A caring physician recommends the RSV vaccination to an elderly patient with pre-existing conditions. The patient refuses the shot because she knows, from social media, that physicians are part of a dark conspiracy putting harmful chemicals into their patients.
One of the authors of this piece was that physician. Another, earlier in the pandemic, received phone and email threats after writing about the importance of getting the COVID vaccine.
Doctors are of course not all-knowing, and the essence of science, is in fact, a healthy skepticism. But toxic skepticism, fear and doubt borne of ignorance and a steady overload of false information can be even more pernicious than an old-school blind faith in physician expertise. In an Information Age bad information is dangerous, even deadly.
Dr. Peter Hotez and colleagues at Baylor College of Medicine calculated that the U.S. suffered 200,000 unnecessary deaths just from people not getting the COVID-19 vaccinations. Looking at the U.S. Covid response overall, a New York Times investigation concluded that if the United States had taken the same public health measures as Australia, “about 900,000 lives would have been saved.” Whatever the exact number, even one unnecessary death is too many.
Rising anti-science attitudes in the U.S. — and anti-evidence generally — have become infused into the country’s culture wars. Anti-science sentiment impeded our pandemic response, and it prevents us from adequately addressing climate change and other societal problems. Anti-science is, quite literally, killing us. Why, then are so many drawn to bad science and wild conspiracy theories?
In his book “Foolproof,” Sander van der Linden writes, “…conspiracy theories spread so easily… because they are psychologically attractive; they offer simple explanations for complex events; they restore a sense of agency and control in a world increasingly filled with chaos and uncertainty.” Today bad science, pseudo-science and suspicion of the established scientific community are magnified on social media and cable news, amplified by the reach and speed of the web.
Many people, companies and governments choose to peddle conspiracy theories, disinformation, and a hostility to science — to disseminate what they know are lies — for a simple reason: anti-science is profitable. Misinformation pays.
The architecture of the internet encourages giant social media and search engine companies to monetize their interactions with consumers through “addressability,” that which “connects advertisers and publishers to consumers across digital channels and devices.” Advertisers and commentators, needing to encourage customers to click on their messaging, have learned that misinformation sells. Through the use of algorithms which identify susceptible consumers, absurd conspiracies — lizard people running the government, Democrats molesting children in a pizza parlor basement — become seductive, marketing tools.
Disinformation in the service of profit is nothing new. The colonial American economy was largely based on growing, harvesting and selling sugar (later also cotton and tobacco), to sweeten dishes and to make rum. Slaves — used throughout the colonies but particularly on plantations — mainly consisted of three groups – indentured servants, native Americans, and captured slaves from Africa. But people from Africa proved superior for this work. They brought skills and experience in growing crops in a climate similar to southeastern North America. They were proficient at inland waterway navigation and handy at making, using and repairing farming tools. They were intelligent and, with greater immunity to the diseases present in the southern colonies, were more likely to remain physically healthy and strong.
Plantation owners and businessmen needed to justify the practice of enslaving other people, especially the valuable people from Africa, so they created a myth, of Black inferiority. If Black people were somehow less smart, less skilled, less worthy — even less human — the moral rationale for the superior race owning, training and using those who were inferior was an easier sell. Those being enslaved, of course, didn’t buy it, so the whole system could only be sustained by unspeakable cruelty.
The 20th Century was an era of unprecedented scientific achievement and an equally vigorous assault on science by political and corporate interests. In the 1930s-40s Soviet Union the pseudoscientific writing of rogue scientist Trofim Lysenko became state doctrine, resulting in, among other disastrous consequences, a severe famine in which millions of ordinary Russians lost their lives. In the 1950s, tobacco companies used disinformation to keep people smoking for the “health” benefits while flatly lying to Congress and the public about the connections their own research revealed between smoking and lung cancer. Later, Purdue Pharmaceuticals and the Sackler family conned a nation into the widespread use of opioids, addicting millions while fully aware of the negative effects of their hugely profitable product, oxycontin.
Today the gun lobby has successfully blocked public health research into preventing gun violence, and as we emerge from the emergency phase of a four-year-long pandemic, many states have passed laws limiting the authority of their public health officials in the next (inevitable) pandemic or the next wave of COVID.
Although participants in the Misinformation Economy continue richly enhancing their bottom line, we are not helpless. We can turn AI to advantage to identify and eliminate or quickly call out misinformation across the web. We can improve civics education and vote science-denying elected officials out of office. We can find creative ways to reshape the digital environment with financial disincentives for disseminating falsehoods.
In the 1987 movie “Fatal Attraction,” sane people (played by Michael Douglas and Anne Archer) are in a nightmare war against insanity — the bunny boiling, knife wielding jilted lover (Glenn Close). Today sane, evidence-based people are engaged in an existential struggle with evidence-denying, anti-science craziness. Jared Diamond tells us, in “Collapse: How Societies Choose to Fail or Succeed,” that the failure of a civilization can often be attributed to a collective failure of its members to face reality. That reality can be human-inflicted environmental damage, climate change, enemies, changes in friendly trading partners, and a society’s political, economic, and social responses to these shifts — all problems which challenge us today. We have arrived at a crossroads of human civilization, and at this precise moment, unless we reverse course, we are choosing to fail.
Peter Katona, MD, has been clinical professor of medicine at the UCLA David Geffen School of Medicine in Infectious Diseases, and adjunct professor of Public Health at the UCLA Fielding School of Public Health in Epidemiology. He helped design UCLA’s campus COVID policy. Kavita Patel, MD, MS, is a Stanford University biodesign policy adviser and medical contributor to NBC. She served in the Obama administration as director of policy for the Office of Intergovernmental Affairs and Public Engagement. She currently practices in Washington, D.C. Seth Freeman, MPH, is an Emmy-winning writer/producer for television, a playwright and a journalist, who writes about technology, education, policy and public health.