COVID-20 and the Year of the Conspiracy Theory

Source: Matryx/Pixabay

2020 has turned out to be the year of the conspiracy theory. Sure, conspiracy theories have been around forever, but it's hard to recall a time when they've been so integrated with mainstream discourse, endorsed by American political leaders, and relevant to public health.

While the World Health Organization warned of an “infodemic” of COVID-19 misinformation back in February, it probably didn’t anticipate just how virulent belief in conspiracy theories (BCT) would become. As we near the end of the year, conspiracy theories about the origins of COVID-19, its lethality, and its optimal management have merged with other pre-existing conspiracy beliefs about Bill Gates, vaccines, 5G networks, and QAnon.

The consequences of such belief have been serious, including the arson of cellphone towers in the UK and the intentional derailment of a train at the extreme or a Pew Poll from September indicating that up to half of Americans would either “definitely” or “probably” refuse a SARS-CoV-2 vaccine.¹ A recent study confirmed that belief in COVID-19 conspiracy theories predicted non-adherence to a variety of guidelines for prevention and the embrace of pseudo-scientific practices.² As we head into 2021, with the pandemic raging on while vaccines becoming increasingly available, COVID-related conspiracy theories will likely end up having profoundly Darwinian effects.

Conspiracy theories reject authoritative accounts of reality in favor of some plot involving a group of people with malevolent intent that is deliberately kept secret from the public. Real-life examples of conspiracies have occurred in history, but most conspiracy theories are either unsubstantiated, untrue, incredulously complex, or frankly outlandish. And yet, surveys have consistently found that belief in popular as well as medical conspiracy theories are held by 50% or more of people in the US, with about 20% of Americans and Britons alike endorsing the conspiratorial belief that serious vaccine side effects such as autism are being deliberately hidden from public awareness.^3,4,5

This ubiquity of BCT is best understood by distinguishing the individual, societal, and political factors that give rise to it. Psychology research has found that BCT is associated with a long list of “cognitive quirks” including attribution and perceptual biases; needs for control, certainty, closure, and uniqueness; “bullsh*t receptivity,” lack of analytical thinking, and science illiteracy; and mild psychotic symptoms.⁶ However, such cognitive quirks are traits that most of us have, varying in degree between those who believe in BCT and those that don’t and shouldn’t be mistaken for evidence of mental illness. As widely shared beliefs that typically lack a self-referential component and sometimes turn out to be true, conspiracy theories are distinguishable from delusions and are not associated with mental illness per se. In that sense, thinking of BCT along the lines of mass psychopathology is the least accurate or helpful way to understand the phenomenon.

In contrast, a “socio-epistemic” model argues that BCT is best understood as a social phenomenon with two central components: 1) “epistemic mistrust” of authoritative informational accounts and 2) biased misinformation processing.⁷ When people mistrust authoritative accounts, they become vulnerable to “falling down the rabbit hole” in a search for answers, especially online, where they seek out and find conspiracy theories that are adopted as appealing counter-narrative indictments of epistemic authority.

Trust in government and the medical community are near all-time lows in the US,^8,9 while international survey data indicate that 45% of respondents only believe scientific claims that align with their own personal beliefs.¹⁰ Such epistemic mistrust has many potential causes. Sometimes it is justified or earned, as in the case of real-life trust violations that have given rise to Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)-related conspiracy theories widely endorsed by African-Americans in the US.¹¹ Conversely, mistrust can reflect a form of subclinical paranoia or an expression of racial or cultural prejudice that manifests as “intergroup conspiracy theories” such as those with an antisemitic focus.¹² During the COVID-19 novel pandemic, trust in institutions of scientific and medical authority has been compromised by a lack of transparency and missteps in communicating reliable information such as whether or not masks should be worn, the iterative nature of scientific discovery and the premature publication of scientific findings ahead of peer review, and the censorship of public health institutions for political motive.

When epistemic mistrust leads people to search for counter-explanations, the subsequent information processing that occurs must be understood in terms of the ubiquity of misinformation and deliberate disinformation on the internet and on social media where “fake news” travels “farther, faster, deeper, and more broadly” than truth¹³ and “echo chambers” and “filter bubbles” contribute to “confirmation bias on steroids.”⁷

Last year, researchers reported that anti-vaccine pages on Facebook outnumbered pro-vaccine pages more than 2:1 with followers growing more rapidly and interacting with other groups with potential ideological overlap, such as those focused on “wellness” or more generalized safety concerns.¹⁴ Meanwhile, followers of pro-vaccine groups were more static, without evidence of nearly as much interaction or ideological conversion of vaccine “fence-sitters.”

Another study found that of the 150 most-viewed videos identified about COVID-19 on YouTube as of March, 27.5% contained false information and were seen by over 62 million viewers worldwide.¹⁵ In May, the COVID-19 conspiracy theory video Plandemic went viral and was viewed by millions in the 2 weeks before it was taken down by the major social media sites. These findings highlight that BCT cannot only be understood and countered as a problem of individual belief but as a problem of pervasive misinformation that consumers are often unable to distinguish from facts.

Coronavirus Disease 2019 Essential Reads

Update on COVID-19 and How It Changes the Brain

How Political Partisanship Can Be Deadly

Conspiracy theories must also be understood as a tool of political propaganda intent on deception. Political conspiracy theories, such as the claim that SARS-CoV-2 was deliberately manufactured in a lab as a bioweapon, can serve a scapegoating role, shifting blame for mismanagement of the pandemic. Likewise, it is now well known that misinformation related to vaccines and COVID-19 are spread online via “bot” and “trolls” as part of a massive disinformation campaign by Russia and other countries with a goal of fomenting discord and undermining trust in democratic institutions of authority.¹⁶ It should also be recognized that peddling misinformation is a for-profit industry that benefits from the creation of a “post-truth world” where the very concept of facts and truth are cast into doubt.¹⁷

While BCT should not be conflated with mental illness, health behaviors should not be guided by false beliefs within a mentally healthy society. Accordingly, the real-time proliferation of conspiracy theories that has been witnessed during COVID-19 should be regarded as a symptom of a sick society in which mistrust of institutions of authority and a “wild west” of online misinformation are the root causes. Going forward, a public health approach to BCT must therefore focus on:

• Institutions of epistemic authority working to regain public trust by becoming more trustworthy.
• Communicating reliable medical information through in-person interactions with healthcare providers as well as within online spaces.
• Promoting resistance to BCT through evidence-based “inoculation strategies” that warn of misinformation and “beat it to the punch.”
• Doing a better job of teaching analytic thinking and scientific literacy within educational systems at an early age.
• Restructuring the digital architectures that facilitate the dispersal of misinformation and disinformation online.

Given the daunting scope of such interventions, it should come as no surprise that many wish that BCT could be “cured” by something as simple as referral to a psychiatrist.