Fighting Misinformation During COVID-19
Nurses are on the frontline of the COVID-19 response

On the 200th anniversary of the birth of Florence Nightingale on Tuesday, we marked International Nurses Day, a day for the world to focus on the invaluable role that nurses play in our society. They not only have a tremendous role in health settings but are also crucial for the economic wellbeing and national security of the world.

Among the issues confronting our health care professionals every day on the front lines, is the issue of fake medicines and treatments, which has become all of the more pervasive in the COVID-19 era.

The International Council of Nurses has drawn up a position statement on sub-standard and falsified (SF) medicines which calls for a concerted, collaborative effort by health professionals, industry, governments, law enforcement bodies, customs, and other stakeholders.

Among other things, it urges governments to recognise the risk that SF medical products pose to public health and develop national action plans that include comprehensive legal frameworks, robust reporting systems, and strong national regulatory mechanisms linked to the global regulatory network as well as greater pharmacovigilance capacity.

Busting the Myths

The COVID-19 pandemic has created ideal conditions for criminals to exploit people’s fears of contracting the disease by advertising falsified treatments and vaccines, promoting fake tests and spreading unsubstantiated rumours of potential cures. In Iran, at least 44 people died in early March from drinking toxic alcohol after a coronavirus cure rumour.  An American man died and his wife went into critical care after they took chloroquine phosphate in an apparent attempt to self-medicate for the novel coronavirus. As the Alliance of Safe Online Pharmacies (ASOP) has warned: ” While the nation struggles to deal with the public health implications of the COVID-19 pandemic, criminals are exploiting fear and confusion for profit by peddling fake preventions, treatments and cures online. At best, these phony products are ineffective, at worst, they are deadly.”

The World Health Organization (WHO), like the US Food & Drug Administration (FDA), has warned against other mythical cures for COVID-19, and emphasized that, to date, there is no specific medicine recommended to prevent or treat COVID-19.

In March, Interpol’s Operation Pangea found 2,000 online links advertising counterfeit items related to COVID-19, and seized more than 34,000 counterfeit and substandard masks, “corona spray”, “coronavirus packages” or “coronavirus medicine”.

Many countries already crippled by infectious diseases and weak health systems could go under in the COVID-19 outbreak and increase the spread of misinformation and fake cures.

“COVID-19 is on the rise in Africa, and we are already facing shortages of critical protective equipment and a plethora of misinformation,” says Thembeka Gwagwa, ICN’s second Vice-President, and a nurse from South Africa. “Lack of access to care will mean many people will seek cheap, fake medicines which will have devastating consequences.”

Fake medicines as a whole are unsafe and ineffective, failing to treat or prevent the intended disease; they may have little or no effect – or cause disastrous patient outcomes, such as poisoning, disability and death.

 The Role of Healthcare Professionals

Nurse and midwife immunizes baby in Nigeria

Healthcare professionals, such as nurses, are in the front line of treating patients with COVID-19 and are vital in the fight against substandard and falsified (SF) medicines and misinformation. They administer, monitor and, in some countries, prescribe treatment and are therefore well-positioned to detect SF medical products. However, identifying SF medicines can be difficult as they are often visually identical to the original, genuine product. It may be only through monitoring a patient that either a side effect is identified or there is no effect at all, and this raises a red flag that the medication is a fake.

Nurses also play an important role in educating the public on safety concerns related to the use of SF medical products and dispelling false rumours about potential cures. They actively promote health literacy to support properly informed preventative measures and discourage self-diagnosis and self-prescribing. While nurses’ workloads are under severe pressure during this pandemic, the work of educating and informing patients and their families should not be seen as an additional burden but rather as part of safeguarding the health of the public – a vital role that nurses play throughout the year.

The Fight the Fakes campaign aims to raise awareness of fake medicines and gives a voice to their victims, is now warning of an ever-growing “infodemic” alongside the coronavirus pandemic.

The Solution

Without including nurses and other healthcare professionals in developing and implementing national action plans to combat SF medical products, we will not succeed in the fight against SF medicines. Nurses are often the principal and sometimes the only health professionals providing primary healthcare in often tough settings such as hospitals and clinics at risk of being overrun by COVID-19.

2020 is the International Year of the Nurse and Midwife. Never before has the value of what nurses do been clearer to the world. As we watch nurses and other health professionals give all they have and more to fight this pandemic, the WHO has released the first ever State of the World Nursing Report. This provides compelling evidence of the value of the nursing workforce globally and calls for governments to invest in the nursing workforce.

The fight against the COVID-19 pandemic, future pandemics and fake medicines highlights the urgent need to strengthen health systems, educate more nurses and better support the ones we have. If we are to be prepared for the next health crisis – and, undoubtedly, there will be one –the health workforce requires urgent investment.


Howard Catton is the CEO of the International Council of Nurses (ICN).

Image Credits: Acumen Public Affairs, WHO.

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