I hope the following post helps clarify important facts and details that have often been misunderstood about the Coronavirus pandemic. Please utilize this information and the sources cited in conversations with your own family, friends and coworkers.
20 Facts about Covid-19
1. What is it?
2. Where was it first discovered?
3. Where did it originate?
4. Is Covid-19 the flu?
SARS-CoV-2 is not influenza (or what is commonly known of as “the flu”). While some people might refer to it the “flu,” it is not in the same viral strain or family as Influenza.
5. How is it transmitted and what are common symptoms of Covid-19?
The coronavirus is an airborne virus so it is transmitted through droplets in the air. Symptoms may include some or all of the following: fever, chills, muscle and body aches, cough, sore throat, shortness of breath, loss of taste or smell, headache, nausea and vomiting, congestion, runny nose, diarrhea, See NIH, John Hopkins Medicine, and CDC.
6. Is it accurate to call Covid-19 a pandemic?
Yes. A pandemic occurs when a virus is spread around the globe, infects more people than an epidemic and usually has a higher death count. The worldwide spread of the coronavirus fits this description.
7. Is the mortality (death) rate for Covid-19 the same or comparable to Influenza (the flu)?
8. Have hospitals lied about their Covid patient case load in order to profit from federal funds?
There is no evidence to indicate that hospitals lied to profit off Covid. Facebook and Twitter posts ran amuck during the initial months of the coronavirus pandemic suggesting that hospitals were falsifying Covid cases and deaths in order to receive federal funds. These unfortunate posts seemed to be fueled with a motivation to downplay the severity of the pandemic more than anything else.
By and large, most hospitals did not profit from the pandemic. They lost money. Covid hospitalizations cost hospitals billions of dollars (see Health System Tracker). The reason for this was that many of them, particularly those in Covid hot spots, chose to cancel all or most elective procedures to give primary attention to Covid patient care, even designating entire floors as Covid care units, due to the enormous influx of Covid patients during the first surge of the pandemic. This is why the CARES Act was established. It was intended to support hospitals with grant money that were depleted from revenue streams they would normally have had in pre-pandemic times.
The CARES Act was a bill both houses of Congress passed and was signed into law by former President Trump in late March of 2020. CARES allocated federal funds to be paid to hospitals for Covid patients because our country was (and remains) in a public health emergency due to the coronavirus pandemic. According to Fackcheck, there was two aspects in which hospitals were paid more for Covid patients than in pre-pandemic times: One, hospitals were paid “an additional 20% on top of traditional Medicare rates for COVID-19 patients.” Two, hospitals were reimbursed “for treating uninsured patients with the disease (at the enhanced Medicare rate).”
However, the funds were largely distributed disproportionately. According to Fackcheck, in the spring of 2020, the first $30 billion of the CARES Act was distributed to hospitals with providers who participated in Medicare. In other words, this was based on past revenue brought in from patients on Medicare prior to the pandemic. This past revenue was specific to Medicare fee-for-service revenue (also called Original Medicare: which includes Medicare Part A & B) and not Medicare Advantage, Medicare Part D and Medigap. A Kaiser study confirmed that the grant money was distributed based solely on the revenue that came in by patients on Medicare Plans A & B and not on the hospitals total “coronavirus burden”–in other words, any costs accrued related to patients with Covid, which includes patient costs, but also medical equipment used, medical staff income, etc.
The break down of this is where things get tricky. If I am understanding this correctly, larger and wealthier private healthcare systems (like teaching hospitals) and non-profit hospitals were more likely to qualify for more federal funds per Covid case for Covid patients on Medicare while hospitals in low income communities, safety-net hospitals and small town rural hospitals did not. The problem with this method of distributing funds is that wealthier hospital systems could have made up for financial losses brought on by the pandemic without as much federal aid (due to private insurance payments to the hospital in addition to hospital stocks–at least those hospitals where employees could own shares of stock) whereas small town rural hospitals (or critical access hospitals), safety-nets or those in poorer communities might not. The irony is these kinds of hospitals needed more federal support, not less, but generally received disproportionately much less.
An investigation by NPR and a PBS Series Frontline found a “widening [financial] gap between wealthy hospitals” and safety net hospitals. According to NPR and New York Times reporting, some of the wealthiest hospitals in the nation received enormous aid from the CARES Act while small town, rural and those in poorer neighborhoods received very little by comparison.
As for the remaining grant money following the first $30 million in 2020, HHS, led by former Secretary of HHS, Alex Azar, had claimed it would go to help “‘medical providers particularly impacted by the COVID-19 outbreak’ as well as rural hospitals and those with lower shares in Medicare revenue.” However, it is not so clear this is what has actually happened. Here is a break down by state on how much each state received during the initial $30 million payout. Here’s a breakdown of the total planned expenditures for the CARES Act under the Trump administration.
Instead of asking the question, “Have hospitals lied about their Covid patient case load in order to profit from federal funds?” the perhaps more relevant question to ask is, “Why wasn’t federal Covid aid based primarily on the financial burden on hospitals brought on by the coronavirus pandemic instead of some other metric?” In a national free healthcare system, distributing federal funds might have been so much easier to navigate during the pandemic. In a system like ours that claims to be a “free market,” hospitals are often at the mercy of private insurance companies and the reoccurring obstacle of how to ensure equity across the board for all patients.
So while there was no great conspiracy that most hospitals in our nation were part of some elaborate scheme in order to make big money off of Covid, it is a fact that some of the wealthiest hospitals pre-pandemic continued to profit due to federal Covid aid while many others received funding disproportionately according to either Medicare revenue or total revenue.
Note: This response primarily deals with the CARES Act Aid under the Trump administration. For information on total spending of both CARES (under the Trump administration) and the American Rescue Plan (under Biden’s administration) go to US Spending.
See the following articles: Fackcheck (1st article), Fackcheck (2nd article), USA Today, Politico, NPR, New York Times, Healthline, RevCycle Intelligence, Kaiser Family Foundation (May 2020 findings), Peterson & KFF, Kaiser Family Foundation
9. Was the actual number of Covid deaths much lower than the official reports?
It has been a common suggestion by critics of public health measures that the Covid death count in the US has not been accurate and that the actual number of deaths is much lower. Some have even claimed that many deaths counted as “Covid deaths” are actually people “who died with Covid, not from Covid.”
The reality is that, rather than the death count being inflated, it is likely much higher than the CDC has reported. This is not to suggest the CDC has been inaccurate in its reporting; rather, this is to be expected in a pandemic. As was true of the Spanish Flu of 1918, there are always segments of the population that get missed in the final death count.
Take for instance those who died with Covid at home and unable to be tested, or those who were underinsured who did not seek medical help out of financial struggle, or those who were afraid of entering a hospital at the height of the pandemic or during the surges that followed, or the millions of people who were misled by misinformation about the coronavirus and did not seek medical help. It is a much higher likelihood that a great number of people that died from Covid were not reported.
Consider too the fact that the overall death toll in the United States was “21% higher between March 15, 2020 and February 21, 2021.” In other words, more people died in the first year of the pandemic than would have been the case had a catastrophic pandemic not occurred. While statistics can and do fluctuate year to year in the United States (as elsewhere), there is generally a steady range of people who die with varying medical conditions on a yearly basis. The point: the most logical reason to explain the increased overall death toll in the United States is the coronavirus pandemic.
What about the claim that many people whose death was attributed to Covid simply “died with Covid, but not from Covid?” I suggest that those making this claim are drawing at straws to prove prior assumptions about the pandemic. Let’s consider what is being implied by the above claim: “since people already had a preexisting condition, we can just as easily assume they died from the preexisting condition and not from Covid.” In fact, the opposite is true.
As Dr.Deborah Birx, the former White House Coronavirus Response Coordinator, suggested earlier in the pandemic, simply because someone has a preexisting condition, it does not automatically mean they died from the preexisting condition. The fact that they were infected by Covid at the time of death must be understood as a major contributing (even cause) of their death. Said differently, people with preexisting conditions may not have died when they did had they not had Covid. It is very possible that these people might have had many more weeks, months, even years left to live with their condition had they not had Covid.
10. Do masks work in protecting people against Covid?
Yes. Since SARS-CoV-2 is an airborne virus, wearing masks has substantially limited the virus from spreading in the United States. Had mask mandates not been put in place over the last year, there is no question that both Covid cases and the death toll would have been much greater all across the United States. Wearing masks literally saved lives. See Stanford Medicine, John Hopkins Medicine, CDC and It’s Ok to be Smart.
11. What is a Covid vaccine and how does it work?
As I stated in my previous blog on the Covid-19 Pandemic, “Typically, vaccines include a weakened form or dead form of the virus. When injected in the body it is intended to create an immune response that imitates an actual viral infection so that when (or rather if) we are infected, our bodies will have learned how to fight the virus much quicker and more efficiently. It must be noted that an immune response from a vaccine is not a viral infection.
The three Covid vaccines in use in the United States are similar in that they initiate an immune response in our bodies just as traditional vaccines do. While the J&J Covid vaccine uses the more traditional virus-based technology, Pfizer and Moderna use mRNA material to create an immune response. What is mRNA? According to the University of Maryland Medical System, ‘mRNA is a piece of genetic material that cells use as “instructions” to create certain proteins [called “spike proteins”] in the body…In the case of the mRNA vaccines, your body is never exposed to the germ but is still able to produce an effective immune response.’
The more people who get vaccinated in local communities and states, the more we can build our resistance against the coronavirus, and its variants, until we are no longer at pandemic level worldwide. On the flip side, the longer we wait to get vaccinated as a nation, the more the virus can reproduce other strains (called variants), perhaps even variants more powerful than the delta variant. As has been hypothesized, and is in the realm of possibility, if this happens, our best vaccines thus far may not be able to stop the spread of new variants.”
12. Does the Covid vaccine cause someone to get Covid?
13. What are breakthrough cases? How often do they occur?
A breakthrough case occurs when a fully vaccinated person is infected by the coronavirus. Yes, breakthrough cases can occur, but they are rare. One study by John Hopkins shows 1 in 5000 may become infected by Covid. According to Dr. Rachel Bender of Fred Hutchinson Cancer Research Center in an interview with NPR, “people who are fully vaccinated have lower risk of getting infected or dying from Covid-19 than the unvaccinated.”
Critics have suggested that since Covid vaccines don’t eliminate the possibility of infection, there is no reason to get vaccinated. While they rightly assert Covid vaccination doesn’t eliminate the possibility of infection, it does however decrease the probability of infection. It also decreases the likelihood of severity in symptoms if a breakthrough infection occurs. Saying that we shouldn’t get vaccinated simply because breakthrough cases will still occur is like saying we should never go to a doctor simply because we could still get sick or that we should never put on our seatbelt just because people who had their seatbelts on still died in a car crash. It is a false equivalence.
14. What is the delta variant and why does it matter?
The delta variant is a strain, or mutation, of SARS-CoV-2 (the novel coronavirus). All viruses mutate given enough time if unchecked. The delta variant is no different. Last May, June, July and August, this particular variant of the novel coronavirus consistently demonstrated itself as a more contagious and dominant strain as Covid hospitalizations among the unvaccinated increased dramatically. There has even been evidence to suggest that the delta variant causes more severe illness in some people.
15. Why did the CDC change its mask guidance from what it was in May (vaccinated people can generally unmask in most settings) and then reverse it by July (vaccinated and unvaccinated should mask indoors in areas where there’s substantial or high transmission rates)?
In May 2021, the CDC updated its guidance from recommending everyone mask in most settings to suggesting fully vaccinated people can unmask in most settings. They updated their guidance because Covid vaccines continually proved effective to protect those vaccinated against Covid infection and that breakthrough cases were rare. In addition to this, some health officials have suggested there was an implied reason–to incentivize unvaccinated folks to get vaccinated.
Let’s consider four facts leading up to their decision in May: 1) By the end of April, half of the states in the US reported a drop in Covid cases; 2) By Mid-May, just prior to their decision, around 40% of the US was fully vaccinated (meaning they had received the one shot of the J&J vaccine or the two shots of the Pfizer or Moderna vaccine), and that number was steadily rising; 3) Fully vaccinated people rarely became breakthrough cases, and when they did, this rarely led to serious illness or hospitalization; 4) The vaccination effort and Covid testing effort under the Biden administration reaped significant results: millions of vaccines and Covid tests were distributed and made easily available to pharmacies, hospitals and clinics all across the US in rapid succession. All four of these facts formed the backdrop of the CDC’s May guidance.
At the same time, what the CDC did not anticipate was just how contagious the new dominant variant, the delta variant, would become by late spring and early summer. Although the CDC’s May guidance allowed fully vaccinated people to unmask in most places, it still strongly recommended that unvaccinated folks mask up in most places (especially indoors when around unvaccinated family, friends and coworkers and in densely crowded places outdoors). However, with no way to monitor this new guidance, there was too much wiggle room for tens of millions of unvaccinated people across the nation to no longer mask. As the delta variant took prominence in May, it was inevitable that it would spread like wildfire among the unvaccinated. Because of this, Covid hospitalizations among the unvaccinated rapidly escalated in June. Being highly contagious, the delta variant even caused more breakthrough cases among the vaccinated. By the end of July, the CDC made an almost full reversal of its guidance, recommending that both fully vaccinated and unvaccinated folks mask up indoors in areas where there’s substantial or high transmission (which, in a very short span of time became large pockets all across the United States).
The CDC’s decision to change its earlier guidance in May, while understandable, was premature.
16. Are there sometimes adverse (or harmful) physical effects from the vaccine?
Yes, there can be adverse effects. However, these are rare. Most of the time, a Covid vaccination (like all vaccines) causes very minor physical effects that last temporarily. Some of those effects are pain, swelling, and redness in the location of the shot, as well as some tiredness, headache, muscle pain, chills, fever and nausea throughout the body. Remember, a vaccination is intended to create an immune response. That’s part of the point–that our body learns how to fight the virus if and when we are actually infected. Remember, being vaccinated is not the same as being infected even though the immune response from the vaccine mimics or acts like an infection. It is only temporary (lasting 1-3 days) whereas a real Covid infection may accompany symptoms that last up to 14 days and can be much more severe.
As for adverse effects, disease specialists and other medical professionals have continued to conclude that the benefits of the vaccine far outweigh any potential harmful effects. For stats on those who experienced adverse effects, see the four sources below.
17. What are the biggest sources of misinformation and disinformation about Covid?
Kaiser Family Foundation did a recent study that showed three news sources were the cause of most misinformation and disinformation surrounding the coronavirus (FOX news, OAN and Newsmax). Data from Pew Research and PRRI (Public Religion Research Institute) has shown similar findings. Pew Research also includes social media as a source.
18. What demographics are most likely to believe misinformation about Covid?
While COVID-19 is not a respecter of party affiliation, the evidence consistently suggests that a much higher percentage of people who identify as conservative and or Republican have been more susceptible to misinformation about COVID-19 than others, particularly those who trust news sources like FOX, OAN and Newsmax or get their news solely from social media.
19. What is the best way to counter misinformation and disinformation surrounding Covid?
Listen to the concerns of those who repeat misinformation. When you respond, stick with the facts. Share the facts calmly and from a posture of humility. Set boundaries of how and when you will speak about Covid with family and friends who are misinformed. Check your motivations. Is this about caring for them or about being right? Decide not to get into heated debates over misinformation. As soon as the conversation breaks down into argumentation or yelling, it’s time to end the conversation. There are some people you simply can’t talk about Covid with.
20. Is there any precedent for vaccination mandates for children and adults?
The first vaccine mandate in the United States happened over a two hundred years ago. In fact, George Washington mandated smallpox vaccinations for all his soldiers in 1777. In 1809, Massachusetts became the first state to mandate a smallpox vaccination for those over 21. In 1813, the US government established the first vaccine agency. Since the mid 1800’s, states began to implement vaccine mandates for school children. Every single state in the US has had vaccine mandates for school children on the books. For example, vaccines for polio, tetanus, rubella, measles and the flu (influenza) have all been mandated or highly encouraged in many states. Mandating the coronavirus vaccine is no different. For more on the history of vaccine mandates in our country, click on the links below.
Updated December 3, 2021
Photo was a Fusion Medical Animation downloaded from Unsplash