veryone’s got an opinion, but we know not every opinion is valid or useful. After all, if you are aboard a plane that starts rapidly losing altitude, whose insights do you want to immediately hear: the pilot or the chatty passenger next to you? The COVID-19 pandemic has highlighted how opinions of nonexperts can gain credibility and create misunderstanding, confusion, and doubt about complex public health matters and decisions at a time when the best available expertise is what is needed.
Over the past year, the U.S. public has witnessed massive media presence and accessibility of public health experts. Representing a wide range of areas — including infectious disease epidemiology; clinical medicine; vaccine science; ethics, law, and policy — these experts have used social and traditional media to engage with public audiences to convey the best available COVID-19 information and debunk misinformation.
Nevertheless, amid the COVID-19 disinformation promoted in large part by anti-vaccine activists, conspiracy theorists, and even some elected officials, there lies a less considered but formidable challenge to public health communication: social media influencers. These are individuals who, in part or entirely through their online activity, have established their reputations for offering viewpoints on specific public issues — including politics, popular culture, health, and science. In doing so, they have amassed flocks of social media followers numbering in the hundreds of thousands, or even millions. Their numerous and diverse ranks include journalists, bloggers, academics, and health professionals. Notable examples include political pollster Nate Silver, journalist Matthew Yglesias, social scientist Zeynep Tufekci, economist Emily Oster, and nutritionist Eric Fiegl-Ding — all of whom have received attention and criticism for their public comments on various COVID-19 topics. Through a combination of their viewpoints and audience size, influencers are able to shape public discussion on a range of issues and ideas. However, the pandemic has revealed how some influencers can be a hindrance in a time of crisis due to three elements.
First, many influencers do not have any background, be it schooling or work experience, in public health areas immediately relevant to the serious COVID-19 issues they are offering their perspectives on. For example, in December 2020, Silver posted on Twitter his hubristic criticism of the Centers for Disease Control’s vaccine allocation guidelines. Soon thereafter, numerous public health professionals raised to Silver how he had misinterpreted the report. This qualification issue also extends to influencers who have advanced degrees in science or other fields, but no expertise in the specific areas for which they are commenting, e.g., infectious diseases, epidemiology, vaccine science, or public health.
Second, large follower counts provide influencers an outsized voice for shaping public understanding of COVID-19. Thus, whenever influencers speak outside of their areas of expertise, their bandwidth offers great potential to fuel misunderstanding of public health issues, sow doubt in the credibility of scientists and other professionals most knowledgeable about the complicated issues being discussed, and undermine the public’s confidence in public health, science, and related fields. As an infectious disease epidemiologist once noted about Feigl-Ding and his 493,000-plus followers, “When he says something that’s really wrong or misleading (about COVID-19), it reverberates throughout the Twittersphere.
Third, influencers fuel and feed off of a fast-moving “hot-take” culture that offers opportunities and rewards for their opinions on any topic of potential public interest. Regardless of whether one’s hot takes are delivered via tweets, blogs, Op- Eds, magazine pieces, or other general audience forums, the goal is to gain the public’s — not the scientific or professional community’s — attention.
A patient sits helplessly while proponents of different medicines brawl with each other.Lithograph by C.J. Grant, 1834.
Together, nonexpert viewpoints; large, receptive audiences; and hot-take culture are dangerous pollutants to the social and traditional, e.g., cable news, media ecosystem the public relies on for information. Because influencers offer their viewpoints for broad, general audiences, any subsequent public recognition of their ideas — even if inaccurate or over-simplified — can lead to the influencer gaining credibility or legitimacy with the public on that specific COVID-19 topic or issue. Such reception can inappropriately elevate nonexpert influencers to the level of true experts. In terms of public awareness, this situation is problematic all by itself. Yet, it can get worse whenever experts identify inaccuracies with the influencer’s hot take and attempt to correct them for the public’s benefit. In such instances, nonexpert influencers can find themselves in the midst of debate with actual experts. This can elevate the status or legitimacy of the influencer in their audience’s eyes. Complicating matters even further, any such professionally appropriate criticism leveled at the influencer’s viewpoints often risks triggering social media “Stan Culture,” a phenomenon where an influencer’s most ardent social media followers defend the influencer regardless of the fallacy of the influencer’s original points. In the worst cases, followers may even verbally attack experts who rightfully raised accurate counterpoints — effectively, a form of silencing critics.
Altogether, influencer culture is more than simply bad takes and uninformed opinions. Instead, it presents real dangers to the health of the general public. This distracts from public health experts when they are trying to communicate the most up-to-date, accurate, and informed evaluations of the latest pandemic matters.
The phenomenon is especially tragic when you consider the vast depth of available public health, medical, and other related expertise in the U.S. Influencers have tremendous opportunities to be public health allies by using their recognition and audience reach to bring attention toward and amplify the voices of experts for any specific COVID-19 issue. While many do, it is not common enough, as personal hot takes and thinking of oneself as a “brand” are central to influencer culture.
The pandemic has already offered many lessons for public health to consider for the future — especially with regard to public education. Communicating the best available knowledge to the public in the most effective and respectful ways is a major challenge that lies ahead for public health. Teaching students and others how to be more critical consumers of information in the social media age is one step toward that goal.
Expertise does not mean infallibility — experts can make wrong conclusions or bad recommendations. Also, expertise is insufficient for engendering the public’s confidence in public health already compromised by disinformation efforts. But when it comes to pulling our plane out of a nosedive — or, in terms of current COVID-19 mortality, averting the equivalent of several jumbo jet crashes each day — we need to ensure that it is expertise we are hearing loud and clear.
Carpiano, a professor of public policy and sociology, is an expert in public and population health and medical sociology. His research focuses on social, behavioral, and policy factors related to vaccine hesitancy and acceptance, as well as health disparities in the U.S. and abroad. He is a member of the Lancet Commission on Vaccine Refusal, Acceptance, and Demand in the USA.