misinformation

The Myth

The global disruption caused by the coronavirus disease (COVID-19) has resulted in conspiracy theories and misinformation about the scale of the pandemic and the origin, diagnosis, treatment, and prognosis of the disease. Falsified information including international disinformation has been spread through various social media platforms such as Twitter, Instagram, Youtube, and WhatsApp. In some countries such as India, Bangladesh, Ethiopia, journalists have been arrested for allegedly spreading fake news about the pandemic.

Misinformation has been propagated by prominent public figures, celebrities, and politicians, while, several religious groups have claimed that their faith will protect them from the virus. Some claim that the virus is a bio-weapon, accidentally or purposely leaked from laboratories, a population control stratagem, the result of a spy operation, or linked to 5G network.

On Jan 30th, several news channels reported about the increasing spread in the conspiracy theories and false health advice in relation to COVID-19. Notable examples at the time include:

“ Bill Gates is behind the COVID-19 pandemic”

“ COVID-19 can be cured by ingesting Clorox”

“ Coronavirus can be prevented by anti-corona sprays”

“ Gargle with an antiseptic and warm water such as vinegar, salt, or lemon for every day to clear your airways”.

On February 2nd, the World Health Organization (WHO) described a “massive infodemic” of incorrect information about the virus, which makes the work of public health practitioners even more difficult and poses risk to global health.

Misinformation is among the most critical issues confronting our frontline heroes. The issue of fake medicines and treatment has become all of the more pervasive in the age of COVID-19. This urges the governments to recognize this serious issue and calls for the development of a unified national and international response and action plan that include comprehensive legal framework, robust reporting systems, and strong national regulatory mechanisms linked to the global regulatory network as well as greater pharmacovigilance capacity

Busting the Myth

The pandemic has created ideal situations for criminals to exploit people’s fears of contracting the disease by advertising falsified information regarding treatments and vaccines, promoting fake tests, and spreading dangerous rumors about potential cures. In some countries, several people have died from drinking toxic alcohol after coronavirus cure rumor. The World Health Organization (WHO) and the US Food & Drug Administration (FDA), has warned against other mythical cures for COVID-19 and confirmed that, to date, there is no specific treatment recommended to treat the SARS-CoV-2 viral infection.

Several countries around the world are struggling with infectious disease and fragile health systems, and the increased spread of false information on fake cures could put these systems under huge pressures and make the situation for physicians and public health practitioners a lot harder than what it already is.

“ COVID-19 is on the rise in Africa, and we are already facing shortages of critical protective equipment and plethora of misinformation,” says Thembeka Gwagwa, ICN’s second Vice-President, and a nurse from South Africa. : Lack of access to care will mean many people will seek cheap, fake medicines which will have devastating consequences”.

Our role as citizens and healthcare professionals

Researchers at Massachusetts Institute of Technology have shown that videos and posts that trigger an emotional response are shared more and are most likely to influence the public.

As citizens, we have the most important role in curbing misinformation. Social media platforms are a source of immense power that can influence the public and promote awareness about fake cures and false news. Since out-of-context images are a major source of misinformation, citizens can learn to use reverse search image tools such as RevEye and TinEye to locate their origin and verify the truthfulness of these images. Videos can sometimes be misleading and present an even higher level of complexity, however, tools like InVid have begun to make a difference. In general, we should always be vigilant and verify the accuracy of information by looking up a reliable source before we spread the information.

As healthcare professionals, our role is to educate the public on safety concerns related to the use of fake medical products and dispel false rumors about potential cures. Our role is to promote health literacy to support properly informed preventative measures and discourage self-diagnosis and self-prescribing. Although healthcare professionals are under severe pressure during this pandemic, however, the work of educating and informing patients and their families should not be seen as an additional burden but rather as part of safeguarding the health of the community and the public.

Furthermore, there are several campaigns that aim to raise the awareness of fake medicines where victims get to voice their own stories with fake medicines. These campaigns are now a warning of an ever-growing “infodemic” alongside the SARS-CoV-2 pandemic.

Lastly, our fight against COVID-19, future pandemics, and falsified medical information emphasis the urgent need to strengthen the health system, promote health literacy and citizens’ sense of awareness and responsibility, educate healthcare professionals, and better support the ones we have. If we are to be prepared for the next health crisis, and without any doubts, there will be one, we need to better support and invest in our public health and health workforce sector.

References:

https://news.harvard.edu/gazette/story/2020/05/social-media-used-to-spread-create-covid-19-falsehoods/
Rochwerg, Bram MD^1,2; Parke, Rachael PhD^3,4; Murthy, Srinivas MD⁵; Fernando, Shannon M. MD⁶; Leigh, Jeanna Parsons PhD⁷; Marshall, John MD⁸; Adhikari, Neill K. J. MD^8,9; Fiest, Kirsten PhD^10–12; Fowler, Rob MD^8,9; Lamontagne, François MD^13,14; Sevransky, Jonathan E. MD¹⁵Misinformation During the Coronavirus Disease 2019 Outbreak: How Knowledge Emerges From Noise, Critical Care Explorations: April 2020 – Volume 2 – Issue 4 – p e0098 doi: 10.1097/CCE.0000000000000098
Cuan-Baltazar, J. Y., Muñoz-Perez, M. J., Robledo-Vega, C., Pérez-Zepeda, M. F., & Soto-Vega, E. (2020). Misinformation of COVID-19 on the Internet: Infodemiology Study. JMIR public health and surveillance, 6(2), e18444. https://doi.org/10.2196/18444
Li HO, Bailey A, Huynh D, et al. YouTube as a source of information on COVID-19: a pandemic of misinformation?.BMJ Global Health 2020;5:e002604
Citizens’ use of social media in government, perceived transparency, and trust in government. Public Perform Manag Rev.2016; 39: 430-453
Nicole M. Krause, Isabelle Freiling, Becca Beets & Dominique Brossard(2020) Fact-checking as risk communication: the multi-layered risk of misinformation in times of COVID-19, Journal of Risk Research, DOI: 1080/13669877.2020.1756385

“The views, opinions and positions expressed within this blog are those of the author(s) alone and do not represent those of the American Heart Association. The accuracy, completeness and validity of any statements made within this article are not guaranteed. We accept no liability for any errors, omissions or representations. The copyright of this content belongs to the author and any liability with regards to infringement of intellectual property rights remains with them. The Early Career Voice blog is not intended to provide medical advice or treatment. Only your healthcare provider can provide that. The American Heart Association recommends that you consult your healthcare provider regarding your personal health matters. If you think you are having a heart attack, stroke or another emergency, please call 911 immediately.”

Often, and especially during the COVID-19 pandemic, there is a plethora of misinformation that is spread. We have all probably seen at least one scientific publication, news article, social media post, or YouTube video that is spreading information that is not accurate. Every day, I am bombarded by conspiracy theories or unfounded scientific claims while skimming through social media. During a time when information is rapidly disseminated through the internet, it is often difficult to extinguish a lie.

Sometimes, misinformation is inadvertently spread by well-meaning individuals who have not had the time or energy to confirm or critically appraise the information shared. “Liking”, “retweeting”, and/or sharing a post from a colleague/friend/relative is facile. We have all probably “retweeted” or shared certain articles and posts that we did not completely critically assess before sharing. Sometimes dissecting truth from fallacy is difficult, especially when information is disseminated widely. Our current technological advances with the internet and social media magnify opinions, good and bad. Occasionally, one may think, if multiple people I know and/or respect are sharing certain information and the number of posts about the false information outnumber those on the truth, then the misinformation must be true.

Occasionally, misinformation about science or medicine is shared by members of our own scientific and/or medical communities, which can sometimes be more damaging to our profession. For example, more assumed credibility may be given to a scientist or healthcare provider, even if his/her expertise is not in the area that is commented on. Conspiracy theorists may continually reference these “experts” to support their arguments. Sometimes, refuting incorrect information requires massive efforts but may never eliminate the long-lasting negative effects of the misinformation. For example, Andrew Wakefield’s infamous, now retracted scientific article that was published in The Lancet and falsely claimed an association between the measles, mumps, and rubella vaccine with autism is unfortunately still being referenced to support arguments against vaccinations even though multiple studies have overwhelmingly refuted the claims made in the retracted article.

With less malicious intent, some misinformation may be spread by the media or others in reference to research articles. Certain conclusions of research papers are sometimes not justified by the data presented due to inadequate sample size, biases, issues with the experimental design, etc. During a pandemic, since rapid dissemination of scientific and medical information is needed, there is frequently a tradeoff with the scientific rigor and reproducibility of the results. Since access to papers in preprint servers are available to the public, the media and public figures may tout certain research findings as truth when they have not been vetted by the peer-review process. A fellow AHA early career blogger, Dr. Allison Webel (@allisonwebelPhD), recently wrote an outstanding blog discussing the importance of the peer-review process (https://earlycareervoice.professional.heart.org/in-defense-of-peer-review/). Of note, even peer-reviewed articles are not free from research misconduct and incorrect conclusions. There are many articles retracted from high impact journals. Before the development of the internet and social media, critiques and feedback of research findings were typically only discussed at scientific meetings or at other selective venues (e.g., local conferences/presentations, journals typically not viewed by lay people, etc.). Now, these debates occur in the public arena with beneficial and negative aspects and frequently with nonexperts. These public debates may dilute the truth when unfounded comments are perpetuated.

What should we do about the spread of misinformation? Propaganda and false information are always going to be spread but we should try to mitigate their breadth and potential damage. On an individual level, researchers should thoroughly assess their results and determine whether their data are valid and whether the claims they make in publications are justified by the data before presenting the findings to the public. Limit overreaching conclusions. Scrutiny of results by authors and the research community is essential to the scientific process. Developments and advances in science often occur when findings are reproduced either within a specific lab/group or by other labs/groups and this is especially important to realize during a time when a deluge of single-center, small sample size papers are published about the COVID-19 pandemic. Dr. Elizabeth Knight (@TheKnightNurse), another fellow AHA early career blogger, recently calls to attention the scientific lessons learned from the current pandemic (https://earlycareervoice.professional.heart.org/evidence-whats-good-whats-good-enough-whats-dangerous-lessons-for-now-and-later/).

How do we influence other people’s opinions? Internal changes are often easier to make than changing other people’s opinions. However, we are all likely an influential source of information within our own social circles and networks. We may feel more comfortable directly communicating with people we know to correct misinformation. Altering the opinions of people who we do not personally know is more challenging. At minimum, as researchers and healthcare providers, we should not intentionally try to deceive the public. Flagrant dishonesty from researchers and/or healthcare providers may erode the public’s trust in our profession, possibly to a greater extent than a nonexpert’s comments. We all make mistakes and honest misunderstandings and misinterpretations can affect all of us. However, deliberately lying and abusing the influence of one’s position as a scientist or healthcare professional is more offensive. I do not know how best to address colleagues who blatantly mislead the public. If an individual we personally know is deceiving others, we can directly communicate with him/her about the impact of the misinformation. Depending on the extent of the damage created by an individual in our professional community who is propagating false information, should we review his/her ability to maintain as a member of our profession?

What are your thoughts on how we can preserve the public’s trust in science and medicine?

Battling the Pandemic of misinformation

The Importance of Maintaining the Public’s Trust in Science and Medicine