Over the past few weeks, politicians and doctors have promoted numerous treatments and cures for Covid-19, including malaria drug hydroxychloroquine, tissue plasminogen activator (tPA), sunlight, and even disinfectant injections. Obviously some of these treatments are more likely to help than others, but none have sufficient evidence to know whether they work. It seems like every day there’s another unproven “cure” for coronavirus. How did this get so out of control?
The issue of poor science in medicine is not new, write Lown Senior Vice President Shannon Brownlee and medical investigative journalist Jeanne Lenzer, in a recent article in Issues in Science and Technology. In fact, medicine has a long history of doing things that don’t work, but in this pandemic, these deficiencies have been exposed.
The pandemic has revealed several major fault lines in medical research, write Brownlee and Lenzer:
- A lack of rigorous studies that provide meaningful results with as little bias as possible
- Our rush to do more in medicine, regardless of whether we know it works
- The media’s role in hyping unproven treatments, and
- The lack of regulation of new medical treatments, and the invasion of politics into these decisions.
Lenzer and Brownlee explain the history of medical research, from the 1918 pandemic (in which anti-malarial drugs were also touted as a cure), to the start of the era of evidence-based medicine. Although we have come a long way, the coronavirus shows how we are still repeating the errors of centuries past.
These mistakes will not only have an impact on patient health now, but they will make it more difficult to fight the next pandemic. They write:
"The first rule of a good clinical trial is to establish an appropriate control group. It was the only thing that persuaded doctors to abandon bloodletting. If we don’t follow that rule now, SARS-CoV-2 or another novel virus will roll around again, and we will still have no effective medicines to treat it."