In early February 2020, a British tabloid published an article claiming a British schoolteacher had been cured of Covid-19 by drinking whiskey and honey.
The story was seized upon by social media users. At the same time, widespread use of alcohol-based sanitizers, as a method to prevent the spread of the coronavirus, led some people to believe that drinking high-proof alcohol could help ward off the illness.
In Iran, where alcohol consumption is illegal for Muslims, the results were catastrophic. More than 1,000 people were taken ill and hundreds died of poisoning or went blind after drinking black-market methanol.
Iranian state-backed news outlets publicly debunked the practice. But according to one Iranian doctor, this may have made the situation worse.
“The government tried to stop this,” he tells IranWire, “and people don’t trust the government.”
In a damning report published on April 6, the United Kingdom’s House of Commons foreign affairs committee singled out three countries – China, Russia and Iran – for allegedly spreading false information about the origins and spread of the novel coronavirus. British members of parliament concluded that “Disinformation about Covid-19 has already cost lives”, adding: “The current situation – what the World Health Organization (WHO) are already calling an ‘infodemic’ – has become a major issue in terms of the impact on public health.”
In a special report published in late March, the European Union’s External Action Service (EU/EAS) also highlighted a worrying trend of coronavirus-related disinformation spreading both online and offline. It defined disinformation as “the intentional production and/or dissemination of verifiably false content, spread either for political or financial reasons.”
No crisis occurs in a vacuum, and no pandemic has taken hold before in a world so exposed to contradictory messages on social media, TV and the internet: in other words, in a world so vulnerable to disinformation. In this febrile environment, how seriously can bad data and false narratives impact on public health?
Coronavirus in China: Public Health Catastrophe or PR Campaign Fodder?
The first death from Covid-19, the disease caused by the novel coronavirus SARS-COV-2, was recorded in China on January 11, 2020. But the coronavirus soon escaped China and by March 12, two months later, the WHO formally characterized the spread of coronavirus as a pandemic.
But on January 14 the WHO said on Twitter: “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus identified in #Wuhan, #China.”
Two weeks later, WHO director-general Dr Tedros Adhanom Ghebreyesus praised the Chinese response to the outbreak and said that thanks to Chinese health professionals’ efforts, the number of cases outside of China was “relatively small.”
He added: “There is no reason for measures that unnecessarily interfere with international travel and trade. The WHO doesn’t recommend limiting trade and movement.”
The WHO relies on data and information provided by its member states, and the remarks turned out to be woefully premature. At the time of writing, 1.4 million people are known to be infected with coronavirus across the globe, and more than 80,000 people have already died from a virus now known to be twice as contagious and 10 times as deadly as seasonal flu.
The UK Parliament’s foreign affairs committee also said: “From the outset China has sought to obfuscate the data. Deliberate misleading of the WHO and scientists in other countries obscured analysis in the critical early stages of the pandemic.”
The Chinese government insists that all the data it reports to the WHO is accurate. Dr Elaine Shuo Feng, a China-born epidemiologist at Oxford University, said that without clear evidence the UK Parliament’s assertion could itself be “politically motivated.” “The reporting numbers highly rely on available resources,” she added.
Entire categories of omission, though, are critical. In a report dated March 22, the Hong Kong-based South China Morning Post stated that, according to Chinese classified data, a total of 42,000 asymptomatic cases of coronavirus had been detected by the end of February but not included in the official tally of coronavirus cases, which then stood at about 80,000.
In a joint study, a group of specialists in China, the United States, Britain and Hong Kong estimated that these “hidden” cases were the source of infection for 79 percent of documented cases before Wuhan went into lockdown on January 23. “These undocumented infections ... can expose a far greater portion of the population to the virus than would otherwise occur,” they wrote.
In the same period, an army of online bots originating from China were re-deployed to react to the virus and to spread targeted messages about China’s response. Research by ProPublica shed light on thousands of fake and hijacked Twitter accounts that praised the Chinese Community Party’s response to the crisis and, in some instances, spread disinformation about the origin of the virus.
The EU’s EAS noted that the narratives included: “China and especially Xi Jinping have done an admirable job of containing the coronavirus; the virus did not originate in China; the West instrumentalized the virus in order to harm China” and, elsewhere, that “China is coming to rescue the EU as Brussels abandons EU member states”.
In a follow-up report on April 1, the EAS added that such disinformation has “potentially harmful consequences for public health” by fuelling distrust in countries’ health systems and official guidance. In African countries, it said, “China’s proactive communication around support delivery creates reputational challenges for other donors” which means that vital aid could be obstructed in reaching the areas where it is now most sorely needed.
Iran: Too Little, Too Late
From the outset of the coronavirus outbreak in Iran, officials sought to downplay the seriousness of the virus while trumpeting the healthcare system’s capacity to cope.
Early cases were flagged to authorities in January but not publicly confirmed until weeks later, while officials continued to deny any deaths had taken place from Covid-19 until February 19: two days before parliamentary elections. By March 21, the Health Ministry had reported a total of 20,610 infected people and 1,556 deaths across the country.
Dr Arash Alaei, an Iranian HIV/AIDS doctor living in the US, told IranWire it is hard to gauge the impact of early under-reporting on public health in Iran. But he noted that, according to the Iranian Red Cross, on the weekend of Norooz in late March more than eight million people still travelled across the country to celebrate Iranian new year with their families.
“The government tried to undermine the significance of the virus. Now they’ve changed their minds, people don’t trust them,” he says. “If the government doesn’t share the exact figures, people may not have the right level of sensitivity and concern and go out into the streets. On the other side of the coin, they might protect themselves better” – or, as he and his brother Dr Kamiar Alaei noted, they may also turn to unverified and dangerous remedies touted on the internet.
The Doctors Alaei were arrested and held in Evin Prison, Tehran from June 2008 to December 2010 and August 2011, respectively, while working on harm-reduction programs in the country.
Now based in New York, Dr Kamiar Alaei believes the regime’s shock decision on March 24 to block a delegation from Médecins Sans Frontières (Doctors without Borders, or MSF) from setting up a field hospital in Isfahan could have been an attempt to prevent proper external data collection. The Health Ministry accepted MSF’s donated supplies the next day, but made no mention of its nine personnel.
“These doctors might get a better understanding of the number of deaths and infected cases, which is not what the government wants,” Dr Kamiar Alaei says. “The head of Isfahan Province invited them, but someone interfered, probably on the basis that their reports might be accurate: an accurate number for Isfahan could be generalised for the rest of the country.”
At the time, hardliner followers of Supreme Leader Ayatollah Ali Khamenei were accusing MSF and its staff of being French spies, in posts on social media and in the Iranian press. This followed public comments by Khamanei and ex-Iranian president Mahmoud Admedinejad, promoting a conspiracy theory that the virus was a US-made biological weapon.
For countries minded to refuse external help for political reasons, the stakes are high. Expert modelling the world over has predicted a higher infection rate and death toll in Iran than has so far been published. One Iranian projection assumes a 30 percent attack rate, or 25 million infections. The death toll in this scenario could be 125,000 to 250,000 people - but only if Iran’s ICU bed capacity is increased threefold and 60,000 additional trained personnel are brought in to work in acute settings. If not, the author predicts, some 750,000 Iranians could lose their lives.
Kaveh Khoshnood, a professor of epidemiology at the Yale School of Public Health, told IranWire: “They need to give health experts a platform to speak. We don’t know any country that was fully prepared for this; it’s okay to say you are completely under-resourced and under-prepared.
“The key is to make sure the epidemic is seen as a public health issue, not a political issue. People are making poor decisions based on bad information and it’s costing them their lives.”
Professor Khoshnood said these conspiracy theories could also engender a fresh public health crisis further down the line, if they lead some people to mistrust an eventual foreign-made vaccine.
“Vaccine hesitancy is one of the WHO’s top 10 health challenges,” he says. “There is data suggesting disinformation has led to severe consequences when it comes to vaccination. We need active vaccine preparedness, information and truth-telling so that when a vaccine is available we don’t get a push-back from the public.”
Russia: Disinformation, a Data Whitewash And Arrests
Between January 22 and April 1 the EEAS monitoring team found and logged 150 examples of pro-Kremlin media platforms publishing disinformation about coronavirus, aimed at both domestic and international audiences.
Outlets including RT, Sputnik and Dialog, publishing in Russian, English, Arabic, Spanish, Italian and other languages, have variously claimed that coronavirus is a biological weapon originating in US or Western secret laboratories, that Covid-19 is “fake” and a “common cold”, that gay marriage is the cause of coronavirus and that a constellation of “miracle cures” – from saline solution water to Siberian cedar tree extract – can be used to treat Covid-19.
These messages, researchers claimed, “are characteristic of the Kremlin’s well-established strategy of using disinformation to amplify divisions, sow distrust and chaos, and exacerbate crisis situations and issues of public concern.”
As well as eroding public trust in health systems and encouraging people to not follow medical advice, the messages have undermined the dangers of coronavirus. One e-journal linked to the Kremlin wrote that “When the panic is over, Covid-19 will have killed less people than normal flu”, while other outlets have claimed Big Pharma is exaggerating the scale of the epidemic to ramp up sales.
Speaking to AFP on February 22, Philip Reeker, US Acting Assistant Secretary of State for Europe and Eurasia, said: “By spreading disinformation, Russian malign actors are choosing to threaten public safety by distracting from the global health response.”
At the time of writing, Russia had declared 8,672 cases of coronavirus and 63 deaths in the country. But simultaneously a small study endorsed by Deputy Prime Minister Tatyana Golikova projected that five percent of Russians could already have had Covid-19, with or without symptoms.
Dr George Budny, a Washington-based Russian doctor who claimed asylum in the US in 2014, told IranWire: “As far as I know there are no tests specifically for Covid-19 in many parts of Russia outside of major cities. The process of registering public health statistics prevents recording of data derived from new, officially uncertified testing methods – be it foreign or Russian-made ones.
“I do not have an answer to whether the Russian Ministry of Health is ‘massaging’ public health information in order to prevent panic, or the epidemiological situation is under control,” he added.
On April 3 it emerged that Anastasiya Vasilieva, head of the Russian Alliance of Doctors, was detained by authorities after calling the official figures on infections and mortality rates “lies.” She was arrested while trying to deliver protective equipment to a hospital in Novgorod. It followed the case of another activist, Vyachaslev Egorov, trying to organize a fundraiser to buy masks for doctors at a hospital in Kolomna.
Natalia Zviagina, Amnesty International’s Russia Director, said: “It is staggering that the Russian authorities appear to fear criticism more than the deadly Covid-19 pandemic. They are willing to punish health professionals who expose flaws in the public health system.”
Russian grassroots activist Evgeniya Chirikova, who is now based in Estonia, told IranWire: “There are reports on Russian TV which, like in the days of the USSR, report on excellent hospitals that are well-equipped with everything necessary for the coronavirus. But many hospitals lack protective equipment for medical personnel. At the same time, Russian authorities are trying to shut up activists who are telling the truth about the deplorable state of the healthcare system.”
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