| Daily Briefing

'An erosion of the truth': Just how bad is Covid-19 misinformation online?

Several lawmakers are pushing back against Amazon after finding its top products related to Covid-19 and vaccination promote misinformation—an issue that has also plagued other prominent technology companies and websites in recent months.

The 6 biggest Covid-related myths we've seen, busted

Amazon algorithms promote products with Covid-19 misinformation

According to NPR, investigations from academic researchers and journalists in recent months have found that Amazon's algorithms promote books with Covid-19 misinformation, including false anti-vaccination claims and conspiracy theories.

For example, the top result for "Covid-19" and the third result for "vaccine" on Amazon is currently a book by Joseph Mercola, a Florida physician who has promoted several disproven claims about the Covid-19 vaccines, NPR reports.

The investigations also found that many people have managed to bypass rules against promoting false cures in product reviews, such as for ivermectin (an anti-parasite drug for animals) that FDA has expressly warned people not to take.

According to Renée DiResta, who studies misinformation at the Stanford Internet Observatory, "bad actors" can manipulate Amazon's systems to promote misinformation because they can categorize their own books.

"If you write a book about cancer and argue juice cures cancer, you can categorize your book as a cancer book, and it can end up No. 1 in Amazon's oncology section," she said.

In addition, DiResta said that Amazon recommending products to shoppers based on what others have purchased is another area of concern. "The recommender system doesn't have an awareness of what the content is," she said. "It just understands that people searching for certain terms buy certain products. Amazon's business is to sell products."

Lawmakers push back against Amazon

Lawmakers including Rep. Adam Schiff (D-Calif.) and Sen. Elizabeth Warren (D-Mass.) have pushed back against Amazon's practices. Both have sent letters to Amazon's CEO Andy Jassy asking about the company's misinformation policies and its efforts to prevent its algorithms from recommending products associated with Covid-19 misinformation.

In his letter, Schiff wrote, "Amazon is directly profiting from the sensationalism of anti-vaccine misinformation, while these conspiracy theories continue to directly contribute to Covid-19 deaths."

In particular, Schiff said he was concerned that Amazon's content guidelines do not include policies on vaccine misinformation.

While Amazon had previously told Schiff that it "provide[s] our customers with access to a variety of viewpoints," he said this stance "cannot possibly justify the sale of false information that directly endangers your customers."

In her own letter, Warren said Amazon was "either unwilling or unable to modify its business practices to prevent the spread of falsehoods or the sale of inappropriate products."

When Warren's staff searched for products related to Covid-19 or vaccines on Amazon, she said they found several books promoting ivermectin or claiming that vaccines were "making people sick and killing them."

"Collectively, this is an astonishing sample of misinformation that appeared in only a few potential searches relating to COVID-19," Warren said.

In response, Tina Pelkey, a spokesperson for Amazon, said, "We are constantly evaluating the books we list to ensure they comply with our content guidelines, and as an additional service to customers, at the top of relevant search results pages we link to the CDC advice on Covid and protection measures."

A broader 'erosion of truth' online

Several other prominent technology companies, including Facebook, YouTube, and Twitter, have also been criticized for how they have handled health misinformation during the pandemic—which has since become a broad problem online.

According to NewsGuard, a firm that rates the credibility of popular news and information websites in the United States, the United Kingdom, Germany, France, and Italy, more than 500 websites have promoted misinformation about the coronavirus.

Of the more than 6,700 websites analyzed, 519 have published false information about Covid-19, and several were "created to specifically spread misinformation," according to the company. Some of the top 50 Covid-19 vaccine myths identified by NewsGuard include claims that they change people's DNA, lead to infertility, or would create new variants of the coronavirus.

"It's become virtually impossible for people to tell the difference between a generally reliable site and an untrustworthy site," Gordon Crovitz, co-founder of NewsGuard, said. "And that is why there is such a big business in publishing this information."

In addition, NewsGuard found that 339 of the 519 sites promoting misinformation have primarily American audiences—and some have become more popular than trustworthy sources of Covid-19 information.

For example, NewsGuard found that Children's Health Defense, an anti-vaccine advocacy group, received more engagement in the past 90 days than CDC and NIH.

"We've rated all the news and information sources that account for 97% of engagement in the U.S. Of those, 7% are publishing Covid misinformation," Crovitz said. "That's as if 7% of all cereal boxes contained strychnine and the cereal companies said, 'Well, it's only 7%.'"

"What we've seen in the last 20 months is an erosion of trust, an erosion of science, and an erosion of the truth," said Andy Pattison, team lead for digital channels at the World Health Organization's Digital Health and Innovation Department. "And I think that's really scary." (Bond, NPR, 9/9; Funke, USA Today, 9/8)

Advisory Board's take

6 ways health care leaders can fight misinformation

By Pamela Divack and Solomon Banjo

The news about Amazon highlights how misinformation can surpass any given algorithm. The possibility for common online platforms like Amazon to amplify misinformation, even if unintentionally, creates a large reason for concern. Unfortunately, without incentives to fight or stop the spread of misinformation, this trend is likely to continue in the future.

Society as a whole must continue to grapple with the role that big tech plays in health information and stopping the spread of misinformation. In the meantime, there are several ways health care leaders can continue to fight back:

  1. Recognize that Covid-19 misinformation isn’t always just about the virus or vaccines.

    Information about potential city lockdowns, masking, social distancing restrictions, booster shots, FDA and regulatory policies, and/or the availability of treatments for coronavirus, and are also subject to exaggeration or false claims.

  2. Teach patients how to spot misinformation versus fact.
  3. Misinformation can live in various formats and may be masked by facts, quotes, and data from reputable sources. This is often made more complicated when shared by loved ones, trusted figures, or local information sources. As a result, a whole story can seem credible at first, only to discover as you read closely the facts don't add up. However, there are ways to spot it. For example, common sources of misinformation are based on personal stories, not covered in reputable outlets, or are written to generate a strong reaction.

  4. Continue to lean on your role as a trusted messenger and proactively share information with patients.
  5. Providers often serve as a patient's most trusted source of insight. However, in a recent poll from SymphonyRM, 41% of patients lost trust in their doctors amid the pandemic. And among those individuals, just over half noted it was because their provider rarely or never communicated with them about Covid-19. Health care leaders should take these findings as another sign to proactively communicate with patients and proactively distill the facts from the flood of information and misinformation.

  6. Be aware of your role in spreading misinformation amongst clinicians.
  7. As the medical community increasingly turns to social media channels and closed online clinician communities like Doximity, clinicians must weigh the benefits and risks of engaging online in public versus closed communities and carefully consider what they share on online. Moreover, they must assess the risks of online medical debates—for example, about emerging evidence or guidance—spilling out into the public and creating confusion. 

  8. Train your staff to be good “digital citizens”.
  9. Health care organizations must promote guiding principles for clinicians on social media and arm them with tools to identify, report, and counter misinformation. Mayo Clinic, for example, developed the Mayo Clinic Social Media Network to enhance the use of social networking tools among their workforce.

  10. Consider opportunities to work with tech partners like Amazon to combat misinformation.
  11. While today this remains a future goal, health care organizations should assess their role in helping tech companies meaningfully spot and block misinformation. There is a chance for cross-industry collaboration to help achieve a shared goal of preventing the spread of misinformation.







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