A study published in JAMA Internal Medicine suggests that the American public is highly susceptible to endorsements from public leaders regarding unproven COVID-19 drug therapies — even when such drugs have been linked to fatal poisonings.
Although no current drug therapies have been proven to be highly effective in the treatment of COVID-19, worry about the virus may cause the public to look for unsubstantiated treatments. As study authors Michael Liu and his team describe, “when several high-profile figures, including entrepreneur Elon Musk and President Donald Trump, endorsed the use of chloroquine . . . and hydroxychloroquine (with the antibiotic azithromycin), . . . to treat COVID-19, it drew massive public attention that could shape individual decision-making.”
Chloroquine and its derivative hydroxychloroquine are two antimalarial drugs originally developed to treat and prevent malaria. The effectiveness of these drugs in combatting COVID-19 has been largely unsupported, and harmful effects of unsupervised use have been reported.
Liu and colleagues conducted a study to see how the endorsement of these drugs by high profile figures coincides with public interest in buying the drugs.
As the authors describe, “The fractions of Google searches (http://google.com/trends) originating from the United States that included the terms buy, order, Amazon, eBay, or Walmart (the latter being the top 3 e-commerce companies) in combination with chloroquine or hydroxychloroquine per 10 million total searches were monitored.” Daily queries were monitored from February 1, 2020, to March 29, 2020.
An analysis was conducted to see how these Google trends would change following the endorsements of the drugs by Elon Musk on March 16, and by President Donald Trump on March 19. They also examined whether search trends would change following the first report of a fatality connected to chloroquine on March 22.
Results showed that searches for buying chloroquine increased by 442% after Musk and Trump showed their support for the drugs. Searches for buying hydroxychloroquine went up by 1389%.
As the authors report, the largest spike occurred the day of Trump’s initial televised endorsement, when there were 28,319 estimated Google searches for buying chloroquine and 20,311 estimated Google searches for buying hydroxychloroquine. “These changes represent about 93 000 and 96 000 more searches than expected for chloroquine and hydroxychloroquine, respectively, with 216 000 total searches for both drugs over just 14 days,” the researchers report.
Alarmingly, even after the first report of a fatal poisoning related to the drugs was made public, Americans continued to enquire about purchasing the drugs at levels much higher than usual, with searches remaining 212% higher than normal for chloroquine and 1167% higher for hydroxychloroquine.
“In times of public health crises,” Liu and his team reflect, “therapies not supported by adequate evidence—such as would lead to US Food and Drug Administration approval—should not be touted by public figures . . . Until such time as these or other drugs are found to be effective for COVID-19 treatment regulatory agencies and public-facing companies should be actively mitigating the negative consequences of this misinformation.”
“Additional surveillance will clarify this study’s findings, including estimating the number of sales of chloroquine containing products. Nonetheless, the present analysis suggests that in times of public health crises, demand for unproven and potentially hazardous COVID-19 treatments is massively increased by endorsements.”
The study, “Internet Searches for Unproven COVID-19 Therapies in the United States”, was authored by Michael Liu, Theodore L. Caputi, Mark Dredze, Aaron S. Kesselheim, and John W. Ayers.
