How a Public Health Approach Could Help Curb the Infodemic

Yet, in some countries, there are newspapers, television news channels and radio shows that are deliberately undermining the possibility of a shared reality around COVID-19 public health guidelines. One recent study explored the impact of TV on behaviour around COVID-19 in the US by unpicking the behaviour by viewers of two Fox News shows — Hannity and Tucker Carlson Tonight. While Carlson warned about the threat of COVID-19 starting in early February, Hannity downplayed the virus until mid-March. Places with more Hannity viewers had more COVID-19 cases and deaths. Given that Fox News has downplayed the virus overall, effects are likely even stronger on its viewers compared to those on users of other media outlets.

More traditional media have possibly exerted a greater effect on many in the United States than social media. In their 2018 book Network Propaganda: Manipulation, Disinformation, and Radicalization in American Politics, Yochai Benkler, Robert Faris and Hal Roberts found that Fox News and Donald Trump himself spread far more false beliefs than Russian agents or Facebook clickbaiters from 2015 to 2018. This dynamic has only intensified in 2020. Most recently, President Trump claimed that mail-in votes would be fraudulent, and cited that as a reason why he may not accept the election results next month. Without addressing political polarization, there can be no United States of healthy conversations.

Government Communications

The United States is an extreme example. Just like COVID-19, the infodemic has hit different places with different intensities. While there is still much to learn about why particular approaches worked, rapid and responsive government policy proved essential to address both epidemics.

There are reasons why misinformation has proven less of a problem in places like South Korea, Senegal, or New Zealand that have also largely controlled the pandemic. A few weeks ago, I co-authored a report with Ian Beacock and Eseohe Ojo that examined public health communications in nine democracies around the world. Compared to countries such as the United States and the United Kingdom, other jurisdictions took public health communications and adapted them to the particular contexts of their populations. We used our in-depth study of these nine countries to develop the five RAPID principles of effective democratic health communications (rely on autonomy, not orders; attend to values, emotions and stories; pull in citizens and civil society; institutionalize communications; and describe it democratically).

The acronym was not chosen by chance: a big-data study in the Journal of Medical Internet Research during the first 100 days of COVID-19 in 12 countries concluded that “the public is highly responsive to governmental risk communication during epidemics.” The study showed that when governments informed their populations swiftly with clear public health guidelines, there were fewer online searches for and purchases of questionable treatments.

Without delving into detail here, we found that governments and health officials’ provision of clear, compassionate, consistent and contextual communications dovetailed with better COVID-19 outcomes, as measured by the country’s own understanding of success. The great communicators of science and risk incorporated emotions and societal values, showed compassion and empathy, explained uncertainty, and pulled in citizens and civil society, all of which made messages more credible and wide-reaching. These strategies and others are not rocket science, but when executed well, they were highly effective. In contrast to citizens’ experience with messaging in, for example, the United Kingdom — using the same social media networks — citizens in New Zealand knew that Jacinda Ardern’s Facebook Live appearances were the place to find reliable information.

Governments need to step up to provide transparent, clear and trustworthy information. And politicians need to decide when it is time to engage in politics as usual and when it is not. In Canada, British Columbia’s response was so effective in part because the opposition party (the Liberals) supported public health officials and the BC government’s approach. Other governments have built trust by admitting mistakes: Norwegian Prime Minister Erna Solberg talked this summer about her regret at such a strict lockdown, which she in hindsight saw as too stringent. Others have found balances of privacy that work for them; South Korea is creating technologically savvy systems to show the location of cases, while Taiwan’s Digital Minister Audrey Tang built a real-time map showing the number of masks available to purchase from pharmacies during the early months of the pandemic.

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If, however, politicians and public health officials cannot provide clear, basic information, how can they expect their citizens to keep listening? Early in October, four politicians and public health officials in Ontario took three minutes to answer a question about how many people could gather for the Canadian Thanksgiving long weekend. I watched that clip, and afterwards I had no idea what I would have to do if I were living in Ontario.

Officials also need to make themselves trustworthy by following their own rules. In the United Kingdom, Dominic Cummings, chief adviser to the prime minister, broke lockdown rules and faced no consequences. A study in The Lancet found that this action weakened public faith in the government’s COVID-19 response.

Political, Social and Economic Problems

One Health reminds us that we will not stop the emergence of other novel pathogens if we do not attend to broader problems such as climate change that may seem unrelated to COVID-19 at first glance. But climate change has laid the foundations for novel pathogens to emerge, as animals and people flee previously habitable environments. So, too, if governments do not address the broader social and economic determinants, will online conspiracy theories and rejections of public health guidelines continue and accelerate.

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It’s clear that the more problematic parts of the online world do not have equal purchase for all people and in all countries. There are many extra-platform reasons why conspiracy theories have taken hold. In the polarized United States, the pandemic has accelerated already disturbing trends: In 2017, only eight percent of Democrats and eight percent of Republicans believed in using violence to advance political goals. By December 2019, these percentages had already doubled to 16 and 15 percent, respectively. By September 2020, the numbers believing this had grown to 33 percent of Democrats and 36 percent of Republicans. When violence has become accepted as an appropriate response, an online rumour can spark offline crimes far more swiftly.

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