Surf's up -
Until a few weeks ago, I was trying to persuade people that H1N1 was not the benign bug they had been inclined to believe; by last week, the public mood had shifted so much that I found myself trying to talk people down from the proverbial ledge, and not to panic about a situation that they cannot entirely control.
What's astounded me about the swinging pendulum of opinion on swine flu is the effect - not always good, sometimes outright dangerous - that the web has had.
I shouldn't be so surprised. I've been covering health and medical issues for much of my career, and wrote news reports for many years for the Medical Post, the Canadian Medical Association Journal and WebMD, among others.
Two long-recurring issues have been coming together in recent weeks: the reliance of consumers on web-based information, no matter the source, and a deep, scientifically unsound suspicion of immunization.
Since the mid-1990s, physicians everywhere have reported the same phenomenon: patients arriving for appointments armed with sheafs of information they've collected from websites. This is often a good thing, with patients doing their own homework to aid their treatment and recovery. But there are downsides, from wonky self-diagnosis to falling prey to sites with outrageous claims and specious arguments.
There's the anti-vaccination lobby, which has picked up new steam in the swine-flu era. Never mind that a central tenet of the last wave - namely, that immunization supposedly causes autism - has not only been thoroughly and repeatedly debunked, but the prestigious medical journal that posed the question, the U.K.'s Lancet, has retracted what it published in the first place.
Public health officials are waging two wars this year: one, to protect the public from the sickness and, yes, death that comes with a pandemic, and the second against the inaccurate and sometimes bizarre material that has been reproducing online, in a totally different meaning of the word "viral."
So, what's out there? An awful lot.
I was astonished at the links presented to me by anti-vaccine types or skeptics in my own circle, and noticed that most pointed to a "doctor" who was behind the respective sites they had picked. A closer look at the major sets revealed something else.
For instance, there's a doctor who's a dentist, not to mention a veteran conspiracy theorist who, among other things, says the H1N1 vaccine causes HIV.
Then there's the Canadian who says he went to medical school, but turns out not to have a licence to practise.
There's the American doctor who fails to mention her practice privileges were revoked. There's also the well-known Joseph Mercola, an American who is not a medical doctor but rather an osteopath, a profession that under no circumstances endorses pharmaceuticals of any kind (although Mercola's slick-looking site has a full store of his products that he would like you to buy). (Some of the crunchier of the granola-minded people I know have been promoting his site; my response has been a suggestion they take a look at Mercola's far-right-wing beliefs and involvements.)
There's much wackier stuff out there, and a lot of it dangerous, given that people are basing important decisions about their health on the most dubious of information. In the last month, on at least a dozen occasions, I've heard or read comments that go pretty much like this: "Well, I read on a website ..."
But which website? There are plenty of lessons coming out of our recent experience with H1N1. One is that even though there is plenty of solid material out there (albeit often presented in a sterile way, or cluttered with hard-to-digest text), there are untold numbers of places with misleading or just plain wrong (and even bizarre) statements.
We live in an age when consumers demand certainty. Medical scientists know they cannot guarantee with absolute certainty the safety of any procedure. Everything - from a vaccine to going to the dentist to getting in a taxi - carries some sort of risk; what's needed is to explain to people, who take to the web seeking comfort or validation of their suspicions, the big picture of population health. That's a tall order.
Consequently, we have lessons to learn about risk, about public health (the field that excels when people can't see what it has achieved), about vaccinations, and - yes, absolutely - about how to evaluate what you're reading online.
Evaluating Health Information on the Internet
I'm adding this link, to a National Cancer Institute page, because it provides excellent advice on assessing the value of what you're reading online, particularly in terms of transparency, sourcing and credentials. Feel free to share it.
John Gushue is a writer in St. John's. Blog: johngushue.typepad.com.