[Covid-19 disinformation is coordinated, effective, lucrative, and
costs lives. This is true during the pandemic and it will be true for
other public health problems. It’s a public health and biosecurity
threat. And we need to treat it like one.]
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THE SCIENCE (AND BUSINESS) BEHIND COVID-19 DISINFORMATION  
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Katelyn Jetelina
January 20, 2023
Your Local Epdemiologist
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_ Covid-19 disinformation is coordinated, effective, lucrative, and
costs lives. This is true during the pandemic and it will be true for
other public health problems. It’s a public health and biosecurity
threat. And we need to treat it like one. _

#bebest-disinformation-michael-nuccitelli-ipredator, by iPredator
(public domain)

 

Rumors around COVID-19 vaccines and death, like the _Died Suddenly
_video we highlighted earlier this week
[[link removed]],
aren’t random. Disinformation campaigns are deliberate, often
orchestrated, and highly effective in confusing people enough to
change behaviors, like not getting the COVID-19 vaccine. And it’s a
very lucrative business. Malicious rumors continue to be a massive
challenge in public health, but we aren’t hopeless. There are things
that can be done.

_Note: Disinformation is different than misinformation. Disinformation
is false information which is deliberately intended to mislead.
Misinformation is misleading information WITHOUT malicious intent.
Both are different than healthy scientific debate._

LANDSCAPE

Rumors, stigma, and conspiracy theories related to the pandemic are
everywhere. One study 
[[link removed]]found that in the infancy
of the pandemic (April 2020), they were present in 85 countries and in
25 different languages. The countries with the highest levels? India
followed by the U.S. and China.

Analyses have found 
[[link removed]]that
12 people—coined the “disinformation dozen”—are responsible
for 65% of misleading claims, rumors, and lies about COVID-19 vaccines
on social media. Their impact is most effective on Facebook (account
for up to 73% of Facebook rumors), but also bleed into Instagram and
Twitter. A scientific study 
[[link removed]]published
in _Nature _found that 1 in 4 anti-COVID-19 vaccine tweets
originated from the so-called Children’s Health Defense—which is
controlled by one man.

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Top low-credibility sources. We considered tweets shared by users
geolocated in the U.S. that link to a low-credibility source. Sources
are ranked by percentage of the tweets considered

Bots — or automated accounts on social media used to spread online
disinformation— have been successfully used to manipulate
democracies. They are starting to be used for public health topics,
too, like e-cigarettes and medications.

During the pandemic, research 
[[link removed]]found accounts linking to
coronavirus information from less reliable sites were more likely to
be bots. Another study  [[link removed]]found
that bot activity the weeks before and after the original COVID-19
vaccine roll-out were present for pro- and anti-vaccine content.
However, it was particularly high for anti-COVID-19 vaccines and
highest leading up to the roll-out.

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Percentage of bots by stance by time period. Source: Blane et al.,
2022, J Med Internet Res [[link removed]]

As Georgetown’s Center for Security reported
[[link removed](AI)%2C%20specifically,spread%20false%20or%20misleading%20information.],
amplification of disinformation campaigns will get worse with the rise
of artificial intelligence and machine learning.

Why does it work so well?

False information goes farther, faster, deeper and more broadly than
the truth. One study (published in 2018—before the pandemic) found
false news was 6 times faster at spreading than the truth, reached far
more people, and was more broadly diffused.

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Slide made by Katelyn Jetelina; Data source from Voshoughi et al.,
2018

Why does false news spread so quickly? There are specific tactics 
[[link removed]]used
to ensure that information goes viral:

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_LEVERAGE SOCIAL MEDIA_. Our information ecosystem is very different
than it used to be. We have social media. It's a huge part of how
people get their news and the greatest source of health information
worldwide.

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_EXPLOIT INFORMATION GAPS QUICKLY. “A lie can go around the world
before the truth gets its pants on.” _It takes an order or
magnitude more effort to refute rumors than to invent them (This is
called Brandolini’s Law). Filling the information void quickly is
key. We saw this with the NFL injury, for example.

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_FAIL TO PROVIDE CONTEXT. _Vaccine rumors are intentionally vague.
Specifics are not narrowed down; conditions that may seem the same to
an untrained person, but to a medical professional are entirely
distinct. (Myocarditis is not caused by a blood clot.) Different
hypotheses are blended together allowing proponents to shift from one
to the other when the data doesn’t turn out like they expected.

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_KERNEL OF TRUTH._ Almost all vaccine rumors have a kernel of
truth–something that is true but then distorted, taken out of
context, or exaggerated. For example, VAERS _does _say that more
than 18,000 people have died after the vaccine. However, this is taken
out of context given the surveillance system and post hoc fallacy.

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_SOWING DOUBTS ABOUT SCIENTIFIC CONSENSUS. _This was famously done in
the 1960’s from big tobacco: companies funding sham studies.
Researchers found  [[link removed]]this
tactic was intentionally used with vaccines during the pandemic.

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_EXAGGERATE PARTISAN GRIEVANCES_. Harvard identified
[[link removed]] the most common
narratives of COVID-19 disinformation were “corrupt elites,”
“freedom under siege,” and “health freedom.”

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_PRESENTING FRINGE VIEWS AS MAINSTREAM. _This was dangerously on
display last Friday when the BBC invited a prominent anti-vaxxer on TV
to talk about statins, but instead hijacked the conversation and
pivoted to mRNA vaccines leading to death. This was dangerous because
using airtime from a “legitimate” mainstream media source gives
the rumors credibility. He knew it too, as he continues to tote the
fact that he made it on BBC getting tens of thousands of likes.

Effective

Social media is a domain for manipulating beliefs and ideas. The
danger is that it ultimately leads to real-world actions, such as not
to vaccinate.

The Kaiser Family Foundation found 
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between June 2021 and March 2022, 234,000 deaths could have been
prevented with the primary series of vaccinations.

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The impact of these rumors will bleed into other vaccines. A
recent _MMWR 
[[link removed]]_pape
[[link removed]]r found
only 14 states have ≥95% coverage of the MMR vaccine among
kindergarteners; 13 states have <90% coverage.

The danger is that infectious diseases violate the assumption of
independence. One person’s actions directly impact the person next
to them. We are seeing this in the Ohio measles outbreak, where some
children hospitalized are only partially vaccinated because they
weren’t old enough for the complete series.

Why spread rumors?

_Why would people intentionally push a rumor?_ It’s simple: To turn
a profit. Disinformation campaigns, like COVID-19 vaccines, turns out
to be incredibly lucrative business model. The _Center for Countering
Digital Hate_ outlined 
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clearly. Some examples include:

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Joseph Mercola uses health disinformation to promote the sale of
supplements, books and food. During the height of the pandemic, he
promoted a new website designed to prevent or treat COVID-19 with
alternative remedies. His business has a net worth of $100 million.

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Robert F. Kennedy Jr is the leading anti-vaxxer of the pandemic, as he
owns the Children’s Health Defense. He gained more than 1 million
followers in 2020 and traffic to his website rose sharply in March
2021 with 2.35 million visits.

What to do about disinformation?

Treat it like the public health problem it is: Investment,
surveillance, prevention, intervention. Establish public-private
partnerships. Integrate education into schools, like Finland, who has
started educating their youth
[[link removed]] about
disinformation.

On an individual-level, combating every rumor that pops up will be a
game of whack-a-mole. Researchers have found 
[[link removed]]that
education about disinformation tactics makes people more likely to
reject disinformation. Some examples include:

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Games, like the GoViral
[[link removed]], teaches people how
information is manipulated.

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Creative videos, like by Truth Labs for Education, educating on
different tactics, like scapegoating:

Bottom line

Twelve people are responsible for 65% of disinformation about COVID-19
vaccines on social media. It’s coordinated, effective, lucrative,
and costs lives. This is true during the pandemic and it will be true
for other public health problems. It’s a public health and
biosecurity threat. And we need to treat it like one.

Love, YLE

_“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn
Jetelina, MPH PhD—an epidemiologist, data scientist, wife, and mom
of two little girls. During the day she works at a nonpartisan health
policy think tank and is a senior scientific consultant to a number of
organizations, including the CDC. At night she writes this newsletter.
Her main goal is to “translate” the ever-evolving public health
science so that people will be well equipped to make evidence-based
decisions. This newsletter is free thanks to the generous support of
fellow YLE community members. To support this effort, subscribe
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* disinformation
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* Medical disinformation
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* COVID-19
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* public health
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