This is largely because there are less children than adults, but children also don’t seem to get as sick when they get infected. They most often have mild symptoms, and most recent data suggests nobody under 10 has died of COVID-19. As in adults, it is likely many children infected with COVID-19 may not display any symptoms at all. It may also be that children are less likely to catch COVID-19 (are less susceptible to the virus), but this is uncertain.
Clearly, children with illness or weak immune systems are at high risk, similar to adults with these conditions.
2. Children can get COVID-19 and spread it to adults.
Given how kids play and interact with each other and the physical closeness/proximity of many children (for example in school, playground), they are a common source of spread of infections, like colds and flu. And every parent of young kids knows how many bugs come and make the adults sick! This is largely why schools and other childhood activities are being cancelled.
3. Children should fully participate in “social distancing”.
Since children are an important source of spread of infections in a community, having them fully participate in (and learn about) principles of public health (e.g. handwashing, self-isolation for symptoms, avoiding ill people, reducing social contact) is very important to slowing the spread of COVID-19 and “flattening the curve”. 
Stay safe... we are all in this together!
Dr Sanjay Mehta

Dr. Sanjay Mehta, Support

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