The New Normal

by Jennifer Ashton, M. D.

  A problem usually develops, however, whenever demand outstrips supply: All sorts of purveyors magically appear out of the woodwork to fill in the gaps. This has empowered many with a pen or a pulpit to start delivering “news,” regardless of whether they have any journalistic cred or medical expertise. Today, so-called experts now interpret complex studies and disseminate medical advice even though they’re the chief marketing officer of a tech company or a campaign employee for a political candidate or party. One news outlet even suggests searching “I’m not an epidemiologist, but . . .” on Twitter to see just how many people now espouse medical advice.10

  Unfortunately, politicians themselves, along with some governmental organizations, have also contributed to the infodemic, spreading disinformation, which is false information or propaganda shared deliberately for personal or political gain. For example, Russian military intelligence has pushed out pandemic propaganda on English-language websites, according to declassified U.S. intelligence,11 while the European Commission has accused China of spreading disinformation inside the European Union.12 A handful of American politicians have also made or supported false claims, turning the virus into a political weapon and ratcheting up the country’s potential for mistrust.

  What’s more, not all research, even that which appears in prominent medical journals, is based on valid science. For example, a commentary published in September 2020 in The New England Journal of Medicine suggested that people may be able to immunize themselves against the coronavirus by wearing masks, with the perception that masks expose people to a small amount of the virus at a time almost like a vaccine would.13 The commentary got a lot of press, but even though The New England Journal of Medicine is a very credible publication, the premise of the commentary is simply untrue.

  Another example: A Belgian-Dutch team of researchers published a study that subsequently went viral suggesting that runners and cyclists could spread COVID-19 at distances of more than six feet, advocating people stay up to thirty-five feet behind runners and up to sixty-five feet behind those cycling hard.14 The “study” was self-published and based on computer modeling, not actual research, but it still seeded fear in millions and caused many to stop exercising outdoors.15 The researchers later admitted that their findings were blown out of proportion.16

  This is why it matters so much where you get your medical news today—or more specifically, whom you’re getting your news from. In the new age of the infodemic, the messenger becomes as important as the message. Because if you can’t trust the messenger, you likely can’t trust the message, either.

  Reevaluate Your Medical News

  Whether you already distrust everything you’re reading and hearing about the virus—or learning about the infodemic makes you now think twice about medical news—I want you to know that it’s important not to give up on medicine or the media. I truly believe that most people in medicine and the established media want to help people, not fool them with fake news or bad science. But you do have to do a little legwork to make sure you’re getting your news from a trusted source.

  When you see or read medical news, start by asking yourself who, what, where, and how: who’s giving the news, what are they saying, where did they get their information, and how was that information determined. You have to put your news under the microscope to understand what you’re really consuming and if it’s valid.

  Focus First on the Who

  Of all the who, what, where, and how variables, the most important one when it comes to medical news, in my opinion, is the who: Get the who right and the other factors usually fall into place.

  The reason I feel so strongly about the who is that I not only love what I do, I also realize how much is at stake. Whenever I give medical information, it’s not just people’s health and lives on the line—it’s also their trust. When medical news isn’t communicated accurately or effectively, people lose faith in medicine or the media altogether. That development, if sustained over the course of someone’s lifetime, can be disastrous.

  Here are seven steps to help you determine the best “who” to guide you in our new normal:

  1. Ask for credentials. Credentials establish credibility, which is why you should suss them out immediately in those who deliver medical news. Not everyone is qualified to interpret and present complicated medical information, and degrees of understanding can vary greatly with someone’s qualifications. Would you rather get your medical news, for example, from a part-time sports reporter—or a doctor with ten to twenty years’ experience? Similarly, would you rather hear an epidemiologist speak about infectious diseases—or a psychiatrist or veterinarian? Would you rather read a story written by a medical journalist who’s written extensively on health and healthcare—or by a junior reporter who also dabbles in entertainment news?

  In general, medical doctors tend to have a better understanding of medical information than those who aren’t M.D.s. Sometimes people ask me how an OB-GYN can cover medical stories dealing with cancer, COVID-19, or chronic obstructive pulmonary disease (COPD). It’s a good question. The answer is simple: In medical school, doctors learn about the entire human body and every specialty. We don’t just specialize in one body part or group of body parts—we need to understand the whole body to understand how it connects to that part or group. However, because I am board certified in one specialty, I always—I repeat, always—discuss medical stories with colleagues and national experts in the respective fields I cover. Think of it like being an interpreter in a foreign language, that language being Medical.

  But not all doctors are competent communicators and can relay information to the public in a way that’s understandable, impactful, and empowering. This has nothing to do with a doctor’s knowledge base, intelligence level, or clinical experience. You can be the smartest doctor in the room but might not have the knack to communicate emotionally charged information to a lay audience. You can think of it like you do a doctor’s bedside manner: Some doctors have it and some don’t.

  One thing that makes me a successful communicator and helped me achieve the position of chief medical correspondent at a major national network is that I speak to viewers—not necessarily at them and never down to them. I speak the same way on the air as I do in my medical practice—in other words, I don’t just play a doctor on TV. I have real patients who depend on me, and I speak to them about complex issues in a way that they can digest. Similarly, I always try to make segments relatable and absorbable, and I don’t believe in dumbing down the news. I like to tell people what I know and what I don’t know so they have all the information to be able to make their own decisions.

  2. Analyze the outlet. In general, the larger and more prestigious a media outlet, the more scrutiny whoever works for the outlet will face, both externally and internally. I work for ABC News, for example, which is seen by millions of people, including thousands of doctors, agency experts, and researchers. If I got the information wrong, I wouldn’t have a job. There’s also internal oversight in whatever news I deliver, with a team of medical editors and attorneys fact-checking the material before it goes to air.

  3. Separate actors from part-time players. Accountability is key. When your job is to appear on air regularly or write frequently for a national publication, you have a reputation to uphold. You need to get it right—this time and every time—or you can lose your job. Established medical journalists who report regularly also know the language to use and don’t get sidelined by a camera in front of their faces or the opportunity to have a byline in a major magazine like some part-time players can. Regular correspondents also can’t check out whenever they want.

  4. Listen or look for source citations. Good medical journalists disclose where they get their information, whether it’s from a new study, a health organization, or another expert or doctor, or if it’s their own professional opinion. On Good Morning America, I’ll qualify what I say by using phrases like “in my opinion” or “the CDC recommends.” If I spoke with an
other doctor for insight, I’ll identify that person by name and credentials if airtime permits. If my info is based on research, I’ll clarify where that study was conducted or published. This way, viewers can assess or determine if the information is legitimate (see more on how to do this here).

  5. Consider the motive. Medical journalists shouldn’t be motivated by personal or professional goals, but it unfortunately can happen—and more so now in the infodemic age. That’s why it’s so crucial to scrutinize a person’s credentials and make sure they deliver the news regularly and qualify their sources—two characteristics that people with an agenda are less likely to do. Also watch out for anyone who speaks in extremes—if something seems too one-sided, it probably is—appears too enthusiastic, or doesn’t qualify with simple yet critical words like “may,” “can,” and “possibly.”

  6. Ignore the blowhards. No one knows everything in medicine and science, and people with professional integrity have no problem admitting that. If someone pretends to know everything or even most things in medicine, you’re listening to the wrong messenger. Telling viewers what I know and what I don’t know also makes it very clear which areas of information have limitations and may need to be viewed cautiously.

  7. Find someone who doesn’t just report, but also explains. It’s one thing to explain the news—it’s another to connect the dots to make sure viewers and readers understand how the news might affect them. Look for a journalist who realizes that medical news can be personal and emotional and is able to address you as a person, not as a statistic or an impersonal bystander.

  Where Not to Get Your Medical News

  You now know where to get medical news—or rather, who to get it from. But where shouldn’t you turn for trusted medical information? It’s quite simple: Stay away from social media, including Facebook, Twitter, YouTube, Instagram, and TikTok. The majority of misinformation spread about the pandemic to date has occurred on these platforms, according to research.17 Fake posts are also more likely to go viral on social media and be seen, liked, or shared by millions of people.18

  Facebook, in particular, has proved to be one big hotbed for pandemic misinformation.19 In August 2020, Facebook revealed it had already removed 7 million posts containing false information about the virus, including some claims about fake preventative treatments and cures.20 Efforts to stem misinformation haven’t been effective, either, with the nonprofit group Avaaz finding 40 percent of coronavirus misinformation remained on Facebook after administrators were alerted that the claims were false.21

  The bottom line: Don’t get your medical news from social media. If you see an interesting article or premise, go to the source or search off social media to learn more. Additionally, think twice before sharing or liking posts about the pandemic, and don’t be afraid to contact platform administrators whenever you think a story or account may be spreading misinformation.

  Assessing the What, Where, and How

  While the messenger matters immensely, it’s critical to learn how to evaluate news yourself and be able to spot false claims and inaccurate or exaggerated information. Here are ten questions to ask about any news story to help you assess medical information and uncover the real truth behind the headlines:

  1. Did you really watch or read? Headlines, anchor introductions, and electronic captions under TV segments are sometimes made to sell the story more than tell the story. That’s why it’s so important never to take a headline at face value—you have to watch the segment closely or read the entire story. This may sound obvious, but in our ADD era of fast-moving media, few people actually take the time to finish a news story or pay close attention to an entire television segment.

  Case in point: Pew Research Center found that people spend less than one minute reading news articles under 999 words and less than two minutes reading articles between 1,000 and 4,999 words22—hardly long enough to comprehend a new or complex topic. If a headline or anchor introduction captivates you, take the time to read it through or listen closely without multitasking. With medical information, the devil is often in the details, and nuances or subtleties can be vitally important.

  2. Is the headline based on new information? New information is at the core of medicine and science—without it, we’d be stuck diagnosing disease based on outdated criteria, wondering how an infection or illness occurs inside the body, and prescribing drugs or treatments that may not work as well as others. While it can feel unnerving when new information changes the recommended guidance or standard of care, it’s important to realize that this is how good medicine can and does work. Whenever you hear surprising health news where the medical guidance or messaging has changed, ask yourself if it’s based on new information or evidence that doctors or researchers didn’t know before. If so, pivot and adapt.

  3. Where did the headline originate? New research often makes medical news, but not all studies are conducted with the same scope and rigor. In general, national health agencies, large hospitals or medical centers, and major academic institutions have the kind of machinery and staff needed to conduct high-quality research. That’s why studies conducted at Harvard Medical School or the Cleveland Clinic, for example, tend to carry more weight than research performed by a small college without a medical school, a minor medical center, or a team of doctors with no established affiliation. Keep in mind, too, that almost anyone can conduct a study and hire a publicity team to get the information out to the media, which is why it pays to be discerning about the origins of medical news.

  4. How many outlets are reporting the same headline? Major networks and publications can get information wrong from time to time. But it’s unlikely that multiple major networks or publications will get the same information wrong at the same time in the same way. Compare stories, read or watch closely, and look for subtleties or variations in explanation.

  5. Is the headline a correlation or causation? Correlation does not imply causation and association is not the equivalent of cause and effect. Both are Rule No. 1 of statistics and scientific methodology—and why articles claiming that certain foods boost immunity are usually inaccurate (see here for more on this). Here’s how it works: When a researcher observes a person has increased immunity after eating an orange, for example, that correlation is not the same as the researcher being able to show that oranges improve immunity through X, Y, or Z channel. If this distinction wasn’t such a big deal, we might all believe that eating ice cream raises the risk of getting attacked by a shark, since both are more likely to occur on hot, sunny days.

  How this understanding can help you in a pandemic is by providing a way to separate facts from unproven possibilities. Let’s use the example of so-called COVID toe, or the red, swollen toes doctors began seeing in a small percentage of patients diagnosed with COVID-19. Many people assumed COVID toe was another sign of the disease, but if you applied the correlation-versus-causation test, you’d discover that COVID toe was simply associated with the virus, not necessarily caused by it. As testing for the virus increased in accuracy, researchers discovered that many patients with COVID toe don’t actually test positive for the disease, leading them to theorize that red, swollen toes may be a consequence of people wearing shoes less frequently due to more time inside.23

  6. Is there a potential conflict of interest? A lot of newsworthy studies are either conducted or funded by pharmaceutical companies, medical-equipment manufacturers, industry groups, or other businesses with vested interests. This doesn’t mean the study is corrupt or invalid, but you should take possible conflicts of interest into account when you consider the conclusions made by the research.

  7. Does the headline sound too good to be true? When something sounds too good to be true, it often is. For example, many headlines touted homemade cures for COVID-19 at the beginning of the outbreak. While some might sound ridiculous now, that didn’t stop plenty of highly intelligent people thinking they could avoid getting the virus by gargling with warm salt water, for example—an early myth ma
de up on social media.24

  8. Has the information behind the headline been peer reviewed? In the new normal, medical information comes out at such a rapid pace that it’s not always peer reviewed before it becomes a major headline in the media. Peer-reviewed research means that a team of doctors and scientists have analyzed the study to make sure its methodology and conclusions were well-conducted and logical. You can think of peer-reviewing like American Idol for medicine: Experts judge the study and either punch it through to be published, reject it, or ask for revisions, helping to ensure quality control. If the news you’re receiving is based on research that hasn’t been peer reviewed, that doesn’t discount the information, but you should take it with a grain of salt. Also, look for the difference between a study and a commentary. Commentary—as, for example, the piece in The New England Journal of Medicine that advocated that masks could be a crude vaccine— means opinion, not science.

  9. What’s the sample size? There’s a big difference between exciting news based on a study of thirty thousand people and exciting news concluded from a sample size of thirty. In general, the more patients involved in a clinical study or observational review, the more likely the results are to be accurate. A large sample size lends statistical power to studies and obviates the risk that the results were reached by chance. That’s not to say a study conducted on thirty people isn’t interesting or worth reporting, but no one should make decisions about their health or standard of care based on such a small sample size.

  10. Does the sample size apply to you? Here’s something that’s happened repeatedly in the infodemic age: People draw broad conclusions about a disease based on a study conducted on a unique demographic. In medicine, you can’t compare one population with potentially different genetics and lifestyle factors to another. For example, how the coronavirus impacts people in China may not translate directly to how it affects Americans. Be sure to assess demographic details when you hear or read medical news, and don’t automatically draw conclusions between unique populations.