Physicians say they regularly treat people more inclined to believe what they read on Facebook than what a medical professional tells them.
An emergency room doctor in Illinois was accused in April of profiting from naming coronavirus as the cause of a patient's death, a rumour spreading online.
An internist in New York treated a vomiting patient in May who drank a bleach mixture as part of a fake virus cure found on YouTube.
And in June a paramedic in Britain aided a clearly sick man who had refused to go to a hospital after reading misleading warnings about poor coronavirus treatment on social media.
Doctors on the front lines of the global pandemic say they are fighting not just the coronavirus, but also increasingly combating a never-ending scourge of misinformation about the disease that is hurting patients.
Before the pandemic, medical professionals had grown accustomed to dealing with patients misled by online information, a phenomenon they called Dr. Google. But in interviews, more than a dozen doctors and misinformation researchers in the United States and Europe said the volume related to the virus was like nothing they had seen before. They blamed leaders like President Donald Trump for amplifying fringe theories, the social media platforms for not doing enough to stamp out false information and individuals for being too quick to believe what they see online.
Last week, researchers said that at least 800 people worldwide died in the first three months of the year, and thousands more were hospitalised, from unfounded claims online that ingesting highly concentrated alcohol would kill the virus. Their findings, based on studying rumours circulating on the web, were published in the American Journal of Tropical Medicine and Hygiene.
Doctors' frustrations fill Facebook groups and online forums. The American Medical Association and other groups representing doctors say the false information spreading online is harming the public health response to the disease. The World Health Organization is developing methods to measure the harm of virus-related misinformation online, and over two weeks in July the group hosted an online conference with doctors, public health experts and internet researchers about how to address the problem.
Doctors say patients regularly resist their counsel, more inclined to believe what they read on Facebook than what a medical professional tells them. The falsehoods, they say, have undermined efforts to get people to wear masks and fueled a belief that the seriousness of the disease is overblown. Some doctors say they face abuse when they participate in online discussions to correct the record.
"This is no longer just an anecdotal observation that some individual doctors have made," said Daniel Allington, a senior lecturer at King's College London and co-author of a recent study that found people who obtained their news online, instead of from radio or television, were more likely to believe in conspiracy theories and not follow public health guidelines. "This is a statistically significant pattern that we can observe in a large survey."
Dr. Howard Mell, an emergency room physician in an Illinois suburb of St. Louis, said the wife of a man who had died from the coronavirus in April accused him of falsely filling out the death certificate to make more money for himself. He explained that the form was accurate and that his pay was not based on the cause of death.
"She yelled, 'We've seen online how you guys get more money,' " Mell said.
Since then, the situation has not improved, he said. Several times per week, he meets someone who believes false medical information that was discovered online.
"It has absolutely become a job unto itself," said Mell, who is also a spokesman for the American College of Emergency Physicians, a group representing ER doctors.
Some doctors say they get into arguments with patients who demand prescriptions for hydroxychloroquine, the unproven drug championed by Trump. At some hospitals, people have arrived asking for a doctor's note so they do not have to wear a mask at work because they believe it will harm their oxygen levels, another online rumour.
"Now the numbers have picked way back up again, and I feel a lot has to do with things on social media, like this isn't a big deal, and we don't have to take all these steps," said Dr. David Welsh, a surgeon in Indiana who has treated coronavirus patients, referring to a recent infection surge in his area.
Online platforms like Facebook and YouTube, which is owned by Google, have introduced policies to limit coronavirus misinformation and elevate information from trusted sources like the World Health Organization. This month, Facebook and Twitter removed a post by Trump's reelection campaign that falsely claimed that children do not get coronavirus.
"We have been aggressive in both removing harmful false claims and directing people to authoritative information," Facebook said in a statement. The company, which held a call with doctors in June to hear their concerns, said it had removed more than 7 million pieces of virus misinformation and added warning labels to millions more.
YouTube said it was "committed to providing timely and helpful information around Covid-19" and had removed more than 200,000 dangerous or misleading videos.
But untrue information continues to spread. Last month, a video from a group of people calling themselves America's Frontline Doctors was viewed millions of times. It shared misleading claims about the virus, including that hydroxychloroquine is an effective coronavirus treatment and that masks do not slow the spread of the virus.
The scale of the problem led last month to a British parliamentary report that added to calls in the country for tougher laws against the largest social media platforms, like Facebook and YouTube.
Dr. Ryan Stanton, an emergency room physician in Kentucky, said a number of sick patients had waited until it was nearly too late to visit a hospital because they were convinced by what they had read online that Covid-19 was fake or "no big deal."
"They thought it was just a ploy, a sham, a conspiracy," Stanton recalled. "It just blew my mind that you can put these blinders on and ignore the facts."
Thomas Knowles, a paramedic in Britain, said a person in June refused to be admitted after reading that hospitals would make his condition worse. The incident so troubled Knowles that he went searching social media for virus-related misinformation, where he encountered false claims like doctors taking people's blood for research and then leaving them to die.
"I've never personally encountered such a strong, consistent — and so clearly coordinated from somewhere — collective of people so entrenched in their false beliefs," Knowles said.
Some doctors in cities like New York said the volume of patients believing misinformation had declined as the disease swept their area. But, they said, it remained a troubling trend.
Dr. Parinda Warikarn, who works at Elmhurst Hospital Center in New York, said the patient who had ingested bleach after seeing the bogus treatment on YouTube came into the hospital with severe abdominal pain.
"He clearly really believed that he was going to prevent Covid," she said. "Luckily, his wife and two young children didn't take this solution."
A growing fear is that vaccine conspiracy theories could undermine eventual vaccination efforts, said Dr. John Wright from the Bradford Institute for Health Research in England.
"Social media brings many great things, but it also provides a platform to sow the seeds of doubt, and that's what has happened," he said.
Wright recalled that Congolese immigrants believed a social media rumour that Covid-19 was a government trick to deport them, and that others, from the Indian community, cited posts about doctors intentionally infecting patients. A nurse at the hospital complained to Facebook about people posting names and pictures of health workers accusing them of leaving patients to die.
Mell, the physician in Illinois, encounters regular abuse from Facebook users when he has pushed back on false information. But he believes the effort is necessary to keep falsehoods from spreading.
"Doctors have to continue to speak the truth as loudly as we can," he said. "People need to hear it."
Written by: Adam Satariano
Photographs by: Jess T. Dugan, Dave Sanders, Eve Edelheit and Dylan Cole
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