An individual who did not believe that COVID exists became sick and went to see the doctor. After some testing was done, he was informed that he was infected with the coronavirus. Saying “that is not possible,” he intentionally coughed in the nurse’s face and walked out. This is a true story but, unfortunately, it is not an isolated story.

Others do recognize the existence and the seriousness of Covid-19 but spread misinformation, blatant anti-science concepts, and some frankly conspiratorial theories about the virus’ origin, treatment, and why the vaccines are dangerous, at best. 

Here are just a few minor and, in a few cases, hilarious examples of misinformation followed by surveys of conspiracy theories and then the more serious and concerning anti-science and conspiracy concepts.

Breathing in steam or saltwater will kill the virus in your nose. Smelling sesame seeds cures COVID-19. Sea lettuce prevents COVID-19. Holding your breath for ten seconds is a good test to see if you are sick with COVID-19. One of the best stories is that Russian President Vladimir Putin released 500 lions onto the streets of Moscow to keep people indoors. Fortunately or unfortunately, none of these are true or correct.

Misinformation during a serious event is common, and conspiracy theories arise during times of stress. A few surveys are illustrative.

Investigators at the University of Basel in Switzerland surveyed 1,684 participants in July 2020 regarding conspiracy theories. The surveyors gave a list of presumed Covid-19 conspiracy theories such as “Big Pharma created coronavirus to profit from the vaccines.” Ten percent agreed strongly with at least one of the presented theories. Another twenty percent agreed sightly or moderately with at least one theory; seventy percent agreed with none. 

“Most popular were statements suggesting that the virus was man-made, or that the official explanation of the cause of the virus was questionable.” [The concept that the virus might have been released by accident from the Wuhan Virology Institute, once debunked by many scientists and the media, is being reconsidered intensively by the U.S. government as a legitimate possibility.] The ten percent tended to be younger, were more stressed, had more extreme political views, and had a lower educational level.

A Pew Research Foundation survey in June 2020 found that five percent of Americans believed then that the pandemic was created intentionally by powerful people, and another 20% believed this was likely true. Of those with a high school or less education, 48% thought it was definitely or probably true compared to 24% of college graduates and 18% with a graduate degree. Republicans were more likely to ascribe to this theory than Democrats, as were Blacks compared to whites and Hispanics.

A Cornell University study of media misinformation in late September 2020 examined the results from an analysis gleaned from 38 million English language Covid-19 articles between Jan1 and May 26, 2020. 1.1 million news articles (nearly 3% of all Covid-19 articles) “disseminated, amplified or repeated misinformation.” Only 16% indicated any evidence of “fact-checking” suggesting that “the majority of misinformation is conveyed by the media without question or correction.” The five most prevalent topics were “miracle cures,” “deep state,” a Democratic party hoax, the Wuhan laboratory as the source of an intentional bio-weapon thesis, and related to Bill Gates, such as implanting a chip with a vaccine shot.

Why do these beliefs develop? When big problems are leading to prolonged stress, we need big explanations. The concept that the pandemic originated from bats or the wet markets in Wuhan City, China is not psychologically satisfying. It is much more satisfying to believe that a person, a group, or a country created it with an underlying nefarious purpose — the “deep state.” [This, of course, is a different belief than that the virus was accidentally released.]

Over the summer and fall, friends asked me to look at two lengthy videos they had received, wondering if the information therein was accurate. Each was a talk given by an apparently respected physician. Each was an excellent presenter, seemed reasonable and expert, and both were very effective at sowing doubt about accepted science. 

One commented early in her presentation that Dr. Anthony Fauci, director of the NIH Institute of Allergy and Infectious Diseases, was “not an infectious disease doctor.” “He is an immunologist.” She also said that she fell asleep at a lecture he gave when she was an intern. Each of these was meant to undermine Dr. Fauci’s credibility. 

Dr. Fauci, however, is very well trained in infectious diseases and has been involved with them his entire career. Yes, his research uses immunologic techniques, but these are focused on understanding infectious diseases. As to her falling asleep, she was a surgical intern, and the lecture occurred early in the morning. 

My supposition — she was tired from being up much of the night, and probably a talk about infectious disease immunology was not of perceived great relevance to this particular surgical intern.

She suggested that the name of the virus was inappropriate. She said to call it “the Wuhan virus” or the “China virus.” She compared these names to “German” measles, “Middle East Respiratory-distress Syndrome” (MERS), and “Lyme” disease. Without saying it directly, she was implying that the virus was released from the laboratory.

 She did not say that most infections, e.g., polio, pneumococcal pneumonia, meningococcal meningitis, etc., do not use a place name for identification. The actual name assigned by the World Health Organization to this virus is Severe Acute Respiratory Syndrome-related CoronaVirus-2 or SARS-CoV-2. The disease name, COVID-19, is from the words Corona Virus Infectious Disease 2019. 

For those who believe that China or a laboratory in China released the virus intentionally, it is understandable that they would like to see the terms “Wuhan virus” or “China virus” used.

Another claim was that masks do little to protect the acquisition of the virus. She presented apparently solid scientific evidence that masks do not entirely prevent the passage of viruses. It is undoubtedly true that masks are not perfect and that some, such as the N95 masks, are better than a simple mask of sheeting. 

Nevertheless, masks are the best method to prevent airborne spread, especially when both parties wear them. But the clear implication of her explanation was that masks are not effective and therefore not necessary.

Certainly not limited to these two speakers is the belief that hydroxychloroquine is safe and effective for treating Covid-19. There was a lot of initial enthusiasm for this drug due to a French study that showed a reduction in the concentration of virus in nasal swabs of infected patients when treated with hydroxychloroquine, with or without azithromycin, for five days. 

Hydroxychloroquine is inexpensive, is generally safe, and has been widely used for decades, so it was promptly hailed as a potentially beneficial drug to use for COVID-19, including by President Trump. 

The FDA gave emergency use authorization in March 2020. There were, however, no clinical trials at the time that had proven for or against its efficacy. Nevertheless, many physicians and some infectious disease associations recommended hydroxychloroquine at least until further information became available. 

Soon an article was published in the Lancet, a highly regarded medical journal based in the United Kingdom and authored by well-respected academic physicians. It reported data collected by an analytics firm from 96,032 patient records from 700 hospitals over six continents. The report stated that, based on this review, hydroxychloroquine was not only ineffective but was dangerous. This information shot across the world in no time. 

Not appreciated then, yet noted in retrospect, the analytic firm that conducted the analysis was relatively small with few employees, had a non-existent track record, and would not let the authors or anyone else view the underlying data. Yet, it had somehow obtained presumably reliable patient-level data when regulators in most countries prohibit access to such protected healthcare information. 

The authors who had used this material were roundly criticized for inadequate attention to these basics. They were contrite, and the paper was withdrawn. Unfortunately, mainly based on this article, the World Health Organization and others had already stopped ongoing scientific trials of hydroxychloroquine.

Despite the back and forth, eventually, multiple clinical trials were completed, some looking at treating hospitalized patients, some looking at treating patients who had very early symptoms, and some looking at preventing disease in high-risk populations. None showed much if any value and the FDA has rescinded its emergency use authorization. Nevertheless, some still claim its effectiveness.

Another drug, ivermectin, has been suggested by many as effective and safe for preventing or treating Covid-19. Ivermectin is an anti-parasitic drug that has been highly effective in treating river blindness in Africa and a diarrheal disease caused by strongyloidiasis. It is cheap, it is effective, and it is generally safe. It has been used for decades, and the World Health Organization classifies it as one of the twenty essential medications. So why consider it in COVID-19? Because in cell culture, it reduced virus counts by 99+%. But in clinical use, there has been minimal information. 

The most intriguing observation comes from India. Amid a rapid increase in infections, hospitalizations, and deaths across the country in April and early May 2021, yet with only a few percentage of individuals yet vaccinated, ivermectin was made generally available by the government to all at no cost. How many took it is unknown, but temporally the case counts began to fall precipitously. Whether this drop was related to the widespread use of ivermectin is unknown.

This presumed impact of ivermectin contrasts with a randomized clinical trial comparing placebo to ivermectin to treat mild Covid-19 (See graphic above.). Those who received ivermectin had resolution of symptoms, on average, by day ten compared to day 12 for placebo, not a statistically significant difference. 

The jury on ivermectin is still out, but the true believers have offered the India observations as solid evidence that ivermectin is effective. The Indian Health Ministry, as of June 7, 2021, has, however, reversed its recommendation for using ivermectin. I think the final answer is still pending.

Let us move on to vaccination. One of the frequent anti-vaxxer claims is that the mRNA vaccines are unsafe. Why? Because “it will mess with my DNA” or “it is used as a chip for tracking me.” In actual fact, the messenger RNA does not get into the cell nucleus where the DNA resides, so it is not possible for it to interfere with or to change a person’s DNA. And the concept of a chip is just, well, interesting. Since the Bill and Melinda Gates Foundation is an active vaccine advocate and study funder, some conflate this with Microsoft and from there to an embedded chip. 

Despite the science to the contrary, many do not trust it or the scientists. They feel, and present powerfully, that the mRNA vaccines are unsafe. The lead image of this article is of a person holding a sign which says, “this is a planned global power grab — the mRNA vaccine will kill millions more than CVI.” 

Individuals like this will not accept the carefully developed science as reviewed on this CDC link entitled “Science Brief: COVID-19 Vaccines and Vaccination.”

Many concerns have been raised for women of childbearing age. Are the vaccines safe during pregnancy? Can they cause infertility? The large, prospective randomized clinical trials from which the FDA decided to authorize them for emergency use did not include pregnant women. This is standard practice until a drug or vaccine is determined to be safe in the general population. 

However, it is also essential to be aware that pregnant women are at substantially higher risk for severe COVID-19, namely hospitalization, intensive care, or even death. In an article published in the New England Journal of Medicine on April 21, 2021, the CDC reports there have been no added risks reported to those pregnant individuals vaccinated since the new vaccines from Pfizer/BTN and Moderna became available. The Centers for Disease Control now recommends that pregnant women should be vaccinated.

Vaccines will likely be available for children as young as 2 years of age by September or soon thereafter. This will raise substantial anxiety among parents, especially mothers, who will be bombarded with anti-vax propaganda. Parents only want the best for their children but with the knowledge that kids usually do not get seriously infected and since the vaccines are new and testing will have only recently been completed, it is no wonder that anxiety will be high for many.

One of the more vocal anti-vaxxers, anti-masking, advocates for hydroxychloroquine and ivermectin is Dr. Simone Gold, an emergency medicine physician in the Los Angeles area. She started an organization called “America’s Frontline Doctors.” She gave a talk in Washington, D.C., which was videotaped and quickly went “viral.” Pun intended. Among her claims are that vaccines can produce infertility in normal women. That totally misrepresents facts. There is no evidence that vaccines can cause infertility, but it is out there, and many people are concerned as a result. 

Another one of her claims is that the vaccines are “experimental.” This is an interesting statement given that they were authorized by the FDA only after considerable data analysis, publishing the data on their website, a review by an outside group of experts, and then given emergency use authorization. She also said that since the FDA is collecting adverse event data that if you get vaccinated, then you are “participating in an experiment and don’t even realize it.” She is implying there must be some concern or why bother to collect this information. It is unfortunate because the FDA collects adverse event data on every vaccine and every drug continuously into the future. This data collection continually proves itself very useful. 

For example, this surveillance methodology, both by European regulators and the FDA, quickly detected the unusual blood clotting disorder with reduced platelet counts was detected with the Oxford/AstraZeneca vaccine and the Johnson & Johnson vaccine. These blood clots are very rare, but they are real and serious. As a result of their recognition, appropriate warnings have be given. 

Another example often touted as a reason not to be vaccinated is the later development of Bell’s Palsy or temporary paralysis of one of the facial muscles after vaccination. However, when evaluated over time in vast numbers of those who had been and those who had not been vaccinated, Bell’s Palsy does rarely occur, but no more frequently in the vaccinated than in the general population.

In Dr. Gold’s video, she gave recommendations for the vaccines and for therapy. She indicated that vaccines should be “prohibited” for those between the ages of 20–50. They should “probably be prohibited” for those between the ages of 50–70. For those over the age of 70, it would probably be better to take hydroxychloroquine or ivermectin. For nursing home residents, it should be a case-by-case decision. She firmly espoused the use of hydroxychloroquine and ivermectin. It is of interest that on January 6, 2021 videos of the United States Capitol insurrection showed Dr. Simone inside with a megaphone. She has since been arrested by the FBI and indicted by the Justice Department.

So-called “influencers” on social media with their large followings are sometimes the most effective purveyors of misinformation. A recent article on Medium by Mathew Remski discussed what he calls “Reverse Contagion Anxiety.” He writes that social media influencers are “turning the vaccine into a virus” and claiming that the vaccine sheds a virus or something that can harm others nearby.

What happens when these misrepresentations and misinformation create enough concern? Perhaps the most glaring is the possibility of losing one’s job if vaccinated! The Centner Academy in Miami which teaches grades K through eight is warning its teachers not to be vaccinated. In an article in Science magazine, April 26, 2021, “Florida private school threatens jobs of teachers who seek COVID-19 vaccines.” A letter was written by Leila Centner, co-founder of the academy, which was sent to teachers. “It is our policy, to the extent possible, not to employ anyone who has taken the experimental COVID-19 injection until further information is known…It is in the best interest of the children to protect them from the unknown implications of being in close proximity for the day with a teacher who has very recently taken the COVID-19 injection.” (My italics).

Ms. Centner wrote the following to explain the academy’s decision. “Tens of thousands of women all over the world have recently been reporting adverse reproductive issues simply from being in close proximity with those who have received any one of the COVID-19 injections, for example, irregular menses, bleeding, miscarriages, post-menopausal hemorrhaging, and amenorrhea (complete loss of menstruation).”

This is a telling example of what can happen when the anti-vaxxers create enough concern to sway otherwise intelligent people that the vaccines are unsafe. The National Institutes of Health has stated that “there is no evidence that individuals vaccinated for COVID-19 can transmit the viruses to others or that vaccination of one person can have negative health effects on others.” The CDC has a detailed review entitled “Myths and Facts Regarding Covid-19 Vaccines,” but unfortunately, this and the NIH statement will not be enough to convince those genuinely concerned. The Centner Academy has not altered its vaccine approach.

What is needed? These types of misinformation, anti-science theories, and conspiracy theories have become extremely common at a time of great crisis, stress, and frustration for everyone. In that setting, people can be led into thinking that at least some of this misinformation is valid. 

What we all need is to learn to think critically using tools such as careful analysis, open-mindedness, and problem-solving. Schools need to teach critical thinking at all levels, and the media needs to utilize it in reporting and support it. 

Another key is for reporters and their editors to insist upon primary data before accepting some statement as fact. All too often, when a claim is made, the reference is to a speech or an article that in turn is based on someone else’s paper or statement, etc. but following it back leads nowhere. 

As readers, listeners, or viewers of the media, we need to be able to assume the reporter did his or her job of finding the actual primary source and its credibility. Unfortunately, that is commonly not the case.