The CoViD treatment controversy: Dumbing Down and Post-Truth
In July 2018 Donald Trump, US President at the time, played a round of golf at his own course in Scotland. Protesters were there, as was usual when Mr Trump went anywhere, seeking to make their views known. They unfurled a large banner on which they had written “Mr Trump, you are below par” or words to that effect. What happened next was not what they expected. Mr Trump left his game for a short while, walked towards the group, smiled and waved. Then he went back to his ball.
The next day some Conservative MPs suggested the protesters had embarrassed themselves. Labour members reacted with indignation. The media enjoyed the circus as usual. Nobody explained or, if they did, that explanation did not reach me, why this might be so. The protesters had made a basic error; intending to insult Donald Trump they had actually complimented him. His friendly reaction probably meant he had mistaken them for supporters.
Golf is an unusual game in that a player wins by scoring low. The best theoretical score a player can achieve on a single hole is one. The best possible score for a whole course would be 18. Of course, most players, if not all, score much higher. No one is likely to be that good at golf. Par is the average number of shots players need to hole the ball. Better players will take fewer shots on average, that is they are below par. Worse players will be above par, needing more shots. By using a technical metaphor they did not fully understand the protesters had written the opposite of what they intended. They had demonstrated the adage that a little learning is a dangerous thing.
The problem here is that a little learning is all most of us can achieve, not because we don’t desire to know more, but because information has become hard to obtain and verify.
Some of that is inevitable when the media is involved. I might define journalists as people paid not to know what they are talking about, and that wouldn’t be far wrong. Journalists would be better described as people paid to talk about something of which they know little. That is inherent in their job. Generally speaking, unless they really are employed as expert correspondents in their own field, that is unavoidable. The job of reporters is to research a subject, perhaps asking an expert questions in the process, but more likely reading documents, and then produce, to a deadline, a succinct and entertaining account of what they think they’ve understood. It’s not surprising that often they get it wrong. They generally lack the skills to achieve what they’re setting out to do. Their skill is in reading and writing, not understanding technicalities in which they remain uneducated.
Some of that is inevitable, but not all. There was a time when the broadcast media and the ‘quality’ newspapers tried to give a full account of events, complete with explanations. There was a time when political analysis would be about policies: their effect as well as their popularity. There was a time when people seeking knowledge could find it, when explanations were available and discussion was encouraged. People distinguished between facts, which had to be verifiable, and opinions which their holders had to be prepared to justify. That all seems a long while ago now. That was in the days when people cared about truth. Those were the days when critical thinking was the essence of academic thought and students were encouraged to challenge the information they received.
About a fortnight ago, someone posted on a site I frequent a link to a video by a retired teacher and nurse with a non-medical PhD who, using his doctoral title, has been talking in technical terms about CoViD and treatments, seeking, it would appear, to educate the public on the subject. In a medical context, his doctorate is highly misleading, easily confused with a physician’s courtesy title when, in reality, he is less qualified in medicine than even a junior ‘doctor’ would be. He cited six studies claiming they proved a generic drug, Ivermectin, had a similar action to Pfizer’s new Paxlovid™, together with other mechanisms to block viral reproduction. The information he presented, explaining thoroughly in simple layman’s terms, looked impressive and, as he repeatedly invited his listeners to check the facts for themselves, he seemed very confident in his grasp of the subject.
However, when I checked the cited papers, they were far more cautious than he had been. That was for good reason, for they were all in silico simulations. Only one paper had actually proceeded to repeat the tests in vitro.
(Now, I hope I'm using these technical terms correctly! As I understand it, in silico means using a computer algorithm to model molecules and their interactions with the aim of discovering how they are likely to react when the real molecules meet. Naturally, it’s limited by the necessary simplification involved in making such a model and by the artificial setting within the algorithm which might not reflect the circumstances and surrounding influences when actual reagents are mixed. I understand in vitro to refer to reacting actual chemicals with each other and observing how they behave in a test tube or dish. Again, this is a simplified context since conditions in a container are unlikely to match those inside a living organism where all sorts of parallel complex processes are at work. Nonetheless, at least real molecules are involved rather than idealised mathematical representations.)
Feeling a little confused, I asked a pharmacist friend to take a look. She was not impressed at all. In fact, she stopped watching after a few minutes. To her knowledgeable ear he made no coherent sense. He misused pharmaceutical terms. He spoke in a strange manner for a pharmaceutical expert. She quickly realised he did not understand his subject and his talk was not worth the time spent listening. It was she who checked his background and informed me of his lack of medical or pharmaceutical qualifications. She was shocked that a person with a Health Service background would publish material outside his field of competence.
Returning to computer modelling, I can see its use for rapid selection of likely candidates for further study but, clearly, it can prove nothing. It is just an initial guide to what might (or might not) be useful. Therefore, such modelling proves nothing. Once again, a little learning had proved dangerous.
However, one of the papers had mentioned over 50 clinical trials on Ivermectin in human CoViD patients and provided a link to a trials database page run by the US government (https://clinicaltrials.gov/ct2/results?term=Ivermectin&recrs=e&cond=COVID-19&view=results) so I followed that link. It produced 27 results, which puzzled me a little as I’d expected more. Of these 27 trials, most of which were finished, only six had reported their results. Most of these trials had small samples. One had no control group. Another had replaced six people who’d had a bad reaction to the Ivermectin as if that weren’t part of the result. Two were not about treating patients but protecting from infection people facing a high risk of exposure. Those seem to suggest a useful effect, but in one case it was unclear how the control group was selected. As the people involved were healthcare personnel wearing PPE and no placebo was mentioned I wondered whether they might be self-selecting rather than ramdomised, in which case there could be a difference in how the two groups regarded the risk of infection, resulting in different rates of care in observing Personal Protection protocols.
As a lay person with neither medical nor statistical training I’m not qualified to comment on the findings. I felt reassured trials were ongoing or yet to report and therefore the truth concerning Ivermectin’s effectiveness or otherwise would soon be known. Then two more developments happened which confused me further.
The first was my discovery of an article on the BBC website (https://www.bbc.co.uk/news/health-58170809) suggesting studies supporting the use of this particular drug were either falsified or showed little or no effect. The second was another link sent to me by one of those who’d sent me the first in response to my reporting what I'd found. It was https://ivmmeta.com/. This showed 66 trials, mostly positive for Ivermectin, though not all and also contained a great deal of argument, and criticism of negative reports to professionals and the media. They listed a large number of points, although many of those were repetitive because a lot of the negative reports had used the same information or shared the same authors and the criticism was repeated for each one separately. They claimed to have sought to correspond with the detractors but received no response.
This is a trend I have also noticed over recent years in my own experience. When trying to establish facts or weigh opinions it is most useful to correspond with those who disagree to understand their arguments and discuss the issue. That is the way to reach a consensus and mutually to understand where truth might lie. It is one way knowledge grows. More and more, I have found, people simply fail to respond. It is as if they no longer wish to discover what is real or reasonable, but wish to stay with a limited view from one perspective only. Is this from fear their position might be untenable and yet they are emotionally so committed to it they cannot bear to have it challenged?
Whatever the reason, the effect is to produce two parallel but non-engaged views of the world, and it becomes impossible for the ordinary person to know which is closer to reality. The controversy over generic drugs and CoViD is an example showing how dangerous this can be, for it illustrates just how important truth is. Either these treatments help or they don’t. That is not subject to opinion. It will be a fact, but I cannot tell which is the fact and which is the lie in the absence of engagement. Nor can the medical profession nor the politicians, all of whom have to rely on the information they’re given. So when someone criticises the data and others criticise the criticism it’s imperative a dialogue ensues so a consensus of suitably qualified experts emerges. Now, it might well be that has happened but it isn’t clear to the public it has, because the data has not been discussed in public. Instead, some countries have banned prescription of these drugs, which should not be necessary if physicians know they are ineffective, since doctors are qualified and ethically responsible for judging what to prescribe.
Coercion will naturally lead people to believe something’s not right and feeds into conspiracy theories. No responsible doctor would choose to prescribe an inappropriate medicine and if they did for a while would soon stop if they saw no benefit from it. Word would spread quickly among a professional community. So far as I know, no health professional suggests dropping standard treatments in favour of these controversial ones, so why is it so important? It leads to suspicion someone might be afraid of further investigation, and that leads to fears of dishonesty.
Argument and experiment would help resolve these issues when dealing with reasonable people. Reasonable people need argument, so why is argument apparently no longer used to resolve controversial issues, not just here, but in general?
CoViD is a natural phenomenon, and natural phenomena have no interest in human opinions, however forcefully put or policed. As such, it illustrates the danger of a world in which opinions are coerced rather than formed by free activity and where truth is considered no longer a concern. Only the truth about nature will do. Nature will not bend to our misguided beliefs, whatever they might be. If we do not understand that then we really understand nothing at all.