We all know that we are going through a crisis of historic proportions that is being fueled by fake news and alternative facts. The problem was dire before the arrival of the coronavirus; now it is paramount, because it is clear that fake news threatens not just our political system but the basis of our culture and civilization.

I want to make two main points in this talk. First, fake news didn’t just become a problem because of Trump, or the pandemic. It’s been around for a long while. Therefore the solution to the problem isn’t just getting rid of Trump. We’re still at the beginning of the problem of fake news. It’s not over just because he lost the election.

Second, I want to argue that the problem of fake news can’t begin to be solved unless the medical and scientific community accepts that it has an absolute responsibility to aggressively debunk fake news and defend and support scientific principles. In other words, I am addressing the readers of this blog directly.

Fighting fake news is not going to be easy. To many people, myself included, perhaps the most frustrating aspect of our situation is the persistence of fake news even in the face of actual facts and evidence. It is impossible to have a rational discussion with people who still believe, despite all the evidence, that hydroxychloroquine is an effective preventive measure or treatment for COVID-19, or that COVID-19 is no worse than the seasonal flu, or that doctors and other healthcare professionals are purposely exaggerating the danger of the pandemic in order to line their own pockets. As might be expected George Orwell understood this well:

“In the end, the Party would announce that two and two made five, and you would have to believe it. It was inevitable that they should make that claim sooner or later: the logic of their position demanded it. Not merely the validity of experience, but the very existence of external reality, was tacitly denied by their philosophy.”

The sad reality is that, at this stage, fact checking in real time can only get you so far. It’s like trying to repair a broken automobile while you’re driving down the highway. If something goes wrong it’s too late to keep going while you fix the basic underlying problem. Certainly it would have been much easier to prevent the breakdown in the first place by fixing that underlying problem. Our current situation is a product, perhaps inevitable, of our decades-long catastrophic failure to perform that preventive maintenance of defending and supporting science, medicine, and rational discussion.

There’s nothing new about fake news, or alternative facts, or propaganda. They’ve been around for a while. It’s just that now, when it’s most urgent, that we are able to comprehend the consequences of this neglect.

In the words of Warren Buffet, “you only find out who is swimming naked when the tide goes out.“  Well let me tell you, the tide is well and truly out, and there are a lot of naked bodies out there. The problem is that many people still believe in the emperor’s new clothes.

It should come as no surprise that we are being strangled by fake news about COVID-19. The ground was well prepared.  Look what happened in 2014. Donald Trump’s political rise was fueled, in part, by his response that year to the Ebola breakout in west Africa. Trump tweeted more than 80 times about Ebola in 2014.

Here’s just one of his tweets:

 

As an aside let me just say that the idea that people who go to far away places to help are great but must suffer the consequences strikes me as a perfect encapsulation of the Trump philosophy.

We shouldn’t be surprised now by his attacks on the FDA and the CDC, when in 2014 he was already undermining the CDC:

Where was the response, where was the outrage, from the scientific and medical community? Trump then was only a private citizen, but he already had an outsize influence because of his TV show, his celebrity status, and his platforms on Fox and other media sites. These were enough to propel his views into the mainstream discussion. Trump and his media enablers got used to the idea that they could get away with spouting their nonsense without any consequences.

We can never know with certainty, and these things don’t occur in isolation, but it is reasonable to wonder whether a truly vigorous and insistent attack on Trump’s idiocy, by a broad coalition of the scientific and medical establishment, during the Ebola crisis, might have dampened or thwarted his future political prospects.

The same pattern has repeated itself during the pandemic. Consider just one astonishing example. When Trump himself contracted the coronavirus he received a completely nonstandard cocktail of unapproved and untested drugs. Individually the safety and efficacy of these drugs was unknown and, adding insult to injury, Trump was almost certainly the first person ever to receive this specific combination of drugs.

There were a few critics who pointed this out, but there was no concentrated expression of condemnation or outrage from the medical community. This would have been an extraordinary opportunity to educate the public about why it is important to test drugs in randomized controlled trials, and why it is essential that people should not be treated on an ad hoc basis based on the personal opinion or best guess of individual doctors and patients.

Instead, Trump’s treatment was often referred to as VIP treatment, something that was exceptionally desirable and preferable to ordinary care. The message received by most people is that Trump received the best possible care and that the standard care given to everyone else is for chumps.

Now let’s imagine for a moment an alternative and far better universe in which a president volunteered to participate in one of the many randomized controlled trials for coronavirus therapeutics or, prior to being infected, one of the vaccine trials. Such a gesture would have provided an unprecedented and incomparable boost to the public understanding and support of clinical trials and, more generally, scientific principles.

Of course Donald Trump is hardly alone. There have been so many figures who have been allowed to abuse and distort scientific and medical information without contradiction or consequence. Trump, Dr. Oz, Dr. Mercola, Deepak Chopra…  the list goes on and on and on. The latest and most egregious example is Dr. Atlas, Trump’s one-man Stanford-affiliated enabler and supporter of covid denialism. Is it unreasonable to speculate whether if there had been vigorous and insistent pushback against Dr. Oz we wouldn’t now have to contend with Dr. Atlas?

 I am willing to bet that every single person in this scientifically sophisticated audience has been in a social situation where grossly distorted scientific and health misinformation has been spread, without questions or objections from those who know better.

Scientists and doctors today remind me of the aristocrats in Edgar Allan Poe’s Masque of the Red Death. They think they can retreat to their cloistered ivory tower and ignore or disregard the raging plague around them. The aristocrats enjoy their exclusive party until the plague arrives and wipes them out. In our time the doctors and scientists think that their particular line of work can continue without interruption by the larger assault on the scientific enterprise. They think or hope they can work on the coronavirus without being impacted by the virus of fake news. Further, they perceive that they will pay a personal price if they publicly take on the role of defending science and rejecting alternative facts.

It’s not clear how this pandemic of misinformation can be fully defeated, but it is certainly clear that any progress at all will require the scientific community as a whole, and each member individually, to accept the responsibility to fully participate in the defense. Lies and distortions must be resisted by those who know best before these lies have a chance to spread unchallenged.

(Note: This is a revised and expanded version of a talk delivered on Sunday, December 6 at the CVCT Global Forum.)

 

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