The “infodemic” of misinformation about coronavirus has made it difficult to distinguish accurate information from false and misleading advice. The major technology companies have responded to this challenge by taking the unprecedented move of working together to combat misinformation about COVID-19.
Part of this initiative involves promoting content from government healthcare agencies and other authoritative sources, and introducing measures to identify and remove content that could cause harm. For example, Twitter has broadened its definition of harm to address content that contradicts guidance from authoritative sources of public health information.
Facebook has hired extra fact-checking services to remove misinformation that could lead to imminent physical harm. YouTube has published a COVID-19 Medical Misinformation Policy that disallows “content about COVID-19 that poses a serious risk of egregious harm.”
The problem with this approach is that there is no common understanding of what constitutes harm. The different ways these companies define harm can produce very different results, which undermines public trust in the capacity for tech firms to moderate health information. As we argue in a recent research paper, to address this problem these companies need to be more consistent in how they define harm and more transparent in how they respond to it.
Science is subject to change
A key problem with evaluating health misinformation during the pandemic has been the novelty of the virus. There’s still much we don’t know about COVID-19, and much of what we think we know is likely to change based on emerging findings and new discoveries. This has a direct impact on what content is considered harmful.
The pressure for scientists to produce and share their findings during the pandemic can also undermine the quality of scientific research. Pre-print servers allow scientists to rapidly publish research before it is reviewed. High-quality randomized controlled trials take time. Several articles in peer-reviewed journals have been retracted due to unreliable data sources.
Even the World Health Organization (WHO) has changed its position on the transmission and prevention of the disease. For example, it didn’t begin recommending that healthy people wear face masks in public until June 5, “based on new scientific findings”.
Yet the major social media companies have pledged to remove claims that contradict guidance from the WHO. As a result, they could remove content that later turns out to be accurate.
This highlights the limits of basing harm policies on a single authoritative source. Change is intrinsic to the scientific method. Even authoritative advice is subject to debate, modification and revision.
Exactly what is considered harmful can become politicized, as debates over the use of malaria drug hydroxychloroquine and ibuprofen as potential treatments for COVID-19 exemplify. What’s more, there are some questions that science cannot solely answer. For example, whether to prioritize public health or the economy. These are ethical considerations that remain highly contested.
Moderating online content inevitably involves arbitrating between competing interests and values. To respond to the speed and scale of user-generated content, social media moderation mostly relies on computer algorithms. Users are also able to flag or report potentially harmful content.
Despite being designed to reduce harm, these systems can be gamed by savvy users to generate publicity and distrust. This is particularly the case with disinformation campaigns, which seek to provoke fear, uncertainty and doubt.
Users can take advantage of the nuanced language around disease prevention and treatments. For example, personal anecdotes about “immune-boosting” diets and supplements can be misleading but difficult to verify. As a result, these claims don’t always fall under the definition of harm.
Similarly, the use of humor and taking content out of context (“the weaponisation of context”) are strategies commonly used to bypass content moderation. Internet memes, images and questions have also played a crucial role in generating distrust of mainstream science and politics during the pandemic and helped fuel conspiracy theories.
Transparency and trust
The vagueness and inconsistency of technology companies’ content moderation mean that some content and user accounts are demoted or removed while other arguably harmful content remains online. The “transparency reports” published by Twitter and Facebook only contain general statistics about country requests for content removal and little detail of what is removed and why.
This lack of transparency means these companies can’t be adequately held to account for the problems with their attempts to tackle misinformation, and the situation is unlikely to improve. For this reason, we believe tech companies should be required to publish details of their moderation algorithms and a record of the health misinformation removed. This would increase accountability and enable public debate where content or accounts appear to have been removed unfairly.
In addition, these companies should highlight claims that might not be overtly harmful but are potentially misleading or at odds with official advice. This kind of labeling would provide users with credible information with which to interpret these claims without suppressing debate.
Through greater consistency and transparency in their moderation, technology companies will provide more reliable content and increase public trust—something that has never been more important.
While educrats scramble to get schools ready for opening in less than two weeks and teachers threaten a sickout over the lack of planned mandatory COVID-19 testing, a respected healthcare agency has revealed that Mayor de Blasio for two months sat on its offer to test all school kids and teachers for free.
Beginning in June, the 800,000-patient, 2,500-doctor Somos network said it reached out to the mayor five times to offer to set up free testing sites at NYC’s most at-risk public schools. But meetings were canceled and calls ignored — until this week, when de Blasio finally had a video chat with the agency on Wednesday.
Still, no deal was struck and the non-profit says Hizzoner continues to say he doesn’t want to mandate testing.
Dr. Ramon Tallaj, chairman of Somos — which runs 38 city-backed COVID-19 testing sites in clinics, tents and churches throughout New York and has tested 325,000 low-income New Yorkers since March — says on-site testing at schools is a matter of life and death.
“The mayor is surrounded by people who do not grasp what is going on,” Dr. Tallaj told The Post. “If he opens schools the way he is proposing, parents are going to die.”
Currently, the city’s official plan to reopen schools relies on students and teachers to voluntarily seek out testing at city-run sites and hotbed hospitals.
The Department of Education website adds: “If a student or teacher is feeling sick, they are required to stay home and, if their symptoms are consistent with COVID-19, are asked to get tested.”
Without mandatory testing, warned Tallaj, a specialist in internal medicine, “58% of the children and their families who have not seen the virus could get infected by the 1 or 2% who are positive with the virus.
“The majority of the newly infected children, who do not show symptoms, will go back to their small apartments in poor neighborhoods, potentially infecting their parents and grandparents in our community.”
Somos proposes an initial wave of 80 testing sites at public schools in more poor areas, handling 120 to 140 students per day. Tallaj said his 2,500 doctors could eventually test all of the 1.1 million students at all 1,866 DOE schools, but would need financial backing from the city.
Tallaj believes de Blasio balked at his offer because he wants to do testing in city hospitals, which would keep federal Medicare, Medicaid and FEMA charges with the city.
Somos also relies on those federal programs. But with a coronavirus crisis looming when schools reopen on Sept. 10, Tallaj said his agency would provide its physicians to the city gratis and do the testing using its own funds. He said Somos will seek reimbursement from the city at a later date for costs like testing supplies and PPE.
No student or teacher would pay for the tests, he said.
Tallaj says that he believes de Blasio only returned his call this week because of building pressure from the teachers union and the City Council, which has both demanded mandatory testing for teachers and students. The United Federation of Teachers has even threatened a sickout if every student and staffer in the public school system isn’t tested before in-classroom schooling resumes.
In an Aug. 21 letter to the mayor, Tallaj wrote, “It is truly unfortunate that … [we] have yet to find a time to schedule our meeting which we agreed upon back in June. Usually when this happens, it means this isn’t a priority for you. Is this fair for me to assume?”
Tallaj also offered to donate 500 telemedicine computers to public schools allowing symptomatic students direct access to their pediatricians and medical charts at school. But the city was also hesitant to accept, according to a Somos spokesperson, citing the need for legal review.
“We’re working through every option to make testing as widespread and convenient as humanely possible for members of our school community,” a spokesperson for the mayor said, noting that back in June the UTF was not yet demanding mandatory testing for teachers and students.
Countries’ approaches to combat the spread of the coronavirus have varied throughout Europe, North America, Australia, Japan and South Korea, but most publics in these regions believe their own country has done a good job of dealing with the outbreak, according to a new Pew Research Center survey of 14 advanced economies. Overall, a median of 73% across the nations say their country has done a good job of handling novel coronavirus, which has reached nearly every corner of the globe, infected more than 20 million people worldwide and resulted in the deaths of several hundred thousand.
But the pandemic has had a divisive effect on a sense of national unity in many of the countries surveyed: A median of 46% feel more national unity now than before the coronavirus outbreak, while 48% think divisions have grown. This includes 77% of Americans who say they are further divided than prior to the pandemic, while just 18% believe the country to be more united.
In addition, a median of 58% say that their lives have changed a great deal or fair amount due to COVID-19. Women in particular have felt the effects of the virus most acutely.
And in a quarantine period marked with critiques of actors ranging from China to the United States to the World Health Organization, a median of 59% believe more international cooperation would have reduced the number of coronavirus cases facing their country. Young people in many nations are especially likely to hold this viewpoint.
These are among the findings of a new Pew Research Center survey, conducted June 10 to Aug. 3, 2020, among 14,276 adults in 14 countries: the United States, Canada, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden, the United Kingdom, Australia, Japan and South Korea. The survey also finds that public attitudes toward their own country’s dealing with the coronavirus epidemic and national unity are linked to feelings of trust in others and economic confidence in their nation.
Most people think their own country has done well handling pandemic response
Across the 14 countries surveyed, a median of 73% say that their own country has done a good job dealing with the coronavirus outbreak. Just 27% believe their country has handled it poorly. However, there is some variation by country on this assessment.
About seven-in-ten or more give their nation’s coronavirus response a positive review in Denmark, Australia, Canada, Germany, the Netherlands, South Korea, Italy and Sweden. And more than half in Belgium, France, Japan and Spain share this sentiment.
In two countries – the United Kingdom and the United States – people are divided in their beliefs when it comes to rating their government’s performance responding to the coronavirus. These two nations also have high levels of political polarization on views of the government’s handling of this crisis. In the U.S., 76% of Republicans and independents who lean to the Republican Party say the government has done a good job, while just a quarter of Democrats and Democratic leaners agree, a 51 percentage point difference. A majority of right-leaning Britons (55%) give a positive rating to their country’s handling of the pandemic, led by Prime Minister Boris Johnson’s Conservative government, but just 26% on the left hold the same opinion.
People in Spain, which is currently led by the left-leaning Spanish Socialist Workers’ Party, are also split ideologically on assessing their government’s response to COVID-19, but in the opposite direction: 73% on the left are pleased with how their country has managed the outbreak while 40% on right are not, a 33-point difference. Those on the left are also more positive on their country’s response to the outbreak than those on the right by double digits in Italy (18 points more positive), Sweden (17 points) and South Korea (15 points).
Economies around the world have contracted due to the unprecedented nature of the coronavirus outbreak, and the U.S. Congressional Research Service reports that the global economy could grow between 3% and 6% less in 2020 compared with previous projections. These economic effects also relate to how people assess their own nation’s handling of the pandemic. Across all 14 nations included in the survey, those who think their current national economic situation is good are also more likely than those who believe the economy is bad to say their country has done a good job of dealing with the coronavirus outbreak.
This divergence is especially pronounced in the United States. Among those with a more optimistic view of the economy, 78% report that they approve of the way the U.S. government has dealt with the virus. But those who think the American economy is currently in poor shape are less than half as likely to give the government response a positive rating.
Coronavirus has changed many lives throughout 14 nations
Each of the countries in the survey have suffered the effects of the coronavirus. The number of deaths vary in the 14 countries from about 100 to more than 100,000 when the survey was fielded, and some nations completely locked down while others like Sweden, Japan and the U.S. used different measures to attempt to stave off the virus. Across the 14 countries surveyed, a median of 58% say the pandemic has changed their life either a great deal or fair amount, while 42% report not too much change or none at all.
About two-thirds or more in South Korea, Sweden, the U.S., the UK, Japan and Canada say their lives have changed at least a fair amount due to the pandemic. (In all of these countries except the UK, the government never imposed a national-level lockdown.) And at least three-in-ten in South Korea, the U.S., Sweden and the UK say their lives have changed a great deal since the outbreak began. Majorities of people in Spain and Italy – two early hotspots – have also noted changes in their lives because of the outbreak.
In six countries, about half or more say that their lives have not changed much or at all since the onset of the virus, including 54% of the Dutch, 53% of Australians, 53% of the French and 51% of Belgians. In each of these six nations except Australia, governments did put in place national-level lockdowns to counter the spread of COVID-19.
In 12 of the 14 countries surveyed, women are more likely than men to say their lives have changed due to the coronavirus. In nine of those countries, the gender gap reaches double digits – including in Sweden, the U.S. and France, where women were more likely to say this by 15 points each.
The changes that women have experienced during the pandemic could take many forms, and data underscores that women’s burdens have increased both at work and at home. Women around the world typically do more unpaid work at home than their male counterparts, such as child care and housework, and this may be amplified by closure of schools and day care centers to combat the spread of COVID-19. Additionally, according to the Organization for Economic Cooperation and Development, a higher share of women than men in each of the surveyed countries participate in part-time employment, which is more likely to have been interrupted by the pandemic. And a report from Citi asserts that coronavirus-related job losses have disproportionately affected women globally.
Little consensus on whether the pandemic has brought people together
The degree to which civic division has changed since the coronavirus emerged is itself a divisive question. When asked if their country is now more united or more divided than before the coronavirus outbreak, people in many countries are split, with a 14-country median of 46% saying their country is more united and 48% saying their country is more divided. (Since the onset of the coronavirus, countries in the survey have also experienced the effects of a global recession and protests related to the death of George Floyd, a Black American killed by a White police officer in May, among other events.)
In the U.S., where a patchwork of coronavirus-related restrictions reflects broad disagreement over the best path to economic recovery while mitigating the spread of the virus, roughly three-quarters say that the U.S. is more divided than before the coronavirus outbreak. Only about two-in-ten Americans say that the country has become more united. Though Americans of all ideological tilts say the country has become more divided, Democrats and Democratic-leaning independents (81%) are more likely than Republicans and Republican leaners (74%) to say division has increased.
In contrast, nearly three-quarters in Denmark say there is more unity now than before the coronavirus outbreak. More than half in Canada, Sweden, South Korea and Australia also say their countries have become more united since the coronavirus outbreak.
In every country surveyed, those who think their country has done a bad job of dealing with the coronavirus outbreak are more likely to say that their country is now more divided. This is particularly true in South Korea, where 74% of those who believe South Korea has done a bad job of dealing with the coronavirus say their country is now more divided, compared with just 29% among those who say their country has done a good job of dealing with the pandemic, a 45-point difference.
In Europe, those who have favorable opinions of right-wing populist parties are more likely than those with unfavorable views to say division has grown since the coronavirus outbreak began. This is especially true in Germany, where thousands have gathered to protest coronavirus restrictions in recent weeks, including some protestors affiliated with the far right. Fully 75% of Germans with a favorable opinion of the right-wing Alternative for Germany (AfD) party say Germany is now more divided than before the coronavirus outbreak, compared with 51% of those with an unfavorable view of AfD.
Other countries that have seen similar protests against prolonged lockdowns, including the Netherlands and Spain, also show gaps between those with favorable and unfavorable views of right-wing populist parties in their country.
Feelings of national disunity are tied to feelings of distrust as well. In many countries, those who say that, in general, most people cannot be trusted are more likely to say their country is now more divided than those who say most people can be trusted. In 11 of 14 countries surveyed, this gap exceeds 10 percentage points.
France is a particularly stark example. A majority (63%) of those who say most people cannot be trusted also say the country is more divided now than before the coronavirus outbreak; fewer than four-in-ten (37%) of those who think most people can be trusted see more division.
Publics generally agree that more international cooperation would have potentially reduced virus-related fatalities
As confirmed cases of the coronavirus top 20 million globally, many in the countries surveyed say that count could have been minimized through stronger international cooperation. A 14-country median of 59% say that if their country had cooperated more with other countries, the number of coronavirus cases would have been lower in their country. In comparison, a median of 36% say such cooperation would have been futile in reducing cases.
Missed opportunities for cooperation to reduce coronavirus cases are felt especially strongly in Europe, where failure to coordinate the initial response led to sudden and severe outbreaks in Northern Italy and Spain. More than half in seven of the nine European countries surveyed say that more cooperation would have reduced coronavirus cases.
Notably, 78% of Danes think the number of coronavirus cases would not have been reduced by international cooperation. A majority in Germany also say that cooperation would not have reduced case numbers.
Americans on the whole say that more cooperation could have limited the number of coronavirus cases. A majority (58%) of U.S. adults say that if the U.S. had cooperated with more countries, the number of American coronavirus cases would have been lower.
Much as younger people globally tend to have more favorable opinions of the UN and younger Americans give higher approval ratings to the WHO for its handling of the coronavirus outbreak, those ages 18 to 29 are more likely than those 50 and older to say that more cooperation would have reduced the number of coronavirus cases in their country.
In Australia, for example, the difference between younger and older respondents on the question of international cooperation on the pandemic exceeds 30 percentage points. While 61% of Australians ages 18 to 29 say more cooperation would have helped reduce the number of coronavirus cases, only about a quarter of Australians 50 and older say the same.
In most countries, those who say cooperation would have lowered the number of coronavirus cases are also more likely to say that their own country has done a bad job dealing with the coronavirus outbreak. For example, 64% of Britons who say cooperation would have reduced the number of coronavirus cases also think the UK government has done a bad job of dealing with the coronavirus outbreak.
Whether people think more cooperation could have helped stop the spread of the coronavirus relates with whether they align with the ruling party’s ideology.
In the U.S. and the UK, where right-leaning parties currently hold national executive power, those on the left are more likely to say that more cooperation would have reduced the number of coronavirus cases. Those on the right are more skeptical of the effectiveness of international cooperation.
On the other hand, the left-wing Spanish Socialist Worker’s Party currently holds power in Spain and Spaniards on the ideological right are more likely than those on the left to say their government could have limited coronavirus cases by cooperating more with other countries. And in South Korea and Sweden, where the governments are technically led by left-leaning coalitions, a similar pattern follows.
Hydroxychloroquine (HCQ) 2400 mg during 5 days was used in Belgium for COVID-19•
Impact of HCQ on mortality among 8075 patients with COVID-19 was assessed•
Lower mortality in HCQ-treated patients as compared to supportive care•
Lower mortality is irrespective of symptoms duration
Abstract
Background
Hydroxychloroquine (HCQ) has been largely used and investigated as therapy of COVID-19 across various settings, at total dose usually ranging from 2400 mg to 9600 mg. In Belgium, off-label use of low-dose HCQ (2400 mg in total over five days) was recommended for hospitalized patients with COVID-19.
Methods
We conducted a retrospective analysis of in-hospital mortality in the Belgian national COVID-19 hospital surveillance data. Patients treated either with HCQ alone and supportive care (HCQ group) were compared to patients treated with supportive care only (no-HCQ group) using a competing risks proportional hazards regression with discharge alive as competing risk, adjusted for demographic and clinical features with robust standard errors.
Results
Of 8075 patients with complete discharge data on 24th of May and diagnosed before the 1st of May, 4542 received HCQ in monotherapy and 3533 were in the no-HCQ group. Death was reported in 804/4542 (17.7%) and 957/3533 (27.1%), respectively. In the multivariable analysis, the mortality was lower in the HCQ group compared to the no-HCQ group (adjusted hazard ratio [HR] 0.684, 95% confidence interval [CI] 0.617–0.758). Compared to the no-HCQ group, mortality in the HCQ group was reduced both in patients diagnosed ≤ 5 days (n=3975) and > 5 days (n=3487) after symptom onset (adjusted HR 0.701, 95% CI 0.617–0.796 and adjusted HR 0.647, 95% CI 0.525–0.797, respectively).
Conclusions
Compared to supportive care only, low-dose HCQ monotherapy was independently associated with lower mortality in hospitalized patients with COVID-19 diagnosed and treated early or later after symptom onset.
Sinovac Biotech Ltd’s coronavirus vaccine candidate CoronaVac was approved for emergency use as part of a programme in China to vaccinate high-risk groups such as medical staff, a person familiar with the matter said.
China National Biotec Group (CNBG), a unit of state-owned pharmaceutical giant China National Pharmaceutical Group (Sinopharm), also said it had obtained emergency use approval for a coronavirus vaccine candidate in social media platform WeChat last Sunday.
CNBG, which has two vaccine candidates in phase 3 clinical trials, did not say which of its vaccines had been cleared for emergency use.
China has been giving experimental coronavirus vaccines to high-risk groups since July, and a health official told state media in an interview aired last week that authorities could consider modestly expanding the emergency use programme to try to prevent possible outbreaks during the autumn and winter.
State media Xinhua reported late on Friday that two vaccine candidates were approved in June for the emergency use program launched in July, without identifying the specific products.
Officially, China has given little details on which vaccine candidates have been given to high-risk people under the emergency use programme and how many people have been vaccinated.
In June, prior to the emergency use programme, employees at state firms travelling overseas were allowed to take one of the two vaccines being developed by CNBG, state media Global Times reported. China’s military had also approved the use of CanSino Biologics’ vaccine candidate.
Seven vaccines against the coronavirus are in final trial stages around the world, and four of them are from China.
But no vaccine has yet passed the final stage of trials proving it is safe and effective – conditions usually required to be met to get regulatory approval for mass use. COVID-19 has killed over 800,000 people worldwide.
