COVID 19: How Do We Flatten The Infodemic Curve?

A year before the COVID-19 was declared a pandemic in March 2020, WHO had warned that vaccine hesitancy was among the top 10 public health challenges facing the world. Vaccine hesitancy - reluctance or refusal to vaccinate despite the availability of vaccines – has over the years, threatened to reverse progress made in tackling vaccine-preventable diseases.

This is despite the scientifically established fact that vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year.

Today, as the first set of COVID-19 vaccines are being rolled out, we find ourselves in midst of another infodemic – which is akin to fast-spreading infectious disease that has the potential to severely hamper the rollout and uptake of vaccines in population and impact the nation-wide COVID-19 vaccination drive. While vaccine hesitancy is caused by several socio-economic and cultural factors, it is also caused by disinformation and misinformation. i.e. an infodemic. And the time to time to arrest potentially negative and dangerous infodemic is impacted on public health is now.

What is an infodemic?

The WHO defines an infodemic as a situation when there is an overabundance of information, both online and offline, and includes deliberate attempts to disseminate wrong information to undermine public health response and advance alternative agendas of groups or individuals.

Furthermore, this can result in threatening health gains made so far due to poor observance of public health measures, thus reducing their effectiveness and endangering countries’ ability to stop the pandemic. Since April 2020, the WHO has already convened hundreds of field experts to help develop a guidance framework and full infodemic management plan that have to be followed by key stakeholders – a country’s authorities, civil society, UN agencies, technology platforms, science, and research tracks, as well as media and journalism.

A Framework to Manage Infodemics

Together, the goal is make calibrated plans and take time-bound action on: strengthening the scanning, review and verification of evidence and information, strengthening the interpretation and explanation what is known, fact-checking of statements and addressing misinformation, strengthening the amplification of messages and actions from trusted actors through to individuals and communities that need the information, strengthening the analysis of infodemic, including information flows, monitoring of acceptance of public health interventions, and factors affecting infodemic and behaviour at individual and population levels and lastly strengthening systems for infodemic management in health emergencies. But this needs deliberate effort and extensive training to harness better results. Simply providing more and more information, or using celebrity endorsements, as is often done, will not be enough. We have to address the infodemic by understanding its specific causes and countering those specific areas.

For example, think about how tech - platforms can be leveraged in this case. We already know that digital information affects people’s behaviour - but this time around we can leverage evidence and metrics for information and communication patterns online, and how they relate to health attitudes and status to our advantage. Information patterns can be shared with public health professionals and policy makers, to help them refine messaging. Take two examples mentioned in recent WHO consultative workshops around Infodemic management. One is from India and demonstrates how we can leverage advanced technologies to fight the infodemic. We are talking about the WASHKaro app - which initially a water, sanitation and hygiene (WASH) intervention, designed to address this problem by matching WHO guidelines to users’ interests. The app was set up to provide users with bite-sized pieces of information authenticated using machine learning and natural language processing to match sources of verified and authentic information, such as WHO reports, against daily news. The app also delivered narrated content in Hindi and English using state-of-the-art text-to-speech engines.

When COVID-19 hit, WASHKaro’s development team decided to provide a full information suite to users, including capacity for contact tracing; a symptom tracker and access to WHO chatbots; access to WHO Myth Busters; and the ability to communicate with other phones running the app and tell users to maintain physical distancing.

While advanced technologies like machine learning can be deployed, it is also crucial to manage information disseminated by appointing spokespersons within right authorities. For example, analysis of COVID-19 information on social media in the Americas suggests that the top influencers are heads of state, not technical organizations. Another insight showed that the hashtags used by ministries of health: roughly half of ministries of health in the Americas are using Twitter, and the hashtags most identifiable as coming from them are not the same as those hashtags most used elsewhere. This raised questions about whether authorities should pivot to use the hashtags most commonly used by others, and/or also come up with a series of hashtags identifiable with the ministries. It would also be beneficial to coordinate the regional and international use of hashtags and ensure constant reference to portals containing real evidence. Further, when communicating, ministries need to understand that not all information is suitable for everyone to comment on, and to know what information to use, from what source, and for what purpose. Active two-way participation with audiences is essential for this purpose—and not only for social media more broadly, but also for interaction and communication in specific conversations.

So far India’s approach to curb the spread of infodemic, during the early phase of pandemic has been proactive: The central government had urged social media players to have in place awareness campaigns on their platforms. Even the Supreme Court issued an order directing media outlets to be responsible and ensure dissemination of verified news only.

The Ministry of Health and Family Welfare also recently launched COVID-19 Vaccine Communication Strategy to build trust and enable greater confidence in the COVID-19 vaccine amongst all people by employing transparency in communication, while also managing any mis/disinformation and rumours around it.

But more still needs to be done to rapidly counter vaccine misinformation and build demand for vaccination. Each state government may consider the key components that can be useful to contain the negative effectiveness of misinformation and rumours in the context of vaccine. This includes a plan to deploy social listening which can help track rumours and misinformation at the field level; develop a library of factual information and, where possible, consult with experts who can help determine whether the information is correct: developing a Standard Operating Procedure (SOP) - to verifying and assessing the impact of misinformation on public trust; regularly disseminate vaccine-pro content through various channels; amplify trusted online voices such as UNICEF, WHO and public health agencies; engage with and sensitize media-persons and broadcasters, at national and sub-national levels, prior to the roll out of vaccination; deploy transparency in risk communication.

Finally, India must learn from other countries who have managed the infodemic systematically. Thailand is good example. When the Thai authorities conducted research in the early phase of the pandemic, they discovered that misinformation was widespread everywhere and had to be countered by official trustworthy sources of information. Furthermore, they felt that managing infodemic went beyond the health sector, and a “whole-of-society approach” was critical to counter misinformation. Since the beginning of the pandemic, the Thai authorities, have lead the communication on COVID via Center for COVID-19 Situation Administration (CCSA) led by the Thai Prime Minister. There have been Live TV daily briefing as an official source of information delivered by the CCSA spokesperson. Transparent, evidence-based, and easy-to-understand messages, guidelines and information have been put out to ensure citizens’ trust and adherence. Finally, government has been working with other actors (government and nongovernment) to amplify the messages and reach the broader audience.

Global studies have already warned that in several countries, current levels of willingness to accept a COVID-19 vaccine are insufficient to meet the requirements for community immunity. In India, today, as the vaccines are being rolled out, the infodemic is getting more severe and we need to urgently launch a systematic counter measure to make sure that one of the most important immunization roll out in history of India’s public health meets its full potential.

(Dr Naveen Thacker is the Executive Director of International Paediatric Association, which examines India’s immunisation program.)