The paradox of the link between health literacy and health promotion: the case of COVID-19.

COVID-19 brought out the critical issues of public health messages and the relationship between health literacy, health promotion, and public health. The aim is to analyse these concepts to provide a framework in which mutual influences are ontologically analysed; more specifically this article will explore whether health promotion should improve health literacy or health literacy is actually a pre-requisite for understanding (and put into practice) health promotion/public health messages. Public health must protect the public from misinformation and on this nurses and other health care providers play a crucial role in supporting individuals and communities in the comprehension of public health messages. The paradox under analysis is the link between health literacy and health promotion; what the role of health literacy is when, as in the case of the recent outbreak of the COVID-19 pandemic, Public Health must address tens of hundreds of health promotion messages to the whole population. During the outbreak, there was an underlying uncertainty, every day new data and information emerged and every day something more was understood (or misunderstood) about the virus. There was a massive presence of COVID-19 misinformation, particularly on social media in terms of, among others, treatments, the utility of wearing mask, COVID-19 cases by age group, conspiracy theories, all added more confusion and uncertainty to the public. Public health must protect the public from misinfromation. While in practice actions have been put in place to improve patients' compliance with respect to health promotion it is unclear the ontological relationship between health promotion and health literacy within the Public Health context.