Letter to the Editor: Social Media Is a Double-Edged Sword in the COVID-19 Pandemic.

I read with interest the article on misinformation on coronavirus disease 2019 (COVID-19) by an international team of journal editors.1 The COVID-19 pandemic has been paralleled by an “infodemic” on social media. The index survey included at least a third of participants who have had the experience of working on editorial boards of various medical journals. The majority of them have identified social media as a source of both information and misinformation. While the world is concerned about inequalities based on race, economy and access to health, a more pressing disparity lies in the access to trustworthy and professionally moderated flow of information. Social media platforms have the power to neutralise this inequality. However, geography of social media use is uneven globally, complicating the issue of inequality. Equality ensures that all participants have equal access, but justice determines fair access.2 Thus, a basic principle for justice is access to trustworthy sources.

The index survey has delved deep into how misinformation can be minimized on online platforms, including preprint servers. One noteworthy recommendation is to launch a global, open COVID-19 bibliographic database. The other powerful suggestion is to incorporate artificial intelligence checks for facts as well as for plagiarism.

The pandemic has started a race to publish. Numerous novice and ambitious authors are eagerly waiting to draft their articles and target top journals even at the expense of unjustified short-cuts and breaches of ethical norms. Unsurprisingly, reports with poorly validated primary data and redundant ideas are on rise and, by a chance, end up in even top medical journals blindly trusted by all.

It is believed that plagiarism is also increasing. Not only the absence of appropriate citations but also the lack of or false citations may also constitute plagiarism.3 Authors need to understand the concept of plagiarism in full. Journal editors need to play a more active role in screening for plagiarism, and not just relying on software.4

Complementing the editors, peer reviewers also need to keep their senses heightened. At the beginning of the pandemic, there were some incidences of hastened evaluations at top journals that led to harshly criticized publications and uncovered unpreparedness of the publishing world to operate in the time of crisis. Haste often makes waste. The process of peer review is far from perfect but it is a significant checkpoint for filtering misinformation. It is often a thankless job, but its importance cannot be underscored.56 One way to overcome the issue can be the use of open peer review and linking reviewer comments to social media sites.7 This can help provide reviewer recognition as well as accountability. Also, it can help readers on social media sites to have a critical view of studies by reading a third person's viewpoint.

Social media can be used for surveys as well as promoting health awareness.8 Maintaining mental health of a population during a pandemic is a difficult task, and social media can help in this regard, too.9 Social media plays an increasingly important role in medical education.10 It can help reduce gender imbalance in medicine.11 Social media platforms can also transform into teleconsultation sites in medium and low income countries.12 Social media editors can share properly validated and cleared of any conflict journal articles via popular online channels.1314

The eagerness to publish during the pandemic may also transgress ethical boundaries. Most of the preprints that created a ruckus on social media have either not seen the light of publication, or have been rapidly published only to be retracted or put under a notice of concern. An instance is the preprint on ivermectin that changed practice in South America, only to disappear conveniently afterwards.15 A couple of articles in high impact journals were retracted within a month of publication leaving their ghosts behind on social media.16

To sum up, social media is proving to be a double-edged sword. The flow of information is difficult to moderate. Social media accounts should be moderated by skilled professionals capable to distinguish information, tag peer-reviewed reports and unpublished preprints, and filter out misinformation. The pressure on journal editors and peer reviewers is heightened. Authors should also understand their responsibilities. Only with all acting in conjunction, will we be able to utilize the true benefits of social media, without falling prey to misinformation.