How the New York Times Lies about SARS-CoV-2 Transmission: Part 2

by Aug 3, 2020Health & Vaccines5 comments

A woman wears a mask while grocery shopping (Photo by Anna Shvets, licensed under Pexels license)

The New York Times misrepresents the science to support the claim that the spread of SARS-CoV-2 is driven largely by asymptomatic carriers.
To read a summary of the key points of this article, click here.

In part one of this multi-part exposé on how the New York Times has for months systematically deceived the public about the transmission of SARS-CoV-2, we saw how award-winning reporter Apoorva Mandavilli mischaracterized the science in a March 17 article to persuade readers that the airborne transmissibility of the virus had been proven.

To bolster that message, the headline begged the question by asking “How long Will Coronavirus Live on Surfaces or in the Air Around You?” The rest of the article similarly characterized the science as though the question remaining was how long viable virus can remain in the air once aerosol particles are generated by infected individuals such as through coughing or sneezing. In truth, as revealed by examining Mandavilli’s own cited sources, the question remained whether airborne transmission occurs in the community setting.

Also, to bolster the claim, Mandavilli characterized the cited studies as contradicting the position of the World Health Organization (WHO) that SARS-CoV-2 is not airborne. In truth, the WHO rightly maintained that the airborne transmissibility of the virus remained unproven and that further research was required to determine whether it could be spread via smaller aerosol particles as well as larger respiratory droplets.[1]

(If you have not yet read part one, please click here to do so before continuing because it provides critical context for getting the most out of this installment.)

The deception continued in a Times article by Mandavilli published on March 31 titled “Infected but Feeling Fine: The Unwitting Coronavirus Spreaders”. (The title in the print edition was “Silent Infections Hobbling Battle to Thwart Virus”.) The article summary stated, “The C.D.C. director says new data about people who are infected but symptom-free could lead the agency to recommend broadened use of masks.”

The article’s overall message was that community spread of SARS-CoV-2 is driven largely by infected individuals who have no symptoms, including through airborne transmission.[2]

Once again, however, to propagate that narrative, the Times misrepresented the science, such as by fallaciously equating the proportion of individuals who are asymptomatic with the proportion of transmission that occurs asymptomatically.

Contents

The Times’ Case for Asymptomatic Airborne Transmission

Just as the article’s headline communicates that anyone who is infected with SARS-CoV-2 but has no symptoms may easily spread the virus to others, so does the lead paragraph.

The article begins, “As many as 25 percent of people infected with the new coronavirus may not show symptoms, the director of the Centers for Disease Control and Prevention [CDC] warns—a startingly high number that complicates efforts to predict the pandemic’s course and strategies to mitigate its spread.”

The “high level of symptom-free cases” had led the CDC “to consider broadening its guidelines on who should wear masks.”

“This helps explain how rapidly this virus continues to spread across the country,” CDC Director Dr. Robert Redfield is then quoted as saying.

The Times then characterizes a “‘Patient Z’” in Guangdong, China, as an “example” of such an asymptomatic spreader, linking to a study in the New England Journal of Medicine.
While the CDC had maintained “that ordinary citizens do not need to wear masks unless they are feeling sick”, there was “new data on people who may be infected without ever feeling sick, or who are transmitting the virus for a couple of days before feeling ill”, which had caused the CDC to reconsider its guidance.

It remained unknown “precisely how many people are infected without feeling ill, or if some of them are simply presymptomatic”, but researchers had “spotted unsettling anecdotes of apparently healthy people who were unwitting spreaders.”

The Times then characterizes a “‘Patient Z’” in Guangdong, China, as an “example” of such an asymptomatic spreader, linking to a study in the New England Journal of Medicine.

“Researchers now say that people like Patient Z are not merely anecdotes. For example, as many as 18 percent of people infected with the virus on the Diamond Princess cruise ship never developed symptoms, according to one analysis.”

“A team in Hong Kong”, the article continues, “suggests that from 20 to 40 percent of transmissions in China occurred before symptoms appeared.”

As the Times characterizes them, the cited studies demonstrated a “high level of covert spread” of SARS-CoV-2, and the new data on asymptomatic or presymptomatic transmission had prompted “many experts” to go “against the recommendations by the C.D.C. and the World Health Organization” by “urging everyone to wear masks—to prevent those who are unaware they have the virus from spreading it.”

“If you have a passing contact with an infectious person, you would have a very, very low chance of transmission occurring,” Dr. Benjamin Cowling, an epidemiologist at the University of Hong Kong, told the Times.
One of the means by which infected individuals may unknowingly spread the virus, the Times continues, is through airborne transmission. Some experts were now saying that “this virus appears to spread both through large droplets and droplets smaller than five micrometers—termed aerosols—containing the virus that infected people might release especially while coughing, but also while merely exhaling.”

Importantly, the Times included the caveat that experts “emphasized that the level of virus in both types of particles is low, so simply jogging or walking by an infected person does not put people at risk.”

“If you have a passing contact with an infectious person, you would have a very, very low chance of transmission occurring,” Dr. Benjamin Cowling, an epidemiologist at the University of Hong Kong, told the Times.

“The risk goes up”, the Times continued, “with sustained contact—during face-to-face conversation, for example, or by sharing the same air space for a prolonged time.”

The article then quoted Dr. Cowling describing the WHO’s stance on masks and its position that “aerosol transmission doesn’t occur” as “perplexing” and “wrong”.

Next, the Times said that there is “some confusion” around the term “asymptomatic transmission” and a “largely semantic debate about what proportion of people who appear to be perfectly fine but then become ill—as in the report in the New England Journal of Medicine of an apparently asymptomatic spreader who later acknowledged having felt mild symptoms.”

The Times paraphrases Dr. Jeffrey Shaman, an infectious diseases expert at Columbia University, saying that, ultimately, “these definitions are unimportant.” But they “may matter”, the Times adds, for “being able to understand the true scope of the pandemic.”

For instance, the WHO had concluded after a mission to China “that most people who were infected with the virus had significant symptoms.” However, Dr. Cowling’s team had observed that, early in the epidemic, China had used a definition for confirmed cases that “left out mild and asymptomatic cases” and consequently “vastly underestimated the scale and nature of the outbreak there.”

“We’ve estimated in China that between 20 percent and 40 percent of transmission events occurred before symptoms appeared,” Dr. Cowling told the Times.

The Diamond Princess study, the article asserts, “bears out this scale.” Once docked, “researchers tested all of the passengers” and “found that 18 percent of the infected passengers remained symptom-free throughout.” The proportion of asymptomatic cases among the general population would likely be higher, perhaps 40 percent, according to one of the researchers, Dr. Gerardo Chowell, because “the passengers on the ship tended to be older and therefore more likely to develop symptoms.”

“There have also been many hints, subtle and not, that the virus can be transmitted via aerosols”, the Times continues. “Sixty members of a choir in Mount Vernon, Wash., north of Seattle, gathered on March 10 for a practice session for over two and a half hours. None of them felt ill, and they made no contact with one another. But by this weekend, dozens of the members had fallen ill, and two had died.”

This event “points toward airborne transmission via aerosols”, and while the virus “is still most likely to be expelled with a cough or a sneeze”, studies on other respiratory viruses, including influenza and other coronaviruses, “have shown that people can release aerosols containing the virus simply by breathing or talking—or, presumably, by singing.”

Suggesting that individuals without symptoms are more likely to spread the virus, the Times stated that several studies had shown that people infected with SARS-CoV-2 “are most contagious about one to three days before they begin to show symptoms”, which is described as “presymptomatic transmission” (as opposed to “asymptomatic” transmission).[3]

In sum, the message that the Times delivers to its readers is that community spread of the virus is driven largely by people who have no symptoms through airborne transmission, which are the beliefs that apparently serve as the rationale for executive mask-wearing orders and other lockdown measures that have been implemented in many states.

However, the science does not say what the New York Times claims it says.

Asymptomatic Infection Doesn’t Equal Asymptomatic Transmission

The key deception throughout this New York Times article is how it equates asymptomatic infection with asymptomatic transmission. The article cites the CDC as estimating that 25 percent of individuals infected are asymptomatic and quotes the CDC director, Robert Redfield, suggesting that this helps explain the virus’s rapid spread.

In the interview from which the quote was taken, Redfield distinguished between asymptomatic transmission, which he described as “pretty much confirmed”, and presymptomatic transmission, which he said could occur “probably up to 48 hours before we show symptoms” based on the finding of significant amounts of virus in patients’ throats. What he said helps to explain the spread of the virus was both asymptomatic and presymptomatic transmission, and not asymptomatic transmission alone, as mischaracterized by the Times.[4]

There is no indication in the interview of what data Redfield was relying on for these statements, but it’s important to recognize that the detection of virus in patients’ throats prior to symptom onset merely indicates the potential for presymptomatic transmission as opposed to demonstrating its occurrence.

Since people without symptoms are, by definition, not coughing or sneezing, it stands to reason that they are less likely to spread the virus. After all, as the Times concedes, the virus is “most likely to be expelled with a cough or a sneeze”. That leaves droplets or aerosols generated by speaking or breathing as the means by which the virus might be spread by individuals without symptoms.

However, “Patient Z” was not found to have asymptomatically transmitted the virus to anyone else.
In an attempt to characterize asymptomatic transmission as not merely hypothetical but proven, the Times next refers to “Patient Z” in the New England Journal of Medicine study as an “example” of someone who unwittingly spread the virus despite having no symptoms.

However, the Times’ claim that this study demonstrated a case of asymptomatic transmission is false.

In the study, titled “SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients”, researchers identified “Patient Z” as someone who “reported no clinical symptoms” but for whom nasal swabs tested positive for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR) assays.

However, “Patient Z” was not found to have asymptomatically transmitted the virus to anyone else. The authors rather commented that the similar viral load detected between this asymptomatic person and symptomatic patients “suggests the transmission potential of asymptomatic or minimally symptomatic patients.” (Emphasis added.)

The researchers qualified the hypothesis that asymptomatic individuals might be able to spread the virus by noting, “How SARS-CoV-2 viral load correlates with culturable virus needs to be determined.” In other words, just because viral RNA was detected using RT-PCR assays does not necessarily indicate the presence of infectious virus.[5] That important caveat was not relayed to Times readers by Mandavilli.

“Currently, there is no clear evidence that COVID-19 asymptomatic persons can transmit SARS-CoV-2, but there is accumulating evidence that a substantial fraction of SARS-CoV-2 infected individuals are asymptomatic.”
The Times employs the same deception again with the study on cases aboard the Diamond Princess, which is titled “Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020”. According to the Times, this study showed that “people like Patient Z”—deceptively meaning asymptomatic spreaders—“are not merely anecdotes” and that it “bears out” an estimate that 20 percent to 40 percent of the community spread of the virus occurs through presymptomatic transmission.

But, once again, the Times’ claim that this study demonstrated asymptomatic transmission is false. Once again, that study only estimated the proportion of asymptomatic infections aboard the ship and did not document any asymptomatic transmission.

On a minor point, the Times claims that all the passengers were tested, which is also untrue. There were 3,063 tests conducted and 3,711 passengers and crew aboard, so at most 83 percent were tested, with those who had symptoms or who were at higher risk being prioritized. A high proportion of passengers were also elderly. Consequently, as the Times rightly notes, the estimated asymptomatic proportion of 17.9 percent indicates a conservative estimate in terms of generalizability to the broader population.

More importantly, while the Times cites this study as though proof of asymptomatic transmission, its authors in fact pointed out that, “Currently, there is no clear evidence that COVID-19 asymptomatic persons can transmit SARS-CoV-2, but there is accumulating evidence that a substantial fraction of SARS-CoV-2 infected individuals are asymptomatic.” (Emphasis added.)

They hypothesized that “transmission of SARS-CoV-2 by asymptomatic or paucisymptomatic cases may be possible, even though there is no clear evidence as yet of asymptomatic transmission” (emphasis added).[6]

Thus, the Times’ characterization of these studies as having demonstrated a “high level of covert spread” of SARS-CoV-2 is a bald-faced lie.

As for the estimate that 20 percent to 40 percent of transmission occurs before spreaders develop symptoms, the Times provides no explanation for how this estimate was arrived at by Dr. Cowling and his team. It does link to a study coauthored by Cowling on the preprint server medRxiv titled “Impact of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China”.

That study estimated the scale of the epidemic by projecting backward a later case definition to account for earlier reporting bias resulting from the exclusion of milder cases and cases without links to Wuhan, where the outbreak originated. Another change was that the early case definition required virological confirmation of infection, whereas this was later changed so that patients could be “clinically confirmed” without lab confirmation of the presence of SARS-CoV-2.

Whereas 55,508 confirmed cases had been reported in China as of February 20, the authors hypothesized that, had the broadened case definition been used from the start, there would have been 232,000 confirmed cases by the same date. They also wrote that the number was likely to be greater than that, too, “because many mild cases were not tested or confirmed, and some infections were asymptomatic.”

They do not acknowledge the possibility that counting cases as “confirmed” which were not lab confirmed would, on the other hand, bias the case count upward by including misdiagnosed patients whose symptoms may have been caused by another virus, such as influenza.

That study did not provide an estimated proportion of either asymptomatic or presymptomatic transmission.[7]

The study also provided no data contradicting the finding of the WHO’s mission to China with respect to transmission that “Asymptomatic infection has been reported, but the majority of the relatively rare cases who are asymptomatic on the date of identification/report went on to develop disease. The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.”[8]

“The proportion of truly asymptomatic infections is unclear but appears to be relatively rare and does not appear to be a major driver of transmission.”
In a WHO situation report published on April 2, just two days after the “Infected but Feeling Fine” article was published in the Times, it noted that the available data indicated that SARS-CoV-2 “is primarily transmitted from symptomatic people to others who are in close contact through respiratory droplets, by direct contact with infected persons, or by contact with contaminated objects and surfaces.”

Contradicting Mandavilli’s claim that people are most contagious in the days before they develop disease symptoms, the WHO observed that the data indicated that viral loads were highest in the nose and throat “early in the course of the disease”, meaning “within the first 3 days from onset of symptoms”, and that “people may be more contagious around the time of symptom onset as compared to later on in the disease.”

The WHO acknowledged that “transmission from a pre-symptomatic case can occur before symptom onset”, with presymptomatic transmission having been documented in “a small number of case reports and studies”. It also acknowledged that “some people can test positive” for the virus “from 1-3 days before they develop symptoms”—which, of course, is not the same thing as saying that people are most contagious before they develop symptoms, as the Times claimed.

Rather, this indicated that “it is possible” that infected individuals “could transmit the virus before significant symptoms develop.” (Emphasis added.) “It is important to recognize”, the WHO added, “that pre-symptomatic transmission still requires the virus to be spread via infectious droplets or through touching contaminated surfaces.” Naturally, a person who is not coughing or sneezing is not as likely to spread the virus as someone who is, as the Times also acknowledged.

Echoing the Diamond Princess study falsely characterized by the Times as having demonstrated asymptomatic transmission, the WHO also stated that, while a few reports had documented asymptomatic infections, “to date, there has been no documented asymptomatic transmission.”[9]

In sum, the Times claimed that numerous studies had shown that a significant proportion of community transmission of SARS-CoV-2 is driven by symptomless spreaders but failed to produce even a single study to support that assertion.

Asymptomatic vs. Presymptomatic: An ‘Unimportant’ ‘Semantic Debate’?

While the Times conveys the message that the distinction between asymptomatic and presymptomatic transmission is “unimportant” and a “semantic debate”, only important for “understanding the true scope of the pandemic”, it is in fact a distinction with practical relevance.

As the WHO points out on a Q&A page of its website about COVID-19, “The distinction is important for public health strategies to control transmission. For example, laboratory data suggests that people might be the most infectious at or around the time they develop symptoms. Therefore, in WHO’s case investigation and contact tracing guidance, it is recommended that people be considered ‘contacts’ if they had contact with an infected person from 2 days before that he/she developed symptoms.”[10]

“Detection of viral RNA does not necessarily mean that a person is infectious and able to transmit the virus to another person.”
Whereas the Times claimed that studies had shown that infected individuals are more contagious before they develop symptoms, it provides no studies to support that claim. The only relevant study cited is the New England Journal of Medicine study, but with the exception of “Patient Z”, all patients tested for SARS-CoV-2 RNA had symptoms, and all samples from nasal or throat swabs were collected only after symptom onset in these patients. The authors stated that higher viral loads “were detected soon after symptom onset”, but they had no data on viral load prior to symptom onset.[11]

As already noted, apart from being unsupported by its own cited source, the Times’ claim that people are most contagious one to three days before developing symptoms is contradicted by information from the WHO, which states that studies show the highest viral load around the day of symptom onset.

More recently, in a scientific brief published on July 9, the WHO similarly emphasized that, “To better understand the role of transmission from infected people without symptoms, it is important to distinguish between transmission from people who are infected who never develop symptoms (asymptomatic transmission) and transmission from people who are infected but have not developed symptoms yet (pre-symptomatic transmission).”

The brief also discusses studies finding viral RNA in people one to three days before they develop symptoms, including the New England Journal of Medicine study. As the WHO points out, evidence indicates that viral RNA can be detected in people one to three days before they develop symptoms, with the highest viral loads “observed around the day of symptom onset, followed by a gradual decline over time.”

However, as the WHO also observes, “Detection of viral RNA does not necessarily mean that a person is infectious and able to transmit the virus to another person.”

The brief states that “The extent of truly asymptomatic infection in the community remains unknown.” The proportion of individuals whose infection is asymptomatic “likely varies with age”, and studies show “that children are less likely to show clinical symptoms compared to adults.”

Furthermore, “SARS-CoV-2 transmission appears to mainly spread via droplets and close contact with infected symptomatic cases.” Data suggest “that transmission occurs during close and prolonged contact.” Studies also suggest “that individuals without symptoms are less likely to transmit the virus than those who develop symptoms.”[12]

According to the Times, the “largely semantic” nature of the distinction between asymptomatic and presymptomatic transmission is illustrated by a report in the New England Journal of Medicine “of an apparently asymptomatic spreader who later acknowledged having felt mild symptoms.”

But the controversy about that report was not at all semantic. On the contrary, the controversy it generated was because its authors falsely claimed that the index patient transmitted the virus while asymptomatic when in fact she had been experiencing symptoms of illness.

Using a name for the virus that has since been changed, that report was titled “Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany”. Its authors claimed that the index patient, a Chinese woman who had traveled to Germany for company business, had transmitted the virus while having had “no signs or symptoms of infection”. It was only “on her flight back to China”, they claimed, that symptom onset occurred.[13]

But that is untrue.[14]

While the authors of that report had evidently not interviewed the Chinese businesswoman, researchers from Germany’s public health agency, the Robert Koch Institute, did so; and they learned that she had felt ill during her stay in Germany. Having arrived on January 19, the next day, she had felt chest and back aches, which prompted her to take the fever-reducing drug paracetamol. She also reported having felt fatigue during her whole stay in Germany, which she had initially attributed to jet lag; but then she became feverish during her flight back to China on January 22.

Their investigation of the resulting transmission chain turned up no evident cases of asymptomatic transmission. They did identify another patient whom they concluded was “likely” to have transmitted prior to developing symptoms and five additional cases for whom this was “possibly” so. But they also acknowledged the possibility of other infectious encounters that individuals simply had not remembered.[15]

Another limitation of their study that they didn’t mention is the possibility of recall bias with respect to the date of symptom onset: infected individuals may have reported symptom onset based on feeling more severe symptoms and failed to recollect earlier and milder symptoms.

In sum, while the Times characterized the controversy surrounding the New England Journal of Medicine report as being a “semantic debate” about whether the Chinese woman was “asymptomatic” or “presymptomatic”, the truth is that she was symptomatic.

And while the investigation of that transmission chain did turn up evidence of presymptomatic transmission, the distinction is an important one.

So, if children are at low risk of developing serious illness and are less likely to transmit the virus to others, then what is the rationale of policymakers for keeping schools closed?
One example of the importance of distinguishing between symptomatic and presymptomatic transmission is its practical relevance for school closures that have been implemented along with other lockdown measures for which consent has been manufactured by news reports like the New York Times’ deceptive articles on SARS-CoV-2 transmission.

The risk to children from SARS-CoV-2 is low. As noted in a study published in JAMA, the journal of the American Medical Association, “children continue to face a far greater risk of critical illness from influenza than from COVID-19.”[16]

Therefore, it makes no sense for policymakers to keep schools closed due to the risk to children.

A more reasonable concern is that children might transmit the virus to older adults with underlying medical conditions associated with severe disease and mortality. But, as the WHO has pointed out, studies also show that children are more likely to be asymptomatic than adults, and asymptomatic individuals are less likely to spread the virus than those with symptoms.

So, if children are at low risk of developing serious illness and are less likely to transmit the virus to others, then what is the rationale of policymakers for keeping schools closed? To what extent are such closures evidence-based and to what extent are they merely indicative of the sense of mass fear and panic that has been generated by articles like Mandavilli’s in the Times?

Clearly, the distinction between asymptomatic and presymptomatic transmission is not an “unimportant” question or a “semantic debate”, as the New York Times would have us believe, but is an important distinction that has real practical relevance.

The Evidence—or Lack Thereof—for Airborne Transmission

Finally, to bolster the claim that community spread of SARS-CoV-2 is largely driven by people without symptoms, the Times’ “Infected but Feeling Fine” article reiterates the claim that the virus is airborne transmissible.

To support that claim, Mandavilli links to her prior article “How Long Will Coronavirus Live on Surfaces or in the Air Around You?”, which, as demonstrated in part one, grossly deceives readers about the science by characterizing the airborne transmissibility of the virus as having been proven when in fact it remained controversial and open to debate, with important limitations in the available evidence.[17]

In her “Infected but Feeling Fine” piece, Mandavilli backtracked from that position slightly by linking to her prior article while describing the studies she discussed therein as merely having provided “hints” that the virus can be transmitted via aerosols.

The CDC researchers stated that airborne transmission “possibly” occurred in this “superspreading event”, but they also noted that there were “multiple opportunities for droplet transmission from close contact or fomite transmission”.
In addition to citing her prior article, Mandavilli cites an event that “points toward” airborne transmission: the dozens of choir members who developed COVID-19 after attending a practice on March 10.

According to her Times article, nobody at that practice had any symptoms. The source cited for this claim is a Los Angeles Times article stating that, in interviews, “eight people who were at the rehearsal said that nobody there was coughing or sneezing or appeared ill.”[18]

However, just because eight of the attending members had not noticed anyone who seemed sick doesn’t mean that there was nobody attending who was experiencing symptoms of illness.

In fact, a subsequent investigation of this event by CDC researchers found that among the 61 attending choir members, “one person was known to be symptomatic”, having developed symptoms three days prior, on March 7. That individual was identified as the “index patient”.

And while airborne transmission of the virus during the practice is certainly a theoretical possibility, transmission could also be otherwise explained. The CDC researchers stated that airborne transmission “possibly” occurred in this “superspreading event”, but they also noted that there were “multiple opportunities for droplet transmission from close contact or fomite transmission”.

Notably, the investigators concluded that, rather than transmission occurring at a distance as could be explained by aerosols but not larger droplets, transmission during the choir “was likely facilitated by close proximity (within 6 feet) during practice and augmented by the act of singing.” They described the event as underscoring “the importance of physical distancing, including maintaining at least 6 feet between persons, avoiding group gatherings and crowded places, and wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain during this pandemic.”[19]

Citing the CDC study among others on superspreader events, the WHO scientific brief notes,

In these events, short-range aerosol transmission, particularly in specific indoor locations, such as crowded and inadequately ventilated spaces over a prolonged period of time with infected persons cannot be ruled out. However, the detailed investigations of these clusters suggest that droplet and fomite transmission could also explain human-to-human transmission within these clusters. Further the close contact environments of these clusters may have facilitated transmission from a small number of cases to many other people (e.g., superspreading event), especially if hand hygiene was not performed and masks were not used when physical distancing was not maintained.[20]

In sum, the Times once again misleads readers by falsely claiming that nobody at the choir practice had any symptoms and by failing to explain that, while airborne transmission is one possible explanation, the superspreader event could also be explained by droplet and fomite transmission.

Finally, the Times cited two studies to support its suggestion that people can transmit SARS-CoV-2 via aerosols simply by breathing or talking.

The first of those was a preprint version of a study that includes Dr. Cowling as a coauthor, which has since completed peer review and was published in Nature Medicine on April 3 with the title “Respiratory virus shedding in exhaled breath and efficacy of face masks”.

As the Times acknowledged, this study did not look at transmission of SARS-CoV-2 but of other respiratory viruses, including influenza and common human coronaviruses that are a common cause of the common cold. As the Times also rightly notes, the study did show that individuals infected with common coronaviruses can generate aerosols containing viral RNA simply by breathing.

However, what the Times once again failed to explain to its readers is that, as discussed in part one, the detection of viral RNA does not necessarily indicate the presence of infectious virus. As the study authors note, they “did not confirm the infectivity of coronavirus” detected in exhaled breath.

Consequently, they did not claim that their findings demonstrated airborne transmissibility but merely that “aerosol transmission is a potential mode of transmission for coronaviruses” (emphasis added).

Another caveat that the Times did not relay to readers was the fact that, despite collecting breath samples for thirty minutes (with some participants coughing during the collection), “the majority of participants with influenza virus and coronavirus infection did not shed detectable virus in respiratory droplets or aerosols”, and for those who did, the viral load in both respiratory droplets and aerosols “tended to be low”.

This implied “that prolonged close contact would be required for transmission to occur, even if transmission was primarily via aerosols”.

Unlike with coronaviruses, that study did find infectious influenza virus in aerosols.[21]

Should You Get a Flu Shot to Protect Yourself During the Coronavirus Pandemic?

That brings us to the second study the Times cites to support its contention that SARS-CoV-2, too, could be spread via aerosols from breathing or talking, which was published in PNAS in January 2018 and is titled “Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community”.

That study, as the title indicates, also found viable influenza virus in the breath of infected individuals. This, of course, does not prove that SARS-CoV-2, too, is airborne transmissible. As the study authors point out, questions also remain about the relative importance of airborne influenza transmission as compared to other modes of transmission.

Interestingly, though, what was arguably the most important finding of that study was “an association between repeated vaccination and increased viral aerosol generation”. In fact, they found that there was over six times as much aerosol shedding among individuals who’d had a flu shot both in that and the prior flu season as compared to individuals who did not receive a flu shot either year.[22]

In fact, they found that there was over six times as much aerosol shedding among individuals who’d had a flu shot both in that and the prior flu season as compared to individuals who did not receive a flu shot either year.
It is not surprising that the Times would choose not to relay that important piece of information to its readers given how it has consistently advocated public vaccine policy, including the CDC’s recommendation that everyone aged six months and up, including pregnant women, receive a flu shot annually. In doing so, the Times has likewise deceived its readers about the science, as I have detailed extensively in another multi-part exposé.[23]

As another example, in a feature published by the Times on April 6 titled “How to Protect Yourself and Prepare for the Coronavirus”, the Times instructed parents to vaccinate their children with the flu shot. “The flu vaccine is a must,” the article stated, “as vaccinating children is good protection for older people.”[24]

The implication is that the influenza vaccine confers herd immunity by preventing transmission. However, a systematic review of the scientific evidence titled “Vaccines for preventing influenza in healthy children” published in Cochrane Database of Systematic Reviews in February 2018, researchers commented that they “could find no convincing evidence that vaccines can reduce mortality, hospital admissions, serious complications, or community transmission of influenza.”[25]

Of course, the finding of the influenza study cited by Mandavilli to support the claim of airborne transmission of SARS-CoV-2 indicates that getting a flu shot might increase the risk of transmission via aerosols.

Furthermore, studies have found the influenza vaccine to be associated with an increased risk of infection with non-influenza respiratory viruses, including common human coronaviruses. In fact, the lead author of one of these studies, titled “Increased Risk of Noninfluenza Respiratory Virus Infections Associated With Receipt of Inactivated Influenza Vaccine”, is none other than Dr. Benjamin Cowling.

Furthermore, studies have found the influenza vaccine to be associated with an increased risk of infection with non-influenza respiratory viruses, including common human coronaviruses.
In a randomized placebo-controlled study published in Clinical Infectious Diseases in June 2012, Cowling and his colleagues found that there was “no statistically significant difference in the risk of confirmed seasonal influenza infection” between children who had received a flu shot and children who hadn’t.

Additionally, they found that vaccinated children had an increased risk of non-influenza infections during the nine months following vaccinations, including from common coronaviruses, although the results were only statistically significant for an increased risk of infection with rhinoviruses and coxsackie/echoviruses.[26]

A second study, titled “Influenza vaccination and respiratory virus interference among Department of Defense personnel during the 2017–2018 influenza season” and published in Vaccine in October 2019, found that getting a flu shot was associated with a statistically significant increased risk of infection with common human coronaviruses.[27]

The findings of these studies raise the question of whether getting repeated annual flu shots might increase the risk of infection with SARS-CoV-2, which is certainly a hypothesis worth investigating; but, of course, you won’t read about such findings in the pages of the New York Times.

Conclusion

For months, the New York Times has systematically deceived the public about what science tells us about SARS-CoV-2 transmission by pushing the narrative that community spread is driven largely by asymptomatic individuals, including through the airborne route. This narrative has served to manufacture consent for extreme lockdown measures that have caused immense harm and violate fundamental human rights.

In part one, we saw how the Times reporter Apoorva Mandavilli deceived about the scientific evidence for airborne transmission in her March 17 article “How Long Will Coronavirus Live on Surfaces or in the Air Around You?”. In this installment, we’ve seen how the same reporter likewise deceived about the evidence for asymptomatic transmission in her March 31 article “Infected but Feeling Fine: The Unwitting Coronavirus Spreaders”.

Similarly, Mandavilli cited the Diamond Princess study as though proof of asymptomatic transmission even though the study authors explicitly stated that there remained no clear evidence of asymptomatic transmission.
The key deception of the latter article is its fallacious equation of the proportion of asymptomatic infection with the proportion of asymptomatic transmission.

To that end, Mandavilli falsely characterized “Patient Z” in the New England Journal of Medicine study as an example of an asymptomatic spreader when in fact the study did not identify that patient as someone who had transmitted the virus.

Similarly, Mandavilli cited the Diamond Princess study as though proof of asymptomatic transmission even though the study authors explicitly stated that there remained no clear evidence of asymptomatic transmission.

While the Times claimed that infected individuals are most contagious in the days before symptom onset, it presented no sources to support that assertion. The only relevant source cited, the New England Journal of Medicine study, found the highest viral loads soon after symptoms developed and had no data on viral loads prior to symptom onset.

That claim is also contradicted by the WHO’s observation that studies rather show that patients have the highest viral loads early in the course of the disease, “around the day of symptom onset”. Furthermore, as the WHO rightly points out, the detection of viral RNA in nose or throat swabs does not necessarily mean that the infected individual is contagious.

The Times also tries to dismiss the distinction between asymptomatic and presymptomatic transmission as “unimportant” and a “semantic debate”, but it has real practical significance both for epidemiologists and policymakers, such as with respect to the question of whether schools should remain closed or reopen.

Mandavilli also reiterates the claim that SARS-CoV-2 is airborne transmissible by citing her prior deceptive article and the “superspreader” event with the choir in Washington state. But she falsely claimed that nobody at the practice on March 10 had symptoms, and as CDC researchers later acknowledged, while perhaps indicative of aerosol spread, that transmission event could also be explained by droplet and fomite transmission.

Furthermore, she cites a Nature Medicine study that observed aerosol shedding of other coronaviruses in the breath of infected individuals but chose not to relay to her readers the fact that the study authors did not confirm the viability of the detected viral RNA.

Also not communicated to Times readers was the fact that most infected individuals did not shed detectable virus in either droplets or aerosols via breath despite thirty minutes of sample collection or that, for those who did have detectable viral RNA in their breath, the viral load “tended to be low”.

The Times similarly cited a PNAS study on influenza transmission as supportive of the airborne transmissibility of SARS-CoV-2, but just because viable influenza virus can be found in the breath of those who have the flu does not mean the same is true for those with COVID-19.

Furthermore, despite over a century of research on the virus, scientists are still uncertain about the significance of aerosols in the community spread of influenza, and even if we assume SARS-CoV-2 is airborne transmissible, it appears from the available evidence that prolonged close contact would still be required for infection, just as with droplet transmission alone.

In keeping with its function of manufacturing consent for public vaccine policy as well as lockdown measures, the Times also declined to relay to its readers the finding of its own cited study that individuals who received a flu shot shed more than six times as much aerosolized virus in their breath than those who did not.

In forthcoming installments of this series, we’ll further examine the propagandistic nature of the New York Times’ reporting and how it has systematically deceived the public for months about the what science tells us about how transmission of SARS-CoV-2 occurs in the community setting.

Summary of Key Points

  • A March 31 article titled “Infected but Feeling Fine: The Unwitting Coronavirus Spreaders” by New York Times reporter Apoorva Mandavilli characterized studies has having as having demonstrated that a fifth or more of community spread of SARS-CoV-2 is driven by infected people who remain asymptomatic.
  • Mandavilli also reiterated the claim she made in a March 17 article that studies had proven the airborne transmissibility of the virus, which, as demonstrated in part one of this series, was untrue.
  • Mandavilli further deceived Times readers in her March 31 piece by fallaciously equating the estimated proportion of people who have asymptomatic infections with the proportion of asymptomatic transmission.
  • The Times characterized a study in the New England Journal of Medicine as having shown that a “Patient Z” had been an asymptomatic spreader. However, the authors of that study in fact did not claim that this patient had transmitted the virus to anyone else but merely hypothesized that asymptomatic transmission might be possible based on the finding of viral RNA in nasal swabs from the patient. The researchers further noted that the finding of viral RNA using RT-PCR assays is not necessarily indicative of the presence of infectious virus, but once again, as in her March 17 article, to sustain the preferred narrative, Mandavilli declined to relay that critical piece of information to her readers.
  • Similarly, Mandavilli characterized a study of cases aboard the cruise ship Diamond Princess as having shown that a fifth or more of transmission is attributable to asymptomatic spread. In fact, the authors of that study only estimated the proportion of symptomatic infection and explicitly stated that there remained “no clear evidence that COVID-19 asymptomatic persons can transmit SARS-CoV-2”.
  • Mandavilli also quoted a researcher leading a team out of Hong Kong that estimated, contrary to information from the WHO, that the proportion of presymptomatic transmission is between 20 percent and 40 percent. However, the team’s study that the Times links to in relation to their research did not provide an estimate of either asymptomatic or presymptomatic transmission, and no other information was provided to be able to determine how the team arrived at their estimate of presymptomatic spread. Consequently, the study presented no data contradicting the WHO’s prior statement that asymptomatic infection “does not appear to be a major driver of transmission” or its statement that the virus “is primarily transmitted from symptomatic people”.
  • Mandavilli claimed that infected people “are most contagious about one to three days before they begin to show symptoms”. However, the only relevant source cited to support that claim, the New England Journal of Medicine study, presented no data on viral load in patients prior to the onset of their symptoms, and, once again, the Times failed to inform readers that the detection of viral RNA is not necessarily indicative of the presence of viable virus that could be transmitted to others.
  • While acknowledging a distinction that epidemiologists recognize between “asymptomatic” and presymptomatic” transmission, Mandavilli nevertheless uses the former synonymously with the latter, characterizing the distinction as practically insignificant and a “semantic debate”.
  • To support that point, Mandavilli cited the controversy that arose over another report published in the New England Journal of Medicine about an index patient the authors described as asymptomatic while also noting that she later developed symptoms. However, that is a false characterization of the nature of the controversy. It was not a semantic debate about asymptomatic versus presymptomatic transmission. Rather, the controversy arose because, as a separate investigation had determined, the report authors’ claim that the index patient had no symptoms at the time she transmitted the virus was false.
  • An example of the practical significance of the distinction is that rationale behind school closures: since children are more likely to be asymptomatic and asymptomatic individuals are less likely to transmit the virus, school closure policies don’t make much sense in light of the harms they are acknowledged to cause.
  • To support the contention that SARS-CoV-2 is airborne transmissible, Mandavilli cited her March 17 article, but this time she included caveats indicating that this remained theoretical, not proven, as she had falsely claimed in her prior report.
  • Additionally, Mandavilli claimed that transmission of the virus at a choir practice in Washington state demonstrated that asymptomatic individuals can spread the virus through the airborne route. However, a CDC investigation of that event reported that the index patient did have symptoms. The CDC researchers also hypothesized that airborne transmission might have occurred while noting that there were also plenty of opportunities for droplet or fomite transmission.
  • To support the argument that SARS-CoV-2 can be spread via aerosols generated by simply breathing, Mandavilli also cited a study in Nature Medicine finding RNA of common human coronaviruses in breath aerosols. While acknowledging that this study did not examine whether SARS-CoV-2 RNA could also be found in breath aerosols, Mandavilli once again declined to inform Times readers that the detection of viral RNA doesn’t prove the presence of infectious virus, and the study authors explicitly noted that they did not demonstrate virus viability. The Times also did not inform readers of the authors’ conclusion that, even if coronaviruses are airborne transmissible, their results indicated that prolonged close contact would still be necessary for transmission to occur.
  • Finally, Mandavilli cited a study in PNAS finding infectious influenza virus in breath aerosols. With the Times having consistently advocated that people comply with the CDC’s recommendation to get an annual flu shot, though, Mandavilli declined to inform readers that study’s finding that vaccinated individuals shed more than six times as much aerosolized virus as infected individuals who did not get a flu shot.
  • Similarly, while quoting a coauthor of one of them, the Times also did not inform readers that other studies had found the influenza vaccine to be associated with an increased risk of infection with non-influenza respiratory viruses including common human coronaviruses.

To return to the start of the article, click here.

[Correction appended August 7, 2020: As originally published, this article referred to the CDC director in a few places as Robert Redford. Whoops! That’s the name of a famous actor. The CDC director’s name is Robert Redfield.]

References

[1] Jeremy R. Hammond, “How the New York Times Lies about SARS-CoV-2 Transmission: Part 1”, JeremyRHammond.com, July 29, 2020, https://www.jeremyrhammond.com/2020/07/29/how-the-new-york-times-lies-about-sars-cov-2-transmission-part-1/.

[2] Apoorva Mandavilli, “Infected but Feeling Fine: The Unwitting Coronavirus Spreaders”, New York Times, March 31, 2020, https://www.nytimes.com/2020/03/31/health/coronavirus-asymptomatic-transmission.html.

[3] Mandavilli, “Infected but Feeling Fine”.

[4] Sam Whitehead and Carrie Feibel, “CDC Director On Models For The Months To Come: ‘This Virus Is Going To Be With Us’”, NPR, https://www.npr.org/sections/health-shots/2020/03/31/824155179/cdc-director-on-models-for-the-months-to-come-this-virus-is-going-to-be-with-us.

[5] Lirong Zou et al., “SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients”, New England Journal of Medicine, March 19, 2020, https://doi.org/10.1056/NEJMc2001737.

[6] Kenji Mizumoto, “Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020”, Eurosurveillance, March 12, 2020, https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180.

[7] Tim K. Tsang et al., “Impact of changing case definitions for COVID-19 on the epidemic curve and transmission parameters in mainland China”, medRxiv, March 27, 2020, https://doi.org/10.1101/2020.03.23.20041319.

[8] World Health Organization, “Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)”, WHO.int, February 28, 2020, https://www.who.int/publications/i/item/report-of-the-who-china-joint-mission-on-coronavirus-disease-2019-(covid-19).

[9] World Health Organization, “Coronavirus disease 2019 (COVID-19): Situation Report – 73”, WHO.int, April 2, 2020, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf.

[10] World Health Organization, “Q&A: How is COVID-19 transmitted?”, WHO.int, July 9, 2020, accessed July 16, 2020, https://www.who.int/news-room/q-a-detail/q-a-how-is-covid-19-transmitted.

[11] Zou et al.

[12] World Health Organization, “Transmission of SARS-CoV-2: implications for infection prevention precautions”, WHO.int, July 9, 2020, accessed July 16, 2020, https://www.who.int/publications/i/item/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations.

[13] Camilla Rothe et al., “Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany”, New England Journal of Medicine, March 5, 2020, https://doi.org/10.1056/NEJMc2001468.

[14] Kai Kupferschmidt, “Study claiming new coronavirus can be transmitted by people without symptoms was flawed”, Science, February 3, 2020, https://www.sciencemag.org/news/2020/02/paper-non-symptomatic-patient-transmitting-coronavirus-wrong.

[15] Merle M Böhmer et al., “Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series”, Lancet Infectious Diseases, May 15, 2020, https://doi.org/10.1016/S1473-3099(20)30314-5.

[16] Lara S. Shekerdemian et al., “Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Unites”, JAMA, May 11, 2020, https://doi.org/10.1001/jamapediatrics.2020.1948.

[17] Apoorva Mandavilli, “How Long Will Coronavirus Live on Surfaces or in the Air Around You?”, New York Times, March 17, 2020, https://www.nytimes.com/2020/03/17/health/coronavirus-surfaces-aerosols.html. Hammond, “How the New York Times Lies about SARS-CoV-2 Transmission: Part 1”.

[18] Richard Read, “A choir decided to go ahead with rehearsal. Now dozens of members have COVID-19 and two are dead”, Los Angeles Times, March 29, 2020, https://www.latimes.com/world-nation/story/2020-03-29/coronavirus-choir-outbreak.

[19] Lea Hamner et al., “High SARS-CoV-2 Attack Rate Following Exposure at a Choir Practice — Skagit County, Washington, March 2020”, May 15, 2020, https://www.cdc.gov/mmwr/volumes/69/wr/mm6919e6.htm.

[20] WHO, “Transmission of SARS-CoV-2”.

[21] The version cited by the New York Times is: Nancy HL Leung et al., “Respiratory Virus Shedding in Exhaled Breath and Efficacy of Face Masks”, Research Square, March 7, 2020, https://doi.org/10.21203/rs.3.rs-16836/v1. The peer-reviewed print version is: Nancy H. L. Leung et al., “Respiratory virus shedding in exhaled breath and efficacy of face masks”, Nature Medicine, April 3, 2020, https://doi.org/10.1038/s41591-020-0843-2.

[22] Jing Yan et al., “Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community”, PNAS, January 18, 2018, https://doi.org/10.1073/pnas.1716561115.

[23] Jeremy R. Hammond, “Should You Get the Flu Shot Every Year? Don’t Ask the New York Times.”, JeremyRHammond.com, February 7, 2018, https://www.jeremyrhammond.com/2018/02/07/should-you-get-the-flu-shot-every-year-dont-ask-the-new-york-times/. Jeremy R. Hammond, “How the CDC Uses Fear and Deception to Sell More Flu Vaccines”, JeremyRHammond.com, April 2, 2018, https://www.jeremyrhammond.com/2018/04/02/how-the-cdc-uses-fear-and-deception-to-sell-more-flu-vaccines/. Jeremy R. Hammond, “How You’re Being Lied to about the Risks of Getting a Flu Vaccine Annually”, JeremyRHammond.com, January 11, 2019, https://www.jeremyrhammond.com/2019/01/11/how-youre-being-lied-to-about-the-risks-of-getting-a-flu-vaccine-annually/. Jeremy R. Hammond, “The CDC’s Criminal Recommendation for a Flu Shot During Pregnancy”, JeremyRHammond.com, May 14, 2019, https://www.jeremyrhammond.com/2019/05/14/the-cdcs-criminal-recommendation-for-a-flu-shot-during-pregnancy/.

[24] Amelia Nierenberg and Tim Herrera, “How to Protect Yourself and Prepare for the Coronavirus”, New York Times, April 6, 2020, https://www.nytimes.com/article/prepare-for-coronavirus.html.

[25] Tom Jefferson et al., “Vaccines for preventing influenza in healthy children”, Cochrane Database of Systematic Reviews, February 1, 2018, https://doi.org/10.1002/14651858.CD004879.pub5.

[26] Benjamin J. Cowling et al., “Increased Risk of Noninfluenza Respiratory Virus Infections Associated With Receipt of Inactivated Influenza Vaccine”, Clinical Infectious Diseases, June 15, 2012, https://doi.org/10.1093/cid/cis307.

[27] Greg G. Wolff, “Influenza vaccination and respiratory virus interference among Department of Defense personnel during the 2017–2018 influenza season”, Vaccine, January 10, 2020, https://doi.org/10.1016/j.vaccine.2019.10.005.

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About Jeremy R. Hammond

About Jeremy R. Hammond

I am an independent journalist, political analyst, publisher and editor of Foreign Policy Journal, book author, and writing coach.

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5 Comments

  1. Jill Herendeen

    Did Mt. Vernon, WA have 5G in March? How about that cruise ship?

    Reply
  2. Mehrtash Olson

    Typo: Robert Redfield, not Redford, is CDC director. Feel free to delete this comment.

    Reply
    • Jeremy R. Hammond

      Whoops! I’ve corrected the error. Thanks for pointing it out.

      Reply
  3. Frank Papp

    Excellent analysis. I always wonder if readers of the NYT actually perform any fact checking on their own, or do they just accept as fact whatever the NYT publishes just because it is NYT.

    Reply
    • Jeremy R. Hammond

      Thanks, Frank. I also wonder whether NYT editors actually perform any fact checking or just accept as fact whatever their reporters write.

      Reply

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