We refer to repeatedly copy-and-pasted text shared across multiple digital platforms as "copypasta" — a sort of chain email for the social media age. Copypasta has been a major feature of the COVID-19 pandemic and the misinformation associated with it, often claiming to provide anonymously sourced "insider" information on how to treat, cure, or avoid the disease that is often incorrect and dangerous. As always, we remind our readers that anonymous claims on the internet should never be taken as factual, efficacious, or even safe.
In late December 2020, a piece of copypasta allegedly written by someone whose friend "came down with Covid in November" and received information from a nurse on how to fight the disease "at home" went viral:
HOW TO FIGHT COVID AT HOME
No one ever talks about how to fight Covid at home.
A friend came down with Covid in November. She went to the hospital, running a fever of 103, a rapid heart beat, and other common symptoms that come with Covid. While she was there they treated her for the high fever, dehydration and pneumonia. The doctor sent her home to fight Covid with two prescriptions - Azithromycin 250mg & Dexamethason [sic] 6mg. When the nurse came in to discharge her, she asked her, "What can I do to help fight this at home?"
Though the post, narratively speaking, seems to make a series of recommendations for post-hospitalization recovery, the title — and several of the points made throughout — suggest or mislead the reader into thinking these tips are meant to be preventive or curative in absence of, or prior to, hospitalization. This latter interpretation is the most problematic way to view these suggestions.
In some cases, the suggestions have some scientific basis but are misapplied to home-care situations; in others, the information is flat out wrong. In general, experts say, the post's content risks providing people who are actually sick a reason to delay professional care that could be life-saving. Below, we go through the post point by point.
Sleeping On Your Stomach
The post makes this claim:
Sleep on your stomach at all times with Covid. If you can’t sleep on your stomach because of heath issues sleep on your side. Do not lay on your back no matter what because it smashes your lungs and that will allow fluid to set in.
This advice is not applicable to home care. In the medical world, placing patients on their stomach (the prone position) for respiratory reasons is known as proning. Evidence that predates the COVID-19 pandemic derived from patients who have Acute Respiratory Distress Syndrome (ARDS) suggests that patients who require ventilation in an ICU setting could benefit from prolonged time in the prone position. A limited study of proning in severe cases of COVID-19 in an ICU setting suggests some benefit as well.
Though a clinical trial is underway investigating the question, no evidence suggests any benefit to a person who does not already require ventilation. If you require ventilation you should not, it bears highlighting, be attempting home care. David Vines, a principal investigator on the COVID-19 trial for proning in milder cases, told Snopes by email that with around 200 patients participating so far, they "have not seen a significant trend in benefit or harm."
"The concern with the public using the prone positioning at home to lessen symptoms," Vines told us, is that using this technique "may delay necessary medical care with proven benefits. Their delay in receiving this care from a medical provider could result in their death," he explained, stressing that "anyone having trouble breathing, bluish lips, or inability to stay awake should seek emergency care immediately."
Building off the flawed assertions about sleeping in the prone position, the post additionally claims:
Set your clock every two hours while sleeping on your stomach, then get out of bed and walk for 15-30 min, no matter how tired or weak that you are. Also move your arms around frequently, it helps to open your lungs.
Breathe in thru your nose, and out thru your mouth. This will help build up your lungs, plus help get rid of the Pneumonia or other fluid you may have. When sitting in a recliner, sit up straight - do not lay back in the recliner, again this will smash your lungs. While watching TV - get up and walk during every commercial.
At least as phrased here, this is dangerous advice. The notion that you should exercise even if you feel too "tired or weak" goes against virtually all medical advice regarding breathing and COVID-19. Shortness of breath from basic activities like short walks is an indicator that professional medical care may be needed, according to Joseph Khabbaza, a pulmonary doctor at Cleveland Clinic who spoke to WBUR about caring for a COVID patient at home:
The main indication for going to the hospital would be shortness of breath — and that kind of is a general term. But if you find you're winded just from walking from the bedroom to the bathroom, that's a good gauge that you might be short of breath because significant lung inflammation may be developing. You also may be short of breath because your oxygen level is too low. The lungs cannot absorb enough oxygen to meet the needs to do such a small task, such as walking to the bathroom. That is really the most important thing because the way this virus can kill people is by that respiratory failure that lands people on the ventilator. The earlier recognition of that, the better.
Broadly speaking, the advice regarding breathing exercises may be more relevant to people who have spent time in an ICU during the course of their illness with COVID-19. For example, experts with the Johns Hopkins Rehabilitation Network recommend breathing exercises during recovery from COVID-19 hospitalizations, as prolonged time on a respirator weakens muscles in the lungs, among other things. Some of those exercises do involve arm movements that increase oxygen capacity in the lungs. Again, though, even in recovery, the notion that you should work through exhaustion is dangerous. On the Hopkins breathing exercise page, the facility explicitly states:
When recovering from a respiratory illness like COVID-19, it’s important not to rush recovery. … Only increase repetitions or move to the next phase when you can complete the exercise without feeling too out of breath.
The post then makes this claim about staying hydrated with non-cold beverages:
Drink Pedialyte, Gatorade Zero, Powerade Zero & Water with Electrolytes to prevent you from becoming dehydrated. Do not drink anything cold - have it at room temperature or warm it up. Water with lemon, and little honey, peppermint tea, apple cider are good suggestions for getting in fluids.
In general, staying hydrated is important for maintaining good health, or for replacing fluids lost during a fever. As such the suggestion of water and electrolytes is not controversial. Hydration and electrolytes, as well, are indicated as important for recovery from COVID-19 specifically. Problems emerge, however, with the claim that beverages used for hydration must not be cold.
Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, addressed the notion that cold water is harmful in the context of COVID-19 recovery on a March 20, 2020, edition of Johns Hopkins' "Public on Call" Podcast. "There’s also a claim that if people drink cold water, their lungs will become fibrotic," she told listeners, referring to a condition in which lung tissue is scarred and degraded. "I want to stress that there's no evidence at all to support these claims."
Foods to Eat
In terms of food, the post asserts:
Eat at least 1 - 2 eggs a day, plus bananas, avocado and asparagus.These are good for Potassium. [...] Drink a smoothie of blueberries, strawberries, bananas, honey, tea and a spoon or two of peanut butter.
In terms of recovery, these are all fine foods to eat, and many are included on lists specifically made for COVID-19 recovery diets authored by medical professionals. These suggestions should not be considered effective at preventing infection, however. While a link may exist between low blood levels of potassium and severe COVID cases, this fact should not be viewed as evidence that increased potassium uptake could be effective in preventing COVID-19.
Foods To Avoid
The copypasta post asserts that people recovering from COVID-19 should not drink dairy or eat pork. This information is not supported by any reputable source. In terms of dairy, it is contradicted by several reputable sources that explicitly recommend dairy products, among many other foods, during COVID-19 recovery. There has been, since long before COVID, a misconception that dairy products create more phlegm in the lungs. While it's possible dairy products make existing phlegm thicker and feel more irritating, it does not actively contribute to production.
In terms of pork, we are unclear what exactly the author of the viral post is referring to. There is a belief held by some practitioners of alternative medicine that pork can contribute to "dampness" and phlegm, but this is not supported by peer-reviewed science. While several processed pork products may be counterproductive in terms of health, a ban on pork as a source of protein does not seem to be supported by any COVID-19 related medical advice. The Hospital for Special Surgeries in New York recommends pork chops as a source of meat that contains zinc, for example.
Vitamins And Probiotics
Speaking of Zinc, the viral copypasta recommends "Vitamin’s D3, C, B, Zinc" as well as daily probiotics. In terms of recovery following COVID-19 infection, this advice is not at all controversial, though any dietary changes made during recovery from COVID-19 should be assessed by a medical professional.
This advice is, however, problematic if interpreted to be a way to "boost" your immune system in a way that could prevent infection from COVID-19. This notion relies on a flawed understanding of how the immune system functions. According to Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security, “There is no evidence that you can boost your immune system by ... taking specific vitamins or supplements.”
The post also makes a series of recommendations regarding over the counter drugs:
Tylenol for fever. Mucinex, or Mucinex DM for drainage, plus helps the cough. Pepcid helps for cramps in your legs. One baby aspirin everyday can help prevent getting a blood clot, which can occur from low activity.
Any use of drugs, including over-the-counter ones, should be informed by recommendations made by a doctor, nurse, or pharmacist, not online posts — even this one. Both Tylenol, which reduces fevers, and Mucinex, which reduces phlegm, are commonly used to treat symptoms associated with a variety of viral or bacterial infections. However, the use of Pepcid (an antacid used to treat heartburn-related diseases) for leg cramps is unsupported by any research that we are aware of, and the drug is not approved for that purpose.
In terms of aspirin, evidence does suggest that COVID-19 patients clot more easily. Hopkins' Adalja, quoted on the Johns Hopkins School of Public Health website, said that, "People with coronavirus have the ability to form clots more easily." In terms of using aspirin to prevent complications from clotting, limited evidence suggests that it may reduce mortality in severe COVID cases that require hospitalization. Evidence for use in milder cases or in non-hospital recovery settings is currently lacking, however. As always, talk to a doctor before starting a regular aspirin regimen for any purpose, as it could lead to other complications.
If we interpret the post as presenting recommendations made for people who were hospitalized with COVID-19 and sent home for further recovery, the post misses the mark in several cases described above. If, however, the post is interpreted as ways to keep people safe at home without going to the hospital, the post is dangerous, as it encourages notions that could prolong the decision to seek medical care in urgent situations. All told, it's a good reminder to not get medical advice from posts that end in "copy paste and share."