Fake News - At the expense of health

Working Paper No. 24

Disinformation costs money. And sometimes life. Especially in the context of medical topics. This is the fault of those who deliberately spread false information and conspiracy theories. But it is also the fault of those who prepare fertile ground for them. When bad communication shakes trust in experts, medical professionals and political decision-makers, people go in search of their own truth.

Underestimated

Bad communication starts where we underestimate "fake news" and conspiracy theories. Classify them as a phenomenon of a few "lost and confused" people in questionable Telegram groups, rather than as targeted and professionally executed disinformation campaigns.

An example: In December 2020, there was a hack of the European Medicines Agency (EMA). Information from the approval studies for COVID-19 vaccines was stolen, falsified, and published out of context. A targeted cyberattack to undermine confidence in vaccines and cast doubt on official approval procedures. Hardly the work of a few "lost and confused" people.

Excluded

However, the fertile ground for this is prepared by the content of renowned information sources that presuppose extensive and profound general knowledge and/or are phrased in a sterile and complex manner. After two years of pandemic, who can actually define exactly what "7-day incidence" means or explain how "mRNA vaccines" work? Nevertheless, news all over the world report about it as if this was common knowledge. The result: dangerous semi-knowledge. This does not automatically lead to conspiracy theories, but to misunderstandings such as the assumption that a vaccine efficacy of 60 percent means that 60 percent of the vaccinated people are protected while the other 40 percent are not. Such misconceptions and misunderstandings are breeding grounds for disinformation.

This effect is reinforced by the fact that people with comprehension problems feel excluded from complicated, sterile information that is perceived as "elitist". They have the feeling that they are being overreached in discussions that require more profound knowledge. They feel, like they have nothing left to say and, moreover, that they can no longer participate in decision-making. The helplessness they feel in public discussions as well as in conversations with family, friends and acquaintances, leads to a sometimes feverish search for simplified arguments and "alternative" explanatory approaches.

Consequential

The consequences are severe and go beyond obvious effects such as high incidence rates among the unvaccinated. We are talking money, to start with the cost difference between mild and severe COVID-19 courses. With reference to the scientific service of the AOK Bundesverband, WirtschaftsWoche and ZDF put the average cost difference between easy and severe courses per case at 28,800.00 EUR (intensive treatment without ECMO) and 86,600.00 EUR (intensive treatment with ECMO). This is not only a burden on the health insurers, but also on the solidarity community.

Note: The majority of German citizens and residents are enrolled under a public health insurance scheme, which is funded by taxpayers’ own national contributions.  In turn, everyone has access to high-quality and affordable healthcare, regardless of income or status.

With the increasing public debate about "the pandemic of the unvaccinated" and the associated costs, voices calling for higher cost-sharing by the unvaccinated have increased. Fake News and disinformation therefore also raise the danger of progressive desolidarization and thus threaten social systems based solidarity.

Deadly

Serious consequences of disinformation are not limited to COVID-19. A particularly serious impact of disinformation is treatment refusal and/or rejection of preventive and protective measures. For cancer, for example. A study by the Huntsman Cancer Institute, published in July 2021, reported that one-third of the most popular (highest-reach) articles on cancer treatment in social media contain misinformation. The vast majority of this misinformation has the potential to harm cancer patients, because it often supports therapeutic-approaches that can negatively impact the quality of treatment and thus survival.

Avoidable

This is avoidable. Not through legal regulation of social networks, not through censorship or draconian punishments, but through good and better communication.

Particularly in health communications, we need to address relevant yet sensitive topics at an early stage. Missing or faulty communication creates a vacuum that is quickly filled with misrepresentations, half-truths and false conclusions. Vaccination skepticism is not a phenomenon that only emerged with the pandemic. During a pandemic, however, it is difficult to convince vaccination skeptics. In health communication we need to go with the age old medical insight: prevention is better than cure. Precaution begins when we address sensitive and controversial issues early on, inform and educate, and start a dialog before the fronts harden and before others usurp the power of interpretation.

Trust requires the full truth. This includes allowing opposing opinions, respecting concerns and fears, and being open about things on which we cannot yet make a clear statement. Only in this way can we create a basis of trust, that is key for a successful and respectful conversation. Communication is not a one-way street where we provide content similar to press-releases for others simply to consume it. Communication is about sharing data, facts, arguments and opinions. This does not happen if we only communicate superficially, only address the facets we are sure about or if we want to make ourselves unassailable. Nevertheless, holistic and honest communication also means that we clearly distinguish between objective facts and their interpretation. That we discuss different interpretations, opinions and alternative courses of action. That is democracy. However, a common basis of facts is and remains an indisputable prerequisite.

With all the attention paid to lead generation, gender-appropriate language, and legal impeachability, we quickly neglect the content itself. But complicated content needs to be communicated in a short, concise, clearly understandable way. With the multitude of topics and the complexity of a VUCA world, we all increasingly lack the time, the desire and the overview of what information is really important and correct. We cannot and should not have to look up medical terms on Wikipedia. We need "talking medicine" that helps people understand and gives them orientation, regardless of their general education.

Public and honest dialog also means that we tolerate objective criticism as well as unobjective shitstorms. That we stand by our brand, our values and our expertise. Open and efficient brand communication arises where brands appear in public, take a stand on societal issues and make their values and their expertise tangible for the general public. We have to decide whether we want to engage in public dialog all-in, or whether we want to remain just spectators, just bystanders.

This is not the holy grail and by no means a conclusive catalog of measures to put a stop to conspiracy theories and fake news. These are approaches and food for thought, an appeal not to leave difficult and conflict-laden topics to intellectual arsonists. This is anything but trivial. We know that. But we also know from experience that it can pay off. We know that brands with a clear stance are not everybody's darling but have a very loyal base of customers and employees and are therefore much more resilient to crises than their colorless competitors.

Wide-ranging

This applies not only to medical e and health communication, but also to politics, business and NGOs. Targeted disinformation campaigns are not limited to the medical and healthcare market, and we would do well not to take "fake news" and its far-reaching effects lightly and leave the solution to government regulation alone.   

List of sources:

Cyber Peace Institute. (2021). Playing with Lives: Cyberattacks on Healthcare are Attacks on People (p. 61). Available at: https://cyberpeaceinstitute.org/publications/sar001-healthcare/ [last accessed 04.01.2022].

Alvarez, S. (2021). The cost of Corona - and how "nudging" can help. Available at: https://www.wiwo.de/politik/deutschland/92-000-eurofuer-ecmo-beatmung-die-kosten-von-corona-und-wie-nudging-helfenkann/27603280.html [last accessed 04.01.2022].

Johnson, S.B. et al. (2021). Cancer Misinformation and Harmful Information on Facebook and Other Social Media: A Brief Report. Available at: https://academic.oup.com/jnci/advance-