The Impact of COVID-19 on Nurses:

“Coronavirus is a Hoax” The Birth of Conspiracy Theories and the Politicalization of COVID-19

Mary C. Vrtis, Ph.D., M.A., MSN, RN, OCN, NEA-BC, FCN

September 18, 2025

Time to read:

Support for Nurses in the Early Days – Focus on New York City

In the early days of the pandemic in New York City, there were so many victims of COVID-19 infections who died that refrigerated trucks were needed to serve as temporary morgues. In late March 2020, in response to a social media movement #clapbecauseyoucare, New Yorkers who were quarantined began to clap for healthcare workers, first responders, and essential workers at exactly 7 pm every evening. Given the horrors that healthcare workers and first responders were facing, this moving gesture was greatly appreciated (Jeffrey, 2020), at least initially.

This video from March 28, 2020, from ABC, channel 7, demonstrates the support shown for healthcare providers, emergency medical services, the police, and other essential workers  (https://abc7news.com/clapbecausewecare-clapbecausewecare-new-york-city-7pm-clap-nyc/6058316/)

People from all over the five boroughs of New York City opened their windows and clapped for several minutes. Health care providers would sometimes step outside a hospital to see and hear this important gesture from neighbors. These thank you efforts lasted into April of 2020, and similar support for health care providers also started in other large cities.  

The video from Northwell Health from April 8, 2020, shows how the community demonstrated support for staff at Lenox Hill Hospital in Manhattan through the clapping and thank you letters. (https://www.youtube.com/watch?v=eq4WqsIKZX8mm). As shown in the video, New Yorkers were well aware by this time that nurses and other direct care providers faced a very real risk of death when caring for infected patients. In the video, clinicians from Lenox Hill discussed how important community support was.

From Heroes to Demons: The Villainization of Nurses and Medical Experts

Then suddenly, the situation began to change. Disinformation was rampant. Conspiracy theorists began to introduce negative messaging that demonized nurses, medical experts, public health officials, scientists, and other healthcare providers who were trying to save lives (Alba and Frenkel, 2020 March 28). By March 2021, 21.9% of 2,500 nurses surveyed reported that they experienced violence in the workplace and by September 2021 that number had increased to 30.6% (National Nurses United, 2022, April 14). We will do a deeper dive into this topic below.  

Between March 2020 and January 2021, over half of U.S. local health departments surveyed had staff members who had been subjected to at least one episode of harassment. There were over 1,499 episodes of some form of attack on local health department professionals reported during this 10-month period.  At least 222 public health officials left their positions due to “intimidating acts,” “undermining of professional duties, marginalization of their expertise, social villainization, and disillusionment” (Ward, et al., 2022).

Attacks targeting nurses, medical professionals, public health staff, and physician-scientists who were trying to do everything possible to save lives and find solutions were a worldwide phenomenon. Dr. Anthony (Tony) Fauci, the world-renowned infectious disease specialist who played a crucial role in the U.S. response received so many death threats directed toward himself and his family that he had to hire a security team for protection (Fauci, 2024).

A Political Rally in South Carolina February 28, 2020

On February 28, 2020, Dr. Tedros Adhanom Ghebreyesus, the Director-General of the World Health Organization opened a briefing to update the media on the status of emerging COVID-19 epidemics in multiple countries on February 28, 2020. In his opening remarks he expressed concern as to how rapidly the SARS-CoV-2 virus was spreading throughout the world. Figure one shows the information from the World Health Organization situation report #39 published on that same date. On the day that Dr. Tedros expressed concern about the novel virus rapidly spreading across the globe, on February 28, 2020, the Republicans held a rally in South Carolina for the upcoming presidential race. During a long monologue, then President Trump used the word “hoax.”

The following is from a transcript of statements made during this segment of the rally as recorded on https://rev.com:

“Now the Democrats are politicizing the coronavirus, you know that right? Coronavirus, they’re politicizing it. We did one of the great jobs. You say, ‘How’s President Trump doing?’ They go, ‘Oh, not good.’ They have no clue. They don’t have any clue. They can’t even count their votes in Iowa. They can’t even count. No, they can’t. They can’t count their votes.

One of my people came up to me and said, ‘Mr. President, they tried to beat you on Russia, Russia, Russia.’ That didn’t work out too well. They couldn’t do it. They tried the impeachment hoax. That was a perfect conversation. They tried anything. They tried it over and over. They’d been doing it since you got in. It’s all turning. They lost. It’s all turning. Think of it. Think of it. And this is their new hoax. But we did something that’s been pretty amazing. We have 15 people in this massive country and because of the fact that we went early. We went early, we could have had a lot more than that. We’re doing great. Our country is doing great…’”

“So a number that nobody heard of, that I heard recently and I was shocked to hear it, 35,000 people on average die each year from the flu. Did anyone know that? 35,000, that’s a lot of people. It could go to 100,000, it could be 27,000. They say usually a minimum of 27, goes up to 100,000 people a year die. And so far we have lost nobody to coronavirus in the United States. Nobody. And it doesn’t mean we won’t and we are totally prepared. It doesn’t mean we won’t, but think of it. You hear 35 and 40,000 people and we’ve lost nobody and you wonder the press is in hysteria mode. CNN fake news and the camera just went off, the camera. The camera just went off. Turn it back on…” (Egan, 2020; Trump, 2020 February 28).

Though he did NOT specifically state that the virus or the pandemic was a hoax, referring to the Democrats, he stated: “And this is their new hoax,” without clarification. He then went into a confusing series of remarks about death rates for the flu. Given the information in the transcript above, it is not surprising that some of his followers began to view the COVID-19 pandemic as a hoax. Nor is it surprising that many misinterpreted these statements to mean that the flu was more likely to be deadly than COVID-19.

Looking back in time, it is easy to see that at the end of February 2020, most Americans were not very concerned about an infection that was causing illness in China, some 7,000 miles away.

During the White House Coronavirus Task Force briefing on February 29, 2020, a reporter asked: “You were down in Charleston last night using the word ‘hoax’ when talking about Democrats. Somebody is now dead from this. Do you regret that kind of talk?”

The President: “No, no, no. ‘Hoax’ referring to the action that they take to try to pin this on somebody, because we’ve done such a good job. The hoax is on them, not – I’m not talking about what is happening here; I’m talking what they’re doing. That’s the hoax. That’s just a continuation of the hoax, whether it’s the impeachment hoax, or the ‘Russia, Russia, Russia” hoax. This is what I’m talking about. Certainly not referring to this. How could anybody refer to this? This is very serious stuff.”

“But the way they refer to it – because these people have done such an incredible job, and I don’t like it. And that’s the hoax. That’s what I’m talking about.”

Trump White House Archives (2020, February 29). Remarks by President Trump, Vice President Pence, and members of the Coronavirus task force in press brief. https://trumpwhitehouse.archives.gov/briefings-statements/remarks-president-trump-vice-president-pence-members-coronavirus-task-force-press-conference-2/

Politicization of the Emerging COVID-19 Pandemic

When SARS-CoV-2 emerged in December of 2019, the U.S. was bitterly divided over political issues and in the midst of highly polarized Presidential election campaigns. Though Trump did not himself say that the pandemic was a hoax – an entire alternate reality was constructed within social media platforms around the deliberate disinformation that COVID-19 was not real. Staunch defenders of the MAGA (Make America Great Again) movement appeared to sincerely believe that the pandemic was a hoax created by the Democrats to hurt Trump politically. Many of the followers already accepted a number of other, unrelated conspiracy theories that are beyond the scope of this document. People who accepted the hoax idea had little to no interest in listening to messaging from the Centers for Disease Control and Prevention about the deadly potential of this virus.

Conspiracy Theories Sow Mistrust

Conspiracy theories are a form of deliberate disinformation created by individuals or groups with an agenda to target people who can be swayed to believe. Many conspiracy theories are presented in such a way that people can easily get drawn in by a mixture of truth and lies. Other conspiracy theories are so outrageous that it is hard to understand how anyone could consider the assertions to be factual (Grimes, 2021).

Individuals who believe in one conspiracy theory tend to accept multiple conspiracy theories, even when they do not make sense or when one accepted theory is in direct conflict with another (Chadwick, et al., 2021; Imhoff & Lamberty, 2020). “Conspiracy mentality” is a phrase used to describe this attitude of acceptance that the world is ruled by secret, very powerful forces. These forces are sinister and cannot be trusted, so believers cannot trust in social norms, experts and scientists who may be part of the conspiracy (Imhoff & Lamberty, 2020).

Most conspiracy theories related to COVID-19 are based on the belief that there are secret plots behind the public health emergency. Belief that COVID-19 was hoax and a conspiracy led to suspicion of public health officials and medical personnel. Factual, accurate information and recommendations that were in conflict with the conspiracy theory were ignored (Chadwick, et al., 2021; Imhoff & Lamberty, 2020).

Conspiracy theories are an international phenomenon and social media facilitates dissemination. COVID deniers, people who did not trust that the virus or pandemic were real could be found across the globe.

In May of 2020, Bruder and Kunert (2022) analyzed data from the German national COVID-19 Snapshot Monitoring (COSMO) survey conducted from May 12 to 13, 2020 (n=1,013). The Conspiracy Mentality Questionnaire was used to measure:

• Belief in conspiracy theories.
• Social fears and worries, about losing loved ones, financial, job loss, etc.
• Trust in media, public health representatives, government, and science. 

Financial and economic worries such as job loss and recession and belief in conspiracy theories were linked, but fear of losing a loved one was not. Beliefs in conspiracy theories and mistrust of government, public health, and media were connected (Bruder & Kunert, 2022).    

Unfortunately, acceptance of various conspiracy theories is very widespread. One recent survey of 1,010 adults and 1,012 teens conducted for the Center for Countering Digital Hate (CCDH) found that almost half of adults (49%), 60% of teens 13-17 years old, and 69% of teens who were “high social media” users believed at least four of the eight most common, widespread conspiracy theories. Three of these were important during the COVID-19 pandemic:

“Anti-vaccine -The dangers of vaccines are being hidden by the medical establishment.”

• 47% of adults, 58% of teens, 66% of high-use teens indicated this statement was true.

“COVID-19 – The coronavirus is being used to force a dangerous and unnecessary vaccine on the public.”

• Believers: 43% of adults, 54% of teens, 61% of high-use teens.

“Deep state: There is a ‘deep state’ embedded in the government that operates in secret and without oversight.”

• Believers: 51% of adults, 59% of teens, 67% of high-use teens (CCDH, 2023).

Mistrust of government contributed to the widespread failure to trust information on how to protect oneself and others coming from the Centers from Disease Control and Prevention. 

The Rise of COVID-19 Related Conspiracy Theories

As we will show, with the availability of the Internet, social media, and 24/7 news cycles, conspiracy theories spread rapidly to a worldwide network of individuals ready to become true believers.

Conspiracy theories generated during the COVID-19 pandemic were responsible for deepening the political divisiveness that contributed to the massive number of deaths in the United States. If we are to prevent a similar phenomenon with the next infectious disease that becomes widespread, then nurses and the American general public need to have a better understanding not only how to prevent infection, but how to counter deadly disinformation. With the ability of ordinary people to use artificial intelligence (AI) to create “deep fakes” that look and sound just like real people, it will be even more difficult for internet users to sort out what is and is not true in the future.

During the pandemic, conspiracy theories served many purposes, and there is so much we still do not understand. Clearly, the division between believers and non-believers exacerbated pre-existing social, cultural, and political animosity in the United States. In other chapters we will provide examples of how individual decisions to refuse to comply with social distancing recommendations and mandates resulted in devastating consequences for the general public and specifically for nurses who were infected by their patients.

Troll Farms, Automated Bots, and Other Bad Actors

It is difficult to comprehend why anyone would have wanted to produce disinformation about a lethal virus that was causing a worldwide pandemic, but that is exactly what happened.

It became public years ago that there was foreign interference leading up to the 2016 presidential elections. A U.S. Senate report on Russian interference in the 2016 election concluded that disinformation by bad actors from the Russian Internet Research Agency intended to pit Americans against each other and the U.S. government. The report states: “The Committee found that IRA influence operatives consistently used hot-button, societal divisions in the United States as fodder for the content they published through social media in order to stoke anger, provoke outrage and protest, push Americans further away from one another, and foment distrust in government institutions.” (U.S. Senate, 2019). Those goals have clearly been achieved.

By the time the U.S. began to see the first patients with COVID-19 infections in March 2020, the campaign to disrupt the 2020 U.S. elections was extensive and similar activities were also directed at the U.K., Australia, India, Central American and South American countries (Hao, 2021). Adding conspiracy theories promoting falsehoods about the deadly COVID-19 infection was relatively easy. To understand how this silent invasion into American homes and hearts was carried out, there are some methods that need to be addressed.

Troll Farms

Troll farms are “professionalized groups that work in a coordinated fashion to post provocative content, often propaganda to social networks” (Hao, 2021).  

Jeff Allen (2019, October), a data scientist and researcher formerly employed by Facebook, described how these efforts were discovered at Facebook:

“In 2016, a group of Pages burst forth into the American political scene. The owners of the pages did not speak English particularly well, or Spanish, or any other language commonly spoken in America. They did not have any real understanding of American politics. And their primary interest in entering the American political publishing scene was to make a fast buck and cause chaos. Regardless, they were able to become a significant fraction of all civic discourse on our platform leading into the 2016 election.

It is profoundly strange that people who do not speak the local language, do not understand US politics, and fundamentally do not care about US politics, were able to become one of the loudest voices in the civic space on FB.

In the three years since, we have created a large policy and monitoring apparatus that helps us squash these actors when they pop up in the civic space. And we have created guardrail demotions that prevent the worst of the worst. But we have not fundamentally changed the way our platform operates to make it resilient against these actors.

The “Troll Farms” are a loosely defined set of FB Pages run out of the Balkans that target foreign audiences. Primarily US, but they also target Central and South American countries, UK and Australia, and India” (Allen, 2019, October 4). https://s3.documentcloud.org/documents/21063547/oct-2019-facebook-troll-farms-report.pdf

Social media pages allow millions of people to connect with others with similar interests, specifically targeting people based on religious ideology, race/ ethnicity, and political persuasion. When documented in 2019, Allen expressed concerns that top Facebook community pages were troll farm generated:

“Our platform has given the largest voice in the Christian American community to a handful of bad actors, who, based on their media production practices, have never been to church.” There were 75 million users per month accessing these pages.

“Our platform has given the largest voice in the African American community to a handful of bad actors, who, based on their media production practices, have never had an interaction with an African American.” Over 30 million users per month accessed these pages.

“Our platform has given the 2nd largest voice in the Native American community to a handful of bad actors, who, based on their media production practices, have never had an interaction with a Native American.” Approximately 400,000 users per month visited these pages.

“Our platform has given the 5th largest voice in the American Women’s community to a handful of bad actors, who, based on their media production practices, are not women and don’t particularly care about any issues confronting women.” Around 60 million users per month accessed these pages.

In October 2019, there were approximately 15,000 Facebook pages targeting Americans run by troll farms located in Kosovo, Macedonia, Slovenia, and Albania that were identified in the internal Facebook report. Many had been taken down (Allen, 2019). Most troll farms were associated with the Russian Internet Research Agency (Hao, 2021).

Troll farm generated social media content is often copied and frequently plagiarized directly from other sites. The pages have provocative content that attracts millions of users per month. In addition, the content is pushed to new feeds of potential new users through algorithms that identify a person’s interests based on what they choose to view while online. The process is totally automated. Much of the content is Russian generated. A lot of the content is totally fictitious (Hao, 2021).

Content generated by trolls was initially easier to identify as bad grammar, poor spelling, and incorrect use of American idioms was evident. Today that is no longer true. It was a simple matter for the bad actors running the troll farms to add COVID-19 disinformation and conspiracy theories to their already extensive list of activities.

Clickbaits

Most people are familiar with internet-based advertisements, and use of privacy settings and know that an internet browser can be set up to customize a user’s home page so that they get the type of news they prefer. As shown in figure 3, algorithms are used to identify items that may be interesting to a specific user.

In order to sell more products, to interest more subscribers or users, or to get a message out to a lot of people who are likely to pay attention, ads that the user can click on are pushed to user’s news feeds, social media sites, emails, etc. Someone is generally paid for hosting an ad, when a user clicks on the link, and advertisers are paid for any purchases.

If, for example, an individual human tends to click on funny cat or dog videos, then algorithms used by internet browsers, social media, news feeds, and free email sponsors will “push” more animal related ads to tempt that user. All of this is determined by artificial intelligence or machine learning algorithms that analyze user data, make decisions about the information, and then perform the tasks necessary to push similar content to the user. No humans are needed after the algorithm is programmed. Users are happy because they do not have to work to search for what interests them.

Clickbaits, are a bit more nefarious. These are internet ads with provocative “teaser” statements or images that attract attention and encourage people to click on the link for the full story. They are often attributed to “news” sources that are not well known and, in many cases, are just names that only exist to generate disinformation. Figure 3 shows some of the clickbait ads that were found in Yahoo “News” and Google News.

Each time a link is clicked by a user, money is paid to the troll farm, and the social media company is also very well paid because more users equate to more advertisers.

Automated Bots

Automated bots are apps that follow programmed instructions that appear to be carried out by humans. The apps can run independently as programmed to scan content and even interact and chat with users and to amplify (forward) webpage content to users identified by algorithms (AWS Amazon, n.d.). “Good” bots help to reduce human workload. Troll farms and individuals with evil intent use malicious bots to post and repost disinformation. 

Using bots with Twitter works like this:

An original tweet is created by a human or found online by a human. The message is something that the human believes will influence real people who will read or view the information in the original post and react to it. A bot can be used to amplify the message, that is, send out millions of retweets forwarded to real people. Some bots can even respond to what people say and chat with users in real time. Most of the time the person interacting does not realize that they are interacting with an app. People can be further enticed to join online user groups, participate in live activities organized within the group, and promote conspiracy theories.

In the past, a program called Botometer could be used to help researchers differentiate retweets generated by a bot versus those retweets that were sent by humans. Botometer is a machine learning program that scores Twitter accounts, and higher scores suggest that the account is most likely an automated bot. Millions of retweets could be easily examined by Botometer to help monitor how the social media platform Twitter was being used to provide accurate COVID-19 information, for example, by the CDC to send out critical information to millions of Americans. It was also capable of determining how Twitter was being misused by bad actors to send out dangerous disinformation about COVID-19.

Botometer was developed as a joint project of the Observatory on Social Media and the Network Science Institute at Indiana University. The program allowed researchers to analyze Twitter data using a tool that had been created by independent information technology science teams, and there was no charge to use the program (https://botometer.osome.iu.edu/).

Now under the ownership of Elon Musk, Twitter was re-named X and the company has stopped allowing researchers to use this free program. Now researchers have to pay Musk to use X developed and owned tools to analyze millions of tweets and retweets.

A Closer Look at Some of the Conspiracy Theories

The Ivermectin Controversy – “Big Pharma: the Government is Blocking Alternative Treatments”

An oral ivermectin was previously approved by the FDA for humans to treat stongyloidiasis (round worms in the intestine) and Onchocerca volvulus, a filariae worm larvae that grows under the skin and in the eyes after a blackfly bite, causing “river blindness” which is usually identified in some areas of Africa (CDC, 2017). The oral tablets for human use required a prescription.  

Ivermectin is primarily used in the U.S. as a veterinary medication given to horses and cows to kill the worms that tend to invade their gastrointestinal tract. The Food and Drug Administration approved ivermectin for this purpose years ago and it is readily available as a paste without veterinary prescription in farm stores. The syringe contains an ivermectin dose appropriate for a horse that weighs up to 1250 lbs.

Before a medication of any kind is approved by the Federal Drug Administration for use in people to treat a particular disease or condition, it has to be tested in clinical trials to show that it is safe and effective for that indication. Safe means that the effectiveness of the drug outweighs any toxic side effects. When the drug is used for a condition for which it is not FDA approved, that is considered “off label” use.

In early 2020, a lot of drugs were tested while the search for COVID-19 treatments was intense. Ivermectin was tested because it slowed growth of SARS-CoV-2 in vitro (outside of the body) when the virus reproduced in tissue culture, which is essentially human cells grown in a petri dish (Caly, et al., 2020). Ivermectin had not been tested for human use in COVID-19, but as figure 4 shows, the number of prescriptions for the drug started to increase dramatically in July to November of 2020, especially in Texas, Oklahoma, Georgia, Alabama, Mississippi, Arkansas, Louisiana, Florida, Tennessee and Arizona (Lind, et al., 2021).

A team from the Centers of Disease Control and Prevention used data from the National Prescription Audit and the Total Patient Tracker database from 48,900 U.S. retail pharmacies to investigate use of ivermectin. Before the pandemic, U.S. outpatient pharmacies filled 3,589 ivermectin prescriptions per week. In January 2021, there were 39,102 ivermectin prescriptions filled. As shown in figure 4, the rate of prescriptions for ivermectin dropped off quickly when it was determined that ivermectin was not useful as a prevention or treatment for COVID-19 (Lind, et al., 2021).

The FDA determined that the drug was not effective for COVID-19 and did not approve use of it.

Human prescriptions for ivermectin were 24 time higher during the pandemic than before it started, and between July and August 2021, prescriptions quadrupled In the United States. The Oregon Poison Center, is a telephone service that provides advice in the event of an exposure to drugs or poison for Oregon, Alaska, and Guam. Approximately 0.25 calls per month related to ivermectin were received in 2020. In the month of August of 2021, there were 21 calls about ivermectin. Of these 11 people had used ivermectin to prevent COVID-19 and 10 were using ivermectin to treat COVID-19 (Temple, et al., 2021).

Only three people had a prescription from either a physician or a veterinarian. Seventeen people bought and used a veterinary form of ivermectin. Most people who called had complications pretty quickly within a couple of hours after using a large, single dose for the first time. Six people did not show toxicity until several days of repeated doses taken early. Of the 21 people who had taken ivermectin, six, all of whom had taken it for prevention, had to be hospitalized. Three of the six had a prescription. Signs of toxicity included severe confusion, ataxia (imbalance and difficulty walking due to loss of muscle control in the extremities), seizures, low blood pressure, weakness, and gastrointestinal symptoms (Temple, et al., 2021).

U.S. private and Medicare Advantage plan insurers paid $2,493,716 for ivermectin prescriptions the week of August 13, 2021. The researchers estimated that the total costs for a year would be $129,673,240. Insurers do not typically afford reimbursement for ineffective care but heavily subsidized the costs of this treatment (Chua, Conti, & Becker, 2021).

After the clinical trials failed to show value in COVID-19, physicians were less likely to prescribe the drug off label. There were still enough people determined to use ivermectin, and so many turned to the over-the-counter veterinary preparations that the FDA put out a message via Twitter on August 21, 2021, see figure 5.

“You are not a horse. You are not a cow. Seriously, y’all. Stop it.”

The message continued:

“Why You Should NOT Use ivermectin to Treat or Prevent COVIC-19. Using the drug ivermectin to treat COVID-19 can be dangerous and even lethal. The FDA has not approved the drug for that purpose.” See figure 5 (FDA, 2021 August 2021).

After the FDA denied approval for ivermectin use for COVID-19, social media activity related to the drug increased. In terms of conspiracy theories, whenever the FDA did not approve an alternative drug or treatment, the Big Pharma conspiracy was invoked. This theory suggests that the big pharmaceutical companies secretly conspire with politicians and regulators to block access to alternative or natural therapies. In this case believers consider ivermectin and hydroxychloroquine as alternative, even though they are actually medications used for other purposes, presumably because government regulators denied approval.

 A study conducted by Diaz, et al. (2022), illustrates how Twitter was used to disseminate disinformation.

The researchers used multiple software programs to identify 420,101 tweets generated from April 1 to October 1, 2021, by users who were in the U.S. when the tweet was created. 

Tweets were categorized based on their keywords into six topics.

• Ivermectin effectiveness and safety studies: Scientific merits – 196,874 tweets (46.9%).
• Safety of Ivermectin for animal use in humans – 48,277 tweets (11.5%).
• Discussion of how the anti-vaxxers were promoting ivermectin and endangering people – 47,922 tweets (11.4%).
• Big Pharma/ governments blocking alternative treatments including hydroxychloroquine and ivermectin across the globe – 46,456 tweets (11.1%).
• U.S. Government blocks ivermectin and hydroxychloroquine – 42,754 tweets (10.2%).
• Effects on hospitals and physicians: ivermectin refusal and ivermectin overdoses – 37,818 tweets (9.0%).

Overall, most tweets were negative on ivermectin, that is the people posting agreed that this was not an appropriate treatment for COVID-19. Tweets categorized as effectiveness and safety studies were the most neutral and science based. The researchers indicated that ivermectin continued to be a politically charged issue. Tweets generated by users in red states (primarily Republican) were mostly pro ivermectin. Tweets that were created in blue (predominately Democratic) states were more negative about ivermectin. The authors concluded that “Real-time analysis of social media content and generation of new social media content by public health agencies may offer and opportunity to close the gap between scientific evidence and public knowledge more rapidly and increase public trust.” 

The FDA put out an additional warning about ivermectin in December of 2021, see figure 6: The webpage indicates that ivermectin was not approved for COVID-19 because it is not effective and can have some serious adverse effects. The reasons why animal medications should not be used in humans was also stressed (FDA, 2021 December 10).

There were at least seven U.S. lawsuits initiated by guardians of individuals with COVID-19 infections because hospital authorities refused to allow administration of ivermectin (American Bar Association, 2021).

There were still a lot of Americans who tried ivermectin in 2022. Perlis, et al. (2023) used results from 13,438 U.S. adults who responded to the COVID States Project, wave 26 survey. This survey was conducted online every one to two months. Participants were from all 50 states. This was a non-probability sample. The time period for this wave of the survey was December 22, 2022, and January 16, 2023.

Of the 13,438 participants who self-reported that they had current or prior COVID-19 infections, 440 (3.3%) of respondents used ivermectin and the drug was prescribed by a medical professional in 69.3% of cases (Perlis, et al., 2023).

The #FilmYourHospital Campaign is Initiated

As the numbers of Americans infected with COVID-19 started to rise rapidly, the Coronavirus is a Hoax theory was supported by another conspiracy effort, the #FilmYourHospital Twitter campaign.

The hashtag started with a Twitter user who posted “#FilmYourHospital. Can this become a thing?” Users were instructed to take cameras to local hospitals and to film empty emergency rooms, parking lots, etc. The underlying assumption was that if hospitals were operating normally or had low volume that the pictures would support the hoax theory. At that time, lack of adequate personal protective equipment supplies caused most hospitals to take drastic measures, including cancellation of elective surgeries, procedures, and treatments that could be delayed.

In April of 2020, Canadian researchers Gruzd and Mai identified and analyzed approximately 100,000 #FilmYourHospital Twitter tweets and 43,000 retweets from March 28 to April 9, 2020. They found that the hashtag had been initiated and amplified by far-right conservative internet personalities. The Twitter accounts used most heavily did not appear to be automated and there was some coordination between far-right groups and conservative internet personalities.

The researchers determined that two user accounts were most influential in boosting the effort, and one of these accounts was owned by a woman who lost the race for a seat in the U.S. House of Representatives that was held by Nancy Pelosi, then Speaker of the House. The efforts to continue these activities were sustained by pro-Trump supporters. A second wave of amplification then moved beyond the U.S. (Gruzd, & Mai, 2020, April 22).

Another group of researchers from the UK, Spain, and the U.S. conducted a study using data from a 7-day period from April 13 to 20, 2020. They analyzed 22,785 #FilmYourHospital tweets and 11,333 Twitter users. The researchers identified that approximately 9.2% of the accounts were automated, “bots.” “Probable bot” accounts sent 136 tweets during the 7-day study period and a total of 323,096 tweets from the time of inception to when the accounts were removed. These automated accounts received 373,508 likes and had 22,855 followers before removal. Many of these accounts existed before the #FilmYourHospital campaign started. YouTube videos in support of the conspiracy theory were also popular.  (Ahmed, et al, 2020). Twitter eventually deactivated these accounts.

Botometer, the machine learning program that scores Twitter accounts, was used to analyze the data. A higher score suggests that the account is most likely an automated bot. (https://botometer.osome.iu.edu/).

Now, under new ownership (Elon Musk) Twitter was renamed X and has stopped allowing researchers to use this free program. Outside monitoring of social media is important to help identify trends, concerns, and bad actors spreading dangerous disinformation. Whereas Botometer made such studies comparatively easy, researchers have to pay X to use Twitter owned tools that may not be free of bias.

COVID-19 Deniers and the Consequences for Nurses

Failure of COVID-19 Deniers to Protect Self and Others

From the beginning of the pandemic, conspiracy theories were put forth that reduced the ability of those who believed them to protect themselves and others from the SARS-CoV-2 virus. There were claims that face masks could activate the virus, cause bacterial or fungal pneumonia, and cause oxygen deprivation. Disinformation about testing was rampant. One conspiracy theory was that the cotton swabs inserted into the nasopharynx damaged the blood-brain barrier (Stein, et al., 2021).

In general, those who accepted disinformation as factual did not follow public health procedures or lockdown recommendations (Harvey, 2020). People with strong belief in conspiracy theories were most likely to mistrust science and to refuse to follow public health measures (Constantinou, et al., 2020). Research has shown that in the U.S. COVID-19 deniers and those who embraced other conspiracy theories tended to be divided by political viewpoints. Accurate information and public health guidance was overshadowed by the volume of disinformation coming from other sources (Blevins, et al., 2021).

COVID-19 Deniers: Dying in Disbelief

A Washington Post article cited emergency room nurse Jodi Doering who described the pain of watching unvaccinated COVID deniers literally go to the very moment of their deaths still believing that the pandemic was an elaborate hoax. Her story is one that is representative of the experiences related by countless nurses who cared for patients with COVID-19 infections, both publicly and privately:

“Jodi Doering, an emergency room nurse in South Dakota, was overwhelmed Saturday night. Her patients were dying of COVID-19 yet were still in denial about the pandemic’s existence. It’s like a ‘horror movie that never ends,’ Doering wrote on Twitter.

Her anxiety and despair are shared by many health-care workers who are facing a dramatic surge in COVID-19 patients. But some front-line workers, like Doering, also face the emotional toll of treating patients who, despite being severely ill, are reluctant to acknowledge that they have been infected with a virus that President Trump has said will simply disappear.

Doering said she has COVID-19 patients who need 100-percent-oxygen breathing assistance and who will also swear they don’t have the illness…

“I think the hardest thing to watch is that people are still looking for something else and a magic answer and they do not want to believe COVID is real… Their last dying words are, ‘This can’t be happening. It’s not real…’ ‘Some patients prefer to believe that they have pneumonia or other diseases rather than COVID-19, despite seeing their positive test results’” (Villegas, 2020).

Nurse Kathyrn Ivey articulated the consequences of disinformation and conspiracy theories when she wrote of the real-life experiences for critical care nurses and their unvaccinated patients (Ivey, 2022).

“Back in August, the beds of my hospital in Tennessee filled with COVID patients in varying stages of respiratory distress. Some wore a plastic mask that covered their mouth and nose, hooked up to a machine that delivered forceful breaths into the patient’s open mouth. Others were sedated, paralyzed, with a plastic tube down their throat, every breath driven by the ventilator that kept them alive. The anger of the nurses, myself included, surged along with the patient population. Rage seeped along the halls of the intensive care unit, burned in the quick conversations in the medication supply room, and settled around all of us as we tried to keep our heads above water for yet another push of the pandemic that had turned so many of us into open wounds. I was angry at everything: angry at the systemic failures of the government to act, angry at the individuals who treated COVID as a joke and angry at the disinformation that ushered in more death.

Every wave of COVID has been a special type of hell, but that August surge was much worse than those before it, as the summer of 2021 spiked to a boiling peak after a spring full of hope. This time we had the vaccine that should have put an end to all of it. The vaccine that so many health care workers had clung to like a lifeline for the first waves and the brutal winter was here, safe and effective—and largely ignored by patients that were first a trickle and then a torrent rushing into the emergency rooms, the medical surgical units, the intensive care unit, all gasping and dying and begging for a miracle, younger, sicker, crashing faster. Every death as devastating as it was preventable. Chart after chart told the same story: ‘COVID positive. Unvaccinated. Intubated, sedated, paralyzed. Prognosis is guarded in this critically ill patient.”

Eventually, that summer surge receded. By that, I mean that we occasionally had three or four open beds. My patients were all still sick, so sick. Many of them no longer had an active COVID infection, but their bodies had been so ravaged by the virus that they remained on breathing tubes as one organ system after another failed.”

Who Benefited from Anti-Vaccination Conspiracy Theories and Myths

Research showed early on that unvaccinated people were 14.1 times more likely to die from a COVID-19 infection than those who received the bivalent booster that included both the first form of the Omicron version. Those who had the original monovalent vaccine series were 2.6 times more likely to die than those who received a bivalent vaccine booster (Johnson, et al., 2023).

The anti-vaccination movement has been around for a very long time! “A Brief History of Vaccination” dates the first actual vaccination for smallpox to 1796. For centuries before that, there were numerous attempts to produce immunity by deliberately exposing healthy people to smallpox (WHO, n.d.). In 1722, some 70 years before the first vaccination, a preacher named Edmund Massey presented a sermon entitled “Sermon Against the Dangerous and Sinful Practice of Inoculation.” Massey was opposed because preventing illness interfered with God’s punishments for human sin.

Long before the first COVID-19 vaccines became available for administration to the public in December of 2020, myths and disinformation were already on social media. Members of the various pre-existing antivaccination groups have found social media platforms very helpful in amplifying anti-vax sentiment about ALL vaccines before the SARS-CoV2 virus even existed (Hussain, et al., 2018). 

FALSE statements, myths and conspiracy theories that contribute to COVID-19 vaccine hesitancy include:

• COVID-19 vaccination is a way for pharmaceutical companies to make money.
• A trackable microchip would be injected with the vaccine, this theory was related to the Bill Gates and 5G conspiracy theories.
• 5G cellular technology worsens COVID-19 infection.
• Vaccines cause autism.
• Infertility occurs after the vaccine.
• Embryonic stem cells from aborted fetuses are used.
• DNA is altered by the vaccine.
• Various fictitious people were purported to have died after getting the vaccine during clinical trials.
• The vaccine is poisonous.

(Chadwick, et al., 2021; Gagliardone, et al., 2020; Gruzd, et al., 2023; Islam, et al., 2021; Ullah, et al., 2021; Center for Countering Digital Hate, 2021, March).

So, COVID-19 conspiracy theorists already had an audience ready and willing to accept negative statements about vaccines. Antivax influencers were intent on deliberately spewing disinformation about vaccines that had not yet been developed. The messages were amplified using social media platforms (such as Facebook, Instagram, Twitter, and YouTube). Those who already believed that the COVID-19 pandemic was a hoax were able to defend their decisions to avoid vaccination by repeating a long list of deliberately inaccurate vaccine information. The consequences in the U.S. were numerous lawsuits fighting against vaccination and mask mandates.

The Anti-vax Movement Generates Revenue

The Center for Countering Digital Hate (CCDH) is a not-for-profit organization that analyzes content of digital material that supports hate and misinformation on the Internet. In March of 2021, CCDH published results of analysis of Anti-Vaxxers disinformation efforts regarding COVID-19 vaccines. CCDH followed 425 accounts spewing anti-COVID vaccination posts across Facebook, Instagram, Twitter, and You Tube. By clicking on likes and forwarding links to others, followers of these accounts generated 59.2 million followers in December 2020. In June of 2020, 877,000 more followers had been added. In the month and a half between February 1 and March 16, 2021, 12 anti-vax individuals spouting conspiracy theories were responsible for 65% of the COVID-19 vaccination disinformation and often disinformation about masks as well (CCDH, 2021 March).

Most were making money from these efforts by selling goods or services, from donors who supported these crowdsource elites, and advertisers. Notoriety and political capital are also advantageous to crowdsource elites who promote conspiracy theories. In addition to individual accounts, some of these people were associated with innocuously named, mostly “not-for-profit” organizations through which they enrich themselves. For example, three of the Disinformation Dozen identified by CCDH personally saw financial benefits as a result of childhood vaccination myths and conspiracy theories, but also as a direct result of the pandemic:

• The Children’s Health Defense is a not-for-profit anti-vaccine organization, associated with Robert F. Kennedy, Jr. (CCDH, 2021, March). Kennedy is the son of Robert F. (Bobby) Kennedy, former U.S. Attorney General and nephew of former U.S. President John F. Kennedy. He has recently launched an unsuccessful 2024 campaign for U.S. president. Mr. Kennedy’s personal reported income last year was $7.8 million with $1.6 million received in consulting fees related to lawsuits against pharmaceutical companies and $516,000 in salary and bonuses from the not-for profit (O’Brien, 2023). In 2025, during the second Trump administration, Kennedy was appointed to the U.S. President’s Cabinet as Secretary of Health and Human Services and currently heads the division of government responsible for all aspects of healthcare policy and oversight.
• Informed Consent Action Network (ICAN), a not-for-profit anti-vaccination organization based in Texas was started in 2016. It is associated with Del Bigtree, a well-known anti-vaxxer. Tax records for ICAN showed that the organization benefitted financially from the COVID-19 pandemic while spreading false information about the vaccines. Revenue was up by 60% in 2020 with reported revenue of $5.5 million. Bigtree also benefitted personally in that his ICAN not for profit salary increased from $146,000 pre-pandemic to $221,000 in 2020 (Zadrozny, 2022). The not-for-profit received federal COVID-19 Paycheck Protection Program loans of approximately $166,000 to publish anti-COVID-19 vaccination disinformation in May of 2020 (Sparber, 2021, January).
• National Vaccine Information Center (NVIC) is associated with Joseph Mercola. Mercola is a prominent anti-vaxxer and COVID-19 denier who sells dietary supplements and “alternatives to vaccines” via Facebook, Twitter, and Instagram to approximately 3.6 million followers (CCDH, 2021 March). Prior to the pandemic, Mercola contributed a tax deductible $2.9 million to NVIC. His personal net worth was to be over $100 million in 2017 from sale of nutritional supplements and purported alternatives to vaccines (Satija, & Sun, 2019 December 20). NVIC was reported to have received $334,000 to $335,000 in Paycheck Protection Program loans to fuel its COVID-19 vaccine disinformation campaign (Guzman, 2021 January 19) before the vaccines were even available.   

Vaccines, Microchips, and the Demonization of Bill Gates in Conspiracy Theories

Bill Gates, the co-founder of Microsoft, and a leading proponent of vaccination for preventable diseases that were killing children, was a target of the anti-vax movement long before the SARS-CoV2 virus came to be. In 1998, the Bill and Melinda Gates Foundation donated $100 million to start a worldwide vaccination program. The goal was to finance vaccinations needed by children in developing countries (Bill and Melinda Gates Foundation, 1998). In 2010, the Foundation pledged an additional $10 billion over the following 10 years to vaccination programs in developing countries (Bill and Melinda Gates Foundation, 2010). By June of 2022, Bill and Melinda Gates had also committed another 2 billion dollars to the COVID-19 vaccination effort (Bill and Melinda Gates Foundation, 2022). See figure 7.

The philanthropist had a long history of not only advocating for worldwide childhood vaccinations to prevent needless deaths and disability but also paying for the vaccines through the Bill and Melinda Gates Foundation. It is not surprising that the anti-vax pundits and far right internet personalities created Bill Gates conspiracy theories. The manipulators initiating the accusations, internet personalities and exploiters of automated bots that amplified these accusations were making a lot of money and gaining political capital (Center for Countering Digital Hate, 2021, March 24).

Full blown demonization of Bill Gates emerged after he was critical of the inadequate governmental COVID-19 response in 2020 (Wakabayashi, D., et al., 2020, May 4). There were/ are multiple versions of absurd conspiracy theories that claimed Bill Gates:

• Planned to inject microchips with the vaccine that would allow governments to track people (or implant global tracking systems).
• Knew about the COVID-19 pandemic before it started.
• Created the COVID-19 virus.
• Held a patent for the COVID-19 virus.
• Intended to depopulate the world using vaccinations for COVID-19.
• Would make huge profits from the sale of vaccines.
• Knew that the COVID-19 vaccine would kill more people than it would cure.
• Was working on behalf of Big Pharma to spread COVID-19 to make money off of the vaccines.

(Gagliardone, et al., 2020; Hakim, 2021; Wakabayashi, D., et al., 2020, May 4; Wakefield, J., 2020, June 6). See samples of the conspiracy theories put forth in figure 8. There were thousands of such examples of attacks on Gates at the height of the pandemic.

Although Gates primary focus has been computer science, given his work with vaccine projects, he understood the devastation that viral infections can create. Long before the COVID-19 pandemic, in 2015, Gates gave a TED talk for BBC during which he said: “If anything kills over 10 million people over the next few decades, it is likely to be a highly infectious virus rather than war.” Links to recordings of this talk were amplified through social media to prove the conspiracy theories, and by June 6, 2020, the resurrected TED talk had been viewed over 64 million times (Wakefield, J., 2020). In 2017, following his TED talk, the Bill and Melinda Gates Foundation became a founding member of a private-public partnership, the Coalition for Epidemic Preparedness Innovations (CEPI). Founded in Davos, Switzerland, including the Gates Foundation, there were more than 35 member countries when it was established (Coalition for Epidemic Preparedness Innovations, 2022). Unfortunately, the prevailing anti-science focus of the U.S. president’s administration in 2020 resulted in backlash against the most knowledgeable scientists and public health experts in the world.

Bill Gates (2020, March 18). Bill Gates Reddit Ask Me Anything

As the conspiracy theories centering on Gates spread worldwide, they were woven into the social structures and cultural beliefs in various countries. In the U.S., there were great divisions between Republicans and Democrats that was exacerbated leading to and after the 2016 and 2020 presidential elections with one side claiming the election was stolen after Biden won. So, there were already many elections related conspiracy theories circulating long before the emergence of the SARS-CoV-2 virus. Widespread acceptance of election related conspiracies provided a fertile bed for new COVID-19 conspiracy theories.

As has been shown, an individual with a “conspiracy mentality” is likely to believe in multiple conspiracy theories, even when the theories conflict with each other. Many Americans from the side of the aisle that believed that the election was stolen also bought into the conspiracies related to Bill Gates. Unfortunately, these political divisions prevented a country wide attack on the common enemy, COVID-19, when the virus reached the U.S. in March of 2020 (Shahsavari, S., et al., 2020, July 15).

Similar dynamics also occurred elsewhere. For example, Gagliardone, et al. (2021) described the cultural differences related to how the Bill Gates conspiracy theories were viewed differently in South Africa and Nigeria. In Nigeria, politics were also partisan, and Gates theories were used to “cast a negative light on the government and its action, and denounce alleged corruption cases, and less so to point to shady plots.” Whereas in South Africa, Gates conspiracy theories “resonated with deep-rooted sentiments of resentment toward the West and corporate interests accused of benefiting from experimenting on African citizens’ lives” (Gagliardone, et al., 2020).

When the first Trump administration announced a decision to withdraw from the World Health Organization in the midst of the worldwide pandemic, Gates – like many other scientists and health officials – reacted. On April 15, 2020, Gates used Twitter to state: “Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds. Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them. The world needs @WHO now more than ever” (Wakabayashi, D., et al., 2020, May 4).

Already targeted, amplification of the Bill Gates conspiracy theories were raging uncontrollably. From January to early May 2020, there were over 16,000 Facebook posts that were liked and commented on by approximately 900,000 followers. Ten YouTube videos targeting Bill Gates posted in March 2020 had been viewed in March and April 2020 almost five million times (Wakabayashi, D., et al., 2020, May 4). 

Chang and Ferrara (2022) used a 4 billion dataset of Twitter tweets on COVID-19 and 5.4 million users of COVID-19 related tweets to investigate bot/ human interactions and political diet. The researchers used Botometer (which as noted above is no longer available for use with Twitter.)  Botometer gave a score that could be used to determine if the Twitter user was a bot or a human account.  To assure that the score was accurate, the researchers manually validated 200 accounts. They found that Bill Gates conspiracy theory tweets were retweeted by conservative users three times more often than by liberal users (Chang & Ferrara, 2022).

Figure 9 shows results of one of the countless conspiracy theory fact checks that were completed by mainstream investigative media outlets who cared about providing accurate information.

The 5G Conspiracy Theory

This conspiracy theory is extremely convoluted, and this author has not figured it out at all.  The 5G refers to the generation of cell phone technology that was relatively new during the COVID-19 public health emergency years. Whatever this theory purports to explain, the amplifiers blamed Bill Gates as well. Figure 10 provides a graphic for the reader to puzzle over.

Please see the chapter The Birth and Re-emergence of the “Vaccines Cause Autism” Conspiracy Theory for more information on this topic.

Summary

When COVID-19 arrived in the U.S. in March of 2020, those infected died so quickly that refrigerated trucks were needed in some large cities because there was nowhere else to store the bodies. In New York City, which was one of the locations hit hardest in the earliest days, the community thanked nurses, healthcare providers, first responders, and essential workers by opening doors and windows and clapping at 7:00 pm every evening. The clapping would continue for several minutes.

This expression of gratitude was picked up in other large cities and continued to mid-April 2020. Then a rapid change in attitude became evident with some segments of the population. Healthcare providers not only cared for critically ill patients dying from COVID-19, but nurses and other healthcare personnel were becoming infected and dying themselves. While this was happening, attitudes changed and care providers were villainized, resulting in a rise in violence against nurses and others.

The emergence of conspiracy theories such as the “Coronavirus is a hoax,” and others that were promoted through social media sowed mistrust and COVID deniers frequently went to their deathbeds failing to accept that the infection was real. The country was already deeply divided by political party and instead of coming together against the viral common enemy, further polarization occurred. Promotion of pandemic related conspiracy theories were politically and financially beneficial to those who developed and amplified them through social media.

As of August 25, 2025, COVID-19 infections have killed 1,226,890 Americans and 7,099,773 world citizens (World Health Organization. Cumulative confirmed COVID-19 deaths, accessed September 18, 2025. https://ourworldindata.org/coronavirus)

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