2020•11•20

The EPIC Tracker blog is part of a series linked to the UNU Evidence, Policy, and Interventions for COVID-19 Tracker (EPIC Tracker). The tracker is a comprehensive repository of policies that have been enacted in response to a wide range of issues impacted directly by the SARS CoV-2 (Coronavirus) or indirectly by the measures taken to control the pandemic. This series has two aims: First, to raise and explore a range of health-addressed research and policy challenges that have arisen as a result of the COVID-19 pandemic. Second, to demonstrate the purpose and potential of the UNU EPIC Tracker as a comprehensive policy repository.

by Emmanuel Tsekleves, Claudia Abreu Lopes, Nik Norma Nik Hasan, Jia Xuan Yap, Derrick Chan and Fatima Ghani Gonzalo

The infodemic crisis

The COVID-19 pandemic has been aggravated by the abundance of false information regarding all aspects of the disease from its etiology and mechanism of spread, to its prevention and treatment. Hoaxes and rumours can lead to adverse health outcomes as they suppress healthy behaviours—such as wearing masks and maintaining social distancing—and create social stigma that can lead to hostility towards patients, health workers and other groups. Since the Ebola outbreak in West Africa, the health sector has learned that trust in health authorities, community engagement and accurate information can go a long way in helping the public comply with public health measures. Social and behavioural science offers the basis of effective health communication including strategies to contain rumours and counter-misinformation.

As a novel disease, the rapid increase in the volume of new scientific information about COVID-19 surpasses human processing capabilities. Besides the general public, researchers, policymakers and journalists have also been impacted by the sheer volume of information during the pandemic, creating an ‘infodemic crisis’. Infodemic refers to an exponential increase in the volume of information associated with a global issue such as a pandemic which also includes misinformation (false information unintentionally shared or spread) and disinformation (false or inaccurate information deliberately intended to deceive). In the words of the WHO Director-General, Tedros Adhanom Ghebreyesus, ‘we’re not just fighting an epidemic; we’re fighting an infodemic’.

People are selective when dealing with an overwhelming amount of information, acting as cognitive misers that tend to save cognitive resources. New information is filtered through their values and experiences and anchored in existing knowledge. Through a process of comparing and contrasting, the unfamiliar is turned into familiar. It is not surprising that one of the first widespread rumours was that ‘COVID-19 was only a bad flu’. 

In parallel, rumours and conspiracy theories are fabricated with doubtful intent. Disinformation is difficult to countervail as it contains the elements of a credible theory namely, statistics, facts and expert sources. In line with reactance theory, people have an innate desire for autonomy and experience psychological reactance or opposition when they sense that their freedom to think and act independently is threatened. The popularity of COVID-19 conspiracy theories results in part from the motivation to restore the freedom restricted due to measures such as quarantine and lockdowns. Conspiracy theories gain more strength in times of crisis and when psychological needs are frustrated due to social isolation, for example.

During a pandemic, people may feel anxious, depressed, emotionally drained, and unable to meet important demands. The anxiety causes them to seek immediate answers and consider any health-related COVID-19 news to be true. Older adults (aged over 65 years) are more likely than younger generations to believe in misinformation and to spread fake news on social media platforms.

“During a pandemic, people may feel anxious, depressed, emotionally drained, and unable to meet important demands. The anxiety causes them to seek immediate answers and consider any health-related COVID-19 news to be true.”

With social media reaching more than half of the world’s population in 2020, rumours and misinformation spread faster and further than the truth, bringing in new challenges to the health emergency response. In Malaysia and Indonesia, for example, an overabundance of information and misinformation shared via social media has clouded peoples’ understanding of the virus and has made it more challenging for the government to implement measures to mitigate the pandemic. The general public also claimed that they received too much unclear information from different sources on social media which have led to confusion about COVID-19.

Widespread fake news or misinformation makes it hard not only for the public but also for decision-makers and health workers to find trustworthy sources and reliable guidance when they need it. As anyone can publish information online, it is impossible to keep quality control, particularly, when it is crucial to act and to make decisions quickly.

What measures are governments implementing to counter-misinformation?

An infodemic cannot be eliminated but it can be managed. “Infodemiology” is the science of managing infodemics based on the adaptation, development, validation and evaluation of evidence-based measures and practices to prevent, detect and respond to misinformation and disinformation.

For example, the WHO Information Network for Epidemics (EPI-WIN) aims to track and respond to misinformation, myths and rumours and to provide access to timely, accurate, and clear advice and information from trusted sources on public health events and outbreaks, by developing global resources for social listening, fact-checking and misinformation management. The emphasis is mainly placed on low and middle-income countries, where there is a need for more targeted public health information not only through social media but also by-way-of other information and communication technologies (ICTs) such as the radio and short message service (SMS).

In this unprecedented situation, governments across the globe, in collaboration with public health professionals, researchers, and policymakers are looking at each other for advice and trialling policies and interventions that can be implemented by their own national and regional authorities. The different measures can be grouped into three types, with various degrees of effectiveness and respect for the right to freedom of expression and to privacy of individuals:

1. Producing and disseminating evidence, accurate risk communication and improving information access for the public. 

The messages should be culturally tailored and translated to several languages, formats and channels to increase outreach and inclusion of special groups such as digital illiterate groups, unconnected women, and persons living with sensorial disabilities. Frontline healthcare providers should also be equipped with the most recent research findings and accurate information to communicate with patients or at-risk populations. Partnerships between mass media, community organizations, support groups, and civil society should be built at local and global levels so that validated information is consistently communicated across online and offline platforms. For example:

• The government of South Africa has set up a WhatsApp channel in collaboration with Praekelt.org that provides credible and factual details around COVID-19.
• Ethiopia is pioneering talking books with COVID-19 preventive messages to be used by women mentors and community health workers during women-to-women group meetings and community mobilisation activities. Talking books enable remote monitoring and user’s feedback that allows the correction of misinformation.
• The Ghana Health Service (GHS), in partnership with United Nations Development Programme (UNDP) is extending health promotion, public outreach, and awareness on coronavirus to vulnerable populations, including persons with disability and people living with HIV. Using various community engagement approaches and channels, the health promotion is extended to hard-to reach communities including prisons, immigration detention centres, and underserved and border communities.
• The Ministry of Health of New Zealand launched a series of videos with information about COVID-19 in sign language, contributing to improve public awareness of the deaf community.
• In Burkina Faso, the Ministry of Health has partnered with Development Media International to create multi-language radio spots broadcast in stations across the country. The content was developed with advice from the WHO Global Outbreak Alert and Response Network (WHO GOARN) and Africa Center for Disease Control and Prevention (Africa CDC).

2. Investigative responses aimed at identifying, debunking, and removing COVID-19 misinformation and rumours from online platforms (infoveillance). 

Technologies like natural language processing and text-mining algorithms are helpful in detecting the unique characteristics of fake news. As examples of interventions to identify online misinformation:

• The WHO has partnered with several social media platforms and seven major tech companies—Facebook, Google, LinkedIn, Microsoft, Reddit, Twitter, and YouTube—that has agreed to stamp out fraud and misinformation, and to promote critical updates from healthcare agencies.
• Malaysia’s Communications and Multimedia Ministry created a Rapid Response Troop to monitor unverified information that can cause public distress, by seeking an explanation from parties responsible; and an information verification portal for the public to check the authenticity of information before sharing it with others.
• The Department of Health of the Philippines in collaboration with technology partners developed Kontra COVID, a chatbot with a digital information triage deployed on Facebook and Viber channels.
• In Latin America, Latam Chequea—a collaboration between fact-checking organisations from 18 countries and Google—created a resource that flags misinformation and provides checked information about the measures that governments are taking to combat and mitigate the effects of COVID-19.

There is mixed evidence regarding debunking myths and rumour as it has been shown that misinformation can still be believed after being debunked. Other approaches to counter-information are inoculation that consists of pre-emptively exposing people to small doses of misinformation (including scenarios about COVID-19); uncovering rhetoric techniques common to different types of science denialism; and nudging social media platform users to think about accuracy by periodically asking users to rate the accuracy of randomly selected posts.

“There is mixed evidence regarding debunking myths and rumour as it has been shown that misinformation can still be believed after being debunked.”

3. Governance-based responses which include law and policy.

In some countries, organisations and individuals involved in the production and dissemination of misinformation are subject to legal action. Fines and jail sentences should be based on comprehensive investigations and should ensure suspects’ legal rights. For example, Thailand, Egypt, Saudi Arabia, UAE, Iran, Oman, India,  Turkey and the Philippines apply jail sentences related to production and spread of misinformation.

Conclusion

It is clear from health epidemics in the past, that trust and accurate information can significantly help the public in following public health measures which help decrease the spread of disease. However, in the COVID-19 pandemic, we witness an ‘infodemic’, which has confused both the general population and the policymakers. This leads to policymakers making limited informed decisions and the public to follow appropriate and trustworthy information on COVID-19 prevention. Fortunately, there are several national and international initiatives tackling this infodemic in different ways and this global effort presents opportunities for governments to learn from each other in tackling not just the current infodemic but also to prevent future infodemic crises.

Policy resources on infodemics

• The disinformation map published by the Centre for Human Rights-University of Pretoria in partnership with other organisations seeks to support human rights defenders by tracking and analysing all laws, policies and other government actions on disinformation across Sub-Saharan Africa. 
• A research institute for artificial intelligence in Trento has set up a COVID-19 infodemic observatory, providing an infodemic risk index per country using automated software to daily monitor millions of tweets.
• The Design Research Society Special Interest Group on Global Health has an open access repository containing crowdsourced information on COVID-19 public health messages and information set by official national, regional and international bodies.