How doctors are navigating coronavirus information online: 'Like the Wild West out there'

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The medical misinformation regarding coronavirus that's targeting consumers on the web has placed doctors in an unusual position of trying to not only fight COVID-19 on the front lines but also having to weed through what's fact and what's simply hearsay.

“It’s like the Wild West out there,” Dr. Jeremy Faust, emergency medicine instructor at Harvard Medical School told Fox News of his coronavirus experience.

With people self-isolating, they are spending more and more time on the Internet reading COVID-19 content, unverified reports or anecdotes are popping up on popular forums. Unfortunately, that includes non-professionals doling out advice on social media sites like Facebook, or in forums like Reddit, which sometimes includes unfounded claims about "coronavirus cures." 

Another bogus claim was the "friend of a friend" text chain about a national quarantine that was quickly debunked.

The issue for Faust and others working to treat coronavirus is that the information being shared isn't necessarily held to a standard of proof. And he, like most doctors, still wants patients to get their advice straight from medical professionals.

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But there is another side to sharing medical information online that Faust and others say is actually helping to combat the COVID-19 virus in new and innovative ways: F.O.A.M., or Free Open-Access Medical education/instruction, which brings together medical experts seeking advice -- or offering their first-hand knowledge -- on how to battle coronavirus.

Faust is one of the founders of the F.O.A.M. movement and co-hosts a podcast, FOAMcast, which now exclusively discusses coronavirus-related topics.

Faust, whose background specializes in emergency medicine, regularly features other doctors of all specialties who are involved in the movement and have been working on COVID-19 research.

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“Textbook knowledge is what medicine believed to be the case a couple of years ago. And journal knowledge ... is considered maybe what was thought to be a year ago, or six months ago, or a few months ago, when those were submitted and accepted. And F.O.A.M. and the movement [are] really what's happening now and, in the future,” Faust said.

Faust describes the movement as, “a group of self-appointed people” who have built a community over the last decade using various forums to share medical findings among a trusted group of medical professionals.

Another member of the movement is Dr. Josh Farkas, an assistant professor of pulmonary and critical care medicine at the University of Vermont, and contributor to F.O.A.M. blog EMcrit. In mid-March, Farkas posted to his blog about using CPAP or continuous positive airway pressure machines to help patients breathe where hospitals are short on ventilators, a widely reported problem.

Doctors from around the globe weighed in on Farkas’ post confirming that they too had positive experiences using CPAP machines on coronavirus patients.

The online platform has been critical to the rapid dissemination of information in this outbreak, especially so for doctors who are used to weeks or even months-long peer review process before publication.

"As we struggle with how to treat a disease that so recently was totally unknown, this rapid exchange and updating of information is crucial," Farkas told The Wall Street Journal of sharing coronavirus experiences over the Internet.

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“We don't want to be in a situation where we have to wait years and years before we move the ball forward, especially in a moment like this,” Faust said.

Another F.O.A.M. colleague, Reuben Strayer, associate medical director of emergency medicine at Maimonides Medical Center in Brooklyn, and author of EmDoc, told The Wall Street Journal he couldn't imagine combating coronavirus in a pre-Internet world.

"How could you communicate about a disease nobody knows anything about that is marching across the planet?" he told the news outlet.

However, Faust urged caution about carefully weighing which information to trust.

“It's very easy to hear anecdotes of things working and not noticing that actually they don't work as well as we think they do, or they have some harms that we're not picking up," he said.

Faust said one of the things he finds most promising about how the F.O.A.M. movement is being used to help with the coronavirus is that doctors are not only sharing positive news and innovations but also warning about things that have not worked or additional precautions needed.

He pointed back to his colleague’s CPAP discovery as an example.

“We learned early on, that in some cases, that intermediate step could be a little dangerous because it really makes droplets fly far in and out of the patients and could put health care workers at risk," he said.

And as doctors navigate the front line against the novel coronavirus, they find themselves fighting a two-front battle: one against the virus itself, the other against the bureaucratic red tape of FDA approval.

Doctors are making complicated risk calculations now more than ever and while their years of strenuous training and requirements have prepared them for this moment, even F.O.A.M.’s most invested, like Faust, said science remains the key.

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"There's a difference between a great idea and a great idea that doesn't work. And that's that science tells us which of those things is which.” Faust said. “We’ve got to do this quickly, but we have to do it correctly. Otherwise, we actually could shoot ourselves in the foot”

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