Riding the ups and downs of conflicting scientific studies and expert advice about the coronavirus pandemic can leave anyone with a bad case of motion sickness. Within the past week, contradictory information surfaced about the treatment and the transmission of COVID-19.
On Monday, a World Health Organization epidemiologist told reporters at a news conference that people who test positive for the disease but experience no symptoms rarely infect another person. Detailed contact tracing in numerous countries found no such transmission, according to Dr. Maria Van Kerkhove. Fears about asymptomatic transmission led to many of the social distancing and face mask rules around the world, but Van Kerkhove’s statement seemed to indicate those measures might not have been necessary.
A study published on June 3 in the Annals of Internal Medicine reviewed data from 16 groups of COVID-19 patients worldwide and determined that 30 to 45 percent of all cases were traced to people who do not show any symptoms.
Appalled scientists pointed out the contradiction almost immediately.
“Communicating preliminary data about key aspects of the coronavirus without much context can have tremendous negative impact on how the public and policymakers respond to the pandemic,” scientists at the Harvard Global Health Institute said in a statement released on Tuesday.
Van Kerkhove backtracked the same day. She called the discrepancy a misunderstanding, noting she based the assertion on two or three studies and that the estimates came mostly from models, which are not always accurate.
The confusion extends to COVID-19 treatments, as well, particularly regarding the anti-malarial drug hydroxychloroquine. Shortly after the coronavirus started spreading in the United States, anecdotal evidence surfaced suggesting that the drug could be a cost-efficient, readily accessible treatment. Physicians such as Vladimir Zelenko, a general practitioner in New York, began to report promising results in patients. He told Reuters that, as of April 6, the drug helped to lessen the severity of the illness in 200 of his patients, none of whom required hospitalization. Stories like that one spurred doctors to prescribe and patients to request hydroxychloroquine.
But anecdotal evidence needs rigorous scientific study on a drug’s safety and effectiveness to back it up. So numerous researchers began to test hydroxychloroquine. A study published on May 22 in The Lancet indicated the medication not only did not help hospitalized patients but also gave them a nearly 24 percent higher risk of death due to irregular heart rhythms. Within days, experts in the United States and Europe abruptly halted numerous hydroxychloroquine studies, and the WHO paused recruitment for its trials.
Many experts thought halting the research so quickly was an overreaction.
“This is a drug that has been used for decades,” noted Miguel Hernán, a Harvard epidemiologist and researcher in an ongoing trial of hydroxychloroquine in Spain and Latin America. “It’s not like we know nothing about its safety.”
The Lancet study, which used hospital records gathered by a little-known data analytics company, Surgisphere, came under rigorous scientific scrutiny. More than 100 scientists and other experts raised concerns about the researchers’ methods and the legitimacy of Surgisphere and the data it reported. The number of patients involved in the study, their demographics, and the doses prescribed seemed impossible, said Nicholas White, a malaria researcher at Mahidol University in Bangkok: “It began to stretch and stretch and stretch credulity.” The Lancet retracted the study last week.
The use of hydroxychloroquine also got tangled up in politics after President Donald Trump promoted it as a COVID-19 treatment and later said he was taking it as a preventive measure. Before the retraction, former Vice President Joe Biden cited The Lancet’s hydroxychloroquine studies to criticize Trump.
“This is absolutely irresponsible,” the presumptive Democratic presidential nominee said on a Yahoo News virtual town hall. “Look at the studies that have been done. It does much more harm than good.”
The WHO announced on June 3 it would resume its study of hydroxychloroquine. But researchers question whether they can recruit enough patients to restart the studies now that headlines have convinced many people that the drug is toxic.
“The problem is, we are left with all the damage that has been done,” White told Science Magazine.
Some studies proceeded despite the controversy. The U.S. National Heart, Lung, and Blood Institute chose to press on after its safety monitoring board reviewed data and found no issues, said Matthew Semler, a critical care physician at Vanderbilt University and a co-researcher of the study.
In the crossfire of political opponents and the dizzying back-and-forth of scientific studies, how can the average person know how to respond to the pandemic? The best option at this point is to pray for guidance, then take sensible precautions and follow the recommendations of a trusted physician who knows your health history.