The United States has been caught in the throes of yet another incredibly fast-spreading and viral outbreak, and it’s not the coronavirus — it is the lethal outbreak of misinformation around multiple aspects of health and science. With President Donald Trump referring to Dr. Anthony Fauci as a “disaster” and complaining on a campaign call that “people are tired of hearing Fauci and all these idiots” continue to talk about the coronavirus, the source of misinformation isn’t hard to identify. Public polling shows that Americans have a high degree of trust in Dr. Fauci. But as the president and his closest advisers spread lies and misleading information, that trust shows signs of eroding and the American people are going to suffer because of it.
Trump: “Fauci is a disaster. If I listened to him, we’d have 500,000 deaths,” before later saying it would be 700,000 or 800,000. “If there’s a reporter on, you can have it just the way I said it, I couldn’t care less.” (CNN was given access to the call by a source.)
— Kaitlan Collins (@kaitlancollins) October 19, 2020
We’ve seen other symptoms of this plague of misinformation when Trump misstated that “85 percent of the people that wear masks” catch coronavirus, referring to a Center for Disease Control and Prevention study that had no such finding but instead pointed out how people who caught the coronavirus were two times more likely to have been to a bar or restaurant, a finding that has been reinforced through national contact tracing efforts.
News that the White House has embedded political operatives — neither of whom has a professional history in public health — into the CDC’s headquarters further attests to the entrenched and insidious nature of this misinformation virus. How can we protect ourselves against harmful misinformation if our trusted sources are misleading us?
The White House’s controlling of messaging on vital information to the public is part of an effort that systematically dismantles the integrity of and trust in an organization intended to impart facts and lifesaving guidelines to the public, separate from any political agenda. Public polling shows that Americans have a high degree of trust in Dr. Fauci. But as the president and his closest advisers spread more lies and mislead the public, that trust shows signs of eroding and the American people are going to suffer because of it.
How can we protect ourselves against harmful misinformation if our trusted sources are misleading us?
Viral spread by definition is fast and, to be even more technical, multiplied repeatedly by the same number. One person infecting three people becomes 1 billion in only 21 steps because of exponential growth. The president has an incredibly powerful bully pulpit and isn’t a regular person, so his misinformation only needs to influence three people to become truly lethal. The misinformation might seem innocuous at first; the off-hand comment about using bleach in the body to kill Covid-19, or jokes about wearing masks, but this misinformation spreads like a virus. And more people will die because of it. It then grows, spreading to infect others — senior White House officials, heads of state, Cabinet members who refuse to quarantine, wear a mask or distance in a crowd. Next, entire cities and states launch rallies against mask mandates, creating superspreader events in multiples.
The misinformation campaign continues, with the president attending rallies without even minimum safety precautions for attendees and stating that “we are rounding the turn” of the impact of Covid-19 despite record numbers of cases in the last seven days. He urges people to not be afraid of the virus, while states like Wisconsin are opening army field hospitals to handle the overwhelming surge of patients.
The misinformation virus is not limited to the president, who has erroneously stated that he was cured of Covid-19, despite one of his treatments being experimental and not widely available to regular Americans who have contracted Covid-19. This misinformation virus has spread to the president’s inner circle and advisers, with his closest aides minimizing the impact of Covid-19 and even neglecting to make attendees of events where the president was present aware of the risk. This includes former Gov. Chris Christie of New Jersey, who stated that he found out through the media that he might need to get tested because of his exposure at a White House event last month. Despite dozens of close aides and officials being infected at what Dr. Anthony Fauci deemed a superspreader event, little follow-up or acknowledgement has been made to the hundreds of essential workers at the White House complex who face increased risk and lack the ability to work remotely or ensure that their families are not exposed to a serious illness.
Dr. Fauci is one of our country’s most distinguished public servants. He has served 6 presidents, starting with Ronald Reagan. If more Americans paid attention to his advice, we’d have fewer cases of COVID-19, & it would be safer to go back to school & back to work & out to eat. But the president’s advisers are not merely being passive in an urgent situation; they are actively spreading misinformation with the most dire of consequences. Dr. Scott Atlas, now considered a crucial Covid-19 adviser to the White House, had a tweet removed recently that falsely claimed that masks do not work. Atlas has also been an advocate of concepts related to herd immunity, which would allow the infection to spread throughout the population while keeping vulnerable persons protected. The problem, of course, with such a concept is that with a virus like Covid-19 with a conservative estimate of a 0.5 percent fatality rate, we would still see at least 1 to 2 million more lives lost from Covid-19. And in a stunning display of conscious bias, there has been little to no acknowledgement of the incredible health care disparities in Covid-19, with Black people, Indigenous people, and people of color facing issues of health care access, increased hospitalizations and a disproportionate burden of deaths. The president has systematically undermined scientific agencies by either directly refuting his own health agency heads or inserting completely unqualified people into the highest levels of government with direct influence over scientific reports and data. The president has also systematically undermined scientific agencies by either directly refuting his own health agency heads or inserting completely unqualified people into the highest levels of government with direct influence over scientific reports and data. The extent of the damage of this influence is still largely unknown, but at a minimum we now understand that CDC recommendations around reopening and school safety were either changed or completely buried to fit the White House’s agenda. This unprecedented influence led to the country’s scattered approach to reopening, with some cities and states opening up too early and experiencing rising cases around the Fourth of July (now considered the second peak of the epidemic) responsible for tens of thousands of lost lives. Trump has propagated misinformation around health care long before the threat of a pandemic came to the United States. In 2015, he campaigned on the notion that the Affordable Care Act was so flawed that it needed to be replaced with “something terrific” but the only actions that have been taken since that speech are efforts to take away benefits from patients by allowing for short-term plans that do not have to cover people with pre-existing conditions and do not cover basic benefits such as prescription drugs or mental health care. The numbers of uninsured have increased steadily over the last several years with millions of people expected to lose health care coverage due to job losses related to Covid-19, posing an even greater challenge with the country’s swelling unemployment numbers. In short, more people, not less, have lost access to health care under Trump. All at a time when the country needs high quality health care the most. Of course, inserting politics into public health decisions and campaigns is not new; historically, public health plans have been used to control populations and sway public support. And it is always the patients, specifically the most vulnerable poor, Black, Indigenous and people of color, who are harmed the most, with far-reaching and fatal effects. Still, the level at which politics, not science and medical expertise, has brazenly led the U.S.’s faltering Covid-19 plan in 2020 is unique, and requires a collective antidote. Upcoming rallies, debates and town halls are likely to be incredibly rich with more lies and myths. But just like the nation is fighting the coronavirus with mitigation measures, we must fight the virus of misinformation with truth, facts and data. Any less will allow the virus to win.
Dr. Kavita Patel
Dr. Kavita Patel is a teaching professor of medicine, Division of Hospital Medicine, at Stanford University and a board-certified internal medicine physician. She served in the Obama administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement in the White House. Her area of expertise is around the intersection of health policy, clinical medicine and innovation. She also spends time advising venture capital and is a medical contributor for NBC News. 
