Don’t Believe Everything You Scroll: Navigating Science and Health Misinformation

Dr. Noc: Whatever we can do to pull that lever to increase the availability of actual evidence-based health content from a diversity of experts on the topics, I think is kind of the only way forward from here.

Megan Hall: Americans are consuming more science and health information online than ever before, and at the same time, they’re becoming less certain about what information they can trust. I’m Megan Hall for Scientific American Custom Media. There’s a growing public distrust in the institutions that paved the way for medical innovation and public health. How is that sentiment getting in the way of innovation, and what’s still happening behind the scenes despite the skepticism? Joining me is Morgan McSweeney, known online as Dr. Noc, a science communicator and immunology expert, whose videos reach millions of viewers every month across TikTok, Instagram and X. Thanks for joining me, Dr. Noc.

Dr. Noc: Yeah, pleasure to be here.

Megan Hall: You have a PhD, and it’s focused on basically developing medicine to help people with immune issues. So, what got you interested in that topic?

Dr. Noc: Yeah, I wasn’t always interested in it. So when I started in college, actually going back to before college, my my wife, who was at the time my girlfriend, was premed. She was like always passionately premed. She is now a doctor. I didn’t really know what I wanted to do too much, so I kind of just copied her. We decided we wanted to go to college together. I knew like I kind of like science. I’m kind of good at science. I will also be premed, and then it wasn’t until really taking microbiology lab, which is where I mean, for example, the final exam was like they give you this vial. It’s like a murky solution. They say, “This has got three to six unknown bacteria.” Your final is to take it and figure out what they are without doing genetic sequencing. And so you have to take it and you have to you know streak it out onto petri dishes and isolate the colonies and like run these chemical tests, and that was kind of the first spark for me of like, oh, science is about like hunting for an answer. It’s not like memorizing this pile of facts. And so then I went on to get like a research job in an actual research lab. I say I mean a $0 per hour job.

Megan Hall: Internship.

Dr. Noc: Internship volunteering. That’s what really showed me what it’s like to do real science separate from coursework science, and so I said, "Okay, I’m going to go get a PhD.” I didn’t know exactly in what. I knew I was interested in microbiology and virology and immunology. So in grad school, not all programs are like this, but the one I went to, UNC Chapel Hill, like you do rotations your first year, and so I did one in kind of a translational lab. Translational being different from like you hear about basic science, which is, as you know, it’s not it’s not easy science. It’s like fundamental science.

Megan Hall: You’re not hunting for something specific. You’re trying to kind of understand how things work, right?

Dr. Noc: That’s right. Yeah, it doesn’t have like a direct application. Like nobody’s going to build a product directly off of the research you’re doing, but it could be fundamental to you know the rest of human civilization.

Megan Hall: Right. Understanding how the world works.

Dr. Noc: Yeah, like how water freezes, or you know all of those types of things. And then after that, ever since then, actually, I’ve been working on antibody-based medicines, mostly for infectious disease, so respiratory infectious disease like influenza, RSV, COVID, MPV, but all of it antibody based, and so that’s what I work on, kind of with my full time scientist biotech hat, totally separate from like making science content.

Megan Hall: Did you ever think when you’re doing all this research that you would be making these short little videos for TikTok?

Dr. Noc: No, not not in 1,000 years, as you can probably tell. I mean, no one, you know, who I knew growing up or in school would be like, "Oh, that guy’s gonna make social-media content.” I’m kind of super introverted by nature. It doesn’t feel natural. It still doesn’t feel natural, but you kind of learn to do it. It was at the beginning of the pandemic. I was kind of just, you know, like seeing a lot of misinformation online, and it was the thing that I was studying because you know we’re advancing antibody treatments for respiratory disease, and so I figured why not try making some like science-based content online and see how it goes, with no real long-term plan, which is kind of still where I’m at.

Megan Hall: Was it because you were frustrated? I mean, you must have been seeing so much misinformation flying around, so much fear, and then here you’re saying, “Look, I’m an expert in this stuff. You’re getting it wrong.”

Dr. Noc: I think you phrased it exactly right. It feels like it’s so intuitive if you have like that type of training in science, and you see something that’s just so grossly wrong. Information that like you know is going to hurt people if they act on that information. It’s almost like you feel like you’re compelled to try to correct it in a way.

Megan Hall: According to a Harris poll study commissioned by Bayer, 80 percent of Americans say that social media contributes to misleading or false health and science information. So, where do we go from here?

Dr. Noc: That’s a low estimate. It definitely does. It certainly contributes to misinformation. That’s good, though. I mean, the silver lining there is a lot of people recognize that there’s a problem with health misinformation on social media, and so you’re kind of primed to already be a little bit suspicious of health claims that you’re seeing. Where we go from here is getting that 80 percent to 100 percent, I mean, in my ideal world, where people just kind of blanket aren’t trusting health advice that they’re getting from social media, but that’s not realistic because I mean, an increasing fraction of younger people from the same poll that’s their primary source of health and science information. And so whatever we can do to pull that lever to increase the availability of actual evidence-based content from a diversity of experts on the topics, I think is kind of the only way forward from here. There, you know, it’s unreasonable to expect people to do their own research. I don’t think it’s possible. It’s unreasonable to ask people to talk to their doctor. People are spending and getting more information from social media, and I think that’s going to continue to be a source of where people become informed.

Megan Hall: There’s lots of skepticism about scientific institutions. Where do you think that comes from?

Dr. Noc: Yeah, some of it, some of it, I think, has been earned, unfortunately, by scientific institutions. Some of it is manufactured as a consequence of how kind of social-media algorithms work today. I think it’s important to distinguish between those two and to acknowledge that some of it like is earned, and so that’s kind of a hard thing to hold those two things true at the same time. And that’s compounded by kind of the mechanistic, the manufactured part of it, which is algorithmic, which is that I mean, as you well know, the things that sell on social media often are like strong emotional engagement and fear and outrage and playing to things that people hope are true or things that people fear might be true, and those things are typically not aligned with sort of very carefully balanced scientific takes on you know the regulatory framework in the United States.

Megan Hall: So how do you think you became so popular? Because that’s exactly what you do, right?

Dr. Noc: I should say, you know, the way I said that made it seem like people don’t want to hear like the nuance behind these things. I’ve learned that’s actually that’s not true. People people do want to hear the nuance. The trouble is kind of framing it in a way that feels authentic, that feels interesting. You know, because you’re competing on social media against the entire world of whatever might be next. You’re never more than like a flick of the thumb away. And over time, you build up that relationship with someone online, like the parasocial type of relationship, where then when they present something, you know, it feels like it’s coming from almost like a trusted friend or family member rather than, oh, this person in a white coat representing the scientific institution, who you know, I don’t know what their motives are.

Megan Hall: So was that sort of the key to your success, letting people get to know you a little bit?

Dr. Noc: I think that’s a big part of it, and I didn’t realize that at first. The type of communication I did at first was very like, here’s the facts, here’s what I think of it. That’s why you should think it too, and that is compelling to some people. What I learned though is kind of the people who will respond to that presentation of the evidence probably already were going to find that evidence and make those decisions anyway. The people who are on the fence—people talk about it like the movable middle people—they don’t know who to trust, and so they don’t know whether they can trust that the evidence that you’re sharing has not been manufactured by industry in some way. And so, throwing more evidence at that group of people is just going to make them feel more frustrated because it’s not solving the source of the issue, which is the trust in the first place. I learned that interestingly on a live stream in COVID. I’ve talked about this a couple times before, but I still remember because this was the moment where it shifted for me. It was like I was doing a live stream, and this was right after the COVID vaccines just came out, and so naturally everyone had questions about like what were the clinical-trial design and how were they developed so fast and like what’s the efficacy and safety. But then at the very end, I said like, “I’ve got to go, I got to go make dinner because my wife is coming home from the hospital, you know, sorry, bye.” And then it was only like 20 or 30 minutes later, that I saw a message came in, and it was something to the effect of, “I didn’t know if I could trust you until you said you had to go make dinner for your wife, and I realized like you’re a real person, and you’re giving us your genuine interpretation of like what you’re seeing,” and like that was the thing that made it click, not all the evidence in the clinical-trial design, and so that’s kind of shifted for me. Like, oh yeah, it’s okay to do a silly dance every once in a while, or talk about you know what I’m having for breakfast. Not only is it okay, it could actually be crucial.

Megan Hall: So, do you think that’s the key to combating this misinformation online? Just getting more doctors, more science experts posting videos and mentioning that their moms and they’re making dinner.

Dr. Noc: And dancing.

Megan Hall: I mean, is it all about just developing a friendship as a science expert?

Dr. Noc: I think it would help a lot. I mean, there’s two levers you can pull. One is you can try to decrease the spread of misinformation on social media. There you run into some thorny issues of free speech and regulation, and you know, government overreach, and what are the platform’s roles? Not only what should they be, but how do you do it effectively? How do you distinguish between misinformation versus you know just asking questions in good faith? So, that lever is kind of hard to touch. The lever that lever that is easier to touch is ramping up the production of high quality evidence-based health information, and we definitely need more people doing it. I can tell you, not everybody likes me. People are not hesitant to leave me comments about that.

Megan Hall: Let’s talk about evidence-based. That’s a term that experts use a lot. But what do we mean when something is evidence-based and there’s a lot of evidence out there.

Dr. Noc: Of varying degrees of quality. Yeah, this gets hard because, it’s not just experts who talk about evidence-based. It’s anybody can say that a lot of things are evidence-based. It’s kind of like a buzzword to give yourself credibility when it may not be there in terms of what you’re citing. The way that I think about it is that, like the thing, the statement that you’re making, or what you’re proposing, or the intervention you’re hawking had the opportunity to fail in some way, but didn’t. Right? So, the claim you’re making is falsifiable, and somebody tested that falsifiable claim. Now, there’s a hierarchy. This is really hard on social media. You’ll see influencers. They’ll put up a screenshot of study title from PubMed published in a journal. You’re not going to be able to know instantly, you know what’s the quality of that journal? What’s the quality of that study? Was that study perhaps correctly conducted and the person accurately recounted what that study found, but it was at odds with these other 99 studies that found something totally different. All that is very hard to assess, even for me. Like in a moment while I’m scrolling, if it’s outside of my kind of narrow window of expertise, I can’t very quickly tell whether someone is kind of honestly and accurately interpreting evidence on social media.

Megan Hall: So, what are people supposed to do?

Dr. Noc: Ideally, you know, in a perfect world, I and nobody else would be making you know health and science you know type of recommendations or content on social media. We don’t live in a perfect world though, and so the first thing I tell people is get information from your physician. In addition to your physician, now what I recommend, for example, if you have questions about your child, you can look to the AAP, the American Academy of Pediatrics. If you are pregnant, you can look to professional organization ACOG, American College of Obstetricians and Gynecologists.

Megan Hall: So, would your recommendation be just don’t try to get evidence from the internet, especially social media, because there’s no way to really assess if it’s real or not.

Dr. Noc: Yeah, which I recognize is ironic, because like that’s the type of content that I make. I mean, I don’t give health advice, but I’m commenting on scientific topics. You have to recognize when someone’s telling you sort of an emotional story, or they’re recruiting you into particular identity, like as a protective parent, or you know, someone who’s doing the type of research that other people don’t do, and recognize when you’re kind of being led down that path, and just take a moment to say, I don’t know if this might be true or not. It’s unreasonable to expect people to, you know, leave the social media platform and go look up the primary literature, and you look at the methods of that paper and see, oh, is that accurate?

Megan Hall: How many people are even trained to do that?

Dr. Noc: No, yeah, that’s right. I mean, even if you go do that, you can get past the paywall, and you’re looking at the methods section. Like, what are you going to do with that information?

Megan Hall: Did you study this?

Dr. Noc: And even if looking at that one paper, do you have knowledge of the rest of the field that’s been published recently? It’s a huge endeavor, like hundreds of hours, you know, if it’s not something that you know like the back of your hand. And so, it’s not reasonable to expect people to to do that type of assessment of a claim. What I do encourage people to do is kind of just to mentally like pause, like set off an alarm bell that like oh, this video is trying to get me to believe something about my health, and just pulling yourself out of that sort of passive reception state is the first step to not being led down sort of that path of belief unknowingly.

Megan Hall: How do you think all this skepticism is getting in the way of innovation or in support for scientific research?

Dr. Noc: Yeah. Well, first of all, I think it is. I think for a long time, the scientific establishment thought they were insulated from you know what the public thought about science. I think there was some sense of well, we’re gonna sit here, we’re gonna develop what we know to be useful things for people, where their benefits outweigh their risks, and we’re gonna hand these off to the public, and you know the physicians or whoever it might be are going to recommend it to people, and it’ll be a good thing for society, regardless of what people thought of us during the process of development. I think it’s become clear recently that that while that may have been largely true, it’s not true anymore, and so we’re seeing that you know sort of a shifting public confidence in science is translating to policy now in very tangible ways.

Megan Hall: Let’s be clear about one thing that there’s more skepticism about lately, which is vaccines. Can you just say on the record what we know about vaccines, how safe they are and how they’ve improved our lives?

Dr. Noc: Yeah, I mean it’s one of the best studied interventions in like all of human medicine in history, and I should say we have a daughter. She’s two years old. My wife is board certified in pediatrics. She’s received all of the vaccines recommended by the AAP, you know, the schedule on the schedule. And so, you know, I’m putting my it’s not my money where my mouth is, but that’s the vote of parental confidence that I have in the vaccines, having critically reviewed them, sort of with my expertise and my wife’s expertise. Now that’s because you know a couple years ago there was a big review that came out. It’s estimated 154 million lives have been saved over the past 50 years from vaccines alone, and like 95 percent of those were in children under five, 100 million of those were in children under the age of one, and so if you add all those up and divide it over the years, that’s like a child every 10 seconds whose life is being saved because of vaccines. That only addresses the efficacy part, not the safety part. The phrase, though, about vaccines that I’ve become very frustrated with is, you know, vaccines are safe and effective, and what I’ve learned is that, of course, what what we mean to say is that the benefits of vaccine outweigh their risks, which is true for all the recommended vaccines. But people can very easily misinterpret if you say vaccines are safe and effective. Some people think that means vaccines are 100 percent safe, and they have no side effects and risks, and then when those people learn correctly that sometimes vaccines do have risks and sometimes they can be serious risks, the feeling is, oh well, you’ve lied to me. You sat here and told me they were safe and effective, and yet here is this very real safety finding. Therefore, why am, why should I expect to follow your recommendation for the health of my child? And so that is certainly true. People want the nuance. People want to hear, okay, well, what are the risks and benefits of vaccines? How do those relate to the risks and benefits of the disease that they’re meant to prevent? And how do those stack up? And I mean, it’s not surprising to learn that people have rigorously evaluated and weighed those benefits and risks.

Megan Hall: So how do you balance not giving a blanket statement with holding people’s attention and not confusing them? Because you just spouted up a lot of statistics and numbers that I mean, a lot of people might get confused. So how do how do you do both at the same time?

Dr. Noc: Yeah, that that is the central problem is figuring out how to do it, and there’s no one broad answer for how to do it, and there’s no one way to say a type of messaging that’s going to resonate with everyone. So, you know, the way I just laid it out, maybe will feel compelling to some people or useful to some people in a way that they can then go look it up or talk with their doctor about it.

Megan Hall: But it sounds like what you’re saying is science experts sort of made the mistake of not trusting the public’s intelligence, that they almost dumbed down the message too much, and then people didn’t believe them. Is that right?

Dr. Noc: I think so. I think things were, particularly around the time of COVID, things were stated too confidently. I think with the intent of not overwhelming people with too much nuance, and then when it turned out, you know, the scientific establishment changed their mind on something, people were like, "Oh, why should I trust you now? You should have been upfront from the beginning about this is the type of data that could change. This is how it could change. This is what would lead us to change our mind.” Rather than taking a very sort of heavy-handed and prescriptive outlook from the beginning, I think people can handle the nuance, and I think it was a mistake thinking we need to dumb this down for the public.

Megan Hall: You are participating in Bayer’s Science Delivers campaign, so why are you participating? Why do you want to be part of it?

Dr. Noc: Yeah, I think it’s exciting. It’s no one’s really captured the spirit of like the real, really the value of science like this one. The tagline is "Don’t just trust the science,” and I think the mistake you know a lot of other messaging initiatives have made in the past is treating science like, oh, here’s your pile of facts. Like, do you trust this or not? Are you on our team or not on our team? And the difference is that Science Delivers, it’s more about like this is the scientific process. This is how we prevent ourselves from fooling ourselves by implementing the scientific method, because you know any given anecdote or story from a friend or family member, whatever it might be, it’s really really easy to get fooled by something that you hope is true or something you fear might be true, and our best defense against that is the scientific method. It doesn’t give us the right answer all of the time. It maximizes our odds of coming to the right answer, and it’s delivered. You know, you don’t have to reach more than an arm’s length away from something that has made our lives better or easier or helped our health in some way through the scientific method.

Megan Hall: Thanks again, Dr. Noc, for being here. It’s been great speaking with you.

Dr. Noc: Thanks for having me.

Megan Hall: This video podcast was produced by Scientific American Custom Media and made possible through the support of Bayer.