Online searches for hydroxychloroquine to treat coronavirus rose by 1,389% after Trump's endorsement: Study
Internet searches for unproven coronavirus treatments saw a massive increase following endorsements of the drugs hydroxychloroquine and chloroquine by US President Donald Trump and entrepreneur Elon Musk.
Researchers from the UK and US found that queries for purchasing hydroxychloroquine were 1,389% higher, while searches for buying chloroquine were 442% higher following the high-profile claims that these drugs were effective COVID-19 therapies.
"These statements (on unproven drugs for coronavirus and Trump’s comment on injecting disinfectants, for example) are not evidence-based and are incredibly dangerous. The position of President of the US offers one an immense amount of influence."
"So, when President Trump endorses potential therapies on national television, people will listen and seek them out. Disinfectants are hazardous substances and can be incredibly poisonous if ingested or even applied externally," Michael Liu, a graduate student at Oxford and the study’s first author, told MEA WorldWide (MEAWW).
Recently, Trump also touted an ongoing federal study on sunlight, asking if one can inject light and disinfectants inside the body to kill the novel coronavirus.
Currently, there are no approved treatments or vaccines for COVID-19. Over 3,125,260 cases of the new coronavirus have been reported globally, and more than 217,360 have died in the COVID-19 pandemic as of April 27, shows the Johns Hopkins tracker.
"COVID-19 has caused enough suffering already – we do not need misinformation to further exacerbate the current public health crisis," Liu told MEAWW.
The team that conducted the current study includes experts from the University of Oxford, UK; University of California (UC), San Diego, US; Johns Hopkins University, US; and Harvard Medical School, US. They hypothesized that since there are no approved treatments for COVID-19 yet, people may end up searching for unproven therapies.
Therefore, when several high-profile figures such as Trump and Musk endorsed the use of chloroquine and hydroxychloroquine to treat COVID-19, it brought the issue of misinformation to the forefront of public discourse.
The researchers used Americans’ Google searches to track how the public began shopping for these unproven drugs soon after these high-profile endorsements. “We know that high-profile endorsements matter in advertising, so it stands to reason that these endorsements could spur people to seek out these medications,” says Liu.
The experts looked at Google trends to track searches originating from the US between February 1 and March 29, 2020, related to chloroquine and hydroxychloroquine. This time period included the first endorsement by Elon Musk on March 16, Trump’s first endorsement on March 19, and the first reported chloroquine poisoning in the US.
They tracked all Google searches mentioning the drugs "chloroquine" or "hydroxychloroquine" in combination with "buy", "order", "Walmart", "eBay" or "Amazon".
The team then compared these phrases' search frequency over that time frame with a hypothetical scenario in which there were no high-profile endorsements, based on historical search trends for the same terms.
"We specifically wanted to know if people were looking to buy these drugs, instead of just looking to learn more about them," says Dr John Ayers, study co-author, co-founder of the Center for Data-Driven Health at the Qualcomm Institute, and vice chief of innovation in the Division of Infectious Disease & Global Public Health, both at UC San Diego, in the analysis.
The team also found that the first and largest spikes in searches coincided with Musk’s twitter endorsement and Trump’s first televised endorsement, respectively, with the latter occurring on March 19 (chloroquine, 28,319 estimated searches; and hydroxychloroquine, 20,311 estimated searches).
The team says that in absolute terms, they estimated that there were over 200,000 total Google searches for buying these two drugs in only 14 days following high-profile endorsements.
"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," say the researchers in their findings published in JAMA Internal Medicine.
"This could be evidence that thousands of Americans were interested in purchasing these drugs," says Dr Mark Dredze, study co-author and associate professor at Johns Hopkins University.
Even after widespread reports of a fatal chloroquine poisoning in Arizona on March 23, queries for purchasing either chloroquine or hydroxychloroquine remained high. Searches for chloroquine and hydroxychloroquine were 212% and 1,167% greater than expected following the first reported poisoning through the end of observation on March 29.
"Musk's and Trump's endorsements are especially troublesome for three reasons. First, these treatments have inconclusive clinical efficacy. Second, these drugs have potentially fatal side effects. Third, chloroquine-containing products such as aquarium cleaner are commercially available to the public without a medical prescription," says Liu.
According to the researchers, in times of public health crises, therapies not supported by adequate evidence -- such as would lead to US Food and Drug Administration (FDA) approval — should not be touted by public figures.
Endorsements can lead to unsupervised use of the products with dangerous consequences to the people who take them, and hoarding of these medications can result in shortages for those who require them for legitimate health reasons, the research team explains.
These negative consequences are magnified in this circumstance because chloroquine containing products are commercially available to the public through such sites as Amazon, the experts write.
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. The FDA should warn the public against procuring unapproved therapies unless prescribed, says the team.
"Even during these unprecedented circumstances, we must still practice evidence-based medicine. This means allowing the usual FDA approval process to run its course so the public is protected from unnecessary harms," says Liu.
According to the researchers, Google responded to COVID-19 by integrating an educational website into search results related to the outbreak, and this could be expanded to include searches for unapproved COVID-19 therapies.
Similarly, retailers must establish warnings or withhold products that might be linked to use for COVID-19 treatment, they suggest.
"Everyone – public health officials, regulatory agencies, the media, local leaders, and companies – has a role in protecting the public from misinformation. First and foremost, people should discuss any potential COVID-19 therapies with a licensed healthcare provider. Second, regulatory agencies such as the FDA must respond immediately to sources of misinformation and warn the public against potential harms,” Liu told MEAWW.
He added, "The media should not amplify sources of information and instead actively remove them. Finally, retail companies must also provide warnings or even withhold products that are being touted as unproven COVID-19 therapies (for example, when Lysol manufacturers issued warnings about ingestion and when eBay removed sales of chloroquine-containing products)."