Misinformation during disease outbreaks | Tara Kirk Sell (2020)

Organizational Context & Funding

• The Johns Hopkins Center for Health Security (CHS) has been preparing for pandemic threats for over 20 years, recently receiving a major grant from the Open Philanthropy Project to expand work on Global Catastrophic Biological Risks (GCBRs).
• As of the podcast recording, the Effective Altruism Funds website added options for direct donations to the CHS and the biosecurity program at the Nuclear Threat Initiative.
• Tara Kirkell, a senior scholar at CHS, serves as co-principal investigator for the Center's Disease Prediction Project, an online platform collecting and testing forecasts on disease outbreaks.

Assessment of U.S. Response & Trust

• Kirkell states the federal government "broke pretty much every rule" of risk communication, citing slow responses, lack of consistency, and over-reassurance that eroded public trust.
• She predicts the U.S. risks losing the trust of half the populace regarding public health interventions due to misinformation and authoritative inconsistency.
• The CDC is criticized for a "silenced" state under federal leadership, compounded by a loss of institutional knowledge due to recent retirements and disappointing testing efforts.
• In contrast, state-level leadership from Governor Cuomo (NY), Governor Hogan (MD), and the King County Public Health Department (WA) is highlighted as excellent and responsive.
• Singapore's Prime Minister is cited as a global model for risk communication due to transparency, calmness, and clear foreshadowing of policy changes.

Misinformation & Disinformation Dynamics

• Misinformation about diseases follows consistent themes across outbreaks (e.g., Ebola, Zika, COVID-19), with an estimated 10% of tweets during Ebola containing false information or misinterpretations.
• Disinformation is identified as an active tool for foreign actors to sow division, though Kirkell notes it is difficult to pinpoint specific countries other than Russia due to the sophistication of capabilities in multiple nations.
• A study correlating county-level mortality rates with Fox News viewership suggests higher fatality in areas watching Sean Hannity (who downplayed the virus) compared to Tucker Carlson (who warned early).
• Tech companies' efforts to flag misinformation and link to authorities are deemed valuable but insufficient for audiences already rejecting mainstream science; individual media literacy remains a critical component.

Economic & Policy Trade-offs

• Kirkell expresses strong criticism that the U.S. response to COVID-19 was not timely, arguing that the cost of delaying action (lockdowns) was far higher than the cost of early investment in testing and capacity.
• The "Garden for Governors" report co-authored by CHS advocates for a phased reopening based on risk matrices (e.g., ventilation, duration of contact) rather than blanket bans.
• The report suggests non-contact sports (e.g., swimming) and certain retail settings may be safe to reopen if ventilation is adequate, while advising against close-contact indoor activities like bars and movie theaters.
• A CHS proposal to hire 100,000 contact tracers for $3.5 billion is described as having gained significant interest as a cost-effective method to resume economic activity.
• Kirkell warns that focusing solely on COVID mortality ignores the broader public health crisis, including delayed cancer screenings, increased obesity, potential suicides, and economic poverty.

Technological Recommendations & Future Readiness

• The CHS 2018 report "15 Emerging Technologies" highlights microfluidic paper-based testing and easy-to-use ventilators as critical innovations to solve current bottlenecks in diagnostics and hospital capacity.
• Self-spreading vaccines are identified as a high-potential but ethically fraught concept that could bypass distribution hurdles, possibly reserved for "break glass" emergency scenarios.
• Drone-based surveillance for collecting environmental samples (e.g., mosquitoes) and telehealth robotics are proposed to reduce exposure risks for healthcare workers.
• Kirkell emphasizes that the U.S. healthcare system's thin margins prevented the stockpiling of essential PPE, suggesting that price gouging during emergencies might incentivize private sector stockpiling.
• The "cycle of panic and neglect" is cited as a systemic failure where preparedness focuses on the last pandemic rather than generic countermeasures like platform technologies for vaccines.

Forecasting & Prediction Markets

• The CHS Disease Prediction Project, funded by Open Philanthropy and founders Pledge, engaged over 1,000 forecasters but faced challenges in writing unambiguous questions due to the rapidly changing nature of the outbreak.
• The project confirmed that forecast accuracy is entirely dependent on the quality of underlying surveillance data; without reliable testing and reporting, forecasting models cannot succeed.
• Kirkell argues that forecasting platforms should serve as decision-support tools rather than definitive guides, requiring diverse inputs to avoid "eggs in one basket" errors.
• The stock market is noted to have failed in predicting the pandemic's trajectory due to a lack of domain expertise among traders relative to the specific nature of biological threats.

Career Advice for Biosecurity

• Aspiring professionals are advised not to fear starting at the "ground floor" with entry-level tasks (e.g., data entry, reference counting) to gain necessary experience.
• Networking is identified as a crucial factor, with Kirkell crediting a personal connection for her entry into the field after retiring from professional swimming.
• The job market for GCBRs is expected to expand primarily through government funding at the CDC and local public health levels, though few roles are exclusively dedicated to GCBRs without broader pandemic preparedness duties.

Serology & Good News

• Emerging serology studies suggesting higher infection rates (and potentially lower fatality rates) are viewed with cautious optimism, though sampling biases and false-positive rates remain significant concerns.
• Kirkell acknowledges the possibility that the virus may have circulated earlier than widely believed, which would alter the understanding of the disease's severity and spread.

Personal Context

• Kirkell reports an intense workload balancing CHS research, teaching duties, and childcare during the pandemic, noting that the situation has led to significant sleep deprivation.
• She emphasizes the psychological importance of voluntary compliance versus coercive lockdown orders, expressing a preference for informed public choice over mandates where possible.