Misinformation spreads so quickly that public health officials should be monitoring social media platforms in real time to debunk bogus claims as fast as possible, a new study suggested.

Over the course of one day, May 20, the study identified 153 English-language videos with monkeypox conspiracy theories on social platform TikTok. The videos had been posted a median of 30 hours before, and in total, they’d already received 1,485,911 views according to the study published in the medical journal JAMA Network Tuesday. TikTok has more than 1 billion users monthly, the study says, and public health officials need to identify and disprove deception on social platforms before it spreads.

The study sorted the false claims on TikTok into 11 categories and found the most prominent theories were that monkeypox was a planned pandemic introduced for power, control, money or to instill fear. About a third of the videos said that monkeypox was an excuse to administer or mandate vaccines worldwide. About one fifth of the videos said billionaire Bill Gates was involved with the virus in some way. The study aimed to understand how fast misinformation can spread and devise strategies to counter it, researcher Timothy Caulfield, Canada research chair in health law and policy at the University of Alberta, said in an interview.

“This is also a reminder to public health agencies about the amount of misinformation out there, the speed that it can arise, and the need for those public health entities to fight misinformation quickly and efficiently,” he said. “Even if these themes seem absurd, respond with good, engaging content on social media platforms to meet the misinformation where it resides – and it resides on platforms like TikTok.”

The spread of misinformation about monkeypox is not an anomaly. Lies about Covid were also fueled by social media platforms, which affected confidence in the COVID vaccine. Kaiser Family Foundation’s COVID-19 Vaccine Monitor, a research project tracking the public’s attitudes and experiences with COVID shots, found that 78% of adults believed a false COVID statement to be true or were unsure of it. That correlated with both vaccine status and partisanship, according to the report.

Caulfield said he was surprised to see how individuals seemed to be reading from a script. Individuals often used monkeypox conspiracy theories as an entry point to a “rant” – they would go on to talk about climate change, vaccines or the war in Ukraine, he said. Social platforms themselves will likely need to get involved in confronting misinformation, in addition to everyone from regulators and governments to clinicians and researchers, he said.

TikTok referred a request for comment to its community guidelines on harmful information. For its part, the platform started a proactive detection program with its fact-checkers to identify and remove evolving false claims. The program has identified 33 new misinformation claims and removed 58,000 videos, according to a Sept. 28 statement. TikTok also provides access to World Health Organization information about COVID and monkeypox through tools like labels on videos and public service announcement hashtags, according to the statement.

“We’ve got to come at it from absolutely every direction,” Caulfield said. “It’s really important that whatever tools we use on these platforms to fight misinformation, we want them to be evidence informed.”