The Perfect Enemy | Twitter stops COVID info moderation, health experts are concerned
February 8, 2023
Read Time:5 Minute

Twitter’s decision to stop enforcing its policy against COVID-19 falsehoods has alarmed Bay Area public health experts who worry the platform can again become a super-spreader for misinformation amid an ongoing pandemic, but many prominent voices have vowed to stay on.

“I’m going to keep tweeting good information as long as there is an audience that is looking for it,” said Bob Wachter, UCSF’s chair of medicine, who has amassed over 270,000 followers. “Since Musk took over, about 2% of my followers have left, which is too bad. But an awful lot of people are still following me. While I hate to see misinformation being given a larger platform, I think it’s important that voices of science and facts and reason continue to do all they can to get the word out. So for now, I’m sticking.”

The latest change under Elon Musk’s chaotic reign over the social media giant was made last week but noticed only by eagle-eyed users on Monday, buried in a one-sentence update to Twitter’s online rules: “Effective November 23, 2022, Twitter is no longer enforcing the COVID-19 misleading information policy.

Practically, that means moderators will no longer remove or flag posts with false or deceptive health information related to the coronavirus. That abandons an industry-wide effort launched in December 2020.

“I am absolutely terrified and despondent,” said Peter Chin-Hong, an infectious disease expert with UCSF. “Permitting misinformation is not just about freedom of speech. There is a direct pathway between misinformation and death if science-based interventions like vaccines are not embraced.”

Before Musk took over less than a month ago, Twitter reported that it had suspended 11,230 accounts and removed 100,000 misleading posts under the policy. Twitter’s massive reach had provided a fertile ground for spreading conspiracy theories and science-denying falsehoods about the virus and the government efforts to combat it.

By Tuesday, several of those accounts were again testing the boundaries of the new Twitter.

“COVID was created in a lab by the Chinese with the assistance of Dr. Fauci,” a self-described “citizen journalist” tweeted, immediately drawing 6,000 likes. “This policy was used to silence people across the world who questioned the media narrative surrounding the virus and treatment options,” tweeted Simone Gold, a physician and leading purveyor of COVID-19 misinformation.

Chin-Hong characterized Musk’s move as a threat extending beyond COVID-19 misinformation.

“This catalyzes a further distrust in science and medicine that could ripple out beyond COVID-19 to all aspects of health care, and future pandemics not yet named,” he said. “Moreover, it further adds to the moral injury that we have faced as health care workers throughout the pandemic, contributing to burnout and more resignations. Now is not the time.”

Since taking ownership of Twitter, Musk has fired moderation teams and rolled back many of the rules previously in place that were meant to combat misinformation.

Musk has repeatedly pledged to prioritize free speech and transparency on his platform and has criticized Twitter’s previous suspension policies as murky and harmful to conservative viewpoints, raising concern from critics and online safety experts about misinformation campaigns and hate speech.

“I think that COVID has shown us how digital communications platforms — and their ability to disentangle information from misinformation — are a fundamentally critical part of epidemic response,” said Abraar Karan, an infectious disease doctor at Stanford. “Abdicating that responsibility will be damaging and will ultimately lead to fewer people trusting the legitimacy of the platform, for whatever that is worth.”

UCSF infectious disease specialist Monica Gandhi said her “biggest fear” is the spread of vaccine misinformation on Twitter.

“I would be very worried about people with ‘M.D.’ in their names who dissuade people from taking vaccines,” she said, adding that this refers to all vaccines, not just for COVID.

Despite her dismay, Gandhi said she won’t leave Twitter because she hasn’t “seen the advantage of other platforms.” Chin-Hong and Karan also said they will maintain their accounts for now to share their thoughts and work about COVID-19.

Chin-Hong also voiced uncertainty “about the direction Twitter is moving into and whether it will continue to be the powerful tool of advocacy and communication that it has been during the pandemic, when politics interfered so mightily with science.”

He added, “I’m feeling some resolve to double down to continue to promote evidence-based science. If all these voices leave, even more balance will be lost. But I also want to be a safe and hate-free environment, and that is where things are uncertain.”

Twitter has been a powerful messaging tool for government agencies to provide the safety information, regulations and science during the pandemic.

In the Bay Area, a spokesperson for Marin County’s health department said the agency will maintain its presence on the service. “Thankfully, we have established a relationship with the majority of our residents and have built a reputation for providing factual, timely information,” said Laine Hendricks.

Solano County’s health department also will remain on social media platforms, officials told The Chronicle, responding to a query about Twitter on Tuesday. “We will continue to provide health education information through Solano’s web site, social media, and community outreach efforts,” they said in an email.

Other Bay Area health departments did not immediately respond with their plans.

Epidemiologist Eric Feigl-Ding urged prominent public health experts to stay on Twitter and defend accurate information about the virus: “Stay folks — do NOT cede the town square to them!”

Dr. Ashish Jha, the White House COVID-19 coordinator, said Tuesday that COVID-19 misinformation is far larger than one platform, and that policies prohibiting COVID misinformation weren’t the best solution anyway. Speaking at a Knight Foundation forum Tuesday, Jha said reasons for COVID misinformation included legitimate uncertainty about a deadly illness.

Simply prohibiting certain kinds of content isn’t going to help people find good information, or make them feel more confident about what they hear from their medical providers, he said. He called for “collective responsibility,” to combat the misinformation: “The consequences of not getting this right — of spreading that misinformation — is literally tens of thousands of people dying unnecessarily.”

Musk, who himself has spread COVID misinformation on Twitter, has also laid off the communications staff at San Francisco-based Twitter, so no more information was available on the new policy.

Aidin Vaziri and Kellie Hwang are San Francisco Chronicle staff writers. Email:,