A modern and busy Minister of Health’s to-do list for infodemic management

• As the world moves past the COVID-19 pandemic, we can take stock of what we have learned about addressing the infodemic that accompanied it and to prepare for the next one.
• IHR(2005) was released before public versions of Facebook or WhatsApp, where infodemic challenges were geographically local. Today, the world needs more than just “rumor tracking” to address the information overload and health misinformation that both communities and health workers experienced during COVID-19 and mpox.
• We have learned that an infodemic, which is an overabundance of information, accurate or not, in the digital and physical space, accompanying an acute health event such as an outbreak or epidemic, can wreak havoc on people’s trust in health systems and on their healthy decision-making.
• We have learned this through the COVID-19 experience, and most recently, mpox.
• We have also learned that infodemics are far more than just misinformation—it is like a severe weather pattern in the information environment, causing information overload and too much information which can include outdated information. It also includes questions, concerns, and information voids, where people seek information but cannot find it.
• The digitized world we live in especially affects how we seek and find health information. During emergencies, our psychology gets altered too. We tend to believe the first thing we hear, we have trouble processing complex information and look for additional information. This is the perfect storm.
• Like a wildfire or hurricane, infodemics are phenomena of the information environment we don’t have a lot of direct control over, but we can minimize harm while it happens, and outside of the emergency, better prepare for them.
• When a health authority, especially in emergencies, doesn’t people’s information and health service delivery needs, distrust can grow and lower adherence to health guidance is likely.
• We need to make it as easy as possible for people to find and act on the health information that can protect themselves and their families. The only way we can do this is to understand the information environment by monitoring and responding to people’s questions, concerns and information needs. This type of infodemic monitoring, just epidemiological surveillance, can a powerful way for health systems to better understand and address potential weaknesses in the public health response.

Here’s what countries can do right now to build resiliency in health systems, society and communities against the harmful effects of health misinformation and to foster a healthier information environment:

1. Fix your health system’s digital footprint. Did you know the majority of people seek health information using their phones and not desktops? How future-proof are your health system’s public-facing websites and social media channels? Are they accessible to people with disabilities? Are they mobile-friendly? Is the content up to date and readable at 6th grade reading level? Do you know how high your country’s MOH website ranks in a Google search and why? Coordinate your health information publication with other authoritative health information sources, such as government health advisory groups, medicines agencies, medical associations, and institutes of public health. Then double check, are they all saying the same thing or are they creating confusion and spurring misinformation because their messages are mixed?
2. Promote new ways of promoting health content. People don’t passively digest health information that is shown to them—find ways of engaging audiences and stakeholders in more fruitful methods of dialogue, question and answer and addressing concerns. This includes working with peer-to-peer programs and finding ways to use chatbots and AI tools to serve more tailored health information more quickly in different contexts to people, patients and health workers.
3. Bake in infodemic management into emergency structures before the next emergency. When an EOC structure is stood up, ask yourself, do we need a better understanding of how the public is understanding, discussing, and acting on health information or misinformation on this topic? Use an information environment analysis to plan for the capacity to rapidly answer all these questions. This also may mean training and resourcing more infodemic managers during pandemic preparedness planning, including building the appropriate networks and SOPs to support their work. Infodemic management as a public health practice and emergency response architecture is also part of the community protection subsystem of HEPR, where is emphasizes promoting an information environment that is supportive of the uptake of health guidance, treatments, diagnostics, vaccines and PHSM. It has also been introduced into preparedness tools such as Preparedness and Resilience for Emerging Threats and Pandemic Influenza Preparedness.
4. Leverage infodemic insights generation in routine for your highest priority health policy areas. Such infodemic insights, which distill those previously mentioned online and offline questions, concerns, information voids, and circulating narratives and mis- and disinformation on a health topic, can inform how a program responds and plugs gaps in the information environment. Some countries have repositioned their pandemic-era capacity for infodemic insights into monitoring seasonal influenza conversations, routine immunization vaccine confidence, tracking sentiment about mental health, breast cancer, and nutrition and deceptive marketing in health. Any time there is a noisy information environment between health guidance and people’s perceptions and behaviors, an infodemic analysis can help understand why.
5. Train health workers on how to communicate more effectively online and offline with people they care for, and address misinformation, and do a better job of protecting them. A key lesson we have learned is how we have not prepared health workers to address the onslaught of health misinformation. They are the most trusted source of health information across countries and cultures globally, and many have become loud advocates for promoting accurate health information. However, they also have been stigmatized, received abuse and suffered online harassment for promoting health. What policies do you have in place to protect your health system staff from online harassment and doxing? If you don’t have a policy yet, now is a good time to start thinking about developing one.
6. Promote digital, information, science and health literacy. We can inoculate the public against misinformation by building their capacity to more critically assess the information they see and how they share it and reduce the spread of misinformation. Investing in promoting these literacies in primary education, as well as in medical and health higher education can pay dividends in the future.
7. Leverage intergenerational information-seeking behavior to protect vulnerable members of society. Older people, people with disabilities, people facing access barriers, and children all face additional hurdles in finding and acting on credible health information, or distinguishing inaccurate information from accurate. People from communities that have been marginalized may also face barriers in getting health information in their language or it provided in an acceptable format. In these instances, emotionally manipulative health misinformation can easily fill the void. In many families and communities, there inevitably are family members who have better tech-savvy or internet access. Some of you who had teenagers at home and know this to be true. Think about who has access to digital tools and resources in families and how they share what they learn with their grandma, or translate for their neighbor. Plan to amplify accurate information and address misinformation through these digital natives.
8. Promote greater transparency and more research in information space as it relates to health. Many technology platforms are cutting down their public safety teams and content moderators, which means that popular online spaces are becoming easier to spread health misinformation, hate and abuse. For researchers, assessing the problem of identifying the scale of online harms and what strategies may be effective in mitigating misinformation is made harder when the same companies severely limit what data is shared with researchers. This means this worrying and growing public health problem can’t be properly researched, leaving us blind to future threats. The advent of AI further underscores the need to reduce biases in algorithms and promote better accuracy and content checks. What you can do now is to promote research collaborations that connect academics and researchers to public health structures and with technology platforms.

Happily, WHO has some tools and resources to help accomplish many of these strategies. This includes:

• Managing infodemics in the 21st century, coedited by WHO staff Sylvie Briand, Tim Nguyen and Tina Purnat. Free Open Access: https://link.springer.com/book/10.1007/978-3-031-27789-4
• WHO/UNICEF How to build an infodemic insights report in 6 steps https://www.who.int/publications/i/item/9789240075658
• OpenWHO infodemic management elearning channel: https://openwho.org/channels/infodemic-management
• WHO competency framework: Building a response workforce to manage infodemics
• WHO EARS – https://www.who-ears.com/#/
• WHO fifth infodemic management conference: steps toward measuring burden of infodemics
• WHO fourth infodemic management conference: advances in social listening
• WHO public health research agenda for managing infodemics
• WHO third global infodemic management conference: Whole of Society challenges and solutions to respond to infodemics
• Whole of society framework for managing the COVID-19 infodemic

I wrote this LinkedIn blog in the summer of 2023, after having been asked for briefing notes several times. Follow me on LinkedIn. if you’d like to read more of my commentaries.