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How to end the misinformation pandemic

Ellen F. Foxman, MD, PhD
Physician
November 24, 2021
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Like any stressor, COVID-19 has revealed great strengths in science and medicine. But it exposed weaknesses that could have been tolerated before but now are untenable.

Perhaps the best example of both is COVID vaccines — the success they have had against the COVID pandemic and the fuel they have provided for an equally dangerous pandemic: the misinformation pandemic.

There was no guarantee that a COVID vaccine would even be possible, and now we have safe and effective vaccines for a virus that emerged less than two years ago and has killed over 5 million people. This is an unprecedented triumph. But not the triumph it could be.

Rather than uniting the country against a common enemy, the battle against COVID distressingly remains a politically divisive issue.

At present, 60 percent of the country has been fully vaccinated and 70 percent have had at least one dose of the vaccine.   . But U.S. vaccination rates are low compared to other developed countries. And there is still a lot of anger, suspicion, and refusal of vaccines and other proven public health measures. At the same time, throughout the pandemic, there have also been waves of willingness to accept unproven and dangerous treatments like hydroxychloroquine. There is an important lesson about communication here. Experts who care about public health better pay attention to it.

The president, the CDC, the FDA and most doctors and scientists have said that vaccines will save your life and protect your health. So, why are so many people not on board?

When I think about this question, I remember that when I first started medical school, I read a classic text called Talking with Patients, first published in 1955.

The introduction of this book states, “Of all the technical aids [in medicine] none comes even close in value to the skillful use of spoken words….and while in therapy many mechanical and chemical aids are truly miraculous in their effectiveness, words continue to play a tremendous role.” Biomedical technology has changed a lot since 1955, but the paramount importance of making a true connection has not changed.

Back in 2020, Trump’s promotion of hydroxychloroquine, with no evidence, hit home with a sector of the population because he communicated individual empowerment and optimism when reliable authority figures did not. The situation reminded me of the dietary supplement industry, which convinces so many people to spend money on dietary supplements that tout fictional health benefits.

Unlike FDA-approved drugs, no one checks whether there is any merit to the claims of dietary supplements, or even if the ingredients on the label are actually in the bottle. Moreover, dietary supplements are not regulated and can be dangerous or even deadly. But dietary supplements are marketed in a way that makes people feel like they are in control of their health care, like they are an important party, like they have a say.

There is no question that there have been outstanding medical communicators during this pandemic. However, there is also no denying that too often medical advice is given in a top-down fashion, with doctors or public health officials being the experts and gatekeepers of a mysterious, impenetrable topic, in a way that disempowers and increases anxiety in the very people or communities they are trying to help.

The internet and social media have democratized access to information like never before and have made the top-down style of communication even less effective.

In my view, the misinformation pandemic has arisen in part because the bad guys who spread misinformation for their own gain already get this, and the good guys are still catching up.

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Having the right credentials and information is not enough to build trust and motivate action. These days, the giving and receiving of information is expected to be bidirectional, a partnership between an expert and an interested member of the public. In this environment, a message that empowers and connects with the values of the recipient can be compelling even if completely based on false information, as in Trump’s communications promoting hydroxychloroquine. True and valuable information will not change behavior if it is prescriptive rather than interactive.

To be sure, vaccine hesitancy is a complex topic that goes beyond the issues raised here. However, I believe that most people do fundamentally care about their own health and the health of their families. If we in the health care and public service industries do too, we can find common ground.

During COVID, health issues have become polarizing political issues, but it didn’t have to be this way. Health is a common interest that bridges political divides. Because of this, health professionals are uniquely positioned to help heal some of the extreme political divisions in our country.

The way to do this is by recognizing the power of words. I don’t mean fervently declaring one’s position and arguing why those who disagree are wrong. There has been way too much of this, and health professionals are no exception. Rather what’s needed to deliver the best health outcomes for the most people is listening, engaging and having something to offer that misinformation peddlers don’t — interventions that work.

It’s also time to recognize the importance of innovating how those of us in health professions communicate. COVID has made it clear that getting your message across is an essential part of health care — the best interventions in the world can do nothing if people do not believe in them. Effective communication strategies should be pursued, studied, innovated and taught with the same rigor as the biological aspects of medicine.

Biomedical innovation has been a resounding success in creating vaccines and treatments to fight the COVID pandemic. Now let’s put the same effort into understanding how to tackle the health care concerns of different communities and how to reach across the political divide with empathy. That’s how we end the misinformation pandemic.

Ellen F. Foxman is an immunologist.

Image credit: Shutterstock.com

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How to end the misinformation pandemic
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