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Public health, pandemic and publishing: a call for accountability

Public health experts must speak up when powerful interests – whether President Donald Trump in the United States or businessman Clive Palmer in Australia – promote unproven treatments for COVID-19, according to Dr Lea Merone, a senior public health registrar and PhD scholar.


Lea Merone writes:

Wealthy businessman Clive Palmer recently paid for an advertising spread in The Australian newspaper for medicines that United States president Donald Trump has been promoting for COVID-19, despite a lack of reliable evidence for their use for this indication.

In Australia, according to the Department of Health Therapeutic Goods Administration (TGA), “advertising direct to consumers is not permitted”.

As a result, the TGA has been investigating concerns about the off-label promotion to the general public of prescription medicines as COVID-19 treatments. According to the TGA’s advertising code, penalty could be anything from an educational letter or warning to criminal prosecution.

When we reached out to the TGA for comment, they told me that enforcement action was not warranted.

“Fake news”

After The Guardian reported concerns about Palmer’s advertisement, he took to Facebook, calling The Guardian “fake news”, adopting a phrase popularised by Donald Trump to describe false, often biased information.

The term is politically loaded and often used by conservative politicians to contest negative portrayal of themselves and discredit the media.

(Below are grabs from Clive Palmer’s Facebook page)

Panic buying

Conflicting media messages lead to public confusion and confusion fuels fear.

Therefore, it is hardly surprising that the public are afraid, panic buying, isolating and grasping onto the idea of an early cure.

The scale of the COVID-19 pandemic is vast, affecting most countries and with more than 1.9 million cases  globally to date.

Amidst warnings from the World Health Organization that spread of the novel coronavirus is increasing in pace, the need for an effective treatment does indeed grow ever more urgent. Talks of cures are tantalising to even the most rational of us.

Trump’s hyperbole has led to increased purchasing of the medicines hydroxychloroquine and azithromycin despite concerns about the potential for adverse outcomes such as severe heart arrhythmias, as Croakey reported recently.

Since these comments, there have been reports of individuals self-medicating with chloroquine-containing products, leading to serious illness and death, resulting in a statement from the CDC advising the general public against using chloroquine phosphate. 

Tackling false information

This case study is an example of the urgent need to counter misinformation about COVID-19. False information can cost lives.

According to the five principles of ethical journalism, the media has a responsibility to ensure truth and accuracy and to be held accountable for “fake news” and make efforts to rectify these circumstances. If media outlets do not start accepting accountability, the consequences for public health could be significant.

In the spirit of accountability, some social media platforms are making efforts to filter through the “fake news”.

Twitter has endeavoured to verify credible sources for COVID-19, however, this process appears slow and certainly seems to doing little to stem the flow of “fake news”, despite the platform’s efforts to delete inaccurate information.

Indeed, social media appears to be inundated with “bots” spreading panic regarding COVID-19; on a single day bot accounts were responsible for 1,627 COVID-19-related hashtags.

Facebook has developed algorithms to seek out sensationalist claims, such as advertising homeopathy or “cures” and have placed bans on the sale of certain items that are in short-supply owing to the pandemic. Instagram, owned by Facebook, has been redirecting those searching for COVID-19 information to reliable sources. 

Holding publishers to account

It is time that more traditional media outlets took the same measures to ensure publishing of quality, evidence-based information from reliable sources and this includes taking greater responsibility for advertising within TGA stipulations.

In short, in a time of “fake news”, publishers need to accept a degree of accountability and act with integrity. The public are afraid and those who are most vulnerable tend to have the lowest health literacy. These people look to the voices through the media for guidance, it is no hyperbole to say that lives depend on correct messaging.

In public health, particularly during the pandemic of a novel virus, it is essential we get the messaging right and calm the media hype surrounding a drug that has since “flown” from pharmacy shelves and has the potential for shortage. Fake news benefits only those who financially profit from the frenzied purchases of public panic.

Public health experts need to speak up to counter the claims made in the advertisement from Clive Palmer and advocate for responsible, ethical use of media.

New restrictions on prescribing hydroxychloroquine for COVID-19 in Australia will ensure correct and safe prescribing.

It is essential that the media, the general public and health professionals maintain a high degree of scepticism about claims made for unapproved treatments for COVID-19. Particularly as recent news demonstrates that a clinical trial of chloroquine in Brazil was stopped prematurely because of safety concerns.

• Dr Lea Merone is a senior public health registrar and  PhD scholar. On Twitter @LeaMerone


Further reading

How false hope spread about hydroxychloroquine to treat covid-19 — and the consequences that followed, fact check by The Washington Post, 13 April

Hydroxychloroquine-COVID-19 study did not meet publishing society’s “expected standard”, Retraction Watch, 12 April

Former FDA leaders decry emergency authorization of malaria drugs for coronavirus, Science, 7 April

No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection (pre-print), 30 March

Trump touts hydroxychloroquine as a cure for Covid-19. Don’t believe the hype, fact check by The Guardian, 7 April

Australian government experts at odds with health department over using hydroxychloroquine to treat coronavirus, The Guardian, 9 April

Chloroquine and hydroxychloroquine in COVID-19: Use of these drugs is premature and potentially harmful, BMJ, 8 April

Advice on off-label medicines for treatment and prophylaxis of COVID-19, statement by Australian Health Protection Principal Committee, 7 April

Watch

The Washington Post fact checker

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