Vera Zakem’s highly informative New York Times Opinion piece of April 22nd, Pandemic Propaganda Is Coming, Be Ready for It, sounded a very important alarm about a predictable outcome of the Covid-19 pandemic. She notes, “We are likely to see conspiracy theories and false narratives from state actors such as Russia and China, news outlets and advocacy groups, and individuals ranging from partisan activists to white supremacists, and even our friends and neighbors who may inadvertently share conspiracy theories without malicious intent.” The question of who and what to believe now has an element of life or death decision making attached to it. With no less an authority than President Trump wondering about the use disinfectants as a treatment for Covid-19, health care workers and public health officials have cause to worry about how their messages are being processed by the general public.
But what can be done about it? Twenty-years ago, when I was the co-chair of the Federal Advisory Committee to the Centers for Disease Control (CDC) for HIV/AIDS and STD Prevention and Treatment, I published a series of articles about the importance of understanding conspiracy theories about the origins of HIV. I described it as the elephant in the room because while it was a widely acknowledged challenge in our efforts to communicate with the public, there were few ideas about how to confront such theories effectively.
As an African American professor at an Ivy League medical center, I did my fair share of lecturing about HIV/AIDS in the Black community in a wide variety of community settings from churches to drug treatment programs. I noted that invariably, and almost without exception, the first questions that I’d be asked was, “Doc…where does AIDS come from? Is this a man-made bug that was created to destroy minorities, gay people, drug users, and others?” My public health colleagues were well aware that such thinking existed, but their typical response was to try to simplify the message, that is, put it in language that the scientifically challenged might better understand. Then as now with Covid-19, such thinking completely misses the point.
Beliefs in conspiracy theories about diseases often arise in part because their explanations fit the facts and the lived experiences of the believer. Twenty years ago, the fact that 70 percent of the HIV pandemic worldwide was centered in Africa as well as in Black communities from the United States to the Caribbean to Brazil was a topic of heated discussion. HIV/AIDS, it was repeatedly noted, follows the path of the international slave trade from Africa to the New World. “Everywhere you look,” I recall one Haitian American audience member pointing out, “we are the ones with highest rates of infection and mortality. Am I supposed to believe that this is an accident?”
My point is not to advance theories about the origins of HIV/AIDS. What is at issue instead is the assumption that these beliefs can only be met with well-developed explanations of science for the illiterate.
When “dummied-down” explanations of HIV or Covid-19 are provided to those who entertain conspiracy theories or dangerous myths about treatments and cures, we miss the point if we assume that those who raise such questions are, at best, ill-informed. The problem is not that our explanations are too complex, to borrow a phrase from the film Cool Hand Luke, “what we have is a failure to communicate.” We must understand instead why such theories are so satisfying.
Perhaps the real power of conspiracy theories is that they give us someone or something to blame. In the mystery films of Hollywood years ago, a happy ending followed the naming of the guilty party and the solving of the crime. Covid-19 conspiracies often do just that. In the face of an unrelenting series of pandemic horrors, not surprisingly, the competition between good science and conspiracy theories is less about explaining why we are in this mess than knowing instead who or what to name as the cause of our pain.
But our collective pain is also compounded when we don’t trust the messenger. In the Bronx, New Orleans, or Detroit, lack of access to testing and an acute awareness of the neglect of the public health needs of the Black community is horribly visible in the overrepresentation of community residents in Covid-19 mortality rates. Mistrust of the medical profession in general and of public health officials in particular is rampant and has a long, ugly history. Our challenge is clear. Before we can frame credible messages, it is essential that government leaders and public health officials accept that their first priority is to become credible messengers. The battle for truth, surprisingly enough is not to be fought with science, but in the quest to win public trust. In too many locales, one thing is clear.
We aren’t there yet.
Written by Robert E. Fullilove, III, EdD
