The world and indeed our country, Jamaica continue to experience the effects of the SARS-CoV-2 and the subsequent COVID-19 epidemic.

Keeping the population informed about the SARS-CoV-2 is important in terms of limiting spread, informing the need to seek medical attention and how best to protect ourselves. Unfortunately, several myths have arisen which at best serve to misinform the public and at worst can lead to bodily harm and death. This week we will try to look at some of these myths.

Myth #1: It is a disease affecting old people only

This is a particularly prevalent myth that is not exactly true. It is true to say that the elderly are more prone to getting COVID-19 disease and, when infected, they will likely have it more severely. There is, however, no age at which you cannot get COVID-19 disease.

Severe disease and death, although less likely, do occur in the young (and indeed the very young), just at a lower frequency. In short, youth is not a protection against COVID-19 disease or its serious complications. It is also important to remember that young people who get infected (even when they have no symptoms) can pass on the disease to older people who they encounter. Those elderly people may not be as fortunate.

Myth #2: COVID-19 disease cannot spread in hot countries

Given our current experience, it is difficult to know why this myth persists. There is evidence to suggest that some aspects of a tropical climate may help in limiting the spread. For instance, when looking at how long virus particles can survive on surfaces in the environment, hotter temperatures mean shorter virus survival times. At four degrees Celsius SARS-CoV-2 can survive for 28 days on plastic or metal vs three days at 21-23 degrees Celsius. The temperature required to kill or inactivate the virus is estimated to vary from 55-65 degrees Celsius (up to 92 degrees Celsius for particularly contaminated samples). It is important to note that these are not temperatures normally reached in tropical climates.

Other epidemiological studies have raised the question as to whether the spread of the virus is slower in countries that have hotter climates. There is also the issue that diseases from respiratory viruses are more prevalent in the fall and winter months in temperate climates. All of the above certainly may be true, but that must be balanced against the fact that outbreaks of COVID-19 disease are occurring in the Caribbean region, the African continent, South Asia and the Middle East – so that living in a tropical climate cannot protect against disease spread in an absolute way. There is also no evidence to suggest that standing in the sun protects persons after exposure. In summary, hot or tropical climate is not a protection against COVID-19 infection or from bad outcomes from an infection.

Myth #3: Herbal/home remedies can prevent or treat COVID-19 infection

We currently have no vaccine that can prevent transmission or indeed medications that have been unequivocally proven to treat COVID-19 infection. Given this, there has been a lot of advice coming out on social media about various home and herbal remedies that are purported to help. There are, in fact, too many of these to name. Several examples include garlic, alcohol, lime, various vitamins and bicarbonate. While most of these herbal remedies will likely do no harm, they offer no protection or efficacy in treating COVID-19 disease. Importantly, they may cause people to lower their guard and stop washing their hands frequently or stop practising social distancing.

Myth #4: Should I drink bleach or other disinfectants? Should I use them to kill SARS-CoV-2 on the skin?

This particular myth has gained more traction following President Donald Trump’s press briefings in the USA. The first thing to say is that drinking bleach, or any disinfectant, can result in severe complications or death. Disinfectants are also not recommended for use on skin or internally. They can serve as irritants (sometimes having severe effects and resulting in chemical burns) to skin and mucous membranes. This myth appears to arise from the fact that disinfectants can kill viruses including the SARS-CoV-2. Using a disinfectant to clean a surface which may have been exposed to the virus can reduce the risk of spread. It is important to remember, though that in addition to killing any virus particles that may be present they are also quite good at killing body cells as well. Most disinfectants for home use are diluted to limit damage to skin cells, but even in these cases prolonged skin contact can be harmful and therefore should be avoided.

Myth #5: Can antibiotics prevent/treat COVID-19 infections?

Unfortunately, the SARS-CoV-2 is a virus and hence will not be killed by antibiotics. One antibiotic, Azithromycin, has been used in studies to treat COVID-19 disease but has not yet been demonstrated to have a consistent beneficial effect. In this setting, Azithromycin is not acting as an antibiotic but rather as an agent to increase the efficiency of virus-killing mechanisms of the cell. Another agent, an anti-malarial drug called Hydroxychloroquine has been shown in laboratory studies to prevent entry of the SARS-CoV-2 into cells and subsequent multiplication, but this has not yet been demonstrated to be of clinical benefit. Both Azithromycin and Hydroxychloroquine have potential side effects that can be more severe when they are used together. It should be noted that there are special occasions in which patients who have COVID-19 infections are given antibiotics. This most commonly occurs when the patient has a bacterial infection that is occurring at the same time as COVID-19 infection, or more rarely to prevent an added bacterial infection. The use of Hydroxychloroquine, Azithromycin or any other antibiotic should only be done under the direction of a physician.

Myth #6: Should I use ultraviolet (UV) light on my body to kill SARS-CoV-2?

While UV light has been used to kill SARS-CoV-2 in several settings, most commonly disinfecting hospital rooms or equipment, UV light is significantly toxic to the human body – particularly the skin and eyes. Skin exposure can lead to short-term damage with burns or longer-term damage with premature aging and cancer. The eyes are extremely sensitive to UV light and high levels of exposure can result in inflammation and temporary vision loss. Longer-term exposure may lead to cataracts or permanent loss of vision from macular degeneration. One potentially safe home use of UV lights during the COVID-19 pandemic is on small items that potentially may collect virus particles, such as a cellphones or keys. Home UV light generators are available commercially and are commonly used to sterilise baby bottle lids or some types of home medical equipment. These devices usually have an enclosed chamber to ensure that UV radiation cannot escape and make contact with the skin or the eyes.

Given the above, it is important that we continue to get information from reliable sources such as our physicians or official websites. In the current environment, although we would wish for a miracle cure it is essential that we continue the measures that have been useful so far. Hopefully, we can look forward to a return to a more normal life.

Stay safe.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists at Heart Institute of the Caribbean (HIC) and HIC Heart Hospital.

Send correspondence to emadu@caribbeanheart.com or call 876-906-2107