By Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDP, Greenwich Health Dept Promotion Specialist
In January 2020, the Trump administration initially declared the U.S. to be in a COVID-19 public health emergency. We were experiencing rapidly rising cases, hospitalizations and death from SARS-CoV-2, the new virus that had emerged from China. We knew little about the virus and less about how to effectively treat it. We’ve been operating under that emergency status, and rightly so, ever since. We’ve had 12 renewals of the Public Health Emergency Declaration, the most recent having been signed into effect on Jan 11, 2023 by Secretary of Health and Human Services, Dr. Xavier Becerra.
Looking at coronavirus figures today, the January decision was prudent. The US has had a total of 104,764,296 cases of COVID-19 since the virus emerged, and we’ve suffered 1,140,015 COVID-19 deaths. Right now there are 1,633,082 active cases in the USA that we know about (Worldometer, 2-12-23); only lab-tested positive cases show up in our reported figures. Many folks home-test and many don’t test at all if they are mildly ill or know that someone in their circle is COVID positive. This significantly skewers our data; our real numbers of active cases are undoubtedly much higher than the figures indicate, and they are high enough already. To look locally, view the tracking figures in the
chart for Connecticut just since January 2023. Connecticut’s case numbers keep rising by the thousands each week, hospitalizations are declining, but look at the numbers of COVID-19 deaths occurring in Connecticut every 7 days (portal.ct.gov, 2-9-23); (ct.gov only records figures every 7 days).
Debate continues on whether or not people should wear masks, about who should get vaccinated, and how many vaccines are enough. There may be a case for how many vaccines are needed, but the fact that vaccines save lives is scientific fact. The public is bombarded with accurate, inaccurate, and for some debased reason, intentional disinformation about all facets of COVID-19, vaccines, and treatments.
The Kaiser Family Foundation (2021) reported that 78 % of US adults believe at least one of the 8 false statements about COVID-19. Two thirds of our unvaccinated adults believe or are unsure about at least half of the 8 untruths put out in COVID disinformation campaigns. Republican responders were found to believe at least half of the 8 false COVID-19 statements. This is three times the number of Democrats who fall victim to that disinformation. Disinformation is not victimless or costless.
At this point in the pandemic, everyone is being called upon to make their own best decision for them and their families, but this is quite a reach when accurate information, unintentional misinformation, and deliberate disinformation (intentional falsehoods and misrepresentations) abound. The issues are confusing and the science complex. Along with bonafide science/evidence-based data is all the “spin” that accompanies the disinformation campaigns. Artful spin adds a false imprimatur of validity to the untruthful information being passed off as truth.
This is why ethical health, science and public health professionals repeatedly direct the public to valid sites such as the CDC, FDA, and State and local Health Departments, along with reputable healthcare institutions, universities, and credible professional journals. The problem with spin is that it is also directed against the long-standing transmitters of facts, so the people one has traditionally looked to for health and public health guidance are also made to look as though they are being untruthful despite the facts, science and evidence to the contrary.
Some of the classic examples of false and misleading information campaigns arose from fraudulent and misinterpreted studies that were tragically believed by some and passed along to multitudes of others, some with good intentions, and others not. Not all “scientific” studies are valid or well-intended. Study design, sample size, how the problem is framed, and the research methodology used are critical. So to, are the knowledge, skill and expertise of the research evaluators. The ethical underpinning of the researchers and others involved in the study must be beyond question. Valid studies are peer-reviewed, (i.e.: evaluated by credible authorities in the field).
Disinformation pulled from bad science intends to misguide people, thus it is far worse than misinformation which can be unintended. It intentionally spreads inaccurate and invalid information disguised as fact. In the case of pandemic diseases such as COVID-19, this costs lives, health, and years of productive life lost because a preventable or treatable disease goes unprevented, improperly treated, or untreated. Some will live with the consequences of becoming infected for many years, as in case of those who now have long-COVID. Consider how many lives were lost early in the pandemic before we had the safe and effective vaccines and treatment approaches we now have. Those who bought into and continue to buy into the false and misleading disinformation campaigns about vaccines being dangerous are in the same boat as those at the beginning of the pandemic before we had life-saving vaccines. Fortunately the Omicron variances of today are less lethal than earlier COVID-19 strains and we have better treatment approaches to help anti-vaxxers despite themselves. But viruses mutate; that’s what they do. What comes down the pike in the future is not yet known to us. Look again at the numbers of people dying from COVID-19 every 7 days right here in Connecticut. Ask yourself if you feel you can afford to internalize disinformation instead of actual facts? There but for the grace of God is anyone of us on that list of the thousand in the country who are still dying each day. That is a verifiable fact, although those dying are more likely to be the elderly, those with underlying health conditions, and those with compromised immune systems.
How is the average citizen today to be expected to separate truth from carefully crafted spin? It is so important that “we the people” put politics and preconceived notions aside and verify the validity and good standing of those who are providing the health and public health information upon which we, the general public, are expected to make critical health care decisions. You basically have only yourselves to rely on now so we all need to act as though our lives and the lives and well-being of those we love depend upon our not getting duped by disinformation.
Sadly to say false and deliberately untruthful COVID-19 information is also being put before the public by credentialed healthcare providers in violation of their codes of ethics. Some of these provocative individuals and groups have been discredited by their professional associations and colleagues both here and abroad. A notable example of this fraud is the intentional misrepresentation of data from VAERS, the Vaccine Adverse Event Reporting System. A well-known newscaster terrified the public by falsely reporting that almost 4,000 people had died after getting COVID-19 vaccines. He touted the VAERS report as his source (VAERS is a government open-access data base). His comment was outright untrue and misleading and resulted in many people fearing they or a loved one would die from a very safe vaccine that could not only save their health and lives, but also protect others from contracting a deadly disease from them (Antivaccine activists use a government database on side effects to scare the public). Anyone can (and do) report all kinds of perceived side/adverse effect of a medication to VAERS, but reporting a death or a side effect says nothing about what actually caused that death or side effect. In this instance, there was no substantiation to the falsehood that 4,000 deaths occurred from COVID-19 vaccines, as the embedded article details. There were three people with an extremely rare blood clotting disease who took the J & J vaccine that died out of the millions who were vaccinated.
Another blatantly deceitful and poorly designed study that continues to serve anti-vaxxer campaigns to this day was the MMR vaccine study done by Dr. Andrew Wakefield and a dozen of his colleagues. This “study” was deemed fraudulent across several countries (The MMR vaccine and autism: Sensation, refutation, retraction, and fraud). A retraction was issued by 10 of the co-authors who admitted that there was “no causal link” between the measles, mumps, rubella vaccine and autism because their data was insufficient and the study was meritless. There were also undisclosed financial interests by the 12 lawyers who funded the study, all of whom were representing the parents of these autistic children in a lawsuit. Only 12 (not random) children were studied and there were no control groups, yet the study concluded, falsely, that the MMR vaccine caused autism (The discredited doctor hailed by the anti-vaccine movement) To this day, numerous parents continue to believe in this denounced but well-financed deception spurred by credentialed physicians and others with a financial interest in the outcome to build a case against the vaccine manufacturer. Numerous children today still go unprotected based on that massive lie that spanned the continents. Measles outbreaks in the US, Canada and the UK were attributed to the resultant high non-vaccination rates of children by parents who believed the lies, and many continue to believe them today, despite the fraudulent study having no merit. Dr. Wakefield was struck from the UK’s Medical Register, but he became a hero in the anti-vaccine movement despite his lies and fraudulent study having been exposed and widely denounced.
Fortunately healthcare associations are coming down hard on the licenses and ability to practice of healthcare professionals who spread these kinds of harmful falsehoods because they adversely affect people’s health and lives, as well as public health. I contend that the same is needed for politicians and others who betray their oaths of office and ethical practice at the cost of other people’s health and well-being.
Ethical Responsibilities of Healthcare Professionals
The American Medical Association and American Nurses Association have come out with strongly worded statements denouncing their members who violate their ethical oaths of practice by spreading disinformation. The actions recommended will hurt unethical health professionals in the pocketbook and in their ability to practice. (See the resources below).
The American Medical Association (AMA) adopted a policy this past June with a comprehensive strategy to stop the spread of health-related disinformation by health professionals. This was undertaken to protect the health of the public, to identify actions that the AMA and other groups could take, including state licensing boards, social media companies, publishers, credentialing boards, state specialty societies and by those who accredit continuing education. This report (AMA adopts new policy aimed at addressing public health disinformation) outlines the many ways disinformation provided by health professionals is directly linked to the promotion of “unproven COVID-19 treatments, false claims of vaccine side effects, and unfounded public health guidance that is not supported by scientific evidence”. Interestingly, their report cited a Center for Countering Digital Hate study that found that two thirds of anti-vaccination social media posts could be traced back to 12 people nicknamed “The Disinformation Dozen”.
The American Nurses Association (ANA) states its mandate that nurses are expected to practice from a science and evidence-based position. This means based on valid scientific evidence that comes out of studies that are validly designed, executed, evaluated and interpreted. If you are going to rely on a study’s outcome, look up the authors and the journal to see if they are credible sources. Some formerly credible people (with valid credentials) seem to have veered down some odd paths. They have been denounced by their peers, their institutions and their professional associations. The ANA notes that with SARS-Co-V-2 being a potentially deadly virus, any nurse who provides the public with misinformation that is not supported by the CDC and the FDA about masks, vaccines, medications, or COVID-19 disease itself, threatens public health because their non-science-based misinformation
can lead to illness and possibly death, and can act to prolong the pandemic. The ANA statement reminds nurses of their ethical responsibility and informs these health professionals that doing so not only places patients and the public at risk, but also may place their own licenses and careers in jeopardy. For 21 years in a row, nurses have been voted in the National Gallup Polls (Nursing Ranked as the Most Trusted Profession for 21st Year in a Row) to be the most trusted professionals with the highest ethical standards of all professions.
Those of us in public health continue to urge you to use common sense when making COVID-19 decisions for you and your families going forth. Consider your own risk factors and the risk factors of those you live and work with, and those with whom you visit; take into account those with whom you will be coming into contact if you plan on being in an indoor group. Wear a mask when it is prudent to do so for your sake, or for the sake of vulnerable others. Consider to whom you may bring the COVID-19 virus if you pick it up, because you may not even know you have it, yet you would still be contagious. You have the option to wear a mask whether or not it is required. Stay home if you are sick. We are still urging people to get vaccinated and boosted and to get their flu vaccines as well. Get tested if you have symptoms, or if you have a known exposure. Remember that COVID-19 home tests only have about an 80% accuracy rate for detecting the virus. If in doubt, get a PCR test.
Resources:
ANA. (2021) Policy Statement: Dissemination of Non-scientific and Misleading COVID-19 Information by Nurses. ANA website www.nursingworld.org
Harmon, G. E. (2021). Flow of damaging COVID-19 disinformation must end now. AMA; Leadership. Flow of damaging COVID-19 disinformation must end now
Jakubeck, K. (Ed.)(2022). AMA adopts new policy aimed at addressing public health disinformation; AMA AMA adopts new policy aimed at addressing public health disinformation
KFF. (2021). COVID-19 Misinformation is Ubiquitous: 78% of the Public Believes or is Unsure About At Least One False Statement, and Nearly a Third Believe At Least Four of Eight False Statements Tested COVID-19 Misinformation is Ubiquitous: 78% of the Public Believes or is Unsure About At Least One False Statement, and Nearly a Third Believe At Least Four of Eight False Statements Tested
(N. A.) (2021) COVID-19 Disinformation. How to Spot It—and Stop It. Union of Concerned Scientists. COVID-19 Disinformation How to Spot It—and Stop It
(N. A.) (N. D). Meeting COVID-19 Misinformation and Disinformation Head-On: The U.S. needs a national strategy to combat health-related misinformation and disinformation. Johns Hopkins Bloomberg School of Public Health Downloaded 2-12-23. Meeting COVID-19 Misinformation and Disinformation Head-On