Each morning during these most unusual of times, I find an inbox filled with messages from both my medical colleagues and well-informed laypeople attaching articles or links to webpages referencing the latest “breakthroughs” in the fight against the coronavirus.
Hydroxychloroquine is the cure. Young people don’t get COVID-19. Patients who take an angiotensin-converting enzyme inhibitor, or ACEI, a common drug to treat hypertension, are more susceptible. People with asthma don’t get it. Or do get it.
Here’s one that I must admit is my favorite. The makers of Lysol emphatically state that the product should not be injected or ingested to “clean” the lungs, a headline says without apparent irony, affirming what should be fairly obvious. But there may be a different standard for “obvious” now.
All of this makes me think that we have entered the “silly season” of the pandemic, characterized by fast science, science that doesn’t get peer-reviewed. Clickable science.
Call it what you want, but I call it dangerous science. Welcome to the new era of Science on the Fly, where the data can be right, or wrong, misleading or even harmful, but routinely reported with only minimal or incomplete evidence.
In a world starved for news about the coronavirus we are supposing that if we just keep spreading information about it, then things will be all right. But we have confused information with knowledge, which, under normal circumstances, would only be annoying or distracting but now could negatively affect people’s health beyond that of the viral effects.
So what are we to do when we are bombarded — on the television, internet and newspapers — with a constant dose of medical “findings?”
As consumers of this avalanche of information, we need to be skeptical, circumspect about what we are being told. I learned skepticism in medical school, and I haven’t forgotten it. We were taught to use our common sense, described by one of my medical school professors as a sense not commonly had.
He was on to something, I think especially now. In confronting a new headline, one that screams something works, or doesn’t, we would do well to have as a first reaction, I doubt that’s true.
If we think hydroxychloroquine is the answer, then the medication flies out of the pharmacies, hoarded by folks preparing for the apocalypse, and unavailable to people who actually need it, for diseases like malaria and lupus in which efficacy has been proved. If someone stops taking an ACEI and their hypertension gets out of control, they may suffer a stroke or heart attack.
The current environment, in some ways, harks back to when I was in medical school and residency, when HIV had emerged. Remember when we read in the newspapers back then that one could get AIDS from a doorknob, or only if one was Haitian, or homosexual, that heterosexuals were protected from this new “gay cancer?”
None of that turned out to be true and it seems likely — no, probable — that our early coronavirus information will be equally untrue and may enhance, not diminish, the anxiety we all feel about this crisis. But one significant difference from then to now is how quickly we receive information — how it spread in the late ’80s and early ’90s might as well have been by pony express compared with today’s warped speed dissemination, which has no regard to whether something is true or untrue but primarily whether attention grabbing or not.
As a medical doctor, I have some ability to separate out the wheat from the chaff, as the saying goes. So when reading something about any medically related topic, I first think to myself, I doubt it, then work my way toward acceptance from that starting point.
Right now, we have a beast to feed, fostered by a partnership among an information-starved public, a media that knows it has our captive attention and medical scientists who want to provide new information and, yes, wouldn’t be opposed to publishing novel findings to enhance their careers.
So what should we do? First, take a deep breath. The practice of medicine has always had an element of uncertainty and necessitated an acceptance that we may not know everything we want to know at that moment. We should be comfortable with risk, especially the risk that we will need to act with an imperfect data set, especially as we make tentative steps toward coming out of our houses and reopening society.
The science will come, and it is our only way out of this. And it will emerge in the quiet moments in scientists’ laboratories or by statisticians’ careful calculations. It will not come as a blaring headline on a news webpage or, dare I say, from a briefing room podium.
So next time you see a new treatment being touted or a finding about for whom among us the virus has a predilection, say a simple phrase to yourself: I doubt that’s true.
Dr. David Weill is principal and founder of the Weill Consulting Group, a biomedical consulting firm. He is the former director of the Center for Advanced Lung Diseases and the Lung and Heart-Lung Transplant Program at Stanford University Medical Center.