Organized Disinformation Fanning the COVID-19 Flames of Vaccine Hesitancy  

Our pandemic response has undoubtedly been stymied, largely due to the divisive effects of organized disinformation. Early in the pandemic, nearly half the COVID-19 information on Twitter (now X) was flagged as posted by bots that appeared to follow the propaganda playbooks of Chinese and Russian Intelligence. A European Union document came to similar conclusions, stating that Russian propaganda campaigns pushing fake news in multiple languages were designed to hinder the EU’s pandemic response. Most recently, the Washington Post reported that Russia had 100s thousands of phony online sites and social media bots and that only 1% have been detected. Putin's “Chef,” Yevgeny Prigozhin, widely conducted the Russian disinformation campaign. He also headed the notorious Wagner mercenary group and was indicted in the Mueller report concerning his interference in United States elections. We are dealing with a highly organized disinformation campaign designed to weaken our society on many levels.

At the heart of many of these misleading posts is an all-or-nothing approach to infection control. For example, the contention that masks do not work is often based on studies that follow individuals in high-exposure settings for weeks or months. This was one of the fundamental flaws in many randomized controlled trials in the Cochrane report on masking. With highly infectious agents such as COVID-19, just one lapse in protective gear usage during the study could easily result in an infection and blunt any difference between the control and experimental groups.
 
One can easily see that interventions may lessen the likelihood of becoming infected, but as exposure time increases, the chances for a lapse in protection also increase. However, for the high-risk public (and I’m not sure who isn’t high risk for long COVID), wearing an N95 mask for a short encounter to pick up groceries or to enter a restaurant for a ‘take out’ home dinner makes sense and will markedly lessen your chances of becoming infected.

There is now evidence that it is not just the setting and exposure time that are important; viral dosage also plays an important role. Dosage concerns were mainly theoretical constructs until the publication of the recent study on prison populations by Margaret Lind, et al in Nature Communications. They found that during the Omicron wave, prior infection, vaccination, and hybrid immunity reduced the infection risk of residents without documented exposure and, to a lesser degree, in residents exposed in large areas (cellblocks). There was no reduction in infections with close exposure in small rooms (prison cells). Early in the pandemic, it was theorized that masks would help lessen the severity of disease by decreasing the amount of virus one is exposed to. This report adds credence to this assertion. The study also observed that hybrid immunity is best, further validating the recommendation for those previously infected to become vaccinated.
 
Thus, lowering the viral dosage will make it less likely to become infected and develop COVID-19 and long COVID. Masks and ventilation improvements are the best ways for individuals to add protection—hence a multilayered approach.
 
Many disseminators of disinformation downplay the idea of a multi-layer approach and proclaim that if you can still catch COVID-19 while wearing a mask, they do not work, ignoring that seldom is a single intervention 100% effective. Everything from treating a cold to cancer involves multilayer approaches, as does automobile and airline safety. Why should COVID-19 be any different?
 
As COVID-19 cases and hospitalizations increase, do not fall prey to disinformation. It is wise to be vaccine-boosted, wear a mask in high-risk settings, and carry a CO2 monitor to determine safe indoor ventilation. These steps will help us all avoid the disabilities caused by long COVID and help to maintain the health of our families and the nation’s workforce.