3.1. Mistrust, Fake News, and Resulting Implications
infectious diseases, infection
INFECTIOUS DISEASES, INFECTION
From the start of the study, the research team met multiple challenges. First, the aggressive and divisive rhetoric employed by former president Bolsonaro since his election in 2018 seemed to have created a generalized climate of distrust in the country, including towards science and scientific institutions that have repeatedly been discredited by the government [During the first field visits and baseline data collection, the presence of study personnel (field teams formed of undergraduate and graduate students from Fortaleza) in many of the clusters, some of which were controlled by gang factions, was met with suspicion and resistance. To tackle this issue, the research team sought the collaboration of municipal workers specialized in infectious diseases and community health agents, in an attempt to improve the relations between the research team and community members. Yet, this collaboration with local workers was not very fruitful, as they appeared to be uninterested to mobilize and contribute to the study. We believe that the lack of financial compensation for their collaboration efforts was an important barrier, which was not possible to provide given budgetary constraints.In January 2020, soon after the baseline data collection started, fake news began circulating about COESA and its personnel. Multiple messages were shared on WhatsApp, warning cluster residents about untrustworthy individuals pretending to be affiliated with a university (i.e., the research team) visiting households. These messages stressed that these individuals were collecting personal information on children, that they were refusing to show their material to community members, and that they were making children sick by injecting them with an unknown liquid after collecting blood, sending some of the children to the hospital because of the infection they were given. Here are some examples of the messages that were circulating in Fortaleza about the study:

While the origins of the fake news circulating about COESA are unknown, the local research team hypothesized on different potential sources. These included gang members in the clusters, who were displeased with the presence of the research team in their territory. Another hypothesis is that the communities themselves spread the fake news to protect their children, as they were worried that the research team was using blood samples for purposes other than the research. These messages started not only circulating in the communities targeted by the study, but also in surrounding neighborhoods and municipalities. 