In his speech at the Munich Security Conference on February 15, 2020, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus stated: “we’re not just fighting an epidemic; we’re fighting an infodemic.” Social media platforms are flooded with false information, half-truths, and conspiracy theories, all of which shaped the online environment during the COVID-19 pandemic. This, coupled with post-truth politics, which relies on emotionalism, facilitates a domain where mere assertions are posited as facts. The digital space thus becomes a petri dish of misleading and false information proliferating during a disease outbreak – in other words, an “infodemic”.
As noted by multiple international organizations, including the United Nations’ Cybercrime and Anti-Money Laundering Section, misinformation and disinformation are at the heart of the infodemic, posing a threat to global health security. In Canada, similar sentiments have been expressed by the Chief Public Health Officer regarding Canadian searches for information on COVID-19. In fact, 96% of individuals believe that they came across false or misleading information in the first few months of the pandemic. If large segments of the population have encountered mis- and disinformation, in what way does the online infodemic pose a risk to healthcare structures?
Developing the eHealth Space: Has it Always Been Problematic?
Ensuring access to reliable health information online – what the WHO deems “eHealth” – has been an ongoing challenge for policymakers and healthcare providers. Since the election of Donald Trump in 2016, post-truth rhetoric has solidified in the social lexicon; as a result, many online spaces have been affected – including eHealth. Establishing credible digital resources for individuals seeking treatment or advice for illness and chronic conditions has historically been challenging. However, the unprecedented amount of mis- and disinformation in various online social media spaces has enhanced pre-existing eHealth shortcomings.
Health information, understood here, is any medical information regarding symptoms, treatment of disease or injury, and wellness advice from diet to fitness. Despite attempts by international organizations such as WHO to invest in online “health” website domains, where content would be moderated using a quality control of ethical criteria, the governance of the online health space has remained “hands-off.” One of the salient deterrents to operationalizing a governance structure is the scale required to successfully serve a public health system that engages in preventative care while also providing patient-centric, individualized treatment. Additionally, organizations and governments pursuing health interventions, even for the purpose of disease surveillance, vaccination programs, or epidemiological modelling, could be perceived as intrusive. While there are potential risks of stronger eHealth governance, such as individual privacy infringement, the rise of mis- and disinformation has reanimated the discussion of potential safeguards protecting the masses – especially with the heightened influence of social media platforms during an infodemic.
The Virality of Health Mis and Disinformation
During the COVID-19 pandemic, StatsCan reported that only one fifth of Canadians always checked the accuracy of online information presented, and 53% of Canadians shared COVID-19 information they found online without knowing if it was accurate. These statistics highlight the severity of the infodemic: Everyone is susceptible to and can spread false or misleading information – even without intent. This can be damaging in two distinct ways. Firstly, it generates feelings of mistrust towards official sources of information. Secondly, it has the potential to impact individual healthcare choices.
Misinformation in the digital health space can create the impression that there is no consensus on a topic, leaving individuals to wonder if information sources are credible. Confirmation bias, especially in social media echo chambers, can be found on many platforms, presenting a challenge to debunking efforts directed against mis- and disinformation. Even if corrective health information, backed by scientific research, is supplied to counteract misinformation, it can be so dissonant from a preferred narrative that it is ignored by individuals. There are an infinite number of ways one can interact on various social media platforms with health information; information silos are easily created and maintained. This allows individuals to only interact with their curated feeds which are reinforced by algorithms aimed at keeping individuals on the website or app for as long as possible.
Interaction with mis- and disinformation online poses a major threat to those who base their individual decisions about treatment and care on information found in the digital health space. For example, a survey of 3,000 residents completed in Spring 2020 by the British Columbia Centre for Disease Control (BCCDC) found that more than half of the respondents interacted with and believed in unfounded treatments for COVID-19, such as heat exposure and vitamin C. This is dangerous because it can affect informed medical decision-making at the heart of patient-centred care. Furthermore, false narratives of cure-all COVID-19 drugs like ivermectin proliferated online due to individuals interacting with content produced by popular media personalities such as Joe Rogan. Despite the fact that the U.S. Food and Drug Administration (FDA) advised against ivermectin to treat COVID-19, these false narratives prompted individuals to make decisions that were detrimental to their health.
Past research has largely focused on developing a cross-sectional analysis of social media data and metadata. It is clear that further research needs to be conducted swiftly on forms of social media that do not include a large textual component, such as YouTube and TikTok. As these platforms continue to increase in popularity, we will not curb the spread of the infodemic anytime soon.
Cover Image: Image copyright: “Man holding phone while leaning on a table” (2018). Photo by charlesdeluvio on Unsplash.
Disclaimer: Any views or opinions expressed in articles are solely those of the authors and do not necessarily represent the views of the NATO Association of Canada.