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“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.
She shares her story and discusses her KevinMD article, “How to end the misinformation pandemic.”
Reflect and earn 1.0 AMA PRA Category 1 CME for this episode.
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Ellen Foxman. She is an immunologist, and she wrote the KevinMD article “How to end the misinformation pandemic.” Ellen, welcome to the show.
Ellen F. Foxman: Thank you very much. I’m happy to be here.
Kevin Pho: We’ll get into the article in a little bit, but first off, can you share your story and journey to where you are today?
Ellen F. Foxman: Yes, sure. I’m a physician-scientist at Yale University. I’m an assistant professor in the Department of Lab Med and Immunobiology, and basically my job is mostly doing medical research to understand how our bodies fight respiratory viruses.
The way I got here was through a long path. Starting in high school, I always wanted to be a scientist, and then as I got further along in my education, I really wanted to do research in a medical field to make an impact on human health. That’s how I got to where I am today, doing research on respiratory viruses. Obviously, during the COVID-19 pandemic, my lab has been doing research on COVID-19, and I’ve been asked to explain COVID-19 and what’s going on to a lot of people, from friends and family all the way to the media. So I’ve had a lot of experience interacting with different people about science communication.
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Kevin Pho: Wonderful. So tell me specifically how the COVID pandemic has affected your research.
Ellen F. Foxman: Well, we started working on this research on COVID, like many, many other scientists in related fields. Before this pandemic came, the main question of our lab was: Why is it that so many people who get respiratory viruses have no symptoms, while other people who get the same virus have severe symptoms? Everyone knows now that that’s true of COVID, but that’s actually true of a lot of respiratory viruses.
We focus on the very early stages of the body’s defense against viruses to try to understand that: How is it that you could get the same virus as your household member, and one of you gets really sick and the other one doesn’t? Obviously, that fits very well with a lot of observations about COVID, so we shifted our research to include COVID and try to learn something about that.
Kevin Pho: All right. And we’re going to talk more about the misinformation pandemic, which is certainly very relevant over the last few years. Your article is titled “How to end the misinformation pandemic.” Now, for those who didn’t get a chance to read your article, can you just walk my audience through it and share the story of why you decided to write it?
Ellen F. Foxman: Yeah, sure. At the beginning of the pandemic, like many other scientists like myself, I was really worried. Actually, like everybody, I was very worried about what would happen. I thought, “Wow, if we could only develop a vaccine very quickly, in an unprecedented, fast manner, that might really be able to make a huge difference in this pandemic.” It wasn’t a sure thing. As us physicians and scientists know, it was really a long shot; it had never been done that fast before. But we actually succeeded in doing that as a broader scientific community, and I really thought that our job as a scientific community would be done, and we would be able to be reflective and look back and learn about the science.
But as you can see, this pandemic is still going on, and one of the frustrations has been that despite the great medical advances that happened, the unanticipated challenge was people not wanting to take the public health advice: people being anti-science, suspicious of vaccines, suspicious of public health advice. That really was what motivated the article, to try to understand what is going on and why that is happening. That’s where the article began.
Kevin Pho: So give us some reasons. Why is there a mistrust in scientists and public health authorities?
Ellen F. Foxman: I don’t know the total answer to that, but as a scientist, I know the most important thing to do is to identify the question, right? And I think that’s one of the most important questions that has bubbled up out of this pandemic: Why is there so much mistrust of science, and how can we as physicians change that?
I really feel like we’re in a unique position because, unlike a lot of other jobs, we actually interact with people from all different sectors of society and all different political and socioeconomic backgrounds. And we all have a common goal, which is to improve people’s health, the people coming to us and the people we’re trying to help. That’s the common goal across all political and socioeconomic lines, so I really think we have a chance to tackle this issue.
Kevin Pho: So tell us a communication story about how you’re trying to communicate science to someone who may not trust everything that you say. Do you have a story to tell in terms of how you approach that scenario?
Ellen F. Foxman: Yeah. I mean, one really interesting thing for me has been talking not only to members of the press but also to my own family and friends, people who are very thoughtful, people who know a lot about a lot of things but don’t happen to know about science. It surprises me that things that we take for granted as common knowledge as physicians are not common knowledge to a lot of people.
I think that one reason why people don’t go with the medical or scientific advice is they really don’t understand where it’s coming from. And if you don’t address that gap in where people are coming from, then the person you’re trying to communicate with isn’t going to listen to you. So I think that one of the most surprising things for me, just from family and friends, even, is appreciating the gap between what I just take as common knowledge as a physician and what other people think from their life experience and education.
Kevin Pho: So can you give us an example of that knowledge gap, something that we in the medical community take for granted that the general public may not? What’s an example of that?
Ellen F. Foxman: Oh, a very simple one is how vaccines work, right? I’ve even had a family member say to me at the beginning, “You know, I have a great idea. What if there could just be a weakened form of COVID that could be used to stimulate an immune response? Then we’d all be immune. Then we wouldn’t even need a vaccine.” And actually, that’s a really great description of what a vaccine is.
I think a lot of people had the idea that a vaccine is some magical thing. The idea of getting infected with the virus that triggers subsequent protection is something that really makes sense, but a vaccine is like this magical, mysterious thing. Making that connection for people is very helpful.
Kevin Pho: So you mentioned that in order to communicate with the public, you have to acknowledge where they come from. Give us an example of how you do that as a science communicator.
Ellen F. Foxman: I guess listening is very important. In medicine, and in sort of positions of authority, we’re used to sharing our knowledge, right? But to figure out how to effectively share the knowledge, the first step is listening to what question you’re being asked and trying to understand why you’re being asked that question. So I think that’s something important that I’ve learned.
Kevin Pho: And when you talk to the press and try to communicate what could be complicated ideas, and you want to disseminate that to the general public so they understand it, again, what are some techniques that you use to better communicate the science that you’re studying?
Ellen F. Foxman: Well, actually, when I was in training, I took a class from science communicators at my university, one of whom is Carl Zimmer, who writes for the New York Times. I remember something he said that really stuck with me, which was, “Don’t worry so much about your terminology being technically perfect.” For example, talking about how a virus amplifies or replicates can be confusing, but saying the virus grows at a fast rate makes a lot of sense to people. OK, it grows, there’s more of it, even though a virus doesn’t technically grow; it technically makes more copies of itself. Getting hung up on precise terminology, for a scientist, is not important when you’re communicating with the general public. Rather, you just want to get your message across in a way that someone can understand.
Another good example is talking about a rocket ship flying to the moon. Well, technically, the rocket doesn’t fly the way we think of flying, like a bird flying, but everyone understands what you mean when you say that. So I guess it’s important to think about using terminology that the person you’re talking to is going to understand, rather than the trap we get caught in as scientists, of trying to have it be technically accurate but maybe incomprehensible.
Kevin Pho: So even at this stage of the pandemic, I still hear about patients asking for unproven therapies like hydroxychloroquine, like ivermectin, and a lot of the information that they get is from their tribes on social media. So I was wondering, in your experience with science communication, what is the role of social media in perpetuating misinformation? And can social media be a tool to help set the record straight and help reach out to people who may be exposed to misinformation?
Ellen F. Foxman: Oh, I absolutely believe that social media is here whether we like it or not. Even if you don’t go on Twitter, and even if you don’t go on other platforms, everybody else is, you know? So I think we can’t ignore the speed at which communication is happening, and if we don’t communicate, that information vacuum will be filled by misinformation. I know that you’re a proponent of this. Actually, I really admire a lot of the work that you’ve done in this arena, and I’ve heard you talk about this before, but I think that’s a really important point.
And then to the other point you made, you know, ivermectin and hydroxychloroquine and vaccines, there’s a lot of information about all of those. An effective strategy I’ve found is: Don’t get caught in the weeds of debating the latest research paper and the number of patients and the error bars. Absolutely, that’s the wrong way to go. What really hits home to people is to pan out to the big picture. For example, instead of arguing about vaccines and all the misinformation out there, you can pan out and say, “Well, look, who is it that’s in the emergency room now? Who is it that’s in the hospital now? And what percentage of those people are unvaccinated?”
If you pan out to that big picture and say, “Those people who are getting seriously ill in this wave of the pandemic are those people who are unvaccinated, and that’s how you know the vaccine works,” that’s something I think everyone can understand, rather than getting drawn into the weeds and debates about specific details, which are often used against correct information.
Kevin Pho: We’re talking to Ellen Foxman. She is an immunologist, and she wrote the KevinMD article “How to end the misinformation pandemic.” Do you have any tips and advice that you could share with your fellow clinicians on how we can perhaps stem the tide against misinformation that’s out there?
Ellen F. Foxman: I’ve been wondering about this from a larger perspective, like how our medical communication strategies can change. But sort of from a specific, day-to-day perspective, I think communicating and even overcommunicating is a good idea, in terms of always getting the information out there and being consistent.
I would say for colleagues in the medical fields who are asked to communicate about COVID: Think in advance of the main message and how to get that out. For example, I personally think that vaccines are a very important, powerful tool in ending the pandemic, and whenever I have the chance, I always try to re-emphasize that point. So I think thinking of a few simple points and trying to re-emphasize those points is a very useful technique.
Kevin Pho: And my final question: What are some of your take-home messages that you want to leave with the KevinMD audience?
Ellen F. Foxman: Well, I guess one thing is that it is, in a way, a very wonderful time, in that I don’t want to underestimate the great successes that medicine and science have had during COVID, with all the interventions we’ve come up with. And the majority of the public is much more engaged and interested in understanding science and medicine and health than they have been in a long time. So those are all positive things.
And it’s a disruptive moment where we can potentially disrupt the ways we’ve thought about communicating as physicians and think about new ways to engage with people in an interactive manner, to be more effective. There have been a lot of difficulties, but it’s also a disruptive moment where we can think about how to change things.
Kevin Pho: Ellen, thank you so much for sharing your time and insight, and thanks again for being on the show.
Ellen F. Foxman: OK, thank you very much, and thank you for all the work that you’ve done with science and medical communication.
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