Proceedings of a Symposium—in Brief

Attacks on Scientists and Health Professionals During the Pandemic

Proceedings of a Symposium—in Brief

Scientists and health professionals¹ have long been targeted in connection with their professional work. Though this problem preceded the pandemic,² it has emerged as a major concern, both in the United States and globally, as a result of COVID-19. Since the onset of the pandemic, scientists and health professionals have been subjected to threats and other attacks—online and offline—resulting from their efforts to combat the spread of COVID-19 with public health interventions and information. Reports of violence—carried out by numerous actors, including governments, groups, and individuals—are wide ranging and have come from all over the globe.³ In some cases, scientists, health professionals, and other groups have been targeted by multiple sources simultaneously, putting them at heightened risk of harm.

Beginning September 1, 2022, the U.S. National Academies of Sciences, Engineering, and Medicine (the National Academies) Committee on Human Rights (CHR)⁴ hosted five webcasts examining the global problem of COVID-19-related attacks on researchers and health professionals, along with concerns regarding repression of information during the pandemic and implications for internationally protected rights. Topics included the targeting of scientists and public health professionals for providing evidence-based health information, global patterns of violence against health personnel, censorship and the right to information, science communication and human rights amid public health emergencies, and constructing a human rights framework for online health-related speech. This Proceedings of a Symposium—in Brief provides a high-level summary of the issues discussed during the series.⁵

THE TARGETING OF SCIENTISTS AND PUBLIC HEALTH PROFESSIONALS

On September 1, 2022, leading U.S. researchers and health experts discussed pandemic-related attacks on scientists and health professionals in the United

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States, including the implications of these attacks, for targeted individuals and for society, and possibilities for addressing them.

Martin Chalfie, University Professor at Columbia University and Chair of the Committee on Human Rights of the National Academies, introduced the session by noting that violence against scientists and health professionals is a multi-faceted problem with enormous implications for society. Such attacks occur in a range of contexts, including in response to researchers’ work on sensitive topics and as a result of health professionals providing guidance and needed care in climates marked by fear, conflict, and mis- and disinformation.

Chalfie highlighted the scope of the issue, citing a 2021 Nature survey of more than 300 scientists—predominantly in the United Kingdom, Germany, and the United States—who had given media interviews related to COVID-19. More than two thirds of researchers reported having had negative experiences as a result of their media appearances or social media comments, with 22 percent receiving threats of physical or sexual violence and 15 percent receiving death threats.⁶ The International Committee of the Red Cross recorded more than 600 incidents of COVID-related violence against health personnel during the first six months of the pandemic alone.⁷ Such violence has occurred in the context of what UN Secretary General António Guterres has called “a pandemic of human rights abuses.”⁸ (According to Guterres, COVID-19 has deepened preexisting divides, vulnerabilities, and inequalities, and opened up new fractures, including fault lines in human rights). Chalfie added that scientists and health professionals are not the only groups to come under attack during the pandemic, as some governments have also used it as a pretext for stifling dissent by cracking down on journalists, political dissidents, and human rights defenders.

Georges C. Benjamin, Executive Director of the American Public Health Association (APHA), emphasized APHA’s concern about this issue and discussed the changing trends he has witnessed related to violence in the workplace. Benjamin noted that violence against health professionals has grown in recent years, due in part to increased visibility and politicization of public health activities. According to Benjamin, the increase in politicization of public health is driven in part by the expansion of social media, which can provide a platform for people to purposefully share false information as a means of generating political conflict. In Benjamin’s view, the anonymity often provided by social media can fuel attacks, empowering people to say things to health professionals they would not say in person. The growth of mis- and disinformation about public health issues on social media has also led to increased skepticism of science and science communicators.

New Research Findings: Harassment and Threats Against U.S. Public Health Officials

Beth Resnick, Assistant Dean of Public Health Practice and Director of the MSPH Program in Health Policy at Johns Hopkins Bloomberg School of Public Health, discussed recent research findings concerning harassment and threats against the U.S. governmental public health workforce, indicating that more than half of surveyed local health departments reported incidents of harassment⁹ during the pandemic.¹⁰ Resnick presented two statistics that underscore the magnitude and longevity of the problem: (1) more than one in five U.S. adults have expressed the view that harassing or threatening public health officials because of business closures during the COVID-19 pandemic was justified,¹¹ and (2) more than half of U.S. states passed legislation during the pandemic that undermines public health authority.¹² According to Resnick, harassment and stress are causing an exodus of workers from the field, thus further threatening public health agencies’ capacity and preparedness.

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To combat this issue, Resnick emphasized the need to protect and support the public health workforce, reject efforts to sideline public health, and revitalize public health agencies. This includes prioritizing public health worker safety, mental health, and wellbeing; implementing policies defending the statutory authority of public health agencies; breaking the cycle of boom- and-bust funding for governmental public health; and modernizing data systems. To raise awareness of this issue, Johns Hopkins University has joined with other partner organizations in the formation of the We Stand with Public Health initiative, which advocates for protecting and supporting public health workers along with broader opportunities to strengthen the public health infrastructure.¹³

Discussion: Attacks Against U.S. Researchers, Public Health Officials, and Other Health Professionals

Michelle Mello, Professor of Law at Stanford Law School and Professor of Health Policy at Stanford University School of Medicine, introduced a panel of health experts who also experienced harassment first-hand during the pandemic. Noting that the line between free speech and harassment has become blurred, Mello offered a definition of “targeting” that goes beyond physical violence to also include behaviors that cross a boundary between one’s professional and personal life, such as abusing a health professional’s family or engaging in ad hominem attacks on individuals rather than criticizing their policies. Targeting also includes actions such as doxing,¹⁴ online harassment, and hate speech.

Nichole Quick, Chief Medical Officer at KCS Health Center, described her personal experience with harassment in her role as the former Chief Health Officer for Orange County, CA. In March 2020, she began to receive death threats related to pandemic response efforts, resulting in the need for armed security. Quick was also subjected to a doxing attack in which her home address and other personal information was released to the public, which led to protestors congregating outside of her home. Given the safety threats to her family and community, Quick was forced to resign from her public health role and move homes. She emphasized that her situation is not unique—many public health officials continue to face similar harassment and are choosing to leave the field. According to Quick, the shrinking public health workforce will result in a loss of expertise ranging from communicable disease control to emergency preparedness, to environmental health, and beyond. She further stressed that the dismantling of public health authority will have far-reaching consequences for public safety.

Quick echoed Resnick’s call for increased support of the public health workforce, but also emphasized the need for policy change. Policies, according to Quick, need to be put in place detailing how threats will be handled and what rights workers have when they come under threat. She also called on the media to consider the weight they give certain voices when it comes to public health. For example, those engaging in harassment should not be given the same amount of airtime as health professionals sharing evidence-based information.

Peter Hotez, Dean of Baylor College of Medicine’s National School of Tropical Medicine and Co-Director of the Texas Children’s Hospital Center for Vaccine Development, discussed the experiences of biomedical scientists during the pandemic. He reiterated that threats against scientists are not new, particularly for vaccine scientists like himself who have long faced public scrutiny related to false claims that vaccines cause autism. Hotez has personally received death threats and anti-Semitic attacks, resulting in the need for protection from law enforcement. During the pandemic, vaccine scientists have been accused of harming children and taking money from pharmaceutical companies. Virologists and epidemiologists have also faced increased harassment during the pandemic. People have falsely accused virologists of creating the COVID-19 virus and epidemiologists of inflating death rates. According to Hotez, these attacks have been well-coordinated and have become an entrenched component of American politics, sometimes coming from politicians directly.

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Hotez noted that the U.S. Surgeon General has been concerned about mis- and disinformation posted through social media, but there needs to be more action addressing the groups generating the content. He explained that there is significant variability between institutions regarding how they respond to harassment of their staff, noting that too often the initial response revolves around minimizing risk to the institution rather than addressing the personal safety or mental health needs of the individual who comes under attack. Hotez suggested that institutions should have clear protocols in place that advise on the processes for handling harassment and other threats. Other suggestions from Hotez included providing young scientists with public engagement training, creating a clearinghouse akin to the Climate Science Legal Defense Fund that biomedical scientists could contact when they need support, and expanding academic study of anti-science, such as through a dedicated journal.

Aletha Maybank, Chief Health Equity Officer and Senior Vice President of the American Medical Association (AMA), discussed the related role of racism and other forms of oppression. Increased media attention to pandemic disparities, combined with growing calls for racial justice in connection with the murder of George Floyd, accelerated organized medicine’s engagement with and commitment to health equity and anti-racism. Backlash included a neo-Nazi protest in response to efforts at Mass General Brigham to help ensure access to specialized cardiac care for Black and Latinx patients.¹⁵ According to Maybank, the AMA’s work on an anti-racist agenda for medicine has been met with significant resistance, including from within the medical community. Maybank personally received death threats related to her efforts, including one scrawled on the front door of her home that led to her need for armed security.

Maybank said systems were not yet fully in place to manage these threats when she came under attack. The AMA was responsive to her physical and cyber security needs, but she was struck by the general silence and lack of urgency around the well-being of those working on racial justice in health. Maybank noted the lack of data on violence against physicians, though evidence indicates that injuries from violent attacks against health care workers in general grew 67 percent between 2011 and 2018, a trend which has continued.¹⁶ Maybank called for more robust data collection systems about violent attacks, including experiences outside the workplace and at the intersection of racism and other “-isms” (e.g., anti-Semitism, sexism, ageism), and the impact on overall well-being, psychological distress, burnout, and quality of care, with standards and measures for accountability. She also emphasized the need to dismantle dominant narratives and develop better frameworks for explaining violence, support and educate students and trainees to enter the workforce, center those who are marginalized or minoritized in developing institutional (protocols or processes) and structural (policy) solutions, and share more widely best and promising practices and solidarity-based strategies from across the health ecosystem to name, confront, and effectively resist hate-based violence and intimidation.

To sum up the panelists’ discussion, Mello offered intimidation as a theme of the targeting experienced by scientists and health professionals during the pandemic, motivated by an intent to disrupt the work of the targeted individuals. In Mello’s opinion, social media and political factors have added momentum to these attacks by harnessing the power of misinformation to generate a climate of fear, creating a perceived need to defend one’s own rights by attacking scientists and health professionals. Far beyond the personal toll targeting takes on affected scientists and health professionals, such behavior will have long-term consequences for public well-being. These threats intersect with longer running currents such as racism, anti-Semitism, and gender bias, resulting in the need for an array of supports and policies to protect scientists and health professionals.

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GLOBAL PATTERNS OF COVID-19-RELATED VIOLENCE AGAINST HEALTH PERSONNEL

On September 21, 2022, experts from the global health community gathered to explore trends, patterns, and types of pandemic-related violence against health personnel¹⁷ and health care; to examine factors driving violence in conflict zones; and to highlight measures and practices useful for preventing and addressing violence towards health systems at all levels.

Michele Heisler, Medical Director at Physicians for Human Rights and University of Michigan Professor of Internal Medicine and of Public Health, noted that the WHO defines attacks against health care as “any act of verbal or physical violence, or obstruction or threat of violence, that interferes with the availability, access, and delivery of curative and/or preventive health services.” Types of attacks can include violence with weapons, intimidation, and psychosocial threats. Attacks often impair the delivery of health care and result in distress and burnout among health workers. Reports of violence against health care have surged globally since the start of the pandemic, and direct and deliberate attacks against health care facilities and personnel in war and conflict zones continue to occur with alarming frequency.

In 2022, the International Council of Nurses, International Committee of the Red Cross,¹⁸ International Hospital Federation, and World Medical Association released a report, Violence Against Healthcare: Current Practices to Prevent, Reduce or Mitigate Violence Against Health Care, that shared practices for addressing this issue.¹⁹Clarisse Delorme, Senior Policy Advisor at the World Medical Association (WMA), noted that the WMA began receiving reports early on in the pandemic about increasing incidents of violence around the world. Between May and July 2021, the WMA and its partner organizations carried out a joint survey to evaluate the perceptions of violence against health personnel and to identify practices to prevent, reduce, or mitigate these types of incidents. Survey respondents reported more than 400 attacks on health personnel, and every respondent reported experiencing verbal aggression. Four main types of violence were reported—verbal aggression, physical aggression, damage or loss (e.g., destruction or theft) of assets, and obstruction of care, with verbal violence being the most common. The types of violence reported in the survey are shown in Figure 1.²⁰ The survey also identified triggers for COVID-related violence against health care. A common context in which such violence occurs is when health personnel encounter individuals opposed to health measures intended to constrain spread of the virus.

Hoi Shan Fokeladeh, Policy Advisor for Nursing and Health Policy at the International Council of Nurses (ICN), noted that, though attacks against health personnel are not a new phenomenon, reports indicate that the treatment of health personnel during the pandemic has resulted in unprecedented rates of depression, stress, burnout, and PTSD, particularly among frontline nurses. In addition to the aforementioned joint report, the ICN produced a survey, Protecting Nurses from COVID-19 a Top Priority: A Survey of ICN’s National Nursing Associations, which captured data

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from national nursing associations and indicated that more than 70 percent of responded associations received reports of violence or discrimination against frontline health personnel due to COVID-19.²¹

Eric Kwezi, International Committee of the Red Cross’s (ICRC) Deputy Health Coordinator in Yemen, noted that violence against health care has long been a problem in countries experiencing conflict. He added that wounding, arresting, or otherwise targeting health professionals often results in continuity of care disruptions, which can have serious health implications for patients.

Panelists identified factors contributing to COVID-related violence against health professionals, including mistrust of the government and health systems, stigma, increased contact with the health care system, and scapegoating of health professionals as an outlet for negative emotions generated by the pandemic. The disruption of health services was named as both a symptom and a driver of violence against health professionals. For example, the canceling of elective procedures while hospitals are over capacity has led to some instances of violence, which further disrupt provision of care, creating a harmful cycle. Five key areas were identified for improvement: security, work environment, mental health and wellbeing, communication, and coordination. Fokeladeh cited a law introduced in Italy as an example of a multi-sector approach to address violence.²² The law, approved by Italy’s parliament in September 2020 with the specific intent to address violence against health professionals, creates a national observatory under the Minister of Health. The observatory is meant to promote the study and the reduction of risk factors to health professionals, to monitor the implementation of safety measures including video surveillance tools, and to promote best practices and specific trainings for health professionals. The law also increases legal consequences for those targeting health personnel.

Panelists offered specific suggestions for addressing violence against health professionals in the workplace, including implementing security measures, providing health professionals with training on communication and de-escalation techniques, and creating monitoring and reporting systems for violent incidents. Broader suggestions included building partnerships with stakeholders to strengthen efforts to protect health professionals, encouraging universities to integrate international human rights law into their curricula, and raising awareness of the issue among both the public and those in the health profession.

CENSORSHIP AND THE RIGHT TO INFORMATION DURING THE PANDEMIC

On September 29, 2022, a panel of experts examined global concerns regarding governmental repression of public health information related to the pandemic. Panelists discussed the challenge of protecting freedom of expression and access to information during the pandemic, while addressing concerns regarding mis- and disinformation.

Vivi Stavrou, Executive Secretary of the International Science Council’s Committee for Freedom and Responsibility in Science, highlighted the importance of the protections contained in the Universal Declaration of Human Rights (UDHR) for researchers and journalists. Article 19 of the UDHR declares that all people are free to receive and share information and ideas through any media, while Article 23 states that everyone has the right to benefit from science, engage in scientific inquiry, and communicate scientific knowledge. COVID-19 has made clear that these rights are often the first to be attacked in times of crisis. The pandemic prompted repression of these rights from governments around the world, according to Stavrou, creating an environment in which censorship and disinformation have flourished.

Stavrou noted that attacks against science are a recurring phenomenon in times of crisis. She highlighted the example of Dr. Elizabeth Bik, a Dutch microbiologist who researches scientific integrity. Dr. Bik questioned the effectiveness of hydroxychloroquine against COVID-19, resulting in what Stavrou described as “toxic and sustained blowback” from mainstream and social media. This example highlights the dangers of

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curtailing freedom of scientific expression and inquiry, which is essential to holding scientists, governments, and businesses to account. Efforts to censor scientific critique or debate not only undermine scientific freedom and accountability but can also pose significant costs to human lives.

Joel Simon, Research Fellow at Columbia University’s Tow Center for Digital Journalism and former Executive Director of the Committee to Protect Journalists, said that journalists and scientists have shared a similar reality during the pandemic. According to Simon, though the past decade has seen a sharp decline in press freedom, a crackdown on the scale of what occurred during the first six months of the pandemic was unprecedented. Much of the pandemic-related media censorship in this period was also scientific censorship, as governments sought to silence journalists covering scientific perspectives on the pandemic that differed from official government narratives. Simon added that censorship strategies look different in different countries and reflect countries’ political environments. Authoritarian governments often resort to more traditional strategies such as imprisonment of journalists and outright suppression of information, while democracies are more likely to censor via flooding or noise, effectively drowning out conflicting narratives.

Michel Roberto de Souza, Public Policy Director at Derechos Digitales, discussed the responsibilities of governments and businesses to protect and uphold freedom of expression and opinion, particularly during public health emergencies. De Souza noted that governments are responsible for providing truthful and reliable information to the public while simultaneously addressing false information. Delayed access to truthful information can put lives at risk and generates distrust among the public, which can have a chilling effect on freedom of expression. According to de Souza, governmental and corporate measures which restrict the sharing of information, such as content moderation, must be necessary and proportional to, in this case, the legitimate aim of protecting public health. This includes digital surveillance measures, which can violate privacy rights. De Souza added that surveillance must be transparent; users should know what information is being collected and why. He also highlighted issues related to internet shutdowns. Internet access proved essential not only for communicating important public health information, but also for continuing work and education during the early months of the pandemic, underscoring the necessity of sustained universal internet access.

Panelists also discussed how the line between legitimate and illegitimate governmental restrictions on rights has often become blurred. Governments have more latitude when curtailing rights such as movement and assembly in the interest of public health than when restricting freedom of expression and other political rights.

REFLECTIONS ON SCIENCE COMMUNICATION & HUMAN RIGHTS AMID PUBLIC HEALTH EMERGENCIES

The pandemic has underscored the critical role science communication plays during public health emergencies. On October 20, 2022, experts gathered to discuss the role of public health officials and journalists in advancing human rights, as well as issues such as misinformation and the politicization of, and trust in, science.

Helle Porsdam, Professor of History and Cultural Rights at the University of Copenhagen’s Centre for Interdisciplinary Studies of Law and Faculty of Law, introduced the discussion by noting that everyone has the right to enjoy the benefits of scientific progress. This right is enshrined in the UDHR but is also made legally binding through Article 15 of the International Covenant on Economic, Social and Cultural Rights, which obligates states to take steps towards the conservation and dissemination of science and to respect scientific freedom.

Chris Beyrer, Director of the Duke Global Health Institute and member of the Committee on Human Rights of the National Academies, discussed his role in the U.S. COVID-19 vaccine trials, including efforts to protect the integrity of the trials against politicization. Beyrer noted that the pandemic has brought about unprecedented sharing of mis- and disinformation about public health,

which has contributed to vaccine hesitancy. To ensure the safety and efficacy of the vaccines, researchers sought to ensure that volunteers participating in trials were representative of the U.S. population. Efforts to slow down the COVID-19 vaccine trials to ensure accurate population representation were met with political pressure, according to Beyrer. He explained that some politicians wanted the vaccines to be rolled out ahead of the November 2020 presidential election, despite knowing this would require ending the trials early. Ultimately, the U.S. Food and Drug Administration did not stop the trials early, which protected their integrity and allowed scientists to communicate accurately about the vaccine’s efficacy and safety.

In contrast, Beyrer described the vaccine trial process in Russia as not being conducted according to international safety standards. As a consequence, high levels of vaccine hesitancy occurred in the country, resulting in significant excess mortality. Russia’s actions, according to Beyrer, constitute a violation of the Russian public’s right to benefit from science, given the legitimate questions surrounding the vaccine’s safety and efficacy.

Bina Venkataraman, Editor-at-Large of The Boston Globe and Fellow at Harvard University’s Belfer Center for Science and International Affairs, noted that the role of journalists during public health crises is to be a voice of clarity and reassurance, but also to hold institutions accountable for their decisions. She discussed the challenges journalists have faced in determining which voices to elevate during the pandemic, particularly when it became clear that a gap existed between the recommendations coming from leading epidemiologists and those coming from the Centers for Disease Control and Prevention. She noted that journalists are often reluctant to weigh in on scientific matters due to information asymmetries. Their uncertainty in such situations can limit the channels through which the public can access reliable scientific information. Venkataraman emphasized the importance of public trust during times of crisis, adding that The Boston Globe used its Editorial Board to call out actions that threatened to erode trust in public health institutions. This includes efforts by politicians to manipulate scientific information through the “bully pulpit.” For example, tweets from politicians that included the hashtag “#FireFauci” served to erode public trust in U.S. health agencies that are responsible for providing evidence-based responses to public health issues.

The panel discussion further explored issues related to the reliability of information and the resulting implications for public health. Beyrer explained that mistrust and mis- and disinformation have had direct effects on vaccine hesitancy, which has been found to follow political party lines. He noted that some forthcoming research suggests that a significant percentage of differential COVID-related deaths by political affiliation may be attributed to mis- and disinformation. The panelists also discussed ways to foster trust between the public and scientists and health professionals. Beyrer explained that uncertainty about the scientific process has been a leading driver of anxiety over vaccines. One way he and his colleagues attempted to maintain trust was by publishing a blog, titled “Vaccine Matters,” to communicate directly with the public in real time about what was happening behind the scenes with vaccine development. This blog was written for a lay audience to humanize and give transparency to the process. Venkataraman added that to build trust, journalists and scientists must engage directly with communities about their concerns and elevate voices that those communities already trust.

CONSTRUCTING A HUMAN RIGHTS FRAMEWORK FOR ONLINE HEALTH-RELATED SPEECH

Concerns about freedom of expression and access to information during public health emergencies, and about inaccurate health information, increasingly involve online speech. On October 26, 2022, panelists discussed the promotion and protection of the right to freedom of opinion and expression and explored possibilities for a human rights-based approach to the regulation of online health-related speech.

Carlos del Rio—Leon L. Haley Jr. MD Distinguished Professor of Medicine, Global Health, and Epidemiology at Emory University’s School of Medicine; International

Secretary of the U.S. National Academy of Medicine; and Member of the Committee on Human Rights of the National Academies—introduced the conversation by noting that one of the most pressing information-sharing challenges to arise from the pandemic relates to social media and other online platforms. These platforms have been essential for sharing public health information but have also served to amplify false information and enable abuse of researchers and health professionals. Confronting the challenges these platforms pose will be critical for protecting public health and human rights in an increasingly digital world.

Evelyn Aswad, Herman G. Kaiser Chair in International Law and Director of the Center for International Business and Human Rights at the University of Oklahoma’s College of Law, noted that one troubling trend to arise during the pandemic is governmental use of measures such as censorship, sanctions, and “fake news” and cybercrime laws to control the narrative on health care-related information.

David Kaye, Clinical Professor of Law at the University of California’s Irvine School of Law and former United Nations Special Rapporteur on the promotion and protection of the right to freedom of opinion and expression, described the key international human rights standards that provide guidance related to freedom of expression. One of the main tools is the International Covenant on Civil and Political Rights (ICCPR). Article 19 of the ICCPR protects everyone’s right to seek, receive, and impart information and ideas of all kinds, regardless of frontiers and through any medium. Article 19 also acknowledges that state actors may restrict this right in certain narrow contexts, including for the protection of public health, as long as restrictions are legal, necessary, and proportionate. Kaye also discussed the UN Guiding Principles on Business and Human Rights (Guiding Principles),²³ which make clear that countries’ human rights obligations extend to protecting individuals from human rights violations at the hand of companies. The Guiding Principles assert that companies are responsible for ensuring that their activities do not interfere with individuals’ enjoyment of human rights; when faced with issues relating to health disinformation, companies need to consider whether the information they allow to be hosted on their platforms is consistent with freedom of expression norms and what human rights implications are associated with hosting such information.

Aswad and Kaye discussed governmental actions that intersect with public health, access to information, and freedom of expression. States are increasingly imposing new laws that carry criminal penalties for sharing information the government determines to be false in some way. Many governments are using this framework to restrict legitimate discussion. Governments themselves also use disinformation as a way of crowding out legitimate information. According to Kaye, this effectively restricts individuals’ rights to seek and receive information and can impair their ability to make sensible health decisions. Aswad noted the increasing use of internet shutdowns as another governmental tool for quieting health speech. Internet shutdowns have emerged as a blunt tool used by governments to limit the ability of people to share information and criticize the government. This method of limiting information sharing can have particularly deadly consequences during times of crisis, including pandemics, as the public can be denied access to potentially-lifesaving information. Government surveillance efforts, such as those associated with COVID-19 testing and contact tracing, have also posed challenges related to the right to privacy.

The speakers examined tools available to private platforms grappling with these issues. Platforms should consider deploying measures that are necessary and proportionate²⁴ to the legitimate aim of protecting public health. Such measures could include labeling content, having fact checkers review material, and limiting the sharing or distribution of certain content. The Oversight Board, which reviews content moderation decisions on Facebook and Instagram (and on which

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Aswad serves), is an example of an independent review mechanism that seeks to promote human rights approaches to online content moderation. Key to any of these tools is transparency regarding how decisions to moderate content are made. The European Union has taken steps to provide researchers with access to companies working in this area, which would increase transparency. Frameworks also exist to help guide companies’ decision-making. Kaye chairs the Global Network Initiative (GNI), which encourages companies to respect international human rights standards related to freedom of expression and privacy. The group has developed the GNI Principles, which offer a framework for responsible company decision making in support of freedom of expression and privacy rights.²⁵ The UN Guiding Principles also provide a framework for thinking through how the rules companies adopt might affect their users’ rights.

Aswad and Kaye identified actions health professionals can take to address online health-related mis- and disinformation. Kaye encouraged health professionals to focus on being a resource to their patients in one-on-one settings by providing information that can help patients to make informed health care decisions. Aswad added that promoting digital literacy campaigns is also useful.

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DISCLAIMER This Proceedings of a Symposium—in Brief was prepared by Ana Deros and Jen Saunders as a factual summary of what occurred during the series. The statements made are those of the rapporteurs or individual meeting participants and do not necessarily represent the views of all meeting participants; the Committee on Human Rights; or the National Academies of Sciences, Engineering, and Medicine.

COMMITTEE ON HUMAN RIGHTS STAFF: REBECCA EVERLY, Director; PATRICIA EVERS, Deputy Director; TRACY SAHAY, Program Officer; ANA DEROS, Research Associate; and PAMELA GAMBLE, Senior Program Assistant.

REVIEWERS To ensure that it meets institutional standards for quality and objectivity, this Proceedings of a Symposium—in Brief was reviewed by ROHINI HAAR, University of California, Berkeley; RANIT MISHORI, Georgetown University; JOSHUA SHARFSTEIN, Johns Hopkins University; and HEIDI TWOREK, University of British Columbia.

For more information, visit: https://www.nationalacademies.org/chr/.

Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2023. Attacks on Scientists and Health Professionals During the Pandemic: Proceedings of a Symposium—in Brief. Washington, DC: The National Academies Press. https://doi.org/10.17226/26936.

Policy and Global Affairs Copyright 2023 by the National Academy of Sciences. All rights reserved.