San Diego County calls medical misinformation a health crisis after 15-hour debate

A crowd cheers a critic of the county Board of Supervisors' plan to declare medical misinformation a public health crisis.
Audience members respond during public comments criticizing a San Diego County Board of Supervisors plan to declare medical misinformation a public health crisis.
(Nelvin C. Cepeda / The San Diego Union-Tribune)

After a 15-hour, sometimes rancorous meeting Aug. 31, the San Diego County Board of Supervisors approved a measure declaring medical misinformation a public health crisis.

The board voted 3-2 after more than 250 people signed up and most spoke against the motion, saying it would lead to restrictions on free speech and other violations of personal freedoms.

“We’re in the unfortunate position of taking action against an issue we wished didn’t exist,” said Board of Supervisors Chairman Nathan Fletcher, who said the measure would not curb free speech or impose any sanctions or punishments against anyone spreading misinformation, which he said “has led people to decline [COVID-19] vaccines and use unproven treatments.”

The measure does not contain penalties for what officials deem misinformation, he said.

“Nothing in this measure would take away anyone’s right to say whatever they want to say,” Fletcher said.

The board considered the new designation in an effort to turn up the spotlight on accurate medical information and discourage people from heeding inaccurate or misleading information, especially as the Delta variant of the COVID-19 coronavirus continues to surge and some people continue to push back against pandemic restrictions and vaccination efforts, officials said.

The action makes San Diego County the first in the nation to name medical misinformation as a public health crisis, Fletcher said.

Supervisors Jim Desmond and Joel Anderson, both Republicans, voted no on the measure, while Fletcher and Supervisors Nora Vargas and Tera Lawson-Remer, all Democrats, voted in favor.

The measure would create platforms for local medical authorities to counter misinformation and would direct the county to follow the recommendations of U.S. Surgeon General Vivek Murthy in his advisory “Confronting Health Misinformation.” They include identifying and labeling health misinformation, examining gaps in health information, documenting sources and impact of misinformation, developing digital resources and training for health professionals, and working with the medical community to develop websites.

“The resurging pandemic has led to more infections and hospitalizations than the region has seen since the beginning of the year, and ICU capacity is once again being tested,” the county’s proposal states. “Urgent action is needed to curb the spread of the Delta variant by combating misinformation, thereby supporting our health care system and, in turn, saving lives.”

Anderson said the declaration was well-intentioned but misguided.

“I do appreciate that none of us want to see our neighbors die, or our family and friends, but I don’t know how you stop misinformation, nor would I want to,” he said.

Desmond, who tweeted thanks to opponents during the meeting, said shifting medical advice on COVID-19 makes it hard to discern what is sound advice vs. misinformation.

“Misinformation I agree is dangerous,” he said. “However, it is hard for me to believe that we or anyone we know knows everything about medicine. Today’s facts may be tomorrow’s misinformation.”

The idea of labeling misinformation drew hundreds to the meeting, including dozens who gathered at the request of people who have protested vaccination and mask requirements in recent weeks. Speakers made short statements in person and by phone until public comments officially ended just before midnight.

Cindy Paris and her daughter Gracie, 16, speak at the county Board of Supervisors meeting.
Cindy Paris and her daughter Gracie, 16, told the county Board of Supervisors that because of their medical history, they could not be vaccinated safely against COVID-19.
(Nelvin C. Cepeda / The San Diego Union-Tribune)

Throughout the meeting, some protesters shouted insults at supervisors, booed statements they opposed and cheered for speakers who berated board members.

After several hours, demonstrators outside the meeting loudly sang a rendition of “The Star-Spangled Banner,” drowning out other speakers who also were criticizing county officials.

Demonstrators said they consider the measure a form of censorship that muzzles their free speech.

“From what you released there, Nathan, it’s all about control,” said speaker Ryan Smith. “You’re attacking free speech.”

Some asked how the county would determine what constitutes misinformation and how would it distinguish truth from fact amid the rapidly evolving understanding of the pandemic.

Others called county officials tyrants, fascists or traitors.

Misinformation about the COVID-19 shots includes “unfounded notions that the vaccines don’t work, that they contain microchips, that people should rely on their ‘natural immunity’ instead of being vaccinated, that the vaccines cause miscarriages,” the board letter states.

Those assertions have stoked vaccine hesitancy at a time when health officials are trying to close gaps in vaccination rates, officials said.

Though some 75 percent of people 12 and older in San Diego have received COVID-19 shots, it has been difficult to persuade the remainder, officials said.

While many of the speakers at the meeting were against the proposal, not all were.

Patty Maysent, chief executive of UC San Diego Health, spoke in favor of getting better information to the public, saying misinformation is compromising the ability to care for desperately sick patients.

“Our health care workers are really tired,” she said. “They’re really stressed. The environment is really growing more hostile.” ◆