As the fight against COVID-19 continues across the U.S. and globally, leaders and concerned citizens are not only fighting a highly transmissible virus—but also misinformation and what can be, at this point, called disinformation.
On Aug. 4, Healthcare Innovation covered an Infectious Diseases Society of America (IDSA) press briefing, in which Ezekiel J. Emanuel, M.D., Ph.D., vice provost for global initiatives, University of Pennsylvania, touched on the current state of education regarding COVID-19 and vaccinations. Healthcare Innovation wrote that “Emanuel also commented on education regarding the vaccine, saying that ‘There has also been a major educational initiative. Obviously, this battling a major disinformation initiative being circulated out there. I don’t think this is misinformation, I think it is clear it is disinformation, that false facts are being spread about the vaccine.’”
Unfortunately, misinformation about the COVID-19 pandemic—from masks being ineffective to the vaccines containing tracking devices—continues to spread. On Aug. 17, The New England Journal of Medicine (NEJM) published a (perspective) article by David Scales, M.D., Ph.D., Jack Gorman, M.D., and Kathleen H. Jamieson, Ph.D., entitled “The COVID-19 Infodemic—Applying the Epidemiologic Model to Counter Misinformation.”
In their analysis, the authors discuss how they believe the intertwinement of the spread of the virus with misinformation and disinformation could be combatted by taking an epidemiologic modeling approach with three key components: real-time surveillance, accurate diagnosis, and rapid response.
The authors write that “First, existing infodemic-surveillance methods could be strengthened to function similarly to coordinated syndromic-surveillance systems. Infodemic-surveillance systems could activate in response to statistical deviations from baseline rates of misinformation or other empirically defined thresholds or markers, such as when the prevalence or placement of misinformation in a known seeding ground suggests the likelihood of contagious spread.”
The authors go on to explain a misinformation/disinformation “superspreader” event that took place in Oct. 2020. The Federalist, a conversative online magazine, wrongly reported, citing a CDC Report, that masks and face coverings did not help to prevent the spread of COVID-19. The authors say that had infodemic monitoring been in place, perhaps the misinformation wouldn’t have spread to Fox News’ Tucker Carlson or to President Donald Trump’s Oct. 15 televised townhall.
The authors move on to their second point, explaining that clinicians use a classification system for diagnosis and scientists look to answer a set of essential questions when encountering a new infectious disease. The same type of system can be used for misinformation. “For example, our taxonomy of misinformation related to masking, which is categorized under prevention, encompasses five types of misinformation: distortions of scientific findings, assertions that the effectiveness of masks hasn’t been proven, claims that masks are ineffective, suggestions that masks increase health risks, and conspiracy theories about masks,” the authors write.
That said, “Third, in the epidemiologic model, rapid response consists of containment and treatment by medical personnel. So-called infodemiologists—modeled on the CDC’s corps of Epidemic Intelligence Service (EIS) officers—can counteract misinformation in traditional media sources and online using evidence-based methods, including empathetic engagement, motivational interviewing, leveraging trusted sources, and pairing rebuttals with alternative explanations.”
The article then brings up Hank Aaron, the American baseball player, who’s coincidental death could be attributed to receiving the COVID-19 vaccination. They explain an infodemiologist could have exposed this misinformation by telling a story about someone they knew who died just before their scheduled vaccine. The authors also explain the distrust of government and health systems in communities of color and suggested infodemiologists cite reputable news stories such as the New York Times article titled “60 Black Health Experts Urge Black Americans to Get Vaccinated.”
The article continues that two of the authors work at Critica, a non-profit organization chartered in the State of New York that is a “community committed to making rational decisions about health and security. In a culture dominated by polarizing politics and an abundance of unchecked misinformation, Critica exists to revolutionize the role of science in making rational health decisions.” The authors comment that their primary audience aren’t COVID deniers, as individuals with such fixed beliefs are not easily persuaded, but people who are susceptible to misinformation or are vaccine hesitant.
“Information goes both ways: these specialists receive surveillance information and recommendations on response strategies while also reporting unusual or prominent types of misinformation circulating in their communities,” the authors mention.
Further, the authors say that in practice infodemic surveillance works by receiving various data from platform-based monitoring tools (ex. Google’s Coronavirus Search Trends website) and social listening and monitoring systems for social and traditional media. Infodemiologists’ on-the-ground reports augment these data streams and action thresholds would be set.
The authors write that “In the case of the CDC report, for example, surveillance would have spotted the mischaracterization in The Federalist. Since research has shown that content from fringe conservative outlets is picked up and amplified by Fox News personalities, the system would have triggered a response. A preemptive message quoting the study’s authors reiterating their findings and dismissing the misreading could have been distributed to community-based infodemiologists and fact-checkers, thereby permitting displacement and inoculation to occur before Carlson’s or Trump’s amplification (or preventing the amplification altogether).”
The authors conclude that “Our model will be more effective for people intrigued by misinformation but not yet under its thrall than for committed acolytes sequestered in echo chambers. But the model’s strength, like that of epidemiology, is in recognizing that effective prevention and response requires mutually reinforcing interventions at all levels of society, including enhancing social-media algorithmic transparency, bolstering community-level norms, and establishing incentives for healthier media diets.”
