Tim K. Mackey
Associate Professor, School of Medicine and Director, Global Health Policy Institute
University of California San Diego
CEO and Co-Founder, S-3 Research LLC

As of the beginning of May 2020, the novel coronavirus (aka COVID-19) global pandemic has claimed the lives of more than 240,000 people and now has over 3.4 million confirmed cases worldwide. This global crisis is impacting all facets of our globalized and interconnected society, including our health, economies, social interactions, international trade, policy decisions and utilization of technology. Its broad reach, expanding scope and uncertain trajectory makes it the most serious global health event we’ve experienced in close to a century. Not since the 1918 influenza pandemic, which killed an estimated 50 million people globally, has the world faced a health emergency that will have such a generational impact. However, this pandemic is also distinctly different from others. During the 1918 influenza pandemic, the radio crystal oscillator was invented, marking a period when commercial radio was just beginning, and electronic TV did not exist. The 2003 Severe acute respiratory syndrome (SARS) outbreak, widely considered the first major infectious disease event in the post-globalization era (Mackey and Liang, 2012), occurred in a world where there was no Facebook (launched in February 2004) and when social media platforms were just beginning to rise as a dominant space to share and interact in a digital medium. In contrast, when the COVID-19 outbreak began in December 2019, more than half (53.6% according to the International Telecommunication Union) of the entire global population was on the Internet (ITU, 2019) and Facebook reported it had a community of 2.5 billion monthly active users globally (Facebook, 2020).

Hence, increased access, propagation and rapid dissemination of information via the Internet, mobile devices, social media and other information and communication technologies is at an all-time high in human history. This has led to a parallel “infodemic” occurring alongside the COVID-19 disease epidemic itself (Zarocostas, 2020).

The World Health Organization (WHO) characterizes an “infodemic” as an over-abundance of information, some accurate but some that is not trustworthy or reliable (WHO Coronavirus disease (COVID-19) Situation Report – 86, April 2020). Importantly, COVID-19 digital misinformation, cybercrime and other forms of online frauds represents a major challenge to outbreak response and ensuring public health objectives are met to mitigate the spread of this unprecedented disease (Polantz and Perez, 2020).

In times of a pandemic, technology can be leveraged for important medical and public health tasks, such as disseminating evidence-based health information and communication, enabling telemedicine to deliver health services remotely and safely, and innovating on traditional public health approaches by using digital health technologies, such as the Google and Apple partnership to develop a digital contact tracing system (Apple Newsroom, 2020). However, the dark side of technology is also abundantly apparent, particularly in how criminals take advantage of the anonymity, convenience and accessibility of Internet technologies to perpetuate cybercrimes in times of vulnerability. Hence, we are in the midst of a “cyber syndemic” where the public health consequences of COVID-19 are simultaneously interacting with the risks posed by online environments that can promote interactions that can actually worsen the spread of the disease. 

Documented COVID-19-related cybercrimes include fake coronavirus applications that are actually malware (Salzman, 2020), phishing scams using email, text message campaigns and robocalls, economic scams regarding government assistance/relief and a host of suspect and counterfeit COVID-19 products now being sold online (Carrns, 2020). In fact, the U.S. Federal Trade Commission (FTC) estimates that COVID-19-related frauds have resulted in close to $12 million in losses for more than 15,000 Americans (Christie and Park, 2020). U.S. Customs and Border Protection have also seized fraudulent COVID-19 testing kits being shipped into the country (CBP, 2020). These COVID-19 crimes not only bring with them economic loss at a time when unemployment rates are skyrocketing, but also bring the dual risk of introducing substandard, falsified and counterfeit products that can actually bring harm to people who are at their most vulnerable by further spreading the disease or worsening their health (Long, 2020).

Specifically, numerous news reports have exposed that online sales of suspect and counterfeit COVID-19 products are readily accessible via social media and e-commerce sites (Heilwell, 2020), revealing how internal controls on these platforms are still immature when dealing with the surge of fraudsters seeking to capitalize on pandemic fears. COVID-19 “cures” and fake testing kits have been found on major platforms such as Amazon (which reported removal of over a million fake COVID-19 products on its platform) (Gonzalez, 2020) and eBay (Heilwell, 2020), as well as other online platforms such as Shopify (Keller and Lorenz, 2020). These products range from ridiculous claims such as curing COVID-19 with oregano or cocaine, all the way to sophisticated testing kits that claim U.S. Food and Drug Administration (FDA) approval (Wehner, 2020). The dark web is also emerging as a source for COVID-19-related commodities, but with so much on the open web, its utility as an illegal source during the early stages of the pandemic may for now be muted (Boyd, 2020).

Importantly, these COVID-19 cybercrime challenges are real and acute, and though technology has enabled these crimes, it may also represent the key tool to combat them.

As a global health professional, the COVID-19 pandemic is a call to action for all of us in the public health community. As a technologist with my own big data and machine learning startup company funded by the National Institutes of Health (Quach, 2020), the COVID-19 cybercrime syndemic has also been a call to build technology-based solutions to help combat illegal COVID-19 scams online. To this end, we have been actively scanning major social media platforms for illegal sale of suspect and counterfeit COVID-19 health products including questionable treatments, fake testing kits and yet to be approved pharmaceuticals.  

However, the task has been challenging, even with our suite of algorithms armed to rapidly detect, classify and report illicit drug sales — processes which we have adapted for COVID-19 — the fast pace of everchanging scams, extremely high volume of content and rapidly changing real-world developments around COVID-19 makes this task a moving target. As legitimate news about promising new COVID-19 testing and diagnostic products, pharmaceutical treatments (e.g. Remdesivir, hydroxychloroquine, etc,), and development of a vaccine hit the Internet, so do scammers and counterfeiters looking to capitalize on a desperate public who simply want to be safe and prepared.  This hyperactive environment means we are constantly adding new keywords for our big data surveillance and constantly adjusting our machine learning approaches to accommodate new scams and products as they emerge.

In this sense, we are both at the frontlines, and just at the beginning of what will be a long war of attrition against the COVID-19 infodemic. Fortunately, international and national stakeholders are taking this challenge seriously, with organizations such as United Nations, Interpol, the European Anti-Fraud Office, the FBI, the FTC, the U.S. Department of Homeland Security and the FDA issuing warnings and fraud alerts to the public while also attempting to stem the tide of unauthorized and fraudulent products being sold online and offline. We are also trying to do our part by building a prototype data dashboard solution that scans popular social media platforms, categorizes illicit COVID-19 sales with machine learning, and displays them in a way to enable public health and law enforcement intelligence (see Figure 1) and have shared these dashboards with the colleagues at the FDA and WHO.

Figure 1:  Prototype COVID-19 Product Surveillance Dashboard Developed by S-3 Research

Vigilance, perseverance and continued innovation will be needed by all stakeholders to effectively combat COVID-19-related misinformation, scammers, fraudsters and counterfeiters in this unprecedented time of crisis. Even when this pandemic slows, its accompanying cybercrime syndemic is likely to continue to go viral.