In a world of unprecedented access to information and incredible connectedness, everyone is an expert. Public health has been one of the many victims of this phenomenon, yet it is the single most important strategy for managing the global crisis we are in.
The problem with public health is that it is not particularly likable. That has not always been so. Public health used to be really sexy. As the germ theory unfolded in the 1800s, microbiologists and bacteriologists were the most interesting people alive. In contrast, public health today is boring and underfunded. Public health has gone from Brad Pitt to George Constanza over the course of two centuries. For example, the anti-vaccine movement has cast a shadow on a crucial scientific invention, and it is directly responsible for preventable morbidity and mortality around the world. Similarly, the World Health Organization has been notoriously poorly funded relative to other UN agencies and considering its broad scope and indispensable role. Conversely, political and economic interests are disproportionately prioritized in international relations, at the expense of public health (for example, the TRIPS agreement, but many other examples are applicable.)
Early in the pandemic, the WHO and other public health and academic institutions started issuing information about the status of treatments for COVID-19: there were (and are) none. Yet, the news about treatments bloomed on social media, be it antimalarials or homeopathic medications. In Iran, hundreds of people died because they self-treated with methanol overdoses. The problem is so widespread that the WHO created a page for debunking myths on its COVID-19 website. It covers everything from putting hot pepper in your soup to drinking bleach. The misinformation epidemic is not new, but COVID-19 has brought it to the forefront of health-related discourse.
We live in an era of public health defamation, but COVID-19 presents an opportunity to reset how information is received. I propose two strategies that should guide health education in the post-COVID-19 world.
Firstly, teach the public critical appraisal skills. Critical appraisal is an inherent part of producing or reading research. Scholars spend hours on end learning how to analyze the literature, and there are countless tools to help them do so. Critical appraisal aims to identify weaknesses (called biases) in the data, extract reliable information, and minimize the risks of implementing poorly researched interventions to the real world. In essence, critical appraisal is a key element of safe health care delivery. With information available to the public at large, the public should benefit from these same skills as early in life as possible. Fake media is available to our youngest. We should equip them with the tools to critically analyze and make informed, unbiased, scientifically sound decisions.
Secondly, make reliable information easy to access. Google has become such a common source of medical information that it has been dubbed “Dr. Google.” Dr. Google works against public health efforts for reliable information. The current pandemic should be the catalyst for a global movement to prioritize legitimate publications in search engines and widen the availability of high-quality research. For instance, the Cochrane Database is an excellent and free source of information for both the general public and health care providers. Partnerships among public health agencies, academic institutions, internet search engines, and social media would enable information sharing to focus on quality and reliability.
The availability of high-quality evidence, coupled with the skills to appraise it, will result in a more informed public that can face an overload of unfiltered material with calm, resilience, and confidence. We must anticipate the next health crisis and build a society that values science literacy and invests in strong public health. Only by doing so will the public at large appreciate, once again, the incredible value of public health and its undeniable power to provide measured and effective guidance when the world as we know it becomes a dangerous and uncertain place.
Anca Matei is an obstetrician-gynecologist.
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