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

by Jason Wang for The 44 North

Winner of our Inaugural Essay Contest


A white cloth sign held up at a protest, which reads: “This is not about a virus, it’s about government total control of people” in black capital letters.
A white cloth sign held up at a protest, which reads: “This is not about a virus, it’s about government total control of people” in black capital letters.
"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

Book Review: Everything is Tuberculosis - The History and Persistence of Our Deadliest Infection by John Green (2025)

Updated: Jan 14

by Abbigale Kernya, ​for The 44 North

Managing Editor


The book cover of Everything Is Tuberculosis by John Green
The book cover of Everything Is Tuberculosis by John Green



Genre: Non-Fiction


“It reminded me that when we know about suffering, when we are proximal to it, we are capable of extraordinary generosity. We can do and be so much for each other. But only when we see one another in our full humanity. Not as statistics or problems, but as people who deserve to be alive in the world.”


― John Green, Everything Is Tuberculosis

“Nothing is so privileged as thinking history belongs to the past.”

Lately, I’ve been thinking about COVID. 


But I still skip every episode from whatever TV show in 2020 where a pandemic invades the static screen. I don’t want to talk about it, and yes, I also can’t believe it happened. 


Sometimes I’m catapulted five years ago in the smallest of places: Standing on the crusted six-feet-apart footprints scuffed on the grocery store floor, or a blue mask snagged on a trash bin, or even the sharp moment of panic when a stranger sneezes on the bus.


Despite all my shoving and pushing it down into a crevice of my memory, the pandemic still happened, and we are still living through it. I still think about it, even when I don’t want to.


John Green is the first person to untangle my stress ball of past anxiety and future confusion about illness into one tidy book. It fundamentally changed my life. Everything is Tuberculosis follows the illness (or, “consumption,” as it was so often glorified as a beautiful wasting disease of the rich and privileged) through the threads of class and capitalism in the past centuries. Green weaves us through the romanticization of the “white man’s disease” to now, where the raging class disparities around the globe ignite the fire for consumption to not only rage on, but fuel humanitarian crises like gasoline on a brush fire.


What took this book (by no means a solely historical textbook) from a simple Crash Course about disease to a commentary on beauty and capitalism was Green’s account of travelling to Sierra Leone to see first-hand how a disease—that was once considered desirable for its beauty and attraction to upper-class intelligence—is now the beacon for a humanitarian crisis. 


In a calling card to end the disparity between the tuberculosis (TB) crisis and access to medication and vaccines, Green details the story of a little boy, Henry, treated in a Sierra Leone hospital. A hospital it may have been, but one much different from the one you and I and John are familiar with. One that is denied access to life-saving medicine. One that is impoverished by colonialism, past and present, and one where children die of an easily curable disease for the sole reason that they were born in a country that the rest of the world turned a blind eye to.


Green details his relationship with Henry throughout the book, from innocent childlike wonder to recounting stories of Henry’s family, where disease and poverty have taken more than just his childhood. Despite the catastrophic humanitarian crisis invading Henry’s lungs, he is hopeful. He is brave, and he fundamentally changes Green’s life. 


The othering of the ill is not something special to our tiny pocket in time, but rather a telltale sign of how disease is treated based on class, race, and access to medicine. From belladonna’s use in the 1800s as a cosmetic to mimic the pale, feverish look of consumption, to the vilification of TB when poor marginalized communities fell victim, to the current rise of unnatural thinness that plagues the beauty standard of our post-COVID society. Everything is connected, and everything is curable.


To paraphrase perhaps my favourite line in the entire book: Where there is a humanitarian crisis, you will find TB. Where there is poverty and colonialism and people stuck under the boot of centuries of oppression, you will find TB. This disease does not compromise on its victims; it does not judge or offer plea deals. Instead, we as humans are the sole perpetrators of the thousands and thousands of deaths every year from this entirely curable disease. It is when humans fail to act, or don’t care, or put profit over human lives, that TB will show up.


It is hard for me to briefly explain how much of an impact this book had on not only my relationship to illness, but also how I view the world. Green makes an excellent argument throughout the entire book that there is no reason that humans should die of a disease like TB. There is no logical reason that in a world where humans have gone to space and built electric cars that even one human life dies from an entirely preventable illness. In that case, tuberculosis is not a disease of medicine, but rather a disease of human empathy and the cavern standing between suffering and power.


Everything is Tuberculosis is as gentle with human spirit as it is fundamentally important to understanding the politics of human suffering. From tender-hearted stories of compassion and generosity, to a century-long study into illness as a catalyst for global misunderstanding of what it means to be alive. 

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