How do we come back from a pandemic of misinformation?

We’ve got two pandemics on our hands: COVID and misinformation. A symptom of this second pandemic is the mistrust of experts. Conspiracy theories have arisen that have led to this mistrust. I’ve lost count of the number of times I’ve been accused of being a tool for “Big Pharma” or some nebulous New World order. I’ve had irate family members of patients whom I was calling to inform of a positive COVID test yelling at me over the phone that I should be ashamed that the medical community has “suppressed” ivermectin as a prophylactic and treatment drug. It’s gotten so bad that at least one spouse of a patient threatened to kill me if their spouse died of COVID. They believed that COVID was a hoax and that if the spouse died it would have been because I didn’t treat them with antibiotics. Between the two pandemics I’ve found the pandemic of misinformation to be much more exhausting. Seeing patients and treating their ailments I could deal with. And after a shift was over I could go home. Misinformation seemed to just keep coming 24/7. Those of us in emergency medicine have all felt burnt out at times, I believe. However, what I was feeling was not just burn out. I couldn’t really identify what I was feeling. Then I was introduced to the idea of moral injury by Dr. Ken Milne. Ken is a huge supporter of FOAMED and runs an excellent podcast called “The Skeptics Guide to Emergency Medicine” so I had started following him as soon as I opened a Twitter account. I read an article he suggested about moral injury and this is precisely what I’d been feeling over the course of the pandemic. Originally, I felt betrayed by the public health officials’ and government’s poor response to the pandemic. These were the folks who were supposed to be helping us prevent individuals from getting sick and supporting our work in the emergency department. Why did it feel that they were acting too slowly and in too lax a manner to prevent disease transmission? Why were emergency departments given, by default, the duty of contacting and educating patients testing positive in assessment centers? Then, not so slowly, it seemed that a significant portion of the population turned on the medical system. It didn’t help that some physicians took the pandemic as an opportunity to raise themselves up as paragons of “freedom.” Also, the sense of entitlement and the overblown sense of knowledge that many people have expressed during the pandemic is really nothing new to anybody who’s worked in emergency over the years—but the frequency and intensity of these encounters has definitely increased. The sad thing is, I don’t think it’s unique to emergency departments, or medicine overall for that matter. It seems to be throughout society. Just look at the Will Smith/Chris Rock incident. Do you think that would have happened in “The Before Times?” About 20% seems to be a recurring portion of the population: 20% oppose vaccines, 20% support the trucker convoy, 20% think Russia is correct in invading Ukraine. I believe that it’s this 20% that is leading to almost 100% of my unpleasant encounters in the ED. I’m sure this 20% was always there, but the circumstances of the pandemic have led to this portion of the population finding each other. The idea that “anti-vaxxers” are just a lunatic fringe has been debunked. They’re coordinated and, to some extent, financed. The best description of their movement has been as a cult. They have their rhetoric and beliefs and, in my experience, cannot vocalize the reasoning behind those beliefs. Logic doesn’t sway them. They distrust the government, experts and traditional media. They place significant trust in alternative media. The use of social media and, consequently, main-stream media has amplified their voices. This has led to their sense that they are able to loudly and, often aggressively, voice their opinion. The flip-side of this is, of course, that 80% of the population still trust the experts and will listen to their advice and be respectful of their opinion. But it often seems as though the vocal minority are drowning out the reasonable majority, to the point that they are driving public policy. Experts, including physicians and scientists, are being marginalized in favour of the screaming, frothing at the mouth 20%. To the point where many experts have been horrendously harassed and threatened with physical violence and even death. Can we return from the state of misinformation? I hope so as I don’t think modern society can function without true experts making important decisions. I certainly don’t have the answers as to how to correct the current situation and I’m not confident that we will. I am confident, however, that without some major shifts in societal recognition of the need for expertise the current climate will serve to accelerate burnout in many areas of our overburdened healthcare system. Dr. Stephen Flindall is a staff emergency physician in York Region.

How do we come back from a pandemic of misinformation?

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