From the WebMD Archives

July 29, 2020 -- A viral video touting hydroxychloroquine as a cure for COVID-19 is the only the latest in a series of rumors, conspiracy theories, and false information about the coronavirus that have spread like wildfire on social media.

President Donald Trump has long touted the antimalarial drug and even took it for 2 weeks himself. But several influential studies showed it didn’t work against the coronavirus, and even could be dangerous. And the FDA warned against using it as a possible treatment for the disease in June.

But the video, published by conservative website Breitbart, called the drug a cure and said people didn’t need to wear masks. Twitter restricted Donald Trump Jr.’s account after he posted the video. President Trump retweeted the video but did not post it to his account. Although Facebook, Twitter, and YouTube took it down, it had already been viewed 16 million times.

"These types of videos are very dangerous to public health and this epidemic," says John Whyte, MD, chief medical officer of WebMD.

The video’s release, promotion by national leaders, and its millions of views reflect the challenges of weeding out misinformation about a new and complex virus when people can freely express and share their opinions.

“People tend to find information on the internet that conforms with their previous beliefs and reinforces them,” says Michael Mackert, PhD, director of the Center for Health Communication at the University of Texas at Austin.

And it’s one of the reasons why coronavirus messages are so confusing. It’s also contributing to a lack of trust in public health messaging around the virus.

Even the country’s top public health leader, Anthony Fauci, MD, said recently that messages about mask wearing were confusing in the early days of the pandemic and could have undermined the public trust.

“It is common for evolving messaging about pandemics to seem contradictory and confusing to the public,” says Gary L. Kreps, PhD, director of the Center for Health and Risk Communication at George Mason University in Fairfax, VA. “So it is important to explain that we are continually learning more about the health risks and how to best respond to these risks. Let the public know we are striving to provide them with the latest state-of-the-art information to promote the best health outcomes.”

Scientists Disagree

The evolving messaging and confusion have, in this case, occasionally extended to the experts we typically turn to for solid information. With such a quickly changing situation, those debates may leave the public wondering who to trust. Scientific debates are not new, but they typically take place in peer-reviewed journals and at professional conferences. The pandemic has changed that.

“A lot of people normally don’t see the messy, quick process of how science advances -- you can have three studies going in one direction and another study going in a different direction. With COVID-19, people are paying a lot more attention to what scientists are saying, and it’s happening really fast,” says Mackert.

Scientists researching COVID-19 transmission and prevention are also under tremendous pressure to come up with answers and make recommendations to the public.

With the stakes so high, waiting a long time to reach a scientific consensus may seem impractical. Also, “scientists sometimes never reach a full consensus about these complex health problems, and different groups of scientists will advocate for their own explanations and evidence,” says Kreps.

That happened in early July, when more than 200 scientists appealed to the World Health Organization (WHO) and the broader medical community to address the idea that COVID-19 is spread through the air. They advocated for preventive measures such as improving indoor air ventilation in public buildings and public transportation.

The WHO responded that short-range aerosol transmission may exist under certain conditions, but it called for more research.

This conflicting information can leave the consumer wondering who to believe and, more importantly, what advice to follow. “The way to interpret this is that it’s being driven by the fact that we don’t know enough yet,” says Mackert.

Misinformation Spreads on Social Media

There are many reasons why some people believe hoaxes and conspiracy theories. “Some social media users are better than others at providing interesting and believable accounts about the pandemic,” Kreps says. “At the same time, many people are very concerned about the pandemic and are eager to get quick answers about how to avoid and respond to the virus, so they may rush to judgment and accept recommendations that are not helpful, and sometimes dangerous.”

For example, when Trump said the virus was not a big problem and would just go away on its own, the messages were easy to understand and follow, says Kreps.

“By comparison, advice about social distancing, sheltering in place, and wearing masks in public were not so simple or easy for many people, and those messages were rejected in favor of more comfortable messages,” Kreps says. “They prefer to listen to people who are most like themselves culturally and politically, who speak simply and provide messages they want to hear.”

President Trump regularly takes to Twitter to communicate his views on the pandemic to the public. For example, on July 9, he tweeted, “For the 1/100th time, the reason we show so many Cases, compared to other countries that haven’t done nearly as well as we have, is that our TESTING is much bigger and better. We have tested 40,000,000 people. If we did 20,000,000 instead, Cases would be half, etc. NOT REPORTED!”

A study published in March found that about 1 in 5 tweets (25%) contained misinformation, and 17% included unverifiable information. The authors analyzed a total of 673 tweets and defined misinformation as a “claim of fact that is currently false due to lack of scientific evidence.”

The results are in line with those published in studies of similar recent epidemics where social media played an important role in spreading misinformation.

The three major social media giants -- Google (which owns YouTube), Twitter, and Facebook -- have recently taken steps to alert their audiences to misinformation appearing on their sites and redirect them to accurate information.

Still, a recent Pew survey found that about 4 in 10 Americans think the coronavirus outbreak has been exaggerated, compared to about three in 10 before the pandemic dominated the national news starting in late April. The increase is particularly stark among Republicans, whose doubts about the outbreak’s seriousness rose from 47% in late April to 63% in early June. The share of Democrats who say the outbreak has been overhyped increased just slightly, from 14% to 18%, according to the Pew report.

More than half of Republicans (56%) who rely on the Trump administration as their main source of information are much more likely to believe in the conspiracy theory that the coronavirus outbreak was planned by powerful people, according to the survey results.

Other Pew research has shown that those who rely on the White House for information on the virus tend to think the disease and pandemic are less dangerous than people who get their news from the national or local news media.

When it comes to getting the facts right, the Pew survey found that Americans rate the CDC and other public health organizations the highest. The survey looked at five key sources of COVID-19 information, including governors and state government, local news media, and news media in general. The center surveyed 9,654 U.S. adults June 4-10, as part of the American News Pathways project.

Nearly two-thirds (64%) of U.S. adults say the CDC and other public health organizations get the facts right “almost all” or “most” of the time when it comes to the coronavirus outbreak, while about half as many (30%) say the same about Trump and his administration. Instead, a solid majority of Americans (65%) say the White House gets the facts right only “some of the time” (29%) or “hardly ever” (36%), the Pew Center reports.

Trust in Public Health Authorities

Despite the bad information and mixed messages, 70% of Americans polled by the Pew Research Center say the best ways to prevent the spread of the disease are pretty well-understood. And even as some research studies have suggested conflicting advice about efforts to confront COVID-19, most Americans consider this to be an understandable part of the research process, rather than a sign that research studies can’t be trusted, according to a July 8 Pew Research Center report.

The message on wearing masks is getting through. Half of Americans report wearing a mask “at all times” when leaving home, while an additional 27% said they wear one some of the time. Only 10% report never wearing a mask, according to the June 30 Axios-Ipsos Coronavirus Index.

Overall, there was widespread compliance with stay-at-home orders this spring and other policies designed to prevent the spread of the coronavirus.

Recent polls show that the vast majority of registered voters trust medical scientists to provide reliable information about the virus and 67% trust the advice of Fauci, according to a New York Times/Siena College survey. “The public trusts Dr. Fauci because he has a long, successful track record of providing good information about infectious diseases to the public, not just about COVID-19, but about AIDS, Ebola, and other serious health problems. He has the scientific credentials to back up his recommendations, he does not appear to have any ulterior motives to misinform the public, and he can communicate his recommendations relatively clearly and simply,” says Kreps.

Fauci also appears compassionate and caring about public health and well-being, and he has “not made many missteps about the pandemic but has provided the best information as it was available,” Kreps says.

That’s a communication strategy public health officials needs to continue, says Hayden B. Bosworth, PhD, a health services researcher and professor of medicine, psychiatry, and nursing at Duke University Medical Center.

“When people look back and wonder why the CDC didn’t recommend masks and social distancing earlier and is now recommending masks, it’s because they didn’t communicate clearly that the evidence continues to develop -- this is so fast and changing so quickly,” Bosworth says. “We need to say this is the best data we have now and the findings may change as we receive more data.”