Google Fights COVID Misinformation, Prepares for 'Next Wave'

John Whyte, MD, MPH; David Feinberg, MD; Bob Brisco


April 27, 2020

Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

This transcript has been edited for clarity.

John Whyte, MD, MPH: You're watching Coronavirus in Context. I'm Dr John Whyte, chief medical officer at WebMD. Joining us again are Dr David Feinberg, vice president at Google Health, and Bob Brisco, CEO of Internet Brands and WebMD. Gentlemen, thanks for joining me.

David Feinberg, MD: Great to be here. Thank you.

Whyte: David, I want to bring up the issue of trust. Google has been very active in removing thousands of videos on YouTube that have misinformation, sometimes dangerous information, whether it's about COVID or other conditions. Can you talk about some of the efforts that you're making to remove inaccurate information?

Feinberg: We want to do a few things. I used to use this as my example, but now it's incredibly timely. "Drink bleach. It cures cancer." If that's the YouTube video, it's really clear that it violates our policy. It's dangerous, so it goes away. That's easy.

"Drink carrot juice. It cures cancer." Well, that's not likely to kill you. But as a licensed physician, it's not necessarily something I'd recommend. I don't mind eating carrots, but don't think of that as your treatment. But we probably don't want to completely police those things away. So what do we do?

What we need to do is create enough content that's engaging such that that video is really hard to find. Now, if you have a prejudice and you want to find it, you can find anything on the Internet. So it would be there. But you'd be bombarded with authoritative, engaging information first.

Think about it. The anti-vaxxers don't have YouTube videos that say, "Don't take vaccines. They're bad." They have engaging videos. And what do we have as the health profession? We still have doctors handing out pamphlets.

So how do we make doctors into YouTube stars so that that's the information people are absorbing? It combats the anti-vaxxers and becomes more available and ingestible. You're seeing that. You're seeing that even on TikTok, where a lot of clinicians are engaging with their audience, giving really good information in a much more up-to-date way.

So that's one way we do it. Another way is for us to ask folks like you to keep putting out good information. The better the information, the more we have page after page of authoritative information before we get to what I would call the junk science. The unsafe stuff is easy, but the middle-of-the-road stuff is the part we want to downgrade so that our users are getting the right stuff.

We did it with COVID. I mean, it's really clear when you come to our homepage on coronavirus that everything has been curated. There is no misinformation when you open the homepage and type in coronavirus.

Whyte: Bob, you've been a big proponent on our Medscape side of making sure that we get the best information out there for our physician community as well.

Bob Brisco: As I mentioned, we serve about 5 million members on Medscape that are physicians worldwide. I know from prior discussions I've had with David that YouTube and Google are also used heavily by physicians for continuing education, to unpack topics that they haven't been dealing with recently. It's most central to our role at Medscape to get that information right.

But I'd love to hear from David as well. We've chatted about this before, about the role Google plays on the HCP side.

Feinberg: I think it was last week that we launched on our YouTube site our first playlist called [COVID-19 Resources for Clinicians—from Clinicians]. It's [14] videos for the doctor who has now decided to go help out and isn't typically an inpatient or ICU or respiratory or ID doc.

So here's what prone ventilation looks like. Here's how to wear your N95 mask. To [prepare] those outpatient doctors who are—God bless them—coming in to help where they're needed. So this was a curated playlist.

We see on YouTube and on Search that a lot of clinicians, doctors, nurses, pharmacists, etc., are coming to us for information. You get the sense that they're about to remove your parathyroid and they just want to check something out on YouTube. So we want to make sure that they're getting authoritative information.

We have a team, together with YouTube, working to say, "Okay, how are we going to service these clinicians that are coming to us for what many times is just-in-time information?"

And when I say, "Hey, your doctor may be looking at YouTube before they operate on you," the lay audience kind of freaks out and laughs and gets nervous. And I say, "But it's better than when I had a book in my lab coat pocket." Because I was still looking at the book. I was going to do a chest tube, and I'd look at it. Don't you want it in video? And don't you want it up-to-date? Because the book is only as good as when it was printed.

So yeah, docs need information. And so do nurses. We have to make sure we provide that.

Brisco: Dave, I just want to go back to a theme that we've addressed here a little bit. It's an interesting one. When we step back and think about the impact of COVID on the healthcare system, there's an accelerative effect of the digital transformation, isn't there? Both in terms of the way physicians are going to use telemedicine and tools, the way patients are going to—it feels like there's an inflection here, doesn't it?

Feinberg: I totally agree with you. And not only is there inflection, I think it's the silver lining. The tsunami that's coming in the next few months in our country—and different times in different parts of the world post-COVID—is going to be patients with COVID who have medical conditions because they got COVID. We've seen Guillain-Barré. We've seen kidney issues. There are going to be a lot of acute care issues that have not been addressed because people haven't gone to the doctor. Because if you have a kidney stone, you'd probably say, "I'm going to ride this out at home because I'm nervous right now about going to the ER."

And all of the chronic conditions and the typical screenings like mammography and colonoscopy haven't been done. So we've got these huge groups of patients that are going to show up in these health systems. Plus, there's the mental health burden. Not only is there going to be PTSD among our providers, but everybody's psyche is going to be different because of this experience.

And so we have this all coming to a health system that is under incredible financial strain right now. Not only that, but they are emotionally strained because docs had to make decisions about who gets the ventilator. They didn't teach us that in med school. They made really tough decisions. They've been put in harm's way in many cases because they didn't have protective equipment, and the financial situation of these health systems is dire. These systems are losing hundreds of millions of dollars a month because they canceled ambulatory service and elective surgery.

And in 3 months, many people who used to have commercial insurance are going to have Medicaid. So now you have Medicare and Medicaid providing a tremendous amount of care for Americans. The government hasn't been collecting money like it used to because of taxes. It's going to cut funding to healthcare. It has to. And so you really are setting up a very frightening healthcare situation in the next few months in America. That's where we want our tools to be able to help.

Brisco: I'm so glad you gave us that tremendous overview. I couldn't agree more. We're going to have to shift the phrase from "flattening the curve" to "managing the curves," plural. As the COVID curve starts to bend the right way, we've got all of these other curves that are going the wrong way on deferred testing, on deferred chronic care treatment, on the socioeconomic impact of COVID. And there's this compounding effect that is certainly going to happen.

It's going to be this critical moment in the world and in our country [where we figure out] how to get that balance right among managing these curves.

I love the way you're framing it, that the silver lining in this is that digital tools are essential to provide some of the efficiency and effectiveness to make the best of this situation. You calling it the silver lining resonates with me. I think it's going to take a while for us to see that because we've got to get through these waves that are ahead of us. But I think your framing of that was brilliant. Thank you for that.

Feinberg: Thanks. I'm also concerned about mental health. There has been an 891% increase in calls to suicide hotlines. The number of guns that were bought in March was more than ever. And we know that when people buy guns, there's an increase in suicides by firearm. We know that when the economy is bad, there's an increase in suicides. We've launched our depression screener, both on mobile and desktop. Next month we're launching an anxiety screener. We already have a PTSD screener.

People come to Google and tell us. They answer the questions about how depressed they are. We've got to get them into treatment. Are you a veteran? Can you do a warm handoff to the VA? And we have to get this done because it's going to kill a lot of people if we don't get it right.

Whyte: Thank you both for joining me. And thank you for watching Coronavirus in Context. I'm Dr John Whyte.

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