Disinformation: A Dangerous Driver of the Pandemic Humayun J. Chaudhry, DO, MACP

Almost two years of combating this deadly virus has nearly exhausted our reserves. As we enter the holiday season – despite more of us doubly or triply vaccinated than ever before – we will need to stay vigilant against the delta variant, which is still here, and the omicron variant, which is now here and may become a bigger concern.?

We will need to make sure that more eligible individuals, including children above the age of 5, get vaccinated as soon as possible. While we are indoors, especially during this winter, we will also need to keep wearing protective masks whenever and wherever that is mandated or advisable, consistent with guidance from public health officials that will be modified depending upon changing circumstances in your town, county or state. And as we hope for the best and prepare for the worst, there is one looming threat to our ability to end this scourge that has become an enigma wrapped in a conundrum: a pandemic of disinformation.?

This August, the World Health Organization reported that false and inaccurate information about COVID-19 online, especially about the vaccines being used to prevent the disease caused by the virus, had only gotten worse. Maria Van Kerkhove, a WHO official, said during a question and answer session on the organization’s social media channels that COVID misinformation was keeping people around the world from getting vaccinated because it was confusing the general public — and likely driving the jump in cases in the U.S., Europe and Asia. After all, the vaccine doesn’t work if you don’t get it.

As early as 1710, Jonathan Swift famously wrote, “Falsehood flies, and the Truth comes limping after it.” In our modern-day world of social media and the internet, myths and misstatements spread rapidly over the globe like wildfire, literally at the speed of light and including among groups least likely to be vulnerable to the virus. Incredibly, most unvaccinated Americans think getting a vaccine against COVID-19 is more dangerous than contracting COVID-19, according to an ongoing research project of the Kaiser Family Foundation. ??

With all sorts of myths and misstatements floating around the internet and in the ether, it should theoretically be comforting to be able to turn to health care professionals to help sort out the wheat from the chaff. Thankfully, the vast majority of physicians and other health care providers have done just that, using every means possible – at the bedside and on social media, in medical journal and newspaper articles, and on radio and TV – to get the word about what is going on with the virus and what we can do, individually and together, to prevent getting the virus and the illness it causes.?

Unfortunately, some doctors and health care professionals (including a few who are known as social media “influencers” with legions of followers) have spread false information about COVID-19 and the COVID-19 vaccine—activities that have the potential to harm lives and further exacerbate the pandemic. Many of these professionals may be under investigation by their state licensing boards (all states publicly report the disciplinary actions they take but most are prohibited by statute to acknowledge whether an investigation is underway), and several have already received disciplinary actions such as a public letter of reprimand, a monetary fine, a temporary licensure suspension or, as in a few egregious cases, a licensure revocation. As I recently told the New York Times, when a doctor speaks people pay attention. It’s concerning, therefore, when any doctor shares a myth or falsehood.?

Physicians who generate and spread disinformation (which is more worrying than misinformation because it intends to deceive) that causes harm, or which has the potential to cause harm, risk disciplinary action being taken by a state medical board. That isn’t new policy; that has always been true, and was reiterated in a unanimous statement issued on July 29 of this year by the board of directors of the Federation of State Medical Boards (FSMB). “In an effort to remind all licensed physicians of their responsibilities in caring for patients,” said Ken Simons, MD, chair of FSMB’s board, “we issued a statement calling attention to the need for physicians to provide accurate information regarding COVID-19 to their patients or risk action (by state boards) against their licenses; not to threaten but to protect the special relationship physicians have in upholding public trust in the profession of medicine.” The statement followed a unanimous recommendation from the FSMB’s Ethics and Professionalism Committee, which includes physicians, attorneys and public members who serve, or have previously served, on state medical boards.?

While it is ultimately up to each state or territorial medical board to decide what action it may wish to take when a complaint is received about a licensee, the type of action it may pursue will be dependent upon that jurisdiction’s statutes and procedures. Each situation is different, includes due process for licensees, and takes time to thoughtfully and properly adjudicate. The FSMB’s ethics committee, chaired by Katie Templeton, an attorney who is also president of the Oklahoma State Board of Osteopathic Examiners, is drafting recommendations to better guide state medical boards about how to manage situations where licensees engage in disinformation. “(We are) providing guidance and support to state medical boards,” said Ms. Templeton, “to clarify professional responsibilities and equip state medical boards with strategies for enhancing ethics and professionalism among licensees, helping them adhere to best practices in medical care, and combating disinformation to keep patients safe.”?

As the FSMB’s chief executive, I was pleased to see many organizations in the house of medicine (e.g., the American Medical Association, the American Osteopathic Association, the American College of Physicians, the American Board of Internal Medicine, etc.) amplify the FSMB’s message, as did more than 18 state medical boards that issued statements of their own. The statements vary in the words they use but they all convey the same message and have become a bit of a Rorschach test. For physicians on the front lines of a pandemic that has resulted in 782,000 deaths (and more than 4.5 million deaths worldwide), the statements are a reminder to remain thoughtful and careful about how to interpret, share and use emerging scientific evidence and data about COVID. For others, the statements are being viewed as threats. Regardless of how the statements are perceived, state medical boards hope physicians will continue to be vigilant about what they read and hear, and thoughtful about what they share online or do in their practice. Just one misleading statement by a physician can have dire consequences in this day and age, when a passing remark can go viral and get amplified many times over from Alabama to Wyoming, Albania to Zimbabwe.?

It has not been easy, of course, for doctors to keep up with all the new information emerging about COVID-19 and its variants, or about the vaccine and who is eligible and when. They are, by and large, doing the best they can in a stressful and difficult situation that they, too, hope will end soon. As for the general public, it’s important that they listen carefully to the advice they read, hear or watch from any source. If you’re not sure the person who is speaking is a qualified physician, go to DocInfo.org and find out for free where they are licensed, where they went to medical school and whether they have ever had a disciplinary action against them.?

In the meantime, remember that the primary mission of every state medical board is to protect the public but they do not have the statutory ability, resources or means to monitor the internet or every physician-patient interaction. If you see inaccurate or misleading content online about COVID-19 or the vaccine, aside from reaching out to the relevant state medical board you can also help by reporting the activity directly to the social media platform where you saw it. The WHO has a helpful guide about reporting misinformation online.?

As the weather starts getting colder across the country, and as we spend more time indoors, I am reminded of the advice Sergeant Esterhaus would give on Hill Street Blues: “Let’s be careful out there.”?