Mankind is, to a large extent, a man-made species. Biological evolution gave our species our intelligence, but we have facilitated our own social evolution. Humanity as we know it today is just as much a product of our architecture, our social structures and our technology as it is the result of adaptations to evolutionary pressures. Social and technological evolution is at the heart of the success of our species, but also presents us with existential challenges. Our status as global citizens, linked to every corner of our planet with ease, and our political and economic structures that rely on our interconnectedness, have left us particularly vulnerable to the challenges presented by emerging infectious diseases.
We have observed how rapidly SARS-CoV-2 has enveloped the globe. From a cluster of initial cases, thought to have first presented in November 20191 in Hubei province, China, to over 300,000 confirmed cases in 169 countries2 (as of 22 March 2020) with the understanding that true numbers are likely to be well into the millions. The rapid spread of the virus has been facilitated by rapid travel across the globe, infections spreading out from the Chinese epicentre like tendrils, slowly encircling the planet. Technological innovations are also fuelling an almost as sinister phenomenon: a global pandemic of misinformation, spreading rapidly through both social media platforms and traditional news outlets, is causing a serious threat to public health.
World Health Organisation (WHO) Director-General Tedros Adhanom Ghebreyesus has addressed this issue directly, saying
“We’re not just fighting an epidemic, we’re fighting an infodemic”3
As governments around the world take increasingly drastic steps to halt the spread of the virus, social media is taking on an increasingly central role in our lives. As the impact of social distancing measures begin to take hold, Facebook, Twitter, and other social media outlets could become the foundation of our lives — a vital connection between families, friends, and colleagues, as well as relief from the crushing relentlessness of negative news. As we become more isolated physically, social media and the web-based sources mote generally will also have to be responsible for our needs as more and more people seek updated, personalised information.
But social media outlets have a poor track record of filtering out misinformation. This is something the WHO is acutely aware of. Aleksandra Kuzmanovic, social media manager with WHO’s department of communications is aware that all communications channels will have to collaborate on the issue, saying: “In my role, I am in touch with Facebook, Twitter, Tencent, Pinterest, TikTok, and also my colleagues in the China office. When we see some questions or rumours spreading, we write it down, we go back to our risk communications colleagues and then they help us find evidence-based answers.”
Evidence is at the heart of the public SARS-CoV-2 communications strategy. Unsubstantiated claims must be buried and, if possible, removed and evidence-based advice from trusted sources must rise to the top. Google has added an information box at the top of every search for “coronavirus”, “COVID-19” or other related terms that directs users to a trusted information source, such as the WHO or another local health institute.
The WHO hopes to roll out the same information boxes across major social media platforms. At this stage of the pandemic, many rumours that began on social media have gained press attention. Across the United States, rumours of impending mass quarantines are rife, leading to out-of-control panic buying and stockpiling. The state of affairs in Massachusetts prompted Governor Charlie Baker to urge his people to seek out the evidence:
“Everybody needs to get their news from legitimate places, not from their friend’s friend’s friend’s friend.”
In March, stories began to spread on social media, though particularly focused on Instagram and WhatsApp, that taking ibuprofen to manage symptoms of SARS-CoV-2 infection enhanced viral replication, made infections worse and generated severe disease in young people, the group known to be least at risk of developing complications. Messages were pinged across the globe, sharing stories of secret medical notes from Austria, Italy and France that painted a picture of pandemonium in ICUs, full of young people in critical condition after taking ibuprofen.
While it is true that medical professionals do not recommend the use of ibuprofen to manage symptoms of SARS-CoV-2 infection, the stories were completely false and incredibly dangerous. Ibuprofen belongs to a class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). As the name suggests, these drugs reduce inflammation. Though inflammation can be at the heart of many conditions, it is also a natural part of the immune response to an infection, so it is possible that eliminating this arm of the immune system will weaken the response to infection overall. However, there have not been enough scientific studies to corroborate this and most doctors are not recommending the use of ibuprofen due to risks of side-effects with long-term use, not because it makes infections worse.
Doctors have urged people that are already taking ibuprofen or other NSAIDs to manage other conditions to continue taking their medication. In the meantime, the NHS have updated their guidance: “there is currently no strong evidence that ibuprofen can make coronavirus (Covid-19) worse… until we have more information, take paracetamol to treat the symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you.”
As the pandemic continues to spread, the infodemic of misinformation will grow with it. It is vital that governments, public health institutions, social media corporations and traditional news outlets work together to debunk and stem the flow of conspiracy theories and incorrect or unvalidated information. Like the measures all of us can take to stop the spread of SARS-CoV-2, we can also take personal responsibility for tackling the infodemic. The information we share with each other must have a trustworthy source, it must be evidence-based and it must not come from groups with an ulterior motive. When it comes to public health, knowledge and information is power, but only when it is true.
