Covid-19: The doctors turned YouTubers
BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1563 (Published 28 May 2020) Cite this as: BMJ 2020;369:m1563Read our latest coverage of the coronavirus pandemic
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Dear Editor,
We have seen a rise in the spread of misinformation and “fake news” recently across the international community with long-lasting impacts. The most recent example is the public health crisis of COVID-19 where incorrect information is spreading, often faster than the virus itself.
The ability to access information within seconds has transformed the way in which we learn about and interact with the world; however, distinguishing accurate, evidence-based information from rumours and misinformation has proved challenging. We have seen the potential lasting impact that this can have with the damaging hoax of the MMR vaccine and its link to autism (Wakefield et al., 1998). This was investigated extensively and found to be false; however, widespread reporting and promotion of these claims, propagated by the internet, still resulted in a decline in vaccination rates throughout the UK and Ireland. This led to disease outbreaks worldwide. The original paper was retracted, and the author found guilty of serious professional misconduct by the GMC, but the rumours persist even to this day and form a huge part of anti-vaccine propaganda.
With great power comes great responsibility. As the world’s 2nd most visited site, YouTube should be held accountable for content that is posted on this platform and should take larger steps in signposting reputable sources of scientific information. Greater checks should be made to enhance the credibility of those posting accurate information - such accounts could be verified, thus enhancing the viewer’s trust in the content. As medical students, we often rely on YouTube as a useful educational tool and finding the correct information can be challenging. The lack of curation is highlighted by a study that showed that only 16 out of the over 68,000 videos on distal radius fracture immobilisation actually met the basic criteria for technical and educational skills (Addar et al., 2017). YouTube’s algorithm has been shown to provide higher rankings to more popular videos instead of basing this on their scientific value (Farag et al., 2020). This further propagates the spread of misinformation and can actually lead to adverse outcomes for patients. In general, but especially at a time of global crisis, social media platforms need to take a more active role in limiting the access to false information. We understand that there is a delicate balance between freedom of expression and censorship that YouTube has to find. However, we were glad to find that in addition to its regular guidelines on hateful, harmful, violent and sexual content, YouTube has introduced guidelines to prevent COVID-19 medical misinformation, which we believe is a step in the right direction ("COVID-19 Medical Misinformation Policy - YouTube Help", 2020).
As future and current medical professionals, there is a necessity to advocate the spread of scientific evidence in the fight against COVID-19. Stokel-Walker’s article points out that many medical professionals have been sharing their experiences through this pandemic in an attempt to provide a more balanced insight. However, there have been instances of doctors using their privileged positions to spread conspiracy theories ("ACEP-AAEM Joint Statement on Physician Misinformation", 2020). We believe that medical professionals need to be held to higher standards than other content creators as a result of the position they hold in the public eye, but those producing high quality content should be acknowledged and rewarded. A possible solution is to create a set of guidelines that medical professionals should refer to before posting medical opinions in the public domain. Similar to the General Medical Council’s Duties of a Doctor (GMC, 2013), this document would ensure that the standards of trust, public health promotion and scientific content are maintained across all platforms. Doctors who produce quality content while following these guidelines could be endorsed by the British Medical Association, Royal Colleges and even Public Health England to provide the public with assurance that they are watching robust, evidence-based videos to educate themselves on any topic.
Yours truly,
Lakshya Soni
References:
Anon (2020) ACEP-AAEM Joint Statement on Physician Misinformation [online]. Available from: https://www.acep.org/corona/covid-19-alert/covid-19-articles/acep-aaem-j... (Accessed 14 June 2020).
Anon (2020) COVID-19 Medical Misinformation Policy - YouTube Help [online]. Available from: https://support.google.com/youtube/answer/9891785 (Accessed 14 June 2020).
Addar, A. et al. (2017) Assessment of “YouTube” Content for Distal Radius Fracture Immobilization. Journal of Surgical Education. [Online] 74 (5), 799–804. [online]. Available from: http://www.sciencedirect.com/science/article/pii/S1931720417300168.
Farag, M. et al. (2020) Use of YouTube as a Resource for Surgical Education—Clarity or Confusion. European Urology Focus. [Online] 6 (3), 445–449. [online]. Available from: http://www.sciencedirect.com/science/article/pii/S2405456919302937.
GMC (2013) Good Medical Practice: Duties of a doctor. [Online]
Wakefield, A. J. et al. (1998) RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet. [Online] 351 (9103), 637–641. [online]. Available from: https://doi.org/10.1016/S0140-6736(97)11096-0.
Competing interests: No competing interests
Dear Editor
Myself being a Doctor and a prolific YouTuber, was very delighted to read the article and fully subscribe to the views of the author. YouTube has emerged as an important medium for dissemination of information in these trying times. I myself learnt a lot about Sars Cov 2 and covid 19 from various videos on YouTube and in turn educated my fellow colleagues by more than 90 videos in native Indian language (5). Popular YouTubers put immense effort and energy to produce good scientific content laced with graphic in a language understood by their audience in particular and the public at large.
Premier Health institution of India All India institute of Medical Sciences New Delhi Used its YouTube channel AIIMS Telemedicine for education and training of doctors, nurses and other health care personnel, on various aspects of Covid 19 starting from diagnosis, disinfection, treatment to high end ICU care and issued guidelines for hospital set ups all across the country in collaboration with Ministry of Health and Family Welfare GOI (1). Their videos despite being more than one hour long were watched by more than 80000 professionals (2). It has been an incredibly successful programme reaching millions of people who are able to watch them at any convenient time, refer to them any number of times in learning and relearning.
WHO has been no way behind in exploiting the YouTube potential to educate public about Novel Corona virus by its Video ‘Novel Coronavirus (2019-nCov) which was launched 4 months back and has been viewed more than 5.3 million times and widely regarded as well as quoted as trusted source of information (3).
Learning has these basic components: watching, listening, reading and writing. YouTube fulfills two of these obligations, and if a well-versed speaker is good at explaining, it is bound to get an audience especially in these scary times when people are searching for latest and authentic information.
In times of Covid, YouTube stopped even Monetizing videos on the subject yet the channels were flooded with attractive animated and innovative short/long videos produced just with the idea of saving lives by education.
The flood has created a mess also. YouTube being a free channel is available to one and all to upload its content and as there is no process to screen/bar the factually wrong content, the gullible viewer gets confused whom to trust. It might be a good idea to create a YouTube content accreditation process to protect the interest of society. But the process is tedious and difficult.
Y Karen Rebelo, deputy editor for Boom, an Indian fact-checking organization, opines that it’s extremely difficult to fact-check YouTube videos because often it’s not a straightforward question of whether the content is true or false. “It’s difficult to debunk a video with half-truths. A lot of it is harmless advice, but none of the videos actually tell you to go to a doctor, which is what you should do.” (4)
In such a scenario it is time to salute the efforts of all those YouTuber doctors who spend their valuable time effort and energy to produce great scientific videos full of passion for the benefit of masses without any pursuit of profit or publicity.
References:
1. AIIMS Telemedicine - YouTube [Internet]. [cited 2020 Jun 2]. Available from: https://www.youtube.com/channel/UClhIpqB1ENbKtsWsVk0P_vg
2. COVID-19 (Epidemiology, Diagnosis &Infection Prevention Practices) - YouTube [Internet]. [cited 2020 Jun 2]. Available from: https://www.youtube.com/watch?v=BTLGGV3_XnI
3. Novel coronavirus (2019-nCoV) [Internet]. [cited 2020 Jun 2]. Available from: https://www.youtube.com/watch?v=mOV1aBVYKGA
4. The Most Popular YouTube Videos About The Coronavirus Are Being Made In India — And They’re Full Of Hoaxes [Internet]. BuzzFeed News. [cited 2020 Jun 2]. Available from: https://www.buzzfeednews.com/article/ryanhatesthis/the-most-popular-yout...
5. https://www.youtube.com/watch?v=hOZL3oCfDFQ&list=PLqPyBK0DbE6NRz3sfJPuLI...
Competing interests: No competing interests
Roles of Doctors In Sharing The Medical Knowledge And Providing Online Treatment Services During COVID-19 in China
Dear Editor
Since the start of the COVID-19 pandemic, the connection between doctors and patients was largely impacted.
Before the pandemic time, people in China could go to the hospital for consultation whenever they want if they had any discomfort. However, due to the limitation of medical services, people might have to wait in line for a long time. Although the long waiting and crowded environment, face-to-face consultation makes the patients feel reasonably comfortable. Due to the so-called convenience, many healthy people went to the hospital only for an unnecessary consultation or confirmation of a medical rumor.
Most of the hospitals in China during the pandemic time adopted the preconception appointment policy to avoid crowds in the hospital. Owing to the clinical patients shrank during the pandemic time, the people who have health problems might have to adopt the new policy, while healthy people postpone their consultation. The telemedicine was not a novelty, it had provided a platform by which Chinese doctors could serve 0.38 patients per online doctor per day on average before the pandemic[1]. Whereas, according to data from online medical service provider AliHealth, its service homepage received nearly 400,000 visits within 24 hours after launching, with 97 percent of them from central China's Hubei Province, where the epidemic is most severe[2].
Furthermore, the short video platforms like TikTok have revolutionized the spread of medical information[3]. With the development of short video platforms like TikTok, the media has become the primary resource of their medical information.
But the information on platforms is patchy. Incredible information on the platform might mislead the people. According to the report of TikTok official, 29,000 coronavirus videos in Europe were removed. Approximately 3,000 of those contained medical misinformation[4]. Unfortunately, parts of the untrusted information might be created by some unprofessional medical workers, even a fake doctor. TikTok and other social media platforms like Facebook and YouTube are attempting to fight against the spread of misinformation[5]. At the same time, authentic doctors, as the provider of professional knowledge, should hold the responsibility for eliminating rumors.
Many doctors have registered their accounts during the pandemic time, and according to our observation, parts of them even acquired tens of millions of followers. Many accounts of registered nurses and official accounts of hospitals also play a significant role in pandemic time[6]. They not only eliminated the untrusted information but also provided the information for the healthy people who usually acquire knowledge from face-to-face consultation before the epidemic.
Furthermore, with the development of online consultation Apps, people with moderate disease transformed their consultation into an online form. Through several leading online consultation apps, doctors logged in their accounts and provided online consultation services.
The online consultation service mainly fills the gap of consultation due to the new policy in the pandemic.
Since the pandemic might sustain for a long time, the new form of information transform might be mastered by doctors. First, as the much more mass information and rapid spread of a new short video platform, the short video platform is a double-edged sword. We should take sufficient responsibility for the spreading of trusted medical knowledge. Second, the new form of information transform should be reserved even after the pandemic. Cause of the high convenience and accessibility, the online service should be an adequate substitution of formal consultation.
In the end, with the rebalanced connection between doctors and patients, we hope that during the pandemic time, even after the pandemic time, the new role of doctors in short video platforms should continue to develop and the online consultation service should also be sustained.
Xin Zheng*, Xin Zhang*, Yao Xu, Li Jiang
xinzheng@northwestern.edu mike.zheng@163.com Department of Urology, Beijing Youan hospital
13263372236@163.com Department of Urology, Beijing Chaoyang hospital
18611908765@163.com Department of Orthopedics, Beijing Friendship hospital
faithjiang1994@126.com Department of Obstetrics, Beijing hospital
*The Xin Zheng and Xin Zhang are the joint first authors.
References:
[1] Ramakrishna R, Zadeh G, Sheehan JP, Aghi MK. Inpatient and outpatient case prioritization for patients with neuro-oncologic disease amid the COVID-19 pandemic: general guidance for neuro-oncology practitioners from the AANS/CNS Tumor Section and Society for Neuro-Oncology. Journal of Neuro-Oncology. 2020;147(3):525-529 'doi': 10.1007/s11060-020-03488-7['2020-04-09].
[2] China Focus: Free online medical services help curb coronavirus outbreak - Xinhua | English.news.cn. Retreved 2020-9-18 from http://www.xinhuanet.com/english/2020-02/02/c_138749185.htm
[3] Creative Production of ‘COVID‐19 Social Distancing’ Narratives on Social Media. Retreved 2020-9-18 from https://onlinelibrary.wiley.com/doi/10.1111/tesg.12430
[4] Coronavirus: TikTok deletes 29,000 rule-breaking videos. Retreved 2020-9-18 from https://www.bbc.com/news/technology-53436774
[5] TikTok says it has removed 29,000 coronavirus videos in Europe. Retreved 2020-9-18 from https://www.cnbc.com/2020/07/17/tiktok-covid-19.html
[6] How Health Communication via Tik Tok Makes a Difference: A Content Analysis of Tik Tok Accounts Run by Chinese Provincial Health Committees. Retreved 2020-9-18 from https://www.mdpi.com/1660-4601/17/1/192
Competing interests: No competing interests