By Dr. Marwa Saleh
May 19, 2020
In late March, several news outlets1,2 ran headlines stating that hundreds of Iranians died and others went blind after drinking adulterated alcohol for protection against COVID-19—some of them were children. On a similar note, the Journal of Histopathology documented the case3 of a 41-year-old American who was hospitalized after drinking disinfectant leading to the severe injury of her small bowels.
Other stories include a father who died of COVID-19 after delaying medical help because he believed that COVID-19 was just like the flu, and the couple5 who ingested chloroquine (not intended for human use) leading to the death of the husband and hospitalization of the wife.
The tragic incidents were the result of misinformation and these consequences aren’t rare; A WHO report6 in February stated that we were facing a “massive infodemic.” The hazards of misinformation are vivid—misinformation costs lives.
We all have a role to play, especially medical professionals
The infodemic is too extensive to take on by a single community sector; doctors, media outlets, health authorities, and individuals each have a role to play.
But doctors and nurses hold a distinctive responsibility. Medical professionals have always been considered sources of health information. In fact, according to the Merriam Webster dictionary7: “The word doctor comes from the Latin word for “teacher.” Moreover, the World Federation for Medical Educators (WFME) task force8 includes “communicate, educate and research” as one of the key roles of doctors.
Do people trust doctors?
According to a 2019 GALLUP poll,9 when asked to rate the honesty and ethical standards of different professions, 85% of Americans participating in the survey rated nurses highest and 65% rated doctors with high honesty at third place. So more than half the participants trust doctors more than any other profession including journalists, police officers, and government personnel.
These sentiments are shared worldwide. According to Wellcome Global Monitor’s survey in 2018,10 “73% of people worldwide would trust a doctor or nurse more than any other source of health advice, including family, friends, religious leaders, or famous people.”
Anyone can be a victim of misinformation
Doctors aren’t immune to misinformation. After all, COVID-19 is a new disease with many unknowns. Even doctors who try to stay up to date with the scientific literature can be misled by bad research. Six research papers have been retracted to date.11 The problem is, doctors are in a position of authority and expertise, and their words are taken to heart.
Many doctors12 have played a role in the fight by disseminating factual health information through their social media accounts, but others13 have contributed to the stream of misleading information.
Advice to avoid misinformation
I interviewed Dr. Abraar Karan MD, MPH, at Brigham & Women’s Hospital/Harvard Medical School, asking for his advice on how to navigate information during the COVID-19 pandemic.
See for yourself
“The key is to go back to the primary source and come to your own conclusion”, Dr. Karan says.
He thinks you should see for yourself what the literature says because if you get your information from a secondary source, it can be reframed or lost in translation.
He adds that one of the benefits of looking at research papers that have not yet been peer-reviewed is the additional scrutiny that is required when people are forced to engage with the data and look at the methodology, results, and limitations of the research.
Listen to what the experts say
Not all doctors are adequately trained or have enough time to critically appraise complex scientific literature.14 Just like you follow consensus guidelines or get a specialist’s consultation in a specialty outside your field of practice, turn to the experts for their input.
“The burden of responsibility falls on the experts; the medical community has many people who can critically appraise literature. Constantly read from many sources about the same article,” Dr. Karan says.
Social media has facilitated the exchange of ideas between experts from all over the world making it easy to read different expert opinions.
Remember that science changes
It is difficult to balance ‘conveying the importance’ and ‘conveying the uncertainty’ of science without leaving people feeling that science itself is useless. It is because of that balance that scientists, doctors, and organizations like the WHO received a lot of backlash when new evidence emerged causing changes in publicized recommendations.
“I don’t think anything is set in stone, everything is subject to human error and reading between the lines,” Dr. Karan notes.
He advises doctors and the public to think of science in terms of probability; if science reaches a conclusion, that means that there’s a high probability that it’s true, not a 100% certainty that it is.
If new evidence emerges, “Science mandates that we correct our course and minimize the damage and maximize the benefit,” added Dr. Karan.
And remember, when it’s your turn to give information, how you say something is just as important as what you say.
“Logic and emotions are competing these days due to the overwhelming amount of information. Speaking to both heart and mind is vital when we communicate about COVID-19,” Dr. Kristine Sørensen, president of the International Health Literacy Association, posted to Twitter recently.14
People turn to doctors as a source of their health information, so misinformation can be hazardous. Doctors can act as advocates for spreading reliable information by getting back to the original source of information, listening to the experts, reading from multiple sources, communicating compassionately and having the humility to admit to error.
Ed Yong, a science journalist in the Atlantic writes, “In a pandemic, the strongest attractor of trust shouldn’t be confidence, but the recognition of one’s limits, the tendency to point at expertise beyond one’s own, and the willingness to work as part of a whole”.15
Learn more about the critical evaluation of scientific research with HMS CME Online:
Research Methods 101 for the Provider: A Guide to Critical Research Consumption
- Malekian, Somayeh. Iran Confronts Deadly Alcohol Crisis in Midst of Dealing with Coronavirus. ABC News Network, March 27, 2020. .
- Fazeli, Yaghoub. Iranian Child in Coma after Being given Alcohol for ‘Coronavirus Protection’. Al Arabiya English, March 22, 2020.
- Binder, Lukas, Christoph Högenauer, and Cord Langner. Gastrointestinal Effects of an Attempt to ‘Disinfect’ from COVID‐19. Wiley Online Library. Histopathology, May 7, 2020.
- Christensen, Karen. 2020. Twitter.Com. https://twitter.com/KarenChristensn/status/1258195775810502656.
- Edwards, Erika and Hillyard, Vaughn. A Man Died After Ingesting A Substance He Thought Would Protect Him From Coronavirus. 2020. NBC News, March 24, 2020. .
- 2020. World Health Organization. Novel Coronavirus (2019-nCoV) Situation Report-13. February 2, 2020
- “The History Of ‘Doctor'”. 2020. Merriam-Webster.Com. https://www.merriam-webster.com/words-at-play/the-history-of-doctor.
- The World Federation For Medical Education. Role Of The Doctor. 2020.
- Reinhart, RJ. “Nurses Continue To Rate Highest In Honesty, Ethics. January 6, 2020. Gallup News.
- Report Summary: Wellcome Global Monitor 2018. 2020. Wellcome.Ac.Uk.
- Retracted Coronavirus (COVID-19) Papers. 2020. Retraction Watch.
- Coronavirus: Doctors Fight Back against Misinformation Online. BBC News. January 31, 2020.
- Williams, Austin. ‘Reckless and Untested Musings’: Health Experts Criticize 2 Doctors Urging Ease on Social Distancing. FOX 5 New York. FOX 5 New York, April 29, 2020.
- Sørensen, Kristine. 2020. Twitter.Com. https://twitter.com/k_srensen/status/1262056258653298689?ref_src=twsrc%5Etfw%7Ctwcamp%5Eembeddedtimeline%7Ctwterm%5Eprofile%3Aihlasummit2020%7Ctwcon%5Etimelinechrome&ref_url=http%3A%2F%2Fwww.ihlasummit2020.org%2F.
- Yong, Ed. Why the Coronavirus Is So Confusing. The Atlantic. May 6, 2020.
Author bio: Dr. Marwa Saleh is a cardiologist and medical writer who loves writing about cardiology, public health, and psychology. She combines her medical experience and writing skills to spread health literacy through writing. She is a proud member of AMWA and AHCJ.
*OPINIONS EXPRESSED BY OUR GUEST AUTHORS ARE VALUABLE TO US AT LEAN FORWARD, BUT DO NOT REPRESENT OFFICIAL POSITIONS OR STATEMENTS FROM HARVARD MEDICAL SCHOOL.