We are in an unprecedented time in medicine as we face a pandemic of an emerging viral disease spreading rapidly across the world. Information regarding the COVID-19 pandemic is also expanding at lightning speed. This leads to an overabundance of information which can alter our decision-making abilities. This editorial will help the reader develop a plan to manage excessive information and misinformation.
We’ve all about had it. Too many patients, too many worried well, not enough PPE, testing kits, and the never-ending, ever-changing flow of information.
We are at an unprecedented time in the information age. News travels faster than light speed, traversing the globe in the blink of an eye. We hear of celebrities, professional athletes, and politicians testing positive for coronavirus seemingly every hour. The latest count of total infected and deceased pops up on my Twitter every few hours.
Journalists, politicians, medical professionals, business leaders, family members, and even the guy next door have a take on the pandemic. The latest and (not so greatest) news is pounding your brain from TV, email, social media, your employer, your neighbors, and overheard conversations 24/7. It’s like trying to take a sip of water from Niagara Falls.
How do we sort through it all?
Information overload, also referred to variously as infobesity, infoxication, information anxiety, and information explosion, can be defined simply as a situation when one receives too much information about a subject. Although getting enough information to make informed decisions is a good thing, getting too much information can result in a significant reduction in decision-making quality.
Imagine the process of deciding where to have dinner. If there are two local restaurants, the choice is easy. You go to the one with the best reviews. But what if there are 400 local restaurants with five-star reviews? This makes the decision harder and it’s easy to get frustrated and just resort to the easier choice of fast food.
Misinformation is also running rampant right now. By the strictest definition, misinformation means that the giver of information is deliberately giving wrong information for some sort of secondary gain. However, inadvertent misinformation can also occur in situations when the accuracy of information is difficult to verify. Before you know it, even with the best of intentions, well-meaning people pass along incorrect information.
Here are a few examples of misinformation I have heard from both patients and healthcare providers:
- You can get coronavirus from popping bubble wrap because it was made in China by infected workers.
- You can get a rapid test for coronavirus for $50 from a person who is going door to door testing people.
- Children don’t get the disease, but they carry it, so stay away from all children.
- The virus doesn’t like heat, so as soon as the weather warms up, we’ll be good.
So how do we deal with the massive influx of information about COVID-19 when the science, and therefore societal consequences, of this pandemic are evolving so rapidly?
The first and most critical step one can take to determine if information is accurate is to consider the source. Information that comes from word of mouth, social media, 24-hour news outlets, and even our own government officials should be confirmed with a reputable (and, ideally, peer-reviewed), source and not assumed to be accurate.
You can likely trust information coming from a high-ranking clinician in your healthcare organization, especially if that information is in print, such as a protocol. Be sure the information references organizations like the CDC, WHO, a state or local health department, or randomized controlled, peer-reviewed studies from reputable institutions. Use the internet to confirm the information on multiple platforms to ensure it is accurate.
Carefully review any published data. Remember that this is an emerging disease, and any scientific studies or findings are likely preliminary. In normal situations, changes in treatment and evaluation of disease processes require years of study, with multiple randomized-controlled studies that are prospective, and data that are reproducible. There simply has not been enough time for this to occur with COVID-19. Most studies available at this time are retrospective, with small numbers of participants, and are therefore difficult to draw reliable conclusions from.
In most cases, years of clinical trials are necessary to determine if a therapy is safe and effective. One example would be estrogen for perimenopausal women. Many studies showed benefit and the science made sense, but ultimately it was determined that routine estrogen therapy was actually more risky than beneficial. Also recall the case of Oxycontin. Early publications suggested that this was the end to chronic pain and, seemingly miraculously, without any addiction issues. Those studies, however, were sponsored by the manufacturer who had a vested interest in their product’s success. This is a prime example of misinformation.
Remember that desperation and stress can affect your decision-making. Excessive cognitive load, ie, excessive information, can worsen the stress already inherent in a pandemic situation. We are already overstressed, anxious, and wary of what the future will bring. We are worried about our families and friends, our patients, and the economic aspects of this pandemic. Excessive information can add to that stress. When making decisions based on newly acquired information, stop and think for a minute about the basis for that decision. Again, consider the source, vet it carefully, take a deep breath, then make the decision.
Consider unplugging from social media. Although it’s great to hear how everyone is doing, to see an uplifting dog or cat video, or a humorous meme, you are likely to get more misinformation from social media than anywhere else. If you do stay plugged in, don’t add to the information overload. Avoid pandemic information altogether and stick to making connections with family and friends, especially those who are isolated. This will improve your emotional well-being without adding to information overload.
Uncertainty can lead to heightened tension and stress, in any scenario. A pandemic is a situation of tension and stress on steroids! Most of us have not lived through anything like this before and have no basis for comparison. Remember, everyone is as fearful of the unknown as much as you are. Be a voice of reason. Filter the information, review it carefully, and adopt a reasonable approach. Above all, don’t panic. We will get through this, and like every human crisis before, we will rise to the challenge, and overcome.
Tracey Q. Davidoff, MD, FCUCM is an urgent care physician in Lake Buena Vista, FL; and Vice President, College of Urgent Care Medicine; and a member of the JUCM Editorial Board.