- While doctors face the pandemic, they’re also encountering an “infodemic.”
- Misinformation can affect the patient-doctor relationship.
- Misleading or inaccurate information can influence behaviors that increase the risk of infection and worsen the course of an infection.
FDAhave removed the Emergency Use Authorization (EUA) for hydroxychloroquine and chloroquine for the treatment of COVID-19. Based on a review of the latest research, the FDA determined that these drugs are not likely to be an effective treatment for COVID-19 and that the risks of using them for this purpose might outweigh any benefits.
With more than 1.7 million confirmed cases of COVID-19 in the United States and more than 100,000 deaths from the virus, physicians face unprecedented challenges in their efforts to keep Americans safe.
They also encounter what some call an “infodemic,” an outbreak of misinformation that’s making it more difficult to treat patients.
“The most prevailing theme regardless of misinformation on a website or someone sharing a Facebook post is eroding trust. Medical experts and doctors who are trying to help patients, whether in general or in the office, [are seeing] the doctor-patient relationship being broken down over time and especially during this pandemic,” Dr. David Stukus, associate professor of pediatrics in the division of allergy and immunology at Nationwide Children’s Hospital in Columbus, Ohio, told Healthline.
Stukus says people are having a hard time trying to understand what information is reliable and what information they can trust.
“Oftentimes their personal doctor may give them information that contradicts what they heard online or from someone else, and that really puts the patient in a tough position as they try to determine the best path forward for their own health,” he said.
While misinformation online has been around for a while, Stukus says it has increased during the pandemic.
“Previously, there were different focuses of misinformation, such as anti-vaccine groups or conspiracy theorists or unsubstantiated claims about supplements. Now all those different areas are focused on one area, and that’s COVID-19,” he said.
Dr. Joseph M. Pierre, health sciences clinical professor of psychiatry at University of California, Los Angeles, says the damage that misinformation can have depends on how much people’s belief in the misinformation leads to behaviors that increase the risk of infection, worsen the course of the illness, or pose other risks in their own right.
“Most of the evidence falls into the first category: By not observing proper social distancing and not wearing masks, the risk of infection is greater. More cases mean more morbidity and more death and the potential to overwhelm medical resources,” Pierre told Healthline.
Lack of understanding when it comes to proper use of masks and personal protective equipment (PPE) for healthcare workers poses a challenge.
“If some people are not wearing masks, but others are stockpiling N95 masks and other PPE, that puts healthcare workers at risk,” Pierre said.
When people in charge of towns, cities, states, and countries spread misinformation, the potential for belief in misinformation to result in policies can have harmful effects.
Dr. Bruce E. Hirsch, attending physician and assistant professor in the infectious disease division of Northwell Health in Manhasset, New York, says an example of this is when President Trump informed the public he was taking hydroxychloroquine as a preventive measure.
“To approach this enormous challenge, we need some intellectual honesty and clarity, and to disregard expertise and to make decisions and model decisions based on hunches is inviting us to handle challenges on the basis of rumor and uninformed opinion. The magnitude of that error is epic,” Hirsch told Healthline.
Stukus agrees, noting that the harm of this proclamation is documented.
“Early on when the president touted the benefits of hydroxychloroquine and azithromycin, people started to hoard this medicine, and state boards had to shut it down because they were getting so many prescriptions for this unproven therapy that it was not available for those who truly needed it, such as those who have lupus and autoimmune conditions,” Stukus said.
He adds that calls to poison control centers increased after the president suggested using disinfectant to prevent contracting the new coronavirus.
“When people in charge who have large platforms make recommendations regarding treating and/or public health policies, their words absolutely matter because people will follow their advice. It’s imperative that they base their recommendations upon evidence and expertise of doctors and other medical professionals,” Stukus said.
Same goes for doctors spreading information that’s contrary to the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH).
Stukus says as videos and dialogue from naysayer doctors spread on social media, it can be difficult to navigate.
“This is the next wave of misinformation. Certain political ideologies are using doctors to promote their agendas, so now you have someone who is qualified, and maybe they are giving information to counteract the CDC for instance. It’s hard to reconcile that,” he said.
His best suggestion is to research what studies and data they’re sharing. Ensure that the studies are peer reviewed or published, and that the medical experts don’t have a financial motive.
“If the source of information is also selling a product and/or service, they are by definition conflicted, so that should be a giant red flag. There are well-established tricks and marketing ploys that people will use often in the realm of pseudoscience where they will offer these explanations that aren’t backed by evidence,” Stukus said.
“As a general rule, if information is an extreme outlier, it’s probably not accurate, or if it sounds too good to be true, it probably isn’t,” he added.
When recommendations change or evidence flip-flops, skepticism may arise. However, Stukus says change is the beauty of science.
“That shows us that we can evolve, and if the evidence shows that our prior thoughts were incorrect, we need to be able to change our recommendations and advice based upon the best quality of evidence at the time,” he said.
“Science is an iterative process, whereby we arrive at facts and truth through repeated and controlled observations. That means that it’s inherently self-correcting as we revise conclusions based on ongoing research. Scientific facts aren’t immutable dogma chiseled on a tablet. They change based on the best available evidence we have at a given point in time,” he said.
Because research of COVID-19 has only been underway for 6 months, information is evolving rapidly, and new information may contradict old.
“There’s still much we don’t know about exactly how [COVID-19] spreads, what effects it has on the body, or how to best treat it. That means that the best available evidence is preliminary, but that doesn’t mean that we should ignore it or turn to other sources of information or opinion as if they’re just as valid,” Pierre said.
He explains that conspiracy theories based on mistrust lead to vulnerability to misinformation.
If people mistrust science because it sometimes “changes its mind,” Pierre said, “that shouldn’t be used to embrace other opinions based on no evidence at all, which are typically selected based on confirmation bias: what we want to believe rather than what the objective evidence supports.”
If you can’t find information you need or have questions specifically related to you, call your primary care doctor.
“Your personal doctor should always be a resource for individual specific questions because they know best how to apply all the nuances retaining to your health, and how to incorporate all the other general [COVID-19] recommendations,” Stukus said.
Dr. Laura Boyd, primary care physician at Edward-Elmhurst Health Center in Elmhurst, Illinois, says her clinic receives a lot of calls about COVID-19.
“Most doctors’ offices are receiving calls and answering questions, and doing phone or video visits to help clarify and/or order testing over the phone based on patients’ symptoms. It is always best to call your doctor’s office first instead of worrying about symptoms and waiting too long to seek treatment,” she told Healthline.
If your primary care doctor has limited testing, she suggests looking on your state’s public health website for available testing sites.
With a lot of unknowns related to this virus and disease, Boyd says many patients are feeling overwhelmed and anxious for a treatment.
“Unfortunately, there is no specific medication recommended for COVID for outpatient. There are a lot of ongoing studies with various drugs going on within the hospital setting. Patients should always contact their doctors about their specific symptoms as they can treat the symptoms that go along with COVID, but there is no cure,” Boyd said.
While we wait for treatment and a vaccine, Hirsch, who treats patients hospitalized for COVID-19 complications on a daily basis, says everyone can do their part by washing hands, wearing a mask, and staying 6 feet apart.
“As an infectious disease doctor working in the hospital, I see the damage of the pandemic and the worst cases of what’s happening. We are trying to get the best possible outcome and confronting this overwhelming biologic reality of this terrible epidemic the best we can,” Hirsch said.
Everyone at home can help in the fight too, he adds.
“Follow information that is science- and evidence-based, and avoid that which is not,” he said.