Medical misinformation threatens to derail COVID health response

Debates over misinformation, censorship and free speech have dominated the recent news cycle, with Australia’s acting Prime Minister Michael McCormack questioning the decision of social media platforms to ban outgoing US President Donald Trump from posting content.
 
The perma-ban stemmed from President Trump’s comments before, during and after the assault on the Capitol by his supporters, in which he falsely maintained the election had been stolen from him, and was accused of inciting violence.

But prior to last week, he had also had coronavirus-related posts deleted for suggesting it is ‘less lethal than the flu’, and been identified as the ‘single largest driver’ of the COVID misinformation ‘infodemic’.
 
Despite this, Acting Prime Minister McCormack has defended President Trump’s right to post on the grounds of ‘free speech’, and also applied the same argument to support Coalition colleague Craig Kelly – a former furniture salesman – who has been singled out for repeatedly spreading COVID misinformation.
 
La Trobe University’s Dr Mathew Marques, who uses social psychology to understand the formation of attitudes towards socially contentious scientific research, told newsGP misinformation can undermine trust in health-related decisions and erode behaviours required to keep the community safe during the pandemic.
 
‘People should look to trusted sources such as public health experts, and not celebrities or other merchants of doubt seeking to profit from undermining scientific advice by spruiking non-evidentiary based alternatives,’ he said.
 
‘Research suggests that increased susceptibility to misinformation negatively affects people’s self-reported compliance with public health guidance about COVID-19, as well as people’s willingness to get vaccinated against the virus and to recommend the vaccine to vulnerable friends and family.’
 
The coronavirus-related comments and posts made by Mr Kelly and other public figures – such as Pete Evans, Miranda Kerr and Isobel Lucas – have resulted in calls from the Australian Medical Association (AMA) for the Federal Government to invest in ‘long-term, robust online advertising’ to counter the claims, while the RACGP has also waged a long-term war against medical misinformation.
 
It has also led to former Prime Minister Malcolm Turnbull and current Opposition political figures, including Federal Labor Health spokesperson Chris Bowen, to publicly rebuke Mr Kelly and effectively call on the Government to stop him from posting unproven information on the pandemic.
 
However, Associate Professor Adam Dunn, Head of Biomedical Informatics and Digital Health at the University of Sydney, told newsGP ‘there isn’t a simple answer to censorship’.
 
‘Censoring or de-platforming people who spread misleading content may in some situations create a Streisand effect, and for other situations it might effectively limit its spread – the challenge is that we don’t yet know which situation is which,’ he said.
 
‘In the worst-case scenario, censorship and de-platforming might drive disenfranchised communities to the darker corners of the web where they become isolated, the content they are exposed to becomes increasingly unbalanced, and that can lead to extreme behaviour.
 
‘If authorities want to use censorship and de-platforming as a tool for reducing the spread of misinformation, then they need to quickly fill any information void with consistent, simple communications that reach people in the spaces where they spend their time.’
 
According to Associate Professor Dunn, it is not known if rogue politicians and celebrities have any ‘real impact’ on behaviour as it is hard to measure and most research focuses on what certain people say, rather than what information is seen and how it might influence decision making.
 
‘When politicians and celebrities say something misleading, it is an opportunity to have a positive influence,’ he said.
 
‘Calling out celebrities and politicians without correcting them risks unintentionally amplifying the misleading content in a broader audience, [and] censoring them risks driving their audiences away and out of reach.
 
‘But refuting misleading content publicly can reduce misperceptions in their audiences.’
 
Research suggests misinformation comprises only a small amount of what most people typically see online; one recent study found that for all but about 6% of Twitter users, anti-vaccine content makes up a ‘negligible’ proportion of the vaccine content they see and engage with.
 
Associate Professor Dunn says he is ‘often disappointed’ when people promoting misinformation are amplified as a result of being called out.
 
‘There are better ways to refute and correct misinformation, including new evidence from realistic psychology experiments that show that correcting COVID-19 myths on social media can reduce misperceptions in lasting ways,’ he said.
 
‘In most cases, the aim is to reduce misperceptions of the silent observers of the discussion rather than the people promoting misinformation.’
 
RACGP President Dr Karen Price has already flagged that GPs will be called on to help bust myths and promote evidence-based information, particularly as Australia embarks on the largest vaccine rollout in recent history.
 
‘There are many challenges ahead, including the need to build community confidence in the new vaccines through evidence-based information campaigns that address the community’s specific concerns and deal with misinformation and myths,’ she said.
 
‘These challenges also underpin why general practice will be so crucial in the rollout. GPs are perfectly placed to increase vaccine confidence and uptake. We are connected to our communities, we know our patients and they trust us.
 
‘This is especially true for GPs who engage with culturally and linguistically diverse communities and Aboriginal and Torres Strait Islander peoples. The GPs who live and work in these communities will know how to talk to their patients in a culturally appropriate way, and discuss any concerns patients may have.’
 
Dr Marques also believes GPs will be relied on heavily, both now and into the future, to combat misinformation surrounding the pandemic.
 
‘Robust findings suggest that higher trust in scientists are associated with lower susceptibility to coronavirus-related misinformation,’ he said.
 
‘Non-pharmaceutical interventions are still key, such as communicating trustworthy information about the vaccines via credible sources. GPs and other health professionals will play a key role.’
 
Associate Professor Dunn says existing guidelines published before the pandemic about communicating to vaccine-hesitant patients will be just as applicable for the new coronavirus vaccines.
 
‘In general, they suggest first understanding where the patient is on the spectrum from accepting to refusing,’ he said.
 
‘If they are hesitant about the vaccine, then good approaches include building rapport, finding shared values, and avoiding adversarial debates.’
 
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