How to Combat COVID-19 Misinformation

John Whyte, MD, MPH; Steven Brill

Disclosures

February 03, 2021

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

  • NewsGuard is a website that rates the reliability of more than 6000 websites responsible for about 95% of the news online.

  • NewsGuard created HealthGuard to identify trustworthy sources of online health news and information. Consumers can download the HealthGuard browser extension for free until June 2021 to rate the reliability of online health sources.

  • HealthGuard rates health sources based on ethical journalism criteria, including not repeatedly publishing false content, presenting information responsibly, regularly correcting or clarifying errors, and handling the difference between news and opinion responsibly.

  • Consumers can consider using HealthGuard's rating system on their own to avoid unreliable websites.

  • NewsGuard was created to restore faith in legitimate journalism.

This transcript has been edited for clarity.

John Whyte, MD, MPH: Welcome, everyone. Thanks for joining. I'm Dr John Whyte, chief medical officer of WebMD, and you're watching Coronavirus in Context. There's a lot of misinformation out there, especially when it comes to your health. How do you know what to believe?

To provide some insights and even give you some tools, I've asked Steven Brill to be here. He's an award-winning author, journalist, and co-CEO of NewsGuard. Mr Brill, thanks for joining me.

Steven Brill: Happy to be with you. Thanks for having me.

Whyte: Tell our audience about NewsGuard. Why did you feel that there was a need to create it, and what does it do?

Brill: Here's the need to create it, in a nutshell: If you think about how we consume media before the internet, just think about a library. You go into a library, books are neatly arranged on shelves according to subject matter. You take a book or magazine off the shelf and you can read the book jacket and it tells you something about the author and who the publisher is. You can get a sense of whether you want to read that and the credentials of what you're going to be reading.

Now, imagine you walked into a library and instead, there were 2 billion pieces of paper just flying around in the air. You grab one out of the air and start to read it. You don't know who's financing it, you don't know what their credentials are, and you have no idea what their agenda is. Worst of all, there's no librarian there to tell you something about all of that, the way there is in a library. That's the internet, your Facebook and Twitter feeds, your Google and Bing search. That's everything on the internet.

Whyte: But Steven, in some ways, people might be thinking — and this is why I think there's an analogy — it's in the library, so even though there are billions of pieces of paper around, it's in the library; it must be okay. So if it's on the internet, it's okay.

Brill: Well, a library is a library, where people care about content. Facebook is not a library, and the people running Facebook are not librarians. They apparently don't care much about the reliability of what they're serving up. In fact, their claim is that they don't even serve it up to you — that it's everybody else, it's just a platform. So, anybody can be a publisher. Now, the good thing about the internet is that anybody can be a publisher, which makes it much more democratic. The bad thing about the internet is that anybody can be a publisher.

When you take all of those issues of unreliability, trustworthiness, and understanding of who's feeding you the news, and combine that with the subject of healthcare, all those dangers multiply. Because first of all, good information about healthcare is really important. It's much more important that you get good information about the quality of a treatment than it is about whether you should go watch a movie or not. It's really important and it's fraught with all kinds of emotional issues. If you're sick, you're scared. Let's say a doctor tells you that you have some kind of a disease. The first thing you do is Google the disease. That's what everybody does.

Now, luckily if you Google and WebMD comes up (which has a big green rating from NewsGuard because, according to our nine criteria, WebMD is reliable), it is something you can count on. But the next site that might pop up in a Google search might be something called "cancer.news." And cancer.news looks exactly like cancer.org. Cancer.org is the site of the American Cancer Society. Cancer.news is a hoax healthcare site that will tell you that if you can get some apricot pits, you can cancel your appointment with your oncologist because the apricot pits are going to cure your cancer. And trust me, they have more engagement online than the Mayo Clinic or cancer.org.

So, at NewsGuard, we've created a whole subset of product called HealthGuard, which is targeted at all the health sites out there — anything online that in any way covers healthcare, it provides advice about healthcare (whether it's about the COVID vaccine or cancer or good diets). We have a browser extension that people can download for free; they can download HealthGuard for free. If they have that browser extension, when they go to Facebook, Google, or Twitter, they will be able to see our little green or red icons. When you hover over one of our green icons, it will tell you why this is green according to our nine criteria — they're basic journalistic criteria. If you hover over it and it's red, it will tell you why it's red, unreliable; we run through all the criteria.

Whyte: I want to go over these criteria. You break it down (the scoring) first in terms of credibility. When we want to assess credibility, what do we look for? You start off with, "Does not repeatedly publish false content." But that can be a challenge, because how do you know?

Brill: The first thing we know is that when it comes to healthcare, we don't know. So we consult experts. We will cite sources, whether it's the American Cancer Society, the Centers for Disease Control and Prevention, the US Food and Drug Administration, or the Mayo Clinic. We will read a website, and let's say the website literally says (I'm not making this up), "apricot pits cure cancer." You can search and you will find that that myth is out there enough that the American Cancer Society, Memorial Sloan Kettering Cancer Center, or MD Anderson may have actually posted something on their website to knock that myth down. And that's what we will cite. It's not my opinion about whether fruit pits cure cancer.

Whyte: That's why I assume it's based on experts.

Brill: It's an expert. Everything we do is done by humans. There are no algorithms here. We have hired dozens of journalists to read all these sites and do the research, and it's done according to nine criteria. Now, the first one, as you mentioned, was repeatedly publishing false news. There are other criteria, such as disclosure of the ownership of the site. Let's say you come to a site because you're worried about whether you can get melanoma or not, and if the site that pops up recommends a certain drug or screening material, you'd probably want to know whether that site is owned by whoever happens to be selling that product as opposed to whether the site is WebMD, which doesn't own any drug products.

Whyte: So, the criteria are: it does not repeatedly publish false content; it gathers and presents information responsibly; it regularly corrects or clarifies errors; handles the difference between news and opinion responsibly; and avoids deceptive headlines. That's just on the credibility side.

Steven, it would seem like you need to hire an army just on credibility, and we haven't even gotten to transparency.

Brill: We have been able to rate in the countries where we operate (including the United States) all the news and information sites responsible for 95% of all engagement online. The key to this is that we rate the overall reliability of the site, its processes, and its standards. That doesn't mean that The New York Times or WebMD or the Mayo Clinic site might not make a mistake; it just means that they'll correct their mistakes. Overall, it means that you can rely on them more than you can rely on cancer.news.

That's a key ingredient in the overall processes and integrity of the publisher, and that's how we achieve scale. By the way, we do this in a journalistic way. If we're going to criticize any site and give even one red mark for just one of the nine criteria, they're still going to get an overall green, but we call for comment. Journalists call for comment; algorithms don't call for comment. So, everything about our process is totally transparent, and it's completely accountable. If someone complains about a mistake we've made, we investigate it. If we made a mistake, we correct it.

Whyte: On the transparency side, the website discloses ownership and financing, it clearly labels advertising, it reveals who's in charge (including possible conflicts of interest), and the site provides names of content creators along with either content or biographical information. Are those things that consumers should look for as well?

Brill: Absolutely. Basically, the nine criteria have to do with what's on the website. In essence it's a road map for a consumer (even if they're not using our browser extension, which I hope they will) and they can look for those nine criteria themselves. For example, if you're reading something on a healthcare site that's giving you healthcare advice, you should want to know who's giving you the advice. Is this person a cancer expert or is this person a journalism intern (and not even a medical intern)?

Whyte: Why do you think people are so easily misled when it comes to their health? People know when they read stock tips online or read information about finances that they need to double-check everything, do their own research, and look around.

Nobody goes online and then tries to fix their own brakes in their car. But when it comes to health, somebody has a website or a blog, and all of a sudden they're like, "Oh, I should try that." It's your body. Where is the disconnect there?

Brill: First of all, I'll disagree with you a little bit — there is a whole bunch of fraudulence on the personal finance side, so...

Whyte: Well, we do know that. We all get their requests of "give me your routing number because I have got to give you $10 million."

Brill: But your point is well taken: You would never think to fix your car brakes or change the plumbing in your house by yourself. But let's look at what happens when you're in a healthcare situation. One of the temptations is that you want to find an easier, better alternative than what the doctor has suggested.

To give you a personal example: Four years ago, I was told during a routine checkup that I had an aortic aneurysm, which is really bad stuff. You have no symptoms. If it bursts, you just die, but you have no symptoms. I was working out every day and I was healthy. My doctor said, "You need to have open-heart surgery." I took it very seriously — he's a great doctor — but I still went home that night and started Googling around to see if there's an easier way to deal with this. And luckily I didn't succumb to the articles that said if your doctor says you have an aortic aneurysm and you need open-heart surgery, here's something else you can do.

But a lot of people are scared; they're not informed, and they're clutching at straws. In the case of COVID vaccines, traditionally there's a lot of skepticism about vaccines. That has really ramped up in the past few years based on campaigns about the measles vaccine, the MMR vaccine, and now you have the COVID vaccine (which by everybody's understanding has been "rushed"). But there may be less understanding in the nature of what "rushed" in this case really means. It has still gone through the clinical trials it needs to go through and so on.

There's that sort of anti-vax fear in the air. Then there's all the politics associated with COVID, where a certain percentage of the population has been persuaded that COVID is not even real. So, if that's not real, why should you take a vaccine for it?

We are finding that a third or more people in this country and around the world are saying they won't take the vaccine. The place where it's really been driven home is the reports you and I have been reading lately that even non-MD healthcare workers are hesitant about the vaccine (like, a third of them). My wife got her first vaccine yesterday morning. She and the nurse who was giving her the vaccine were chatting and my wife said, "Well, you must have had the vaccine. How was it?" He replied, "No. I haven't taken the vaccine." She asked, "Why not?" He responded, "Well, I don't know. You know, I want to see what happens. I want to wait."

That's a nurse in a highly regarded hospital giving the vaccine. If you came in to that vaccine room as my wife did, and if you were at all hesitant about the vaccine and the first thing the nurse who's about to give it to you tells you is, "I don't want to take it" — just think about that.

Whyte: What made you decide to co-create NewsGuard? Was there a particular event? Or was it just a point in time where you were like, Enough is enough?

Brill: It's a combination of things. All the businesses I've started have been journalistically oriented, except for one. In this case, it was geared toward how to restore belief in legitimate journalism and everything that goes with that. Everything that's so important to our democracy. In this case, so important to our healthcare goes along with belief in legitimate journalism.

The only way to do that is to weed out the other stuff. That also helps with advertising. If advertisers are scared that nobody believes anything, then they stop advertising on news (which many have). And if instead they have a way to advertise on news that is overall reliable, it doesn't mean that you agree with everything on the website. Overall, it means that these are people who wake up in the morning and they're trying to do something good. It was meant to restore faith in the profession that's been my life.

Whyte: And how's NewsGuard supported?

Brill: We have different kinds of licensees. There is a way that a consumer can subscribe to either the HealthGuard browser extension or the NewsGuard browser extension. But during this emergency, we are making the HealthGuard browser extension available for free to everyone in the countries we serve until the end of June. Our real business model is the companies that serve consumers. For example, broadband providers or Microsoft (through its Edge browser) licenses NewsGuard and gives it to all of its customers. On the advertising side, advertising agencies license a NewsGuard-related product called BrandGuard and use it to make sure their clients (their brands) are not advertising on sites that will embarrass them, and that they're advertising on legitimate news.

If you take the view that I do, that there's a market for people looking for ways to provide a "trust tool" for the internet, then this looks like a pretty good business model. So far, it is.

Whyte: Steven, I want to thank you for taking time today and for all that you're doing to help combat misinformation, which really is rampant right now, particularly as it relates to health.

Brill: Thanks for having me.

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