Commentary: Misinformation a concern as respiratory illness surge in China triggers COVID-19 memories
It’s natural for people to be concerned about whether the rise in respiratory illnesses in China might possibly herald a repeat of the COVID-19 pandemic. But misinformation might be the more dangerous problem, says NUS Saw Swee Hock School of Public Health’s Hsu Li Yang.

A children's hospital in Beijing, where there have been surging cases of respiratory illnesses, particularly in children. (Photo: AFP/Jade Gao)
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SINGAPORE: China has seen a surge in acute respiratory illnesses affecting children since mid-October, prompting the World Health Organization (WHO) to request more information to determine if there were “clusters of undiagnosed pneumonia” among children in Beijing and Liaoning as reported in the media.
It’s no surprise people are concerned about the possibility of another pandemic, given news of a “mysterious illness” that might remind us of how COVID-19 began. After all, haven’t public health experts been warning that future pandemics are a matter of when not if?
This is known as the availability heuristic, where we take mental shortcuts based on familiar facts or immediate recent experiences and events.
China’s National Health Commission attributed the respiratory illness rise to endemic viral and bacterial respiratory infections and said on Saturday (Dec 2) that no new infectious diseases have been found so far.
WHO had earlier said that the situation in China mirrored what had occurred in other countries a year or two ago. In these countries - typically at the start of winter - the relaxation of COVID-19 precautions had resulted in a surge of other respiratory pathogens such as influenza and respiratory syncytial virus (RSV).
Singapore had similarly seen a spike in such cases in August 2022 and February 2023. On Saturday, the Ministry of Health said there was no indication of increases in severe respiratory illnesses, including in children.
WHAT ARE WE TO MAKE OF THESE DEVELOPMENTS?
The current surge of respiratory illnesses in northern China does not portend a new pandemic. And there’s more positive news.
The global system of surveillance and response is clearly operating better than it did prior to the COVID-19 pandemic, which in turn was already a vast improvement compared to the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak.
This is not just in terms of technical capability - the cause of the respiratory infections in Beijing and Liaoning were rapidly ascertained - but also in terms of transparency and international cooperation.
China’s secrecy and delays in releasing information to WHO during the early days of the COVID-19 pandemic, which further fuelled the divisive debate about a “Wuhan lab leak” or an animal origin for SARS-CoV-2, will unfortunately colour perceptions of the country’s transparency for some time to come.
For the current surge in respiratory illness, WHO requested additional information from China on Nov 22, via its International Health Regulations mechanism. The very next day, WHO and Chinese health authorities held a teleconference, where the requested data were provided.
The more such reporting and accounting is normalised, the better prepared we will be for future pandemics.
FAKE NEWS AND MISINFORMATION CAN RUN RIFE
But this episode also demonstrates the ongoing challenge of struggling against misinformation, particularly in the social media space.
On Nov 21, an abridged, edited and machine-translated excerpt from Taiwanese media FTV News was posted on the Program for Monitoring Emerging Diseases (ProMED) site. It highlighted an “outbreak of pneumonia in China”, with children’s hospitals in Beijing and Liaoning “overwhelmed with sick children”, schools “on the verge of suspension” and parents questioning “whether the authorities were covering up the epidemic”.
ProMED is the global disease surveillance system run by health experts that sounded the early warning on COVID-19. This ultimately triggered a WHO response that fuelled further global media reports and conjectures.

A quick search on X (formerly Twitter) for “China respiratory illness” revealed a flurry of activity - hundreds of posts and shares over just a week. These posts, many from media organisations, presented various slants on the “mysterious illness” ranging from factual to hyperbolic.
This is problematic and also reminiscent of the COVID-19 pandemic, where conspiracy theories and misinformation spread widely on social media and sowed many seeds of societal mistrust.
There is currently also no clear way of nipping erroneous or misinforming (deliberate or otherwise) posts in the bud, given the nature of social media platforms. Misinformation can and will go viral, particularly if, in the near future, artificial intelligence is increasingly used to generate such content.
LESSONS FOR THE NEXT PANDEMIC
We may never be able to prevent future pandemics, but we can mitigate their impact. Two critical interventions are highlighted by this episode: A strong global outbreak surveillance system with transparent sharing of data and accountability, and the ability to tamp down erroneous or misleading health information.
The former involves not just capacity and technical development at country-level, but also increasing the funding and resources to intergovernmental organisations such as the WHO, as well as establishing legally binding international agreements and instruments to foster collaboration and pandemic response between countries.
Tackling erroneous or misleading health information requires a multi-faceted approach. Such efforts have already begun in many countries including Singapore.
One key component of this involves educating the general population about health and media literacy. Legal and policy frameworks are also necessary to hold social media platforms accountable. Health organisations may well need to have in-house teams of fact-checkers and communication experts to rapidly respond to emerging misinformation.
False and misleading claims about COVID-19 and its vaccines persist today. Those who worry about the next pandemic should also inoculate themselves against misinformation.
Hsu Li Yang is Vice Dean of Global Health at the NUS Saw Swee Hock School of Public Health.