In spring of 2020, as the world was still adjusting to the notion of a ubiquitous, invisible threat lurking behind every corner, Amy Greer tweeted a link to her research.
The response was not what she expected.
“I had voice mails on my work phone of people yelling at me about the fact that I was responsible for their kid not being able to go to prom,” Greer recalled.
The response seemed out of step with what she thought were fairly straightforward findings. Her research showed this new virus was highly transmissible and that the only way to reduce its spread without vaccines was “nonpharmaceutical interventions” — for example, physical distancing.
It was a moment that made Greer, an infectious disease epidemiologist at the University of Guelph, realize the reach of Twitter — and the real-world consequences of sharing fact-based scientific research online.
She recalled a colleague cautiously peering into her office as she played a long “expletive-laden rant” from a person accusing her of single-handedly destroying the mental health of Ontario’s children. Greer experienced threats of sexual violence and kept some voicemail messages in case she might need to forward them to police.
Around this time last year, she received an unexpected box at her home with no note indicating who or where it was from. She assumed the worst.
“I was worried it might actually contain something dangerous,” Greer said, adding that it took a few days to confirm it was sent by someone she actually knew, and that the accompanying card had simply got lost in the mail.
“Prior to that, I lost a lot of sleep about the fact that it might represent a risk to myself and my family and that it had happened because of my media and social media presence.”
That social media platforms can be a breeding ground for hate and harassment is not new, but what has happened to medical experts during a global health crisis appears to be unique — those accustomed to high standards of scientific ethics and academic rigour, and who were not necessarily trained in public communication, found themselves in the throes of a real-time public conversation that turned angry, frustrated and tribal.
Their experience over these past three years in some ways underscores the state of our public discourse, but it will also have consequences that reverberate into the future and potentially affect whether Canadians hear directly from those with expertise in times of crisis in the future.
The Star spoke with a range of medical experts who said Twitter was a vital tool at the start of the pandemic.
But what began as a fruitful marketplace of ideas in a time of crisis has instead become, they say, a scorched-earth battleground, where trolls waged war on epidemiologists and spread lies about vaccines and the virus itself.
Others found themselves divided, with medical factions forming and scientists engaging in online disputes that have at times left the public unsure of who to trust.
In the face of the hostility, some medical experts have stepped away, ceding the conversational ground to others.
Elon Musk’s purchase of the platform and Twitter subsequently dropping its policy on removing COVID-19 misinformation have done little to suggest to them that things will get better anytime soon.
Before the pandemic, Greer had a Twitter account, but she became more active in the face of COVID. She had worked in government during the H1N1 pandemic, but this was different — the asymptomatic nature of COVID’s spread, combined with the sheer speed at which information (not to mention the virus) travelled, created a sense of public panic.
People were desperate for information. Twitter emerged as the fastest way for medical experts to share their knowledge, and citizens flocked to it. The platform saw a nearly 20 per cent increase in users over the course of 2020, the pandemic’s first year.
As governments fumbled with confused public messaging, Greer said she felt a responsibility to step up. She found the platform to be a useful town square, where medical experts could share literature about the spread of the virus, all while keeping the public informed.
But as doctors and scientists built huge followings, they also found themselves sucked into a vortex, where medical experts were attacked no matter their position. Those who urged caution in lifting pandemic restrictions were cast as alarmists. Those who debunked early theories about how the virus was spread or conditions linked to infection were accused of minimizing its danger.
Dr. Lynora Saxinger still has filters for the words “Commie,” “Nazi,” “c—” and “b—-” on her email inbox.
“That still gets stuff occasionally, which is nice,” she said, sarcastically. “The other funny thing is how often ‘Nazi’ and ‘Commie’ appear in the same email, which makes me think that that person hasn’t really studied history.”
Saxinger, a professor and infectious diseases expert at the University of Alberta, locked her Twitter account because of the online polarization, meaning a user must request permission to see her feed.
Saxinger said Twitter was once useful for professional networking, but has become increasingly dysfunctional — she described it as a “Wild West shootout.”
“It’s not a place of discourse anymore,” Saxinger said. “It’s a place of mob rule.”
Early on, she said, she noticed how contentious tweets saw massive traction, while opinions expressing uncertainty or nuance went unnoticed. She believes part of the problem is that social media rewards divisive opinions because of algorithms that amplify posts that see engagement.
“It’s like this primal instinct: you notice things that are a threat and you want to make sure everyone knows about it,” Saxinger said.
“So I think Twitter has this aspect of being like a commons, which is its strength, but it’s also its most tremendous drawback when things are contentious,” she added. “Because then it just becomes the loudest voice who recruits the most supporters becomes the bigger expert. But that’s not actually how the world really works.”
Dr. Shazma Mithani, an emergency room physician in Edmonton, said she gradually noticed Twitter’s tone grow more toxic over the pandemic, but especially in the past year. In particular, she gets “piled on” after any mention of vaccines, she said.
So she now sometimes limits who can reply to her tweets. She has also received many misogynistic and racist remarks — women who spoke to the Star consistently said they receive more personal attacks, including threats of sexual violence, compared to their male colleagues.
The steps she’s taken to protect her mental health also leave her feeling conflicted; she knows the tweets on which she limits engagement see far fewer impressions. And she’s unsure of her future on the platform. She pointed to concerns about changes such as how anyone can purchase a blue check mark, which was previously only offered to journalists, celebrities, politicians and other public figures.
“Now anyone can get verified, so even that extra layer (of protection) is gone,” Mithani said.
More worrisome is what she believes the polarized space has created: an erosion of trust — not only in medical professionals, but also in government institutions.
“The concerning thing that’s happened over the last few years … is that it’s very hard now for the general public to know what to trust and what not to trust,” she said.
While trolls and harassment are generally seen as part of the territory on social media, a phenomenon that experts say seems unique to the pandemic is the emergence of medical “camps” — or the experts themselves bickering over differences of opinion.
“We’re at that point now where rather than people getting scientific information and trying to help interpret it, what you mostly have are polarized camps who are getting the scientific information and are using it or manipulating it to argue their point of view,” said Dr. Andrew Morris, an infectious diseases professor at the University of Toronto and medical director at Sinai Health/University Health Network.
Dr. Nathan Stall, a geriatrician at Sinai Health, is also someone who has reduced time spent on Twitter because he said it’s become too chaotic and confusing.
“At some point, it became impossible for people, even myself included, to make sense of who’s an expert and who’s not an expert,” Stall said.
“But they’ve also seen academics literally tear each other’s eyeballs out.”
He said he’s less concerned about trolls, who he believes the public can usually identify, as he is about people he said are using the pandemic to, in his view, build a personal brand or push certain political positions.
When the honest brokers pack their bags, who is left to fill the void?
“You basically ceded the territory to only those who are the loudest voices,” Stall said. “We’re seeing this in a number of areas, where the people who are speaking on issues and being platformed on some really prominent channels are not necessarily people who would have lived experience or expertise or credentials. And I think that that’s actually doing a lot of damage.”
A recent online exchange that left some watchers puzzled was an argument between Morris and Colin Furness, whom Morris accused of overreaching in his online statements. Furness is an assistant professor at the University of Toronto’s Faculty of Information who also holds a Master of Public Health in epidemiology. He has been a frequent face and voice in the media, including in the Star.
Furness had reeled off a series of COVID’s supposed potential effects on children, and said parents should be worried. Morris said there wasn’t evidence to support Furness’s characterization — calling it “fear-mongering” among other things.
Furness, who teaches a class called Information, Misinformation, and Health, shot back on Twitter and in an interview with the Star. He argues that he’s an academic, not a clinician, and that he aims to make sense of emerging data where definitive conclusions don’t exist.
He refers to it as “epidemiological sensemaking.”
“That is to say, we’ve got this phenomenon, we’ve got a theory, we’ve got biological plausibility, we’ve got consequences — we’ve got all the pieces to make sense of this. Could we at some point be proven wrong? Yes. And that is always true in science,” said Furness, who has nearly 40,000 followers on Twitter.
Some, meanwhile, pointed out how online polarization makes the average citizen more skeptical of science.
“Scientists and doctors need to stop fighting on social media,” said user @ankleskater. “You’re ALL tarnishing the name of science at a time when it should be easy to rally the public to be more pro-science than ever.”
The retreat of medical professionals from Twitter, in addition to regular users departing because of Musk’s recent purchase, raises questions about the platform’s fate — will it go the way of MySpace, as a sort of dormant parking spot on the web? Or will it become even more toxic and join the internet’s seedy underbelly?
Twitter’s future also has implications for how information spreads in a world where there is no single centralized forum. Where will the public go to find the information they need and can trust?
That’s an answer readers may have to seek out offline.