Ask almost any physician about the outlandish medical theories they’ve heard, and they’ll probably ask you how much time you’ve got. But COVID-19 has brought a whole new meaning to the term "conspiracy theory."
"It has been an … interesting few months,” said David Stukus, M.D., an associate professor of pediatrics in the allergy and immunology department at Nationwide Children’s Hospital.
Among a few of the problematic theories Stukus has heard: Some (incorrectly) blame 5G wireless technology for the spread of COVID-19. Others posit Bill Gates is somehow responsible for creating the virus in order to promote a vaccine. And other fringe theories have questioned whether governments are releasing the virus for population control.
(Nationwide Children's)
That's always been misinformation, particularly online, among groups with different agendas.
"What COVID-19 has done is it's brought them all together with one target in mind, and it has really ramped up not only the amount of misinformation but really the pervasiveness and unrelenting nature of it," Stukus told Fierce Healthcare. "It's really bad. It's everywhere."
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He's among doctors who say it's time for physicians to push harder against the misinformation, pointing to a recent piece in the journal Nature about the importance of trying to "'flatten the curve' of the infodemic."
"We need to fight back," Stukus said. "We absolutely need to lend our expertise in clear, consistent, basic evidence-based messages."
(Vituity)
But what are the best ways to get the message through?
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Combat pseudoscience with real science: There's always been psuedoscience, snake oils, and medical cures and anecdotes. But with COVID-19, those ideas have ramped up, Stukus said. "This is pseudoscience 101. You cherry-pick some very limited data, say done in a lab or mice, and extrapolate it to the same benefit in humans. Or you have data on one virus and extrapolate that to all viruses. You combine it with a catchy media headline and you have the next big thing," Stukus said. Doctors should be ready to educate patients on the evidence-based science or let them know what science is still unresolved, he said.
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Have the conversation, even when it's not technically your job: "It’s important for all of us to stand up and talk to our patients about the issues when we hear misinformation being spread," said Gregg Miller, M.D., chief medical officer of Vituity, which provides physician staffing in emergency departments around the country. He also still serves as an ED physician and recalled treating a pediatric patient with a laceration whose father said he and his wife chose not to vaccinate the child because of information they'd seen on social media. “Normally in the ER, that’s just something you drop because he’s here for a cut," Miller said. "Let’s just sew him up and move him on. That’s something for him and his wife to figure out. But it was a slow day, and I said: ‘Could we just talk about that?’” Miller said he listened to the man's concerns and talked to him about the dangers of not being vaccinated he'd seen firsthand. “Having that conversation with the dad, even though I wasn’t going to give the vaccines in the ER, at least opened the door and hopefully that kid did go on to get vaccinated," Miller said. "Just like that, we need to be having conversations with our patients when we hear them make false statements about COVID. I think it’s tough for us to do that, but we need to.”
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Embrace the power of the anecdote: Anecdotes resonate well with people far more effectively than data—which often helps misinformation spread so easily. "The reason anecdotes are so effective is that it's a relatable story. There are elements where people can say: 'Oh, that reminds me of my own past experiences.'" Stuckus said. "You have that natural connection to it which is very different than if you have an expert in a white coat telling you things about what the evidence shows." However, the experts in white coats can use that concept to their advantage. "There are ways you can weave in those elements to make it easier to understand. This is where analogy comes in," Stukus said, pointing to Ohio public health expert Amy Acton's comparison of the pandemic to a hurricane. "For instance, when the eye of a hurricane comes, you don't wait until the eye is over your house before you start taking precautions. You board up your windows and leave town before the hurricane even comes in. That's why we need to do social distancing now. For some people, examples like that just help some people understand."
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Clear and concrete messages are best: Clear messaging helped the U.S. quickly understand and embrace the idea of "flattening the curve." It also helped people quickly understand the idea of "social distancing." "The whole 'six-feet' idea is brilliant because you give people a specific number to focus on," Stukus said. "That's very different from saying something like: 'You know, stand shoulder-width apart, or give yourself enough distance.' There's some evidence to support six feet. But really, it's a made-up number. But now it gives everyone—stores and restaurants—a real concrete number to keep in mind."
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Don't let politics cloud science. "It’s crazy how this epidemic has become so political. Wearing a face mask is now a political statement, right?" Miller said. While many of the public health issues align with Democratic policies, that doesn't mean it's a partisan idea, Miller said. He's seen similar concerns about public health messages from organizations like the American College of Emergency Physicians on gun violence because it is such a political issue. But there are solid data to support that guns tend to make people less safe and there are steps to make gun ownership safer—no matter where a person stands on Second Amendment rights. Professional organizations can lead the way in taking a stand based on the evidence. "Really, it’s just science. These are just the facts," he said.