Why is polio making a comeback?

WEBVTT

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Tegan Taylor: Good evening. Welcome to Curiosities Live! I'd like to begin by acknowledging the traditional owners of the lands from which we're all joining today. Pay my respects to elders past and present. My name is Tegan Taylor. I'm an ABC broadcaster and health and science journalist

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Tegan Taylor: And I'm your host for this session this evening. We're here to discuss why diseases like polio and measles, diseases we've made such strides at reducing, why they're making a comeback.

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Tegan Taylor: We'll look at the science, but we'll also discuss why scientific evidence isn't always enough to influence the decisions people make.

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Tegan Taylor: And what this means for all of us. So, joining me are two UTS experts who bring very different but complementary perspectives to this conversation.

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Tegan Taylor: Distinguished Professor Steve Djordjevic is an infectious disease expert whose research spans microbiology, genomics, and antimicrobial resistance. Steve, please give us a wave.

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Tegan Taylor: And, Professor Marin Andre Rizoiu is a data scientist whose research looks at how information, influence, and misinformation spread through online networks. Andre, wave, please.

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Tegan Taylor: Here he is. This is a conversation that we want you to be part of. I would love to fold your questions throughout the discussion, and I'll also dedicate some time to Q&A towards the end. So if you have a question at any time throughout the discussion, you can see in the chat there's a link to Mentimeter.

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Tegan Taylor: That is the Q&A platform for tonight, so click on the Mentimeter link.

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Tegan Taylor: Have it there, ask your questions, and if you see a question someone else has asked that you want to know, you can upvote it.

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Tegan Taylor: That's how I'll know what you're most keen to know about. So, Mentimeter, the link is in the chat.

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Tegan Taylor: But I want to start with a little bit of scenes that are what's happening, why we're seeing things like polio and measles come back. Steve, polio and measles as our examples, these are both vaccine-preventable diseases. What does that actually mean?

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Steven Djordjevic: So it means that if a substantial proportion of the population, is vaccinated.

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Steven Djordjevic: Then we have this thing called herd immunity, and that… that… then rates of vaccination for each infectious disease is different.

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Steven Djordjevic: But once we get herd immunity, the ability of the infectious agent to spread from person to person is severely diminished.

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Steven Djordjevic: And that's really important because there are vulnerable populations in the community, such as the frail, elderly, and some Indigenous populations that are in remote locations.

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Steven Djordjevic: They are unable to receive the vaccine, and so when we have good blanket cover through herd immunity, they are protected.

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Tegan Taylor: When I say making a comeback, what does this mean? Like, what are we actually seeing here?

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Steven Djordjevic: So, what happens is,

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Steven Djordjevic: So, again, it's different for each of the infectious diseases. So, what's happening… one of the reasons why we are seeing infectious diseases,

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Steven Djordjevic: resurging that have traditionally been well controlled by vaccination is because we are… the population is not sufficiently covered by vaccination, because people are becoming hesitant to vaccinate.

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Steven Djordjevic: And so what happens then is that, the…

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Steven Djordjevic: the community spread from person to person starts to creep up, and as an infectious agent replicates, it has its capacity to, I might say increase its abolence, but it becomes more virulent, more people get exposed, more people succumb to this infection.

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Steven Djordjevic: And that's very problematic.

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Tegan Taylor: You mentioned, hesitancy there, vaccine hesitancy. Andre, what does that look like in practice? What kind of attitudes are we seeing shift?

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Marian-Andrei Rizoiu: We are observing people starting to question, sometimes they question the efficacy of the vaccine itself.

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Marian-Andrei Rizoiu: you know, the typical saying of, I took the flu last year, and I still got the flu. People don't… there's… there is a lack of understanding of how it actually works.

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Marian-Andrei Rizoiu: The concept of… of herd immunity is very… it's kind of poorly understood also, so that's not the most… that's not the…

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Marian-Andrei Rizoiu: That's not what people know more… most. But I guess where we start seeing an uptick into these alternative views is when we see penetration of online social platforms and discussion places.

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Marian-Andrei Rizoiu: Where people start congregating online and exchanging ideas, and that's where they start forming these thematic groups.

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Marian-Andrei Rizoiu: pages,

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Marian-Andrei Rizoiu: WhatsApp groups where they start exchanging these alternative views and endorsing and reinforcing, views, that are detrimental. So there will be… there will be references to authority, of how… how immunization programs are just a way of controlling, controlling, or so on and so forth.

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Marian-Andrei Rizoiu: And they keep propagating this type of information, which then, in time, being repeated, leads to this hesitancy that Steve was referring to.

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Tegan Taylor: I definitely want to get into that pathway in a second. Steve, what's it like as someone working in health to hear that those are the sort of attitudes that people are being drawn to?

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Steven Djordjevic: Well, it's… it's sort of sad. We're sort of almost like a victim of our own success. So, I think I want to zoom out a little bit, if I may, Tegan, because…

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Steven Djordjevic: we should remember the number of deaths that are associated with infectious diseases. I mean, infectious diseases is the number one killer of humans in history, full stop, and not by a small margin. It's like, you know, hundreds of millions of deaths.

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Steven Djordjevic: associated with quite a large number of vaccine-preventable diseases, which have now… so vaccination is interesting, because in some instances, we…

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Steven Djordjevic: don't see the organism, appearing anymore. So things like, we don't see, smallpox, smallpox being almost completely eradicated.

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Steven Djordjevic: And that's because the vaccines have worked really effectively, and it's also because the infectious agent, has succumbed to that vaccination regime. Then we have diseases like influenza.

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Steven Djordjevic: Which, have killed more than 200 million people worldwide, and still kill many people every, every winter, or every year.

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Steven Djordjevic: And these viruses are able to chop and change their genetic makeup very, very frequently as they pass through animal populations.

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Steven Djordjevic: And so what happens is every year we need to get vaccinated, okay? And the vaccine

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Steven Djordjevic: may not prevent you from getting an infectious disease, to get the full-blown influenza, but what you will experience is an ameliorated form of that flu, okay? And we should also differentiate flu from the common cold, because the word flu

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Steven Djordjevic: is used very, very frequently. If you have the flu, you are bedridden at least for 3 days, you have a raging temperature, you have body aches, and you really feel

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Steven Djordjevic: Whereas a cold, a head cold, is very different.

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Tegan Taylor: Deb, you did such a good job there of explaining something very, very complicated in just a couple of minutes, and yet, it still took you a couple of minutes to explain that. You couldn't put that in a tweet, or in a simple post on social media.

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Tegan Taylor: Andre, is that part of the problem here? We're so used to having such small bites of information that even, sort of, generous nuance gets lost?

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Marian-Andrei Rizoiu: There are multiple components here. Yes, definitely the expectations on how we receive information is definitely…

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Marian-Andrei Rizoiu: has definitely changed, and yes, there are significant chunks of, of the online population, or the population that… that will consume information in the form of, either short messages, tweets, Facebook posts, or more recently, reels on… on Instagram, so…

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Marian-Andrei Rizoiu: yes, Steve did an amazing job describing it in just a minute, but then if I am used to flipping through TikTok reels, one after the other, that is not what I would expect to receive. But…

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Marian-Andrei Rizoiu: the way we perceive the information and we consume it is one way. However, the…

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Marian-Andrei Rizoiu: What our research… my research has shown in,

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Marian-Andrei Rizoiu: in the past years is that it is mainly the phenomenon on how people consume this information, which is the real culprit, which is one of the main culprits here. So, this misinformation around vaccines is actually

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Marian-Andrei Rizoiu: part of the general phenomenon of misinformation at large. And our audience has probably met this term before, over and over again. We hear about conspiracy theories, we hear about

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Marian-Andrei Rizoiu: political misinformation, and so on and so forth. So the question now comes on why… why the prevalence of misinformation? I guess that's one of the big… the big ticket items here is… so our… our info… our research actually shows

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Marian-Andrei Rizoiu: That even the term misinformation is slightly misleading, because this… it has nothing to do with information.

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Marian-Andrei Rizoiu: Misinformation is not an information problem.

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Marian-Andrei Rizoiu: misinformation is a, is a, sort of, is a social identity issue. So, people do not consume the inform… the misinformation because

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Marian-Andrei Rizoiu: they do not have access to the right information. We all have access to it. In fact, Stephen was saying it, that information about vaccines has never been more abundant. There's… there's never been a single… a single period in the life cycle of

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Marian-Andrei Rizoiu: humanity, where it would have been as easy as it is for us now, today, to find all the information I want about every other vaccine that I want, together with all the scientific results, the replication results, the field studies, and so on.

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Marian-Andrei Rizoiu: it's not about that I can't find the information, it's not that our… that people that believe these alternative views cannot find the information. So if it's not an information problem, then what is it?

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Marian-Andrei Rizoiu: So, what we find it is, is that misinformation is, is just one way that groups people together. Let me give you an example.

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Marian-Andrei Rizoiu: Back in the days, Joel's a bit my age, there was,

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Marian-Andrei Rizoiu: back where I grew up, in a small town where I grew up, I either liked soccer, or I didn't have lots of friends. So, there was not a lot of options out there. So, of course I like soccer, like everyone else. But today, with our digital… with our digital environment.

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Marian-Andrei Rizoiu: no matter how fringe my ideologies and my worldviews are, I will get, I will find someone online that has… that shares those views. So what the… the digital communication environments of social media platforms,

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Marian-Andrei Rizoiu: mainly the social media platforms. What they allow, they allow us now to reach… to be connected to all… to a very wide, set of individuals out there.

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Marian-Andrei Rizoiu: And then I can always connect to people that think similar to me. So then I can start embracing those communities, and those communities that start functioning

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Marian-Andrei Rizoiu: as both endorsers, so people there, they understand me, they feel me, they think like me. So I get the homophily, I have the feeling of belonging, I have my… it fulfills my psychological needs. But also, they function as a filter.

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Marian-Andrei Rizoiu: Because the information that flows through those communities is always aligned to the communities themselves. So, on one hand, I have people that constantly endorse what I'm saying, and give me the thumb up, no matter what I say, things that probably wouldn't be acceptable in the… in my offline immediate community, in my family, my group, my…

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Marian-Andrei Rizoiu: my school, but then there I get endorsed, but also I get the information through those communities, and that gets filtered. Corporate that to the fact that almost half of the adult population today gets their information

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Marian-Andrei Rizoiu: from their social media groups. And you start getting these phenomena where you can actually live in these bubbles, and you get completely disconnected from reality.

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Marian-Andrei Rizoiu: You… you… and then these communities can pick up, and then they can drift as much to the left, to the right, to the center as you want, so…

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Marian-Andrei Rizoiu: Then we start… and that's not, and that's what partly explains the phenomena that we are seeing today, together with things like political polarization and so on and so on. But to stay within this field, it's really what explains at least partially, the

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Marian-Andrei Rizoiu: The emergence of such a wide set of anti-vaccination views.

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Tegan Taylor: this sense of an echo chamber, the self-fulfilling communities that we surround ourselves with. So you're asking your questions by using the Mentimeter link there. We've had a question come through that I am going to treat as if it was asked in good faith, and I think we can use it as a bit of an example

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Tegan Taylor: of how to debunk misinformation. Someone has asked, don't vaccines cause autism? Can we use this as a bit of an example to

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Tegan Taylor: talk about the truth of what we know, but also in a way that we know is evidence-based. Steve, I might start with you.

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Steven Djordjevic: So, to just follow on a little bit from what Marian-Andre said.

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Steven Djordjevic: It's important… so, the scientific process is constantly challenging information. So, we constantly debate data.

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Steven Djordjevic: And we… and we re… we… we go forward in the way we… we think about a problem based on the reiteration of data that supports… even if we look at it 9 or 10 different ways, it still comes to a particular pathway that's supportable by the data.

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Steven Djordjevic: Whereas I think when you're in a… when you're in an environment that Marian-Andre was talking about, then that filter, that… that ability to challenge is severely diminished.

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Tegan Taylor: Hmm.

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Steven Djordjevic: So, to get back to this autism question, I think,

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Steven Djordjevic: There, is no real evidence that vaccines cause autism.

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Steven Djordjevic: there… the evidence has been widely, widely disputed. There has been a number of studies which challenge

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Steven Djordjevic: That link.

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Steven Djordjevic: And there is no…

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Steven Djordjevic: Serious demonstrable evidence to support the fact that… to support the contention that vaccines cause autism.

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Tegan Taylor: Alright, Andre, how do you do?

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Marian-Andrei Rizoiu: Hi, this is… I really like how Steve positioned this, because

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Marian-Andrei Rizoiu: This… the scientific method of always inquiring, always going after what we know and questioning ourselves is actually not…

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Marian-Andrei Rizoiu: Doing us a favor when it… when we talk about communication in the community at large.

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Marian-Andrei Rizoiu: the number of times I hear, but the science doesn't know. The science contradicts themselves, even the researchers can't agree. This is… this is the thing that I…

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Marian-Andrei Rizoiu: here, and I see in these groups over and over again, the scientists can't agree. They can't… they can't set the… they can't be on the same, on the same view. And

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Marian-Andrei Rizoiu: This is not a sign that science doesn't work, it's just a sign that that's how science works, is that we keep updating our views. Now, in this context, I happen to know quite a bit about where this originated. It was… it originated to one paper that was published, that was published ever since it was retracted, debunked multiple times.

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Marian-Andrei Rizoiu: it has been, it's demonstrated right now as being, invalid, scientifically, over and over again. So, as far as scientists see this.

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Marian-Andrei Rizoiu: we… we have strong proof that that was false… that was proper false information. If you want, really, the term misinformation, it's… that was misinformation.

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Marian-Andrei Rizoiu: Probably not intentional, but still doing the harm. The issue now with… with…

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Marian-Andrei Rizoiu: With it is that once this type of

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Marian-Andrei Rizoiu: this type of narratives, opinions, they are released in the wild, almost like Pandora's box.

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Marian-Andrei Rizoiu: And the point is that no amount of debunking is going to help.

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Marian-Andrei Rizoiu: Because at that point, Sharing the misinformation, sharing this point, like, like this, like the view

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Marian-Andrei Rizoiu: vaccines cause autism, or vaccines are just the attempt of Bill Gates to inject chips into my arm.

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Marian-Andrei Rizoiu: They,

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Marian-Andrei Rizoiu: These… these type of… these type of opinions, they… when people emit them, they don't necessarily believe them, they don't document them either.

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Marian-Andrei Rizoiu: emitting such opinions is usually done to signal ingrouping. It's almost like saying, I belong to this community, I belong to this group. In fact, we know that most people that share misinformation, they don't even read it. They don't even open it. There's been multiple,

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Marian-Andrei Rizoiu: empirical experiments where they… we've seen that this test, they didn't, they don't even open it. So, if they don't…

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Marian-Andrei Rizoiu: And now this is the conundrum, right?

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Marian-Andrei Rizoiu: if they don't necessarily listen to the information, and you already have the Pandora from the genie from the Pandora's box that got out, what can you do, right? So if miso… if telling them what's right doesn't really make for what

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Marian-Andrei Rizoiu: For the wrong information, then what can you do?

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Tegan Taylor: well, what can you do? Because you're our guy on that, if… like, what… what's the approach?

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Marian-Andrei Rizoiu: Well, I'll have to prefix by saying that

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Marian-Andrei Rizoiu: we don't really know exactly. We know… we know some things that work, but we do not have the definitive answer, which is perfectly fine.

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Marian-Andrei Rizoiu: Right? For science, it's perfectly fine to accept that we don't know everything, and that we're still working on it. So, a couple of things that we do know that work. First of all, we do know that, that critical thinking, works. So, what we would call

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Marian-Andrei Rizoiu: pre-bunking. So these are concepts in misinformation science. Debunking is when you're trying to correct something that is wrong, and you're essentially saying, no, no, that's not true, because here's all the facts.

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Marian-Andrei Rizoiu: Debunking is good, debunking is great, it has its purpose, because it keeps us on course, it keeps us sane.

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Marian-Andrei Rizoiu: It doesn't work in convincing people otherwise. And that's been repeated over and over and over again. The only people that go to the debunking websites are those that don't trust the misinformation in the first place. So it's essentially preaching to the choir a bit.

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Marian-Andrei Rizoiu: That is the debunking. We do know that pre-bunking works. So, for example, teaching, teaching people proactively, giving them the information proactively, usually, usually, works.

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Marian-Andrei Rizoiu: works better, not always the same way. So, what we… what we've seen is that people tend to get in the world of misinformation. They tend to go because, they are in a period in their life where they have a, they have a confusion and an unhappiness, the typical two components.

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Marian-Andrei Rizoiu: And what they do at that point, let's, let's say,

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Marian-Andrei Rizoiu: let's say that you have a… or an individual that starts searching for information about the safety of vaccines. And honestly, it doesn't take long to be online and to search online before you find this alternative.

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Marian-Andrei Rizoiu: And let's say that they start engaging a bit with the information, and they get curious, right? We're all curious, like, is this really true?

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Marian-Andrei Rizoiu: So, it turns out that consuming this information is almost like a radicalization pathway, and you have different stages of how extreme the consumption is. At the beginning, I start by just curious, like, whoa, is that?

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Marian-Andrei Rizoiu: Is that it? Can that be true?

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Marian-Andrei Rizoiu: In the second phase, there is a tentative disclosure, we call it the tentative disclosure phase, where the individual, say, goes to the GP and asks, but doctor, don't vaccines cause autism?

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Marian-Andrei Rizoiu: The worst thing that can happen at this point is that the GP answers with a condescending tone, or with a condescending message, because obviously the GPs are there to give them the information. They are in the business of

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Marian-Andrei Rizoiu: the scientific approach and giving them the information, and they do exactly what I just told you doesn't work. They debunk, or even worse, they have a condescending reaction, which then sends the person straight back into the arms of the alternative community, which then embraces them and says.

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Marian-Andrei Rizoiu: She said that. He doesn't want you to know the truth.

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Marian-Andrei Rizoiu: And then from here on, something weird happens. People start living a sort of dual lives. They emerge increasingly into their communities of alternative views.

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Marian-Andrei Rizoiu: While increasingly getting disconnected from their, from their, normal life. Then what, furthermore.

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Marian-Andrei Rizoiu: there's a point where they become active, they don't just consume the information, but they become active parts… they take active part in the life of the newly found community, and they start emerging into the community. And that's when we see… we start seeing the erratic effects. They stop doing their hobbies, they stop seeing their friends.

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Marian-Andrei Rizoiu: They sometimes even start cutting contact with their… with their family.

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Tegan Taylor: Is that necessarily going… like, does one always lead to the other? Are you always going to see someone who starts on this pathway down at this very, isolated, erratic end?

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Marian-Andrei Rizoiu: No, no, no, no, we don't… we find that, we find that not everyone needs to traverse the entire pipeline. We do know that it can… some people can… can move back.

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Marian-Andrei Rizoiu: There is op-ramps, there is interventions at each of the stages, and we also know that the time it takes to go… to traverse the pipeline can vary a lot.

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Marian-Andrei Rizoiu: It can be as little as, you know, a couple of weeks, six weeks, to go entirely. So, it is quite very dependent on each individual. What I described to you is more of a bird's-eye view of the… of how this flows, but now people will start… and actually, most people actually stop at the first and second and third phase, but why…

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Marian-Andrei Rizoiu: This pipeline is relevant is because at the last stage, these individuals are capable of violent extremist acts.

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Marian-Andrei Rizoiu: So that's when they… when suddenly you can… you're seeing, people that, for reasons that are not religious and not, and not political, they can start committing violent acts, which is… which…

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Marian-Andrei Rizoiu: was not very common. Most of… most of radicalization literature concentrates on religious and political radicalization.

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Tegan Taylor: And so, it's rare, but obviously this is a very, kind of.

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Tegan Taylor: It's a big deal. We want to know about that. So your questions are coming through via Mentimeter. It's really fascinating seeing them. Keep them coming. I'm going to fold as many into the chat as we can. We'll also come to them at the end. There is one person who's written, as a polio survivor.

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Tegan Taylor: 73 years later, I am alive. Had an amazing life, and still significantly disabled. It's very difficult in parallel with aging.

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Tegan Taylor: You don't hear many first-person stories like that these days, which is a good thing, but Steve, do you think people like that sharing their stories is a way for people to understand what they're dodging when they participate in vaccination?

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Steven Djordjevic: I'm glad that person asked that question, because we have,

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Steven Djordjevic: First of all, polio myelitis is

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Steven Djordjevic: A debilitating, viral infection that attacks the motor neurons in the nervous system, and so what happens, often they get different forms of paralysis.

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Steven Djordjevic: And, many of them… many, many polio, people can survive to quite long lengths of time. And there's a very famous book, was published in 1955, called I Can Jump Puddles, by Alan Marshall, and, that's a story about how he,

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Steven Djordjevic: how he, I think,

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Steven Djordjevic: dealt with, or dealt with his, he obtained at the age of 6, I think, if I recall correctly.

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Steven Djordjevic: And, it's interesting that polio… so even though you can recover from the infection, you can have long-term, lifetime sequelae, like this person that's asked the question is, clearly indicated, happens.

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Steven Djordjevic: And so, it's important that, that we…

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Steven Djordjevic: try to acknowledge that people can leave, really, and contribute importantly to life after polio and other disease… infectious diseases. But if we can prevent those infectious diseases through vaccination programs.

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Steven Djordjevic: Which we have done very, very successfully. And so I, I think that's… that's a really good message for people.

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Steven Djordjevic: that, there are people who actually lived through that year, the last hundred years where polio was very, very important. So there are many survivors that would really understand the importance of vaccination, as I suppose, my message.

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Tegan Taylor: Absolutely. Andre, so much of what we see on social media that really cuts through is story-based. An individual story is sometimes much more compelling to me than 10,000 people in a study, even though it shouldn't be.

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Tegan Taylor: What is the role of storytelling in helping cut through misinformation?

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Marian-Andrei Rizoiu: It's one of the biggest, one of the best interventions that we see in the later stages.

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Marian-Andrei Rizoiu: So, as we move into beyond just the curiosity, where simple information would be enough, as we move into an active consumption, that is what we find one of the very few interventions at work stories. And particularly for polio and vaccine-preventable diseases, I think

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Marian-Andrei Rizoiu: We need to actually put our finger on one fact, is that most often.

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Marian-Andrei Rizoiu: What we see is that vaccines are being withheld.

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Marian-Andrei Rizoiu: from children. So it's, it's… and I find that to be…

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Marian-Andrei Rizoiu: You know, to be unfair, particularly since the people that consume them, that have hold these views, and will withhold vaccination, they are vaccinated themselves.

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Marian-Andrei Rizoiu: Because somebody else vaccinated them. So, vaccines typically are with help from children. So, in case of polio, this is… I think this discussion, and this example, I'm really… I'm happy that our listener had the courage to… to… to bring it up.

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Marian-Andrei Rizoiu: It is exactly very tragic, because polio is making a comeback, and it's affecting people that did not choose to not get vaccinated. It's affecting children that were… that for… for…

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Marian-Andrei Rizoiu: For whom vaccination was withheld by their parents, due to their parents, their parents' ideology.

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Marian-Andrei Rizoiu: worldviews, parents who themselves are immune to polio because they were vaccinated by the previous generation. Do you find the… do you see the irony of this?

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Tegan Taylor: Yeah, and I was thinking of what we were talking about before with herd immunity, and the fact that vaccination often feels like an individual decision. I'm choosing this for myself, or I'm not choosing this for myself. We do it for the good of the herd, but we're also making decisions for other people, too.

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Tegan Taylor: Steven, how do you kind of engage with that idea of who you're making a decision for?

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Steven Djordjevic: Well, I have to reiterate those views. I mean, I don't know how someone could take their child to a medical center with a vaccine-preventable disease.

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Steven Djordjevic: And… Particularly if it is… it is somewhat life-threatening.

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Steven Djordjevic: or can have, lifelong post-infection sequelae. So I think… I think there's some serious questions that need to be asked on a whole range of moral and ethical,

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Steven Djordjevic: Bright me and stay.

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Steven Djordjevic: But what I… what I really would like the audience here to really understand is that

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Steven Djordjevic: It's concerning to me why vaccination, is being challenged more and more these days, and it comes at a time

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Steven Djordjevic: When vaccination is more important than perhaps it's ever going to be, because

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Steven Djordjevic: We have… we have to remember that life expectancy in a developed nation has increased by about 30, 35 years in the last century.

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Steven Djordjevic: And that is primarily because of… Sanitation, clean water, nutrition, Vaccination, and antibiotics.

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Steven Djordjevic: And we are now in the middle of a silent pandemic, and I really want our audience to understand that. We're in an antimicrobial-resistant silent pandemic.

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Steven Djordjevic: So more and more and more bacteria have acquired the capacity

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Steven Djordjevic: to counteract the effects of antibiotics. We are so reliant on antibiotics, we can't have any surgeries.

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Steven Djordjevic: and expect to survive them. We can't… it's important for childbirth, it's important for…

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Steven Djordjevic: Treating infectious diseases, particularly bacterial infect… Bacterial infectious diseases.

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Steven Djordjevic: and also some parasitic diseases. It doesn't work for viruses at all, and there's a problem there, because when we present to an emergency ward or a doctor.

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Steven Djordjevic: a doctor cannot tell whether we have a viral or a bacterial infection, and they usually administer antibiotics. So, for many infections, like influenza, colds and flus, the patient doesn't want to walk out of a GP without a script, and so that script is most likely to be an antibiotic. So, we are facing

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Steven Djordjevic: an era whereby antibiotics are beginning to not work as well. We're not generating any new antibiotics, at any appreciable rate.

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Steven Djordjevic: And so, the reliance on vaccination is incredibly important now, particularly for viral infections, and particularly, I think it has a lot…

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Steven Djordjevic: great area to grow in our intensive animal industries, where I think vaccination really needs to take off so we can reduce the total tonnage of antibiotics used globally.

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Tegan Taylor: I'd love to unpack that a little bit more, because you were talking about viral diseases, and the two diseases we're sort of headlining with today are polio and measles. They're both viral diseases. Antibiotics don't do anything to stop you from getting them or make you better if you do. Can you unpack a little bit more about the relationship between these two things?

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Steven Djordjevic: Yeah, so… So, viral… viruses, things, like you mentioned, are measles, polio.

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Steven Djordjevic: And then we have bacterial infections like whooping cough, and the bubonic plague.

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Steven Djordjevic: So, those infections, well.

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Steven Djordjevic: Bacterial infections respond very, very well to antibiotics, but they also, if we can use vaccines so that we don't have to use antibiotics, that's even better. But for viruses, we only have vaccines, and we have physical things like wearing masks, hand sanitisation, distancing.

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Steven Djordjevic: Because viruses are usually spread most rapidly by, aerosols.

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Steven Djordjevic: fecal, oral route, or, or sexually. So, so viruses… the only other armory that we have for viruses is… is in the last 20 or 30 years, we've developed antiviral therapies, and,

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Steven Djordjevic: They are available for people that have very, very life-threatening viral infections, and they can give you those, like they can give an antibiotic, but they are not antibiotics. They target specific enzymes within the replication pathways of viruses.

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Steven Djordjevic: So, it's really important that we understand that, because we need to really rationalize the use of antibiotics around the world, not only for human health, but also for animal health.

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Tegan Taylor: Andre, it's two big problems that are both collective problems, right? There's the vaccine push, and there's the antibiotics. Please don't use them unless you absolutely have to.

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Tegan Taylor: Are we, as a society, becoming more individualistic and less collective? Is this something that is potentially behind these problems?

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Steven Djordjevic: Well, I think… I would say that's potentially true, but I think Marian-Andre is probably a better expert to answer that question.

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Tegan Taylor: Yeah, would you like to talk to that, Andre?

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Marian-Andrei Rizoiu: I'm wondering about this. They… I don't think I have a definitive answer to this,

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Marian-Andrei Rizoiu: society definitely feels more divided. It almost feels like we can't… it's increasingly difficult to get to

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Marian-Andrei Rizoiu: To agree, just thinking of politics, but…

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Marian-Andrei Rizoiu: Does it mean that our… that our… that our society of our… or our… the way we function, the way, as humans, anything change? It's unlikely. Humans don't evolve that fast, so it's… there's…

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Marian-Andrei Rizoiu: I haven't thought about this, actually, in those terms, so I would assume this came from a question from our audience, a really astute question, but.

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Tegan Taylor: It's come from me, so I'm the astute one.

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Marian-Andrei Rizoiu: I would probably go with the underlying… the underlying stratum of what makes us as humans. Our psychology, the way we interact, our needs, has not changed. That has not changed in probably tens of thousands of years, or more.

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Marian-Andrei Rizoiu: Things did change, and that are really the way we mediate interactions.

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Marian-Andrei Rizoiu: And now, increasingly, what will change also is the introduction of generative AI and chatbots and personal assistance in the form of artificial intelligence. That is probably going to be the new wave of societal altering technologies. So we are in the middle of a technological revolution, not as much as a human and societal revolution, per se, so I would

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Marian-Andrei Rizoiu: If I would… if I would have… if I would summarize that, I would say I don't think that we as humans, the way we interact… we interact change, but what… it may look like we are more egoisting, more individualistic, because of the… the information we are exposed to and the way we… we interact, and some of our cultural evolution, probably some of what we expect out of life.

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Marian-Andrei Rizoiu: And, so it's very contextual and societal, and more… mostly technological, I would say.

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Tegan Taylor: Well, let's talk a bit about technology. There's a couple of questions coming through about social media. One person says, what role do social media platforms have in monitoring this misinformation? Another says, I can't help but think

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Tegan Taylor: that whatever we do to help solve these problems, they will pale in comparison to what could be done if we had better regulation on social media platforms. Andre, what do we need to do in the social media space?

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Marian-Andrei Rizoiu: I'll need to… in order to tell you

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Marian-Andrei Rizoiu: what… the reluctance and what can be done. I'll need to tell you, maybe take a step back and tell you how social media platforms work.

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Marian-Andrei Rizoiu: There is a saying in the… in the… in the web research and in the IT world, if you don't… if you don't pay for the product, you are the product. And, social media platforms are free to use for ev… for everyone, but how… but they require a lot of… they have large costs.

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Marian-Andrei Rizoiu: uploading all those images takes a lot of space, and so on and so forth. So, there must be a reason why that product is offered for free, to us to use.

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Marian-Andrei Rizoiu: And the answer to that is actually quite simple. It is not offered for free. They are just, we are paying with something else. What we are paying with is our attention.

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Marian-Andrei Rizoiu: So, the currency of the social media world is human attention.

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Marian-Andrei Rizoiu: Attention is simply where do we… what are we concentrating, what are we looking at right now? For example, I like to think that our audience is concentrating their attention fully on us, on our discussion here, and that is the currency that we are, we are, we are holding.

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Marian-Andrei Rizoiu: Now, what do you do with attention?

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Marian-Andrei Rizoiu: well, social media platforms, they transform into money via advertisement. So, you know, that little adverts that go on the side of our screen, they will keep popping us and try to sell us products, exactly what happens on TV, like, exactly what happens on billboards, on… on the street. So…

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Marian-Andrei Rizoiu: It is important to understand that in social media world, attention is everything, because attention is directly monetized and transformed into revenue.

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Marian-Andrei Rizoiu: Now, and that explains a number of things, for example, that we start seeing. The design of the social media platform is not… is not by chance. A lot of the designs are actually designed for… for keeping people hooked.

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Marian-Andrei Rizoiu: the way the recommender of social media platforms works. It is done to recommend new products that the individuals would like to see, therefore stay more on the platform, therefore give more of their attention.

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Marian-Andrei Rizoiu: The infinite scroll of TikTok, Instagram, and similar platforms, it is being shown to be one of the most addictive, addictive patterns. Regular, regular stimuli, irregular,

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Marian-Andrei Rizoiu: Sorry, I have a lapses here, but the idea is it's been shown that when the stimuli comes repeatedly, but then the reward comes intermittently, that's intermittently, that is the most addictive pattern. And you know how we know it?

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Tegan Taylor: shades.

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Marian-Andrei Rizoiu: pokey machines, exactly. You keep pulling the lever, and the money comes every now and then completely unpredictable. So it's been shown over and over and over again that that is the design of addiction. How does it work on TikTok? I scroll, I scroll, I scroll…

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Marian-Andrei Rizoiu: Oh, something good, I like it! I scroll, I scroll. Oh, something else I like! I scroll, I scroll.

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Marian-Andrei Rizoiu: And so, Pokemachine, TikTok.

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Marian-Andrei Rizoiu: Same design, not the same… not the same thing, but same design. So… so where… then… the first question was, what is the role of social media platforms in regulating this information?

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Marian-Andrei Rizoiu: It depends. If in the absence of… in the absence of, regulation, their… their natural… their natural instinct of regulating misinformation is precisely zero.

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Marian-Andrei Rizoiu: And the reason for it is… there's… it's twofold. One, they've… all the social media platforms, they span out of the technology… the technological world, mainly the Silicon Valley in California.

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Marian-Andrei Rizoiu: So, they see themselves as enablers. They see themselves as the providers of the piping.

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Marian-Andrei Rizoiu: And… and they charge for the usage of the piping with attention. So…

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Marian-Andrei Rizoiu: there's… that has been, for a long time, the position that social media platforms have adopted, that they have no role in controlling, moderating anything that flows onto their platform. There's been exceptions, they've… they control quite well what's being, what's being advertised.

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Marian-Andrei Rizoiu: So, for example, they will have

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Marian-Andrei Rizoiu: a lot of controls around political advertisement, paid advertisement. But the organic content, so what regular people post on their social media, it's completely unmoderated.

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Marian-Andrei Rizoiu: But there is a reason for it. We know that

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Marian-Andrei Rizoiu: they optimize everything for engagement. The moment when you introduce any controls, any controls, anybody that has tried to solve a problem where they have competing interests.

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Marian-Andrei Rizoiu: For example, you want something… you want to buy something good, but you also want it to be cheap.

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Marian-Andrei Rizoiu: It turns out that the solution you get, the optimal solution, is neither the best nor the cheapest that you can get on the market.

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Marian-Andrei Rizoiu: Logical, right? That's called multi-objective optimization. So, when you're trying to optimize multiple objectives at the same time, you end up with a solution which is the best on both objectives, but on each of the objectives, it is inferior.

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Marian-Andrei Rizoiu: Now, think about it. I have a company that optimizes on attention, and then I want them to suddenly start optimizing on safety.

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Marian-Andrei Rizoiu: Truthfulness.

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Marian-Andrei Rizoiu: Doesn't matter what. It is a second objective. You'll end up with a solution which, on the original criteria, which is simply attention equals money, it will be inferior. Essentially, and then I'm translating this.

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Marian-Andrei Rizoiu: The moment when you ask a company to regulate into the content to make it safer, you're asking them to reduce their income.

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Marian-Andrei Rizoiu: by default.

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Marian-Andrei Rizoiu: Which then leads us to what can we do? And this is the second question of our audience. Shouldn't we regulate and legislate it? And that is increasingly

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Marian-Andrei Rizoiu: the… the understanding of communities that that is increasingly the pathway forward. I mean, Australia has been… has been done the… some of the bravest first moves in treating… in,

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Marian-Andrei Rizoiu: delaying social media, access, the… the infamous

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Marian-Andrei Rizoiu: ban on access to social media for… for children under 16, which I'm a big… I'm a big fan, I'm not gonna hide it. And I think that it… it is that type of approach that we need to take. We need to understand and recognize that these platforms, they have

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Marian-Andrei Rizoiu: they have effects on our mental well-being, so at the personal level, but also the societal level. And, if I'm not mistaken, there's been a big landmark process that was… the suit that was just settled in the US exactly on this type of harm.

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Marian-Andrei Rizoiu: So the mo… which basically makes us in the… in the research world say that, social media platforms have their… their big tobacco moment, right now. And…

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Marian-Andrei Rizoiu: The same way as the tobacco industry did not regulate itself.

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Marian-Andrei Rizoiu: And it had to be regulated,

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Marian-Andrei Rizoiu: There's a significant chunk of the scientific community in the web research that is of the opinion that regulation is the way to address some of these symptoms.

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Tegan Taylor: So we have some regulation coming, but if I'm understanding you correctly, it's never going to be a perfect system. There's always going to be a trade-off, not just on the quality side, but also on the regulation side.

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Tegan Taylor: Steve, how do scientists and health professionals need to rethink how they communicate evidence in the light of this?

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Steven Djordjevic: It's a really good question.

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Steven Djordjevic: Well, I think… I think the scientific community, the medical community, use the sciences as a base for its decision making, and I don't think we wavered from that. You saw during the COVID pandemic, we got sort of scientific updates almost daily coming through.

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Steven Djordjevic: So, I still think that's the best way to come through. I don't know how you inform the consumer of that knowledge.

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Steven Djordjevic: And how they process that knowledge.

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Steven Djordjevic: Other than… other than to let them know that there is a lot of shortcomings to having uncontrolled

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Steven Djordjevic: uncontrolled access to social media platforms without doing the due diligence to… to… to look at the validity of the information that they're consuming, and to ask questions, and to self-interest… but not only to self-introspect, but also to understand why… why this information is relevant to it, and why they're reading it.

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Steven Djordjevic: And I don't know if that's the role of the scientific community to do that. I'm not saying

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Steven Djordjevic: I'm trying to wash my hands of it. I'm just saying that I don't know how… how we can do that from a scientific perspective.

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Steven Djordjevic: But there is certainly something that needs to be done.

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Tegan Taylor: I do know that someone who works in infectious diseases loves washing their hands of things, Steve, so I'm gonna…

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Tegan Taylor: call you out on that. So what role, if any, do you see scientists having, Steve?

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Steven Djordjevic: Sorry, what was the question?

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Tegan Taylor: what role, if any, do you see them having? Like, surely you've got to be part of the solution.

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Steven Djordjevic: Well, look, I just think we… well, we do it all the time. We debunk the autism, you know, vernacular. I mean, I can't believe one deep… well, actually, it's actually two papers. I can't believe that two papers debunked from the Lancet Journal, has… has that… that,

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Steven Djordjevic: misinformation providers have grappled onto two papers. I mean, any scientist worth their salt would probably read 50 papers a week, and like… and we would rank them, and and so two papers that have been

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Steven Djordjevic: thoroughly debunked. I mean, they have been debunked by enormous,

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Steven Djordjevic: patient number studies, the two ones that I read recently that completely debunked that whole concept of autism. So, if people want to grab onto that, I mean, I don't think that scientists have a solution for how they deal with

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Steven Djordjevic: And the validity and quality of the scientific data.

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Steven Djordjevic: And to get back to that whole concept that scientists don't agree on things, well, you know.

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Steven Djordjevic: If you look at a mobile phone today, and you look at a mobile phone 20 years ago, they're remarkably different, and different mobile manufacturing companies, you know, had different strategies on what's the best way to move their mobile technology forward. Some of them failed, some of them did…

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Steven Djordjevic: did really well, and now we have a product that's infinitely better than what it was 20 years ago. And it's the same for car manufacturers, so I think a process where you've got vigorous debate.

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Steven Djordjevic: And you've got… you have to have certain scientific standards before you can… you can posit a hypothesis or a theory, and then you continually test that hypothesis with reiterated data over… over… over many years. And then you've got technological developments that occur in science, so we could do things today that we couldn't do 20 years ago, because we've got

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Steven Djordjevic: Absolutely new technologies, like genomics technologies.

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Steven Djordjevic: And so, it's a good thing when scientists change and modify hypotheses. It's actually the system working. It's like evolution, it's…

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Steven Djordjevic: It's like… it's like data evolution, okay? It's like everything on this planet has gone through a really severe process of evolution, and what is here?

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Steven Djordjevic: Has… has gone through Many failures before it's got to where it's got to.

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Tegan Taylor: Passionate accuracy, Steve. Andre, I could see you put your hand up before.

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Marian-Andrei Rizoiu: Yes, I did, I did, because… because I really love the point that Steve made, and I wanted to… I didn't want to… I didn't want to interrupt, but there were two points there. One, Steve mentioned the… mentioned the communication, for example, during… during the change in communication, and the updating, and the evolution in the communication.

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Marian-Andrei Rizoiu: I think…

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Marian-Andrei Rizoiu: The answer that I would put to it, before I go into the detail, I think that we need to make a distinction between science and science communication.

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Marian-Andrei Rizoiu: And they tend to be very different branches, right? A good… a good scientist will know how to communicate to other scientists, because we speak pretty much the same language. Then science communication to the general public, I think it's…

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Marian-Andrei Rizoiu: completely different skill set, to be honest. So, just picking up on an example, right? Let's think the COVID times, the early COVID days,

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Marian-Andrei Rizoiu: what…

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Marian-Andrei Rizoiu: we… what you saw in this… what we saw in the scientific world is that we kept seeing the scientific hypothesis being refined and updated and improved, and the process, the evolutionary process that Steve was talking about, that was science at its finest, working and delivering those results in… in incredibly short times.

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Marian-Andrei Rizoiu: That was… that was probably one of the apex of… of our… of our, of our…

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Marian-Andrei Rizoiu: medical research community producing that, that, that…

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Marian-Andrei Rizoiu: the shot in such a record time. But let me tell you how it was seen in social media.

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Marian-Andrei Rizoiu: Social media groups, first of all, you have a bunch of people that are… that are scared of a new development situation. Then you… then you start having contradictory advice.

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Marian-Andrei Rizoiu: Wear masks, don't wear masks, stay 10 kilometers, stay 5 kilometers. And then they start seeing the scientists. This guy says that we should wear masks, the other guy says that we should stay 5 kilometers away, and then they… and then a third guy comes out next week, and he contradicts both of the previous two guys, and what the public sees is not evolution.

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Marian-Andrei Rizoiu: The public sees confusion, because in… we need to understand that what… we need to make a difference between what society needs and what we need to solve the problem, which was a scientific approach.

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Marian-Andrei Rizoiu: Exactly as Steven.

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Marian-Andrei Rizoiu: described it. But then, what does the public need? The public also needs leadership.

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Marian-Andrei Rizoiu: Right? And we started conflating the… they were conflated at the time. The public needed reassurance, they needed leadership, they needed more than just a solution. They wanted to understand what is happening, but most of the public was not equipped with the… with the

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Marian-Andrei Rizoiu: With the knowledge to understand, and that's often a problem… that's often actually an issue, is that a lot of these concepts

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Marian-Andrei Rizoiu: That the misinformation, consumers and sharers push are quite complex.

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Marian-Andrei Rizoiu: And then… Our… our… every human's immediate instinct is to simplify the question.

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Marian-Andrei Rizoiu: So, what am I to believe? I'm gonna… am I gonna believe that science is this complex machinery that keeps updating its hypothesis, and then… and then we have genomics, and we have all these new tools, or am I gonna believe that they have no clue what they're doing, and in fact, it's a big plot?

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Marian-Andrei Rizoiu: Conspiracy theories are always simple, are extremely simple. And this is where debunking them with science makes it an impossible task.

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Marian-Andrei Rizoiu: I mean, how can you convince someone whose entire belief system is around 3 or 4 points.

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Marian-Andrei Rizoiu: in the space, and how can you use scientific knowledge to… it's not… it's not usable, so…

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Marian-Andrei Rizoiu: that's what I wanted to make the difference between the, the…

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Marian-Andrei Rizoiu: the science and science communication, that's where I… there is… there is a… this leads me to the second point, is how do we actually communicate? And this is very important, and that brings you to what we said earlier, where… where we discussed how do you talk to people.

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Marian-Andrei Rizoiu: is by meeting them where they are. So what we found that works best is when communication is adapted to the environment, or to the cohort that you are targeting. So if I'm targeting an academic population, then I will talk as expected by the academics. But if I'm talking to the public.

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Marian-Andrei Rizoiu: If I'm talking to a particular… a particular segment of the population.

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Marian-Andrei Rizoiu: that I want to address, then I need to adapt my language, not only to what they expect, but also to the platform. We see that the same population, when you reach them via different social platforms, they will have different… they will have different expectations. If you want to reach users of TikTok, then it needs to be 60 seconds long.

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Marian-Andrei Rizoiu: filmed…

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Marian-Andrei Rizoiu: filmed, up in front by the phone, saying, hey guys, I just got out of the show, but let me tell you how to vaccinate, to be sure, right? But if I do it on YouTube, then we sit down at a big desk with a bookshelf behind us, and we make a one-hour video in good lighting, and… right? So even those little cues are extremely important to get our message across.

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Marian-Andrei Rizoiu: to the audience. We actually find that when you customize your message to the audience as they expect it, you improve the penetration of the message by at least three times to up the… up to 6 times. So even by just adapting the message.

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Marian-Andrei Rizoiu: we get to where we want. And then, whenever I tell this to people in marketing, they tell me, great, Andre, you just rediscovered hot water. That's what we've been doing for all this time.

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Marian-Andrei Rizoiu: But that's what us scientists, we need to start getting good at. Also, we need to… we need to get our science communication up to speed and make the distinction between the science and how we communicate it.

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Tegan Taylor: I'm never going to say, it's a bad idea to talk about how important science communication is. So you've been asking your questions via Mentimeter, I've been seeing you upvoting them, I want to get to as many as we can now. So we might do a bit of a rapid fire round, Andre and Steve. I might start with this one. Steve, for you.

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Tegan Taylor: What could be the worst case scenario if we continue with these declining vaccination rates?

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Steven Djordjevic: Well, declining vaccination rates would be disastrous, so we will see diseases that…

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Steven Djordjevic: have been well controlled. Things like measles, diphtheria,

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Steven Djordjevic: We've all seen polio research, and then we're going to actually go backwards. So, as I mentioned right at the beginning of my talk.

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Steven Djordjevic: We're a victim of our own success, and we've lost… we've lost corp… we've lost memory, social memory, of what it was like to live in an era before, before the 1900s, right?

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Steven Djordjevic: So, life expectancy worldwide was 32 before 1900, okay? So, and in developed countries, it was 56. So.

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Steven Djordjevic: if you want to go back to those… those scenarios, then, I don't, and I… and I think

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Steven Djordjevic: That's a… that's a real threat that we really need to be making sure we meet.

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Steven Djordjevic: Our… our herd… herd immunity levels of vaccination.

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Steven Djordjevic: Because our children.

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Steven Djordjevic: And our elderly, and anyone who's immunocompromised on cancer therapies are all extremely vulnerable, and more so now because of antibiotic resistance.

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Tegan Taylor: Great answer. This one I'm going to put to you, Andre. Are younger generations more vulnerable to health misinformation because of social media, or are we all equally susceptible?

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Marian-Andrei Rizoiu: Hmm.

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Marian-Andrei Rizoiu: We actually find that younger generations tend to be a bit more resilient.

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Marian-Andrei Rizoiu: The… some of the, some of the more, some more susceptible cohorts are the older cohorts. And the reason is actually quite simple, if you think about it. The young generation, they are digital, they, they, they, they were born in social media. They were using phones before they could speak.

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Marian-Andrei Rizoiu: So, their… their resilience is, is significantly higher, because they will question it. Whereas the older cohorts, there's… they have less,

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Marian-Andrei Rizoiu: defense mechanism.

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Marian-Andrei Rizoiu: But the same was true before, right? When the printing press came out, that was… it was also used to spread ideas, at that time religious ideas, of course, but still ideas nonetheless. So, we do find that the younger… the younger people are… are more resilient to…

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Marian-Andrei Rizoiu: conspiracy theories and… and these more run-of-the-mill, anti,

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Marian-Andrei Rizoiu: misinformation. However, they do… they do have other… they are exposed to other issues, particularly the… the mental impact of social media use, constant comparison with… with any… with impossible beauty standards, and so on and so forth, and… and AI chatbots and assistants.

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Tegan Taylor: Lots of… lots of questions… lots of questions along the lines of, if I'm talking to someone.

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Tegan Taylor: who's starting to talk about these views, how do I respond to them? So, for example, Ugh.

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Tegan Taylor: Faced with someone who holds onto misinformation or disinformation, is there space for patience, curiosity, and care when faced with them? Andre?

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Marian-Andrei Rizoiu: Yes, yes, awesome question, awesome question. And honestly, it's probably one of the most important ones out there, because the way we react

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Marian-Andrei Rizoiu: ease.

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Marian-Andrei Rizoiu: going to decide whether there is a chance to come back from it, or whether… or whether we are pushing down that line. And it's misinformation in general. So, anti-vaccination is one.

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Marian-Andrei Rizoiu: But we see… we start seeing increasing, increasing, levels of toxic masculinity and, and, you know, the type of manosphere, Andrew Tate-type content among our children. It's…

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Marian-Andrei Rizoiu: they tend more to be more like life values and life worldviews rather than misinformation per se. There is some falsehoods in there, but it's just more like opinion, toxic opinions, harmful opinions. The way we react to those is the same way that we react to any type of misinformation.

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Marian-Andrei Rizoiu: The worst thing you can do, and remember what we were talking about earlier, is,

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Marian-Andrei Rizoiu: Is the stigmatizing response.

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Marian-Andrei Rizoiu: So, the way to approach is, with… with understanding. Try to… trying to understand the reasons why the person

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Marian-Andrei Rizoiu: starts, embracing these, these ideologies, which is…

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Marian-Andrei Rizoiu: Remember, it's not an information problem. Don't go and counter the information. There is a reason why that family member, that friend, that colleague, that student, is starting to exhibit those ideologies, and that's because they start hanging out in those groups. Why are they hanging out in those groups?

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Marian-Andrei Rizoiu: And that's going… going and understanding… going and asking questions,

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Marian-Andrei Rizoiu: with empathy, things like, why… why is it attractive to you? Trying to understand the logic behind it. Why is that person joining there? What do you find interesting in it? What does it give you? How do you feel when you… when you engage in these bits? So.

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Marian-Andrei Rizoiu: Just relating and consider… those people are people, and they are there because of a series of events that happen in their lives.

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Marian-Andrei Rizoiu: That is the only way to get to the bottom of it. I'm going to give you an example of why what happens is not what was real. For example, we were tracing during the Melbourne lockdowns, we were tracing this lady online that was organizing online protests, and she was single-handedly responsible for a number of

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Marian-Andrei Rizoiu: a number of these actions. But what we find is that she was actually… what we found via looking through it is that she was suffering from a condition that was… that she could not get treated because of the hospital

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Marian-Andrei Rizoiu: Of the hospital lockdowns. So, the real reason why she was pushing this, this, this entire organization, which seemed to be, which seemed to have a

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Marian-Andrei Rizoiu: A ideological view was actually the constant suffering she was going through.

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Tegan Taylor: the.

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Marian-Andrei Rizoiu: there is, you know, give her the procedure, and you're removing the real reason of why that's happening.

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Marian-Andrei Rizoiu: Please, please, please, please do not stigmatize that person, because that's the surest way to make sure that they go straight back into that community that they came from.

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Tegan Taylor: Empathy.

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Marian-Andrei Rizoiu: Empathy, trying to understand what they gain out of it, why are they there? What do they find? Trying to decompose what are the positives that they actually draw from that community, because you need to understand, when they spend time in those communities, they get something back. It's not as simple as saying, stop doing it.

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Marian-Andrei Rizoiu: Because they will be giving out part of themselves, they will be giving up true friendships, kinships, they will be giving up the endorsement and the moral support. You can't just tell them, stop doing that. It's not as easy as that, so understanding the pluses that they get from that community, and working backwards from there. So, absolutely empathy.

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Marian-Andrei Rizoiu: Absolutely empathy.

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Tegan Taylor: Fantastic, such a good, having that script there. A question here that I might put to you, Steve. This one says, there are many evidence-based strategies healthcare providers can use to help reduce misinformation. However, it requires training, and they are already time-poor.

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Tegan Taylor: How, Steve, do you see this being able to be incorporated into a health practitioner's very busy training practice?

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Steven Djordjevic: Yeah, there's… there's a lot of demands on being, on… on… on becoming a medical professional.

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Steven Djordjevic: You know, there's… there's all… there's… it's so vast, the amount of information they need to consume, and remaining up-to-date is very important, so it's sad that

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Steven Djordjevic: that that's… that is happening. We all… budgetary constraints are a problem for many, many things, and I… it would be good… it would be good to have that, supported, because

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Steven Djordjevic: I think people like to listen to

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Steven Djordjevic: I mean, if you… if you read some of the reasons why people go to GPs, a lot of times they don't go to GPs necessarily because they're seriously ill, but because they're a little bit lonely, they want to have a chat, and I think that is the best avenue to educate them the way,

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Steven Djordjevic: To improve how they're feeling and their lot in life, rather than necessarily coming from a scientist like me, which is going to give it to fans.

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Tegan Taylor: Andre, what kind of training would you like to see those

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Tegan Taylor: GPs, those kind of first port of call practitioners get.

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Marian-Andrei Rizoiu: recognizing symptoms, by recognizing the sim… being informed of what happens, of what's happening, and being informed of the best… the best, way to address it. So.

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Marian-Andrei Rizoiu: And, you know, the…

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Marian-Andrei Rizoiu: the member of our audience pointed out very, very well that they are already very busy. And when we go to a GP, the question is always, what's wrong? What can I help? What's the symptom? Let's debug it. Let's try to get to the bottom, and let's fix it. Whereas.

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Marian-Andrei Rizoiu: Steve already pointed out that people don't necessarily go to the GP just for that. GPs are also seen as sources of authority.

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Marian-Andrei Rizoiu: So, we need to understand the doctors, the…

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Marian-Andrei Rizoiu: for some of the communities, the religious leaders, the teachers, they are sources of authority in our life, and then we will turn to them when we have those questions. So.

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Marian-Andrei Rizoiu: I may go to the GP because I think that I have something, and I would like them to, to be the final decision maker. They'll say to me, no, you don't. So then I'll go home and I'll sleep… I'll sleep, happily. But… so they are these… they are the sources of authority, and people will come to them.

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Marian-Andrei Rizoiu: So they are perfectly placed. They are really perfectly placed.

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Marian-Andrei Rizoiu: to address this. But they need to recognize it, they need to know how to react to it, and what works and what doesn't. And it's not, again, like with many things, you've heard me digressing in other types of misinformation, because the solutions are not specific to this type of misinformation.

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Marian-Andrei Rizoiu: toxic masculinity for our adolescents is the teachers and the peers. And peers are extremely important. Each other, we do have our… the Are You Okay? Day. We already know how to do it. We have programs that train us how to spot… how to spot mental health issues in our peers.

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Marian-Andrei Rizoiu: Why shouldn't we have programs that teach us how to spot these harmful ideologies in our peers?

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Marian-Andrei Rizoiu: And what to do. Like, the first, right, the first respondent.

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Tegan Taylor: Couple more questions, before we wrap. Two that I might put together to put you to put to you, Andri. One says, I'm doing my PhD on health misinformation. I found evidence that while debunking can help, the way it's done can reinforce the false narratives. For example, it strengthens the links between concepts.

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Tegan Taylor: And another person saying, I don't understand what pre-bunking is, and what it works. Can you give us a refresher?

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Marian-Andrei Rizoiu: Yeah, so debunking can work in those… in those initial… in those initial phases, right? In that initial phase where I have an uncertainty, I… I generally want the information.

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Marian-Andrei Rizoiu: And then the pre-bunking… debunking can work because, that… that helps, for example, search engines to deprioritize the information. And even if it's presented to the individuals, it will help up to a point. But our, our,

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Marian-Andrei Rizoiu: our PhD student here is right, that it can make things worse. And it can make things worse in a couple of ways. First of all, it draws attention. Most things online

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Marian-Andrei Rizoiu: have a limited life cycle. And that's because our… remember, again, the online attention? That's a finite resource. It's one of the few fin… no, it's a very finite resource. We all have this limited cognitive capacity. We can't hold more than X things in our head at the same time.

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Marian-Andrei Rizoiu: So, as a society, we have this fixed capacity, so for new things to come in, obviously other things need to fade out, which means that most things, they just fade out by themselves. Now, when you're doing debanking.

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Marian-Andrei Rizoiu: You are essentially trying to put out a fire with a bucket of petrol.

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Marian-Andrei Rizoiu: With a button.

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Marian-Andrei Rizoiu: That's pretty… that's usually what happens. So, you're drawing even more attention to it. And then there is bad ways of doing debunking.

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Marian-Andrei Rizoiu: So, how do you debunk vaccine spaus autism?

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Marian-Andrei Rizoiu: The wrong way of doing it is

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Marian-Andrei Rizoiu: vaccines do not cause autism, because our, our, our… what the audience hears is, vaccines, blah, blah, blah, blah, blah, autism, right? So we don't repeat the… the fake information. And I already forgot the second question, sorry.

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Tegan Taylor: pre-bunking.

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Marian-Andrei Rizoiu: Pre-banking. What is pre-banking? Pre-banking is a tricky one. Pre-banking is when you have hints that some information will be… will appear in the population, and you're sort of… you're seeding the right version of it. So, for example, it happens often in electoral process, where you sort of have ideas of what

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Marian-Andrei Rizoiu: What the electoral misinformation will be about, and you're starting to give the right information.

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Marian-Andrei Rizoiu: But…

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Marian-Andrei Rizoiu: Another way is not on information, the pre-banking, but rather on skills. What we find is that giving people critical skills, critical thinking skills, is

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Marian-Andrei Rizoiu: even more important. So, how do you… the same way as you… as you give skills to people to identify, to identify hawks… hawks emails and… and, and, not spam, but, the phishing emails, right? Is it too good to be true?

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Marian-Andrei Rizoiu: do you see things that are… that are wrong? So, teaching them to decompose a claim instead of just accepting it wholeheartedly and then parroting it back.

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Marian-Andrei Rizoiu: So, pre-banking is… is… usually is understood in this more limited form, is giving the… trying to seed the correct version of the information, or the date… the scientific-backed version of the information. Let's put it this way, because in online there is no correct and incorrect, it's just…

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Marian-Andrei Rizoiu: different views. Or developing the critical skills.

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Tegan Taylor: One more question from the audience I might put to you, Steve. This person says, will we ever be brave enough to mandate vaccination?

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Steven Djordjevic: Nope.

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Steven Djordjevic: That's 51. Nope.

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Steven Djordjevic: People don't like to be told what to do, that is what I've sort of…

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Steven Djordjevic: In my own, just through my interactions in life with different types of people, so…

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Steven Djordjevic: I don't know… I mean… I, I think for,

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Steven Djordjevic: the vaccines that are given to children, like, you know, rubella, measles, diphtheria, I think that they should be mandatory.

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Steven Djordjevic: Because, that child, It's vulnerable.

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Steven Djordjevic: And it's vulnerable to the decision-making of the carer.

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Steven Djordjevic: And I think society has the fiduciary responsibility to look after that child, irrespective of whether or not a parent wants to override it. And I know that's a very controversial thing to say, but I think that's in the best interest of that child.

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Steven Djordjevic: So, I mean, I would probably be in favor of it being mandatory, and even if we do get people who conscientiously object, so long as we reach that herd immunity level, you know, there is a bit of room for tolerance there.

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Steven Djordjevic: About you.

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Steven Djordjevic: That's about the best way I can answer it.

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Tegan Taylor: Fair enough. Well, we have covered so much ground in the last hour and a bit. It's almost time for us to say goodbye, but before we go, I just wonder if you could distill all the things we've talked about today into one thing. One thing that anyone listening could do tomorrow?

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Tegan Taylor: What would it be?

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Tegan Taylor: Steve, I might start with you.

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Steven Djordjevic: Embrace vaccination.

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Steven Djordjevic: 2… To alleviate the scourge of antimicrobial resistance.

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Steven Djordjevic: That's because that's my area, that's my deep area of expertise, and I know probably better than most people on this planet how bad the AMR problem is.

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Tegan Taylor: Yeah.

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Tegan Taylor: Andre?

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Marian-Andrei Rizoiu: It's a very good question. I would go with, question everything.

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Marian-Andrei Rizoiu: If in doubt, Google it.

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Marian-Andrei Rizoiu: And, and one of the most important lessons that I learned, coming again from science is

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Marian-Andrei Rizoiu: Go get your news directly from the… from the main webpage of the news producer.

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Marian-Andrei Rizoiu: So…

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Marian-Andrei Rizoiu: essentially going beyond… trying to bypass the information… the news sources of… from social media. So if you want to know what's going on within the world, get… pick your favorite news producer, doesn't really matter which one. There's… there's paper… there's scientific papers that show that it doesn't matter which one you pick.

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Marian-Andrei Rizoiu: As long as you go directly on their… on their main page and you read from there.

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Tegan Taylor: Well, I'm gonna add my own, based on things that both of you have said, but particularly you, Andri.

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Tegan Taylor: empathy and curiosity in the way we approach these conversations with the people that we love, or that we come into contact with. Well, thank you so much for joining us tonight. Thank you, Steve and Andre, for such a fascinating and timely discussion. I thank you for your questions, they've really helped shape the conversations. You can continue exploring this topic in our Curiosities video series on the UTS website.

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Tegan Taylor: But we'll leave it there for now. Thank you again for joining us.

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Tegan Taylor: Have a great evening!