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      Coronavirus: the spread of misinformation

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      BMC Medicine
      BioMed Central
      COVID-19, Coronavirus, Misinformation, Internet, Antiscience, Pandemic, Public health

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          Abstract

          There has been a global rise recently in the spread of misinformation that has plagued the scientific community and public. Disconnect between scientific consensus and members of the public on topics such as vaccine safety, the shape of the earth, or climate change has existed for a number of years. However, this has progressively worsened as society has become further divided in the political climate of today. In turn, it has created an optimal environment for antiscience groups to gain footing and propagate their false theories and information. The public health crisis emerging due to the coronavirus (COVID-19) is also now beginning to feel the effects of misinformation. We stand with our colleagues Calisher et al., who recently published a statement of solidarity to fight against COVID-19 and to promote scientific evidence and unity over misinformation and conjecture [1]. Just as the coronavirus itself, misinformation has spread far and wide, drowning out credible sources of information. Over the last couple of months, posts from the World Health Organization (WHO) and the US Center of Disease Control (CDC) have cumulatively only achieved several hundred thousand engagements, considerably eclipsed by hoax and conspiracy theory sites, which have amassed over 52 million. This serves to emphasise the popularity of unverified sources of information. Similarly, misinformation was widespread during the early years of the HIV epidemic. It too was plagued by conspiracy theories, rumours, and misinformation for many years, with the effects still visible in regions to this day. Many people continue to argue that HIV does not exist, or cause AIDS, and that its therapies are toxic to human health. All the arguments proposed by these deniers have been rebuked through a multitude of scientific publications and debate. Yet, they continue to persist. The influence of these false arguments can be so infectious that it can influence governmental policy, which has the potential to be fatal. This was particularly highlighted by the Mbeki South African government’s denialism of HIV in the early 2000s and their infamous rejection of the evidence surrounding the efficacy of HIV medication. In turn, thousands of mothers were denied access to antiretroviral therapies. Instead, the government promoted the unsubstantiated use of herbal remedies including garlic, beetroot, and lemon juice for AIDS treatment [2], leading to unnecessary HIV transmission, especially to children from pregnant mothers. This costs more than 300,000 lives [3]. It is important that we learn from past mistakes, and the media has a large role to play in this. It seems in a bid to increase viewership, major media organisations are creating dramatic headlines but are instead inciting panic amongst the public. Whilst healthcare professionals are still learning about the virus, the media has already begun to speculate about the potential health impact that the virus can have, and by publishing the potential worst effects of the virus, it only serves to fuel panic amongst the general public. As COVID-19 turns into full-fledged public health crisis, multiple theories regarding the virus’ origin have taken hold on the internet, all with a common theme: the virus was artificially created in a lab by a rogue government with an agenda. This misinformation originated from social media accounts and websites with no credible evidence to support their claims. These posts have amassed over 20 million engagements, rising each day, and the theories continue to gain traction and following on the internet, despite scientists from multiple nations analysing the genome of COVID-19 and coming to the decisive conclusion that the virus originated in nature from an animal source [4, 5]. If powerful and clear statements are not made denouncing and debunking these fabrications, then the impact on the populous has the potential to be devastating. Furthermore, basic information on how to reduce transmission and exposure to the virus has been muddled by uncredited sources. For example, a popular myth currently circulating is that home remedies can cure or prevent people from getting the virus. Taking vitamin C and eating garlic are being hailed as miracle remedies despite the complete lack of evidence. Whilst many of these are harmless, some have the potential to be very dangerous. One product that has gained traction on social media involves mixing sodium chlorite solution with citric acid, generating chlorine dioxide solution. The instructions then state for this powerful bleaching agent to be consumed, promising antimicrobial, antiviral, and antibacterial actions. The American Food and Drug Administration has previously served severe warnings against this, as it causes severe vomiting, life-threatening low blood pressure, and acute liver failure [6, 7]. Spread of false information drowns out credible sources and in turn results in further public confusion, ultimately leading to greater spread, and inefficient mitigation of virus transmission. In the face of a pandemic, it is important for governments to be transparent and relay clear, honest information to the public. Public confusion leaves citizens unprepared for combatting a public health crisis. Additionally, it is dangerous for politicians to politicise this pandemic. At times like this, the message from government leaders needs to be consistent so that the public can regain trust in civil servants. Governments and figures in the media should utilise the knowledge of experts, particularly from the CDC and WHO, to accurately deliver information in a sensible and precise manner so as to not incite panic amongst the public. The appearance of this virus offers an opportunity for the public and medical health professionals to fight in unity against this common threat. If health bodies appropriately manage, educate, and address the people’s concerns, there is an opportunity to bridge the level of distrust that has arisen by antiscience movements in recent times.

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          Most cited references3

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          Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding

          Summary Background In late December, 2019, patients presenting with viral pneumonia due to an unidentified microbial agent were reported in Wuhan, China. A novel coronavirus was subsequently identified as the causative pathogen, provisionally named 2019 novel coronavirus (2019-nCoV). As of Jan 26, 2020, more than 2000 cases of 2019-nCoV infection have been confirmed, most of which involved people living in or visiting Wuhan, and human-to-human transmission has been confirmed. Methods We did next-generation sequencing of samples from bronchoalveolar lavage fluid and cultured isolates from nine inpatients, eight of whom had visited the Huanan seafood market in Wuhan. Complete and partial 2019-nCoV genome sequences were obtained from these individuals. Viral contigs were connected using Sanger sequencing to obtain the full-length genomes, with the terminal regions determined by rapid amplification of cDNA ends. Phylogenetic analysis of these 2019-nCoV genomes and those of other coronaviruses was used to determine the evolutionary history of the virus and help infer its likely origin. Homology modelling was done to explore the likely receptor-binding properties of the virus. Findings The ten genome sequences of 2019-nCoV obtained from the nine patients were extremely similar, exhibiting more than 99·98% sequence identity. Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%). Phylogenetic analysis revealed that 2019-nCoV fell within the subgenus Sarbecovirus of the genus Betacoronavirus, with a relatively long branch length to its closest relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21, and was genetically distinct from SARS-CoV. Notably, homology modelling revealed that 2019-nCoV had a similar receptor-binding domain structure to that of SARS-CoV, despite amino acid variation at some key residues. Interpretation 2019-nCoV is sufficiently divergent from SARS-CoV to be considered a new human-infecting betacoronavirus. Although our phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans. Importantly, structural analysis suggests that 2019-nCoV might be able to bind to the angiotensin-converting enzyme 2 receptor in humans. The future evolution, adaptation, and spread of this virus warrant urgent investigation. Funding National Key Research and Development Program of China, National Major Project for Control and Prevention of Infectious Disease in China, Chinese Academy of Sciences, Shandong First Medical University.
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            Statement in support of the scientists, public health professionals, and medical professionals of China combatting COVID-19

            We are public health scientists who have closely followed the emergence of 2019 novel coronavirus disease (COVID-19) and are deeply concerned about its impact on global health and wellbeing. We have watched as the scientists, public health professionals, and medical professionals of China, in particular, have worked diligently and effectively to rapidly identify the pathogen behind this outbreak, put in place significant measures to reduce its impact, and share their results transparently with the global health community. This effort has been remarkable. We sign this statement in solidarity with all scientists and health professionals in China who continue to save lives and protect global health during the challenge of the COVID-19 outbreak. We are all in this together, with our Chinese counterparts in the forefront, against this new viral threat. The rapid, open, and transparent sharing of data on this outbreak is now being threatened by rumours and misinformation around its origins. We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin. Scientists from multiple countries have published and analysed genomes of the causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 1 and they overwhelmingly conclude that this coronavirus originated in wildlife,2, 3, 4, 5, 6, 7, 8, 9, 10 as have so many other emerging pathogens.11, 12 This is further supported by a letter from the presidents of the US National Academies of Science, Engineering, and Medicine 13 and by the scientific communities they represent. Conspiracy theories do nothing but create fear, rumours, and prejudice that jeopardise our global collaboration in the fight against this virus. We support the call from the Director-General of WHO to promote scientific evidence and unity over misinformation and conjecture. 14 We want you, the science and health professionals of China, to know that we stand with you in your fight against this virus. We invite others to join us in supporting the scientists, public health professionals, and medical professionals of Wuhan and across China. Stand with our colleagues on the frontline!
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              Traditional, complementary and alternative medicine use by HIV patients a decade after public sector antiretroviral therapy roll out in South Africa: a cross sectional study

              Background The roll out of antiretroviral therapy in the South African public health sector in 2004 was preceded by the politicisation of HIV-infection which was used to promote traditional medicine for the management of HIV/AIDS. One decade has passed since; however, questions remain on the extent of the use of traditional, complementary and alternative medicine (TCAM) by HIV-infected patients. This study therefore aimed at investigating the prevalence of the use of African traditional medicine (ATM), complementary and alternative medicines (CAM) by adult patients in the eThekwini and UThukela Health Districts, South Africa. Methods A cross- sectional study was carried out at 8 public health sector antiretroviral clinics using interviewer-administered semi-structured questionnaires. These were completed from April to October 2014 by adult patients who had been on antiretroviral therapy (ART) for at least three months. Use of TCAM by patients was analysed by descriptive statistics using frequency and percentages with standard error. Where the associated relative error was equal or greater to 0.50, the percentage was rejected as unstable. A p-value <0.05 was estimated as statistically significant. Results The majority of the 1748 participants were Black Africans (1685/1748, 96.40 %, SE: 0.00045), followed by Coloured (39/1748, 2.23 %, SE: 0.02364), Indian (17/1748, 0.97 %, SE: 0.02377), and Whites (4/1748, 0.23 %, SE: 0.02324), p < 0.05. The prevalence of ATM use varied prior to (382/1748, 21.85 %) and after ART initiation (142/1748, 8.12 %), p <0.05, specifically by Black African females both before (14.41 %) and after uptake (5.49 %), p < 0.05. Overall, 35 Black Africans, one Coloured and one Indian (37/1748, 2.12 %) reported visiting CAM practitioners for their HIV condition and related symptoms post ART. Conclusion Despite a progressive implementation of a successful antiretroviral programme over the first decade of free antiretroviral therapy in the South African public health sector, the use of TCAM is still prevalent amongst a small percentage of HIV infected patients attending public healthcare sector antiretroviral clinics. Further research is needed to explore reasons for use and health benefits or risks experienced by the minority that uses both conventional antiretroviral therapy with TCAM.
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                Author and article information

                Contributors
                sk7015@ic.ac.uk
                Journal
                BMC Med
                BMC Med
                BMC Medicine
                BioMed Central (London )
                1741-7015
                18 March 2020
                18 March 2020
                2020
                : 18
                : 89
                Affiliations
                GRID grid.7445.2, ISNI 0000 0001 2113 8111, Imperial College London, ; London, SW7 2AZ UK
                Article
                1556
                10.1186/s12916-020-01556-3
                7081539
                32188445
                88f9d22f-b752-4af5-82be-8b553dce75d4
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 10 March 2020
                : 10 March 2020
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                Medicine
                covid-19,coronavirus,misinformation,internet,antiscience,pandemic,public health
                Medicine
                covid-19, coronavirus, misinformation, internet, antiscience, pandemic, public health

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