No One Is Safe Until We All Are Safe

[MUSIC PLAYING] Welcome, everyone. You're watching Coronavirus in Context. I'm Dr. John Whyte, chief medical officer at WebMD. We talk about COVID-19 being a pandemic, literally affecting every country on this planet. And we're seeing differences in terms of how different areas of the world are addressing it, different cultural issues in terms of communications around vaccine confidence.

So to help provide some insights, I've asked Melissa Fleming to join me today. She's the under-secretary-general for global communications at the United Nations. Melissa, thanks for coming on today.

It's great to be with you, John. Thanks for the invitation.

You know, we've spent a lot of time on this show talking about different communication issues around the vaccine, around COVID, the misinformation that exists in the United States. But this really is a global problem. And I wanted to hear your thoughts about what are we seeing around the world in terms of who's communicating information in a good way? Where are we seeing some of these challenges? What can we learn looking at the global efforts?

Well, John, it has been really a kind of unpredictable experience going forward. I have to say one thing. Where we have seen strong responsible leadership, political leadership based on science, we've seen less kind of believing in miracle cures and thinking that the coronavirus is a hoax. We're seeing more adherence to mask wearing and social distancing. So the political leadership is really key.

But where that is absent, what we're finding is just fertile ground for misinformation to flourish. And that misinformation does not have to originate in that country and in that language. I mean, what we have is the first global pandemic in the social media age. And that means that a piece of misinformation produced in the US travels around the world and can end up in a poorer country, in a developing country, translated and adapted to local needs and cause a lot of damage. So it's really a challenge and quite a race to compete with some of this very kind of compelling, emotive misinformation that is endangering people's lives.

We've become a society where in many ways, there's an attack on science. We used to say maybe I don't understand science. But now people are saying "I don't believe in science" or "oh, Melissa, well, that's your opinion, but this is mine," and even when the facts don't support what they're saying. How did we get to this point? It's really a global problem, isn't it?

It is. It's funny, though, when you look at the polls, you still see that the doctors and the scientists are the most trusted kind of public figures or leaders in society. So it's not all lost. That said, science has really taken a huge beating. And that is because there's so much lack of trust, also due to the kind of media environment that populations are exposed to these days.

It's a media environment that is-- what I say is polluted. It has good information. It has people who are genuinely trying to guide the public with science-based content. But it's polluted with bad information, some of it deliberate, some of it just based on rumor.

And it's very difficult for the public to figure out where is the truth? And therefore, they begin to mistrust the information that's kind of appearing in their feeds and starting to trust the people they know. And people they know might not be scientific experts.

So what we need to do and what we're trying to do at the UN is to really bring back science as something to pay attention to. We are taking the kind of PDF document that is what very often, I have to confess, UN agencies or public health institutions are putting out there for the public to try to figure out and optimizing the key content there for social media. So it can compete with some of this misinformation. And it can build trust and pull people back to the trusted organizations who are going to guide them in their best interests and for their own health.

I want to follow up on some more specifics. And I like this idea, this metaphor that there is pollution out there, this misinformation. And you're working very hard to clean up this pollution. Tell us some of the specific projects and products that the United Nations is working on.

Yeah, well, when the pandemic hit the world, WHO coined the phrase "infodemic" that was spreading alongside the pandemic. And infodemic is this mixture of good information with bad information creating confusion, and just everything that we don't need for a pandemic. So what we really realized is that we were not just in a public health crisis. We were in a communications crisis as well.

And so we decided to start an initiative. We partnered with a social mobilization organization called Purpose, and to start an initiative called Verified. And that was-- the whole goal was to kind of flood the internet with socially-- social-optimized content based on science that is consumable, that's interesting to read, that travels well on social media, and it has a real distribution plan, and at the same time to fight infor-- fight misinformation.

So Verified has been our initiative since the start of the pandemic. We've adapted it. We've moved it forward. We have different kind of mechanisms, depending on the issue.

It's incredible that we still have to put out public health guidance that's very basic-- wear a mask, socially distance. But it's incredible that it's still necessary. Now we have the vaccine that's on everybody's mind. And this is first and foremost in our communications strategy right now, how to promote vaccine equity and at the same time vaccine trust, where we see now the kind of shift in misinformation to not just say this is a hoax, but to say that the vaccine is dangerous or don't take it. And so we really have a big challenge ahead, not just here in the United States, but in countries all over the world.

Tell viewers where they can learn more about Verified, Twitter and other platforms. And we'll post it here as well.

Oh, that's great. Yes, thanks, John. We actually have thought that it would be really important to be able to involve people in our initiative, because we also know that we, as the UN, from New York headquarters, we can broadcast this out. But it's not necessarily going to reach everybody. So we've been deploying our offices around the world in every country to adapt our content in the different languages and to push it out.

But we've also been asking just members of the public to sign up as information volunteers, to be our kind of digital first responders, really to learn about misinformation, but also to share our content in their own groups and their own communities. And you can find out more about it and sign up on shareverified.com. We'd love to have you.

We really encourage everyone to take a minute and do that either during this broadcast or immediately after. You also had an effort, didn't you, where you encouraged people to pause, to think twice before you might post something on social. It's very easy to just all of a sudden have some emotion or some thought and you want to put it down on social. And sometimes that can cause some harm.

Talk to me about this idea that when we're talking about COVID, maybe we should think twice before posting.

Yeah, absolutely. John. I mean, what we were seeing when we were studying the misinformation phenomenon and how it was traveling, I mean, there are certain factors that needed changing, including the platforms. So they have taken quite a number of measures to slow the spread of misinformation and to halt it in some cases, which is commendable. Much more needs to be done.

There's also the kind of individual action and responsibility. We don't want to put everything on the individuals because it really isn't their fault. But on the other hand, we need everybody to take part right now, because it really is damaging lives and risking lives.

So we studied behavioral science on the internet. And we found that this kind of misinformation, it's produced in a way very often to make you feel emotive, a certain oh my god, miracle cure. Maybe I'm going to send this and maybe aunt so-and-so won't have to die from COVID if I send-- or there is-- this is all-- all of this lockdown has been for nothing, this whole thing is a hoax.

Basically, if your heart starts palpitating when you're reading something, maybe a good chance is it might not be true. So we're trying to educate people, even just to take a few seconds' pause. And so our slogan that we hope is going to become kind of a behavioral norm, like don't drink and drive, is to take care before you share. And when you--

Take care before you share.

Yep.

I like that.

That's it. That's it. If you even just say that and then you look at it, look at the source, look at that photograph. Is it really a current photograph? Or maybe it's from somewhere else.

Very often, though, the source is a good place to look. Does it come from a reputable media organization or person? So we're trying to give people also the tools to detect-- to be their own detectives on whether this information--

We do need to be our own detectives. And we need to, as you said, look at the sources, see if it's corroborated somewhere else. That gut reaction, does this make sense-- isn't the challenge everyone's an armchair epidemiologist nowadays? Everybody's an expert because they have a Twitter handle or a blog.

But that's actually not the case. And sometimes folks don't realize that that doesn't make you an expert. And there is expertise in the area of science and public health issues.

Which is why we're really great that there are doctors like you who know how to communicate, because I think this is one of the issues. We're getting people who are not experts, who are not scientists, but are kind of savvy communicators. And then we have the doctors and the scientists who are busy doing-- saving lives, but haven't really learned the skills of communications, which is so critical.

I was going to say that. That has been a challenge, and we should acknowledge that. Public health departments are often understaffed, under-resourced. Government agencies, I worked at one, as you know.

We parse every word very carefully. 20, 30 people touch a document-- it's probably the same where you are-- before sometimes something goes out. And it makes it very hard for people to relate to and understand. And we have a language of parlance in medicine, in health that doesn't necessarily make sense to other people.

Have you ever seen anything in your career that's similar? In some ways we saw all these misperceptions and misconceptions about HIV. But we didn't have social that just amplifies everything. Does anything even come close in your career?

I think in the scale of misinformation, conspiracies, rumors, no. In the public health sphere, I think this is unprecedented and will be studied for a long time. The issue is also because it affects everyone in the world. So there's such a high level of interest. And that means that there's a high level of opportunity for exploitation of people's fears, of people's desires.

I mean, we're seeing people trying to profit-- profit from these fears. And COVID, there are already people peddling vaccines online for profit. So it is-- it is a really, really unprecedented situation. And we've seen misinformation and disinformation for a long time in the-- I worked on climate for a-- we are working on climate, climate denial. In the area of--

Somewhat similar. That's somewhat similar, but not to the scale. And in terms of vaccine confidence, something that we've been talking about and trying to work together on, it's a global issue. People forget that.

We really need to have 70% to 80% herd immunity around the world. Otherwise, there will be significant challenges to truly crush the pandemic. How confident are you from where you sit that we'll be able to reach this goal of herd immunity globally?

Well, first of all, I'm so glad you said that, John, so people understand, because every time I listen to the news here in the US or when I'm in Europe, it's all about vaccinating our nationals. I think we really need to get into the public consciousness that we are never going to be safe. One country will never be safe until all countries are safe, all countries, all communities.

And this is what the UN with WHO, with UNICEF, with the vaccine alliance, CEPI, we are-- we have this mechanism called COVAX, which is the mechanism there to ensure that the poor and the middle-income countries, the most vulnerable, the people in conflict areas can get the vaccine. The issue is it needs to be financed. And the manufacturers need to supply the doses, et cetera. So there are issues involved.

Richer countries, right now what we're seeing if you look in the map is that the wealthy world is well underway in starting to vaccinate its populations. And the other part of the map, particularly in the Global South, there's nothing. And so we're trying to bridge that disparity through advocacy through this mechanism. And it's just-- and just to say, it is in all of our-- even if you don't really care, it's in your enlightened self-interest to make sure that everyone around the world receives this vaccine. 70%, as you said, we need to have 70% of--

At least.

--in the world at least vaccinated if we're ever going to overcome this crisis. It has also an economic dimension if we ever want to recover. So we do have the mechanism. We can do it. It's possible. It just-- it requires funding. And it requires just a little bit thinking beyond your own border and of the other parts of the world and people of the world.

All right, well, then I'm going to ask you to take out your crystal ball and tell me where you think we're going to be summertime. That's what everyone's asking, so I'm going to ask you. Where are we going to be globally?

I think globally, we're going to be-- what we really hope is that we're going to be able to, through also more vaccines being approved by WHO, we'll be able to start at least seeing that the health-care workers around the world have been vaccinated, that as an absolute priority by the summer. That's what we'd love to be able to see, so that at least the health-care systems are shored up. At the same time that there's a whole preparedness effort going on in those countries by WHO and UNICEF, to make sure the health systems are ready when the doses of vaccine come to those countries and that they're able to distribute.

One thing, it's interesting, though, there are many countries in the world who are very pro-vaccine, very often very poor countries. And there are many poor, middle-income countries that have very strong public health systems and are already used to vaccinating their people. So what we might see is that if the supply is there, they might be better at distributing to their populations than in some-- than some of what we're seeing in less centralized health systems, like here.

Especially if you have vaccinations that may not require the logistics of multiple shots and super cold temperatures.

The cold chain is also-- yeah, exactly.

Will we see a resurgence of global travel? Or will that require a bit more time than the summer?

I think we're all hopeful. But again, all of these things in the richer countries who have the supply and are already rolling out in a big way vaccine programs, probably you could see travel within the countries come back. But as soon as it becomes global, if you're traveling to other countries that are not as advanced in vaccines, then we're going to have to pause and wait for that kind of global ability, that freedom of movement and travel that we so enjoyed and probably took so for granted until this time. I can tell you I'm looking forward to that day. But I don't think it is as close as this summer.

You've given us a lot to think about. You've reminded us no one's safe until we're all safe. Think before we share, right?

And verify. We need to be our own detectives in some way in terms of what we read in print and on social as well. Anything else you want to leave our viewers with?

I think that just it's a trying time. I think probably the viewers here really have a real interest in public-health information that is accurate and that is verified. I think let's celebrate and trust our health-care people, friends. They are the pillars of our community. And let's give science the credit that it deserves and trust-- and the trust that it deserves.

That's good. We need to trust science. Melissa Fleming, I want to thank you for taking the time today and sharing your insights. And thank you for all that you're doing globally, around the world to improve communication about COVID.

Thank you so much for having me, John.

And if you have any questions about COVID, drop us a line. You can email me at [email protected], as well as post it on social @WebMD or Medscape on Instagram, Twitter, Facebook, and Pinterest. Thanks for watching.