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As COVID-19 has taken hold as a severe public health emergency, so the spread of misinformation and ‘fake news’ has plagued the scientific community and members of the public. This so called ‘infodemic’ [1, 2] spreading rapidly through social media platforms and other outlets threatens the ability for people to find trustworthy sources and reliable guidance.
Disease outbreaks are often followed by waves of information – some of it accurate, some not and some with negative intentions. This phenomenon accompanied the AIDS epidemic of the 1980’s, where lots of rumours circulated about how the disease could be transmitted (Figure 1). More recently, it was seen during the Ebola epidemic where conspiracy and lack of trust meant that some people were unwilling to seek healthcare from hospitals and clinics [3].
Increasingly, as a new outbreak occurs, social media can allow misinformation to be amplified, spreading confusion further and reaching more people. In several cases with the current pandemic, the spread of misinformation has cost time, public health funds and sadly, even lives. Here are a few examples.
Figure 1. AIDS information poster.
One of the first steps to control an outbreak is to recognise the threat posed by the disease. Some world leaders struggled to acknowledge the mounting concern over coronavirus during the first weeks of the pandemic. In February, President Trump accused the opposition of politicising the deadly coronavirus, claiming that the outbreak was the Democrats’ “new hoax” [4]. In addition, Trump drew on the misleading comparison between the coronavirus and seasonal flu by stating the number of deaths from flu annually in comparison.
In Belarus, the President has continued to minimise the threat of the disease, and not to mandate social distancing, in spite of the large numbers of infections in the country: over 22,000 cases and 131 deaths have been reported. This has drawn concerned comment from the WHO, who have emphasised the need for national control measures to protect citizens’ health [5].
After China, Iran was one of the first countries to experience outbreaks of coronavirus. A lack of clear correct public health information about the virus, fake letters or remarks attributed to senior leaders and a number of conspiracy theories on the origin of the virus substantially contributed the spread of COVID-19.
News of fake cures spread in news and online. One news outlet distributed stories suggesting that gargling with vinegar and rosewater would provide protection against coronavirus. Another tweeted that drinks containing white willow and spices would strengthen the lungs and the immune system against the virus [6]. However the most damaging rumour suggested that drinking methanol would cure COVID-19. Methanol is a powerful form of bootleg alcohol, not safe for human consumption, and sadly there have been more than 700 deaths in Iran resulting from people drinking this toxic chemical [7].
One conspiracy theory that has spread in the UK suggests that the use of 5G technology spreads coronavirus or somehow weakens the immune system and makes someone vulnerable to infection. Whilst there is no evidence for this, the rumour has spread widely on social media (Facebook, Twitter, Youtube and Instagram), and was amplified when some celebrities posted about it online. In the UK, this has led to a number of cases of arson, where people set fire to 5G masts [8].
The release of premature evidence suggesting that chloroquine – an anti-malarial drug – can effectively treat COVID-19 led to a couple in the USA ingesting a non-therapeutic form used as a fish tank additive. This proved fatal for the man, and led to hospitalisation of his wife [9].
Many people purchased the drug after President Trump commented that chloroquine was ‘a game-changer’ in the fight against coronavirus. Whilst several trials are ongoing, there is, as yet, no conclusive evidence of its efficacy, and there is some evidence that high doses can cause harm. After hype around the drug grew, health authorities had to put out counter-campaigns, explaining to people that chloroquine is not an approved drug for coronavirus treatment (Figure 2).
Figure 2. Image from the Nigeria Centre for Disease Control.
1. Be cautious: fake news will often tell you what you want to hear using ‘clickbait’ headlines.
2. Check the date of the story: some untrustworthy news outlets re-publish old stories or even promote outdated news as current. Does the timeline it refers to make sense?
3. Evaluate the source of the news article: are there any other news sources reporting the same thing? How many other sources does this story link to?
4. Turn to the experts: go to reputable sources such as the World Health Organisation, local government or the NHS. Is the information also available here?
Our knowledge of treatment and the epidemiology of COVID-19 is evolving constantly. This means that what qualifies as misinformation may itself be under scrutiny as scientists gain new insights.
As new evidence emerges, the need for evidence-based policy, and education of the public is key to avoid the spread of rumour and conjecture.
Clinical trials are assessing the efficacy and safety of potential tools for treatment of COVID-19. As of 21st April 2020, over 500 clinical trials have been registered globally. These trials include enrolling participants to test a range of therapies including antiretrovirals, hydroxychloroquine, vaccine candidates and transfusion of stem cells. By careful interpretation of trial results, scientists will be able to develop treatments, vaccines, and policies to control the pandemic.
Chloroquine A drug used in the treatment of malaria, and rheumatoid arthritis.
Methanol Also known as wood-alcohol. A form of alcohol which can be toxic if ingested. Consequences of methanol poisoning include vomiting, blindness, and kidney failure.
The WHO Information Network for Epidemics (EPI-WIN) platform works by producing evidence-based answers to the questions and rumours that are spreading on-line. https://www.who.int/teams/risk-communication
Infotagion is a myth-busting website that specifically focusses on coronavirus. It talks about the evidence for claims, and whether they’re safe to believe or not. www.infotagion.com
The UK government has a checklist to avoid misinformation online- check all the points before you share a story: https://sharechecklist.gov.uk/
1. World Health Organisation. WHO Situation Report 13. Accessed May 7 2020. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200202-sitrep-13-ncov-v3.pdf?sfvrsn=195f4010_6
2. Zarocostas J. How to fight an infodemic. The Lancet. 2020 Feb 29;395(10225):676. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30461-X/fulltext
3. Vinck P, Pham PN, Bindu KK, Bedford J, Nilles EJ. Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey. The Lancet Infectious Diseases. 2019 May 1;19(5):529-36. https://www.sciencedirect.com/science/article/pii/S1473309919300635
4. Egan L. Trump calls coronavirus Democrats' ‘new hoax’. NBC News. https://www.nbcnews.com/politics/donald-trump/trump-calls-coronavirus-democrats-new-hoax-n1145721
5. World Health Organisation, WHO expert mission to Belarus recommends physical distancing measures as COVID-19 virus transmits in the community. 21 Apr 2020. https://www.who.int/news-room/feature-stories/detail/who-expert-mission-to-belarus-recommends-physical-distancing-measures-as-covid-19-virus-transmits-in-the-community
6. Sardarizadeh S. Coronavirus: Misinformation and false medical advice spreads in Iran. Feb 29 2020. https://www.bbc.co.uk/news/world-middle-east-51677530
7. Iran: Over 700 dead after drinking alcohol to cure coronavirus. Al Jazeera 27 Apr 2020. https://www.aljazeera.com/news/2020/04/iran-700-dead-drinking-alcohol-cure-coronavirus-200427163529629.html
8. Coronavirus 5G conspiracy theory fuels arson attacks across Britain. Adam Satariano, Davey Alba (the Independent). 11 Apr 2020. https://www.independent.co.uk/news/uk/home-news/coronavirus-5g-conspiracy-theory-telecom-tower-arson-liverpool-birmingham-a9460396.html
9. Vigdor N. Man fatally poisons himself while self-medicating for coronavirus, doctor says. New York Times. March. 2020 Mar;24. https://www.nytimes.com/2020/03/24/us/chloroquine-poisoning-coronavirus.html
10. Limaye RJ, Sauer M, Ali J, Bernstein J, Wahl B, Barnhill A, Labrique A. Building trust while influencing online COVID-19 content in the social media world. The Lancet Digital Health. 2020 Apr 21. https://www.thelancet.com/journals/landig/article/PIIS2589-7500(20)30084-4/fulltext
Figure 1. U.S. Department of Health and Human Services 199- 07/08/2008 UkLW. https://wellcomelibrary.org/item/b16673980
Figure 2. Nigerian Centre for Disease Control. https://twitter.com/ncdcgov/status/1241006420419641345?lang=en
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