More so than ever, the need for accurate reliable medical information has been highlighted. At a time when a single disease is affecting people of many nations, social, and educational background, the hunger for information of any kind is at its greatest. The current coronavirus disease 2019 (COVID-19) pandemic provides us with the opportunity to assess the public's relationship with information on their health and healthcare modalities and asks whether we can learn valuable lessons that can be carried forward post pandemic.
COVID-19 comes at a time when we are more connected than ever. The advent of cheap flights means we are able to travel more frequently, and this physical mobility is mirrored in our global use of telecommunications, allowing us to disseminate information over long distances across vast numbers of people. Indeed, the rapid dissemination of information over online networks is often referred to as going viral.
All too often in the sphere of health care and healthy living, the information that goes viral is, at best, based on poorly interpreted analysis and, at worst, seeks to play to the worst fears of the audience. Outside of the current pandemic, science has struggled with the dissemination of a number of topics and sources of misinformation. Over the past decade, vaccination numbers have declined in regions across the globe. This decline has led to incidents of recurring measles in the UK, tetanus in the USA, and diphtheria in Europe. Dissemination of ideas that have an inherent attractiveness, but are not based on reliable evidence are particularly prevalent among anti-vaccination proponents. One example is the idea that vaccination causes, as a side-effect, other disorders, such as autism. In the face of vast amounts of data demonstrating otherwise, falsehoods over vaccine safety, autism fears, and the role of vaccination in the eradication of diseases are still spread. We see a similar information overload when individuals seek information on how to live healthy lives. From exercise, to nutrition, to the most appropriate treatment modalities for ailments, our best source of information (the internet) is awash with non-evidence-based content. The insufficiency of access to appropriate health care can be a strong motivator to seek guidance from non-medical professionals.
The current pandemic has shown that, in many cases, the people we would typically look to for leadership and guidance show poor judgement on the information that they utilise and share. The public looks to elected leaders to provide the most reliable and fact-based information, expecting public policy to be led by this process. Several examples show that this is not the case. During the Easter period, the president of Tanzania, John Magagula, was quoted as saying, “This is time to build our faith and continue praying to God and not depending on facemasks. Don't stop going to churches and mosques for prayers. I'm sure this is just a change of wind and it will go like others have gone”. The Brazilian president, Jair Bolsonaro, has consistently downplayed the dangers of the COVID-19, endangering the populace by saying, “Brazilians have to be studied, they don't get anything. You see the guy jumping into the sewer there, going out, diving, right? And nothing happens to him”. Comments describing the pandemic as “a little flu”, combined with public visits to busy markets completely mislead the public at a time when sound, life-saving information was required. The US president, Donald Trump, has repeatedly disseminated apocryphal information publicly and via social media to downplay the seriousness of the virus. During a visit to India he stated, “Now they have it, they have studied it, they know very much, in fact, we're very close to a vaccine”. This statement, based presumably on hope rather than facts, caused confusion for citizens. At a rally in early February, he stated, “And by the way, the virus. They're working hard. Looks like by April, you know in theory when it gets a little warmer it miraculously goes away”. This is in stark contrast to the statement made by the head of the US Centers for Disease Control and Prevention a few days later, “We don't know a lot about this virus. This virus is probably with us beyond this season, beyond this year, and I think eventually the virus will find a foothold and we will get community-based transmission”. Deeming the need for a lockdown no longer necessary, the US president's latest communications have sought to encourage citizens to congregate. Encouraging reopening of individual states, President Trump has praised the protestors calling them, “great people”, and has said, “Their life was taken away from them”. “These people love our country, they want to get back to work.” The UK government, fronted by Prime Minister Boris Johnson, the chief scientific adviser, Patrick Vallance, and chief medical officer, Chris Whitty, brought the term herd immunity to the forefront of public consciousness. During a press conference on March 12, the group downplayed the importance of a prompt national lockdown testing and community surveillance, in favour of hoping that herd immunity would passively deal with the pandemic. This led to a false sense of security in the populace, and was counter to more up-to-date modelling data. The end result being a change of policy 3 days later. Political leaders should be installed by the public based on their ability to lead. Although we might not expect them to become true experts in an emergent crisis, the minimum expectation is deference to the deep evidence-based knowledge of those who do. Failure to do so is another avenue to confusion and misdirection of the public at large.
Misdirection at the top encourages similar bad habits among the populace. Social media and social networks allow anyone the platform to voice their theories–however baseless–to a wide community. 5G theories have captured the imaginations of fake news proponents, spreading the idea that this new technology is the true cause of the viral symptoms and mortality we see around us. The ease with which individuals spread videos playing on fear of tech, mixed with pseudoscience correlations, is a major concern. Indeed, the global dissemination of unproven causes and cure-alls for COVID-19 are rampant. From cow urine prophylactics, repurposed bomb detectors (claimed to detect COVID-19 in 5 min), lemongrass and elderberry tea treatments, and the felling of allergic poplar trees, cures and causes are rapidly spread. This rampant abuse of social media platforms has prompted giants to make relatively strident interventions to their systems. Searching google for “COVID-19” or “coronavirus” initially presents a page with government and prominent news agencies, preventing the appearance of more disreputable information sources. YouTube, a Google subsidiary brand, has sought to suppress the promotion of COVID-19-related conspiracy videos, importantly decreasing advertising revenue. Facebook is using its tracking algorithms to direct individuals who like, share, and comment on conspiracy pages to the WHO MythBusters page. WhatsApp (owned by Facebook) has sought to slow the overall speed of dissemination by reducing the number of people to whom a single message that has already been widely shared can be sent. As a messaging service that boasts end-to-end encryption the company is unable to specifically assess and limit the content of individual shared messages. Purely preventing individuals from receiving information in a health crisis is one aspect of the battle, but ensuring appropriate evidence-based knowledge is spread is the key to winning the war.
In the fears and uncertainty that follow a major health-care crisis, individuals seek information and reassurance in the places most familiar to them. Incidences such as the current pandemic present a rare opportunity for health-care communications to speak to and educate a large audience at its most captive. Alongside providing reassurance, quality health-care communication can empower the public with knowledge on how they can contribute to the safety of their immediate community. We will eventually see the end of this pandemic, but a hopeful enduring result might be a more engaged infectious disease-aware society.
EClinicalMedicine
In the fears and uncertainty that follow a major health-care crisis, individuals seek information and reassurance in the places most familiar to them. Incidences such as the current pandemic present a rare opportunity for health-care communications to speak to and educate a large audience at its most captive; Shutterstock