Countering the "infodemic"

False information has become a problem in the current pandemic. Myths and misinformation are circulating about the SARS-CoV-2 and COVID-19, the disease it causes. Anxious people are asking: Does alcohol-based hand disinfection help with the novel coronavirus? It takes only a few clicks to find answers on the internet - some with scientific evidence and some full of bluster. How should we handle this information?

"We're not just fighting an epidemic; we're fighting an infodemic", said World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus during the Munich Security Conference in February, according to the media (1). This applies not just to targeted misinformation but also to scientific studies.

False notions about, for instance, the effectiveness of alcohol-based hand disinfection on SARS-CoV-2 and other pathogens are also circulating. Simply to dismiss them as fake news or the result of sloppy editorial work would be the wrong way to handle them. We should take misapprehensions seriously and unmask them diligently. The scientist Alexandra Peters has led the way. In November last year (in other words, before SARS-CoV-2), she, together with Didier Pittet, dissected a study published in "mSphere“, the journal of the American Society for Microbiology. It called into question the effectiveness of established hand hygiene measures against influenza viruses and therefore also attracted the attention of the popular press (2).

The two scientists' verdict on the study in question following a detailed analysis was scathing. It was not merely the conclusion that was inaccurate, according to Ms Peters. The study showed major flaws in the experimental design and, on top of everything, had no real clinical relevance. All in all, the authors showed a lack of understanding of clinical practice, current hand hygiene recommendations, and the current professional literature. Peters and Pittet wrote this all in a detailed letter to the editor that was later also published in "mSphere" (3). They ended it by making it clear that alcohol-based hand disinfection is extremely effective against influenza viruses and helpful against non-spore-forming organisms, including non-enveloped viruses.

The finger cannot always be pointed at a study's authors or its expert reviewers. This is demonstrated by a similar case that was also contradicted by the scientists (4). In a letter to the editor of the eminent journal "The Lancet" in 2018, they, together with another colleague, turned their attention to a study published in the journal about the supposed development of tolerance of Enterococcus faecium to isopropanol. After analyzing the study, they, above all, blamed the publisher's press department for the spread of the fake news (5). The reason was a press release with the title "Hospital superbugs becoming resistant to alcohol disinfectants". A distorted statement, according to the WHO experts, considering that "alcohol-based handrub is on the WHO essential medicines list and saves millions of lives worldwide every year."

Alexandra Peters, together with other colleagues, is currently developing a set of action guidelines as part of the CLEAN HOSPITALS international initiative, which is also supported by HARTMANN. This will enable scientists to analyze and categorize false information. The tool is then designed to facilitate a systematic response to the fake news. A preliminary version of the action guidelines has already been developed, as has a data collection form. Both are now to be tested and validated.

The WHO is also offering targeted support in the current fight against fake news on SARS-CoV-2. On a web page created specifically for this purpose, the World Health Organization is busting myths about the novel coronavirus and COVID-19. Graphics with questions and answers on every topic can be downloaded and shared with others.

Download graphics with questions and answers about the most common myths surrounding SARS-CoV-2 and COVID-19 and share them with others.

More at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

1. Süddeutsche Zeitung. Forscher geißeln Gerüchte um das neue Coronavirus. Feb 19, 2020. Link: https://www.sueddeutsche.de/gesundheit/covid-19-coronavirus-labor-1.4805658
2. Hirose R et al. 2019. Situations leading to reduced effectiveness of current hand hygiene against infectious mucus from influenza virus-infected patients. mSphere 4:e00474-19. https://doi.org/10.1128/mSphere.00474-19.
3. Peters A, Pittet D. 2019. Influenza and alcohol-based handrub: the danger of ignoring clinical relevance. mSphere 4:e00719-19. https://doi.org/10.1128/mSphere.00719-19
4. Pidot SJ et al. Increasing tolerance of hospital Enterococcus faecium to handwash alcohols. Aug 1, 2018. http://stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aar6115
5. Peters A, Pittet D. Enterococcus faecium tolerance to isopropanol: from good science to misinformation. https://www.thelancet.com/action/showPdf?pii=S1473-3099%2818%2930542-5