COVID-19 has been with us now for over a year now, having emerged in China around this time last year as a mysterious and severe new respiratory disease, from there to spread to the rest of the world and be declared a pandemic around nine months ago, along the way spawning an incredible number of conspiracy theories. Since then, it has ravaged the world, particularly the US, where as I write this the number of people known to have been infected with SARS-CoV-2, the coronavirus that causes COVID-19, recently surpassed 15 million (it’s likely much higher, given the lack of testing early on after the pandemic hit the US), while the death toll from this coronavirus is over 280K and climbing rapidly—and also likely much higher.
For all the carnage in my home country, much of which (although certainly not all) would likely have been preventable with a more competent response to the pandemic from our federal government, there have been two potentially useful developments from the pandemic, at least from a science communication viewpoint. First, the weakness of our dedication to science- and evidence-based medicine has been revealed for all to see. The example of hydroxychloroquine, which was touted as a near-miracle cure for COVID-19 and adopted without good evidence by physicians, politicians, pundits, grifters, and even President Donald Trump (but I repeat myself with those last two), is a perfect example. Second, the flood of conspiracy theories, pseudoscience, and the alliance of the antivaccine movement with the anti-“lockdown”/antimask COVID-19 denial/minimizing movement has slapped a lot of very prominent physicians who had labored in blissful ignorance of these tendencies right in the face and motivated them to want to combat it, for example, Dr. Ashish Jha, a prominent physician and researcher, as well as Dean of the Brown University School of Public Health. Unfortunately, he ignores the role of what I will call the central conspiracy theory of science denial.
Let me just to say right here that my purpose is not to pick on Dr. Jha. Far from it! I welcome him to our club of “quackbusters,” as we can always use new voices, particularly prominent ones with a lot of connections. However, I am going to use him as an example of the naïveté that I see in so many physicians advocating for science- and evidence-based medicine in the face of the disinformation campaigns against science that have arisen with a vengeance during the pandemic. All such science denial campaigns spreading disinformation are rooted in conspiracy theories. In the case of antivaccine disinformation, I once used the term “central conspiracy theory of the antivaccine movement” to describe what I mean. In brief, that conspiracy theory claims that the evidence that vaccines cause autism and all sorts of harm exists but that “they” (the government, the medical profession, big pharma, etc.) are covering it up. I now generalize this to describe the central conspiracy theory of science denialism, which is basically the same thing: The reason that science does not accept the science denialists’ views about science is not because the science denialist is wrong, but because “they” are covering up the evidence for that view! I’ll discuss this more near the end, but for now let me just say that scientists like Dr Jha will always be at a huge disadvantage until they understand this concept. (Even if they do understand the concept, they’ll still be at a disadvantage, just not as profound.)
Scientists miss the central conspiracy theory
Here’s what I mean. Last month, Dr. Jha wrote an essay for the New York Times entitled The Snake-Oil Salesmen of the Senate, in which he described his experience testifying before the Senate Homeland Security and Governmental Affairs Committee. (Of note, the chair of this particular committee is Senator Ron Johnson (R-WI), whom we’ve met before in the context of his promotion of the deceptive and harmful federal right-to-try law.) Dr. Jha thought that the hearing would be about “promising emerging therapies or what Congress might do to accelerate such treatments” for COVID-19, but what it turned out to be about was mainly hydroxychloroquine, leading him to express amazement and dismay. Three academics, one of whom we’ve encountered before (Harvey Risch, who, like Didier Raoult in France and so many grifters in the US and the rest of the world, has been promoting the drug for COVID-19), promotes hydroxychloroquine far beyond what the evidence supports, while Dr. Jha was the lone voice of skepticism. He was blindsided:
In the hearing, I was called “reckless” because I pointed to facts that could prevent people from getting this treatment. The evidence itself, they seemed to be arguing, was the misinformation.
Our fundamental disagreement was about whether we can trust science. Senator Johnson and his witnesses questioned the integrity of the medical community, suggesting scientists were part of some “deep state” conspiracy to deny Americans access to lifesaving therapies. We’ve heard this before — including from President Trump, who has accused doctors of inflating Covid-19 cases for profit.
The hearing was amplified by right-wing bloggers and social media celebrities, who accused Democrats and me (I was summoned to testify by the committee’s Democratic ranking member) of being responsible for hundreds of thousands of deaths. People called for me to be fired and brought to justice.
It was a powerful reminder that not even Congress is immune to toxic conspiracy theories about doctors being in cahoots with government regulators to deny Americans lifesaving therapies.
I can only be amazed that Dr. Jha was apparently unaware that especially Congress is prone to toxic conspiracy theories.
On Twitter, a number of people, myself included, tried to gently suggest to Dr. Jha that he should not have been surprised. If he’d had any familiarity with antiscience movements he would have known to expect this, for example, Mark Hoofnagle:
For those of you not familiar with the five tactics of denialism (taken from Skeptical Science but originally proposed by Mark and Chris Hoofnagle and also listed in a famous paper by Diethelm and McKee in 2009), they are:
- Conspiracy theories. When the overwhelming body of scientific opinion believes something is true, the denialist won’t admit scientists have independently studied the evidence to reach the same conclusion. Instead, they claim scientists are engaged in a complex and secretive conspiracy. Like Dr. Hoofnagle, I’ve now come to the conclusion that conspiracy theories are at the heart of all science denial. To me, the remaining characteristics in this list are more tactics of science denial rather than characteristics, but it is very important for science communicators to be aware of these tactics.
- Fake experts. These are individuals purporting to be experts but whose views are inconsistent with established knowledge, and their use is a favored tactic of science denialists. Fake experts have been used extensively by the tobacco industry who developed a strategy to recruit scientists who would counteract the growing evidence on the harmful effects of second-hand smoke. The tactic of elevating fake experts is often complemented by denigration of established experts as a means of discrediting their work. Tobacco denialists have frequently attacked Stanton Glantz, professor of medicine at the University of California, for his exposure of tobacco industry tactics, labelling his research ‘junk science.” Another target in another scientific discipline isvaccine scientist and outspoken defender of vaccine science Dr. Paul Offit, whom antivaxxers have labeled as “Dr. PrOffit,” and Robert F. Kennedy, Jr. called a “biostitute.”
- Cherry picking. This tactic involves selectively drawing on isolated papers that challenge the consensus to the neglect of the broader body of research. An example is a paper describing intestinal abnormalities in 12 children with autism, which suggested a possible link with the MMR vaccine (yes, Andrew Wakefield’s Lancet paper from 1998). This has been used extensively by campaigners against immunization, even though 10 of the paper’s 13 authors subsequently retracted the suggestion of an association. There’s plenty of cherry picking going on among COVID-19 deniers/minimizers right now, particularly over hydroxychloroquine.
- Impossible expectations of what science can deliver. The tobacco company Philip Morris tried to promote a new standard for the conduct of epidemiological studies. These stricter guidelines would have invalidated in one sweep a large body of research on the health effects of cigarettes.This particular tactic is a variant of the Nirvana fallacy (logical fallacies being the next tactic of denialists listed below), my favorite example of which is how antivaxxers dismiss any vaccine that is not 100% effective and 100% safe as, in essence, useless, toxic crap. This tactic has been particularly effective when wielded by COVID-19 deniers/minimizers, as there is a lot of uncertainty in a lot of COVID-19 science that can be exaggerated.
- Misrepresentation and logical fallacies. This tactic is also a favorite of science denialists. Logical fallacies include the use of straw men, where the opposing argument is misrepresented, making it easier to refute. For example, the US Environmental Protection Agency (EPA) determined in 1992 that environmental tobacco smoke was carcinogenic. This was attacked as nothing less than a ‘threat to the very core of democratic values and democratic public policy’.
I’m sure regular readers of RI recognize all of these characteristics, as they have all at one time or another been discussed here. Interestingly, Diethelm and McKee also note a characteristic common among science denialists that I like to refer to as projection but that they refer to as inversionism:
There is also a variant of conspiracy theory, inversionism, in which some of one’s own characteristics and motivations are attributed to others. For example, tobacco companies describe academic research into the health effects of smoking as the product of an ‘anti-smoking industry’, described as ‘a vertically integrated, highly concentrated, oligopolistic cartel, combined with some public monopolies’ whose aim is to ‘manufacture alleged evidence, suggestive inferences linking smoking to various diseases and publicity and dissemination and advertising of these so-called findings to the widest possible public’.
Basically, in this subset of conspiracy theory, grifters assume that everyone else is a grifter too, and denialists promoting ideologically based narratives for profit think that everyone else is motivated by ideology and profit too.
Meanwhile, someone well known to many of you tried to explain that those of us who’ve been combatting the antivaccine movement have seen this movie many, many times before:
I know, I know, it’s lazy to quote a bunch of Tweets, but why not use them when they’ve already presented what I wanted to say in a way that I wanted to say it?
Basically, this is an issue that skeptics have dealt with dating back to long before I ever started identifying with the skeptic movement. In particular “quackbusters,” like Dr. Stephen Barrett, who was doing the sort of discussions of quackery and applying science-based medicine to deconstructing alternative and “integrative” medicine claims back when I was still in college, encountered this disdain.
Before the pandemic, there was very little incentive, other than interest in the topic and a passion to protect patients, for physicians to publicly combat misinformation, pseudoscience, and disinformation about medicine. It wasn’t rewarded academically. (Quite the contrary, in fact, a phenomenon that Carl Sagan used to bemoan about his public advocacy for science and skepticism in which academics actually showed active disdain or even contempt for such efforts.) In medicine, speaking out against quackery, antivaccine pseudoscience, and medical conspiracy theories is, in fact, can land a physician in a whole world of hurt. I won’t go into the sorts of hurt that my activities have brought my way other than to briefly mention how a cancer quack first tried to get me fired a mere six months after I had started blogging; antivaxxers launched phone and email campaign to my university ten years ago to try to get me disciplined or fired over a made-up “conflict of interest”; Mike Adams launched a full-on campaign of libel against me; and, until recently when Google tweaked its algorithms to deemphasize antivaccine sources in its search results, my Google reputation was utterly trashed by many attacks on my published by antivaxxers and quacks.
Since the pandemic, I’m not convinced that the balance of incentives versus disincentives of speaking out has changed. On the one hand, there is a huge incentive to push back against the flood of COVID-19 misinformation, given the scale of the death and misery caused by the pandemic and how public resistance to science-based public health interventions has contributed to that toll (the incentive having increased even more recently with the impending rollout of approved COVID-19 vaccines provoking a frenzy of antivaccine disinformation). On the other hand, countering that incentive is the disincentive that social media plus the sheer intensity of the antiscience disinformation campaign against COVID-19 science has produced, namely the harassment, attacks, and even threats of violence that have greeted those trying to stem the tide of the pandemic and misinformation about the pandemic. Public health officials have resigned, and in my own state anti-lockdown protesters openly carried weapons into the State Capitol Building in Lansing in May.
Supporting science is important, but…
I’m not going to dwell on that aspect, because what I’m interested in is scientists’ continuing blindspot with respect to conspiracy theories and science denialism. I’m not hear to pick on Dr. Jha, who should be praised for having the courage to speak out (although there will be some nitpicking because it’s unavoidable), but to use his articles and this statement as an example of what I mean:
First of all, I’m not sure why Dr. Jha expresses amazement that there are antivax doctors and doctors still hawking hydroxychloroquine despite the resounding evidence that it does not work to prevent or treat COVID-19. After all, I and many others have been discussing antivaccine doctors—even antivaccine pediatricians!—for a very long time now. Relatively few physicians, as I have pointed out, are actually scientists (nor do they need to be); more importantly, physicians are human and thus prone to the very same human cognitive quirks and shortcomings to which all humans are prone. In some ways, they’re even worse. I don’t have hard data to support my impression (which means that I have to admit right here that my opinion might be colored by confirmation bias). Even so, it seems to me that my fellow physicians, thanks to their education in science and medicine and coupled with their societal privilege, are, if anything, more prone to the arrogance that led them to think that their medical training means that they can just “pick up” other disciplines on their own and the Dunning-Kruger effect, in which they are not even aware of their lack of expertise on topics that they think they know well.
But let’s continue:
The statement by Dr. Jha and these academics was apparently the result of his experience in November, further in response to the announcement on Monday that antiscience crank Dr. Jane Orient was to be the “star witness” at another hearing of Sen. Johnson’s committee on COVID-19 vaccines and—again!—hydroxychloroquine. (I can’t help but note that I strongly suspect, but cannot prove, that her organization, the Association of American Physicians and Surgeons, is also behind an astroturf effort to promote hydroxychloroquine.) Moreover, I can’t help but note that the hearing yesterday featured other COVID-19 denialists, including one of the authors of the Great Barrington Declaration, the the eugenics-tinged “don’t worry, be happy” manifesto advocating that we allow the “young and healthy” to go on about their business because the risk to them is presumably so low while we somehow “protect” the vulnerable elderly an people with chronic health conditions that make them susceptible to severe COVID-19. Also included is an advocate of Ivermectin to treat COVID-19 who uses exactly the same sorts of arguments that hydroxychloroquine cultists started using in March. (Damn. I really have to look into that drug now.)
Overall, the statement by Dr. Jha and colleagues is in general very good, at least as far as it goes. I say “as far as it goes” because the statement is incomplete and illustrates the very blindspot that I discussed. Let’s look at the good first:
The 1918 influenza pandemic powered a new era of modern science, discovery and approaches to public health, helping to build the scientific and public health community, which in subsequent years produced new tests for infection, medicines for treatment, vaccines to stop the spread, and more.
In contrast, the 2020 COVID-19 pandemic, despite having produced some notable scientific gains, has also fueled attacks on how we know what we know, raising doubts about the scientific process by which we generate facts, analyze data, and reach conclusions. We are facing a dangerous barrage of misinformation that ignores evidence and dismisses the scientific process, undermining our national response and belief in science.
It’s certainly hard to argue with that, although the 1918 pandemic produced a torrent of misinformation about science as well. It’s just that one hundred years ago we didn’t have social media to amplify it, the way we do now.
After noting that the evidence has quite convincingly shown that hydroxychloroquine does not work to prevent or treat COVID-19 but that false information continues to fuel farces like Sen. Johnson’s committee hearings and patients demanding the drug despite the lack of evidence and thereby producing shortages for people who actually need it, the statement goes on to say:
We cannot allow groups and individuals pushing unproven treatments to threaten the progress we have made in medical science, including the fundamental commitment to accepting scientific data as the basis for clinical decision making and public health.
Scientific evidence must continue to be the fundamental force driving progress in medical care, even during a pandemic. Scientific evidence is not the experience or intuition of one physician, or even a collection of individual experiences. Rather, it emerges from the concerted work of thousands of clinicians and scientists conducting research as they treat patients, using clear, reliable methods that minimize bias, analyzing facts and data in a rigorous way, and using standardized tools to verify findings. We are part of a medical and scientific community committed to holding each other accountable. That means calling out unfounded conclusions and poorly executed research. It means recognizing the knowledge and expertise of professional organizations of doctors, such as the Infectious Diseases Society of America or the American Association of Family Physicians, and of our key public health agencies, such as the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration. These professional societies and agencies use their expertise to help develop and interpret what constitutes reliable evidence and we believe that following their guidance, not simply those who have been provided a pulpit, is critical.
Bypassing the scientific process to endorse unfounded therapies ignores a century’s worth of medical progress. In advance of the December 8 hearing before the Senate Homeland Security and Governmental Affairs Committee, the undersigned physicians and scientists declare their commitment to the scientific process and the transparency and accountability that sustains and powers that progress.
There’s very little for a skeptic to argue with here, and maybe political considerations kept Dr. Jha and his colleagues from going into the conspiracy theories, but this statement is, as I have pointed out, incomplete. Why is it incomplete? It’s for the same reasons that I mentioned above, but I’ll be more specific. It does not address, except obliquely, the central role of conspiracy theories in science denialism or what I now like to call the central conspiracy theory of science denial.
The central conspiracy theory of science denial beats evidence (usually)
Physicians and scientists who’ve joined the fray against COVID-19 misinformation and disinformation have, like Dr. Jha, often been startled to have been slapped in the face with science denial and the alliance that rapidly formed between antivaxxers and COVID-19 cranks that ultimately expanded to include even QAnon. For Dr. Jha, it took the form of shock at having been included as the “token skeptic” testifying in front of Sen. Johnson’s committee alongside three hydroxychloroquine cranks and alarm that Sen. Johnson repeated the same playbook to include an antivaxxer and all around science denier like Dr. Orient as the “star witness” at a second hearing yesterday. Many, like Dr. Jha and colleagues, labor under the delusion, expressed in their statement quoted above, that good information will chase out bad and the faith in science as the tool that will ultimately deliver us from the pandemic. They believe that the drive to bypass science and clinical trials in the case of, for example, hydroxychloroquine, is rooted more in misunderstanding of the scientific method than in ideology and conspiracy theories.
They are sadly mistaken.
Think about all the major “flavors” of science denialism and then think about the central conspiracy theory of science denial and how it applies. Here are just a few examples:
- Climate science denial. Here, the idea is that the climate science consensus that has concluded from mountains of evidence that human activity is having a what could potentially be a catastrophic impact on the earth’s climate, resulting in warming that could endanger life on earth, is a liberal hoax or conspiracy designed to impose draconian controls on industry. Evidence against global warming is “suppressed” by ideologically driven climate scientists in order to protect that sweet, sweet grant gravy train, while “liberals” don’t want the “truth” to be known because it would endanger their control. In other words, “they” don’t want you to know the truth.
- Antivaccine. Antivaxxers believe that vaccines cause autism and all sorts of diseases (even death!) but you don’t know it because “they” don’t want you to and cover up evidence showing that vaccines don’t work and cause harm, the “they” being the CDC, physicians, big pharma, the FDA, and the government in general, all to protect the sweet, sweet profits from vaccines and/or to impose control. (Examples of this “central conspiracy theory” include the Simpsonwood conspiracy theory popularized by Robert F. Kennedy, Jr. in 2005 and the CDC whistleblower conspiracy theory promoted in Andrew Wakefield and Del Bigtree’s conspiracyfest disguised as a documentary, VAXXED.) In other words, “they” don’t want you to know the truth.
- HIV/AIDS denial. HIV/AIDS denialists believe that HIV does not cause AIDS but you don’t know it because “they” don’t want you to and cover up the evidence that HIV doesn’t cause AIDS and that drug cocktails are useless. Why? Ideology and, of course, the desire to continue the sweet, sweet profits from AIDS drugs rolling. In other words, “they” don’t want you to know the truth.
- Creationism. Creationists, be they “young earth” creationists or “intelligent design” creationists do not believe that evolution explains the diversity of life on earth and that there must have been the intervention of a “higher power” (translation: God). Evidence against evolution is “covered up” because a cabal of atheist Darwinists want to deny God and thus undermine religion. (This is one of the few forms of science denial where the profit motive is not ascribed as much to scientists as it is by other forms, although the desire for power and control by “atheists” does figure prominently.) In other words, “they” don’t want you to know the truth.
- COVID-19 deniers/minimizers/antimaskers/anti-“lockdown” activists. COVID-19 deniers tend to believe that COVID-19 is not nearly as deadly as portrayed, often likening it to “no worse than the flu.” (If that’s the case, then why did COVID-19 surpass heart disease as the number one cause of death in the US for last week? Does the flu do that routinely? I don’t think so.) Thus, because COVID-19 is “not deadly” to any but the old and infirm (an aspect that’s really inspired antivaxxers and COVID-19 deniers let their eugenics freak flag fly high), then lockdowns, masks, and social distancing are unnecessary (and don’t work anyway), nor is the rush to develop COVID-19 vaccines (which are dangerous anyway). The reason you don’t know this is that “they” don’t want you to because “they” want to control you (and get those sweet, sweet COVID-19 vaccine profits flowing). In other words, “they” don’t want you to know the truth.
At its heart, all science denial involves conspiracy theories about hidden knowledge revealed to the few, conveniently enough those who believe in the conspiracy theory. Such conspiracy theories give the believer a feeling of power, as though they have knowledge that few others do and that they are the victims of the conspiracy. It’s not just science denial, either. I can’t help but briefly mention here that 9/11 Truthers and Holocaust deniers also claim that the reason their conspiracy theories are not accepted is that “they” cover up the evidence against (and manufacture evidence for) the “standard” narratives. Truly, denialism is a form of conspiracy theory.
Once you know that denial of science is rooted in conspiracy theory and ideology, then the tactics of denial are much less remarkable, as are the necessary responses. As Mark Hoofnagle put it:
So, what are physicians, scientists, and lay skeptics to do? Discuss the science, yes. Refute the misinformation, yes. Emphasize the scientific method, of course. However, what Dr. Jha and his colleagues appear not to understand is that that is not nearly enough. These are all necessary, but not sufficient, responses to disinformation. Yes, you can laugh at the ridiculousness of some COVID-19 conspiracy theories (“elites” conspiring with aliens to depopulate the world, anyone?), but conspiracy theories have power. Conspiracy theories inspire motivated reasoning, in which believers work very hard to find evidence that supports their preexisting beliefs and to attack evidence that does not. Only by understanding the conspiracy theories at the heart of all denial of science and medicine can physicians and scientists engaged in science communication begin to craft responses.
To win, scientists need to understand the central conspiracy theory of science denial
I’ve written before about the centrality of conspiracy theories in the denial of science-based medicine and public health, having alluded to the elements of a good conspiracy theory before in discussing why COVID-19 conspiracy theories are so attractive. First and foremost, conspiracy theories are about secret or hidden knowledge, knowledge that only the believers in the conspiracy theory possess, knowledge to which the average person not accepting the conspiracy theory is not privy. Holding such knowledge makes the believer feel special, superior, greater than all the “sheeple” out there who do not hold the conspiracy theory. Whether the conspiracy theory is Q, antivaccine pseudoscience, belief that there is a cure for cancer but “they” are keeping it from the people, the believer is special.
The believer is also simultaneously a victim of persecution and a hero. One element common to the most attractive conspiracy theories is that something is very, very wrong with the world and that it is not an accident that this something is so wrong. Rather, it’s wrong intentionally, usually as the result of a dark conspiracy of powerful forces that is causing the wrong and hiding its involvement. Naturally, the believer perceives himself to be a victim of this “wrongness,” and his “waking up” to his victimhood and deciding to fight against it lets him claim the mantle of hero. These elements of the conspiracy theory also make the believer feel special and heroic, because not only is he privy to secret knowledge, but he is now a warrior fighting against these dark forces to reverse his victimization by trying to make the knowledge more public and alerting others to the conspiracy. Conspiracy theories are thus attractive because they are an antidote to a feeling of powerlessness, explain unlikely events (such as 9/11) and even some not-so-unlikely events (e.g., the coronavirus pandemic, some variant of which has been predicted for nearly two decades since the SARS epidemic in 2002), and coping with threats.
It’s thus no wonder that many, if not most, conspiracy theories are ultimately hopeful. They almost always come to the present with “the people” finally “waking up” to the danger and, with the help of the conspiracy theorists spreading the “true” information about the conspiracy, “rising up” to throw off the shackles of their oppressors. We see this in antivaccine conspiracy theories, in which “They” (the CDC, Big Pharma, the medical profession) are finally taken to account for the “misdeeds” of which they’re accused. We see it in Q, bigtime, with Q’s “prophecies” leading patriots to rise up against the deep state or whatever else is the threat at the time. We see it in cancer conspiracy theories in which the “people” are waking up to, for example, “natural cures” for cancer (which are, of course, suppressed by the “cancer industry”) that don’t involve the toxicity of conventional therapies, such as chemotherapy, surgery, and radiation.
Stephan Lewandowsky and John Cook published an excellent short e-book on recognizing conspiracy theories and countering conspiratorial thinking, The Conspiracy Theory Handbook. They note that, of course, actual conspiracies do exist, but hasten to add that such real conspiracies are not discovered by the methods of conspiracy theorists, but rather through conventional science, skepticism, and investigation. I’ve discussed the characteristics of conspiracy theories before in depth (go here for the long version), but, boiled down to their essence, they can be remembered through Lewandowsky and Cook’s mnemonic CONSPIR:
- Overriding suspicion.
- Nefarious intent.
- Something must be wrong.
- Persecuted victim.
- Immune to evidence.
- Re-interpreting randomness.
I’ve also discussed how to respond to conspiracy theories before, emphasizing that simply emphasizing the science, showing the flaws in the pseudoscience and bad science used to support such conspiracy theories isn’t enough. What I’m about to write is very similar to what I’ve written before (some of it word-for-word the same), but I thought it important to repeat it, rather than just link to my previous writings.
Lewandowski and Cook conclude with a number of strategies to respond to conspiratorial thinking. Regular readers are likely familiar with debunking, which can be fact-based, logic-based, source-based, or based on fact checking. Obviously, I try to do a combination of some or all of these, although I like to note that my writing is not aimed at the hard-core conspiracy theorists themselves. (The likelihood of changing the mind of a hard-core conspiracy theory believer is low to non-existent. If you’re lucky you might plant a seed or two that might germinate later, but only at the cost of a lot of effort.) Rather, it is better to inoculate those susceptible to conspiracy theories with the knowledge about the nature of conspiracy theories and other information that will make them less susceptible to a conspiracy theory, plus, when appropriate, knowledge of the relevant science. It is in this vein that I really like Lewandowski and Cook’s concept of “pre-bunking” in addition to debunking:
If people are preemptively made aware that they might be misled, they can develop resilience to conspiratorial messages. This process is known as inoculation or prebunking. There are two elements to an inoculation: an explicit warning of an impending threat of being misled, and refutation of the misinformation’s arguments. Prebunkings of anti-vaccination conspiracy theories have been found to be more effective than debunking.
Fact-based and logic-based inoculations have both been successful in prebunking a 9/11 conspiracy. This indicates some promise in logic- based prebunking, given the seven tell-tale traits of conspiratorial thinking (remember CONSPIR?). If people are made aware of the flawed reasoning found in conspiracy theories, they may become less vulnerable to such theories.
Most importantly, people need to be empowered against misinformation and disinformation:
Conspiracy thinking is associated with feelings of reduced control and perceived threat. When people feel like they have lost control of a situation, their conspiracist tendencies increase. But the opposite also applies. When people feel empowered, they are more resilient to conspiracy theories.
There are several ways to “cognitively empower” people, such as encouraging them to think analytically rather than relying on intuition. If people’s sense of control is primed (e.g., by recalling an event from their lives that they had control over), then they are less likely to endorse conspiracy theories. Citizens’ general feeling of empowerment can be instilled by ensuring that societal decisions, for example by government, are perceived to follow procedural justice principles. Procedural justice is perceived when authorities are believed to use fair decision-making procedures. People accept unfavourable outcomes from a decision if they believe that procedural fairness has been followed.
Finally, here’s one very important aspect of disinformation rooted in conspiracy theories that Dr. Jha and his colleagues fail to address. A lot of disinformation is tactical. In other words, the origin of a lot of disinformation is not genuinely held erroneous beliefs, but rather an intentional campaign of disinformation designed to produce an ideological or profit-motivated end. Climate science denial is likely the most important example of a tactical conspiracy theory designed to promote a political/ideological viewpoint by casting doubt on a strong scientific consensus, but it’s far from the only one. Indeed, among COVID-19 conspiracy theories, anti-“lockdown” disinformation is definitely tactical as well, being designed to cast doubt on the utility of measures to combat the pandemic that are perceived to harm business, empower government, or otherwise interfere with individual “freedom.”
It’s also always important never to discount the role of grift as a motive for spreading disinformation. You’ll rarely go wrong looking for the financial angle behind a piece of disinformation being spread. Just look at all the antivaxxers and COVID-19 deniers/minimizers whose main or side hustle is to sell “natural” treatments or preventatives for vaccine-preventable disease and/or COVID-19, for example. Even the least profit-motivated science denial, creationism, has its grifters. Also, be aware that, sometimes, the “profit” motive is nothing more than a desire for fame and attention that can be achieved through media outlets of a certain ideological bent, as we have seen with doctors pushing bad COVID-19 epidemiology (although they were promoting their urgent care center business too).
As Lewandowski and Cook emphasize, while logical incoherence is one attribute of conspiratorial thinking, that doesn’t mean that all—or even most—conspiracy theories are irrational. Denialist rhetoric is very effective at casting doubt on specific science that conflicts with one’s ideology, which is one reason why it can be so difficult to combat these conspiracy theories. Moreover, as Dr. Hoofnagle has emphasized, if science communicators go into a forum like Sen. Johnson’s committee meetings unaware of the power of conspiracy theories and without strategies to prebunk them, they will always be at such a massive disadvantage as to have minimal chance of being effective. Basically, too many scientists brave enough to walk into the lions’ den are bringing a knife to a gunfight. No, strike that. Too many are bringing nothing but their fists to tank battle.
Don’t get me wrong. I’m happy that Dr. Jha and his fellow signatories to his statement want to combat science misinformation and disinformation about COVID-19 and treatments for it while promoting the scientific method as the best means of getting us out of this pandemic and hope that I didn’t come across as overly critical. It’s just that his article and statement are perfect examples of how academic physicians and scientists tend to miss the forest for the trees when they first encounter science denial of the sort that Dr. Jha has been combatting online, and, reading them, I had to use them as such. I hope they will all consider this constructive criticism from me, along with a hearty, “Welcome aboard!” I also hope that, when the pandemic is finally over and life returns to something resembling pre-pandemic “normal,” all or at least some of these newbies will stick around and continue to combat dangerous pseudoscience and disinformation. I’m sure there will continue to be a lot of it for many years to come.