Global pandemics, conflict and networks – the dynamics of international instability, infodemics and health care in the 21st century

BACKGROUND: The COVID-19 global pandemic is a harbinger of a future destabilised world driven by climate change, rapid mass migration, food insecurity, state failures and epidemics. A significant feature fuelling this destabilised world is networked misinformation and disinformation (referred to as an infodemic), particularly in the area of health. AIMS: To describe the interactive dynamic of climate change; mass population movement; famine; state failure and epidemic disease, analyse developments over the year 2020–2021 and discuss their relationship to an infodemic about disease and public health responses and how this should be addressed in the future. METHODS: Using the concept of ‘the Five Horsemen’ of epochal change and network theory to guide a narrative review. RESULTS: Concepts of epidemiology are reflected in how misinformation is spread around the world. Health care services and personnel face threats as a result that make it more difficult to manage pan global health risks effectively. CONCLUSIONS: Heath care professionals at an individual and organisational level need to counter infodemic networks. Health care professionals who consistently spread misinformation should have their licence to practice withdrawn.