Coronavirus disease 2019: The harms of exaggerated information and non-evidence-based measures

The evolving coronavirus disease 2019 (COVID-19) pandemic 1 is certainly cause for concern. Proper communication and optimal decision-making are an ongoing challenge, as data evolve. The challenge is compounded, however, by exaggerated information. This can lead to inappropriate actions. It is important to differentiate promptly the true epidemic from an epidemic of false claims and potentially harmful actions.

1 | FAKE NEWS AND WITHDRAWN PAPERS

The first report documenting transmission by an asymptomatic individual was published in the New England Journal of Medicine on January 30. However, the specific patient did have symptoms, but researchers had not asked. 3 Understanding the chances of transmission during the asymptomatic phase has major implications for what protective measures might work.

Lancet published on February 24 an account from two Chinese nurses of their front-line experience fighting coronavirus. The authors soon retracted the paper admitting it was not a first-hand account.

Problems with early estimates and responses to the COVID-19 epidemic

• A highly flawed nonpeer-reviewed preprint claiming similarity with HIV-1 drew tremendous attention, and it was withdrawn, but conspiracy theories about the new virus became entrenched

• Even major peer-reviewed journals have already published wrong, sensationalist items

• Early estimates of the projected proportion of global population that will be infected seem markedly exaggerated

• Early estimates of case (infection) fatality rate may be markedly exaggerated

• The proportion of undetected infections is unknown but probably varies across countries and may be very large overall

• Reported epidemic curves are largely affected by the change in availability of test kits and the willingness to test for the virus over time

• Of the multiple measures adopted, a few have strong evidence, and many may have obvious harms

• Panic shopping of masks and protective gear and excess hospital admissions may be highly detrimental to health systems without offering any concomitant benefit

• Extreme measures such as lockdowns may have major impact on social life and the economy (and those also lives lost), and estimates of this impact are entirely speculative

• Comparisons with and extrapolations from the 1918 influenza pandemic are precarious, if not outright misleading and harmful

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