Combating the COVID-19 infodemic: a three-level approach for low and middle-income countries.

### Summary box The COVID-19 crisis has contributed to the development of an ‘infodemic’ that hinders an adequate public health approach to managing the crisis. The WHO defines an infodemic as an ‘overabundance of information—some accurate and some not—that occurs during an epidemic’.1 Fake news, propaganda and conspiracy theories, ubiquitous in the era of social media, have spread since the beginning of the COVID-19 pandemic. Reports suggest that a rumour is three times more likely to be spread in social media than accurate information.2 This is of great concern as it often leads to reduced trust in health institutions and services and impedes the evidence-informed approach in managing the pandemic. The infodemic may also promote hate speech and associated stigmatisation which may contribute to exclusions of vulnerable sections of society. The adverse effects of the infodemic may be exacerbated in low and middle-income countries (LMICs) where low health literacy levels, poor health infrastructure and poor resource settings exist. One example is the spread of misinformation that concentrated alcohol can …