As Ebola fear grips the American public, the Internet is rife with conspiracy theories, supposed miracle cures and Twitter posts of dread.
But amid that are several influential sites that are sticking to the facts about Ebola. Millions have come to rely on these sites, including those run by the Centers for Disease Control and Prevention, the World Health Organization and Wikipedia.
Wikipedia? The online encyclopedia’s Ebola Virus Disease article has had 17 million page views in the last month, right up there with the CDC’s Ebola portal and the WHO’s Ebola fact sheet, as well as the Ebola coverage of prominent health care brands like WebMD and the Mayo Clinic.
Once the butt of jokes for being the site where visitors could find anything, true or not, Wikipedia in recent years has become a more trusted source of information — certainly for settling bar bets, but even for weighty topics like Ebola.
“It is because Wikipedia is such a recognized brand — obviously the CDC is still much more authoritative than we will ever be — that people will click on that link,” said Dr. Jacob de Wolff, 37, an internist at Northwick Park Hospital in London, who founded Wikiproject Medicine in 2004 and has seen it go from obscurity to mockery to acceptance.
On Oct. 15, when it was announced that a second nurse in Dallas had tested positive for the virus, traffic for the Ebola Virus Disease article on English Wikipedia’s site reached a peak of 2.5 million page views — the CDC reported 3.5 million page views that day of its Ebola content, while the Mayo Clinic Ebola content had about 200,000. Search engines, no doubt, drive such traffic totals. An “Ebola” Google search had put Wikipedia’s article above the CDC’s portal. But this weekend Google highlighted the CDC material and moved it to the top. Bing uses Wikipedia’s article for its Ebola summary.
Anyone can edit?
The initial skepticism about Wikipedia was mainly structural: how could you trust an article in an “encyclopedia that anyone can edit?” The growing confidence in the site — certainly when it comes to public health articles — in part reflects the fact that much of Wikipedia is not edited by just “anyone.”
“Wikipedia is a do-ocracy,” said Dr. James Heilman, an emergency room doctor from Canada, who leads the Wikiproject Medicine that keeps close watch on the most important public health articles, including Ebola Virus Disease. “Those who do the most do have a greater influence.”
Many impediments exist to someone casually editing the Ebola article. Only registered Wikipedia editors with at least some experience are permitted to edit the page, and the requirement for sourcing is much more rigorous than for other Wikipedia entries. Newspaper articles, for example, do not cut it.
“A key group of us keep an eye on articles that have become more popular to make sure that Wikipedia’s most-read content is of a reasonably high standard,” Heilman said.
Other health care sources have adapted to the intense interest in Ebola. UpToDate, a subscription service mainly used by doctors and owned by the Dutch company Wolters Kluwer, has made its Ebola information free to the public, including a summary of the basics of the disease written from a patient’s point of view. The publicly traded WebMD said that since the beginning of October millions of people have searched the virus on the site, and the site has produced articles, slideshows and even a quiz to reinforce best practices.
“We pride ourselves on not being sensationalist,” Dr. Michael Smith, the chief medical editor at WebMD, said in an interview. “If you are turning to credible sources of information, you would not panic.”
The editors of Wikipedia’s Ebola page say they earned a place as one of those credible sources. To protect against misinformation, potential editors must suggest adds or changes to the article on a separately maintained page, where editors, frequently Heilman, review them and decide whether to incorporate them.
Heilman, 35, the head of the emergency medicine department at East Kootenay Regional Hospital in Cranbrook, British Columbia, said that since January he had taken fewer shifts at the hospital so he could keep tabs on things and contribute to Wikipedia’s medical articles. He is unabashed about his goals: to emphasize that Ebola does not get transmitted through the air; to call out unproven treatments; and to make sure the language is as simple as possible, in part so it can be more easily translated into other languages.
“We don’t need to write for experts; experts have lots of excellent sources,” he said.
On the public page where changes to the Ebola article are discussed, you can see suggestions that never made it. One user objected on animal-rights grounds that the article calls for killing infected animals rather than quarantining them. Another said a Thai doctor had made progress on a cure, citing a few newspaper articles.
Periodically, the article will be criticized for being too simplified — there will be arguments over whether the article should point out there are multiple strains of the Ebola virus. Others wonder why it includes so little discussion about the current outbreak. It is covered in a separate article.
“My position is that people come to Wikipedia for an overview, for the background picture, and by taking an article on a disease and skewing it to the outbreak, we are doing a disservice,” Heilman said.
The 300 or so core editors of Wikipedia’s medical articles tend to be highly educated, Heilman said. A recent survey, he said, found that half of that core group work as, or are studying to be, health care providers and 85 percent have completed college.
That well-schooled contributor pool is only going to get bigger. On Monday, the University of California, San Francisco, began an elective class for fourth-year medical students that focuses on Wikipedia editing.
The teacher, Dr. Amin Azzam, a health sciences associate clinical professor at the medical school, said he was not certain whether any of his students would work on the Ebola article but that it was possible they would urge other students concentrating on infectious diseases to contribute to it.
“I now believe it should be our professional duty to contribute to Wikipedia — one of the fastest ways we can improve the health of our entire planet!” he wrote by email.