Rise of Infodemics

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Fighting back against misinformation and disinformation

By Stuart Foxman

Since early 2020, it has run rampant through society with widespread exposure and dire consequences. COVID-19, of course, but also false information about the virus and its origins, treatments and vaccines.

Timothy Caulfield calls it the “infodemic.” At Choosing Wisely Canada’s virtual national meeting in May, the Canada Research Chair in Health Law and Policy at the University of Alberta discussed the phenomenon.

Choosing Wisely Canada is the national voice for reducing unnecessary tests and treatments in health care. It is part of a global movement that now spans 20 countries.

When decisions aren’t evidence-based, they can waste precious time and resources, and potentially expose patients to harm. That’s true whether patients are doing something unnecessary or avoiding what is necessary. 

Having quality and reputable information is critical, but that’s often undermined. Caulfield, a Professor in the Faculty of Law and the School of Public Health, and Research Director of the Health Law Institute, said misinformation and disinformation can spread and cause damage just like an infectious disease.

He has been studying the topic for years, long before COVID-19. But the situation is worse than ever now. “I’ve never seen anything like this,” Caulfield said in a session called, “Battling the Infodemics.”

Social media has been a platform and accelerator for much of the spread. (Facebook might be the worst cesspool, according to one study Caulfield mentioned.) From the start, the infodemic on social media has touched all aspects of COVID. 

Consider the conspiracy theories that:

  • The whole thing is a hoax;
  • The virus started as a bioweapon, was caused by 5G technology, or is a government attempt at population control;
  • Treatments like hydroxychloroquine or drinking your own urine (Caulfield showed the headline) are miracle cures;
  • Federal quarantine hotel sites are really internment camps; and
  • Vaccines will change your DNA, cause infertility, or enable Bill Gates to implant a microchip in you.

Yet another aspect of the infodemic is false balance. That’s where two opposing views (around wearing masks, for example) are each shown as having similar validity. Of course, they’re not the same, said Caulfield. If one view is based on science and another on a fringe idea, an equal framing has an effect on public discourse. He characterized social media as a “polarization machine.”

How many people have been hit by the infodemic? Caulfield pointed to studies showing that half of Americans and only a sightly smaller percentage of Canadians have at some point believed one of the big COVID-19 conspiracy theories. 

What’s scary is the “normalization” of such misinformation, said Caulfield: “It washes over people.” 

Fear mongering has real-world impacts that include non-adherence to guidelines, discrimination against certain groups, and a measure of vaccine hesitancy — not to mention illness and death. The seeds of doubt, confusion and outright falsehoods create noise, which makes it harder for the actual science and public health messages to break through.

Need to be vigilant

Who spreads misinformation and disinformation? We can all circulate it, but Caulfield noted one study that found in 20 percent of such information, a prominent person — often a celebrity — is the source. Another study from Cornell revealed that of 1.1 million bits of misinformation, 38 percent could be traced back to one person: Donald Trump.

Sometimes, ideological language is used to push misinformation. For instance, anti-vaxxers are increasingly framing their case in the context of rights. The civil liberties argument allows them to sidestep the science, said Caulfield.

Even some medical professionals can feed the infodemic. Caulfield said professional associations and regulators need to be vigilant. He noted how, earlier this year, CPSO issued a caution to one doctor for tweets deemed inappropriate and unprofessional. (Read the expectations CPSO is developing for physicians using social media.) 

With no evidence, this doctor tweeted: COVID-19 is not a serious health issue; there is no medical or scientific reason for prolonged lockdowns; and a vaccine is unnecessary. A panel of CPSO’s Inquiries, Complaints and Reports Committee found this doctor’s statements were a potential risk to public health.

This April, CPSO issued a “Statement on Public Health Misinformation.” It noted that there have been “isolated incidents of physicians using social media to spread blatant misinformation and undermine public health measures meant to protect all of us.”

The statement focused on professional behaviour and was “not intended to stifle a healthy public debate about how to best address aspects of the pandemic…rather, our focus is on addressing those arguments that reject scientific evidence and seek to rouse emotions over reason.”

As the statement reminded:

“Physicians…have a professional responsibility to not communicate anti-vaccine, anti-masking, anti-distancing and anti-lockdown statements and/or promote unsupported, unproven treatments for COVID-19. Physicians must not make comments or provide advice that encourages the public to act contrary to public health orders and recommendations. The information shared must not be misleading or deceptive, and must be supported by available evidence and science.”

Debunking can work

Who believes COVID-19 misinformation and disinformation? Anyone can be susceptible, but more so, studies show, if you have lower levels of education, health literacy and/or trust in health care.

When people have been exposed to or are spreading false information, it can be difficult to change their minds. Hard core believers and conspiracy theorists are less likely to integrate new thinking into their world views. So, bombarding those people with facts isn’t necessarily effective and can cause some to become even more entrenched in their views.

Yet for others, debunking can work, said Caulfield. Doctors, as trusted voices, have a role to play in fighting misinformation and disinformation. Caulfield offered nine ways to get there:

  1. Provide the science.
  2. Use clear and shareable content.
  3. Reference trustworthy and independent sources.
  4. Note the scientific consensus (and acknowledge that science evolves).
  5. Be authentic, empathetic and humble.
  6. Consider a narrative, e.g., be creative including the use of emotion and humour.
  7. Highlight gaps in logic and rhetorical tricks used by those spreading falsehoods.
  8. Make facts, not the misinformation, the hook that people take away.
  9. Remember the general public is the audience, not the hardcore deniers whose attitudes might be inflexible.

As part of the effort, Caulfield pointed to #ScienceUpFirst — a Canadian social media movement developed by a team of independent scientists, health care providers and science communicators. The goal is to stop the spread of misinformation around COVID-19. You can follow this initiative on Twitter, Instagram and Facebook, and share the expert-vetted posts with your own friends and followers. 

Pushing back on misinformation and disinformation is vital. With good science, and clear and sound messaging from health experts, we can make progress against the pandemic and infodemic alike.