In The Age Of Misinformation, Don’t Be A Contributor To The Problem

There are two battles waging from the COVID-19 virus this year: the obvious fight for human life but also the attack on science. During philosophical and political debates, one steadfast weapon has been the scientific method. Opinion doesn’t matter. State the facts. The thing about facts are, though, that one has to be willing to change previously held points of view with new information. One of the most devastating things observed during this pandemic with regard to human behavior is an absent quest for verity. Instead, it’s “click, copy, and paste.” Somewhere in there, the part where the information is evaluated was lost.

In 2017, major companies reacted to chastisement for their participation in the dissemination of “fake news.” Facebook altered their algorithms for news feed ranks, allowed the community to report “false news,” and started working with fact-checking organizations to flag articles. A recent prime example came with Netflix, Amazon, Google, and Facebook addressing the anti-vaxxer movement due to increased measle cases in the United States. This brought up ethical questions: Is this impingement of free speech? Are companies that allow promulgation of inaccurate scientific information culpable for poor public health outcomes? What is the role of government in oversight of social media?

Enter the world of Facebook Groups – a way for people to privately share information and commonly shared interests. During COVID, I have been invited to several medical groups that have brought levity with their coronavirus memes, inspiration with videos of personnel cheering as patients are discharged from ICU units and education from professionals on the front lines with their in-person experiences and postings of the latest trials. Also observed were some highly unsubstantiated claims for treatments based on opinions. Overall, these groups provide a community where providers have felt they could vent and find comfort. Yet, there are other uses for groups. In fact, some claim that these groups are “destroying America.” Users with fake accounts have infiltrated groups and have posted official appearing articles with highly inaccurate information, which then gets shared between close family members and friends. These efforts have even been used by foreign groups to attempt to influence elections. It can be downright hard to tell if something is fact or fiction.

When presented with important information that could change my perception or actions, I have always tried to go straight to the source or to an expert. In the past, I have felt fairly confident with the information I obtained. I will say that COVID has changed this assurance. When our country first faced a shortage of personal protective equipment (PPE), I turned to the CDC for guidance. I was a little shocked when I saw a recommendation to wear a bandana or scarf on their website. So, I did a Pubmed search and read every article I could find related to the optimal PPE at that time. I was discouraged when the only evidence I could find stated a concern that perhaps cloth coverings increased the risk of infection. Since that time, more research has been done on facemasks, and the authors of the mentioned 2015 study have even written a response to COVID stating a cloth mask may afford some protection, although likely less than a surgical mask or respirator. The point is we didn’t really know the answer when the virus first appeared. And then came another hit to science with the retracted articles on hydroxychloroquine as a COVID treatment in the Lancet and the effects of angiotensin-converting–enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) in the New England Journal of Medicine. To say I was disappointed with “evidence-based medicine” would be an understatement.

So, where does this leave medicine? Perhaps with a needed wake-up call. The rigor of the scientific method is still the best ammunition we have against the virus. But perhaps we need edification on how to use it and its limitations. It is our responsibility as physicians to question, create, learn, and not just regurgitate. As the saying regarding statistics goes, “Garbage in, garbage out.” We need to ensure that our medical students, residents, and fellow practicing attendings are adept at assessing data, understanding its interpretations, and questioning not only the implications but also how the data was gathered.

What are our responsibilities in the age of misinformation? Here are my thoughts below:

• Fact check before you post. People in the community look up to physicians. Do your homework first and ensure a reputable source. Here are a few tips.
• Do not engage in arguments. You are a professional. Remain professional.
• Correct inaccuracies. This is different than arguing. We owe it to our profession and our patients to correct falsely disseminated medical news on social media. A simple statement with a correction of the falsity followed by a link to a credible article is a succinct and appropriate way to be part of the solution. Also, report false articles.
• Learn statistics. More exact: Don’t use statistics incorrectly.

Finally, and perhaps most importantly, don’t be afraid to say, “I don’t know.” In the age of misinformation, don’t be a contributor to the problem.

Alicia Billington is a plastic surgeon.

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