Why is the U.S. Senate holding hearings on snake oil?
There was a super-spreader event last week in the United States Senate. It wasn’t the coronavirus, however, that was spreading, but misinformation.
The Senate Homeland Security and Governmental Affairs Committee held a hearing about early treatment for COVID-19. Yet instead of a robust discussion about promising emerging therapies or what Congress might do to accelerate such treatments, the conversation was all about the malaria drug hydroxychloroquine.
That’s right. Almost nine months into the pandemic, during a surge, with 1,500 daily deaths, senators saw fit to rehash a medical dead end. Trial after trial has found no evidence that hydroxychloroquine improves outcomes for COVID-19 patients; some studies have found that it causes more harm than good.
The hearing and the theater around it are a window into the disinformation campaigns that have hobbled our national response to the crisis and undermined belief in science.
The purpose of congressional hearings is to inform policy with evidence and analysis from expert witnesses. For those of us whose life’s work is the production and evaluation of data, participation is a highlight — a chance to help shape the national debate. But this hearing, at which I testified, was different.
Neither Ron Johnson, the Wisconsin Republican senator who is the chairman of the committee, nor his chosen witnesses — three doctors who have pushed hydroxychloroquine — displayed more than a passing interest in evidence. Intuition and the personal experiences of individual doctors were acclaimed as guiding principles.
The history of medicine is littered with snake- oil salesmen who championed useless or harmful treatments based on personal experience. Early in the pandemic, President Donald Trump referred to hydroxychloroquine as a “game changer” declaring himself “a big fan.” Asked why he was so enthusiastic about it, Trump said, “I feel good about it.”
That’s not how we practice medicine, and unfortunately, his feelings turned out to be wrong.
In the hearing, I was called “reckless” because I pointed to facts that could prevent people from getting this treatment. The evidence itself, they seemed to be arguing, was the misinformation.
Our fundamental disagreement was about whether we
can trust science. Johnson and his witnesses questioned the integrity of the medical community, suggesting scientists were part of some “deep state” conspiracy to deny Americans access to lifesaving therapies. We’ve heard this before — including from Trump, who has accused doctors of inflating COVID-19 cases for profit.
The hearing encapsulated the competing narratives of the pandemic. On one side was a group of people essentially arguing that the coronavirus was no problem because we had a cheap and easily available therapy. On the other side, I
argued that the pandemic is hard, that we have few easy solutions, and that we have to work constantly to protect lives through public health measures while we await widespread vaccinations.
It’s easy to see which narrative is more appealing.
The hearing was amplified by right-wing bloggers and social media celebrities, who accused Democrats and me (I was summoned to testify by the committee’s Democratic ranking member) of being responsible for hundreds of thousands of deaths. People called for me to be fired and brought to justice.
It was a powerful reminder that not even Congress is immune to toxic conspiracy theories about doctors being in cahoots with government regulators to deny Americans lifesaving therapies.
By elevating witnesses who sound smart but endorse unfounded therapies, we risk jeopardizing a century’s work of medical progress. Do we really want to go back to valuing anecdote over data, and no longer use the best evidence to decide which treatments work? Or perhaps worse, do we want to let politicians prescribe our medications? Whether you believe hydroxychloroquine is a miracle drug for COVID-19 should not depend on who you vote for.
Science is the tool we use to know what is true. It is the foundation of modern medicine and public health. We can disagree in good faith about policy trade- offs, what we value, and how best to achieve certain goals.
But science and evidence are the bedrock for that debate. The creeping partisan polarization of knowledge itself endangers all of us.