Since taking over as Peterborough’s medical officer of health last December, Thomas Piggott has used Twitter to talk to his new community, providing updates about the pandemic, encouraging vaccine uptake and pushing back against a groundswell of misinformation related to COVID-19.
So when a small group of people promoting pandemic conspiracy theories once again showed up outside the city’s public health office where he works one Friday last January, Dr. Piggott used the social media site to voice his frustration: “Enough already. Everyone has the right to expressing their beliefs, no matter how wrong they may be. But not at our expense,” he tweeted on Jan. 14.
The next day, the group moved their demonstration to a new location: Dr. Piggott’s house, which he shares with his wife and two small children. The dozen or so individuals left after police arrived.
But a few days later, two of them returned and knocked on the door carrying an empty food container, pretending to bring him a meal as a welcoming gesture. When Dr. Piggott answered the door and realized he was being recorded, they told him he was being served with a cease and desist letter, an encounter they later posted online.
The letter has no legal basis, but the experience left Dr. Piggott shaken.
“I think I would be lying if I said I was okay,” an emotional Dr. Piggott told a media briefing after the protests.
Days before the individuals came to his door, a new federal law took effect making it illegal to harass a health professional – a law that was passed as a result of the growing wave of threats and violence faced by health professionals across the country. Peterborough police charged the pair under provisions of Bill C-3, believed to be the first under the new law.
For Dr. Piggott, the upswing in threatening behaviour – from using social media to spread conspiracies and call him a terrorist, to in-person protests that made their way to his private home – is a major source of worry.
“I was both very shocked and deeply concerned at the escalation,” Dr. Piggott said in a recent interview.
“The passive online negativity and aggression, when it translates to the real world, has real world impacts and consequences on me, on my family and really importantly, on my whole team.”
Dr. Piggott is just one of a growing number of health professionals who have been harassed and abused by individuals promoting false ideas and conspiracies online and in person. They say the rise of health-related misinformation is undermining trust in medical institutions, casting unfounded doubts on vaccines and other scientific advancements and turning health professionals into targets.
The recent suicide of 36-year-old Austrian doctor Lisa-Maria Kellermayr, who was harassed for months by anti-vaccination activists until she was forced to close her practice, has sparked a wave of anger in the medical profession about this problem and the lack of substantive action to deal with threats and abuse.
There have been numerous instances in Canada of health professionals and institutions facing similar attacks and threats. Since the start of the pandemic, Chief Public Health Officer Theresa Tam has been inundated with racist and misogynistic threats from anti-vaccine, anti-science individuals and groups. In February, police arrested James Sears, who was on parole for a prior hate speech conviction, for a video in which he calls for Dr. Tam to be executed.
In February, two Ottawa hospitals, including CHEO, a major pediatric facility, faced bomb threats during the trucker convoy protest. That same month, employees at some Vancouver and Toronto hospitals were told not to wear scrubs to avoid being targeted by anti-vaccine protesters gathered nearby.
Doctors and nurses across Canada say the rise of misinformation and rapid escalation in abusive behaviour from patients and the public are taking a detrimental toll on their mental health and causing some, already exhausted by the pandemic, to leave the profession.
“To be called a liar while you’re working as hard as you can ... it’s just so demoralizing that people are just quitting,” said Gabriel Fabreau, a general internist at Calgary’s Peter Lougheed Centre, who has treated COVID-19 patients throughout the pandemic. “It’s hard to explain how much we’ve seen and how much we’ve been through.”
Ottawa Public Health’s social media feeds earned accolades throughout the pandemic for their clever mix of facts and humour which made otherwise dry messages about the importance of masks, vaccines and other health measures into viral hits, including one bit involving Canadian actor Ryan Reynolds.
But last December, OPH officials had to strike a more sombre tone as they scrambled to debunk a fast-spreading and false rumour that a local child had died after receiving a COVID-19 vaccination.
Alex Munter, president and CEO of CHEO, first learned of the rumour after his inbox began filling with notes from people calling him a murderer.
“Like all lies, it was specific enough to be credible and it was shared on Facebook thousands of times,” Mr. Munter said in a recent interview.
And because of the way social media algorithms work – posts that evoke a strong emotional response tend to get more views, clicks and shares – Mr. Munter doubts that attempts by public health officials to debunk the rumour reached nearly as many people as the original, more shocking post.
“The tools of dissemination are just so much more effective and the social media algorithms are designed to drive those negative interactions,” he said.
Unfounded rumours and outright lies about COVID-19 vaccines for children have become one of the most prominent and damaging forms of misinformation during the pandemic. Research shows this spread of baseless conspiracy theories is causing a significant portion of parents to doubt the safety of COVID vaccines for their kids. A survey conducted by the Angus Reid Institute last October, for instance, found only half of parents planned to get their kids aged 5 to 11 vaccinated, while nearly one-quarter said they would not. The remainder of parents said they planned to wait or weren’t sure what to decide.
Months later, it appears those survey results may have been too optimistic. As of late July, the most recent available data, only 42 per cent of children aged 5 to 11 have received two doses of a COVID-19 vaccine, according to the Public Health Agency of Canada.
“I think social media is directly responsible for the lower rates of vaccination among five- to 11-year-olds,” Mr. Munter said. “We can’t ignore it. It is having a palpable impact on the well-being of children.”
Numerous studies have shown that exposure to misinformation and disinformation – false information that is purposefully deceptive – increases a person’s likelihood of rejecting vaccines. For instance, in a study published in April in the journal Scientific Reports, researchers analyzed millions of geolocated tweets and found that regions with higher levels of online misinformation about COVID-19 vaccines had lower overall vaccination rates.
Nurses and doctors say the spread of conspiracy theories and false information is increasingly turning people against the health care system, causing them to reject vaccines and exposing health professionals to a barrage of abuse.
Eram Chhogala, an emergency and trauma nurse in Toronto, said she’s seen what happens when unvaccinated individuals arrive, seriously ill as a result of COVID-19. On several occasions, she has had to put oxygen masks on people as soon as they arrive at the triage desk because they are having difficulty breathing. Some of those patients told her that, in light of how sick they were, they regret not getting vaccinated.
“People can get hurt, people can get sick,” said Ms. Chhagala, referencing the growing threat of misinformation. “That strains the health care system as well. It’s not that we don’t want to care for people, but what do you do when you have a high volume of people with emergencies?”
Alex Wong, an infectious disease specialist in Regina, said he and many of his colleagues are so exhausted by the polarized rhetoric around mask wearing, vaccines and other pandemic health measures that they’re starting to avoid having those important discussions with patients.
“Frankly, I’m just too tired to actually deal with it the way that I probably should,” Dr. Wong said. “There’s a part of me that doesn’t really want to go back because it was so damaging and so traumatic.”
In Calgary, Dr. Fabreau has treated many patients who have yelled and sworn at him, maintaining their false belief that COVID-19 isn’t real. Often, it isn’t until they’re about to go on a ventilator that the truth hits them, he said.
“There’s this moment. You can see it in their eyes,” said Dr. Fabreau, adding that many of those gravely ill patients then ask for the vaccine. “It’s heartbreaking.”
In a recent interview with The Globe and Mail, Dr. Tam said she is increasingly concerned over the impact harassment and abuse of health care workers is having on those individuals and the implications it has for the system. “It can cause real harm to our workers,” she said. “It results in attacks and harassments of scientists or health workers who are trying to help. That’s really detrimental.”
There’s no clear roadmap for how to combat the proliferation of harmful misinformation. At the same time, purveyors of conspiracy theories and false information are becoming increasingly sophisticated to reach a wider audience.
For instance, many anti-vaccine activists are now casting themselves as guardians of medical choice, said Katrine Wallace, an epidemiologist at the University of Illinois at Chicago, who has focused on improving science communication on social media.
“They’ve started to co-opt those freedom messages because it helps them. It helps them sell their own products,” Dr. Wallace said.
It’s clever new branding, she said, because while it’s easy to debunk anti-vaccine groups’ false claims about the dangers of vaccines, their messages about freedom are palatable to a broad audience and harder to argue against. And it dovetails with right-wing political ideology, Dr. Wallace said, which helps the movement gain influence and clout, she said.
As for what to do next, opinions vary widely. It’s a contentious issue and the source of intense debate. On one side are those, like Mr. Munter, who feel the discord and damage of online misinformation justifies a strong response, such as a government-imposed accountability framework.
But others say such a response could have unintended consequences and that a focus on a broader set of solutions, including working with social media companies to change what posts are favoured by their algorithms, could be the way to go.
“It’s a nuanced conversation that needs a lot of thought,” said Tara Kirk Sell, senior scholar at the Johns Hopkins Center for Health Security, who is starting a research project evaluating responses to misinformation around the world. “If you say social media companies need to block all this social media information, you’re asking them to determine what’s true and false.”
Dr. Sell said part of the challenge is that there’s no real playbook to use as a guide.
“We don’t exactly know what works the best right now,” she said. “The research field is young.”
There are some known strategies to counter misinformation, such as using trusted community voices to deliver public health messages and fact-checking viral rumours, but the scope of the current problem is so big that it warrants a wider, co-ordinated response, Dr. Sell said.
Timothy Caulfield, Canada research chair in health law and policy at the University of Alberta and a leading expert in misinformation, said it’s becoming harder to combat because more people are incorporating conspiracies and false narratives into their personal identity.
“It’s becoming so ideological,” Mr. Caulfield said. “It’s part of their community. It’s part of who they are.”
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