The disconnect between evolving science and medical communication has left people confused about how to interpret public health information, and provided an opportunity for vaccine deniers and politicians to give disinformation on COVID-19.
Image Credit: David Lusvardi, Unsplash
“Science is a self-correcting process.” — Anthony Fauci, MD, during an interview this week with NPR.1
During the aforementioned interview, Fauci, the former White House chief medical advisor and National Institute of Allergy and Infectious Diseases (NIAID) director, was trying to clarify how science information from data evolves and the communication of that data or information can change over time; yet, people want a very finite answer that does not change or evolve. When data suggests a new finding and it is reported, the expectation is that the information reported before has become sacrosanct and no new information can be introduced.
“This was one of the biggest surprises to me when I started to make videos on social media for the lay public, that the public for the most part, does not understand the scientific method,” Katrine Wallace, PhD, research epidemiologist and an adjunct assistant professor of epidemiology and biostatistics at the University of Illinois Chicago School of Public Health said in an interview with Contagion. “I had to make videos that walked through how science is constantly changing with new data. And when we have new findings, it doesn't mean somebody lied before; it just means that we have done more research, and the more data we gather, the more we know.”
“You have a hypothesis, and you test it, and then you get your conclusions...we need to explain to folks that it is a process, and we get more data, and as the data evolves, we can modify our understanding,” said infectious disease epidemiologist Jessica Malaty Rivera, MS, principal, JMR Science, and science communications advisor, de Beaumont Foundation, in an interview with Contagion. “It's rare that we're seeing flip flopping back and forth, right? We might say we didn't know this about this thing at this point; now we know a little bit more, and what it means for us today.”
This disconnect between how the scientific method works and the public’s misunderstanding of it has been a major, ongoing issue since the rise of the pandemic.
“The truth is that we had a novel virus, thousands of people were dying every day, we had no treatment, no vaccines, and had to do the best we could with the information that we had, which was constantly changing in real time,” Wallace said of COVID-19. “When I see people say Dr Fauci lied because there was ‘no science’ behind masks or six feet of social distance etc, it scares me because when we have the inevitable next pandemic people will just remember the revisionist history and not the fact that the non-pharmaceutical interventions that we put into place saved millions of lives.”
Fauci recently appeared on Capitol Hill to give testimony about COVID-19. And along with his testimony there was revisionist history being played out by politicians about how the pandemic should have been handled and even remarks about his credentials. The subject of disinformation has been an ongoing, politicized commentary for years that has served politicians but not their constituents’ best interests.
“I would not look to politicians for this information,” Malaty Rivera said. “[There’s] a lot of disrespect thrown at folks who had good intentions and were operating during times of significant uncertainty—understanding that science is an iterative process, and when things change, it doesn't necessarily mean that it was misinformation; it was that more information was evolving.”
“I think mis- and disinformation as terms have been highly politicized and have been used as slurs and as ways to discredit a person who was speaking or sharing information; in the same way that fake news became a catchphrase to say that something is misinformation or disinformation is to discredit the person and discredit the piece of information.”
Malaty Rivera goes on to say that we are in an age of “subjective truth” where people can have their own interpretations of the truth.
In order to combat misinformation and disinformation, it is important to first understand the importance of credible sources. Just because an article is published on a website or a Youtube video is posted does not equate these pieces of information as credible sources.
Here are some sources of medical information Malaty Rivera and Wallace provided:
However, Malaty Rivera says there are credible sources of information and points closer to home and the relationship people have with their own providers. “I would also say that individual providers are a great place for that type of information, and to go to your provider who knows your health history, and who knows your child's health history best.”
Malaty Rivera knows some people have their doubts when it comes to federal agencies and people have lost faith in the government. “I hate that it’s happening, and I do still consider the CDC a premier public health agency and a trusted place for information, especially related to vaccines,” Malaty Rivera said.
Wallace agrees about people’s providers and the CDC, and adds the local health departments can be helpful in providing information.
The loss of faith or belief in the need for routine childhood immunizations and a decrease in uptake nationwide has had a bad effect, especially as there are small measles outbreaks being seen across the US in recent years. The rise of vaccine deniers and skeptics really began as a paper written over 25 years ago that erroneously claimed the MMR vaccine caused autism.
The key is not to close the door of communication to people that view vaccines through a prism of skepticism or denial, but to stay engaged with them.
“When speaking to vaccine-hesitant parents, the only way to have a productive conversation is to listen to them with empathy. Try to understand where they are coming from, and ask them questions. Then, during the conversation you can point them to accurate data sources about vaccines,” Wallace said.
“The quickest way to shut down a conversation is to make them feel shamed or to fact check or debunk what they are saying. It takes a lot of patience to have these conversations, but listening with empathy is really the only way to have a good conversation with someone who believes vaccines are dangerous. You may not get through to that person during this conversation but you do plant a seed in their mind.“
There are concerns by those in public health that our collective experience with COVID, from misinformation and disinformation to COVID fatigue, could affect future outbreaks and possible pandemics.
“I do worry about the next pandemic, and I am already seeing posts on social media that avian influenza is not real and that it has been made-up because it is an election year,” Wallace said.
And right now, we have seen 9 human avian influenza cases in the US in agricultural workers who were in direct contact with cows and poultry.
“We have said for years that pandemics were a matter of when, not if,” Malaty Rivera said. “And, you know, we've probably heard the term, we are in the era of pandemics. And it might sound like a scary term, but it's because of a combination of influences—environmental influences and climate influences in particular—that might be accelerating this rate of new emerging biological threats. If you had asked me in 2019 what I thought the next pandemic would have been, I would have put my money on H5N1—we've been following it for a long time.”
However, it is important to note, Malaty Rivera does feel reassured that the government is looking after people and the food supply.
“We can be thankful that we have a regulatory body like the FDA that is ensuring through the testing that they've done that our milk supply is still safe, especially if it's pasteurized,” Malaty Rivera said.
Editor’s note: When the interview occurred, there were 3 human cases of avian influenza in the United States. As of July 18, there are 9 cases.
Ultimately, the general public would be best served understanding that medical science information evolves and changes over time with new data being introduced, and the need to utilize credible sources. In addition, the next generation of adults could benefit on understanding the scientific method and how it is applicable.
“I think as a country we need to invest more money in science education in public schools so people understand these basics, and also teach data literacy and news literacy to high school students so they will not fall prey to misinformation,” Wallace said.
This is the second installment of a 2-part series looking at misinformation and disinformation and the effects it has had on public health including MMR vaccinations and COVID-19. To read the first article, go here.
