Frontliners fight against COVID-19, misinformation

Allyson Chiu

THE WASHINGTON POST – Atul Nakhasi couldn’t stop thinking about Dodger Stadium. The storied ballpark-turned-coronavirus-vaccination-site just 10 minutes from his apartment in downtown Los Angeles (LA) had been briefly shut down by anti-vaccine protesters, and Nakhasi, a doctor, was horrified. To him, the nearly hour-long delay amounted to an act of “public harm” and served as a chilling example of how far people who oppose vaccines are willing to go to make their point. He had to do something to respond, but what?

The question weighed heavily on Nakhasi’s mind as he drove to a south LA hospital to begin his 12th straight day of caring for patients, some severely ill with COVID-19. It was still on his mind as he spoke to the family of a young man in his 20s, whose lungs were so damaged that he could no longer breathe on his own. A vaccine might have changed this young man’s life, Nakhasi thought, as he told the father that his son would probably need a permanent breathing tube.

So when Nakhasi got home that evening, despite feeling as though he could collapse into bed and not wake until the next morning, he instead grabbed his phone and opened Twitter. “As a frontline doctor who lives near Dodger Stadium this is outrageous, treacherous; an act of harm to the public,” he typed, retweeting another doctor who was upset by the anti-vaccine protesters. “Every eight minutes,” he wrote, an Angeleno dies of the disease.

It was 6.20pm, and Nakhasi had worked nine gruelling hours. But his day wasn’t over. “You wrap up your day, and you’re hoping the fight ends,” said Nakhasi, 33. “You’re fighting for lives that whole day … keeping people here to the next morning. And then you get home and you feel like the fight never stopped. It just changed turf. The landscape just changed.”

Nakhasi is one of countless healthcare workers who have found themselves combatting the coronavirus on two fronts during a global pandemic that is now stretching into its 12th month. Beyond spending their working hours in hospitals and clinics, many doctors and nurses have also voluntarily entrenched themselves in “the information war” as Nakhasi calls it. It’s a fight Nakhasi and other medical professionals say feels overwhelming.

Dr Atul Nakhasi reviews patient results on a computer in the triage tent outside of Los Angeles’s Martin Luther King Jr Community Hospital. PHOTOS: THE WASHINGTON POST
Cardiologist Adam Karpman at Saint Francis Health System in Tulsa

Baseless claims often spread faster than facts, and purveyors of misinformation are quick to retaliate with vitriol and threats. And yet, healthcare workers, many of whom are already experiencing burnout and the emotional toll of witnessing COVID ravage their patients, haven’t backed down. “It’s never-ending,” Nakhasi said. “There’s not a moment where I don’t feel some level of duty or responsibility” to take action.

A family medicine doctor in rural Kansas, who is also her county’s health officer, responds to a daily flood of pandemic-related texts and social media messages while running her clinic and taking emergency room shifts. A pregnant nurse in California opens up online about her decision to get vaccinated, hoping that her personal story might persuade others to do the same. A pulmonary and critical care physician in Baltimore, who’s done more than 170 virtual town halls, gives out his personal email address to anyone with questions or concerns.

“The misinformation that’s out there is, like, one of our worst enemies,” said Jennifer Bacani McKenney, who has been practicing family medicine for more than 10 years in Fredonia, Kansas, a community of roughly 2,500 people about 100 miles south of Topeka. “It’s almost worse than the virus itself.

“At least we have some science to deal with the virus,” McKenney, 41, continued. “We have strategies to deal with the virus. There’s not a great strategy to deal with the random memes, or the stuff that’s presented as data that’s not actual data, or the bogus YouTube videos or whatever that look like they’re scientific and there’s no basis. It’s amazing the people that believe it and share it, and there’s not a strategy against that.”

In non-pandemic times, Nakhasi barely used social media. Now, he’s the co-founder of #ThisIsOurShot, a digital campaign to promote positive messaging about the coronavirus vaccines through a network of more than 25,000 healthcare workers. He also checks Twitter, Instagram, Facebook and LinkedIn multiple times a day – scrolling through feeds in the morning as he’s scarfing down a bowl of cereal and waiting for his coffee to brew, taking a quick glance on his way to the bathroom at work and signing on again in the evenings at home. These days, he can hardly find time to make himself dinner, instead subsisting on a rotation of peanut butter and jelly sandwiches, Chipotle and Subway.

“Almost every waking second, minute and hour outside of work right now is being spent on digital engagement to build vaccine trust in our communities,” said Nakhasi, a primary care doctor who usually works at a clinic in Compton but has been deployed to nearby hospitals to help with staffing shortages. When it comes to combatting misinformation online, he said, “we are flying the plane and building it at the same time”.

To that end, Asha Shajahan, a doctor in Detroit and one of the leaders of the #ThisIsOurShot campaign, is working an extra 40 hours a week trying to come up with a curriculum for physicians on how to handle social media misinformation. “In general, physicians kind of tend to be siloed and do their own thing because they’re so busy,” she said.

But during the pandemic, Shajahan noted, many have come to realise the importance of “collective impact”.

Healthcare professionals in Illinois launched a volunteer-based organisation called Impact, which aims to use social media to amplify science and educate the public. Meanwhile, others have coordinated messaging through less formal group chats or are teaming up for virtual talks. For instance, a group of Black doctors have started using Clubhouse, a trendy, invite-only, audio social media app, to host sessions on COVID-19.

“We’ve just been kind of joining forces,” said Bernard Ashby, 40, a vascular cardiologist who practices in South Florida and is part of the Black doctor group. After members of the group were vaccinated, Ashby said they went on Clubhouse and “basically said, ‘Hey, we’re alive, we’re fine. These were our experiences.’ “

In a time when facts are frequently questioned and undermined, front-line healthcare workers have found powerful weapons in their own stories. Early on, emotional videos and lengthy social media posts provided glimpses into hospitals overrun with sick and dying COVID-19 patients as doctors and nurses struggling with shortages of protective gear begged people to stay home. More recently, social media sites have been flooded with vaccine selfies, which are often accompanied by detailed captions explaining the decision-making process to get vaccinated, side effects and the science behind how the shots work.

“We need to humanise the pandemic,” Nakhasi said. “What we’ve realised is when you put a face to it, when you put a story to it, people can empathise with it. It builds an empathetic bridge to the public.” That’s what Mawata Kamara, an intensive care unit and emergency room nurse in Alameda County, California, hoped to do when she chose to share her experience getting vaccinated. As a Black woman who at the time was 29 weeks pregnant, Kamara, 36, knew she could relate to two groups of people who have been especially concerned about the vaccines.

“People want to get information from people they can trust or people they believe are going through the same thing they are,” she said. Initially, Kamara also had reservations about the shots. The clinical trials didn’t include people who were pregnant, and both vaccines being distributed to the public had been developed in record time.

“I wanted to admit that I was afraid, even though I’m a nurse,” she said. “I didn’t want people to feel like I had all the answers, I didn’t.”

Instead, she explained in a Facebook post that she had only arrived at her decision after doing her own research, which included talking to other medical professionals who advised her that “the risk was definitely worth taking”. Kamara had seen pregnant people in the ICU infected with COVID who “never made it to see their babies.” And, she wrote, she has another young daughter who needs her.

“I wanted to let people know that it’s OK to take the vaccine from my point of view,” she said in an interview, noting that her post-vaccine prenatal checkups have gone well.

But as healthcare workers have continued to share their personal stories, their openness has come at a cost. “One of the challenges of being messengers in a polarised moment is the vulnerability to be attacked and to be criticised,” Nakhasi said.

Even before the pandemic, medical professionals have been frequently targetted online, particularly if they are doing advocacy work or promoting vaccines, said Vineet Arora, a doctor and medical researcher at the University of Chicago who studies social media. Women, Arora noted, have traditionally faced more intense harassment, including threats.

“We have studied social media attacks and harassment on Twitter, and it’s terrible,” she said. McKenney, the Kansas doctor, has weathered attacks on social media and in person. People she considered friends and good acquaintances have accused her of not caring about the community she grew up in.

Others have called for her to be fired. At one point during the summer, McKenney couldn’t take it anymore.”I very intentionally waited for everybody to leave my clinic, go home for the night, and I just kind of sat in my office,” and started crying.

In recent weeks, Nicole Baldwin, a pediatrician in the Cincinnati suburbs who is a vocal advocate for vaccines, has blocked more than 100 accounts across Twitter, Instagram and Facebook. She regularly deletes negative comments on her posts.

“I’ve been called a psychopath,” said Baldwin, 43, who has also gotten comments from people telling her to kill herself. “Someone called me a female version of Hitler.” But she also recognises that the responses mean her message is getting out there. “I don’t think they would be coming after me or attacking me if I wasn’t making an impact.”