Misinformation about COVID-19 is rampant, particularly on social media. Patients get mixed (and sometimes blatantly false) messages from news sources, family and friends. As our knowledge of the virus continues to grow and evolve, guidance from health experts changes, which leads to more confusion and suspicion. Here are some information and resources you can share with patients to help them sort through the misinformation.
Information about vaccines can be found on the Talking to Your Patients page.
It has been demonstrated that wearing cloth face coverings combined with appropriate social distancing (6 feet) works to stop the spread of COVID-19.
- This opinion piece in the Annals of Internal Medicine argues that universal masking in the health care setting is no longer needed. Universal Masking in Health Care Settings: A Pandemic Strategy Whose Time Has Come and Gone, (Annals of Internal Medicine, April 2023) (acpjournals.org)
- These studies provide background on the effectiveness of cloth face coverings:
- There is no evidence that wearing a cloth face covering compromises an individual’s oxygen levels or causes carbon dioxide buildup that could potentially be harmful. Claims that wearing a mask will make you sick due to increased toxin load are similarly unfounded.
- Use and share the AAAAI handout on wearing a face covering or mask to slow the spread of COVID-19 (also available in Spanish). We also have a mask handout that is written at a lower reading level (also available in Spanish).
- Here is a great link illustrating the effectiveness of masks in reducing spread of the virus.
- The American Medical Association has started the #MaskUp campaign with a toolkit that contains a variety of social media posts and videos that emphasize the importance of mask use.
- Facebook continues to be one of the leading sources of misinformation on face masks and COVID-19.
Hydroxychloroquine and Other False Medical Claims
There is no evidence to support the use of hydroxychloroquine for prophylaxis or treatment of COVID-19 as illustrated in these publications:
- Repurposed Antiviral Drugs for COVID-19 – Interim WHO Solidarity Trial Results (NEJM, February 2021)
- Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19 (NEJM, November 2020)
- A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for COVID-19 (NEJM, June 2020)
- Hydroxychloroquine in Patients with Mainly Mild to Moderate Coronavirus Disease 2019 (BMJ, May 2020)
Similarly, there is no clear benefit to the use of ivermectin or azythromycin for COVID-19. The FDA has additional information on why ivermectin should not be used for the prevention or treatment of COVID-19, and the references below provide additional details:
- Ivermectin for the Treatment of Coronavirus Disease 2019: A Systematic Review and Meta-analysis of Randomized Controlled Trials (Clinical Infectious Diseases, June 2021)
- Antiviral effect of high-dose ivermectin in adults with COVID-19: A proof-of-concept randomized trial (Lancet, June 2021)
- Effect of ivermectin on time to resolution of symptoms among adults with mild COVID-19 (JAMA, March 2021)
- The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial (Lancet, January 2021)
- Effect of oral azythromycin vs placebo on COVID-19 symptoms in outpatients with SARS-CoV-2 infection: A randomized clinical trial (JAMA, July 2021)
- Azithromycin versus standard care in patients with mild-to-moderate COVID-19 (ATOMIC2): an open-label, randomised trial (Lancet Respir Med, July 2021)
- Azithromycin for community treatment of suspected COVID-19 in people at increased risk of an adverse clinical course in the UK (PRINCIPLE): a randomised, controlled, open-label, adaptive platform trial (Lancet, March 2021)
- Azithromycin in addition to standard of care versus standard of care alone in the treatment of patients admitted to the hospital with severe COVID-19 in Brazil (COALITION II): a randomised clinical trial (Lancet, October 2020)
People with allergic disease are not at higher risk for severe outcomes from COVID-19 due to a cytokine storm. Reports that patients with severe COVID-19 infection experience a cytokine storm are being extrapolated by some to infer that anyone with underlying ‘inflammation’, including allergic conditions, is at increased risk. There is no evidence to suggest that a patient’s allergic rhinitis, atopic dermatitis, chronic urticaria, food allergies, history of anaphylaxis, etc., places them at risk for severe outcomes should they become sick with COVID-19.
Supplements or other holistic remedies cannot prevent or cure COVID-19. Claims of supplements, vitamins, or foods that ‘boost immunity’ are rampant, including from medical professionals and large healthcare organizations. Specific unproven COVID-19 treatments being promoted include essential oils, supplements, colloidal silver, Vitamin C, elderberry, homeopathy, and chiropractic adjustments.
Allergists can help patients by guiding them towards these simple fact-checking questions for any claim:
- What are the qualifications of the person making the claim?
- What does the body of evidence demonstrate for both benefits and risks?
- Is the person making the claim directly profiting from services or products?
- How can this apply to my specific situation, including factors pertaining to my medical history and possible interaction with medications or underlying conditions?
Asthma and COVID-19
The majority of evidence does not support asthma as a risk factor for becoming infected with SARS-CoV-2, and there are no data to suggest that, if infected, asthma patients have a more severe course of COVID-19 disease or will experience an exacerbation of their asthma.
Asthma patients should be counseled that their inhaled corticosteroids are safe and necessary to continue use to prevent an exacerbation, and that systemic corticosteroids can and should be used to treat an asthma exacerbation even if it is caused by COVID-19. The studies showing a potentially worse outcome with systemic steroids were in hospitalized COVID-19 patients who received the steroids as a treatment for the viral illness and not for another disease.
There is no evidence that the biologics we use in asthma have any adverse effect on COVID-19 cases, and it would be important to continue them based on the need for asthma control.
You cannot catch COVID-19 from using a nebulizer, and patients that require treatment with nebulized medications should start treatment early and repeat until better. However, if a person with asthma who is receiving nebulized treatment has COVID-19, they could spread the virus to others in close proximity due to the respiratory droplets created through the nebulizer.
Since October 2020, there have been over 120 publications including 4 meta-analyses that clearly demonstrate that asthma is not a risk, and at least a few have demonstrated protection for those with asthma.
Children and COVID-19
Although children are less likely to get seriously ill from COVID-19, they can get sick and they are likely to spread the infection while asymptomatic. Here is some of the latest data:
- Asymptomatic children with SARS-CoV-2 had Ct values (cycle threshold for RT/PCR) 10.3 cycles higher than children with symptoms (so less of a viral load). (J Clin Microbiol; Oct 22, 2020)
- While children are less likely to be hospitalized for COVID-19 than adults, one in three hospitalized children are admitted to the ICU. Hispanics and Blacks accounted for the majority of hospital admissions and 42.3% had an underlying medical condition. (MMWR; Aug 14, 2020)
- A large study including more than 5,700 COVID-19 patients in South Korea indicates that while children under 10 appear to transmit the virus less often than adults, adolescents and older children (age 10-19) transmit the virus at higher rates. (Emerg Infect Dis; July 16, 2020)
- A team from Massachusetts General Hospital demonstrated that children infected with COVID-19, even those who are asymptomatic or with mild disease, have a significantly higher viral load than adults hospitalized with severe COVID-19. (J Pediatr; Aug 19, 2020)
Misinformation about COVID-19 is also addressed in the following resources:
- The Centers for Disease Control and Prevention now has a webpage called "Stop the Spread of Rumors" that lists known facts about COVID-19 and a social media toolkit with sample messages and graphics related to various COVID-19 topics for Twitter, Facebook and Instagram.
- The World Health Organization has a mythbusters webpage that addresses many common false claims about COVID-19.