There are several kinds of widely circulating myths or fallacies that intentionally underestimate the threat of the COVID-19 pandemic and the importance of prevention.
The first is what I call the N=1 narrative — that is, an attempt to generalize about the experience of a single person. It often goes something like: "To ensure that my immune system is strong, I take good care of myself, with regular exercise, healthy food, and supplements. If everyone did that, the pandemic would disappear."
However, of the more than 760,000 Americans who have died from COVID-19, let alone the millions more who have been infected, many were healthy. One indication of that is the way COVID-19 has swept through the ranks of professional sports teams.
The second is a variation on the caveat in medical research that "the plural of anecdote isn't evidence," in the same way that a few examples of drivers of big-rig cabs surviving a collision with a train, such as here and here, are not a persuasive recommendation for trying it. But we see that sort of specious reasoning not infrequently with respect to the COVID-19 pandemic. It often goes along the lines of: "My wife brought COVID home from the nursing home where she works, and the whole family caught it, but it was no worse than the flu. And because we haven't had mask and vaccine mandates during past flu seasons, we don't need them for the COVID-19 pandemic."
The third is the most pernicious because it goes beyond irrelevant personal opinions into the realm of disinformation about the impacts of COVID-19. On social media, we frequently see people asserting that because COVID-19 has a mortality rate in the United States of less than 0.2% (767,000 deaths divided by 47.5 million cases), COVID-19 really isn't such a big deal.
There are two rejoinders to that. First, virtually every public health expert considers something that has caused more than three-quarters of a million U.S. deaths, and which is currently killing more than 1,100 a day, a big deal, whatever the mortality rate.
Second, deaths from COVID-19 are far from the whole story. A systematic review of data from more than 250,000 patients published in JAMA Network Open in October found that more than half of COVID-19 survivors experienced persistent signs or symptoms six months after recovery. About 20% had decreased mobility; 25% had "brain fog," or trouble thinking or concentrating; 30% developed an anxiety disorder; 25% had breathing difficulties; and 20% experienced skin rashes or hair loss. In addition, cardiac problems such as chest pain or palpitations and gastrointestinal symptoms were common.
The COVID-19 survivors who experience these persistent effects, who are often called "long haulers," can include anyone who has been infected, even those who had no symptoms or only mild ones. These findings are frightening, not only because of the suffering and debility inflicted on tens of millions of people, but because these post-infection aftereffects will place continuing stress on our healthcare capacity, to say nothing of lost productivity in the workplace.
There's an obvious take-home lesson here: Don't get infected in the first place. We know how to accomplish that — by getting vaccinated, including a booster dose, and applying nonpharmaceutical interventions, as illustrated in the Swiss cheese figure, which illustrates how multiple layers of precautions lower the probability of contracting a respiratory virus.
That's my prescription for a healthy 2022.
Dr. Henry Miller is a physician and molecular biologist. He was a research associate at the NIH and the founding director of the FDA's Office of Biotechnology. Find him on Twitter: @henryimiller.