Fake news and misinformation kill

Evidence is clear that the Covid bundle works

This bundle is a collection of practices such as increasing ventilation by opening windows, physical distancing, wearing a mask in crowded spaces and sanitising your hands, which reduces the number of viral particles you might inhale.

Debates and disagreements are usual in the world of scientific and medical research. We welcome debate among colleagues, and we have rigorous processes like peer review, ethics committees, regulatory oversight, safety boards and double-blind research methods that help to inform our discoveries and ensure that any biases are brought to light.

These processes are not always perfect – the sciences are not immune to fraudsters, media-hungry charlatans, and reckless outsized egos – but agreement on what we know tends to be a self-correcting, iterative process.  And, in general, debate and dissent are not suppressed or controlled.

Over the last few months however, while frontline health workers have been risking their lives (and many healthcare workers have died in South Africa, as have some of their family members) to treat people ill with Covid-19, we have been dismayed at the spread of accusations that we “know nothing about this virus”.

This is simply untrue; a huge amount of new knowledge has emerged since January 2020, and this has built on substantial prior knowledge about this class of virus, as well as the novel coronaviruses responsible for Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). This improved knowledge has had positive effects: For example, the survival rate of people with Covid-19 has improved.

We are even more dismayed at the extraordinary claims that some researchers have falsified evidence or misled public health officials around the best ways to handle this pandemic.The scientists and clinicians in this advisory group live in a world where we exchange data, new research, hypotheses, disagreement, controversy and wild ideas every day.

In fact, research thrives on these debates and disagreements. We have active discussion groups on WhatsApp, where we discuss and critique everything from the government’s approach to lockdown to new understandings of immunology. We represent a wide array of disciplines, which stimulates interesting and challenging discussions, and our research and other collaborations means we are wired into scientific debates from every corner of the globe.

We do not suppress evidence-based dissent. We have seen this during the Covid-19 pandemic already – some substandard or even fraudulent “research results” were published but soon called out and corrected or withdrawn.

There is a strong incentive for scientists to not remain quiet when they encounter poor research. Apart from scientific ethics, one can gain a lot (recognition, research grants, promotion) from publishing valid evidence to the contrary.

When scientific consensus supports a measure such as mask wearing, this is not based on suppressing dissent, but simply expresses the fact that the best available scientific data indicates that wearing masks in public spaces, especially when indoors and when gathering in groups, helps to slow transmission of Covid-19 and protects people who may be particularly vulnerable to infection.

This is not controversial; it is established science and it is best practice.

It is not up for debate.

It is not only pointless to set up debates about this, but it is also an actively harmful fake controversy. We advocate wearing masks, not because we want to make life difficult for the public, but because we are doing our best to save lives and ensure that the virus is contained in the absence of biomedical preventive measures, including prophylaxis and vaccines.

Truth and fiction

There is a famous adage that journalism students are taught: if you have one person telling you it’s raining and one person telling you it’s sunny, you do not just quote them both. Instead, you look out the window and find out for yourself which person is telling the truth.

In this digital age, there are many people claiming it is raining outside when all the scientific and medical evidence tells us it’s sunny. Ordinary people don’t know who to believe, especially when some of those promoting the lies are people with resources and power and hidden agendas. Rumours and misinformation spread quickly on platforms like Facebook or in WhatsApp message groups.

We, as scientific and medical professionals, have a duty to ensure that we communicate scientific fact properly and make this information as widely accessible as possible for all to see. We are bound by professional ethics to make sure that anything we communicate can be defended by evidence, and we try to be transparent about this.

When we don’t know something, we are honour-bound to admit it. And when we do know, we have a responsibility to ensure that we disseminate these findings far and wide in a way that is easily digestible to a wide array of audiences.

This is the essence of public health; to use our knowledge to communicate to the populace and to develop strategies and behaviours to keep people safe and well.

We also have a duty to speak truth to power

Where a government makes poor choices or lapses into secrecy and does not communicate the reasons behind decisions, professionals must call these behaviours out. Where senior media personalities or advocacy groups put us all in danger with misinformation, they must be held to account.

Control of this virus, in some ways more than ever before, demands a collective sense of responsible community – this means we must be critical of those hiding behind cries of “groupthink”, conspiracy theories, or reckless and inexpert interpretation of data.

Scientists who collude with governments to legitimise unscientific approaches have been a feature of many country responses across the globe and need to be challenged.

Tips on how to counter misinformation

We urge the South African public to take this mandate to end “fake news” as seriously as we do. To this end, we encourage every single person to become critically aware of misinformation and fake news, and we recommend the following tips to help:

1. Check the source. Be sceptical of any information that does not come from a credible scientific source. Any scientific research worth its salt will contain references to research conducted by universities and reputable research bodies. If you aren’t sure, check if the source is listed in one of these databases here or here.
2. Ask yourself who is publishing this information and what their agenda might be. Be very cautious of anything that promises “ground-breaking” new developments unless it is being widely shared by well-established and reputable channels. By this, we mean journalists working for established media organisations where they will do fact-checking and have good editors in place. Or journals that have been in publication for a long time, and that provide peer-reviewed scientific articles. There are many websites out there that look credible and have lots of information on them, and that even promise this information is evidence-based, but it only takes a little investigation to show that these are not legitimate and not backed up by honest scientific endeavour.
3. Search engines are your friend. If you have any doubts, enter the name of the person you’re seeing spreading this information or look up the article online. See what comes up, follow the links to the names of those involved and test their veracity. Real medical experts are easy to find online because they participate in publicly available research; they attend conferences with their peers, and they work for credible scientific organisations like universities or public hospitals. Try googling the names of the people who wrote this article.
4. Use the services of established fact-checkers. In South Africa, we have an excellent organisation called Africa Check – their only purpose is to very carefully and thoroughly investigate information in the media and in the public domain to assess whether or not it’s true. They’re doing a great job on Covid-19 too. Find them here. The World Health Organisation offers a WhatsApp service (+41798931892) for updates on fake news.
5. Be alert to emotion. If you receive a video that makes you feel angry, scared or anxious, be very cautious. Evidence-based science might have significant implications but, in most instances, it won’t seek to make you fearful. Be careful to avoid those pundits who whip up emotion in order to make people afraid to follow their doctor’s advice.
6. Just because they wear a white coat, have certificates on a wall or have graphs or statistics doesn’t mean they are a doctor or a scientist.  Just because they speak with calm authority, have lots of papers on their desk and books on shelves behind them, does not mean they are an expert. There are too many people out there claiming to be scientists and some of them are very sophisticated in using props to create an image of scientific integrity.

Use your critical mind to ask yourself the following questions: who is this person? Are they properly trained and accredited? Are they trying to sell a “quack” remedy that makes them a lot of money? Is their message supported by other scientists or professionals that are trustworthy?

A single person spouting a lot of information about Covid-19 that’s not backed up by lots of other credible sources should make your fake news antennae quiver.

1. If a friend or relative, co-worker or community group sends you something about Covid-19 (or any other health condition), ask them where they got it. If they can’t or won’t give you a recognisable source, then it might be fake news. And “my brother’s friend’s cousin” is not a reputable source.
2. Similarly, if you’ve found something interesting online, consider checking its validity before sharing it uncritically with others in your circle. Don’t become an unwitting accomplice to the distribution of unreliable and unhelpful fake news, but rather take a conscious stand in support of evidence-based, reliable public health information. Each of us has a responsibility to take Covid-19 seriously, and it’s only through every citizen actively playing his or her part that we will overcome this pandemic.
3. When considering whether you might be supporting a conspiracy theory, ask yourself how many people would have to be lying or covering up for this claim to be true, and how plausible it really is that this is happening. Even if you think it is plausible that one government could create a fake pandemic for political purposes, is it really plausible that governments all round the world, including democratic and not democratic, libertarian capitalist oriented and social welfare oriented, Western and non-Western, high and low income, could all be promoting a hoax pandemic? Is it really plausible that most scientists in Europe, Asia, Africa and elsewhere are sheeple, subject to group-think, while one person or a small number of people have seen the truth?

Some of the more common myths about Covid-19

“Covid-19 is a scam and there is no virus.”

There is no evidence to support this claim.

The information communicated by the World Health Organisation, National Institute for Communicable Diseases, and the national department of health, as well as from other stakeholders, is reliable and credible.

The new coronavirus (SARS-CoV-2) is totally real.

At the time of writing, there are just under 50 million people globally who have been confirmed to have been infected with SARS-CoV-2. More than 1.2 million people have died of Covid-19.

While comorbidities may present an additional risk to some affected persons, this does not negate the existence or direct impact that Covid-19 has had on the health and lifespan of millions around the world. Some of us are clinicians who have first-hand experience of this virus in the last few months.

We promise it’s real and can be severe and scary – not because we saw it on YouTube, but because we have seen it in our hospitals and clinics, among our colleagues, friends and families.

“Doctors write Covid as cause of death if someone has tested positive, no matter what they die of, whether it is cancer or a car accident, with Covid massively over-reported.”

Absolutely not.

South Africa has one of the world’s best mechanisms for reporting deaths.

There are currently delays (related to lockdown’s impact on paperwork), and cause of death without an autopsy is dependent on the judgement of the health worker filling in the form.

However, in our experience, the cause of death is usually reported with the most obvious cause. In fact, if someone dies due to cancer or in a car accident, where Covid precipitated that death, it is likely Covid is not reported unless very clearly diagnosed, and hence is likely to be under-reported.

Therefore, looking at the numbers of “excess mortality’’ is really important to get a sense of this under-reporting. Check out the MRC’s weekly reports here.

“The World Health Organisation was created by people like the Rockefeller or Gates families to control global health policy.”

No. The World Health Organisation is a specialised agency of the United Nations and was created by the member states of the United Nations. Those driving the Covid-19 response are scientists and public health experts.

The funding of the WHO is completely transparent, although it is under-resourced for its vital public health mandate. Member states contribute to the funding of the WHO. Private charities, such as Rotary International and the Bill and Melinda Gates Foundation, are also major donors.

Some countries – like the United States – have refused to pay their UN dues, which undermines the work of the WHO.

The WHO employs thousands of well-trained, experienced staff from all over the world. Many of the people on this advisory are part of WHO processes, as volunteers. It makes recommendations based on scientific evidence and has been known to revise its recommendations when new evidence comes to light. There is absolutely no evidence we have seen of any conspiracy in the way the WHO operates.

“The virus (SARS-CoV-2) which causes Covid-19 hasn’t actually been isolated in South Africa.”

Not true. A collaborative effort between the University of the Western Cape and Stellenbosch University obtained the first-known laboratory isolate of SARS-CoV-2 in South Africa on 1 April 2020 (see reports here and here).

“The SARS-CoV-2 virus was created in a Chinese laboratory (or by the CIA or the Russians).”

No. We have no evidence of this. We do, however, have evidence that this virus came through infection in animals, a process we have seen before with coronaviruses and others. The facts show us that the virus “jumped” from an animal species into the human population. This virus was not deliberately created in any laboratory. See explanations here and here.

“Covid is no more dangerous than the flu and it is crazy to worry about a disease that is more than 99% survivable.”

How likely you are to die from it is evolving, with a complex interaction of factors including your own health, the health care you have access to and possibly how high the infectious dose was. Some people claim Covid is less dangerous than the common flu and claims of a 99.9 percent survivability rate are promoted by those who think it is grossly exaggerated.

The CDC currently estimates that Covid in the US has a 0.65% infection fatality rate (deaths per person infected); that is six times the flu infection fatality rate of 0.1%. And 0.65% of the South African population is 390,000 people, nearly eight times our current excess deaths in the past months and nearly 20 times our official Covid deaths.

If we took the worst case scenario and assumed everyone in South Africa had COVID, 0.65% IFR would translate into 390 000 peopledeaths, nearly 8 times our current excess deaths in the past months and nearly 20 times our official covid deaths . But we know not our whole population is infected and if we take our current cases, using the CDC IFR this would amount to 50 630 deaths. This is a lot more deaths than we would expect from flu.

Also, comparing your frail granny to a healthy 14-year-old is silly. Your granny’s chance of getting severely ill and dying is far, far higher. If a 14-year-old falls down the stairs, she is likely to be okay, bar a few bruises. Granny is way more likely to get hurt or die. Aggregating their risk does not help anyone.

And this is only considering deaths; we are learning more every day about long-term effects of Covid (explained in our Advisory here) which can be very serious and debilitating, so of course the fatality rate is not the only concern.

“Mask-wearing is controversial.”

Aspects of mask-wearing (for example, the precise degree of protection they provide from getting the virus or stopping transmission) may be a debate, or which kind of mask is the best, but no one reputable now debates whether masks should be a major part of our response (for more advice and science on masks, see here, here, here).

“The vaccines are just a money-making scheme, and are a way to track you/collude with 5G networks.”

This is one of the most pernicious and dangerous falsehoods.

You can trust (see here, here and here) that there are huge checks and balances in place before a vaccine gets on to the market, including from sceptical regulators and scientists reviewing the data on both efficacy and safety. If a vaccine gets offered to you, it means it has been subjected to meticulous scrutiny, and if you read the package insert, you should get a good sense of how effective and safe it is.

Fears that it is linked to tracking mechanisms and weird associations with 5G are false. Worry about your cellphone, your search history, your bank password, and your FaceBook public profile – not about a Gates Foundation-linked microchip in a vaccine.

“Fogging/deep-cleansing/mouthwash (insert your favourite intervention here) will save you.”

These myths crop up everywhere, often promoted by commercial interests trying to make quick money from your fear, or by those who inexplicably enjoy drumming up controversy. The Scientists Collective offers practical guidance here.

We applaud when governments, news outlets and social media fact-check and at times penalise people who spread misinformation, or at least flag that the media being posted is dodgy and that their fact-checking suggests it should be viewed with scepticism.

This is not “gagging’’ or groupthink or censorship – they can tell their stories on endless blogs and social platforms – it is responsible information sharing.

When you have an uncle who thinks UFOs are controlling the world, you may roll your eyes at his Facebook posts but you don’t help him to share his weird theories.

In this time of coronavirus uncertainty, myths and misinformation can be especially disempowering. You can beat that by playing detective – follow the tips we have suggested if you see something that makes you feel uneasy; if it sounds too good to be true, or if it seems to be whipping up emotions in a destructive manner.

Then, if you want to do something about it, report it to Real411.org, an excellent local online resource that can sift truth from fiction. That way, not only will you be helping to combat disinformation, but you will also be helping ensure others are less likely to fall for it. Every little bit helps.

And, in the meantime, please do wear your mask, keep a physical distance and practise regular hand hygiene.

There are, of course, a range of useful sites that we can recommend people visit to check on myths, including:

• SA government here
• The National Institute for Communicable Diseases here
• WHO here
• John Hopkins University here
• Centre for Disease Control (CDC) here
• And, according to the BBC, even Twitter (see here)

This article first appeared in Daily Maverick/Maverick Citizen.

We thank William Bird of the Media Monitoring Project and editor Nicola Spurr for their guidance with the writing of this advisory. The Scientists Collective who collaborated on this piece are: 

• Dr Nomathemba Chandiwana, Dr Simiso Sokhela, Dr Samanta Lalla-Edwards, Dr Bronwyn Bosch, Nkuli Mashabane, Dr Roxanne Govender, Celicia Serenata, Professor Francois Venter, all at Ezintsha, University of the Witwatersrand.
• Andy Gray, Division of Pharmacology, Discipline of Pharmaceutical Sciences, University of KwaZulu-Natal.
• Dr Ndiviwe Mphothulo, primary care specialist
• Professor Shabir Madhi, Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand.
• Professor Lucy Allais, University of the Witwatersrand.
• Professor Wolfgang Preiser, University of Stellenbosch.
• Dr Elijah Nkosi, private practice.
• Professor Shaheen Mehtar, University of Stellenbosch.
• Dr Jeremy Nel, University of the Witwatersrand.
• Professor Yunus Moosa, University of KwaZulu-Natal.
• Professor Wendy Stevens, University of the Witwatersrand.
• Professor Lucille Blumberg, University of Stellenbosch.
• Professor Glenda Gray, University of the Witwatersrand and Medical Research Council.
• Dr Jantjie Taljaard, Tygerberg Hospital and Stellenbosch University.
• Dr Francesca Conradie, University of the Witwatersrand.
• Professor Marc Mendelson, University of Cape Town.
• Professor Morgan Chetty, Visiting Prof Health Sciences, Durban University of Technology.
• Dr Aslam Dasoo, Progressive Health Forum.
• Professor Eric Decloedt, Stellenbosch University.
• Professor Alex Van Den Heever, University of the Witwatersrand
• Professor James McIntyre, Anova.
• Adrienne Wulfsohn, Emergency Medicine Physician, UKZN
• Dr Regina Osih, infectious disease specialist.  
• Dr Angelique Coetzee, South African Medical Association