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How factually correct COVID-19 headlines can be misleading

Health and Benefits|Wellbeing
COVID 19 Coronavirus

By Jeff Levin-Scherz, MD | April 20, 2021

These three news headlines show the importance of context — especially when it comes to COVID-19.

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About our “The COVID-19 Crisis” series

“The COVID-19 Crisis” series is a weekly update by Dr. Jeff Levin-Scherz covering the latest developments related to the COVID-19 pandemic in the U.S. Explore the entire blog series.

It’s been another busy week of COVID-19 headlines, and sometimes those headlines can be misleading. Context is enormously important. News reports can lead to misperceptions even if they are truthful. Here are three examples of where a headline could give even diligent readers the wrong impression.

  1. 01

    “Breakthrough” cases

    CNN had an exclusive interview with the Centers for Disease Control and Prevention (CDC), and reported last week, “So far, 5,800 fully vaccinated people have caught COVID-19 anyway.” It’s true that 5,800 fully vaccinated people got COVID-19, but that fact alone is utterly devoid of the necessary context.

    Since there were at that point about 75 million people who were two weeks out from their final shots, here are the chances that a fully vaccinated person would:

    • Get COVID-19 (5,800 cases): 1 in 12,500
    • Be hospitalized with COVID-19 (396 hospitalizations): 1 in 200,000
    • Die of COVID-19 (74 deaths): 1 in 1,000,000

    It’s not surprising there are cases of COVID-19 in those who are fully vaccinated; all the clinical trials had some people who got COVID-19 more than two weeks after their final vaccinations. Given how many people we’ve vaccinated, it’s also not surprising that there have been hospitalizations and deaths — but these are exceptionally rare.

    Even percentages can be hard to interpret. It’s easier to understand the probability as events per thousand (or million). Many who read the CNN headline would conclude that the protection from these vaccines is much less robust than it really is. Should those who are fully vaccinated continue to wear a mask when they are indoors with some who have not been vaccinated? Yes!

  2. 02

    Johnson & Johnson (Janssen) vaccine on pause

    The U.S. Food and Drug Administration (FDA) and the CDC advised a “pause” in the use of the J&J COVID-19 vaccine on April 14, when they discovered six cases of a rare type of blood clot among the seven million who have had this vaccination. They asked for this pause so they could inform physicians of this possible risk, which looks similar to a potential complication associated with the AstraZeneca vaccine, which uses a similar approach.

    The blood clots involved are serious. People often have blood clots of the vein that drains the brain (cerebral venous sinus thrombosis) and other blood clots, and they have low platelet counts and rare anti-platelet antibodies. Therefore, they need very specialized treatment; usual anti-clotting drugs can make things worse. All the cases identified so far are in women under 50, although there might be additional cases identified later among men or among those who are older.

    These blood clots are also incredibly rare. But many vaccine conspiracy theorists posted misleading headlines on social media, and many who read the news reports superficially might be reluctant to get the J&J or other vaccines in the coming weeks. To put this in perspective, almost two out of 1,000 Americans have died of COVID-19. We don’t want people to take even small unnecessary risks — and the FDA and CDC are wise to pause this vaccine while they look for more cases and warn physicians not to mistreat those who do have these unusual blood clots.

    But we need to be very careful not to leave the impression that this vaccine is unsafe. It is dramatically safer than many drugs we use regularly, and we have to make decisions about prudent risk taking. We cannot avoid risk altogether.

  3. 03

    Scary prevalence of “long COVID”

    Long COVID or Post-Acute SARS-CoV-2 (PASC), is pretty terrible. People who have been hospitalized, especially in intensive care units, often have continued medical problems with the heart, lungs, nerves and brain. Even those who have had mild cases, or COVID-19 with no symptoms at all, sometimes have debilitating lingering symptoms. These include severe fatigue, brain fog, chest pain, shortness of breath and rapid heart rate. Continued loss of smell and taste is frequent, too.

    You might have been pretty distraught when you read this headline: A third of COVID survivors suffer neurological or mental disorders.

    Yes, the headline is true. A study in Lancet Psychiatry showed that 33.6% of 236,000 who recovered from COVID-19 had some neurologic symptoms six months later. But about 90% of the diagnoses were anxiety, depression, insomnia and substance use. The U.S. Census and the CDC have been doing pulse surveys of mental health through the pandemic and have found that 35% of Americans report symptoms of anxiety or depression in the last wave of surveys, completed in late March. Long COVID-19 is terrible for many. But many COVID-19 survivors who report depression or anxiety or insomnia don’t have long COVID-19.

    A study of Swedish health care workers published earlier this month in JAMA showed that those who had COVID-19 (by antibody test) were twice as likely to have moderate or marked impairment at work as those who did not have COVID-19 (8% versus 4%). They were also more than three times as likely to report mild impairment (14% versus 4%). Here’s a comparison of symptoms at eight months in those who had COVID-19 (antibody positive) compared to those who did not (antibody negative). Long COVID-19 is terrible for those who have it and will be a new cause of disability and medical expenses in the coming months. But this won’t represent one-third of all those who have recovered from COVID-19.

    Symptoms comparison between those who have had COVID-19 and those who haven’t

    Source: Journal of the American Medical Association
    Impairment Antibody + Antibody –
    Loss of smell 9% 0.1%
    Fatigue 4% 1.5%
    Loss of taste 3.7% 0.1%
    Short of breath 1.9% 0.3%
    Sleeping disorder 2.2% 0.8%
    Headache 1.5% 1.0%
    Difficulty concentrating 0.6% 0.2%

Other COVID-19 news

  • Vaccination rates continue to climb despite the pause of J&J vaccines that began last week. We were back up to 3.5 million doses given on April 15 and are averaging 3.3 million shots a day.
  • Plateau in new cases continues. We had more than 70,000 new cases reported on Tuesday and Wednesday of last week — despite the great progress on the vaccine front. We continue to have 35,000 hospitalized with COVID-19. The rate of new cases is highest in Michigan (550 cases per 100k). There are also more than 200 cases per 100k in Minnesota, New York and a number of other Northeastern states.
The 7-day moving average of new cases was 67,442 on April 17, 2021.
Number of new COVID-19 cases in the U.S. reported to the CDC

Seven-day moving average: 67,442 on April 17, 2021. Source: Centers for Disease Control and Prevention

  • The U.S. had more years of potential life lost in 2020 due to the pandemic than other developed countries. Kaiser Family Foundation calculated that the U.S. suffered 160 excess deaths per 100,000, and our rate of excess deaths was most striking for those under 75.
US Ages 0-14: -5 Ages 15-64: 58 Ages 65-74: 420 Ages 75+: 1,247 All Ages: 160 Belgium Ages 0-14: -10 Ages 15-64: 6 Ages 65-74: 255 Ages 75+: 1,430 All Ages: 155 UK Ages 0-14: -4 Ages 15-64: 25 Ages 65-74: 172 Ages 75+: 1,073 All Ages: 122 Switzerland Ages 0-14: 2 Ages 15-64: -0 Ages 65-74: 56 Ages 75+: 1,114 All Ages: 102 Austria Ages 0-14: -0 Ages 15-64: 9 Ages 65-74: 91 Ages 75+: 888 All Ages: 98 Netherlands Ages 0-14: 1 Ages 15-64: -1 Ages 65-74: 136 Ages 75+: 1,005 All Ages: 95 France Ages 0-14: -3 Ages 15-64: -3 Ages 65-74: 188 Ages 75+: 759 All Ages: 88 Canada Ages 0-14: 5 Ages 15-64: 14 Ages 65-74: 131 Ages 75+: 579 All Ages: 65 Sweden Ages 0-14: 0 Ages 15-64: -4 Ages 65-74: -8 Ages 75+: 726 All Ages: 61 Germany Ages 0-14: -1 Ages 15-64: -0 Ages 65-74: 68 Ages 75+: 415 All Ages: 54 Australia Ages 0-14: -2 Ages 15-64: -4 Ages 65-74: 13 Ages 75+: -78 All Ages: -7
In 2020, the U.S. had the highest pandemic-related mortality and potential years of life lost among peer countries.
Excess mortality rate in 2020, per 100,000 people by age group

Notes: Excess mortality rates are per 100,000 people within age group in each country. Source: Kaiser Family Foundation

  • The most recent CDC projections suggest that rates of new infections will rise slightly over the next four weeks despite last month’s projections that new cases would be going down. This graphic shows that the various projections that the CDC compiles differ wildly, with some predicting a new surge and others predicting a return to a downslope in cases. The CDC also publishes projections by state and by county.
While new cases continue to rise slightly, forecasted cases through May 1 vary dramatically, depicting an uncertain trend.
The number of new cases reported in the U.S. each week from January 30 through April 3, 2021, and forecasted new cases over the next 4 weeks.

Source: Centers for Disease Control and Prevention


Population Health Leader, Health and Benefits, North America

Jeff is a practicing physician and has led Willis Towers Watson’s clinical response to COVID-19. He has served in leadership roles in provider organizations and a health plan, and is an Assistant Professor at Harvard Chan School of Public Health.

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