Infodemics and Infodemiology: A Short History, a Long Future

"COVID-19 has certainly changed the world, causing much suffering; it has also established the imperative for accelerated progress in infodemic management."

The arrival of the COVID-19 pandemic was accompanied by an overabundance of information that has been described as an "infodemic". This paper traces the recent evolution of the concept of infodemiology from its original academic beginnings as a form of epidemiology mainly applied to information on the internet, to the applied version of an infodemic accompanying a pandemic. It describes the characteristics of an infodemic, outlines its components, and considers some possible solutions and next steps.

Some definitions provide the reader with a lay of the land: "Epidemiology studies what is happening, while an epidemic is what is happening - one studies diseases, the other is itself a disease outbreak. This distinction is also true of infodemiology/infodemic." Professor Gunther Eysenbach is credited as having coined the term "infodemiology" in 2002. Table 1 sets out some of the primary characteristics of an infodemic. In this context, "infodemic management" is the practice of managing "information events" with the aim of ensuring that everyone has access to the right health expert advice at the right time to be able to take appropriate action.

The paper explores the problematic nature of an infodemic, in that it combines an inordinately high volume of information (leading to problems relating, for example, to locating the information and ensuring is quality and validity) and rapid output, or velocity (making it hard to assess its value, manage the gatekeeping process, apply results, track its history, etc.). Adding to this, "The uncertainty and ambiguity caused by the new and unexpected [i.e., COVID-19] lead to the need to consider multiple narratives at any given time, each of them potentially valid."

After volume and velocity, the third main characteristic of an infodemic is the collateral growth of online misinformation, disinformation, and malinformation. ("The first is an accident, while the other two are intentional.") Discussing each of these harmful types of information, the author explores various solutions that have been proposed. For example, there are arguments for invoking anti-trust laws to break up big data/social media conglomerates; others advocate for legal restrictions (e.g., making internet publishers (mainly the social media platforms) liable for the content they publish). However, many of these actions would require an international legal framework, and there is a need to ensure that remedial actions do not lead to censorship.

Another suggestion that has been made since the birth of the internet is to establish a safe space for trusted information - a top-level internet domain, such as the World Health Organization (WHO)'s proposed ".health". The author examines how WHO's proposal has repeatedly stalled, suggesting that it nonetheless continues to hold promise, particularly in light of the COVID-19 infodemic. He suggests that, to be trustworthy, the creation of any such new top-level domain "would require a very broad consortial approach, with a multi-stakeholder platform that includes a range of stakeholder groups as part of a broader social movement. It could be multisectoral...and it would have to be curated to the highest standards. International standard setting (and community norm setting) would be needed."

Looking ahead, the author proposes a new Sustainable Development Goal (SDG) indicator within the target SDG3 (on health) related to access to reliable health information. "Ultimately, the right to health necessarily entails access to the information needed to make decisions for protecting health." Furthermore, all countries should develop knowledge preparedness plans, appropriate to their own information culture and needs, for future emergencies, he argues. "The results of that work will impact on the way we manage future public health emergencies and, more generally, on the way we communicate as a species."