Dr. Gerald Evans, Medical Director of Infection Prevention and Control at Kingston Health Sciences Centre (KHSC), says he is keeping a close eye on the abundance of misinformation and bad science circulating during the COVID-19 pandemic.
“Before COVID-19, we were having a real problem with information in general. Good, solid, medically scientific information,” he said. “Certainly it’s been even more challenging since COVID-19 came… It’s really, really hard.”
For example, a recent article from the UK’s Guardian, among the most popular English-language newspapers in the world, reported various studies indicating the rate of asymptomatic COVID-19 cases between 43 and 58 per cent.
“That’s way off. I’ve seen that number and it’s so badly off it’s ridiculous,” he said. “That’s one of those issues that really drives anxiety. If you hear thirty, forty, fifty per cent, you think ‘Oh God, anybody could have it.’”
A more accurate term in this instance he said would be “non-symptomatic,” accounting for pre-symptomatic people, who do not yet show signs of infection, as well as those with very mild symptoms who fail to report them.
“We know as physicians who see patients that they often forget to recall symptoms… because they have dismissed them as being minor,” he said. This group is referred to as the “pauci-symptomatics,” he said, from the Latin ‘pauci,’ meaning few.
Additionally, he expects a small number of false positives to sway the statistics, leaving the “true asymptomatics” somewhere between 10 and 15 per cent.
Dr. Hugh Guan, resident doctor at Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health, agrees.
“People use the term ‘asymptomatic cases’ quite broadly, but more specifically, many of these people are pre-symptomatic… People are more likely to be pre-symptomatic in the sense that they were tested positive a day or two before symptoms started, or upon review they had very mild symptoms like a headache or a sore throat,” he said.
He also agrees that truly asymptomatic cases are much lower than 50 per cent.
“Our own experience and across Ontario is that truly asymptomatic cases are rare. There hasn’t been much evidence of asymptomatic cases based on the widespread testing done across the province,” Dr. Guan said.
Covid-19 ‘zombie issues’
Dr. Evans said the public’s anxiety trends downwards as pandemic research progresses, but gets periodically enflamed by bad science reporting.
“I actually call them zombie issues. In the zombie genre, you can knock a zombie down but it will get up again and come after you,” Dr. Evans said. “There’s a whole bunch of those questions that continue to pop up again and again [around the pandemic].”
Poorly reviewed scientific articles are contributing to the confusion, he said. He described one such article on airborne disease transmission, covered in the Toronto Star last week, as “literal crap.”
While the reporter may have done their job, covering an item from a reputable medical journal, he noted that “Anyone who knew the background of the publication would say ‘How did this even get into that journal?’”
Consulting reliable, known experts on emerging research publications is essential.
“I don’t think there’s anything wrong with that Toronto Star story,” he said. “I think that reporter should probably have asked a couple of experts.”
Simply identifying the experts presents a challenge as well.
“There’s a group of us on Twitter, we’re critiquing things like this really bad article that came out on Friday. But on the other hand, there’s a lot of stuff on Twitter that I know is bad,” he said.
“The worst place to get information is Facebook,” he said. “I think one of the places that people would normally trust for good information that you have to be a little suspect about [is what is] coming from political leadership.”
He said he has participated on a number of committees to advise the provincial and federal government on testing policies. He said he has seen time and time again that, when information is shared by experts, it sometimes gets twisted through a political lens.
“I’m writing a paper right now on this whole policy in Ontario to ramp up testing. It’s a good political goal, it’s probably not necessarily the best way to look at things from a scientific point of view,” he said.
Widespread testing in a population with a low probability of COVID-19 increases the risk of false positives, he said. Targeting specific sectors of the population would be more effective.
“I think getting information to the public is very, very challenging. Social media, not great. Politicians, a little better, but not great.”
Dr. Evans said he makes an effort to speak widely to the media, for that reason, in an attempt to spread valid scientific information. However, he said “We’re in an era now where we’re all starting to be more skeptical of even mainstream media, as well.”