Psychology and politics of COVID-19 misinfodemics: Why and how do people believe in misinfodemics?

Abstract

Misinfodemics related to COVID-19 have negatively impacted people’s lives, with adverse health and psycho-sociopolitical outcomes. As the scientific community seeks to communicate evidence-based information regarding misplaced preventive strategies and misinformed help-seeking behaviors on global multifaceted systems, a secondary risk has emerged: the effects of misinfodemics on the public. Published articles on PubMed, EMBASE, Google Scholar and Elsevier about COVID-related misinfodemics have been considered and reviewed in this article. This review examines the mechanisms, operational structure, prevalence, predictive factors, effects, responses and potential curtailing strategies of misinfodemics of COVID-19. The present article shows that the popular variants of COVID-19 misinfodemics could be the joint product of a psychological predisposition which is either to reject information from experts or perceive the crisis situation as a product of misinfodemics mechanisms and partisan ideological motivations. The psychological foundations and political disposition of misinfodemics have implications for the development of strategies designed to curtail the negative consequences on public health.

The mechanisms of misinfodemics

In this modern era, mainstream and social media have become a primary source of information for people all around the world and thus the risk of misinfodemics surrounding the COVID-19 pandemic is even more challenging to curb. The ongoing coronavirus (COVID-19) pandemic outbreak has highlighted the interconnectedness of the modern globalized world where public health threats can extend far beyond their point of origin due to the unvarying reliance on and misplaced confidence in media platforms. During lockdown, quarantine, self-isolation and social distancing, virtual communication has become the major source of interaction (Holman et al., 2020)

The COVID-19 pandemic outbreak has not only escalated the challenges for healthcare, social, educational, economic, political, environmental, cultural and socioeconomic systems all over the world but also gained momentum in innumerable misinfodemics mechanisms: rumors, myths, superstitions, conspiracy theories, claims, hoaxes, false misinformation, fake news, polarization, mistrust in science in times of crisis, absence of fact checking, misinformation (misleading content, false context, manipulated data, fabricated material, imposter documents) and disinformation regarding the etiology and outcomes, and misplaced prevention of the disease (Mukhtar, 2020a; WHO, 2020).

The COVID-19 pandemic outbreak has saturated the mainstream media which disseminate information on a local and global scale. Similarly, social media platforms have also become an accessible source of (mis)information. Numerous incidents initiated by these rumors have caused several mishaps across the world. For instance, a man took his own life after a positive diagnosis of COVID-19 (India), and people have overdosed on the drug cholorquine after the news about its effectiveness against COVID-19 proliferated (Nigeria) (Busari and Adebayo, 2020; Joe, 2020). There has been a failure to make a distinction between empirically-based scientific truths and fabricated, unconfirmed anti-science conspiracy theories among the general public. Such reports reduce the legitimacy of new scientific discoveries regarding a cure or vaccine for COVID-19. This can also create social stigma, resulting in xenophobia, anti-Chinese sentiment, racism, marginalization, reduced compliance and adherence to quarantine and have adverse health and psychosocial impacts (Aguilera, 2020; Rana et al., 2020a, 2020b). These considerations become even more exacerbated during lockdown, leading people on the fringe of popular opinion to spend ever more time on social media. And as people are trying to make sense of their changed lives, self-proclaimed celebrities, self-identified social media stars, politicians and the mainstream media’s public figures are propagating their own subjective interpretations of events in this situation of COVID-19 pandemic (misinfodemics) (Lederer, 2020).

Scientific studies from previous disease outbreaks have demonstrated that misinformation represents a secondary challenge to public health efforts in controlling an epidemic/pandemic (Earnshaw et al., 2019; Kalichman, 2009). Individuals who endorse misinformation about a disease are less likely to follow public health instructions. During the Ebola outbreak in 2014, respondents who gave credence to conspiracy theories alleged that they would be less likely to seek support during the disease outbreak (National Cancer Institute, 2020). In a 2019 study (Montanaro, 2020) conducted in the US, over 90% of respondents reported trust in medical healthcare professionals, in contrast to a 2020 study, where the majority of respondents reported mistrust in information about COVID-19 from the current administration and mainstream media news outlets (New York Times, 2020).

The psychology of misinfodemics

Fear is an adaptive emotion which serves to mobilize energy towards the potential (actual or perceived) threat (Mertens et al., 2018). However, when fear is excessive then this may have detrimental effects on an individual (mental health problems like anxiety and phobia) and community level (hoarding, panic shopping, xenophobia); when fear is insufficient then this may also cause harm for both the individual (incompliance and non-adherence towards quarantine and isolation) and community (reckless implementation of policies that ignores risks to the socioeconomic infrastructure). Likewise, interpersonal safety measures can mitigate certain threats (transmission of disease) but can paradoxically enhance fear (fear of transmission, excessive health anxiety and psychosocial issues). Similarly, social safety measures (lockdowns, curfews) help to control the transmission but prolonged and stringent measures could have negative consequences (socioeconomic impact, mental health impact).

Efforts to curb the misinfodemics process have increased because of its adverse effects on public health communication and to encourage the adoption of sustainable preventive measures, to manage social and physical distancing, psychological health and resilience in socioeconomic conditions, and to address stigma, prejudice, discrimination and inequalities (Mukhtar, 2020b). Among the various factors of psychological vulnerability (Mukhtar, 2020c; Mukhtar and Mahmood, 2018), a propensity to follow popular opinion, excessive social media presence and a predisposition to anxiety and fear lead to uncertainty, intolerance, and unpredictability. Coronavirus brings high levels of uncertainty and the inability to cope with uncertainty is exponentially higher causing anxiety, fear and health-related worry. This situation is exacerbated by the exposure to a plethora of information (including misinformation and disinformation) about the impending threat, from mainstream media and social media alike (Rosser, 2019). Perceived threat information elevates fear, and repeated engagement with trauma-related media content for several hours daily culminates in acute stress and emotional distress and consequently will either increase the fear of the virus, or cause insensitivity towards its course.

Identification and monitoring of the internet’s ‘centrifugal clarification’ to filter the accuracy of content has become more challenging as an increasing number of people rely on social media platforms. One of the challenging problems of misinformation, disinformation and conspiracy theories on social media is the way they emulsify into false, misleading and click-bait content. The World Health Organization (WHO) launched a ‘mythbuster’ feature on its website as a countermeasure to the spread of unauthentic news on social media. People who reported the highest media exposure reported higher acute stress (Holman et al., 2020). Media exposure accumulates ever emerging threats and repeated exposure to these events increase the symptoms of distress. Worry, fixation, herd mentality and misplaced conviction make people more vulnerable to media exposure distress.

Alongside the amount of media exposure, the type and content of exposure matters as well – exposure to tragic events, graphic images, conspiracy theories and violence could instigate posttraumatic stress and fear of the future which will lead to poor personal functioning. In recent years, the mainstream media (electronic, print and social media) have established themselves beyond one government-run channel and the global population has developed an affinity for the news channels in particular. While the older population mainly relies on more traditional news channels, youth look to social media such as TikTok, Instagram, YouTube, Twitter, Facebook and WhatsApp. Social media have become a new conduit for spreading rumors, deliberate misinformation, disinformation, conspiracy theories and personally motivated anecdotes to appeal to followers and attract attention and create panic (Liang et al., 2020). Some self-proclaimed celebrities and media stars have become so influential that a large number of people rely solely on their content (Merchant, 2020). Some social media ‘posts’ are circulating on many platforms and are endorsed by multiple social media account users to encourage optimal personal functioning, maximum productivity, business-oriented activities, and downplaying the intensity of this traumatic event. Certain posts like ‘if you don’t come out of this quarantine with a new skill, your side hustle started, more knowledge, then you never lacked time, you lacked discipline’ circulating on various social media accounts, prompting people to utilize their time in learning new things and skills, exacerbate the worry for already anxiety-prone individuals and place psychological pressure to be productive. Rather, messages like ‘if you don’t come out of this quarantine with a new skill, your side hustle started, more knowledge, then you are doing just fine’ should be disseminated on social media, for individuals to realize that during such an intense traumatic event not everyone is equally endowed with the strength, coping strategies and problem solving skills to transform trauma into a positive emotion, which is okay and not a source of shame and guilt.

There is a coercive impression percolating among individuals regarding the lockdown that people should not assume it is a holiday, but that they must utilize their time productively and engage in occupational or academic activities. This psychological pressure has further aggravated feelings of guilt, shame, regret, sadness, self-pity, anger, internalized emotions, being overwhelmed, negative self-talk, unrealistic expectations and a perceived sense of failure (see Mukhtar, 2020a, 2020b). The psychological pressure to compete with peers in achieving a maximum of tasks, producing occupational and academic outcomes, harnessing a herd of followers and subscribers on one’s media accounts, and downplaying one’s own trauma and that of others will have devastating effects on mental wellbeing.

Lockdown resulting in self-isolation, quarantine and social distancing is far removed from normal leisure time that might be utilized for improved personal functioning – it is a collective traumatic event which poses a serious threat to people and has resulted in a huge loss of lives and displacement for many individuals (Mukhtar and Mukhtar, 2020; Mukhtar and Rana, 2020). COVID-19 is an individual and collective traumatic event and directly or indirectly has affected every individual in the world. All efforts should be directed towards minimizing the negative effects of this traumatic COVID-19 pandemic on ‘survivors’. Many people are going through interpersonal traumatic events in addition to the collective trauma of COVID-19: domestic violence (gender-based violence), abuse (Mukhtar, 2020d), financial burden, loneliness, emotional and behavioral problems, grief and bereavement, fear of losing family, mental health issues, physical injuries or fatalities .

Isolated people facing psychological issues require trauma-focused psychological support (mental health care, psychological support, guidance, treatment, intervention and information) such as psychological cyber-counseling, via one’s smartphone for instance, and mental health hotlines. Professional help-seeking behaviors should be encouraged and endorsed and related barriers like stigma, marginalization, discrimination, shaming and phobias should be discouraged through government-driven programs and evidence-based treatment models.

Emerging pandemics command the intellectual incapacity of decision-making (a degree of irrationality) when bombarded with conflicting opinions and conspiracy theories and thus the empirical interpretation of origins and impacts result in moral judgments based on religious and cultural beliefs. The emergence of HIV/AIDS garnered a plethora of moral judgments orbiting around sexual morality and substance abuse; the arrival of SARS saw blame directed towards primitive farming practices in Guangzhou; and the unprecedented COVID-19 pandemic has welcomed a magnitude of misinfodemics on a multitude of fronts (Ophir, 2018; Richtel, 2020). A psychological predisposition to reject authorized information through denial as a byproduct of deep founded mistrust, and the tendency to view major social and political events through conspiracies and partisan motivations as a byproduct of conspiracy thinking are the likely explanatory factors in understanding ‘why’ and ‘who’ believes in COVID-19 misinfodemics. The association between conspiracy thinking and defense-mechanism denial could be a potential reason for the refusal of corrective actions in several health-related cases (Carey et al., 2020). Misinfodemics could be motivated by various factors – an epistemic desire for causal explanation and subjective certainty, or an existential desire for control and security, or the social desire to maintain a positive image of the self or group (Douglas et al., 2017).

Stigmatization, labeling, scapegoating and fear swiftly follow with a narrative which invokes the vernacular of human conflict – waging war against a killer virus, an indomitable invisible threat, an enemy armed with no-vaccine flinging victims in quarantine camps – losing a sense of proportion and the ability to mitigate fear and use reasonable knowledge-based measures to challenge and normalize the perceived threat of infection. The mechanism of misinfodemics is engrossed in silos of public information which is inept at limiting risks (Wald, 2008), for instance: the social theme focusing on socioeconomic disruption; the scientific theme focusing on medical and health risk communication; and the pandemic theme focusing on state and global response. Populations most likely to be affected by an emerging disease pandemic and a simultaneous misinfodemics include those where there is a disproportionally low or inadequate health literacy, disadvantaged socioeconomic groups, migrants, ethnic minorities and vulnerable groups including older people, people with chronic health conditions and people with disability (Mukhtar, 2020e; Rowlands et al., 2015).

The politics of coronavirus

Conspiracy theories heavily influenced by geopolitics have spread regarding the origin, scale, prevention, treatment and self-diagnosis of the disease: of COVID-19 being a viral bioweapon genetically engineered by a rogue government with a racist and genocidal agenda to wage an economic and psychological war – the Chinese biological weapon conspiracy theory (which has spread throughout the United States, United Kingdom, India and Ukraine), or the US biological weapon conspiracy theory (spread throughout Russia, Iran, China, the Philippines and Venezuela); a plot by Muslims, or a plot by Jews; espionage; a population control scheme; and medical misinformation (vaccine’s pre-existence, cocaine cure, African resistance, 5G, vegetarian immunity and methanol use) and other views endorsed by presidents, governments and public figures abound, causing misinfodemics of incorrect information about the virus, etc., which poses risks on a global scale (McCarthy, 2020).

Meanwhile, COVID-19 could be positively viewed through the partisan lens of right-wing nationalism and the pandemonium of allegations. Coronavirus is a gift for the politics of misinfodemics, censorship and pathological nationalism. A multitude of governments have ‘introduced’ a policy of blame-shifting by launching their power-rivalry statements revolving around illogical reasoning and a narrative of national immunity towards COVID-19: in the US there are claims of a ‘biological weapon against the Western world’, ‘Chinese experiment gone wrong’, ‘China as equivalent to USSR-level threat’ and the most infamous ‘Chinese virus’; Italy has accused migrants from Africa as the disease carriers to its shores; in France, Hungary and the UK there is the narration of a correlation between immigrants and coronavirus (reminiscent of the influx of migrants from war-inflicted countries in 2015 and the so-called border crisis); European right-wingers declare the ‘enemy has not changed, it is migrants’. And so the convergence of two crises aggravates mistrust in scientific, political and economic bodies around the world. These narratives imply through a heavily nuanced differential discourse that their countries are immune to coronavirus and they would not have contracted COVID-19, or could manage it effectively, if only for the absence of immigrants (McCarthy, 2020).

COVID-19 has provided rich fodder for Europe’s nativist populist tune to further incite the clamor to bar immigrants and building walls/closing borders, to anti-immigration policies. Public opinions are shaped by the landscape of media, scientific bodies and the frameworks of governments and thus such obstinate prejudice and confrontations ignite de-globalization, nationalism, nativism, protectionism, tariffs, closed borders and erection of walls which will intensify the COVID-19 pandemic outbreak.

In Pakistan, a research study conducted by IPSOS revealed that 82% of people in the country believed that performing ablution will keep them protected from transmitting coronavirus, and others believed that congregation prayers and shaking hands cannot infect anyone since it is Sunnah (SAMAA, 2020). Claims circulating about Pakistanis’ resistance to coronavirus were quite prevalent as they were backed by Pakistan’s relatively low mortality rate. These rumors argued that Pakistan’s culture, religion, geographical location and climate made Pakistanis less vulnerable to the virus. In India, political activists claimed that drinking cow urine and applying cow dung to one’s body can cure coronavirus; a parliamentarian claimed that saying Namaste instead of Arab greetings prevents the contraction of coronavirus; an influential film celebrity claimed that vibrations generated by clapping and blowing conch shells will kill the virus; a self-proclaimed TikTok media star’s claim about eating a poisonous fruit as a preventive measure hospitalized 11 people; and an ‘anti-coronavirus drug’ and ‘anti-coronavirus mattress’ have been quite prevalent. For example, a popular myth in various countries is that home remedies can cure or prevent people from contracting coronavirus. One of these rumored remedies that has gained traction on social media (with severe, adverse effects) involves mixing sodium chlorite solution with citric acid, producing chlorine dioxide – a powerful bleaching agent – claiming antimicrobial, antiviral and antibacterial benefits. Similar phenomena were observed all over the world, which may have prolonged the health, psychosocial and economic consequences of COVID-19 among the general public (Shu et al., 2017).

It becomes more difficult to limit the negative impact of misinfodemics especially when partisanship can be mobilized in this effort. There could be three strategies to overcome these negative effects: (a) prevention strategies – to limit the aim and spread of, or exposure to misinfodemics; (b) corrective strategies – founded in scientific and empirical knowledge to challenge these predispositions, their effects and subsequent belief system and reduce uncertainty, increase perceived control and promote self-image; (c) collaborative strategies – corrective strategies can be efficacious if other political and social agents can be activated and mobilized to override partisan, ideological motivations and misinfodemics tendencies. When politics and the media promote misinformation, likeminded individuals exposed to this rhetoric are more likely to follow elite cues and motivated reasoning and engage with these ideas. Cues from partisan elites have the potential to inflame and foster misinfodemics as they shape the landscape of information for the general public (Swire et al., 2017). For instance, at the outset of COVID-19, the American political administration referred to COVID-19 as a ‘new hoax’ (Rieder, 2020) and likened the pandemic to common flu (Brooks, 2020) or coronavirus as a bioweapon (Stevenson, 2020). This rhetoric is likely to encourage the adoption of related beliefs and lead likeminded supporters to take the threat less seriously. Media outlets including news personalities and media figures cast aspersion on the threat of COVID-19 by questioning if hospitals were truly filled with coronavirus infected patients (Peters, 2020). After the toll on human life became increasingly apparent and unassailable, change in the reporting and behavior on the part of media and political leaders who had previously (explicitly and unequivocally) trafficked in misinfodemics now hinted at the possibility of misinformation having actually served to correct and prevent negative consequences among the general public.

Animosity, wrapped in hatred inside the hostility

Some media channels initially ran racially labeled and biased headlines on COVID-19, such as ‘Chinese virus pandemonium’, ‘China kids stay home’, ‘China is the real sick man of Asia’, ‘Chinese coronavirus’, or ‘kung-flu’, which caused xenophobia and misperceptions, misled the general public and witnessed a surge in anti-Chinese sentiment and racist-driven cases against individuals of Chinese origin outside China. Anti-Chinese and anti-Asian xenophobia has been reported in many countries including the US, the UK, Australia and many European countries. Many Chinese customers were refused entrance into restaurants in Japan, South Korea, Vietnam and Indonesia (Amnesty International, 2020).

The Office of the United Nations High Commissioner for Human Rights (OHCHR) issued a statement on Twitter: ‘It’s understandable to be alarmed by #Coronavirus. But no amount of fear can excuse prejudice & discrimination against people of Asian descent. Let’s #FightRacism, call out hatred & support each other in this time of a public health emergency. #StandUp4HumanRights.’

A similar response on Twitter began ‘#JeNeSuisPasUnVirus’ (‘I am not a virus’) after a French newspaper’s front-page headline, ‘Yellow alert’. Ontario’s Human Rights Commission (OHRC) stated that discrimination is prohibited under the Human Rights Code (Aguilera, 2020; Ontario Human Rights Commission, 2020).

A government’s dilemma – to be or not to be

At the time of writing, the government of Pakistan under the leadership of Prime Minister Mr Imran Khan has witnessed a sudden setback, as with the number of cases steadily increasing their challenge is to curtail the path of the disease in Pakistan. However, there is a bigger dilemma the government of Pakistan is facing – to be or not to be – partial lockdown or no lockdown. Either way, this message has a common intention – to minimize the urgency and severity of the pandemic, downplay social isolation measures, disregard the potential crisis in the health sector (while exaggerating the impact on the economy for the recession that looms on the horizon) and overlook the mitigating measures necessary to stem transmission and medical mistrust among the public (Alwan et al., 2020; Prem et al., 2020). Religion, politics and business – fundamentally governing aspects of Pakistan – are opposed to the lockdown and are putting pressure on the government, consequently resulting in the lifting of lockdown. In Pakistan, pandemic or no pandemic, hardline clerics hold the power to override the government’s social-distancing instructions, put in place in April 2020. Dozens of well-known clerics signed a letter warning that the government should exempt mosques from the shutdown during the month of Ramadan or otherwise invite ‘God’s wrath’ (an ulterior narrative insinuating the political chaos that clerics have unleashed in the past), exercising their religious authority to gather loyalists to lay siege on the state. The subservient state has already signed an agreement deferentially promising to abide by the deal, begging the question: who is in charge of the government during this pandemic crisis – the government or mosques? Physical and mental health, social and interpersonal factors including intimate partner violence, marital rape, child abuse, domestic violence, racism, xenophobia, dissociation, bias, prejudice, stigmatization and marginalization are the least of Pakistani clerics and mosques’ concerns during this public crisis. Clerics have to protect their two central interests: money and power. Millions of dollars of charitable donations during Ramadan benefit Pakistan’s mosques, which are not under the state’s authority, and clerics who often partake in political power can challenge the government. Despite all the evidence, a prevalent rhetoric undermining the COVID-19 related risks has been endorsed (and ‘austerely’ followed by the public) at the highest level of authority in Pakistan: the clerics.

Religious misinfodemics is a new branch of clerics’ superciliously propagated doctrine narrated through the lens of pandemic religious-explanation: God could not have allowed such a disease to emerge and only through rigorous devotion in congregational prayer can followers of the faith conquer the devil’s machinations in the form of coronavirus; and if anyone tries to halt these efforts then these Zionist agents are the pawns of evil bent on destroying the faith. This dogmatic doctrine seeps through the ever present, ever omniscient online media to infiltrate the minds of sheeple-votary-conformists – usually the heads of the household who enforce these maladaptive cognitive twisted patterns within their families. These instructions dictated by the ‘higher authorities’, and their adherence, are infringing on individual rights and freedom, planting unquestionable canon, propagating anti-science and medical mistrust among the public, putting people at risk, and halting the emergency control and preventive measures necessary to curb the pandemic and thus creating public panic, social unrest and distrust in systems (Kalb, 2003; Strong, 1990). These eschewed beliefs can result in adverse behavioral consequences (for instance, failing to administer polio vaccination to one’s children, attributing it as un-Islamic, and contributing to the resurgence of this once eradicated disease in Pakistan). Misinfodemics, especially those which revolve around science, medicine and health-related topics, are widespread and prompting people to eschew appropriate health-related behaviors (Jolley and Douglas, 2014; Oliver and Wood, 2014).

Potential strategies of curtailment

As research has predicted, there are psychosocial stress and adverse health outcomes for people in self-isolation, social distancing and quarantine, and this crisis situation will require remediation from credible sources of information. These include, in the US for example, the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), and especially WHO, which has partnered with several social media platforms and technological companies (Google, LinkedIn, Microsoft, Reddit, Twitter, Facebook and YouTube) to promote health updates and curb misinformation and disinformation (Hossain et al., 2020). They are seeking to safeguard and ensure effective communication on COVID-19 between healthcare systems and the general public. Despite all these efforts, infodemics is rampant and multiple misinformation and disinformation sources are circulating on social media accounts. To address these discrepancies, certain strategies can be implemented: (a) empirically evidence-based scientific research findings → with integration in communication and information technology → to frontline healthcare providers → who communicate with patients and caregivers and populations at risk → results in positive health outcomes → and subsequent optimization of resources; (b) building strategic partnerships (local and global levels) → coordinate connecting offline and online resources for the communication of uniform information → across all platforms from mass media, community organizations and support groups → to community and society; (c) contain infodemics of information and disinformation → and disseminate scientifically evidence-based information → through ‘data-mining algorithms’ to detect and remove fake news (Shu et al., 2017); (d) those who propagate misinformation (accountable individuals and online portals) should be identified by local authorities and law enforcement agencies → precautionary culturally tailored information, translated into multiple language manuals of factual data regarding COVID-19 should be promoted through mass media campaigns; and (e) an e-care evidence-based approach and e-services in local languages (mostly graphic and pictorial for easy understanding) should be made available → for people with limited access to healthcare, elderly people, rural areas, the general public in self-isolation and quarantined → to decrease COVID-19 infection.

It is imperative to bring communities and institutional leadership together to promote transparency and good information governance to control the misinfodemics related to COVID-19 for both people’s physical, mental and psychosocial health and sound economic, political and systematic functioning during this pandemic (Oliver and Wood, 2014). The world needs coordinated national and international efforts to apply the scientific empirical data in local settings to mitigate the grave predicament of lockdown aftereffects and associated issues. Mass media, healthcare organizations, community-based organizations and stakeholders should strategically join in partnership to disseminate, based on mutual consensus, empirically-based public health messages and remove anti-science online content through natural language processing and data-mining approaches. The best global solution for a global disease is international collaboration – the exchange of scientific ideas, health communication and facilitating coordination.