COVID-19: A journey into “fakemeds”

From China to Senegal, from India to Bolivia, no country affected by the virus has been spared the waves of rumors and misinformation that claim miracle cures for a disease that, to date, has no treatment or vaccine.

Pseudo-medicine evolves along with the spread of the virus

From China to Senegal, from India to Bolivia, no country affected by the virus has been spared the waves of rumors and misinformation that claim miracle cures for a disease that, to date, has no treatment or vaccine.

A look at traditional recipes

It is a known fact in the realm of pseudo-medicine: grandma's remedies are always the first resort and are relied upon as if they were of universal consensus. They are sometimes so simple, obvious, and inexpensive that doubting them is hard. Every country and society has its examples, like hot water or exposure to the sun, and likewise, there is no proof of effectiveness in prophylaxis as well as in the cure of such “therapeutic” options.

Other examples include the Shuang-Huang-Lian (SHL) in China (a mixture of Scutellariae Radix, Lonicerae Japonicae Flos,  and Fructus Forsythiae) or the inhalations of chamomile or Eucalyptus vapors in Bolivia. But a new trend is taking place: these natural potions are being used in blue tents, bearing signs or banners reading: "Ministry of Health".

How do you explain that even for a very novel disease, traditional remedies are praised? "I see this as a sign of what is now to be a subjective perception of what is medicine, and more generally of populist science," says Sebastian Dieguez, a neuroscience researcher at the Laboratory of Cognitive and Neurological Sciences at the University of Fribourg in Switzerland. "Of course, this is not new, but the current context highlights this phenomenon in a way that has never been more revealing. The pandemic is covering a large part of the world almost simultaneously, and there is no known cure or vaccine available. This situation provides a breeding ground for rumors, misinformation, and conspiracy theories of all kinds. It is well known that these are fuelled by uncertainty, mistrust, and a sense of competition”, explained Dieguez.

A withdrawal into one's own identity above all

The mechanism of withdrawal from trusting international scientifically-backed treatments, and relying on untested (at least for the novel disease) “medications” operates on several levels. First of all at the transnational level: some cultures simply don't like the idea of another country imposing "its" remedy on them, especially if it comes from big pharmaceutical companies, and prefer to rely on "what comes from home", especially if it's something they are already familiar with, based on tradition, readily available, etc. Then, even within cultures and countries, we can also see dissensions of this kind: on the one hand, we have the classic distinction between those who rely on medical science and those who prefer "alternative" approaches (for example, the idea of "strengthening one's immune system"). All of this is "populist" in the sense that "solutions" are primarily determined by very strong identity factors, as opposed to those that "elites", "bureaucrats", "foreign forces", "enemies" or "multinationals" would claim to impose for self-serving motives.

Further treatments include "Tan Re Qing" in China, for seriously ill patients, and which includes the herbal extracts Scutellariae Radix, Lonicerae Japonicae Flos, Caprae Hircus Cornu, Forsythiae Fructus, and bear bile powder. In India, a member of the Assam State Legislature, Suman Haripriya, claimed that drinking cow urine and applying cow dung to the body could cure coronavirus.

"We can also mention sesame oil, cocaine, nicotine, bleach, herbal tea, ultraviolet rays..." commented Sebastian Dieguez as some of the items that have been rumored as cures or treatments during the COVID-19 pandemic. "Not only are the claims quite 'big', but it's also not based on much.” Dieguez explained further: “What I find particularly interesting in this case is really this apparent need to graft this or that "remedy" to someone's belief system. It's as if each individual looks around to see what everyone else is thinking, and simply joins the chorus that most resembles their individual belief-system. I can think of no other way to explain such astonishing conspiratorial aggregates as the current passion for chloroquine, rejection of vaccines, and anger against 5G. These topics are, on the surface, completely unrelated to each other, but accepting one irresistibly attracts the other two, as if for the sake of consistency..."

Therapeutic nationalism?

All over the world, many cultural or identity groups lean towards heroes discovering a more or less local remedy... but this also occurs often without any scientific basis. In other words, druids are flourishing in these troubled times - and indeed many are taking inspiration from the supposed success of, for example, hydroxychloroquine, to make their local bouillabaisse.

This is especially true of the Malagasy government, which is making "COVID-Organics", a herbal-based drink being touted as a national flagship cure to COVID-19. This is an “improved” traditional remedy composed of artemisia (a plant traditionally used in Asian and African pharmacopeia to combat malaria) and other endemic medicinal plants - such as ravintsara. The syrup is being produced by the Malagasy Institute of Applied Research.

However, as Dr. Michel Yao, head of emergency operations at WHO Africa based in Brazzaville, explained to the AFP news agency: "Our position on this drug is clear: there has been no testing. Research is encouraged, but any drug recommended should have been tested and tried to prove its effectiveness and safety, so that it is not harmful to the population. This is not the case for this remedy. If it were to be recommended, there would have to be a scientific consensus." In addition, local treatments containing so-called "natural" chloroquine have developed dangerously, such as those based on neem leaves in the Ivory Coast.

The art of keeping face

"Chauvinism and nationalism are unfortunately no stranger to 'populist medicine', but I would say it's only one aspect of it," says Sebastian Dieguez. "It's something that's going to vary enormously from one part of the world, one political regime or one culture to another. The key process here seems to be how we face a situation of adversity: we don't just sit back and wait for the "powerful" to come to our aid, we're reactive, creative and respectful of our traditions, we do things "our way". But more generally, I believe that this kind of phenomenon illustrates the profoundly social nature of all these beliefs. My view is that for most of these remedies, the important thing is not really to "believe" in them, but rather to show that one believes in them, that is to say, to signal one's membership in such and such a group, one's position in such and such a debate, one's personal, autonomous and voluntary involvement in the issues at stake. It's a perspective that's sometimes described as cynical, but unless everyone has suddenly become an expert in biomolecular chemistry or a clinical trial specialist, it seems to me at least a plausible explanation to the current situation."

In Turkey, against a backdrop of dissent from Erdogan's regime, the renowned and media-savvy hematologist Ercüment Ovali has announced that he has found a vaccine against SARS-CoV-2. This vaccine uses dornase alfa, which is usually used to treat lung disease in people with cystic fibrosis. The announcement raised hopes in Turkey, where the virus has officially claimed more than 3,000 victims. Clinical trials on animals are underway and part of the population believes it to be an infallible solution.

Pseudo-medicine, a cure for uncertainty?

Faced with the universality of “fake meds” supposedly capable of preventing or curing COVID-19, we may wonder about our inability to accept the absence of treatment, the uncertainty of how the pandemic will evolve, and how long we wait for a solution. Are we cognitively programmed to fill information voids with pseudo-knowledge? "It is sometimes said that people, in general, do not like uncertainty at all and prefer clear, simple, and definitive answers to the questions they ask," says Sebastian Dieguez. "So it's a cognitive bias, which can be described as 'the need for closure'" he adds. But it's not that simple.

"Some recent research actually suggests that most people deal very well with uncertainty, and prefer to be told 'we don't know' rather than being told misleading statements. So it seems to me that there is a more general problem with the understanding of science and science communication. The idea that science consists of incredible discoveries, sudden revolutions, or triumphs over the prevailing skepticism is overvalued in the media, in films, and even in the popularization of science. Science would be a kind of obstacle course with truth in the end. Maybe it's time to talk about science in a different way, just stop "telling it" like a Hollywood movie with a beginning and an end”, explains Dieguez.

More than ever, we need scientists and physicians who are humble, who are willing to say "I don't know". And governments and societies need to be able to hear them and cope with that uncertainty. The time will come when we will thank them for not making false promises.