top of page

The Pathogen of Perception: Quantifying the Multi-Dimensional Cost of Medical Misinformation

Updated: 3 days ago

by Jason Wang for The 44 North

Winner of our Inaugural Essay Contest


A doctor crossing their arms in front of a purple background with cartoon vaccine syringes. Their face is covered by anti-vaccination social media posts.
A doctor crossing their arms in front of a purple background with cartoon vaccine syringes. Their face is covered by anti-vaccination social media posts.
"The cost of misinformation shows up in obituaries and hospital bills. The value of a scientifically literate society shows up in the deaths that never happen and the crises we prevent before they spiral. My grandmother is alive today because accurate information eventually reached her through the noise. How many others could we save if we made sure it reached them first?"

In the Canadian Armed Forces, we're taught that the most dangerous threat is often the one that remains hidden. Today, that danger is no longer confined to a physical battlefield; it has taken root in the digital spread of medical misinformation.


As a Grade 12 student aspiring for a future in neurosurgery, I see misinformation not merely as a social ill, but as a clinical hazard. It behaves less like an abstract idea and more like a pathogen, producing tangible harms that strain public health systems, burden the economy, and undermine collective safety. During the peak of the COVID-19 pandemic, my own grandmother—a woman who survived the 2003 SARS outbreak in China and understood the visceral reality of respiratory illness—found herself paralyzed by skepticism. Despite her lived history, the sheer volume of digital misinformation regarding vaccine safety led her to abhor the very medical breakthrough designed to protect her.


It was only through exhaustive persuasion and the presentation of rigorous clinical data that she begrudgingly consented to immunization. Her hesitation was not born of ignorance, but of a systemic failure in information integrity. It was through this experience that I realized medical misinformation acts as an informational pathogen that imposes a tripartite cost: biological, economic, and societal, ultimately illustrating that the erosion of scientific literacy is a tangible threat to human life and the stability of the healthcare system.


Misinformation is not a victimless exchange of ideas; it has a direct, pathological impact on human physiology. During the COVID-19 pandemic, researchers attempted to quantify the death toll attributable to vaccine refusal. A 2022 study published in The Lancet estimated that COVID-19 vaccination prevented approximately 14.4 million deaths globally in the first year of availability (Watson et al., 2022). Working backward from that figure, the Kaiser Family Foundation calculated that between June 2021 and March 2022, at least 234,000 COVID-19 deaths in the United States could have been prevented if unvaccinated individuals had received the vaccine (Amin et al., 2022). These were not deaths caused by vaccine scarcity, logistical failures, or overwhelmed hospitals. Medical intervention existed and was available. What failed was the transmission of accurate information to the populations who needed it most.


The pathway from misinformation to mortality operates through two distinct but interconnected mechanisms. At the individual level, false beliefs about vaccine safety leave people vulnerable to severe disease outcomes. COVID-19 disproportionately threatens specific populations: the elderly, individuals with underlying conditions like diabetes or cardiovascular disease, and the immunocompromised. When a 70-year-old diabetic encounters claims that "natural immunity is superior" or that vaccines alter DNA, they're being steered toward a preventable death. The data from 2021 is unambiguous: unvaccinated individuals died and were at higher risk of infection from COVID-19 at rates 13.9 and 53.2 times higher than their vaccinated counterparts, respectively (Johnson et al., 2022). That mortality gap represents actual bodies, not abstract risk calculations.


At the population level, vaccine hesitancy degrades what epidemiologists term “herd immunity, the phenomenon where high vaccination coverage protects even those who cannot be vaccinated by suppressing overall transmission. Herd immunity requires crossing specific thresholds: for measles, approximately 95% of the population must be immune to prevent sustained outbreaks (Osman et al., 2022). When misinformation depresses vaccination rates below these critical levels, diseases that had been eliminated for decades resurface.


Canada's experience is instructive. Between 2019 and 2023, routine childhood vaccination coverage dropped from 90% to 82% (Jacobsen, 2025). In November 2025, Canada lost its measles elimination status after 27 years. Canada recorded over 5,100 cases in a single year (Soucheray, 2025). Two infants died after contracting the virus in utero, before they could be vaccinated. The virus had not mutated into a more dangerous form. The vaccine had not failed. The only variable that changed was information integrity. The cruelty of this dynamic lies in its distribution of harm. The individuals who bear the biological cost are often not the ones who rejected the medical intervention. The infants who died in Canada's measles outbreak made no decisions about vaccine safety. The immunocompromised cancer patient who contracts COVID-19 from an unvaccinated colleague did not choose vulnerability. The child who develops measles because their parents believed discredited claims about vaccine-induced autism did not consent to that infection. When misinformation convinces one person to refuse vaccination, the biological consequences radiate outward, creating community-wide vulnerabilities that extend far beyond individual choice.


Beyond direct biological harm, misinformation creates a preventable fiscal crisis for healthcare systems built on the principle of prevention. The economic logic of vaccination is straightforward: a small upfront cost prevents far larger expenses later.


During the COVID-19 pandemic, this logic played out in real time. Between June and November 2021, hospitalizations of unvaccinated adults cost the U.S. healthcare system approximately $13.8 billion, according to research by the Peterson Center on Healthcare and the Kaiser Family Foundation (Farrenkopf, 2022). That figure represents just five months in a single country. The vaccines were free to patients. The hospital stays were not. ICU beds, ventilators, weeks of round-the-clock nursing care, and post-discharge rehabilitation drove costs that dwarfed what prevention would have required. Each COVID-19 hospitalization in Canada averaged roughly $20,000 for non-ICU care and exceeded $50,000 for ICU treatment, according to CIHI (CBC News, 2021). Across hundreds of thousands of largely preventable hospitalizations, the resulting economic waste becomes staggering. The Commonwealth Fund estimated that COVID-19 vaccination prevented approximately $900 billion in U.S. healthcare costs during the first year of vaccine availability alone (Schneider et al., 2022).


The opportunity cost of this spending is as important as the headline numbers. The National Cancer Institute operates on an annual budget of about $6.9 billion. The $13.8 billion spent on preventable COVID hospitalizations in five months could have funded nearly two years of cancer research. It could have paid the annual salaries of roughly 138,000 nurses or purchased more than 2,700 MRI machines, substantially reducing diagnostic delays. Instead, those resources were consumed treating a disease for which effective, free prevention already existed.


Canada experienced a similar dynamic. Fraser Institute estimated that the Canadian government spent approximately $359.7 billion responding to COVID-19, with an estimated 25% (89.9 billion) wasted (Fuss, Hill, 2023). While not all of that spending was avoidable, vaccine hesitancy accounted for billions that could otherwise have modernized hospital infrastructure, expanded mental-health services, or reduced surgical backlogs that left tens of thousands of Canadians waiting in pain.


Outbreak response costs further expose the inefficiency created by misinformation. When vaccine-preventable diseases resurge, public health systems must mobilize extensive emergency operations: contact tracing, laboratory testing, isolation protocols, and redeployment of clinical staff. Contact tracing a single measles case can cost between $10,000 and $50,000 (Hyle et al., 2018). A 2018–2019 measles outbreak in New York involving 649 cases cost the city approximately $8.4 million in emergency response alone (about $12,900 per case), excluding hospital treatment (Zucker et al., 2020). By comparison, the two-dose MMR vaccine costs roughly $100 (Antoneshyn, 2025). These are not abstract inefficiencies; they are real budget line items and real staff hours diverted from other priorities.


As immunologist Dawn Bowdish has noted, cuts to public-health funding, the lack of a national vaccine registry, physician shortages, and widespread misinformation reinforce one another. Budget cuts weaken the infrastructure needed to counter misinformation. Misinformation lowers vaccination rates. Outbreaks then consume far more funding than the original cuts saved. This reveals something fundamental about how healthcare systems function. Canada’s universal healthcare model rests on an implicit social contract: individuals accept evidence-based prevention, and the system provides care when prevention fails. Misinformation breaks that contract. An unvaccinated patient occupying an ICU bed with preventable disease displaces care for heart-attack victims, trauma patients, or people awaiting surgery. The burden extends beyond money to system-wide constraints: staff burnout, delayed procedures, and overcrowded emergency rooms. Misinformation does not merely waste resources; it degrades the basic capacity of healthcare systems to function.


The biological and economic costs of misinformation ultimately converge in a third dimension: the breakdown of collective capacity to respond to shared threats. As a member of the Canadian Armed Forces Reserves, I have been trained to recognize that mission success depends on accurate intelligence. When field units receive false information about enemy positions or terrain conditions, operations fail, and soldiers die. Public health operates under the same constraint.


Populations cannot mount effective responses to disease outbreaks if they cannot agree on how diseases spread or whether medical interventions work. This is not merely a problem of political disagreement. It represents a fundamental breakdown in the social infrastructure required for coordinated action during crises.


The erosion is measurable. Research by Obohwemu et al. found that lack of confidence, complacency, constraints, calculation, and collective responsibility have all been highlighted as barriers to vaccination uptake among parents to different degrees (Obohwemu et al., 2022). The effect persisted months after exposure, suggesting that misinformation creates lasting changes in trust rather than temporary confusion.


A 2021 study by Loomba et al. published in Nature examined the impact of misinformation on COVID-19 vaccine acceptance across 5,000 participants in the United Kingdom. Participants exposed to anti-vaccine misinformation showed a 6.2 percentage point decrease in willingness to receive a COVID-19 vaccine, and exposure to misinformation emphasizing vaccine side effects reduced stated vaccine acceptance by 6.4 percentage points (Loomba et al., 2021). The effects were largest among individuals who were initially unsure about vaccination, demonstrating how misinformation specifically targets and exploits uncertainty.


The consequences extend beyond immediate health decisions. During February 2022, protests opposing COVID-19 vaccine mandates blocked downtown Ottawa for three weeks, disrupted international trade at border crossings, and required the invocation of the Emergencies Act for the first time since its creation in 1988 (Government of Canada, 2022). The protesters' core belief, that vaccine requirements represented government overreach rather than public health necessity, had been cultivated by years of online misinformation about vaccine safety and efficacy.


Regardless of one's position on specific policy choices, the event demonstrated a critical failure: a substantial portion of the population had become unreachable by conventional public health communication. They were not evaluating evidence about transmission dynamics or hospital capacity. They were operating within a constructed narrative where vaccination itself was the threat. This matters because complex modern societies require institutional trust to function. Climate adaptation, pandemic preparedness, food safety regulation, and infrastructure maintenance all depend on public willingness to defer to technical expertise on questions beyond individual competence. When misinformation convinces populations that expert consensus is either fraudulent or politically motivated, that deference collapses. The immediate result may be preventable deaths during a pandemic. The long-term result is a society that has lost the ability to protect itself from foreseeable dangers.


Misinformation does not merely kill people in the present. It disables the mechanisms societies need to prevent future deaths.


My grandmother eventually got her COVID-19 vaccination, but it took weeks of persuasion and countless conversations before she trusted the science over what she had read online. Millions of others never made it to that point. The 234,000 preventable deaths in the United States, the return of measles in Canada after 27 years of elimination, the billions spent treating diseases we already knew how to prevent—these numbers tell a straightforward story about what happens when people cannot tell truth from fiction. Misinformation kills people, drains resources that could save other lives, and breaks down our ability to respond when the next crisis arrives. But the same networks that carry lies can also carry truth when people know how to recognize the difference.


The answer is not censorship. It is teaching people how to think critically about health information, the same way we teach them to read or do algebra. My generation has grown up watching misinformation kill people we know. We understand how it spreads because we have seen it happen in real time. That experience can become our greatest defense if we treat scientific literacy as essential to navigating modern life safely. The cost of misinformation shows up in obituaries and hospital bills. The value of a scientifically literate society shows up in the deaths that never happen and the crises we prevent before they spiral.


My grandmother is alive today because accurate information eventually reached her through the noise. How many others could we save if we made sure it reached them first?


About the Author

Jason Wang is a Grade 12 Senior student at St. Peter’s Catholic Secondary School in Peterborough, Ontario. He currently works as a lifeguard, swim instructor, piano teacher and recently, an Army reservist. He wishes to pursue a career in medicine and neuroscience/neurosurgery in the future. He is also the creator of “The Axonora Initiative,” a recent YouTube channel focusing on tackling misinformation.”


Connect with Jason on personal Instagram: @jimjamwong08 or through The Axonora Initiative @axonorainitiative



References

Letter from the Editor-in-Chief: Who is Seen, Who is Heard, and What Happens When the Truth is Obscured

by Gillian Smith-Clark ​for The 44 North

Editor in Chief


“Tell the Truth” stamped on pavement in white capital letters
“Tell the Truth” stamped on pavement in white capital letters

This February/March issue of The 44 North is, at its core, about visibility: who is seen, who is heard, and what happens when the truth is obscured: by power, by indifference, or by deliberate misinformation.


Across these pages, you’ll find work that grapples with Black history and resistance, the freedom to read, women’s and girls’ safety, sexual and reproductive health, homelessness, and the quiet, daily ways communities hold one another together when institutions fail them. These themes may appear distinct, but they are bound by a single throughline: access. Access to knowledge, to care, to dignity, and to platforms that refuse to look away.


That tension feels especially sharp right now. In recent weeks, more than 300 journalists were purged from The Washington Post—a decision that lays bare how vulnerable even legacy newsrooms are when journalistic missions collide with corporate ownership. The paper’s slogan, Democracy Dies in Darkness—introduced in 2017 and greeted at the time with both praise and pointed skepticism—now reads less like branding and more like an unintended indictment. What does that phrase mean when an iconic publication is hollowed out by fear and corporate priorities, and when media power increasingly determines which stories survive, and which disappear?


This issue is our response to that question.


Independent media matters not because it is perfect, but because it is accountable. Because it asks uncomfortable questions. Because it makes room for more voices—especially young and marginalized voices—that are too often dismissed, underestimated, or filtered through institutions that no longer serve them. At The 44 North, we remain committed to publishing work that is courageous, ethical, and grounded in empathy, including, and more specifically, when doing so is inconvenient.


You’ll see that commitment reflected throughout this issue. Our review of All My Puny Sorrows by Miriam Toews explores grief, agency, and the limits of language when pain resists resolution. In our Artist Spotlight, Feels Zine offers a bold and tender exploration of queer sex and romance, reminding us that intimacy itself can be an act of reclamation. Nikki Giovanni’s poem “Rosa Parks,” featured in Poet’s Corner, anchors Black history not in abstraction, but in lived courage.


Several pieces examine storytelling as both a mirror and an intervention. Our feature on libraries as vital “third spaces,” including Dear TPL: The Passport Project, highlights how access to books and community resources can quite literally expand lives. “Novel Idea: How Fiction Helps Us See Ourselves” reflects on reading as self-recognition and survival. In The Writer’s Room, “ICE Murders: Lives in Slow Motion” uses current-events-based fiction to confront state violence in ways conventional reporting often cannot.


This issue also includes my own essay, “Watching Minneapolis from Canada: When Power Stops Explaining Itself,” which wrestles with proximity, responsibility, and what it means to witness injustice across borders in an era of relentless images and insufficient accountability.

At the heart of this issue is the winning essay from our inaugural essay contest: “The Pathogen of Perception: Quantifying the Multi-Dimensional Cost of Medical Misinformation” by Jason Wang.


Wang’s essay embodies everything we hoped this contest would epitomize: thoughtful analysis, moral seriousness, originality, and something more: a refusal to treat misinformation as a harmless difference of opinion. “Misinformation is not a victimless exchange of ideas,” Wang writes, tracing how falsehoods about vaccines during the global pandemic translated into preventable deaths—often borne not by those who rejected care, but by infants, immunocompromised patients, and those who never consented to the risks imposed upon them.


What makes this essay especially powerful is its insistence that the solution is not censorship, but literacy: scientific, media, and civic. “The answer is not censorship,” Wang argues. “It is teaching people how to think critically about health information the same way we teach them to read or do algebra.”  In a moment defined by fragmentation and distrust, this is a call not for control, but for collective capacity.


What happens to a society when it loses the ability to respond to shared threats? When truth is drowned out by noise, and institutions designed to inform either retreat or collapse?


This issue is our answer: we build capacity by telling the truth carefully. By amplifying young thinkers who understand the stakes because they have lived them. By defending the freedom to read, to question, to imagine, and to care for one another beyond narrow definitions of individual choice.


If we take the Post’s motto at its word and accept that “Democracy Dies in Darkness,” it is worth remembering that darkness thrives in silence and isolation. It recedes when we insist on seeing the world as it is, clearly—and when we choose, together, to keep the lights on.


— Gillian Smith-Clark

Editor in Chief, The 44 North Media


Why Climate Action Starts With Seeing People: Warm Hearts Awareness Campaign

by Emily Kantardzic for The 44 North

Youth Climate Fellow—Stanford Climate Fellowship & Rustic Pathways


People in coats walking through a blizzard in a city
People in coats walking through a blizzard in a city
"One of the most important lessons the fellowship taught me is that you don’t need a perfect plan or a large platform to begin. I used to believe meaningful change required waiting—for the right idea, the right time, or the right level of confidence. This experience showed me that starting small isn’t a weakness. It’s often how change becomes possible."

Before joining the Stanford Climate Fellowship through Rustic Pathways, I thought climate change was something I understood. I followed the news, knew the statistics, and cared deeply about the issue. However, based on what I’d seen in the media, heard from adults, and believed, I thought: Because I’m a teenager, my voice isn’t big enough to make any change. It was amazing how wrong I was. After doing my research into the opportunities available to teens like me—who want to make change but don't know how to—everything shifted. My perspective on the change I could make transformed once I began connecting climate issues to real people and lived experiences through the sources that were right at my fingertips (and are at yours too!).


The fellowship wasn’t just about learning facts—it was about noticing how climate change shows up in everyday life. Through conversations, workshops, and shared projects, I started to see how environmental challenges are deeply tied to social ones, particularly for people who are already vulnerable.


One moment that stayed with me was realizing how extreme weather affects youth experiencing homelessness in my own city. Cold winters aren’t just uncomfortable—they can be dangerous. That realization pushed me to think differently about what climate awareness can look like when it’s rooted in local, human realities.


Learning to Take Action

As part of the fellowship, we were encouraged to design a project connected to our communities. That’s how Warm Hearts began—a youth-led awareness campaign focused on youth homelessness in Toronto alongside sustainable clothing practices. While it’s still early in its journey, Warm Hearts has already helped turn concern into action.


Through the campaign, I share information about youth homelessness, extreme cold, and the environmental impact of clothing waste on Instagram and TikTok (@warmheartsac). The idea is simple: donating gently used clothing can support young people in need while also reducing textile waste and the carbon footprint of fast fashion.


Partnering with Covenant House in Etobicoke, Warm Hearts has helped collect winter clothing and raise funds for youth experiencing homelessness. Equally meaningful are the conversations it sparks—moments when peers, friends, and community members pause to reflect on empathy, sustainability, and how they can make a difference in their own ways.


Emily wearing a red holiday sweater and a Santa hat, holding a hand-drawn Warm Hearts sign.
Emily wearing a red holiday sweater and a Santa hat, holding a hand-drawn Warm Hearts sign.

What I Took Away From the Fellowship

One of the most important lessons the fellowship taught me is that you don’t need a perfect plan or a large platform to begin. I used to believe meaningful change required waiting—for the right idea, the right time, or the right level of confidence. This experience showed me that starting small isn’t a weakness. It’s often how change becomes possible.


I also learned the power of sharing stories. When people understand why something matters, they’re more likely to care and stay engaged. That mindset has shaped how I think about climate issues, leadership, and community action.


Moving Forward

Warm Hearts is just the beginning. I hope it grows into a broader platform that inspires young people to get involved in issues they care about—whether that’s climate justice, homelessness, sustainability, or something else entirely.


More than anything, the fellowship gave me confidence: confidence to speak up, to try, and to keep going even when things feel uncertain.


The Warm Hearts logo
The Warm Hearts logo

A Note to Other Young People

If you feel a calling to help change the world, that urge is already halfway to the goal. Your voice isn’t too small—don’t let anyone convince you any differently. In situations where most people follow the crowd and don't speak up about topics that really matter, don’t be a follower; be a leader. You don’t need everything figured out to begin. Paying attention, learning, and responding to what matters around you already counts.


Sometimes, meaningful change starts there—and if you want to see what that can look like, Warm Hearts is one example of how young people can take action in their communities. You can follow the journey on Instagram and TikTok @warmheartsac.

bottom of page