I wonder if the recent RSV surge is resulting in some infant RSV cases being labeled COVID.
Not long ago, I spoke with a public health official who worked in Florida during their horrific Delta wave. She told me that 27 children died there during that time, and spontaneously volunteered that many people around her claimed that RSV was to blame, not COVID. She had no idea where that pernicious myth originated.
In contrast, I knew exactly where that noxious tidbit of misinformation came from. In August 2021, as the Delta variant ripped through much of the country, Dr. Tracy Hoeg looked at squiggly lines on a graph and wondered aloud on Twitter if incompetent pediatricians were unable to distinguish between the two viruses.
I wrote about her Tweet at the time, not just because it was absurd- yes, pediatricians can test for RSV and COVID- but also because her post gained traction. Had 10 people seen it, I wouldn’t have bothered. However, online influencers propagated her myth, and as I would later learn, it influenced the real world in significant ways. There are countless other such examples. However, this Florida public health official had no clue how the public she served was awash in online disinformation. She was like a relic from 2005 and almost certainly less effective in her job as a result.
Public institutions like the Centers for Disease Control and Prevention, which saw the conspiracy supporters as “just some people online” who didn’t deserve serious attention
Obviously, a core purpose of SBM is to refute medical misinformation. However, it makes no sense to merely care about why misinformation is wrong while being deliberately ignorant about how it spreads and is disseminated. To deny the role of social media in propagating misinformation is a form of germ theory denial, not for pathogens, but for ideas. Misinformation can go viral, after all.
You don’t need to rely on my anecdote above to know this. There is plenty of research showing how social media drives vaccine hesitancy, often at the hands of malign foreign actors. The Center for Countering Digital Hate detailed this in their report The Disinformation Dozen, and Renee Diresta has both studied this in detail and sadly experienced herself how social media mobs can have a real world impact. Her book Invisible Rulers is a must read. You won’t see the world in the same way. According to one review.
In her personal experience and subsequent research, DiResta observed a profound asymmetry of online passion, savvy, and sheer effort, as the influencers and crowds spreading conspiracy ideas out-hustled pro-vax moms, overwhelmed fact-checkers, and surprised public institutions like the Centers for Disease Control and Prevention, which saw the conspiracy supporters as “just some people online” who didn’t deserve serious attention, according to DiResta.
The upshot: an erosion of public trust in scientific experts, government officials like election authorities, and the mainstream media. The path thus was prepared for Russian interference in the 2016 U.S. presidential election and use of online disinformation to accompany a full-scale invasion of Ukraine; more than 200,000 preventable COVID deaths in the United States alone.
We can all lament the power of influencers and algorithms, but those “some people online” cannot be ignored and dismissed any longer. Indeed, a profound asymmetry of online passion, savvy, and sheer effort is partially how we got into this mess. It is not admirable to delude oneself and imagine that this is 2005, where the public is informed by the nightly news and doctors only disagree via mature, professional letters to the NEJM. To pretend that social media didn’t play an enormous role, if not the essential role, in elevating MAHA doctors (and of course Trump himself) is to deny the objective reality of how misinformation spreads. It is therefore fundamentally no different than any other type of denial that we tackle routinely here on SBM.
It matters that MAHA doctors, every single one of them, were social media stars, and people who ignored what they said online missed their threat. I’ve spoken to many offline doctors who, like the public health official from Florida, were clueless about what MAHA doctors said online. They’ve been shocked by what’s happening today. They were totally blindsided. Meanwhile Dr. Hoeg’s genuine skills at spreading doubt and disinformation on social media catapulted her to the FDA, where today scientists listen in “quiet horror” as she spreads her anti-vaccine nonsense there.
This wasn’t just a one way street, either. MAHA doctors didn’t just rise to power via social media, they were profoundly influenced by it in ways they likely didn’t appreciate, something I discussed in my article on audience capture. I am confident that had you told MAHA doctors in 2020 that they would be teaming up with Kennedy to dismantle vaccines in 2025, they would not have believed it. However, over the past few years, MAHA doctors were radicalized by extremists in their own carefully curated social media feeds to embrace disinformation that would have appalled them not long ago.
He’s faced death threats, but that’s not stopping vaccine scientist Peter Hotez
I post my articles on social media because that is the best way to make sure people read them, and my recent writing has sought to explain how the SBM community lost and MAHA won. How did that happen?
We may not want this to be true, but social media is a key part of that story. For this reason, it is not just acceptable for me to discuss the responses my articles generated on social media, it is occasionally necessary. If this includes juvenile mudslinging from other doctors, so be it. Their words are not my fault.
Aside from Dr. Kelly Brogan, I’ve never met or even spoken to any of the doctors I write about, and my criticisms of them were never personal. However they often pretended my critiques were personal- “just asked you to leave me alone”- to distract from the evidence and data I shared. Rather than privately email their disagreements, or even respond in the comments here, my critics used content-free snark and nasty insults to discredit me in the most public way possible, in forums that shape public opinion. They knew exactly what they were doing and where they were doing it. These disingenuous techniques matter, at least to anyone who wants to truly understand the rise of MAHA. While I didn’t enjoy being called silly names, these doctors weren’t attacking me, they were attacking my warnings. As such, my periodic reporting on their juvenile behavior in articles here is also not personal. It is explanatory.
Obviously, I am just a bit player in all this, and my experience is not unique. Anyone who pushed back against disinformation online was subject to a torrent of such bad faith engagement. Many more prominent voices, especially those not of my privileged demographic group, had it much worse. Thanks to social media, vaccine-heroes got death threats, while disinformation doctors were elevated to positions of great power.
It’s perfectly fine not to be on social media- healthy actually- and there are plenty of social media sites where I am absent. However, there is no virtue in remaining willfully blind from a position of haughty superiority about how social media radicalizes people and drives public opinion. Anyone who claims the impact of social media is just “mudslinging“, is only revealing that they missed how we got to this sad moment, and they still don’t know it.
Most importantly, this is all an ongoing process. This is our new reality, like it or not. Perhaps that Florida public health official deserves no blame for not grasping the threat of online disinformation in 2021. However, there is no excuse for such ignorance moving forward. MAHA disinformation agents clearly understand the power of social media, and anyone who genuinely wishes to oppose them moving forward needs to as well.
