As Twitter rolls back its ban on COVID misinformation, some health experts worry about threat to public health

COVID-19 misinformation on Twitter is reportedly spiking after CEO Elon Musk fired moderators enforcing the social media platform’s COVID misinformation policy which was discontinued in late November.

Public health experts on the platform have expressed concerns that the change could discourage vaccinations.

"Bad news," tweeted epidemiologist Eric Feigl-Ding, who urged other users to stay on the platform in order to counter misinformation. "Stay folks — do NOT cede the town square to them!" Feigl-Ding, a Harvard trained scientist, has more than 700,000 followers on Twittter but some researchers have criticized his tweets as "unnecessarily alarmist," Fast Company reported.

The social media platform's policy was put into place in December 2020 in response to misinformation regarding the COVID-19 vaccine. It was quietly discontinued on November 23 with an update including a one-sentence message to users. The change comes after Twitter was purchased by Elon Musk.

While the increase in misinformation may also be due to the release of the anti-vax documentary Died Suddenly, posts regarding the documentary would likely have otherwise been blocked if it wasn’t for Musk’s change in policy.

“We shouldn’t start moderating everything everybody says, but when people are dying next week, then the week after that, then over and over and over, you can yank a post out, and I don't feel like anybody's free speech has been impacted; that's my opinion,” Paul Russo, a social media researcher and dean of the Katz School of Science and Health at Yeshiva University in New York, told Fierce Healthcare.

Russo added that platforms are responsible for harmful content on their sites and social media companies should make decisions that keep the largest amount of users safe and happy.

"A platform has a non-negotiable responsibility to the health of its community," Russo said. "When I say health of the community, what I really mean is the interaction, the contribution, the engagement of a community, keeping it safe within its platform. That is the spoken and unspoken responsibility. It's a values-based decision, it's ethical. But secondly, it's also a business decision." 

Already, advertisers have left the platform. 

The volume of COVID-19 misinformation has jumped alarmingly on Twitter, according to research from Timothy Graham, senior lecturer in digital media at Queensland University of Queensland (QUT). He ran an analysis measuring the marked increased in seven words commonly used in COVID misinformation circles, revealing the steady decrease in content moderation since Musk purchased the company in late October.

Terms searched were the combinations of "Bioweapon and Wuhan", "COVID and deep state", "COVID and hoax", "COVID and wake up" and "Fauci and lied."

"This is a watershed moment," Graham told ABC News in Australia. "This is a clear signal that COVID misinformation is back on the menu."

Disbanded anti-vax networks have also shown evidence of reforming, according to Graham’s research.

Musk has been a vocal critic of public policy regarding the virus, comparing stay-at-home orders to imprisonment and stating that COVID mortality rates were much lower than reported. The CEO and his supporters have labeled his overtake of the platform as a new era of free speech.

Many against the 2020 COVID misinformation policy pointed to the early days of the pandemic when public health experts seemingly “flip-flopped” as new information was being discovered.

“As a scientist, especially in emergent problems, you can give advice based on what you know,” Russo said. “And sometimes you have to use your scientific judgment or your public health judgment or your judgment as a leader or the expert to decide when to say something or nothing. I think people made decisions based on what they knew, typically from the science or the health community, to err on the side of caution.”

Some medical professionals have expressed support for Musk’s policy change.  

“The world's people deserved a real open and transparent discussion about school closures, lockdown, COVID policy,” tweeted Jay Bhattacharya, M.D., professor at Stanford School of Medicine. “Twitter 1.0 worked to prevent that.”

Bhattacharya is one of the alleged “blacklisted” users who was blocked from trending on the platform before Musk’s purchase of the platform. On Nov. 23, Musk tweeted a poll asking users if he should allow “general amnesty” to all users who were banned from the platform.

"This policy was used to silence people across the world who questioned the media narrative surrounding the virus and treatment options," tweeted Simone Gold, M.D., physician and prominent purveyor of COVID-19 misinformation. "A win for free speech and medical freedom!"

Already, other users who countered public health guidance release from the Center for Disease Control and Prevention (CDC) have returned to the app including former President Donald Trump, Rep. Marjorie Taylor Green and Gold.

Many against the previous COVID policy argued that the platform’s moderators did not offer a well-defined system for determining post validity. Russo said that when it comes to complex issues like health, platform moderators need to be transparent in their methods and how they shift depending on the subject matter.

“So moderators will need multiple moderation types,” Russo said. “There are idiosyncrasies and subtleties within the issues for health-related problems and also hate speech.”

Hate speech has increased on the platform over the last month with the use of the n-word tripled and slurs against gay men and trans people up 58%, according to the Centre for Countering Digital Hate. This counters Musk’s Twitter post on Dec. 2 stating that hate speech has decreased since his tenure began.