Doctors Aren’t Just Fighting a Pandemic, but Also an ‘Infodemic’
By Cathy Cassata
With more than 1.7 million confirmed cases of COVID-19 in the United States and more than 100,000 deaths from the virus, physicians face unprecedented challenges in their efforts to keep Americans safe.
They also encounter what some call an "infodemic," an outbreak of misinformation that's making it more difficult to treat patients.
"The most prevailing theme regardless of misinformation on a website or someone sharing a Facebook post is eroding trust. Medical experts and doctors who are trying to help patients, whether in general or in the office, [are seeing] the doctor-patient relationship being broken down over time and especially during this pandemic," Dr. David Stukus, associate professor of pediatrics in the division of allergy and immunology at Nationwide Children's Hospital in Columbus, Ohio, told Healthline.
Stukus says people are having a hard time trying to understand what information is reliable and what information they can trust.
"Oftentimes their personal doctor may give them information that contradicts what they heard online or from someone else, and that really puts the patient in a tough position as they try to determine the best path forward for their own health," he said.
While misinformation online has been around for a while, Stukus says it has increased during the pandemic.
"Previously, there were different focuses of misinformation, such as anti-vaccine groups or conspiracy theorists or unsubstantiated claims about supplements. Now all those different areas are focused on one area, and that's COVID-19," he said.
Dr. Joseph M. Pierre, health sciences clinical professor of psychiatry at University of California, Los Angeles, says the damage that misinformation can have depends on how much people's belief in the misinformation leads to behaviors that increase the risk of infection, worsen the course of the illness, or pose other risks in their own right.
"Most of the evidence falls into the first category: By not observing proper social distancing and not wearing masks, the risk of infection is greater. More cases mean more morbidity and more death and the potential to overwhelm medical resources," Pierre told Healthline.
Lack of understanding when it comes to proper use of masks and personal protective equipment (PPE) for healthcare workers poses a challenge.
"If some people are not wearing masks, but others are stockpiling N95 masks and other PPE, that puts healthcare workers at risk," Pierre said.
When Leaders and Doctors Spread Misinformation
When people in charge of towns, cities, states, and countries spread misinformation, the potential for belief in misinformation to result in policies can have harmful effects.
Dr. Bruce E. Hirsch, attending physician and assistant professor in the infectious disease division of Northwell Health in Manhasset, New York, says an example of this is when President Trump informed the public he was taking hydroxychloroquine as a preventive measure.
"To approach this enormous challenge, we need some intellectual honesty and clarity, and to disregard expertise and to make decisions and model decisions based on hunches is inviting us to handle challenges on the basis of rumor and uninformed opinion. The magnitude of that error is epic," Hirsch told Healthline.
Stukus agrees, noting that the harm of this proclamation is documented.
"Early on when the president touted the benefits of hydroxychloroquine and azithromycin, people started to hoard this medicine, and state boards had to shut it down because they were getting so many prescriptions for this unproven therapy that it was not available for those who truly needed it, such as those who have lupus and autoimmune conditions," Stukus said.
He adds that calls to poison control centers increased after the president suggested using disinfectant to prevent contracting the new coronavirus.
"When people in charge who have large platforms make recommendations regarding treating and/or public health policies, their words absolutely matter because people will follow their advice. It's imperative that they base their recommendations upon evidence and expertise of doctors and other medical professionals," Stukus said.
Same goes for doctors spreading information that's contrary to the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH).
Stukus says as videos and dialogue from naysayer doctors spread on social media, it can be difficult to navigate.
"This is the next wave of misinformation. Certain political ideologies are using doctors to promote their agendas, so now you have someone who is qualified, and maybe they are giving information to counteract the CDC for instance. It's hard to reconcile that," he said.
His best suggestion is to research what studies and data they're sharing. Ensure that the studies are peer reviewed or published, and that the medical experts don't have a financial motive.
"If the source of information is also selling a product and/or service, they are by definition conflicted, so that should be a giant red flag. There are well-established tricks and marketing ploys that people will use often in the realm of pseudoscience where they will offer these explanations that aren't backed by evidence," Stukus said.
"As a general rule, if information is an extreme outlier, it's probably not accurate, or if it sounds too good to be true, it probably isn't," he added.
Listen to Science, Even When it Changes
When recommendations change or evidence flip-flops, skepticism may arise. However, Stukus says change is the beauty of science.
"That shows us that we can evolve, and if the evidence shows that our prior thoughts were incorrect, we need to be able to change our recommendations and advice based upon the best quality of evidence at the time," he said.
"Science is an iterative process, whereby we arrive at facts and truth through repeated and controlled observations. That means that it's inherently self-correcting as we revise conclusions based on ongoing research. Scientific facts aren't immutable dogma chiseled on a tablet. They change based on the best available evidence we have at a given point in time," he said.
Because research of COVID-19 has only been underway for 6 months, information is evolving rapidly, and new information may contradict old.
"There's still much we don't know about exactly how [COVID-19] spreads, what effects it has on the body, or how to best treat it. That means that the best available evidence is preliminary, but that doesn't mean that we should ignore it or turn to other sources of information or opinion as if they're just as valid," Pierre said.
He explains that conspiracy theories based on mistrust lead to vulnerability to misinformation.
If people mistrust science because it sometimes "changes its mind," Pierre said, "that shouldn't be used to embrace other opinions based on no evidence at all, which are typically selected based on confirmation bias: what we want to believe rather than what the objective evidence supports."
Where to Find the Best Information
If you can't find information you need or have questions specifically related to you, call your primary care doctor.
"Your personal doctor should always be a resource for individual specific questions because they know best how to apply all the nuances retaining to your health, and how to incorporate all the other general [COVID-19] recommendations," Stukus said.
Dr. Laura Boyd, primary care physician at Edward-Elmhurst Health Center in Elmhurst, Illinois, says her clinic receives a lot of calls about COVID-19.
"Most doctors' offices are receiving calls and answering questions, and doing phone or video visits to help clarify and/or order testing over the phone based on patients' symptoms. It is always best to call your doctor's office first instead of worrying about symptoms and waiting too long to seek treatment," she told Healthline.
If your primary care doctor has limited testing, she suggests looking on your state's public health website for available testing sites.
With a lot of unknowns related to this virus and disease, Boyd says many patients are feeling overwhelmed and anxious for a treatment.
"Unfortunately, there is no specific medication recommended for COVID for outpatient. There are a lot of ongoing studies with various drugs going on within the hospital setting. Patients should always contact their doctors about their specific symptoms as they can treat the symptoms that go along with COVID, but there is no cure," Boyd said.
While we wait for treatment and a vaccine, Hirsch, who treats patients hospitalized for COVID-19 complications on a daily basis, says everyone can do their part by washing hands, wearing a mask, and staying 6 feet apart.
"As an infectious disease doctor working in the hospital, I see the damage of the pandemic and the worst cases of what's happening. We are trying to get the best possible outcome and confronting this overwhelming biologic reality of this terrible epidemic the best we can," Hirsch said.
Everyone at home can help in the fight too, he adds.
"Follow information that is science- and evidence-based, and avoid that which is not," he said.
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EcoWatch Daily Newsletter
By Mark Hertsgaard
What follows are not candidate endorsements. Rather, this nonpartisan guide aims to inform voters' choices, help journalists decide what races to follow, and explore what the 2020 elections could portend for climate action in the United States in 2021 and beyond.
Will the White House Turn Green?<p>Whether the White House changes hands is the most important climate question of the 2020 elections. President Donald Trump rejects climate science, is withdrawing the United States from the Paris Agreement, and has accelerated fossil fuel development. His climate policy seems to be, as he tweeted in January when rejecting a U.S. Army Corps of Engineers proposal to protect New York City from storm surges, "Get your mops and buckets ready."</p><p>Joe Biden, who started the 2020 campaign with a climate position so weak that activists gave it an "F," called Trump a "climate arsonist" during California's recent wildfires. Biden backs a $2 trillion plan to create millions of jobs while slashing emissions—a Green New Deal in all but name. Equally striking, his running mate, California Senator Kamala Harris, has endorsed phasing out fossil fuel production—a politically explosive scientific imperative.</p><p>The race will be decided in a handful of battleground states, five of which already face grave climate dangers: Florida (hurricanes and sea-level rise), North Carolina (ditto), Texas (storms and drought), Michigan (floods), and Arizona (heat waves and drought). <a href="https://climatecommunication.yale.edu/visualizations-data/ycom-us/" target="_blank">Public concern is rising</a> in these states, but will that concern translate into votes?</p>
Will Democrats Flip the Senate, and by Enough to Pass a Green New Deal?<p>With Democrats all but certain to maintain their majority in the U.S. House of Representatives, the Senate will determine whether a potential Biden administration can actually deliver climate progress. Democrats need to pick up three seats to flip the Senate if Biden wins, four if he doesn't. But since aggressive climate policy is shunned by some Democrats, notably Joe Manchin of coal-dependent West Virginia, Democrats probably need to gain five or six Senate seats to pass a Green New Deal.</p><p>Environmentalists, including the League of Conservation Voters, are targeting six Republicans who polls suggest are vulnerable.</p><ul><li>Steve Daines of Montana, who denies climate science</li><li>Martha McSally of Arizona</li><li>Thom Tillis of North Carolina</li><li>Susan Collins of Maine</li><li>Joni Ernst of Iowa (bankrolled by Charles Koch)</li><li>John James of Michigan (also a Koch beneficiary)</li></ul><p>Republican Senators are even at risk in conservative Kansas and Alaska. In both states, the Democratic candidates are physicians—not a bad credential amid a pandemic—who support climate action. In Kansas, Barbara Bollier faces an incumbent funded by Charles Koch. In Alaska, Al Gross urges a transition away from oil, though his openness to limited drilling in the Arctic National Wildlife Preserve dims his appeal to green groups. He faces incumbent Republican Dan Sullivan, who receives an 8 percent lifetime voting record from the League of Conservation Voters.</p>
Will Local and State Races Advance Climate Progress?<h4>THE CLIMATE HAWKS</h4><p>Under Democratic and Republican leadership alike, Washington has long been a graveyard for strong climate action. But governors can boost or block renewable energy; the Vermont and New Hampshire races are worth watching. Attorneys general can sue fossil fuel companies for lying about climate change; climate hawks are running for the top law enforcement seats in Montana and North Carolina. State legislatures can accelerate or delay climate progress, as the new Democratic majorities in Virginia have shown. Here, races to watch include Pennsylvania, North Carolina, and Colorado.</p><h4>THE CLIMATE POLICY MAKERS</h4><p>Perhaps the most powerful, and most overlooked, climate policy makers are public utility commissions. They control whether pipelines and other energy infrastructure gets built; they regulate whether electric utilities expand solar and energy efficiency or stick with the carbon-heavy status quo. Regulatory capture and outright corruption are not uncommon.</p><p>A prime example is Arizona, where a former two-term commissioner known as the godfather of solar in the state is seeking a comeback. Bill Mundell argues that since Arizona law permits utilities to contribute to commissioners' electoral campaigns, the companies can buy their own regulators. Which may explain why super-sunny Arizona has so little installed solar capacity.</p><p>In South Dakota, Remi Bald Eagle, a Native American U.S. Army veteran, seeks a seat on the South Dakota Public Utilities Commission, which rules on the Standing Rock oil pipeline. And in what <em>HuffPost</em> called "the most important environmental race in the country," Democrat Chrysta Castaneda, who favors phasing out oil production, is running for the Texas Railroad Commission, which despite its name decides what oil, gas, and electric companies in America's leading petro-state can build.</p>
Will the Influencers Usher in a Green New Era?<h4>THE UNCOUNTED</h4><p>The story that goes largely under-reported in every U.S. election is how few Americans vote. In 2016, some 90 million, <a href="https://www.pewresearch.org/politics/2018/08/09/an-examination-of-the-2016-electorate-based-on-validated-voters/" target="_blank" rel="noopener noreferrer">roughly four out of every 10 eligible voters</a>, did not cast a ballot. Attorney Nathaniel Stinnett claims that 10 million of these nonvoters nevertheless identify as environmentalists: They support green policies, even donate to activist groups; they just don't vote. Stinnett's <a href="https://www.environmentalvoter.org/" target="_blank" rel="noopener noreferrer">Environmental Voter Project</a> works to awaken this sleeping giant.</p><h4>THE SUNRISE MOVEMENT</h4><p>Meanwhile, the young climate activists of the <a href="http://www.sunrisemovement.org/" target="_blank" rel="noopener noreferrer">Sunrise Movement</a> are already winning elections with an unabashedly Green New Deal message. More than any other group, Sunrise pushed the Green New Deal into the national political conversation, helping Representative Alexandria Ocasio-Cortez and Senator Ed Markey draft the eponymous congressional resolution. In 2020, Sunrise has helped Green New Deal champions defeat centrists in Democratic primaries, with Markey dealing Representative Joe Kennedy Jr. the first defeat a Kennedy has ever suffered in a Massachusetts election. But can Sunrise also be successful against Republicans in the general elections this fall?</p><h4>THE STARPOWER</h4><p>And an intriguing wild card: celebrity firepower, grassroots activism, and big-bucks marketing have converged behind a campaign to get Latina mothers to vote climate in 2020. Latinos have long been the U.S. demographic most concerned about climate change. Now, <a href="https://votelikeamadre.com/" target="_blank" rel="noopener noreferrer">Vote Like A Madre</a> aims to get 5 million Latina mothers in Florida, Texas, and Arizona to the polls. Jennifer Lopez, Salma Hayak, and Lin-Manuel Miranda are urging mothers to make a "pinky promise" to vote for their kids' climate future in November. Turning out even a quarter of those 5 million voters, though no easy task, could swing the results in three states Trump must win to remain president, which brings us back to the first category, "Will the White House Turn Green?"</p>
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By Tony Carnie
South Africa is home to around 1,300 of the world's roughly 7,100 remaining cheetahs. It's also the only country in the world with significant cheetah population growth, thanks largely to a nongovernmental conservation project that depends on careful and intensive human management of small, fenced-in cheetah populations. Because most of the reserves are privately funded and properly fenced, the animals benefit from higher levels of security than in the increasingly thinly funded state reserves.
Vincent van der Merwe at a cheetah translocation. Endangered Wildlife Trust
Under Pressure<p>Cheetah populations elsewhere in Southern Africa have not prospered over the past 50 years. In Zimbabwe, cheetah numbers have crashed from 1,500 in 1975, to just 170 today. Botswana's cheetah population has held steady at around 1,500 over the same period, but illegal capture for captive breeding and conflicts with farmers and the growing human population are increasing. In Namibia, there were an estimated 3,000 cheetah in in 1975; roughly 1,400 remain today.</p><p>In contrast, South Africa's cheetah numbers have grown from about 500 in 1975 to nearly 1,300 today. Van der Merwe, who is also a Ph.D. student at the University of Cape Town's Institute for Communities and Wildlife in Africa (iCWild), says he's confident that South Africa will soon overtake Namibia and Botswana, largely because the majority of South African cheetahs are protected and managed behind fences, whereas most of the animals in the neighboring countries remain more vulnerable on mainly unfenced lands.</p><p>Wildlife researchers Florian Weise and colleagues have reported that private stock owners in Namibia still trap cheetahs mainly for translocation, but there are few public or private reserves large enough to contain them. Weise says that conservation efforts need to focus on improving tolerance toward cheetahs in commercial livestock and game farming areas to reduce indiscriminate trapping.</p><p>Van der Merwe says fences can be both a blessing and a curse. While these barriers prevent cheetahs and other wild animals from migrating naturally to breed and feed, they also protect cheetahs from the growing tide of threats from humanity and agriculture.</p><p>To simulate natural dispersion patterns that guard against inbreeding, the trust helps landowners swap their animals with other cheetah reserves elsewhere in the country. The South African metapopulation project has been so successful in boosting numbers that the trust is having to look beyond national boundaries to secure new translocation areas in Malawi, Zambia and Mozambique.</p><p>Cheetah translocations have been going on in South Africa since the mid-1960s, when the first unsuccessful attempts were made to move scores of these animals from Namibia. These relocations were mostly unsuccessful.</p>
Charli de Vos uses a VHF antenna to locate cheetahs in Phinda Game Reserve. Tony Carnie for Mongabay
Swinging for the Fences<p>But other wildlife conservation leaders have a different perspective on cheetah conservation strategy.</p><p>Gus Mills, a senior carnivore researcher retired in 2006 from SANParks, the agency that manages South Africa's national parks, after a career of more than 30 years in Kalahari and Kruger national parks. He says the focus should be on quality of living spaces rather than the quantity of cheetahs.</p><p>Mills, who was the founder of the Endangered Wildlife Trust's Carnivore Conservation Group in 1995, and who also spent six years after retirement studying cheetahs in the Kalahari, says it's more important to properly protect and, where possible, expand the size of existing protected areas.</p><p>He also advocates a triage approach to cheetah conservation, in which scarce funds and resources are focused on protecting cheetahs in formally protected areas, rather than diluting scarce resources in an attempt to try and save every single remaining cheetah population.</p><p>"People have an obsession with numbers. But I believe that it is more important to protect large landscape and habitats properly," Mills said.</p><p>He suggests that cheetahs enclosed within small reserves live in artificial conditions: "It's almost like glorified farming."</p><p>"In the long run we have to focus on consolidating formally protected areas," he added. "Africa's human population will double by 2050, so cheetah populations in unfenced areas will become unsustainable if they are eating people's livestock."</p>
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