The adage holds that truth is the first casualty of war.

The coronavirus pandemic has proven no exception to that. Since the outbreak erupted in March, COVID-19 has become part of the country’s cultural and political battlefield, often at the expense of public health efforts that aim to save lives and prevent the disease’s spread.

Social media has proven a key front for misinformation about the disease, from the wisdom of mask wearing and social distancing, to the dangers of a virus that already has killed more than 300,000 Americans.

NJ Advance Media collected popular claims it repeatedly has seen in its social media feeds over the past 10 months. We asked public health experts to weigh in on five of them by discussing what the evidence shows and offering context to the claims.

CLAIM: The survival rate for my age group is over 99%, yet we’re supposed to be afraid of the coronavirus.

Technically, this is true. COVID-19 is clearly much more deadly for older populations than younger ones, with nearly 80% of New Jersey’s coronavirus deaths occurring among those who are 65 and older, according to the state Department of Health.

Still, fatality rates are tricky to calculate, since science doesn’t have a firm grasp of how many people have contracted the disease, given gaps in testing and the reality that some people never show symptoms. With that said, studies suggest the death rate across all age groups is somewhere in the range of 0.6% to 0.9%, according to Stephen Kissler, a research fellow at Harvard University’s T.H. Chan School of Public Health.

That means that for every thousand people who contract the coronavirus, 6 to 9 would be expected to die. While that may seem like a minuscule number, it is important to remember that the virus is highly contagious and is capable of infecting huge swaths of the population as a result, experts said.

The United States is a country of 328 million people. If half the population got the disease, that equates to 984,000 deaths at the low end of the range, and 1.48 million at the high end, far above the already staggering 310,000 deaths that have been recorded.

“It sounds like such a small number, but if you multiple it by millions of people, you end up with a very, very large number of deaths,” Kissler said.

The risk of death does follow age, with a study published last month in Nature estimating that children ages 5 to 9 have a 0.001% fatality rate, while seniors of 80 years and older have a rate of 8.29%.

So should younger people worry?

Absolutely, said Leslie Kantor, a professor at Rutgers School of Public Health. Younger people are still dying of COVID-19, and the disease can carry consequences beyond just death, including long-term health problems that medicine is only beginning to understand, Kantor said

“Many young people have become very, very ill,” Kantor said. “So an important message to young people is you don’t know how your body is going to handle this.”

Kantor and Kissler also underscored that younger people can easily pass the disease onto older people who are more vulnerable, whether their parents or grandparents, or a stranger during a chance encounter at the supermarket or a restaurant. You might pass it to a friend, who in turn passes it on to an elderly aunt.

“We’re all potentially a link in the chain of someone who will be hospitalized or will die or will have long-term health consequences,” Kantor said.

CLAIM: Everyone who dies these days gets COVID-19 on their death certificate.

But aren’t coronavirus deaths being overstated?

In a word, public health experts say, no.

This claim has circulated throughout the pandemic, with posters insisting that deaths from other causes, whether the flu, heart disease or just plain old age, are being falsely attributed to the virus.

“I don’t really even know how to respond to that,” said Dr. Panagis Galiatsatos of Johns Hopkins University School of Medicine. “It just shows that people have never filled out a death certificate.”

New Jersey’s official COVID-19 death toll stands at more than 16,200, plus another 1,908 deaths that are considering probable coronavirus cases, according to the Department of Health on Friday.

But if anything, those deaths have likely been underreported, epidemiologists and medical examiners say, especially in the early days of the outbreak when many people were dying without being tested for the virus.

How do we know this? Overall deaths in 2020 have leaped at astounding levels.

From March through November, nearly 18,800 more New Jerseyans died than was typical in years past, state mortality data shows. That’s a 35% increase in deaths regardless of cause, and it coincides with the contagion’s two waves.

April was the height of the pandemic in New Jersey. It also was the height of the state’s excess deaths, when 11,805 more residents died than expected. In total, there were 17,895 deaths that month, nearly triple the 6,090 deaths averaged in April from 2015 to 2019.

That gap fell over the summer as the outbreak lulled, but it has picked up again as cases have surged. November recorded more than 825 deaths than expected, an increase of 14% over the average of the past five years.

That phenomenon has also been seen nationwide. The Centers for Disease Control and Prevention estimated that through the beginning of October, 299,000 more Americans than expected died across the United States, with at least two-thirds of those excess deaths attributable to COVID-19.

“The number of people who are losing their lives in this pandemic is larger than we think,” Dr. Steven Woolf, the director emeritus of the Center for Society and Health at Virginia Commonwealth University, told NJ Advance Media at the time. “The excess death count reminds us we are not getting a full sense of how many people are dying.”

Excess deaths represent another way of plotting the disease’s devastation, and capture more than just coronavirus deaths that may have been missed. They also show the indirect consequences of the virus’ impact on society, for instance, those who die of treatable illnesses for which they did not obtain medical attention — the man who had a heart attack at home, rather than risk a trip to the hospital after suffering chest pains.

With the gap between excess deaths and official coronavirus tallies, experts say it remains unclear which factor is driving the difference, though Woolf suspects unrecorded COVID-19 deaths are the more prevalent component. But either way, it suggests the pandemic has been more, and not less, deadly than commonly understood.

CLAIM: Mask wearing, social distancing and other coronavirus measures don’t work. We’ve been doing them since March, yet the disease is still around.

Public health officials repeatedly have stressed that small precautions such as face masks, hand washing and staying 6 feet apart can help limit the spread of COVID-19. As cases surge, it is not because those measures are ineffective, experts said, but rather because too many people are flouting those recommendations.

“Unfortunately, a lot of people haven’t been distancing and mask wearing,” said Kantor, the Rutgers professor. “If we really had been social distancing and masking, we would not be in the situation we are in today.

Galiatsatos, the Johns Hopkins physician, compared the claim to someone who insists that seat belts don’t work — but only buckled up after the car was in an accident.

“Seat belts work, but won’t work if you don’t put them on,” Galiatsatos said.

CLAIM: Of course we have more people testing positive for COVID-19. We are testing way more people today in New Jersey than we did in the spring.

New Jersey spent months building its testing infrastructure, and on some days, as many as 80,000 people are now being tested. That compares to April, when 12,000 tests a day were typical.

That needs to be kept in mind when comparing the number of positive tests today to the number of positive tests in the spring. The more you test, the more you will discover people with the disease.

But there are several trend lines that show the leaping number of COVID-19′s cases is a reflection of more than just that, experts say. If the coronavirus was getting under control, as testing grew, the percentage of positive tests should fall. That was the case this summer, when the state’s positivity rate hit a low of 1.3% on Aug. 19, meaning that for every 100 people tested, just a shade over one was infected.

But that rate has been steadily climbing, and has sat at 10% or above throughout December, a worrisome figure. Johns Hopkins University says that as a rule of thumb, rates of 5% or more should be cause for concern because it suggests the disease is spreading silently.

Amid that, hospitalizations have leaped to levels that haven’t been seen in months, as have the number of people in intensive care and on ventilators — other signs of the second wave’s seriousness.

“The important thing is to pay attention to all of the statistics,” said Harvard’s Kissler. “It is pretty clear to me that cases are going up and going up in a big way and that can’t be attributed to testing anymore.”

CLAIM: Younger people aren’t getting seriously ill or dying, and they are the ones getting the coronavirus this time around.

So far, the second wave of the coronavirus has tended to hit a demographic that is younger and less vulnerable to the virus than was seen in the spring, state officials say. But Gov. Phil Murphy has repeatedly urged younger residents to take the disease seriously, considering the hazards not only to themselves but also to others.

“You could be passing this on to your parents or grandparents and essentially, I hate to say it, killing them,” Murphy warned this month.

More than one-third of the American population is in a higher risk category for the coronavirus, Kissler said, either because of age or because of pre-existing illnesses such as diabetes or heart disease. Given the sheer size of that number, it is impossible to isolate them from the rest of society, and they are unsuspectedly being exposed to younger people with COVID-19, he said.

“This is an infectious disease,” Kissler said. “We all have responsibility to protect not only ourselves, but also those around us.”

As noted previously, coronavirus carries more risks than just death, including sometimes lingering health effects like fatigue and shortness of breath that can last for months.

Galiatsatos, of Johns Hopkins, said he treated a college football lineman who lost 80 pounds after contracting the disease, going from 300 pounds to just 220. He still suffers from fatigue and mental fogginess, Galiatsatos said.

“He can’t get the energy back to where he would like in order to do the activities he needs to do,” Galiatsatos said.

And younger people are dying of the virus.

“From a totally personal perspective, if you are only worried about your health, there are still things to be worried about,” Kissler said.

Original Article