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Matt Morgan: The two pandemics—covid and lies

BMJ 2020; 371 doi: (Published 24 November 2020) Cite this as: BMJ 2020;371:m4516

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  1. Matt Morgan, intensive care consultant
  1. University Hospital of Wales
  1. mmorgan{at}
    Follow Matt on Twitter: @dr_mattmorgan

It’s been a long weekend. The growing number of my colleagues self-isolating has led to increasing gaps in our rota. Combined with the unwelcome return of covid-19 to intensive care units throughout Europe, the long hard summer is morphing into the longer, harder winter. I let out a slow exhale as I sink into my sofa after arriving home late on a Sunday night. Time to recharge, relax, and reflect—but a million voices are shouting at me.

A video on YouTube tells me that the covid tests I ordered were false. A Facebook post proclaims that masks are simply a tool of government oppression. Twitter advises me that those death certificates I’ve written were lies. The hardest part of my day should be the time I spend at work, not the time at home. With so many voices screaming, it’s hard to hear the whispers that really matter. “Thank you” is always quieter than “F**k you.”

Yet the clamour of social media—what Sacha Baron Cohen has called “the biggest propaganda machine in history”—is alive and well. We’re battling two pandemics, not one. Fake news outperforms real news. Lies spread more quickly than truth. And the results aren’t just likes or retweets. Likes can quickly turn to hate. This results in real harm to patients, to families, and to the staff trying their damnedest to care for them no matter what their beliefs.

I strongly believe that there are very few bad people in the world. But there are plenty of bad ideas and bad incentives. A publisher that can’t take responsibility for its content is like a restaurant that can’t safely cook chicken. The restaurant would be shut down, but social media platforms continue to thrive on their digital currency of empty gestures and polarising incentives.

Now, more than ever, the big social media companies should stand up or shut up. It’s fine if they want to see no evil or hear no evil, but then they must also speak no evil. Instead, they scream it at the top of their lungs. Half of the profiles pushing the unethical, dangerous, and discredited case for herd immunity through the Great Barrington Declaration were artificial, bot-like accounts,1 amplified by social media above the consensus view.

As doctors, nurses, and patients, we must move beyond blaming individuals who respond to these bad ideas and bad incentives: instead, let us task the companies with taking responsibility for their output. If not, they can fund the intensive care beds, the staff sickness gaps, and the tissues to wipe away tears when their broadcast untruths result in real world harms.


  • Competing interests: I have read and understood BMJ policy on declaration of interests and declare that I have no competing interests.

  • Provenance and peer review: Commissioned; not externally peer reviewed.

  • Matt Morgan is an honorary senior research fellow at Cardiff University, consultant in intensive care medicine, research and development lead in critical care at University Hospital of Wales, and an editor of BMJ OnExamination.