COVID-19: Debunking Potentially Dangerous Myths

Many myths as to prevention of and treatment for the novel coronavirus (COVID-19) infection are circulating and increasing in intensity. They serve no purpose except to cause confusion, potential injuries and even death.

The origins of these myths include a combination of old wives tales, self-made ideas due to lack of understanding of the virus itself, cultural beliefs and profit. The copycat syndrome is included in the spread of non-scientific information.

In addition to a list of myths released by the World Health Organization, which we strongly encourage you to review, the Infection Control Consulting Services (ICCS) team has been asked to comment on the following six myths.

1. Drinking alcohol can kill the virus. This is a myth and a potentially dangerous at that. The amount of alcohol ingested that would be needed for such a study is lethal and not a scientifically viable option.

2. Zinc lozenges can prevent the coronavirus and most other virus from multiplying in your throat and nasopharynx. The myth claims that it is "best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx." This is a myth introduced by a pathologist and has no basis for prevention of any viruses, according to scientists. It is particularly concerning that anyone would advocate for sucking on a lozenge while laying down and running the risk of choking, besides the lack of evidence that zinc prevents any viruses from replicating.

3. COVID-19 causes a productive cough and drinking hot water will loosen the phlegm. This is a myth as hot water does not affect COVID-19. If the water is hot enough, it can burn a person. In addition, COVID-19 typically presents as a dry cough and not a productive cough.

4. Blowing a hairdryer up your nose will kill the viruses in your nose. This is a ridiculous claim and has no basis. Furthermore, an individual taking such an action runs the risk of burning themselves from the hot hairdryer.

5. Certain medications have been approved in the United States for treating COVID-19. This is a myth as, at the time of publication of this piece, there are no Food and Drug Administration (FDA)-approved medicinal treatments for this illness. Several trials are underway with a few medications. Unfortunately, information was released by the White House that has caused a nationwide shortage in an autoimmune condition medication, placing people with rheumatoid arthritis and lupus in jeopardy if they cannot obtain their medication. In addition, one person has died and their spouse hospitalized after they ingested large doses of a medication in a different form.

6. Silver kills the coronavirus within 12 hours. This is a myth peddled by at least one televangelist who also claimed that his "Silver Solution" strengthened the immune system. As the Mayo Clinic notes, "Colloidal silver isn't considered safe or effective for any of the health claims manufacturers make. Silver has no known purpose in the body. Nor is it an essential mineral, as some sellers of silver products claim." While rare, excessive doses of silver can cause serious health issues. 

Reputable Sources of COVID-19 Information

ICCS stresses the importance of relying upon only healthcare-related updates, including those concerning COVID-19, issued by reputable organizations, including the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), Federal Drug Administration (FDA) and National Institutes of Health (NIH).

COVID-19 Pandemic: Update on Accreditation Surveying

Over the past few weeks, national accreditation organizations have issued statements concerning whether and how they plan to proceed with surveys during the coronavirus pandemic. The following includes highlights from these plans and provides links to each organization's latest official statement on the matter or articles with information about plans if no official statement could be found at this time. Note: Organizations are listed in alphabetical order.

Accreditation Association for Ambulatory Health Care (AAAHC)

On March 17, AAAHC announced, "AAAHC has postponed non-emergency surveys for all Medicare deemed status accreditation (MDS) and non-MDS programs scheduled for a survey with a begin date of March 18 through May 1. … AAAHC will do our best to complete high priority emergency surveys for all MDS and non-MDS programs."

Read the AAAHC statement.

American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)

On March 18, AAAASF announced that it was "… suspending routine on-site ​resurvey activities. ​However, due to the national call to increase healthcare capacity, AAAASF will continue to conduct initial on-site surveys for all of its programs. We will be working directly with these facilities ​that require surveys as needed​, in many cases to provide modified services in response to the emergency situation. In addition, ​AAAASF will continue to provide certain surveys at the discretion of the AAAASF Board, including in response to complaints related to infection control or patient abuse."

Read the AAAASF statement.  

Center for Improvement in Healthcare Quality (CIHQ)

At this time, it does not appear that CIHQ has issued an official statement concerning its plans for managing healthcare accreditation surveys during the pandemic. An article in Patient Safety & Quality Healthcare (PSQH) included a statement from the accreditation organization's CEO. His comments included the following: "At this time, CIHQ has suspended routine reaccreditation surveys for at least the month of April 2020. … We will continue to perform initial surveys for new hospitals, and surveys if needed to address infection prevention and control issues in our accredited facilities."

Read the PSQH article.

Det Norske Veritas (DNV) National Integrated Accreditation for Health Care Organizations

At this time, it does not appear that DNV has issued an official statement concerning its plans for managing healthcare accreditation surveys during the pandemic. An article from Hall Render attorneys noted that they expect DNV to issue an advisory notice explaining management plans and then provided a summary of what they understand to be DNV's survey plans, including the following: "DNV does not intend to cancel all accreditation surveys but will be flexible with hospitals that wish to push back their survey dates. Many hospitals have requested a postponement and DNV has agreed to such postponements." and "DNV is not conducting routine surveys in Washington, New York or California at this time."

Read the Hall Render article.

Healthcare Facilities Accreditation Program (HFAP)

On March 5, HFAP announced that it was suspending most survey activities, but noted that some surveying will go forward, including:

• incoming immediate jeopardy complaints alleging infection control breaches or abuse and neglect;

• complaint surveys alleging infection control breaches;

• initial surveys (for organizations without a CMS certification number);

• CLIA laboratory surveys; and

• surveys of facilities with an immediate jeopardy-level infection control deficiency in the last three years.

Surveys that may go forward include those of facilities with a history of infection control deficiencies and certification surveys for which the facility and the surveyor have agreed to proceed.

Read the HFAP statement.

The Joint Commission

On March 16, The Joint Commission stated that it was "… suspending all regular surveying beginning Monday, March 16, 2020. In some cases, there may be a small number of surveys that will need to continue, such as high-risk situations."            

Read The Joint Commission statement.

ECRI: Sterile Processing, Antimicrobial Stewardship Top Patient Safety Concerns

Challenges concerning sterile processing and antimicrobial stewardship appear on the ECRI Institute's "Top 10 Patient Safety Concerns for Healthcare Organizations 2020" report.

Coming in fifth on the list is "Device Cleaning, Disinfection and Sterilization." In an executive brief, ECRI states that sterile processing failures can lead to surgical site infections (SSIs). Furthermore, "Incidents involving improperly reprocessed instruments can potentially result in devastating effects on patients, damage to organizational and provider reputations, citations and fines from regulatory bodies, prompt review by accrediting agencies and lawsuits."

Coming in eighth is "Antimicrobial Stewardship," which also appeared on last year's list (as "Antimicrobial Stewardship in Physician Practices and Aging Services"). In the brief, ECRI notes, "Despite the increased focus on the importance of antimicrobial stewardship in healthcare, and increased recognition among healthcare workers and patients alike, antibiotics are still being prescribed unnecessarily, when no longer needed, in the wrong dose and with the wrong indication—any of which can increase antimicrobial resistance. Many of these antibiotics are being prescribed in care settings such as long-term care organizations, urgent care centers and dentist offices."

ECRI states that it creates the annual list of patient safety concerns to help healthcare organizations proactively identify and respond to safety threats. The list is compiled using data on patient safety events and concerns and on the "judgment of interdisciplinary patient safety experts from inside and outside ECRI."

The top patient safety concern for 2020 is "Missed and Delayed Diagnoses." Rounding out the top three are "Maternal Health Across the Continuum" and "Early Recognition of Behavioral Health Needs."

KHN: Nursing Homes Struggling With 'Basic Infection Prevention Protocols'

A Kaiser Health News (KHN) report highlights the struggles of many nursing homes around the country — including some that have received the highest government rating for overall quality — with following "basic infection prevention protocols."

A KHN federal records analysis revealed that more than 9,000 nursing homes — or about 61% of all such facilities — were cited for one or more infection-control deficiencies.

Furthermore, the analysis showed that since the beginning of 2017, government health inspectors cited more nursing homes for failing to ensure workers follow infection prevention and control rules than any other type of violation. KHN notes that inspection reports indicate many of the infection prevention and control errors cited are attributable to lapses in following fundamental best practices, such as workers not washing their hands as they move between patients and failing to don masks, gloves and gowns when in rooms with isolated, contagious patients. Violations were also more common at homes employing fewer nurses and aides than those with higher staffing levels.

Patricia Hunter of the Washington State Long-Term Care Ombudsman Program, which advocates for residents of nursing homes, adult family homes and assisted-living facilities, told KHN, "It's all these little things that are part of infection-control practices that when they are added up can create an environment for an infection outbreak."

Of those nursing homes with the maximum government overall quality rating (five stars), KHN noted that 4 in 10 have been cited for an infection-control lapse. This includes the Life Care Center in Kirkland, Wash., where several residents have succumbed to the coronavirus. One publication has described the nursing home as the "national epicenter of coronavirus."

Unfortunately, nursing homes are likely to continue struggling with infection prevention and control. As KHN notes, these facilities are challenged by frequent staff turnover, new workers less likely to know facility protocols, keeping potentially infected workers at home (in part due to low pay and limited time-off benefits) and finding replacement staff.

On Wednesday, March 4, the Centers for Medicare & Medicaid Services (CMS) announced several actions it hopes will limit the spread of COVID-19. These include the following:

• Issuing a call to action to healthcare providers nationwide to ensure they are implementing and maintaining infection control procedures.

• Directing state survey agencies and accrediting organizations to focus facility inspections exclusively on issues related to infection control and other serious health and safety threats, beginning with nursing homes and hospitals.

• Outlining a survey regime that focuses on infection control and other emergent issues, including COVID-19.

CMS Administrator Seema Verma stated,. “All healthcare providers must immediately review their procedures to ensure compliance with CMS’ infection control requirements, as well as the guidelines from the Centers for Disease Control and Prevention (CDC).” 

WHO: PPE Shortage Could Increase Health Worker Risk From COVID-19

The World Health Organization (WHO) is warning of increased risk for health workers of exposure to COVID-19 and other infectious diseases due to the growing shortage of personal protective equipment (PPE).

As WHO notes, disruption to the global supply of PPE has been caused by "rising demand, panic buying, hoarding and misuse" of PPE, including medical masks, respirators, gloves, gowns and aprons. As a result, health workers are increasingly finding themselves ill-equipped to care for patients, including those with or believed to have the new coronavirus.

WHO is calling on industry to increase manufacturing of PPE by 40% and governments to incentivize such production, including easing restrictions on export and distribution of medical supplies.

"We can't stop COVID-19 without protecting health workers first," said WHO Director-General Dr. Tedros Adhanom Ghebreyesus.