Infodemic: How Has the Epidemic of Misinformation Affected the Response to COVID-19?

This is the twentieth document in a series of discussion notes addressing fundamental questions about COVID-19 and response strategies. These documents are based on the best scientific information available and may be updated as new information comes to light.

Written by Carlos Chaccour (Assistant Research Professor and the Chief Scientific Officer of the BOHEMIA Project at ISGloba) and Rafael Vilasanjuan (of Policy and Global Development at ISGlobal), this document addresses how misinformation has played an important role during the COVID-19 pandemic and proposes better practices for the future.

A general public desperate for reliable data and a scientific publishing industry still characterised by many features of the Gutenberg era have contributed to a parallel pandemic: an infodemic. The term infodemic refers to an overabundance of information—some accurate, some not—on a particular subject.

Most aspects of the COVID-19 debate have been burdened by this infodemic. Examples on the therapeutic front include the rise and fall of hydroxychloroquine and the promotion of diluted bleach as a treatment—both largely fuelled by the personal endorsement of the president of the United States— as well as the inclusion of ivermectin in the national therapeutic guidelines of Peru and Bolivia on the basis of in vitro experiments and fraudulent data.

Other critical areas where false or misrepresented information has played a role during this pandemic include the debate around the protection of children during confinement, the use of face masks and the actual level and duration of immunity to the virus. This epidemic of misinformation has been exacerbated by rushed scientific publication, the prioritisation of partisan activism over evidence, and a general excess of opinions and deliberately misleading information in a context of data scarcity.

The Haste of a Pandemic

1. Pressure on Journals. The scientific community has rushed to conduct life-saving research on the novel coronavirus at an unprecedented speed. The rapid emergence of knowledge on the virus (SARS-CoV-2) and the disease (COVID-19) quickly overwhelmed the capacity of the publishing industry to assess manuscripts and publish papers. One prominent journal, JAMA, saw its submissions increase by nearly 300% (11,000 submissions in six months)
2. Pressure on Scientists. With journals overwhelmed, the scientific community turned to pre-prints—manuscripts posted to online repositories without peer review—with the genuine intention of rapidly sharing useful knowledge. This approach accelerated dissemination but did not ensure quality. Pre-prints require that the academic community expend additional effort to discern between rigorous and less-rigorous experiments and interpretations.
3. Pressure on the Public. The general public is rightfully full of questions and demanding answers from scientists and policymakers. Unfortunately, the feeling of urgency among journalists and their audiences has prompted a rush to share new findings and hypotheses, regardless of the quality of the underlying data. This misinformation, in turn, can rapidly lead to anxiety and confusion among information recipients.

Consequences of the Urge

The rush to produce results has led to some flawed and even fraudulent studies making it into very prestigious journals, with immediate consequences. A large observational study published in The Lancet in May 2020 showed that hydroxychloroquine did not benefit (and even harmed) COVID-19 patients. Within 48 hours, the WHO-sponsored Solidarity trial put their hydroxychloroquine arm on hold. Funders and scientists around the world made decisions based on the report. But the data used in the study was never made public by its owner, a now-defunct company called Surgisphere. A previous report based on the same dataset and published in the New England Journal of Medicine influenced how doctors prescribed cardiovascular drugs to COVID-19 patients. Both papers were later retracted by the authors, not the journals.

This scandal has had profound consequences for the credibility of science, just when we need it the most..

The Surgisphere database also contributed greatly to the use of an antiparasitic drug for the treatment and prevention of COVID-19 in the Americas. Thousands of people were injected with a veterinary formulation of the drug, speculation drove prices up and medicines were counterfeited—all as a result of the ivermectin infodemic in Latin America.

The Role of Social Networks and the Media

Social media acts as a double-edged sword in this pandemic and other crises. On the one hand, it has been extremely useful in promoting debate within the scientific community, sharing criticisms of flawed data or papers, and disseminating useful results quickly. On the other hand, it has also helped to disseminate conclusions from flawed studies and deliberately spread misinformation.

• Unlike traditional media outlets, social media companies have no editorial authority over the messages expressed on their platforms, nor do they have any accountability. They only have the capacity to filter—a very modest power compared with the impact they can have when circulating misleading news that lack evidence or are simply fake. Through the use of algorithms that spread information faster and more easily than the virus, social networks have become one of the core sources of infodemics.
• In times of uncertainty, misleading posts are far more popular than those which provide accurate public health information. Social networks have revolutionised the way people communicate. They have made it much easier to form “opinion tribes”—tight groups of people who share ideas, values and selective information.
• At the same time, the discourse in these tribes can also be more radicalised. Their members, who share similar concerns and values and are reassured by a sense of group belonging, may become willing to embrace morally unacceptable proposals. The main problem is that community perspective is lost and the group’s interest is perceived as the only legitimate one.

The media have played an essential role in spreading information and informing the public about preventive measures. At the same time, however, they have been a key player in the infodemic.

• The boundaries between the different sections of the media became more blurred and many journalists, regardless of their background or previous experience, turned their attention to reporting on the pandemic. At critical moments during the first wave of illness, even the sports media reported on COVID-19.
• At the same time, the pressing need for answers and the lack of scientific evidence led to the lionising of experts, with the media whipping itself into a frenzy in search of authoritative voices. It proved to be a challenge.
• The dynamics of the media and the economics of the media business have led to the proliferation of debate programmes, which are cheaper to produce than investigative journalism, generating a confusing barrage of opinions that sometimes blurs the line between political opinion and scientific evidence.
• This unprecedented media coverage took place in real time and at breakneck speed in a context where rigour is valued—although not as much as immediacy—and the time and resources that would be necessary to prepare in-depth analyses or corroborate opinions and facts are typically unavailable.

Conclusions and Recommendations

The COVID-19 infodemic has damaged public trust in science, but it is also an opportunity to review the methods used to communicate science in order to increase transparency and perhaps transform the business model from one that enormously benefits publishers to one that benefits science itself.

Action is needed at four different levels:

1. The scientific community must review the way it engages with the general public. Now more than ever, there is a clear need for transparency and the use of language that is accessible to everyone. The message that rigour is fundamental to research is key, even in times of urgency.
2. Journals now have an opportunity to revisit their business models and reflect on how they shape academic work and research in general. It is time to abandon the vices acquired during times when printed communications were the norm.
3. Social networks need to detox their algorithms to downgrade pages, groups and domains belonging to misinformation accelerators and keep harmful content out of their traffic.
4. We all must help to produce and disseminate quality information, while at the same time avoiding rumours and scandals that will only fuel the parallel infodemic.