We live in a time where any information can be transmitted around the globe in seconds, regardless of its correctness (Maxwell, 2021). Individuals need to develop critical thinking to select the correct, updated and error-free information as much as possible. Unverified online information can shake public beliefs about science, health, politics, cultural norms etc. (Maxwell, 2021). With the large amount of information available, a lot of confusion might appear regarding health information. This phenomenon was first coined in 2003 when the words “information” and “epidemic” were combined into the word infodemic (Briand, 2021). The World Health Organization defines the term infodemic as the “overabundance of information, both online and offline – including mis/disinformation, that occurs during an epidemic” (Briand, 2021). The infodemic spreads among people similar to a disease epidemic, and it makes it hard for people to find reliable and trustworthy sources of information; and during the COVID-19 pandemic, the infodemic was exacerbated by the global scale of the emergency (WHO, 2020). This phenomenon has led to poor observance of public health measures, stigmatization of different groups, health risks and a reduction in the effectiveness of efforts to contain and stop the pandemic (WHO, 2020). Below, we can see some terms that are important when we discuss health information.
Disinformation is defined as intentionally false information, while misinformation is unintentionally false information. So when we talk about “mis-“and “dis- “, we talk about the intentionality to spread such news (Crawford et al., 2016).
How to identify, expose and understand disinformation online?
The 4D model of disinformation campaigns:
- Dismiss: “Don't listen to them, because [..]" – trying to silence the witness (adding an insult)
- Distort: "If the facts don't suit your story, make your own facts"- inventing data (fake evidence)
- Distract: "If the conversation is getting uncomfortable and unfavorable, change the subject and accuse somebody else of the same thing" – changing the path of the conversation, focus on something else
- Dismay: "Try to scare people off" – if someone says that is going to do something unfavorable to you, explain to them what the disadvantages will be (rhetorical perspective)(Crawford et al., 2016).
Fake news can be seen as a deception intended to influence someone else's perception of a specific subject. This deception can be done through false or misleading content released on social channels (Crawford et al., 2016). Research showed that fake news related to health could create confusion and influence the uptake of different treatments and vaccination (Domenico et al., 2021). Moreover, research conducted in the COVID-19 pandemic showed that fake news in health could cause different psychological disorders, fear, fatigue, confusion, panic and depression in different nationalities and populations. All reports indicate that people trust information found on social media and that it affects their health decisions (Rocha et al., 2021). The latest COVID-19 pandemic showed that health professionals are willing to combat fake health information and consider it their duty as medical professionals (Bautista et al., 2021). Researchers in the field developed a conceptual model for healthcare professionals to correct health misinformation on social media, as shown in Figure 1 (Bautista et al., 2021).
Figure 1 – Conceptual model for healthcare professionals to correct health misinformation (Bautista et al., 2021)
COVID19 pandemic and vaccines: a case study
To give you a sense of how fake, the best example is how the COVID-19 pandemic and vaccination generated a lot of discussions on social media platforms. Sarah Brandt, the Vice President of the News Literacy Program at NewsGuard, discussed how over 300 websites with a big audience had spread dangerous lies about the disease since March 2020, when it was brought into attention (Brandt, 2021). Many websites which were spreading alarming news about the deadly effect of vaccines also have official-sounding names like "CDC.News", "Science.news" that are more appealing to individuals and eventually generate a big audience (Brandt, 2021). Inserting small amounts of false information into many places works as a strategy to spread a larger message of disinformation (Crawford et al., 2016). To understand this association better, think about money laundering. To give you an example, to get rid of suspiciousness, individuals who do such things as money laundering do not deposit a large amount of money in a bank account, so they will not be questioned about it. So, fake news spread quickly among the population by inserting a small amount of health information in many places over social media (Youtube, Twitter, Facebook, etc.).
Research in the field that used sentiment analysis as a tool for analyzing social media posts from Reddit related to COVID-19 shows that although sentiments expressed in the community are overall positive than negative, vaccine hesitancy was highly prevalent in the discussion. They call for action to strengthen vaccine confidence on social media (Melton et al., 2021).
Figure 2 - Automated pipeline of processing data and discovering fake news (Shahsavari et al., 2020).
However, it is hard to destroy all those news and educate populations in a relatively short amount of time since these kinds of websites arise overnight. Research in the field focuses on developing tools for early detecting fake news to neutralize them in the shortest possible time. Such tools include machine learning neural networks (Liu & Brook, 2020; Shahsavari et al., 2020) and detection tools to identify fake news (Saxena et al., 2022). An example of an automated pipeline of processing data and discovering fake news in social media is presented in Figure 2 (Shahsavari et al., 2020).
Moreover, due to the amplitude of the infodemic at global level, WHO
established the Network for Epidemics (EPIWIN) to disseminate and amplify
evidence-based information about COVID-19, and to track and respond to
misinformation, myths and rumours (Briand, 2021). The EPIWIN network developed a competency framework for infodemic
management that can assist institutions in strengthening their infodemic
management capacity. The framework is conceptualized around the five
workstreams for infodemic preparedness and response along the epidemic curve,
analogous to an epidemic response, as it can be observed in Figure 3 (Briand, 2021).
Figure 3 - The five workstreams in the epi curve of an infodemic response, analogous to the epidemic response (Briand, 2021)
The five workstreams of the framework are (Briand, 2021):
Workstream 1. Measure and monitor the impact of infodemics during health emergencies.
The application of standardized metrics and tools is needed to track the evolution of infodemics among individuals, communities, societies, and health systems in both digital and physical information environments.
Workstream 2. Detect and understand the spread and impact of infodemics.
A common approach is needed to understand how information and mis/disinformation is spread and how it affects online and offline behaviour in different populations.
Workstream 3. Respond and deploy interventions that mitigate and protect against the infodemic and its harmful effects.
An evidence base is needed to identify effective interventions in different contexts and for different types of acute health events.
Workstream 4. Evaluate infodemic interventions and strengthen the resilience of individuals and communities to infodemics.
Standard evaluation frames are needed to improve the development of interventions and programmatic responses to infodemics.
Workstream 5. Enable, promote the development, adaptation and application of tools for the management of infodemics.
There is a need to enhance the transferability of lessons and evidence-based interventions between contexts, countries and infodemics
The competency framework also comprises four main domains:
- Infodemic management – competencies in infodemiology;
- Prepare and monitor - competencies in the use of effective tools to listen to target audiences and how to design and share appropriate health information;
- Detect and intervene - competencies to design, implement and evaluate interventions to promote resilience to mis/disinformation and to empower individuals and communities to exercise their right to access quality health information;
- Strengthen - competencies to empower health systems to ensure healthier populations through better IM in health emergencies and in regular contexts (Briand, 2021).
This competency framework also has a set of related tasks, knowledge and skills needed to perform the activities presented under each main domain. This framework can be helpful in stopping the present and future infodemics (Briand, 2021).