timothy caulfield’s quest to quash a pandemic of misinformation

he’s been called an “expert in quackery,” but timothy caulfield, a canada research chair in health law and policy, professor in the faculty of law and the school of public health, and research director of the health law institute at the university of alberta, prefers to be known as someone who “does a lot of research countering misinformation.”caulfield is the recipient of numerous academic and writing awards, a sought-after public speaker, host and co-producer of the award-winning documentary series a user’s guide to cheating death, and an author of several bestselling books, many of which debunk rampant misinformation, including the cure for everything, the vaccination picture, and the science of celebrity…or is gwyneth paltrow wrong about everything?.he spoke to healthing about how canadians can figure out fact and fiction in a world full of fake news, why doctors who spread misinformation are so dangerous and why speaking up matters. 

healthing: you have all these distinguished awards, distinctions and standings as a health science and policy expert, yet you’re also described as an “expert on quackery.” is that a fair assessment?

timothy caulfield: [laughs] i think that’s fair to say. i’ve done a lot of research on countering misinformation — that might be a safer way to phrase it. over the last couple of decades, i’ve done a lot of research exploring how science and health issues are represented in the public sphere. and that has included looking at how to characterize misinformation and how to combat it. our research team helped to develop an initiative called scienceupfirst, which is specifically designed to counter misinformation in the context of covid.

there’s so much misinformation — false information that people spread because they believe it to be true — as well as disinformation, which people spread even though they know it’s false. how can we figure out fact versus fiction?

misinformation really has ramped up over the past couple of years, even before the pandemic. and it has gotten more difficult to tease out what’s real and what’s not real. but people can deploy some very straightforward strategies. first, always pause for a moment and ask yourself, ‘is this accurate? what kind of evidence is being used to support this? is it just an anecdote? is it just someone’s opinion? is it just an observational study?’then ask yourself, ‘how does this fit in the body of evidence?’ after all, we know the body of evidence tells us vaccines work. the other thing you want to ask is, ‘is someone trying to sell me something?’ whether it’s an ideology, a brand or an actual product, that’s a red flag. you definitely want to get a sense of the credibility of the person who is involved in this information. also, fact check. do a quick check to see what other reputable voices are saying about the same topic.

from a health perspective, is there a typical profile of somebody who’s responsible for spreading misinformation or disinformation?

i think individuals who are the source of misinformation fall on a broad continuum. on the one hand, you have individuals and entities that have an agenda. they are purposely spreading what is, in this context, disinformation, because they have intent to spread [information that is false]. and sometimes, the goal is just to create chaos.then you have those who are spreading misinformation because they want to sell a product or build their brand. and there are also those who are maybe selling something that they believe works, so the intention isn’t necessarily to harm — but it’s also a form of misinformation.on the other end of the continuum are individuals who are inadvertently spreading misinformation — they’re just trying to figure out how to take care of themselves, their family, their community [and who] have no malevolent intent.

health professionals who spread misinformation are especially dangerous because they hold positions of authority and trust. what can be done to hold them accountable?

when misinformation comes from regulated health professionals, particularly physicians, it is especially harmful. we know that the general public respects and trusts healthcare providers, and they often have a special relationship with their patients, which gives them more sway. we’ve seen that play out over the pandemic where there have been fringe doctors — and by that, i mean physicians who hold perspectives that are counter to the scientific consensus — who have made strong statements about, for example, [off-label treatments] ivermectin, hydroxychloroquine, or natural immunity and have had an outsized impact on public discourse. i think that those individuals’ messaging needs to be countered on social media and in the popular press. and we have to highlight what the body of evidence actually says on whatever topic they’re referring to.

in addition, we need the professional health regulators to step up, so in canada that means the colleges of physicians and surgeons, and in the u.s., it’s the medical licensing boards. they need to monitor members to make sure that they’re not spreading misinformation.

and then there are celebrities who spread misinformation, intentionally or inadvertently. they’re held to a lesser standard, but people still look up to them.

that’s right. celebrities have a dramatic impact in the spread of misinformation. there was an interesting study from the university of oxford that came out early in the pandemic that found about 20 per cent of the misinformation about covid circulating in popular culture had a celebrity or prominent individual as the source. but 69 per cent of what we, the general public, share on social media comes from us sharing what the prominent individual said. so this really shows how celebrities can play a big role in shaping the public discourse.we’re seeing that right now with [vaccine-hesitant] people like [football player] aaron rodgers and [tennis player] novak djokovic, where they’re really having an impact on what people are talking about. and then there are celebrities like joe rogan, the podcaster, who has done incredible harm by giving a platform to anti-vaxx views [and who ironically tested positive for covid last fall].

then you have a combo of the two in dr. oz. what do you think of him running for the republican senate in pennsylvania?

i just wrote a piece on him in scientific american a couple of weeks ago. dr. oz is another example of a celebrity who is a doctor, the worst-case scenario! he’s spread misinformation for years, even before the pandemic, about diets, detoxes, unproven therapies like homeopathy, and about covid. so i’m not surprised he’s running for the gop. he seems like an individual who isn’t afraid to stretch the truth, which might be an asset when you’re running as a politician. but i’d like to see the regulators in the u.s. hold him more accountable for the misinformation that he’s spread.

and the flip side to the typical profile who spreads the misinformation, is there a typical profile of a person who’s most vulnerable to believing it?

we’re all vulnerable. it’s an incredibly chaotic information environment and it’s easy to fall for misinformation. especially right now — there’s so much uncertainty, there’s fear, people are looking for answers. i understand why people can be drawn into the vortex of misinformation.

and there are communities out there that, for historical reasons, might be justified for having a degree of distrust for particular institutions, and we need to be sensitive about that. but we also know that critical thinking skills matter, education matters. it also matters if the misinformation speaks to your values or your preconceived notions.and lastly, there’s a growing body of evidence to suggest that the spread of misinformation is about ideology. and that’s going to make it more challenging, because once misinformation is about ideology, about your personal beliefs and how you identify yourself, it can be more difficult to change people’s minds.

who’s best equipped to change those minds?

we need to come at this problem of misinformation from every angle. so that’s going to mean more of a regulatory response from health canada here and the fda (food and drug administration) and the ftc (federal trade commission) in the u.s. we’re [also] going to need a greater response from regulators like the colleges of physicians and surgeons, for example.we absolutely need to have more education and teaching, more critical thinking skills and more media literacy. but we also need to get on social media and counter the misinformation. research tells us that debunking is most effective if it comes from a trusted expert. so yes, we need clinicians and scientists and community leaders to be part of that conversation, and we need individuals from the communities that are most affected to speak up — that might be faith leaders, local politicians, teachers.

there was a recent new york times article suggesting that domestic extremism, such as the riot on the u.s. capitol building on january 6, 2021, be treated as a public health issue instead of a security and intelligence issue. what do you make of that?

i sympathize with that perspective, and i’m hopeful that one of the legacies of the pandemic is a growing recognition that the spread of misinformation really does incredible harm. it really is a public health concern, and we need to use a range of tools to fight it. the good news is that we also have growing evidence that tells us that debunking does work, that we can make a difference. the battle is complex and it’s going to go on, i think, for decades, but we are starting to gain an understanding of how best to fight misinformation.

your book, relax: a guide to everyday health decisions with more facts and less worry, was released this month. did you have to update it?

i did. the first version was finished before the pandemic started. i’ve [since] done research on this topic and the [updated version] is very much about misinformation. i have a new afterword that puts the book in the context of the pandemic and the evidence that’s emerged since. thankfully, i didn’t have to change anything. the evidence that’s in the book is all still very relevant — in fact, even more relevant than i ever could have anticipated.

what about your other book, the vaccination picture, especially relevant in light of vaccine controversy surrounding the pandemic?

that was a unique project where we invited artists from all over the world to create art — and by “we” i mean myself and my brother, who is an art professor at the university of alberta — about vaccination hesitancy. it tackles where vaccination hesitancy comes from and what we can do to fight it.but the other reason i’m proud of it is because i think one of the ways we need to come at vaccination hesitancy — and really one of the ways we need to come at misinformation — is to get creative. we need to involve artists, comedians, and science communicators who thrive on social media. we need diverse voices, as many voices and as many creative strategies as we can muster in order to win this very complicated battle.

the rational voice needs to be the loudest and most consistent to overcome the irrational?

that’s right. i think you need to go to where misinformation resides, and research tells us that social media has become one of the most dominant drivers of misinformation. so we have to get on social media with good, trustworthy, shareable content and we try to do that with scienceupfirst, but there are a lot of other great emerging initiatives out there also trying to do that. but the voices that are spreading misinformation are loud and there are a lot of them, so we have got to continue to fight that good fight.

are you optimistic?

this is almost a good news story, in a way, because you have these institutions, the world health organization, the united nations, national leaders from around the world, all recognizing that the spread of misinformation is a serious problem. as someone who studies misinformation, i’ve never seen that kind of momentum before, so i’m hopeful that’s a good thing too.

anything else positive you can leave us with?

yeah, the other thing i think we should recognize is that over the past couple of years, the science communication strategies have been effective. it may not feel like it, because we always hear about these divisions and polarizations, but we have to remember that it was just a year ago where almost 50 per cent of the population was pretty skeptical of vaccines and hardly anyone was wearing masks. and through good science communication, good debunking, and good community engagement, we really turned that around.robin roberts is a writer with healthing.ca. she can be reached here. 

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