I debated between writing about a topic that I had neglected due to taking a week off or writing about something that was more relevant. Not the metaverse or Facebook's new name! After confronting the lack of testing for COVID-19 for myself and my wife, I found that my psychic energy was what I was looking for. So it is!
I had thought of taking a week off last week because of the irritation I felt about the retiringNIH director Francis Collins, but I decided to stay. Thankfully, I didn't, which allowed me to think about it more and my anger to diminish. I figured I would lead with it, even though it doesn't change my level of frustration.
Here is what I mean.
Dr. Collins was asked if there was anything he would like to see done by the National Institute of Health.
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December 20, 2021, Judy Woodruff.
Dr. Collins had just announced that he would be stepping down as the Director of the National Institute of Health. He repeated his regret at how he and the National Institute of Health had failed to appreciate how bad antivaccine misinformation and conspiracy theories would be in slowing the spread of COVID-19. This led to a lot of articles.
The problem with Dr. Collins take is being examined.
The problem with Dr. Collins is the public health apparatus.
The most shared quotes from Dr. Collins regarding medical misinformation were his use of his status as a religious man to urge evangelicals to reject vaccine- and COVID-19-related misinformation.
You have watched politics and science collide. Do you think the politicization of science has gotten worse?
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It is worse. It is a reflection of the fact that tribalism is worse than polarization. We are in a bad place. If science produces a result that a political perspective doesn't like, then it has to be attacked. That is what we see happening now, to the disadvantage of getting the facts out there.
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What is the role of the NIH in fighting misinformation about science?
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This situation has turned out to be much more severe than I had thought. I would like to know how this came to pass, and why it could have gotten so widespread. As I stepped down from theNIH, I was concerned about the situation in our nation. We lost a sense of how to tell the difference between a fact and an opinion when our political hyperpolarization began. That is dangerous. Even if we triumph over COVID-19, that epidemic is not going to go away. We need to figure out what happened here and how to get ourselves back to a place where our nation is stable.
In another interview.
It'sbizarre that politics influences precautions like mask-wearing. Can you talk about divisiveness in science?
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There are two epidemics. The virus that causes COVID-19 is the cause. There is an epidemic of misinformation about science.
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The conclusions people make about almost everything seem to be driven by what their tribe says. The latest political statement or a conspiracy on Facebook can often overrule objective facts.
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Estimates show that more than 100,000 Americans will die in 2021 because of misinformation campaigns.
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We need people with the ability to sift through evidence to get accurate information. We are now considered a little bit suspect because it can't just be coming from the government or scientists. Community leaders need to come up with it.
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Politicians who have been the worst offenders in spreading misinformation need to know that history is going to judge them harshly.
Who could possibly have predicted what happened in the last two years is a common view among those completely out of touch with what is happening on the ground. A lot of us who have been at this for a while reply: Who couldn't have? I was at least in the ballpark when I wrote about the first coronaviruses conspiracy theory I encountered, but I didn't think things would get as bad as they have. We pointed out how COVID-19 was a golden opportunity for conspiracy theories.
I got a little angry and took to the internet.
We warned them how antivaxxers would do it, for example, by weaponizing #VAERS reports to make it look like CovidVaccine is deadly. How did we know? It's easy. For at least a quarter of a century, antivaxxers have been doing this.
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David Gorski, MD, PhD is on December 21, 2021.
I generally like Collins.
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David Gorski, MD, PhD is on December 21, 2021.
Mark Hoofnagle is a friend of the person.
Since it was founded in 1998, the NCCIH has produced zero meaningful results.
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We are awash in medical misinformation. We surrendered to the enemy in 24 years.
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Mark Hoofnagle wrote about it on December 21, 2021.
There were many similar responses from groups that promoted vaccination.
It is assumed that it is so bad now because of political polarization by doctors and scientists. Political polarization is bad, but it is not the cause of the COVID-19 misinformation that we have been dealing with for decades. I am happy that someone of Collins' stature is finally recognizing that misinformation and disinformation about health, in particular vaccines and COVID-19, are having a horrible effect and leading to unnecessary death and suffering.
The strange things about disease, medicine, and vaccines that we had been documenting for decades, were having their noses rubbed into them, as my colleagues struggled to believe. I hope you forgive me for saying that, but I will try to remember what I said and look at what might be done in the future.
There was even hostility.
For decades, we have warned about the dangers of medical misinformation, pseudoscience, and conspiracy theories, but few in authority listened or took the threat seriously. Why is this happening? How can we maintain that appreciation and momentum now that COVID-19 has awakened large number of physicians, public health officials, and scientists to the threat posed by medical and scientific misinformation?
During the first year of our existence, one of our regular bloggers, Dr. Val Jones, used a term to describe the attitude held by most physicians towards antivaccine and medical misinformation: "Shruggies."
Shruggie is a person who doesn't care about the science versus pseudoscience debate. Their response when presented with exaggerated or fraudulent health claims is to shrug. Shruggies don't argue the merits ofCAM or pseudoscience in general. They aren't interested in the discussion and are confused by those who are.
She said that she joined the site because she had come to appreciate the danger of medical misinformation, pseudoscience, and conspiracy theories, and that she was willing to join the site for a while.
There is another attitude that is not uncommon among physicians. It is an attitude that goes beyond indifference into contempt for science communication. The core of this attitude is based on the idea that no one but crackpots would ever believe ridiculous things like antivaccine conspiracy theories and that it is somehow beneficial to the medical profession. To them, we should not worry about alternative medicine or antivaccine misinformation, but about clinical trials, the depredations of big pharma, and the question of overdiagnosis.
The best example of this attitude came from an oncologist named Dr. Vinay Prasad, who mocked me and others who spent a lot of time deconstructing medical misinformation as being akin to a basketball player.
Here is a representative account that directed at me.
He was probably referring to me, so the "fellowship-trained" part is what he meant.
A lot of us had a hard time not rolling our eyes at the whole line of attack, even as this occurred roughly a month before the first cases of deadly pneumonia due to a new coronaviruses were observed in China.
He continues to make mistakes. He suggests that skeptics tackle mammograms. His response was silence when shown leading skeptics doing this.
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November 2, 2019.
Didja think to ask any one of us, like me, who was linking science of scicomm over and over again whether or not there was evidence or a literature that supported our technique? Did you stop at the most basic problem in debunking?
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Mark Hoofnagle wrote about it on November 2, 2019.
Steve Novella and I wrote a response to Dr. Prasad a year ago, when he decided to double down on his attacks on social media.
Doctors and other people discount the importance of soft targets. John Horgan made the same arguments about skepticism in general a few years ago. There are legitimate criticisms of the skeptic movement, but Mr. Horgan wasn't about that. He framed skepticism as attacking soft targets like Bigfoot and ignoring hard targets like cancer and world peace. I am not exaggerating. His entire argument could be summed up as, "What you care about is what you care about." What I care about is hard targets. It's very much like Dr. Prasad. Steve Novella said that Mr. Horgan's take was superficial to the point of being wrong and that he was ignorant about what skeptics discuss and what our position is on the examples he gives.
It is interesting that it didn't take long after the Pandemic hit before Dr. Prasad was issuing highly dubious hot takes. He has been featured by Jonathan Howard, our newest member. The time Dr. Prasad made bad arguments against an emergency use authorization for COVID-19 vaccines in children, downplayed the risks of COVID-19 in children, and praised an utterly incompetent study are examples. Dr. Prasad went so far as to say that mask, social distancing, and vaccine mandates were the first steps on the road to fascist rule.
Dr. Prasad's turn suggests that perhaps it would have been better if he had not been so contemptuous towards the efforts of us humble skeptics promoting science-based medicine and refuting misinformation. He is a part of the problem.
Social media is used to spread fake news.
The Politics of Us and Them is a book by the Jacob Urowsky Professor of Philosophy at Yale University, and it was read by me over the holiday break. I highly recommend the book, but it is not my purpose to discuss actual fascist tendencies in this post; that is, in contrast to Dr. Prasad's misguided attempts to portray COVID-19 control measures as incipient fascist tendencies. One chapter caught my attention because of the problem of misinformation and the Pandemic. Professor Stanley points out that fake news was used to foment violence in the past, and that there is nothing new about it. After World War I, fake news stories about mass rape of German women by African troops serving with the French in the Rhineland caused mass hysteria. Prof. Stanley said that the similarity between fake news and history is still there.
The spread of the German propaganda campaign in the 1920s of the "Black Horror on the Rhine" should discourage us from thinking that this sort of "fake news" is a consequence of the modern revolution in social media.
The point is that fake news is not new. Rumors, stories of dubious provenance, and conspiracy theories are not rumors. These have been with us for a long time. This type of misinformation can be achieved through social media, but it would take months or years to reach a global audience. Social media companies labored too long under the belief that bad speech could be driven out and countered by good speech based on data, science, and reason. The companies knew that their algorithms were designed to amplify material that provoked engagement. What is the most likely way to get people to engage? Misinformation and conspiracy theory-laden content tends to spread very quickly compared to any sort of science-based counter, because it is material that angers, frightens, or otherwise provokes strong emotion. Information that Dr. Prasad would consider ridiculous or beneath his engaging with can almost instantly spread to all corners of the earth with an Internet connection. While it is true that Facebook, Meta, and the rest are finally waking up to the danger, they seem unwilling to invest the resources necessary to take on the task of minimizing the spread of misinformation and conspiracy theories on their networks, often instead relying too much on the algorithms that they have.
The problem of misinformation is something that has been warned about by the internet. I started my first post on a snowy Saturday in December of 2004 because I saw how quickly medical misinformation was spreading on the internet. This was before the rise of the internet, before the rise of social media, before the rise of the internet. The rise and proliferation of antivaccine blogs was observed back then. I noted the first fumbling efforts of antivaxxers to use Facebook and Twitter several years later and they became much less fumbling and more adroit over time. There is a huge amount of misinformation on social media, which is spread by many people, including quacks, antivaxers, cranks, and grifters.
There is a bit of fantasy here. I have been saying that everything old is new again for at least a year. In general, I am referring to antivaccine misinformation, and nearly every time I discuss specific COVID-19 antivax propaganda claims, I like to mention how none of these claims is new. There are some examples of false or misleading claims.
I joke that the only reason that antivaxxers haven't claimed that COVID-19 vaccines cause autism is because they weren't approved for use in young children yet. If the EUA for a COVID vaccine for children ages 5-12 doesn't do it, this old trope will appear when the vaccines are approved for children under five.
There is a claim that there is a disease in the vaccines. Hydras can grow to about an inch in size. Maybe there is a new antivax claim about COVID-19 vaccines. I suppose that this one could be a variation on a favorite antivax technique of looking at vaccines under the microscope and gasping at scary looking things, which has been done before.
What about the Vaccine Adverse Events Reporting System database? In my last post of 2021, I talked about the history of antivaxxers weaponizing VAERS, using its open nature and passive reporting design to paint a false portrait of vaccines as deadly, even a new Holocaust. The vaccines were released under an EUA over a year ago, and those of us familiar with the long history of antivaxxers weaponizing VAERS reports were warning before that. VAERS was being weaponized in December 2020 after I received my first dose of the Pfizer vaccine.
The fantasy is here.
If you will, imagine...
Imagine if those of us who were dunking on a 7′ hoop had been ignored or viewed as wasting our time. Imagine if there was an appreciation among our profession that it is worthwhile to debunk the seemingly ridiculous because it often serves as the basis for much less benign misinformation and pseudoscience. The National Center for Complementary and Integrative Health was a base for promoting pseudoscience in medicine since the 1990s, now run by a true believer in woo. Imagine if quackery hadn't entered leading academic centers as it did major medical journals. Imagine if the Cleveland Clinic had not allowed an antivaccine doctor like Daniel Niedes to work there for so long. Imagine if Dr. Collins and Dr. Anthony Fauci had actually done what they did, and spent a lot of money on understanding medical misinformation and conspiracy theories. Imagine if they understood the central conspiracy theory of the antivaccine movement, the conspiracy theory on which all antivax conspiracy theories are based, and of which all antivax conspiracy theories are but a variation? Imagine if it was known that all science denial is a form of conspiracy theory, so that it could have been foreseen how quickly antivaxxers would team up with protesters. Imagine if science communication was appreciated, instead of being seen as a discipline in itself, as it has been over the last 25 years. Imagine if state medical boards realized that being a physician is a privilege, not a right, and that using one's stature as a physician to spread dangerous health and antivaccine misinformation is an offense worthy of having one's medical license removed, rather than having to.
If all the elements of my fantasy had been in place in January 2020, would it have made a difference? I am pretty sure that we would have been better equipped to deal with the epidemic if we had seen the fumbling efforts against the Great Barrington Declaration.
Now that physicians and scientists have realized the threat of health misinformation, how do we keep them engaged? How do we fight misinformation after the Pandemic fades into history, or even back into a state of disrepair?
I have ideas that I hope to discuss in 2022, along with links between old antivaccine misinformation and COVID-19 misinformation, but how old alternative medicine beliefs undergird much of the misinformation we see. We need help in advocating for science in medicine. The problem of combatting irrational beliefs to which humans have always been prone is just one of the things old might seem new again.
