Timothy Caulfield is a Canada Research Chair in health law and policy at the University of Alberta and the author of the forthcoming book Relax, Dammit! A User’s Guide to the Age of Anxiety.
President Donald Trump is getting a lot of treatment for his COVID-19 infection. It has been reported that he has received a highly experimental antibody therapy, an antiviral drug (remdesivir), a steroid (dexamethasone), a heartburn drug (famotidine), melatonin, zinc, vitamin D and aspirin.
The medical facts surrounding Mr. Trump’s condition and care remain foggy. But his physician, Dr. Sean Conley, has justified this aggressive, kitchen-sink, approach thus: “He’s the President. I didn’t want to hold anything back. If there was any possibility that it would add value to his care and expedite his return, I wanted to take it.”
I am not an MD and have no idea what Mr. Trump’s condition is, so I’ll refrain from directly critiquing this specific clinical strategy (though it is worth noting that others in the medical community have expressed concern that this seemingly ad hoc and “multipronged approach” may result in harmful overtreatment).
What I’m worried about is the message that this approach sends to the public. It suggests more treatment is always better (not true). That it is always a good idea to roll the dice on experimental treatments (not true). That people should always have access to these treatments (not true). And that privileged patients should and do have access to special care (shouldn’t be true). But perhaps most worrisome, all of this noise about his therapies injects yet more misinformation and chaos into an already chaotic information environment.
Given Mr. Trump’s notoriously fraught relationship with the truth, it may be hard to believe that he could have a significant impact on public perceptions of a scientific topic such as COVID-19. In fact, Trump has been identified as the single most influential and harmful source of COVID misinformation.
A recent study from Cornell University started with a sample of 38 million articles about COVID-19 in the traditional and online news media. They found that mentions of Mr. Trump comprised an astonishing 38 per cent of the “overall misinformation conversation.”
Studies have found that the biggest category of misinformation is unproven cures and treatments. And in this domain, Mr. Trump has also been a particularly dominant voice. His early endorsement of hydroxychloroquine, for example, almost singlehandedly drove international interest in – and public expectations about – the unproven drug. Incredibly, prescriptions spiked nearly 2,000 per cent after Trump pushed the pharmaceutical. In other words, the Trump-fuelled hype had a direct influence on clinical practice.
Canada has not been immune from the impact of this noise. Despite a growing body of evidence that tells us otherwise, a survey found that 23 per cent of Canadians believe drugs such as hydroxychloroquine are effective in the context of COVID-19. Thanks, Trump.
Mr. Trump has also facilitated interest in some of the more patently ridiculous and clearly harmful “miracle” cures. For instance, his bizarre speculation about the value of injecting disinfectant to fight COVID-19 led to a jump in poison-control calls.
Now that Mr. Trump is an actual a COVID-19 patient, it is curious he hasn’t turned to bleach or hydroxychloroquine. Still, the evidence base for the treatments Trump is taking varies greatly. Some are well-established therapies, such as the steroid. Remdesivir is supported by recent data and is recommended for patients with severe disease – though there remains some controversy about the magnitude of the associated clinical benefits. Other treatments lack good clinical data and are largely experimental or unproven. None of them are a cure.
But the takeaway from the public representations of his treatment is that all of this stuff works or, at least, it is a good idea to try. Indeed, on Monday afternoon Mr. Trump tweeted the following: “Don’t be afraid of Covid. Don’t let it dominate your life. We have developed, under the Trump Administration, some really great drugs & knowledge. I feel better than I did 20 years ago!”
The implication? Chill out. Don’t worry about all those disruptive (and evidence-based) public-health strategies such as masks, handwashing and physical distancing. We have drugs! And I used them! And if it is good enough for the President of the United States, it should be good enough for you.
Countering misinformation isn’t easy. It is particularly challenging when the bunk is flowing from a platform as powerful as the one at the disposal of the President. But evidence tells us debunking can work, especially if it is done well and comes from experts and trusted professionals. We need science-informed voices to rise up and meet this communication challenge. If we work together, perhaps more and more will see that when it comes to COVID-19, the emperor has no clue.
Keep your Opinions sharp and informed. Get the Opinion newsletter. Sign up today.