Filipino medical student Chris Dee talks about the importance of the right kind of information in science
“The idea came about first and foremost because I knew how connected Filipinos were on social media,” Chris Dee told me. A graduate of Molecular Biophysics and Biochemistry from Yale University, studying medicine at Harvard Medical School, Dee was concerned early in the pandemic last year not only with the spread of the novel coronavirus, but also with the misinformation that was floating around the internet.
He is currently based in Boston, but was happy enough to communicate through Messenger. The internet and social media can be an amazing tool, giving people up to date news and information and connecting people from around the world, the way it connected us for the interview. There are, however, drawbacks that may not seem readily apparent. But during a crisis, particularly a health crisis such as COVID-19, these drawbacks could potentially add more stress and confusion to an already difficult situation.
“I was getting my own news from social media, but found that so much of it seemed unreliable,” Dee added. “My training and exposure to research puts me in a good position to sift through the junk. I realized, however, that this is not the case for many people outside of medicine or biology. There are sources like the Department of Health (DOH), Center for Disease Control (CDC), and the World Health Organization (WHO) that are good authorities to listen to, but even that information can be intimidating to a daily user.”
Dee created an evidence-based primer that could be easily shared and updated, edited by two friends in the field of medicine Marc Gregory Yu and Joseph Paguio (because they are in the field of medicine, it had to be peer-reviewed). The Google document has both English and Filipino translations and includes basic information the group felt everybody should know, such as risk factors, symptoms, treatments, and preventative measures. It has spread quickly online and received hundreds of positive comments.
It also has the links to the resources he used. He stressed that one of the most important things for them in this endeavor was to show that the information was coming from reliable sources, a way to combat the misinformation spreading online. But he was also careful to ensure that the information was presented in a way that the average member of the public could understand, without the jargon he was used to in medical journals.
“Initially, we wanted to put primary resources, links to peer reviewed journal articles from Nature or the Journal of the American Medical Association,” he said. “But we decided to add a lot more WHO and CDC sites since those are a lot more patient friendly. Although authorities like WHO and CDC publish resources that are technically written with lay readers in mind, people don’t necessarily think to access them, for whatever reason. Our goal was to distill some of the key resources and also present them in a way that was relatively palatable to a non-medical user.”
On the Facebook post Dee made that included the shared Google document, he wrote: “Caveat: I am a relatively inexperienced trainee, but the authors of many of these resources cited here are the best we’ve got.”
While he describes himself as an “inexperienced trainee,” Dee and his editors boast of an impressive resumé that will give many some assurances that the authors know what they are talking about in the shareable document.
Yu received his MD from the University of the Philippines’ (UP) College of Medicine and graduated from programs in internal medicine and endocrinology at the Philippine General Hospital. He is currently a research fellow at the Joslin Diabetes Center in Boston, as well as at Harvard Medical School. Meanwhile, Paguio also received his MD from the UP College of Medicine. He is currently doing research and a clinical rotation at Memorial Sloan Kettering Cancer Center in New York.
While I have already mentioned Dee’s academic credentials, it is worth noting that he is passionate about combating misinformation in the field of science, where it can be a serious matter of life and death.
In his late 20s, he has chosen to specialize in radiation oncology or cancer treatment. Last year he was the senior author in a paper entitled, “Trends, Quality, and Readability of Online Health Resources on Proton Radiation Therapy.” It includes a lot of the jargon and technical terminology that he actively avoided using in the coronavirus document. Essentially, it discusses how patients look to the Internet and resources online when considered newer cancer treatments, coming to the conclusion that often they could actually confuse and hinder the patient’s decision-making, clouding their judgment.
‘The hardest part is figuring out what we know and what we don’t know, since science is not as straightforward as many people think.’
“Even on clinical rotations I find that a lot of people turn to the Internet before even seeking healthcare providers,” said Dee, drawing a parallel between what he was seeing with the COVID-19 outbreak and the cancer patients he met. “For conditions like cancer, generally patients will bring up what they learn online to the clinic, but will defer to the discussion they have with the physician in making clinical choices. In contrast, with something as widespread as COVID-19, our actions even before any contact with the healthcare system can have great ramifications for ourselves and the people around us. Therefore, the importance of appropriate information among the non-medical public is critical.”
In a field that most of the time deals with facts and figures, not every piece of information comes easily. “The hardest part is figuring out what we know and what we don’t know, since science is not as straightforward as many people think. We don’t ‘know’ things in the black-and-white sense. Instead, we arrive at conclusions based on likelihood and confidence intervals. Take for example the case of fatality rate, we can only really report in ranges because so many factors go into that number: how you define your denominator, based on your population, you age, comorbidities, rate of detection, all that adds to the uncertainty,” Dee explained.
“I think on the ground it is important to be judicious about what you spread. The Viber groups are like wildfire, with many people whose actions can be influenced by what they read. Be careful about what you pass on as ‘truth’ or ‘news,’ because rumors and conjecture may eventually be construed as true,” he concluded on a salient point that seemed to be addressed to both the general public, as well as media practitioners. “The multiple conflicting ideas out there that all claim to be true result in confusion. Confusion results in panic, which is never productive. We fear the unknown. It is critical, now more than ever, to know what we know from what we don’t know.”