Coronavirus in Context: Why Are Some People Believing Conspiracy Theories?

[MUSIC PLAYING] You're watching Coronavirus in Context. I'm Dr. John Whyte, chief medical officer at WebMD. Today I'm joined by Dr. Seema Yasmin. She's a public-health expert and former CDC detective that I'm sure you've seen on-- on multiple news channels. Dr. Yasmin, thanks for joining me.

Thanks so much for having me.

I want to start off with you've written a book about medical myths and why people believe them, but I want to ask you about conspiracy theories and why people seem to be believing some of these, you know, conspiracies about COVID, whether it was made in a Chinese lab, whether Bill Gates is behind it all. How do you address the issue of conspiracy theorists?

They exist because, especially in the beginning of a crisis, there's a vacuum of knowledge. We are learning so quickly. We're trying to answer so many questions. And amid all of that uncertainty, amid the crisis, amid people trying to figure out, wait, I have to wear a mask. I have to stay home. We as humans are looking for a story that helps us understand what's going on.

And sometimes the way that we fill in the gaps of missing data are with conspiracies, which sometimes sound really wild, really absurd. But actually, again, part of our human understanding of these crises, we can be drawn to quite scandalous, quite fantastical, very emotional stories that help us make sense of what's happening.

And funnily enough, I-- you know, I wrote this book, Viral BS, a few years ago, even though it's not going to come out until a few months. And I start the book, John, by talking about my own family's conspiracy theories when I was growing up. So I have a lot of empathy for people who do believe conspiracies because even though they can sound so dramatic, there's often a nugget of truth in them as well.

And just in terms of our seeking certainty, they can be helpful, actually, even though they are dangerous too. But they can be helpful in helping us just trying to make sense of something.

Well, now I have to ask you, what was the biggest conspiracy theory that your parents had while growing up?

It wasn't my parents. It was much more my broader community, my cousins, and there were just conspiracy theories about no one had landed on the moon.

OK.

And as a scientist now I'm like, that's ridiculous. There is evidence, but the context is so important, the context being that the family were immigrants. They were Muslim. They were from the Indian subcontinent living in the UK under a government that had done terrible, terrible things, not only in our home country but around the world. So there was already that distrust of governments, right? There was already this understanding that at one point the British Empire was so big that 1 in 4 or 1 in 3 human on the planet was under the rule of the British Empire. Now that sounds absurd, but it's true, and that's the context within which these conspiracy theories can breed.

You know, and sometimes as you talk about it, it's relating to distrust. I want to bring that in into the issue of, you know, masks, and in terms of you've talked about, you know, science, and there's been confusing information, especially early on, about masks. You didn't need to wear them. Now you do need to wear them. Um, why is there touch your resistance by some people in terms of wearing masks? And the data shows it's actually greater in men than women. What's your assessment of that, Seema?

So there's so much going on there. Part of it is this historical context that scientists like you and I, we love science. We understand it's a process of open mindedness, of developing knowledge. But many communities have been disenfranchised from science and the scientific process. Many communities have been exploited.

You know, when you and I open a medical textbook and we learn about the natural history of syphilis, some of that data came to us from unethical experiments on humans who were purposefully infected with syphilis, who were left to suffer with the disease even when there was a treatment. That's not ancient history. That happened only in the last 50, 60, 70 years, right?

And while I do get frustrated-- you know, like-- for example, a few years ago, there was a really bad outbreak of tuberculosis in Alabama, one of the worst TB outbreaks in America in recent history. And even my own public-health physician friends were getting frustrated. They were saying, oh, but we're doing free testing. We're-- we're giving people cash incentives.

But if you looked at where that outbreak was, it was not an hour's drive from Tuskegee where only until the '70s there were really unethical experiments done in Black people and poor Black people.

So what happens in a crisis? We'll say we are the medical and scientific establishment. We have data. We have facts. Science proves wearing a mask works. And we're saying that to communities that do not have a good relationship with science-- with scientists or with the scientific process. And we are really good, unfortunately, at just being in denial about that, not building bridges, but then in the middle of a crisis assuming that everyone will follow the data and everyone will do what scientists say.

So what should we do? What-- how do we fix that?

So, unfortunately, what's happening right now is we have the highest-ranking scientists in the country being discredited, right? So that doesn't help either. They're also sometimes not speaking up enough about some of the misinformation-- the disinformation being spread from the administration.

I think one way you address this is by realizing that just by pouring facts into a conversation, especially a very polarized one, has been demonstrated to be like pouring kerosene onto a fire. It doesn't help. You have to build bridges first.

And even though it's frustrating and even though it feels like it takes too much time in the middle of a pandemic, you have to understand where people are coming from and that a one size fits all communication approach doesn't work.

Different communities have different relationships with science. Different communities have different history in the context of science, and so we have to have tailored approaches and just remembering that even for us we just like to say but we have data. I can show you evidence. That in itself, it's not enough.

Well, are physicians the best communicators, or is it better that, you know, the public hears from people more like them than the so-called experts? How-- how do we balance that?

So do you know on average how long a doctor lets a patient talk for before they interrupt them?

Probably about 20 seconds.

It's less. It's about between 11 to 17 seconds before we start talking. So we're not even good at taking a history, and our job depends on that.

Doctors are not the best listeners. And when I teach clinical-communication skills, people come in thinking, oh, you're going to teach me how to say certain things, how to frame certain things. And actually a lot of being a good communicator is about shutting the hell up.

And we doctors are not great at that, and we're not great at that in the micro context of those one-on-one patient encounters. But it also goes back to this big issue of we're not listening to communities. We're not understanding what the issues are.

So we need to do more work at teaching physicians to be better communicators and scientists too. And within the context of science, what I hear over and over again is people saying to me right now, can you help me communicate my research on COVID? Can you help me counter the false narratives? Because scientists are saying that they're not getting that training in their scientific education.

We know cases are rising in young people. So, Dr. Yasmin, how do we get young people to follow these public-health strategies that we know work? Where's the disconnect there, and how can you help us?

Yeah, so we often treat communities, whether it's like a certain ethnic community or the community of younger people, as if they are a monolith, and there is so much diversity within even millennials. You know, I joke that I am a geriatric millennial because I'm at the top end of that. But if you lump me together with millennials, then there are some people that are, like, 10, 15 years younger than me. We have completely different life experiences and different perspective.

So I think as people who love data, we actually have to dive into the data a little bit more. Extricate some of the patterns that we're seeing. What are we seeing in the 20-year-old people? What are we seeing in the age groups in their 30s and 40s, right? So I think that helps.

Also realizing that people are deluged with information. I don't have a quick fix or a response to that, but I have a lot of empathy around it, and I think we need to realize that yes, there are-- there is misinformation. There's disinformation. There's also a lot of good information out there, and there's just information overload. So we're trying to get people to be good at understanding how information and data, in the context of them seeing news updates throughout a 24-hour news cycle of us say, oh, look. Here's the new paper in The New England Journal. Here's a paper in The Lancet. And two papers from those two journals get retracted in a given day.

So I don't have necessarily solutions around that. I think we need to study and pay more attention to that information ecosystem.

You're in the Bay Area where tech is, you know, king. Yet we've seen in contact tracing that many folks are somewhat reluctant, um, to download apps, perhaps, that might help in contact tracing. And with your experience as a CDC detective, we know that contact tracing works in containing, um, you know, a pandemic. So why is there the distrust, do you think, of-- of tech in-- in contact tracing?

So just to start off with, public-health intervention and engagement don't work without community buy-in, and I just saw that time and time again as someone-- an officer in the academic intelligence service at the CDC. I get sent to a hot zone, and the first thing I would have to do, as keen as I was to, like, roll up my sleeves and get stuck in, was to build trust with the community at a time of crisis, at a time when people were dying.

And it's fascinating to me that even when you look at their reports on how we contained SARS 18 years ago, it was this 21st-century pathogen, right, but we used 18th, 19th century epidemiological tools.

18 years ago doesn't-- [LAUGHS]

I know. But, you know, we were using old-school tech, if you like, contact tracing.

I am so surprised, I guess, especially living here in Silicon Valley that in 2020 we don't have better ways of doing that, of building trust but also of scaling up public-health interventions like contact tracing. We've seen, in fact, it be quite botched. In the UK, the NHS had an app. Really slow uptake because, I think, of that trust issue. What's going to happen to my data?

And a lot of that, I think, is to do with the tech companies that don't have good track records even in the last few years, you know, of, um, safeguarding our data, not sharing it in unethical ways. So I think we have to address that before we can just say we're going to have an app. We're going to scale up contact tracing, and this is going to fix a lot of it. Clearly it didn't. In fact, it made people much more reticent, I think, of interacting with public-health institutions because they became really worried about my data.

And, finally, you've been one of the leading voices-- physician voices particularly-- in terms of addressing the pandemic. What keeps you up at night?

SEEMA YASMIN: Antivaccine campaigns, how sophisticated they are, how tailored they are, how actually they use all of the ticks and tricks that I teach scientists and physicians, and they do it so well-- tailoring the message, understanding people's vulnerabilities, and then preying on those fears and weaknesses.

I worry that we're just so far behind some of the bad actors who are spreading disinformation because we think data is king and queen and we have facts and that will work, and it doesn't.

So what keeps me up at night has a lot to do with the antivaccine campaigns and not just around COVID-19, although that's really taking off, but I worry about measles. Measles is back. You know, pertussis is back. I worry about those, and I worry about so many kids in the US and around the world who are not up to date with their routine childhood immunizations because of the pandemic.

Well, Dr. Yasmin, I want to thank you for taking the time today to share your insights.

Thank you so much.

And I want to thank you for watching Coronavirus in Context. [MUSIC PLAYING]