WHO's Next Puzzle: how can 12 people fight fake news around the world?

EXCLUSIVE — The WHO has decided to take on the flood of rumors and false news in epidemics. Within the agency, Dr. Sylvie Briand, Director of Global Infectious Hazard Preparedness, is the central figure. Heidi.news conducted an interview with her at the end of a two-week seminal virtual conference that brought together thousands of participants — researchers, public health experts, funders — from June 30 to July 16. The aim? To establish a new scientific discipline, infodemiology. Interview below.

Heidi.news — The WHO Director-General introduced the term ‘infodemic’ in February to refer to the misinformation epidemic in the wake of Covid-19. What exactly are we talking about?

Sylvie Briand — Infodemic is something that has been labeled at the WHO, but in fact, it has always existed, whether you call it rumors or fake news. Whenever we experience epidemics, from the plague to Covid-19, there have always been many competing interpretations of reality. The only difference nowadays is that we have social networks and communication tools that make it circulate much faster, allowing it to also growing very quickly. And this is no longer just at the level of communities, but globally. From this point of view, it's a new problem.

There is a sense that WHO has become aware of this in the last few months. How has this development come about?

In 2009, after the influenza pandemic, we conducted an evaluation that showed how social networks are an important societal factor in the management of epidemics, but it did not lead to interventions. We simply set up a system to monitor what was happening in social media networks but that was limited. What we're trying to do now is to move from an observational to a more interventionist approach.

I've been in a lot of epidemics — the plague, Ebola, Zika... — and risk communication and infodemic management are key pillars of the response. If it's done wrong, it can undermine all interventions. For example, there were a lot of rumors about Ebola. If the population thinks that Ebola does not exist and was invented by white people to take their organs, all the interventions put in place, such as treatment centers or contact tracing efforts, are doomed to fail. It is very important to hear these perceptions, to discuss them with the population, and to react to them.

Methanol ‘treatments’ for Covid-19 has left 400 dead in Iran

A very telling example is the yellow fever epidemic in Angola in 2016. It was decided that the entire population would be vaccinated. And then there was a rumor that if you were vaccinated, you could not drink beer for a week. We immediately saw a drop in vaccination coverage rates! The men were thinking, "If that's the way it is, I'm not getting vaccinated...". It can have a huge impact on the response, it's not just an epiphenomenon or a funny anecdote.

An example of fake news that has struck you during Covid-19?

One of them played a particular role in our desire to tackle the phenomenon more proactively: the rumor that methanol (a toxic variety of alcohol, editor's note) could treat Covid-19. We've had over 400 poisoning deaths in Iran because of that. We know that all epidemics carry their share of false news about treatment or prevention. Some are harmless or benign, at worst people will lose money, but others are really dangerous. And because of the new means of communication, it affects many more people, some of whom do not have the capacity to analyze and protect themselves from it. All you need is a phone to make a video and it easily goes viral, especially among children.

You have just come out of a two-week conference designed to bring together a community of researchers in infodemiology, a new discipline designed to tackle the problem of infodemia. Your first assessment?

It was very important to bring together people from different scientific perspectives and continents. We quickly realized that it was a bit like the Tower of Babel: everyone comes with their references and ways of thinking. We have people from the social sciences who are interested in change, mathematicians who study the speed of propagation, physicists who work on the analogy between rumors and fluid mechanics, and so forth. One of the first actions was to create a glossary so that we could discuss together, with already 200 terms. It is a bit like our own Esperanto.

We also defined a research agenda for the coming months or years based on four important themes (see box below). The agenda should not be set by the researchers alone. We see it in biology, for example: they could be working on protein x, y or z, which interests them a lot, but the impact on public health is almost nil. We are trying to bring together public health professionals, who have real, concrete questions, and researchers. It's also to make it easier for funders who want to fund research areas.

Four questions on the phenomenon

The WHO conference on infodemiology was structured around four main research questions, which were intended to be the basis for the study and control of an infodemic:

• How can the digital information environment be assessed and monitored?

• How is the digital information environment assessed and monitored? How does erroneous or harmful information originate and spread?

• How does information affect individuals and populations?

• What interventions can be used to limit the effects of an infodemic?

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What about funding?

That is a very important aspect: there is no research without funding. We've brought together a few donors, such as the Bill and Melinda Gates Foundation, which is very interested in this subject, or the United States Agency for International Development (USAID). I think we're going to get very different funders on board as we go along. There's Machado's famous line: "Traveller there is no path, the path is made by walking." That's where we're at right now. We are creating a new scientific field: we know the goal, we know what we want to do, but we don't have the path yet.

One of the things that emerged from the pre-conference was that a viral rumor is based on an attractive narrative, on values and emotions. And that the fight against misinformation is all the more efficient that it relies on these mechanisms. But isn't this a delicate matter for a scientific agency like the WHO?

Yes and no. We think that fake news has characteristics that allow them to circulate fairly easily, but it also circulates when there are communication gaps. One approach is to try to identify and fill these gaps so that they are not filled with false information. There is the amount of information, the adequacy of the information to the concerns, and the form. That's one of our problems as an agency: thinking that providing the information is enough. But it has to be delivered in a useful way, on time, in the right form. We are working on that.

A dozen people fighting fake news from around the world

Along with whose guidance?

There are audiences we would like to talk to in order to better understand their information needs: employers, employees, unions, youth. We are also working a lot with the major religions to develop common guides. We are trying to understand what makes certain ceremonies dangerous and how to transform them. We've done a lot of work on Ebola and the plague in Madagascar. Our information network on epidemics, EPI-WIN, started with webinars for 50 to 200 people [at the beginning of the year] and now we have well over 1000 people, with their networks, in all regions of the world.

How many people are working on these issues at WHO?

I don't dare tell you! There are very few: I have a very small team. At the very beginning of the crisis, there were two people, then I took on people from my department who are no longer very active because of Covid-19, which means that there are now six or seven people. And we recruited about the same number of outside consultants.

You don’t feel too much like Sisyphus by fighting against fake news from all over the world, do you?

We're already trying to generate interest. Our role is to lead the way, and thank God we're not alone. At the moment we're trying to build cooperation, for example with UNESCO, which is connected to many journalists and radio networks, the International Telecommunication Union (ITU), or the International Labour Organization (ILO), which reaches millions of employers.

It's the same with universities: we encourage them to conduct research and share their findings with us. A lot of our time is spent making these connections and connecting the right people rather than doing the work ourselves, which we have absolutely no capacity to do.

Other key players, such as Google, Facebook, Twitter... How is it working with them?

There have been a lot of agreements with these tech giants, which for the moment are pro bono: they're partnering with us for a good cause, let's say. It's important for us to start this way because we don't really know how to work with them yet. For example, we've developed tools to monitor rumors and understand how they are born, grow, and disappear. Some have a lifespan of several weeks, while others disappear within a few hours. We're trying to better understand why and access to databases of web actors is very valuable for that.

"I think the vaccine is going to be a very difficult subject."

With hydroxychloroquine, a medical and health issue has become a political and ideological fault line. Isn't this kind of process a nightmare for the WHO?

It often happens in epidemics, which are health crises but also social crises. Interference with politics is common. It is true that it is a bit disturbing because we are more of a technical agency. We are always a little unsettled when politics interfere, especially at the international level. There are fault lines within countries but also, above all, between countries. That is also why creating a science like infodemiology is useful, to integrate people who are doing political science and questioning the governance of crises. We need to make progress in this area and manage these issues proactively, rather than constantly being reactive.

The Covid-19 vaccines are moving forward at a rapid pace, and so is the resistance to them. Do you anticipate a massive wave of anti-vaccine rumors and messages in the coming months?

I do think the vaccine is going to be a very difficult topic for many reasons. We already have pre-existing fracture lines, we're not going into new territory. For example, we have very strong anti-vaccine movements in some countries, based on the supposed side effects, or in others where vaccines are seen as instruments of colonization that are reputed to cause sterility in women. The risk is that some populations refuse vaccines en bloc when they could save many lives, because of biased, erroneous, or incomplete information.

Afterward, people remain in control of their lives and their health, the goal is not to force them, but it is important to ensure that they have access to information and can form a judgment in favor of their health, not just a cookie-cutter judgment based on emotions or group perceptions.