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The pandemic which started plaguing the world at the end of 2019 is not done with its rampage yet. In fact, experts say that it would be unrealistic to expect societies to return to pre-Covid normalcy within the next two years. While Singapore’s Covid-19 death rate is comparatively low, doctors have discovered that this disease does not have to kill in order to inflict lasting suffering on its patients. 

Getting your facts right about Covid-19 is the first line of defence. Dr Leong Hoe Nam, infectious diseases specialist at Rophi Clinic in Mount Elizabeth Novena Specialist Centre, fact checks these 10 myths on Covid-19 infection.

MYTH: Covid-19 affects people in the long-term only if they’ve been severely ill with the infection.

FACT: Long-term effects of Covid-19 can impact anyone who has had it. While some people fully recover from Covid-19 within weeks of illness, some people experience a condition known as “long Covid”. With long Covid, patients experience post-Covid conditions regardless of whether their illness was asymptomatic or not. These are a wide range of new, returning or ongoing health problems people can experience four or more weeks after first being infected with SARS-CoV-2, the virus that causes Covid-19. 

Experts are still studying the impact and prevalence of long Covid. This is what they know for now:

• It can happen to anyone who have had Covid-19, even those who have had mild illness, or did not experience symptoms at all.
• Long Covid can last weeks or months.

• Symptoms include: difficulty breathing or shortness of breath, tiredness or fatigue, symptoms worsening after physical or mental activities, brain fog, cough, chest or stomach pain, headache, heart palpitations, heart (also known as heart palpitations), diarrhoea, sleep problems, fever, mood changes, feeling of pins and needs, rash, changes in smell or taste, and changes in period cycles.

The Centers for Disease Control and Prevention (CDC) in the United States recommend that the best way to prevent post-Covid conditions is by getting vaccinated against Covid-19 as soon as you can. Covid-19 vaccination is recommended for all people ages 12 years and older, including if you had Covid-19 or a post-Covid condition.

MYTH: Recovering from Covid-19 is as easy as kicking off the flu or the common cold.

FACT: Some patients who have been severely ill with Covid-19 experience can suffer from multiorgan effects or autoimmune conditions over a longer time, with symptoms lasting weeks or months. Covid-19 can damage lung function and cause severe weakness and exhaustion during the recovery period. 

Multiorgan effects can affect most, if not all, body systems, including heart, lung, kidney, skin, and brain functions. Autoimmune conditions happen when your immune system attacks healthy cells in your body by mistake, causing painful swelling or tissue damage in the affected parts of the body.

When children get Covid-19, they could experience a rare condition known as multisystem inflammatory syndrome (MIS) during or immediately after the infection. MIS is a condition where different body parts can become inflamed. MIS can lead to post-Covid conditions if a person continues to experience multiorgan effects or other symptoms.

For those who need intensive care, they can experience post-intensive care syndrome (PICS), which can include severe weakness, problems with thinking and judgment, and post-traumatic stress disorder (PTSD). PTSD involves long-term reactions to a very stressful event.

MYTH: The vaccines don’t work to prevent infection by the Delta variant.

FACT: The Pfizer-BioNTech and the AstraZeneca vaccines have been proven to be fairly effective against the delta variant of Covid-19, provided that one receives two vaccine doses. The mRNA vaccine developed by Pfizer-BioNTech (also known as BNT162b2) is 88 per cent effective and AstraZeneca (also known as ChAdOx1 nCoV-19) is 67 per cent effective against the delta variant after two doses. Read the research study published in the New England Journal of Medicine (NEJM) here.

MYTH: Being fully vaccinated does not guarantee immunity against infection, so there’s no need to go for vaccination

FACT: While it is true that being vaccinated doesn’t mean 100 per cent protection against Covid-19, vaccination dramatically reduces the risk of serious illness. Those who have received vaccination experience more benign effects when infected. 

In an article published in The Straits Times on July 23, 2021, it was reported that fully vaccinated people made up 44 per cent of the Covid-19 cases at that time. However, all 484 fully vaccinated cases out of the total 1,096 locally transmitted infections (over the 28 days prior to July 22) were asymptomatic. None of them required oxygen supplementation, needed intensive care or died. 

In contrast, in the unvaccinated group of 279 individuals, 2.2 per cent required oxygen supplementation, six were admitted to the ICU and one died.

Experts pointed out that as more of Singapore’s population became fully vaccinated, seeing more cases among vaccinated individuals was a mathematical certainty, and not a reflection of the effectiveness of the Pfizer-BioNTech and Moderna mRNA vaccines in the national vaccination programme.  

MYTH: Covid-19 can be transmitted through a mosquito bite.

FACT: It can’t. Covid-19 cannot be transmitted through insect bites. SARS-CoV-2 is a respiratory virus which can be spread through droplets from coughing, sneezing, or a patient’s saliva. Researchers from Kansas State University and the US Department of Agriculture’s Agricultural Research Service evaluated whether mosquitoes and biting midges can serve as biological vectors for Covid-19. They found out that the insects which had been fed infected blood are not biological vectors for the disease. It can only happen if a virus gets through the insect’s gut, infects its salivary glands, and then hijack the mosquito’s cell machinery to replicate. You can read more about it here.

MYTH: Drinking more hot water and alcohol can deter a Covid-19 infection.

FACT: No, it can’t. Drinking water, whether hot or cold, cannot cure or prevent a Covid-19 infection. Once the coronavirus is inhaled through the mouth or nose, it will latch its spiky surface proteins onto the healthy cells in the airways and lungs. No known beverage, including water and alcohol, will deter or cure infection. 

In fact, drinking excessive alcohol can weaken your immune system. Adults should limit their alcohol intake to stay healthy.

It is dangerous to drink high strength ethanol, as found in some cleaning products or hand sanitisers. These are poisons and drinking these products could cause disability or death.

MYTH: One should use ivermectin to treat and prevent Covid-19 instead of going for vaccination.

FACT: Merck, the manufacturer of ivermectin, has issued a statement advising against using the drug to treat or prevent Covid-19. Their statement said that their scientists have found:

• No scientific basis for a potential therapeutic effect against Covid-19 from pre-clinical studies; 
• No meaningful evidence for clinical activity or clinical efficacy in patients with Covid-19 disease, and; 
• A concerning lack of safety data in the majority of studies.

The World Health Organization (WHO) has recommended against ivermectin for Covid-19, stating that evidence supporting the use of ivermectin to treat Covid-19 patients is inconclusive. Until more data is available, WHO recommends that the drug only be used within clinical trials. 

Ivermectin is an anti-parasite drug approved for treating people with intestinal strongyloidiasis and onchocerciasis, two conditions caused by parasitic worms. Some forms of ivermectin are used in animals to prevent heartworm disease and certain internal and external parasites. The Food and Drug Administration (FDA) of the United States has not approved this drug in treating Covid-19 patients. It has cautioned against taking ivermectin in large doses, warning that it could be toxic and cause serious harm. “Even the levels of ivermectin for approved uses can interact with other medications, like blood-thinners. You can also overdose on ivermectin, which can cause nausea, vomiting, diarrhoea, hypotension (low blood pressure), allergic reactions (itching and hives), dizziness, ataxia (problems with balance), seizures, coma and even death,” said its statement.

MYTH: It is safe to use UV light to disinfect our homes.

FACT: The FDA warns that UVC lamps used for disinfection purposes may pose potential health and safety risks. The extent of the risks would depend on the UVC wavelength, dose, and duration of radiation exposure, and would increase if the lamp were improperly installed or used by an untrained individual. 

Exposure to UVC exposure to human skin and eyes can cause injuries. UVB and UVA radiation are expected to be less effective than UVC radiation at inactivating the SARS-CoV-2 coronavirus. UVB is known to cause DNA damage and is a risk factor in developing skin cancer and cataracts. UVA is implicated in skin aging and risk of skin cancer.  

The safest way to deploy UVC radiation is to install it inside air ducts to disinfect the air, so that direct exposure to human eyes and skin is minimised. For more information on using UV radiation for disinfection purposes, read FDA’s website here.

MYTH: Saline nose rinse can help prevent a Covid-19 infection.

FACT: According to the WHO, there is limited evidence to suggest that saline rinses are more effective at alleviating the symptoms of a cold. However, regular irrigation of the nose has not been proven to prevent respiratory infections.

MYTH: Mask-wearing will not curb the spread of the SARS-CoV-2 virus, and in fact will raise the level of carbon dioxide in the air we inhale.

FACT: Masks have been scientifically proven to work at reducing the transmission of Covid-19, by blocking the expulsion of droplets from our mouths and noses. They do not form an airtight seal and carbon dioxide can escape, and therefore there won’t be an increase in CO2 inhalation. 

Respiratory droplet transmission is the predominant route of transmission of Covid-19. Everyone needs to wear masks even if we feel well, because we may be infected but asymptomatic. An experiment documented in the NEJM showed that hundreds of droplets ranging from 20 to 500 micrometres were generated when saying a simple phrase. When the mouth was covered by a damp washcloth, almost all the droplets were blocked. 

In 2020, both the CDC and WHO originally did not recommend the wearing of masks among people who were well. Later, this guidance was reversed when evidence showed that both pre-symptomatic and asymptomatic transmission are possible. In fact, studies showed that viral load peaks in the days before symptoms begin to show in the infected patient.    

Combined with hand-washing, vaccination and social distancing, mask-wearing has proven to substantially reduce the risk of transmitting Covid-19. In regions where mask-wearing was enforced by authorities, death rates were lower. 

This article has been verified medically by Dr Leong Hoe Nam, infectious diseases specialist at Rophi Clinic in Mount Elizabeth Novena Specialist Centre (Singapore).