The truth about coronavirus is scary. The global war on truth is even scarier.

The police came for Dr. Li Wenliang in the middle of the night on the first day of the year. Just days earlier, Li, a physician in Wuhan, China, had sent a message to his medical school alumni group on WeChat informing them that a cluster of patients with a strange new virus had been quarantined in the hospital where he worked.

Unbeknownst to Li, he had just issued the first public warning about the novel strain of coronavirus that has sickened more than 125,000 people globally and killed more than 4,600.

Before long, his WeChat message started gaining traction online and, at some point, caught the attention of Chinese authorities. Within a few days, Li was summoned by law enforcement, who reportedly told him the warning he posted on social media was illegal and had "severely disturbed the social order.” He was forced to sign a statement denouncing his warning as a false and illegal rumour, and promising not to speak out again. Less than a month later, the young doctor died from complications stemming from coronavirus disease.

Li was one of eight people summoned by the Wuhan Public Security Bureau that day for posting and spreading “rumours” about cases of a SARS-like illness popping up in Wuhan hospitals. All eight of the detainees were doctors.

Over the next several weeks, China would go on to arrest or detain hundreds of people under the auspices of fighting misinformation. Other countries soon joined in, using existing laws that ban the sharing of “fake news” to impose tight control over the flow of information. In some cases, these laws have been used to go after people selling dangerous falsehoods like the promise of miracle cures. But in many instances, doctors and journalists are the ones being targeted as governments fight to maintain control of the narrative about an outbreak that they couldn’t control.

At a time when access to accurate information can be a matter of life or death, draconian restrictions on speech — even those that target falsehoods and conspiracy theories — threaten to scare people into silence and disrupt the flow of crucial health information, said David Kaye, the United Nations special rapporteur on the promotion and protection of the right to freedom of opinion and expression and a clinical professor of law at the University of California, Irvine.

“Public health can be a basis for restricting information under human rights law, but these kinds of broad restrictions are basically unwarranted and ultimately dangerous to public health, in my honest opinion,” Kaye told National Observer.

Coronavirus 'infodemic'

Despite aggressive efforts by social media companies and health authorities, misinformation about coronavirus has spread faster and farther than the disease itself, leading to what health officials describe as an “infodemic.”

“The COVID-19 outbreak and response has been accompanied by a massive ‘infodemic’ — an over-abundance of information, some accurate and some not — that makes it hard for people to find trustworthy sources and reliable guidance when they need it,” Dr. Margaret Harris, a leading WHO physician, told National Observer.

Some of the most widely shared hoaxes and rumours about the coronavirus outbreak include false information about cures (Vitamin C won’t cure it, nor will bleach), conspiracy theories claiming the virus is a bioweapon that was stolen from Canada (it’s not) or accidentally released from a lab in China (genetic evidence shows it came from an animal, not a lab) and baseless claims that a vaccine for coronavirus exists but is being kept under wraps (there’s no vaccine yet).

In February, more than two dozen public health scientists wrote a letter to The Lancet medical journal expressing concern that misinformation about coronavirus may be disrupting the flow of critical scientific information and eroding international partnerships. The scientists said they were particularly worried conspiracy theories about the virus being manmade could undermine the work of health professionals fighting to contain the disease.

“The rapid, open, and transparent sharing of data on this outbreak is now being threatened by rumours and misinformation around its origins,” they wrote. “Conspiracy theories do nothing but create fear, rumours and prejudice that jeopardize our global collaboration in the fight against this virus.”

Health-related rumours and misinformation can also directly exacerbate infectious disease outbreaks by influencing risk-taking behaviours — specifically, by making people more likely to take risks such as not washing hands or refusing to get vaccinated.

During the 2014-16 Ebola outbreak in West Africa, health officials cited widespread rumours and false beliefs as a major contributor to the spread of disease. Research shows that individuals who believed Ebola-related misinformation were less likely to adopt recommended preventive behaviours — including getting the Ebola vaccine — and were less compliant with disease-control measures such as allowing burial teams to handle the bodies of deceased family members. Rumours and misinformation about Ebola also sparked fears and mistrust that contributed to everything from failing to report symptoms and avoiding treatment, to destroying clinics and committing acts of violence against health-care workers.

Reducing the spread of conspiracy theories and misinformation by even a small amount can have a big impact. One recent study, which used computer models to simulate the relationship between misinformation and the spread of disease during outbreaks, found reducing the amount of false health information being circulated by just 10 per cent could mitigate the harmful influence of that information.

What’s not clear is how to best achieve that. While social media companies have altered search engines and algorithms to highlight information from trusted sources and reduce the visibility of fake cures and other conspiracy theories, that doesn’t stop people from sharing dubious information in chat groups and private messaging apps. Furthermore, a lot of misinformation is slipping through the cracks on major platforms like Twitter, Facebook and YouTube.

Criminalizing misinformation and rumours

In an alarming number of countries, the surge of coronavirus-related misinformation has been used as a pretext to crack down on information-sharing more broadly. In China, the government’s attempt to suppress information about the outbreak may have actually contributed to the spread of the virus, since no one — including healthcare workers — knew how to protect themselves or even that they should be protecting themselves at all.

It’s not clear exactly how many people have been punished for “spreading rumours” in China, because the government maintains a tight lid on that information, too. The U.S.-based Chinese Human Rights Defenders (CHRD), a non-governmental organization that monitors human rights laws and abuses in China, had documented 452 such cases as of March 2, 2020, but some reports suggest the number may be much higher. On Feb. 21, China’s Ministry of Public Security said 5,511 cases involving “fabricating and deliberately disseminating false and harmful information” had been referred to law enforcement.

Similar arrests for spreading “rumours” and “fake news” have been documented in nearly a dozen countries across Asia and the Middle East.

In India, three individuals were arrested for posting WhatsApp messages allegedly containing false information about coronavirus, and police said they’re tracking other people who forwarded the messages. In Malaysia, authorities have arrested at least a dozen people for allegedly spreading false information about coronavirus on social media. They face up to two years in prison if found guilty. Included in this group is a journalist who was charged with causing “public mischief” after posting a series of remarks about the virus on social media.

In Thailand, multiple people have been charged with computer crimes for allegedly sharing false information about coronavirus on social media. Similar arrests have been made in Indonesia, where at least two individuals are facing cybercrime charges that could land them in prison for up to five years. Just this week, Indonesian authorities arrested six more people for violating laws that prohibit the sharing of “fake news” and carry a prison sentence of up to six years.

“It’s absurd, and wholly disproportionate, that people are facing a potential five-year jail term just for sharing false information online,” said Teddy Baguilat, a former congressman from the Philippines who is now a board member of the advocacy group ASEAN Parliamentarians for Human Rights (APHR).

“And think about the chilling impact such measures have on freedom of expression,” Baguilat added. “Keep this up, and people will be too scared to share their opinion about anything.”

Yet as the virus has spread to new countries, so, too, has the crackdown on so-called “fake news.” In Iran, officials have arrested at least two dozen people on suspicions of “spreading rumours” about the virus, and a government spokesperson recently warned that anyone else found to be sharing false information would be sentenced to one-to-three years in prison and flogging.

The United Arab Emirates warned last month that “high punishment,” including prison time, would be handed down to anyone found guilty of spreading false or unverified information about coronavirus. Meanwhile, earlier this month, Saudi Arabia joined the list of countries threatening to impose criminal sanctions for spreading rumours or panic about coronavirus. Anyone found guilty of such charges could face up to five years in jail, plus a fine of nearly a million dollars.

Besides the potential for abuse, laws that impose criminal penalties for spreading rumours may also scare people into silence and make experts think twice before sharing information.

“Criminalization of speech, even if targeted at falsehoods, is highly likely to stifle the real-time sharing of information that is essential during epidemics,” Matthew Bugher, head of Asia Programme for the advocacy group Article 19, told Reuters in February.

That’s what happened after Chinese authorities detained Li and seven other doctors in early January, said Dr. Wang Guangbao, a surgeon and science writer from eastern China. He told The Washington Post many medical professionals, including himself, stopped speaking openly about the virus after seeing the potential consequences.

Crisis of confidence

Draconian restrictions on speech may also exacerbate the factors that make people susceptible to misinformation and conspiracy theories in the first place — namely, fear, mistrust, and uncertainty.

“When governments already aren't trusted to get good information out, making misinformation illegal and arresting individuals likely will increase the skepticism of the populace,” Dr. Tara Smith, an infectious disease expert and associate professor of epidemiology at Kent State University, told National Observer.

This is a problem even in countries that haven’t taken such drastic steps to criminalize misinformation.

In the U.S., the Trump administration has responded to coronavirus with its own assault on science and truth, creating a crisis of confidence that threatens to undermine citizens’ trust in doctors, public health experts and government officials at a time when authoritative information could be a life-saving resource.

In the early days of the U.S. outbreak, when citizens and healthcare workers desperately needed accurate information to mount an adequate response, Trump and other top officials in his administration responded to the crisis by turning it into a political football. In February, then-acting Chief of Staff Mick Mulvaney accused the media in the U.S. of reporting on the outbreak to “bring down” the President, while Trump himself has called the virus a Democratic “hoax.”

When they could no longer deny the reality of the growing outbreak, the Trump administration started spreading false information to make the situation seem more under control than it actually was. Larry Kudlow, Trump’s top economic adviser, said in late February that the outbreak had already been “contained.” The next day, Trump promised Americans that the number of coronavirus cases in the U.S. would soon drop to zero. Meanwhile, Trump’s top congressional allies publicly mocked the idea that the virus was a serious concern.

Behind the scenes, the situation looks even worse. Trump is reportedly obsessed with comparing the number of coronavirus cases in the U.S. to the number in other countries, and has expressed a desire to keep those figures as low as possible — not the actual number of sick people, just the number who end up in the official count. He even said publicly that he didn’t want passengers from a quarantined cruise ship to come ashore because they would add to the total number of cases. “I like the numbers where they are,” Trump said.

In order to keep those figures low, the Trump administration suppressed coronavirus testing just as the first cases were discovered in the U.S., according to The New York Times. To date, the U.S. still doesn't know how many cases it has, since many people are still struggling to find a place to get tested for the virus.

Trump also reportedly ordered high-level meetings about coronavirus to be classified, meaning that experts without security clearances have been shut out of crucial discussions with government officials. The move has “restricted information and hampered the U.S. government’s response to the contagion,” Reuters reported, citing several unnamed officials from within the administration.

In at least one instance, the White House “overruled” the recommendations of its own experts and put a gag order on health officials who wanted to warn elderly people to avoid air travel.

The Trump administration’s attack on the truth may not be as overt as what we’ve seen in countries like China and Iran, but it's every bit as dangerous.

During disease outbreaks and other health emergencies, people need to know about the risks they face and what they can do to protect themselves and their communities. Healthcare workers need real-time information about the crisis in order to adequately prepare for it, and public health officials need data on cases and outcomes to gauge the effectiveness of the response. When people lose trust in the information coming from authorities, they’re less likely to take recommended precautions to prevent the spread of disease and more likely to engage in risky behaviors that endanger everyone’s health.

Misinformation is a serious threat to public health, but the coronavirus outbreak has demonstrated something that researchers have been trying to tell us for a while: The real crisis we’re facing is a lack of trust in our institutions and a corresponding loss of confidence in authoritative sources of information. As hard as it is to contain a disease once it starts to spread, we know it can be done because we’ve done it so many times before. But how do we rebuild trust when it’s constantly being abused? That’s a challenge that will stay with us long after the pandemic has come to an end.