COVID-19 era of misinformation: When your family does not trust you, will your patients?

Sarah Riley Cox J Am Pharm Assoc (2003). 2020 Aug 14;S1544-3191(20)30413-1. doi: 10.1016/j.japh.2020.08.020. Online ahead of print.

I have only seen my grandmother twice since the pandemic began. The first time was about 2 months ago. My sisters and I took our kids to run around in her front yard so she could watch from her porch (a safe 6 feet away). This time, we were in the backyard.She lives in a small slab home in a middle-class neighborhood nestled in the heart of a rural community. I have 2 sisters, and among the 3 of us, we have 10 kids under the age of 8. So, you can imagine 10 children playing tag in my grandmother’s backyard as she sits on the porch watching with enjoyment. She is 92 years young, and although she is in excellent health for her age, she does have chronic obstructive pulmonary disease. She is at high risk for coronavirus disease (COVID-19), so we are careful to maintain our distance, stay outside, and wear masks as we talk with her. Even the kids all have masks that have been ripped off, so they can breathe better while they play tag.I am standing in the sun, watching the kids. My daughter runs by giggling. Then my dad calls my attention. My grandma has a question about a medication. Not unusual. As a pharmacist, I take an active role in her medications. I step up, expecting the question to be about a medication she is taking or maybe saw on a commercial. Instead she asks, “What do you think about this medication the president has taken to prevent the virus?” I am a little surprised, but I answer quickly because I have read the studies and am confident in my ability to analyze the mass of misinformation that is suffocating society.“The evidence to support hydroxychloroquine for prevention of COVID-19 is currently lacking” I say thinking my grandma is looking for a knowledgeable, trustworthy pharmacist to guide her. Again, I am taken back when she just as quickly retorts, “Well, I watched a video where 8 doctors said the opposite.” She smirks a little as if to say, “I got you.”I tried to discuss the studies and provide a patient-friendly but evidence-based education. She did not seem to believe me. Instead, she relied on information from a video. Why? Maybe because it had doctors’ opinions. Maybe because it told her what she wanted to hear. Maybe because it was on a religious channel, and my grandmother will trust anything on a religious channel. It does not explain why I hear others with concerns such as the following:

  • •Lack of trust in pharmaceutical companies—politicizing remdesivir.
  • •Lack of trust in medical journals—misinformation, falsified data.
  • •Cells from aborted fetuses in vaccines.
  • •Vaccines laced with a substance to sterilize anyone who receives it—population control.

As I drove away from my grandma’s house, I began to reflect. How could she not see what I so clearly saw? She has always had the mindset of do what your doctor tells you. Don’t ask questions, just do it. Maybe it is a generational mindset or the culture she grew up in. She has never sought out medical information. She has never sought to understand her ailments. She blindly trusts. Her health literacy is low. She is vulnerable to misinformation and biased information. She is not alone. Many of our patients have low health literacy.This is not new information. What is new, and rather unsettling, is that medical information, science, is being politicized. Health professionals have a responsibility to educate. But what if patients do not trust us? What if they are more apt to believe that we are pushing a political agenda than to believe that we are providing evidence-based information? What if they are more likely to believe what they see on social media, what they hear from a journalist, or a video with medical professionals giving only part of the information?These are questions that the medical community must think about. When 1 medical professional says one thing and another says the opposite, it leads to confusion. Health professionals understand research is complex. We understand that there may be contradiction from one study to the next. We are taught to analyze it. Maybe the study population was different. Maybe the duration of treatment was different. Furthermore, medicine is not a one size fits all approach. But the general public may not understand this. They see contradiction as uncertainty. They do not trust it.How do we regain the public’s trust in health care?


Sarah Riley Cox, PharmD, MS, Assistant Clinical Professor, University of Missouri Kansas City School of Pharmacy at MU, Columbia, MO

Misinformation in the time of COVID-19