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This week, we focus on COVID-19 misinformation, talking to Kolina Koltai, ethnographer of vaccine conspiracy theory communities; Jon Lee, a folklorist who studies the history of conspiracy theories about disease; and Ifeanyi Nsofor, a Nigerian public health expert reporting on religious leaders' role in COVID skepticism.

Transcript

Jon Lee:

Again, if we look at the reasons why conspiracy theories spread, they provide a sense of control, they provide a sense of identity, they provide an outlet for fear and anger of an unknown situation. And what you essentially largely have is people who are trying to regain a sense of power and control over their own lives.

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Introduction

You’re listening to Viral Networks, a look at the current state of mis- and disinformation online, with the scholars studying it from the front lines. We’re your hosts, Emily Boardman Ndulue and Fernando Bermejo.

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Fernando Bermejo:

You just heard from the folklorist Jon Lee, who has done fascinating historical research on how conspiracy theories spread alongside diseases.

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Emily Boardman Ndulue:

Today we’ll be talking about mis- and disinformation in public health. We recorded these interviews in the summer of 2021, when vaccination efforts against COVID-19 were slowing down and vaccine resistance was gaining steam, partially fueled by anti-vax conspiracy theories. Like Jon says, this certainly isn’t the first time that we’ve suffered from a pandemic, and it’s not the first time there’s been an information problem around one either.

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Fernando Bermejo:

Emily, you studied public health communication in grad school, right? Does that influence how you think about these issues of misinformation and disinformation?

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Emily Boardman Ndulue:

Yup I did and it absolutely does. Usually public health communication focuses on what we call health literacy, which basically means we try to help people to make sense of the health information that they encounter. If we’re successful, that means people can be better judges of whether that information is credible or not. As basically all of our guests on today’s episode will tell us, it’s really important to do this work on the local and community levels and it’s been made way more complicated by how quickly and easily bad information circulates on social media. You could say one of the big public health risks these days is that mis- and disinformation can spread like a virus.

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Fernando Bermejo:

We have a really exciting group of guests on today’s episode. In addition to Jon, we’ll be talking to Kolina Koltai, who is an ethnographer of mis- and disinformation on social media platforms, and Dr. Ifeanyi Nsofor, a public health expert in Nigeria. We recorded these interviews several months ago; but, fortunately, what our guests told us then is still true today. On that note, let’s dive into the belly of the beast with Kolina Koltai.

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Kolina Koltai:

My name is Kolina Koltai. I spend the majority of my time thinking about vaccines, both before the pandemic and of course during it and focusing on vaccine hesitancy and particularly the anti-vaccination movement. This of course cannot be done without thinking about the role of misinformation in the way that digital tools anything from Facebook, web browsers, particularly communities that people coalesce and connect with in which they share misinformation and the way that people have made a decision, not just to whether or not to vaccinate their kids, but today vaccinating themselves for COVID.

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Emily Boardman Ndulue:

Since 2015, Kolina has been doing ethnographic research on mis and disinformation in Facebook groups and other online platforms, which means she goes into these groups and talks to people who are actively participating in them. It’s a way to research social media discourse by first understanding the social and cultural context.

Fernando Bermejo:

It’s almost like going out in a neighborhood and talking with people in a community, except everything is online.

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Emily Boardman Ndulue:

Exactly. When she’s observing and interviewing people in these groups, she isn’t trying to change anyone’s mind. She’s trying to understand what kinds of conversations they’re having and how they form conclusions using the information that they’re encountering.

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Kolina Koltai:

When you think about the conversation of how much spread of misinformation, that's a question I often get. How much vaccine misinformation? How much has something spread? And the reality if we say that we actually don't really always know. There's a lot we cannot see and it's not something that I necessarily always should have access to.

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Emily

Kolina described something tricky about her work. People spreading misinformation on social media platforms are good at developing techniques for evading automated moderation. Those very techniques make it hard for researchers like Kolina to keep track of exactly that misinformation content.

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Kolina Koltai:

Instead of ... the word vaccine, they might use a ... syringe emoji, or they might use the @ symbol for A. And this is often because people are trying to avoid algorithmic detection. This is just one learned behavior within these communities of how to avoid moderation. That's not to say that this isn't a behavior that's used in a variety of other communities.

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Emily Boardman Ndulue:

What's changed in these communities? What's the growth been like? Has the narrative shifted?

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Kolina Koltai:

Almost every narrative that we've seen about COVID and COVID vaccines, especially around COVID vaccines has been all things that we've seen before. It's very little that's new. You can imagine, say a story about a vaccine injury. We've seen the thought of vaccine injuries, things about VAERS, which is the Vaccine Adverse Event Reporting System.

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Things about like, we're worried about the money the pharmaceutical company is going to make, or like Bill Gates. Bill Gates was a hot contextual figure in the vaccine world prior to the pandemic. A lot of these things were all like, "Yeah, I've seen this before. Here's a lot of history about it." Even more unusual things like relating a vaccine to anything from the mark of the beast or is there aborted fetal DNA in vaccines? Or all these other even more niche things. Those are still things we've always seen before.

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These are all arguments, and it's because there is a large arsenal of arguments of these are all the dangers of vaccines. If you don't believe this one, here's the other one. And I've actually gone to these conferences in person and gone through these talks where people are giving lectures of how to convince your colleagues, your friends, your family to start questioning vaccines. And one of the techniques that's taught is if someone shoots down one of your arguments, go to the next one, if you can't argue that one anymore. And you keep going down your list.

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I would say the only thing that is new, which I thought was interesting that we've seen so far, is the blending of two different narratives. There's the classic trope that vaccines will threaten your fertility in some capacity. And that's tied to a larger conspiratory idea about depopulation and things like that.

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But then you also have another classic trope, which is the idea of vaccine shedding. What got tied interestingly this year is combining these ideas of vaccine shedding to fertility, where, if I ended up getting near someone who was vaccinated, they are now threatening my fertility. That's tied to a larger conspiratory idea about depopulation and things like that.

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But then you also have another classic trope, which is the idea of vaccine shedding: the idea is that if you say get vaccinated, if I got vaccinated for measles, I am actually a danger to society because I can then spread measles in the first few weeks to other people. It's not the unvaccinated person that's dangerous, it’s the vaccinated person that's dangerous.

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What got tied interestingly this year is combining these ideas of vaccine shedding to fertility, where, if I ended up getting near someone who was vaccinated, they are now threatening my fertility. That they're going to disrupt my menstrual cycle, they are going to ruin something about my reproductive system, just because I'm near someone else who's vaccinated. It's combining those two. That's something that is a pretty new thing.

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We've been in an extended period of the health crisis. This is a long period of crisis versus consistently being in crisis. I listen to the news every day, every day I hear something about vaccines. It has given the opportunity for people within these spaces to evolve and develop and refine and change even narratives and blend them like this.

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Emily Boardman Ndulue:

But Kolina made sure to emphasize during our interview that it’s not just members of anti-vaccine conspiracy groups who are exposed to mis- and disinformation. It’s all of us.

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Fernando Bermejo:

Kolina gave us an example of how health misinformation can cross ideological lines and evolve as a greater diversity of people become exposed.  

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Kolina Koltai:

Prior to the pandemic, prior to 2020 there were actually a fair amount of anti-vaccination accounts and activists who were pro mask. The anti-mask thing was something that was new and it was a major shift in sentiment and opinion on this health behavior that was changed due to a variety of different propaganda really early on into the pandemic.

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We see a variety of different types of Instagram accounts that are not just anti-vax, but also anti-mask. You'll see ones like the health and wellness mom blog which I think also, it's getting a lot of traction in relationship to other conspiratorial stuff, like save the children and what not and that's one type, but then you also will see once that are really it's just straight up absolutely conspiracy and everything, and it's just really way out there.

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Fernando Bermejo:

This makes sense, right? Vaccine misinformation wouldn’t just stay put in Facebook groups of true believers, but it would seep out into other groups and conversations online also. But why would that misinformation be appealing to people who aren’t in these anti-vax or anti-mask groups?

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Emily Boardman Ndulue:

That was one of our big questions for our next guest Jon Lee. Jon is a folklorist, and he’s been interested in tracking conspiracy theories on the Internet for decades. We talked to Jon because we wanted to know why conspiracy theories are so appealing to people. His answer is that they’re actually a version of something we’ve have been doing probably for all of human history: telling stories.

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Jon Lee:

Hello, my name is Jon Lee. I'm an instructor at Suffolk University and I am the author of An Epidemic of Rumors: How Stories Shape Our Perception of Disease.

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Fernando Bermejo:

Published in 2014, Jon’s book discusses the 2003 SARS epidemic and the different types of folklore, including rumors, conspiracy theories, and jokes that emerged during that period in time. Much of the work focused on how folklore spreads via the Internet. With COVID-19, history is repeating itself.

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Jon Lee:

It used to be, we only really studied oral narratives as such as we were studying stories. When we were researching legends in the 1980s, we would just go out and interview people and say, "What do you believe about this?" But then the '90s came about and everything moved online and we had to modify our set of tools to look at what stories did people are passing from email to email, or status updates to status update.

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Fernando Bermejo:

As Jon explained to us, much of his recent work focuses on the spread of conspiracy theories online. Jon sees conspiracy theories as a version of legends, or stories that both the narrators and the listeners regard as at least partly fictional.

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Jon Lee:

Legends are what we sometimes describe as negotiations of the truth. You don't even have to have a full narrative to have a rumor or a conspiracy theory, a legend is usually something of a full narrative, but in conspiracy theory, what you more often have are what we call kernel narratives, where you just say, Bill Gates is the antichrist or microchips in vaccines, which points to this larger story, this larger web that we have connected together, or the conspiracy theorists have connected together.

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And the same thing can happen in rumor where, "Oh, did you hear that X happens to this person?" That's it, that's the entire narrative. It's very tiny, but it points to this larger reality. So legends –

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If you look at the nature of a conspiracy theory that they mostly involve this large assemblage of previously unlinked domains. And once you establish a pattern in conspiracy theory of simply adding another domain to help make the larger conspiracy make sense, then it's easy to just simply plop in something like 5G, that's new — or microchips in vaccines or any other unfamiliar technology.

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And when you look at technology, it's especially the unfamiliarity of new technology that often makes its way into conspiracy theory and into legend as a whole, because people aren't familiar with it. And there's always a little bit of hesitation, fear, reticence as to what this is and how it functions.

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If you go back to the 1970s and 1980s, when microwaves were first introduced into the common house, folklorists collected a lot of legends about people who would wear lead vests while they're working their microwave, or a lot of legends about microwave somehow damaging your DNA or irradiating you simply because it was a new technology and people were unfamiliar with how it worked.

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Emily Boardman Ndulue:

I would like to talk, because you had a book focused on the SARS epidemic, about the similarities and differences that you're seeing with the disease narratives from that time period and the COVID-19 outbreak.

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Jon Lee:

A lot of them are almost exactly the same. Is it manmade or is it natural?  Going back to 2002, 2003 in the early SARS outbreak, there were rumors in that early outbreak of it being a man-made virus. One of the acronyms was Saddam's Awesome Retaliation Strategy, that Saddam Hussein supposedly made it. There were other narratives that said that the FBI or the CIA had made it and released it on the world for various reasons.

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We have with the current COVID outbreak: was it an accident release from this Wuhan lab, where they were studying this and whether it was purposeful or accidental? So the man-made nature of the narrative connects the two incredibly quickly and incredibly well. The same sort of conspiracy theory thinking in a lot of ways, some of that based around the man-made nature of the disease. Was this intentional and who created it and who was the target because of it?

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So certainly xenophobia and othering, this large sense of making it someone else's fault and pointing the finger is incredibly common across epidemics.

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Fernando Bermejo:

Of course, when we interviewed Jon, we also wanted to know what was new in the COVID-19 era. No matter how much history is repeating itself, the Internet has changed considerably since his study of SARS narratives.

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Jon Lee:

I would say that social media is certainly exacerbating the problem, especially as it resorts to misinformation, conspiracy theory groups like QAnon, say, probably could not have existed 30 years ago, or if they did, they would not have been as widespread and as well formed as they are. Social media has allowed that group to come together in a way that it wouldn't have before.

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That certainly not only helps a narrative spread within a group of people who are likely to believe that narrative, because you are more surrounded by people who believe the same things that you do, but it also makes it much more difficult for a correcting narrative or for an alternate narrative to then come into that society because there are more people there to reject the different narrative, especially if you look at some of the problems with trying to debunk narratives, which very rarely works.

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One of the reasons is that you have this group of people who now all believe the narrative. And if there are 10 of you or 50 of you, or 100 of you on this list serve, and you all believe this one thing, and someone else comes in and says, "No, that's not true." Well, you've got 10 against one or 50 against one or 100 against one. And it's so easy to push that person out and disregard the narrative that they are trying to bring in.

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Fernando Bermejo:

Given the history of conspiracy theories online we wanted Jon’s opinion on the World Heath Organization’s decision to deem misinformation problems around COVID-19 a, quote, “infodemic.” Here, Jon refers to the W-H-O as “the who.”

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Jon Lee:

In calling it an infodemic or a misinfodemic, the WHO is missing out on a large reason why these narratives spread in the first place, which is that people are trying to make sense of the world around them. And you have to start there. Again, if we look at the reasons why conspiracy theories spread, they provide a sense of control, they provide a sense of identity, they provide an outlet for fear and anger of an unknown situation. And what you essentially largely have is people who are trying to regain a sense of power and control over their own lives, because they are not being given the kind of information they need to move forward, or they reject the kind of information that we need to move forward.

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Fernando Bermejo:

But is there anything that we can do to reduce the amount of mis and disinformation around health that we're seeing today?

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Jon Lee:

One of the only things that really seems to be effective in, for example, trying to make sure that people are going to get vaccinated is not to try to combat the narratives directly themselves at a federal level, at a governmental level, at a national level, not even at a state level or a city level, you need to move it down to the community level because anyone who does not believe that a vaccine is good for them is not going to believe a medical official who comes on TV and says the vaccine is fine. Even if it's Anthony Fauci, they're not going to believe the president, especially if they didn't vote for that president.

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They're not going to believe the mayor, especially if they didn't vote for that mayor. The people they're going to believe are going to be the local leaders, church leaders, business leaders, important people in local communities who are known entities to a large group of individuals. So it has to be a bottom up approach.  

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Fernando Bermejo:

So far we’ve been talking about anti-vaccine groups and disease conspiracy theories from a US perspective. But these phenomena aren’t limited to one place. Misinformation and disinformation are very much a global issue, and in different cultural contexts, the challenges of dealing with them are bound to vary.

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Emily Boardman Ndulue:

Today let’s take a look at health misinformation in Nigeria, the most populous country in Africa. The country has 36 states, and by UN estimates, has a population of over 200 million people. That’s about two-thirds the population in the US. Our next guest is a public health expert in Nigeria.

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Ifeanyi Nsofor:

My name is Ifeanyi Nsofor. I work with Nigeria Health Watch, a health communications and advocacy fuirm, and also EpiAFRIC, a public health consultant firm, both based in Nigeria's Federal Capital City, Abuja.

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Health misinformation is as old as the country. Growing up, we had all sorts of misinformation about different health issues. But I think what has happened of recent is that, because of social media, because of ease of access to Internet, to information — this misinformation really take on a viral form.

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Over the years, people see health workers from other countries that look different, that speak differently from them. And I think that, for those who want to perpetuate that falsehood of the international community trying to take advantage of us, they see that as a ready tool. The commonest thing that you hear in addition to what you said is they want to sterilize us, they want to reduce our population. That is a common thing that you hear.

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Emily Boardman Ndulue:

Ifeanyi helped us understand the link between images associated with vaccination and these common fears around fertility issues. He believes people designing public health messaging in Nigeria need to understand it too.

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Ifeanyi Nsofor:

What we try to say there, was that when you have such image, people would, on one hand, look at it as, "Look, after all when our wives go to take some contraception, they're injected. Who knows what you have inside injection? They could have all sorts of drugs that would sterilize women with such medication." Because of that, when you're coming up with graphics and messaging for COVID-19 vaccination, it is very important to run away from such kind of graphics because of what it would connote for people, that, "These guys have come again."

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And I think because If you look at similar instances where health advocates have tried to promote a particular drug that maybe eventually people had issues with, they were associated with drugs in the syringes. Let's run away from that and use messaging that, to me, they're really very contextual, that people can relate to easily, compared to other countries.

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So for instance, it will make sense for us to use messaging that would ... We cannot use the same messaging with U.S, as we're using in Nigeria, because these are two different societies, two different levels of experience, exposure, and all sort of issues. And we think that's really very important because if you don't do so, you're likely going to encounter some pushback down the line.

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Fernando Bermejo:

Ifeanyi conducted a survey in March 2020 to understand what sort of early COVID-19 misinformation beliefs existed in Nigeria, and shared with us some key findings from the study.

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Ifeanyi Nsofor:

I think, some of the responses that we got from the respondents were quite interesting. From that particular research, that polling that we did, 26% of the respondents said that they were immune to COVID-19. They have some form of immunity to COVID-19. And when we now dug in further to ask why they thought they were immune, you hear things like, 40% out of the 26% said, "Because I'm a child of God." 30% said, "Because I have strong genes." 17% said, "Because of the hot weather." 8% said, "Because I drink strong Herbs." While 5% said, "Well, COVID-19 is not for Africans."

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And if you look at how the 26% are disaggregated, you realize that it all boils down to religion. And that, to me, is the biggest threat in Nigeria, whether it's regarding COVID-19 or any other health issue, or even other development and economic issues, even political. Nigeria is a deeply religious country, and it showed in that polling, when 26% of the country thought they were immune, and almost half of that 26% percent thought, because they were children of God. And you can imagine how that will translate into behavior change, what people would do, how they would adhere to public health advisers.

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And of recent, we've had very influential religious leaders in the country saying they didn't believe in the COVID-19 vaccine. And two of them come to mind, Bishop Oyedepo that leads one of the largest churches in the country, and also Pastor Chris Oyakhilome, who also leads a very influential congregation. They have come out vehemently to oppose the COVID-19 vaccine, which I think is part of the reason why we have such level of hesitancy, even among health workers, to take the COVID vaccine.

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A day after Bishop Oyedepo came out with his condemnation of the vaccine, I went to a supermarket in Abuja here to buy some things, and the workers at the supermarket were discussing about this and they were using that as the basis to say, "Look, we will not take this vaccine. It doesn't matter what anybody says, because Papa has said so."

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Emily Boardman Ndulue:

Ifeanyi also mentioned that, much like here in the US, there are some people looking to capitalize on misinformation to turn a quick profit.

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Ifeanyi Nsofor:

Yes, there are people with different motives, and they just thrive in the chaos. If you have a situation like I read from our research, where people said that they're immune to COVID-19 because they drink strong herbs. Well, it simply means that people who sell herbs will find that as a good marketing opportunity, to keep marketing their herbs and make sure that people have access to them.

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Emily Boardman Ndulue:

Ifeanyi did suggest that there was a place for religious leaders to help spread quality information about public health issues, it just has to be the right people.

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Ifeanyi Nsofor:

We also have very influential pastors that have spoken for the vaccine, and have really observed all the COVID-19 protocols for their services. For instance, people like Pastor Kumuyi who leads the Deeper Life Church, people like Pastor Adeboye who leads the Redeemed Christian Church that is in seven counties,

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And I think that it's time for us to begin to target such individuals to be the spokespersons. They can quote some of the scriptures for you, but the ones that are pro COVID-19 vaccine also will have scriptures to back up why they believe people should be careful and take the vaccine.

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Emily Boardman Ndulue:

Ifeanyi also pointed out that spreading good health information isn’t just a matter of collaborating with the right leaders, but reaching people using media they’re most likely to pay attention to.

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Ifeanyi Nsofor:

Ultimately, the usual suspect, TV, but again, if you consider the fact that power supply is still a big issue in Nigeria, so most people will not, even if they had a TV, it's just a box because there's no power as to power it, so we need to find other ways where people can engage people beyond television. And I think social media is key, because I think that's why everybody in Nigeria has a mobile phone.

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Radio, especially Northern Nigeria, because that's a very common — If you go to Northern Nigeria, it’s very common to see the Hausa man with his radio. Even riding his bike with his radio, and he's listening to the radio. We need to look at what are the low hanging fruits in different parts of the country, different communities, and already tap into those spaces as early as possible.

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Like I said initially, in designing the right information for people, we need to start as early as possible, and involve communities like pastors and people like that, that would usually get some kind of pushback as part of the design process, as part of the dissemination meetings that we're going to have. We don't have to wait until people begin to hear the wrong things before we start countering them.

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Fernando Bermejo:

A running theme here is when you have something as large as the ongoing pandemic, it’s not enough to just have public health leaders communicating health information. Of course, you need them to be doing their job well, but you also need people outside the healthcare industry who have access to local communities or large online followings to be a messenger to the public as well.

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Emily Boardman Ndulue:

It really does need to be a community effort. This is also shown through health literacy research, which proves time and again that trusted community leaders are critical to effective health messaging campaigns.

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Fernando Bermejo:

In our next episode, we’ll be talking about manipulative actors, troll farms, and the production of misinformation. So stick around for that.

But for now, thanks for listening to this episode of Viral Networks.

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Credits:

Viral Networks is a production of Media Ecosystems Analysis Group. We’re your hosts Emily Boardman Ndule and Fernando Bermejo. All episodes are produced and edited by Mike Sugarman. Julia Hong joined us as a script writer and provided additional research. Music on this show was composed by Nil and our producer Mike. Funding to produce this series was provided by the Bill and Melinda Gates Foundation. And last but certainly not least, we want to give a big thank you to all of the experts who joined us for interviews on this show.

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