One of the most confusing and uncertain developments during the current coronavirus pandemic is the use of hydroxychloroquine to treat Covid-19 patients. Hydroxychloroquine, often used to treat or prevent malaria, lupus, and rheumatism, comes with a laundry list of serious side effects, including headaches, chest pain, a “very slow” heart rate, low blood sugar, low blood cell count, nausea, and skin rashes. An overdose can also induce sudden cardiac arrest.
President Donald Trump has nevertheless aggressively promoted hydroxychloroquine (and sometimes the chemically similar chloroquine), neither of which have been thoroughly tested or approved by medical authorities for use by Covid-19 patients, as promising remedies since his February impeachment acquittal. He has said hydroxychloroquine is “tested, in the sense that you know it doesn’t kill you.” He has called the drug one of the “biggest game changers in the history of medicine.” And he has said taking hydroxychloroquine is “common sense,” adding, “I feel good about it,” “I haven’t heard a bad story,” and “What do you have to lose? Take it.”
Both hydroxychloroquine, also known by its brand name Plaquenil, and chloroquine were developed to help fight malaria, with hydroxychloroquine considered less toxic to humans of the two drugs.
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A small Brazilian study treating Covid-19 patients with higher doses of chloroquine was halted early because patients developed irregular heart rates, which could potentially lead to fatal heart arrhythmias. And at least one person died in Arizona after taking chloroquine phosphate, a chemically similar compound used to clean fish tanks. Nigeria has logged at least three overdoses of chloroquine as well. And although some early studies in China and France indicate that chloroquine and hydroxychloroquine, respectively, might be helpful in treating some Covid-19 cases, they are far from being deemed by any body of experts as coronavirus panaceas.
Dr. Anthony Fauci, who since 1984 has led the National Institute of Allergy and Infectious Diseases and is the government’s top infectious disease expert, sounds a more cautionary note than Trump. In March, he described potential positive effects of hydroxychloroquine on Covid-19 as “anecdotal,” and on April 5, he described data indicating its potential efficacy as “at best suggestive.”
Trump’s comments about the anti-malarials have been enthusiastically embraced by many supporters, including personalities at Fox News, and his retweeting of a comment on Twitter that Fauci should be fired was seen by some as indicating his intention to remove the doctor from his post.
Complicating the matter: Trump and members of his administration have a financial stake in the success of Plaquenil, further fueling concerns that the President is benefiting from his vocal support of the drug. (It’s unclear why remdesivir, a medication invented to fight Ebola, has received less attention from Trump, despite its early use in treating Covid-19.) Hydroxychloroquine, meanwhile, appears to have demonstrated enough benefit in treating some mild Covid-19 cases that it’s in active use across the United States (and the world) in limited, controlled instances.
“It becomes a problem when political leaders contradict scientific experts. That conflict erodes trust in the organization, and forces people to choose whom to believe—in this case, Dr. Fauci or Donald Trump.”—Kate Starbird, Center for an Informed Public, University of Washington.
On March 30, the U.S. Food and Drug Administration approved an emergency plan by the Trump administration to distribute hydroxychloroquine and chloroquine around the country. Doctors at multiple U.S. medical facilities have confirmed to The Parallax that hydroxychloroquine is being used as one of several treatments for their Covid-19 patients, and we have reviewed hospital documents that support these statements. There are currently 26 registered trials of the drug under way at U.S. medical centers, each analyzing how it affects Covid-19 patients in different scenarios.
Amid the mutation of hydroxychloroquine from life-saving medication to political football, a media firestorm over the drug has generated enough heat for the CIA to warn its agents and employees at the end of March: “Please do not obtain this medication on your own.”
Experts say misinformation about the drug doesn’t appear to be emanating from disinformation campaigns. Yet Trump’s role in actively spreading scientifically inaccurate claims about hydroxychloroquine is hardly benign, they allege. Besides putting people’s lives at risk, the president’s comments further erode public trust in the U.S. government, they say, and could pave the way for a coordinated disinformation campaign to take root.
Pablo Breuer, co-founder and vice president of the Cognitive Security Collaborative and a member of the People Centered Internet organization, says the coronavirus pandemic has created an unprecedented opportunity for misinformation to spread. Because so many people around the world are paying attention to news about the pandemic, coronavirus misinformation can spread farther and faster than misinformation on other topics.
“This is really the first time since World War II that you have a singular subject that everyone in the world is concerned with,” Breuer says. This is “not the first time Trump has attacked science. There’s a large segment of people who will echo what he says, even when it’s patently incorrect. The problem has been not just that he’s questioned [scientific findings and opinions] publicly, but [that] we’ve allowed it to continue.”
The world’s singular focus on the pandemic is serving to amplify the president’s statements about the novel coronavirus, says Kate Starbird of the University of Washington’s Center for an Informed Public. She points out that Trump wasn’t the first to publicly tout the use of chloroquine or hydroxychloroquine as a Covid-19 remedy, but that once he did, he “catalyzed the discourse.”
“This is Crisis Communication 101. It’s really important that people can trust the organizations disseminating information. So when that information is not true, it weakens the systems that we need to rely on for information during the crisis,” Starbird says. “It becomes a problem when political leaders contradict scientific experts. That conflict erodes trust in the organization, and forces people to choose whom to believe—in this case, Dr. Fauci or Donald Trump.”
“There’s zero evidence that 5G has anything to do with the coronavirus.”—Dave Troy, misinformation analyst.
Trump’s cheerleading for hydroxychloroquine not only supports unproven science, but could make it harder to gain vital backing for research-supported science, argues Dave Troy, a Baltimore, Md.-based serial entrepreneur with a history of social activism and an expert observer of social-network manipulation.
“In 12 or 18 months, when we get a Covid-19 vaccine, how are we going to get most people to take it? If we let disinformation and misinformation fester between now and then, what will we do?” Troy asks. “It’s hard enough to get people to trust science in this country, as it is.”
Troy notes that the barrier between misinformation (unintentionally false information) and disinformation (intentionally inaccurate information) is malleable. What starts as one can easily influence or become the other, he says, citing Russia’s disinformation campaign against 5G cellular networks. That campaign, a widely discredited effort to impede U.S. adoption of the faster 5G networks, was first revealed in a May 2019 New York Times story and persists today. Earlier this year, Russian media began a coronavirus disinformation campaign claiming that 5G networks caused Covid-19. The debunked campaign nevertheless incited angry mobs in England to rip down 5G towers earlier this month.
Organizations tracking disinformation campaigns have noticed that hydroxychloroquine has shown up in coronavirus disinformation, but is not—yet—specifically the subject of disinformation. “There’s zero evidence that 5G has anything to do with the coronavirus,” Troy says. “This is a case of two 5G narratives mating in the wild and birthing a spectacular new thing.” Hydroxychloroquine misinformation, he says, could just as well get picked up by a disinformation campaign, especially as the science around it changes.
How to tell what’s misinformation in a pandemic
As of today, there is no scientific consensus on how to fight the coronavirus, and we need not look further than how the Centers for Disease Control first told Americans not to wear protective face masks in public in early March, then did an about-face in April, to understand how rapidly authorities are changing their messaging about the pandemic. While discerning fact from misinformation right now is more difficult than normal, however, Starbird and Breuer say there are ways to ensure that the data you absorb and share with friends and family—in person or digitally—is as accurate and up-to-date as possible.
“This is really the first time since World War II that you have a singular subject that everyone in the world is concerned with.”—Pablo Breuer, co-founder and vice president, Cognitive Security Collaborative.
Look for elected officials in agreement with current scientific consensus, says Breuer, and exercise caution when they disagree. “When a mayor, governor, and a Congressional representative are all saying, ‘Stay at home,’ people listen,” he says. “But when the mayor of New York City says one thing, and the New York governor says another, or in Georgia, with a mayor closing beaches only to have the governor demand that they be opened,” expert advice loses its weight, and consumers use a lack of consensus as license to believe (and do) what they want.
Finding and following scientific experts who have been accurate in their pandemic analyses is also important, Starbird says. “You want to find communication that tells you about the scientific finding and the scientific uncertainty. All of this has scientific uncertainty, and if they don’t [acknowledge the uncertainty], they’re lying to you,” Starbird says. “It’s unsatisfying because we want certainty, but we don’t have it right now.”
She also cautions people to watch out for emotional hijacking when reading news stories. The moments when “the news is making you scared or angry, feeling strong feelings of fear, anxiety, anger, even joy, are the times when you’re vulnerable to share [via social media]. Reflect on how you might be vulnerable to share things that aren’t true before you share.”
And Starbird encourages people who have shared misinformation to share corrections, a practice she has done with her own Facebook posts. “Even when the issue is resolved, it diminishes trust over time, which is dangerous in this kind of environment, in a pandemic,” she says.