The controversy surrounding sports superstar Aaron Rodgers is a sobering reminder of how entrenched COVID-19 misinformation is in American society. When the Green Bay Packers quarterback tested positive for COVID-19 and revealed that he was unvaccinated (which is against NFL rules), he justified his decision not to get vaccinated by citing a litany of widely debunked COVID-19 vaccine myths, to the horror of scientists aware of the athlete’s immense popularity and reach. Other celebrities who have expressed vaccine skepticism, like the Brooklyn Nets’ Kyrie Irving and the actor Matthew McConaughey, have drawn sharp criticism for spreading misinformation on their enormous platforms as well.

But the scientific community has also denounced another subset of influential Americans: physicians who share misinformation about COVID-19 and the vaccines. Some, like a group that calls themselves America’s Frontline Doctors, even help people get prescriptions of ivermectin and hydroxychloroquine, neither of which are approved for treating COVID-19 (and are very lucrative for the prescribers). These doctors—a handful of whom have been nicknamed “the Disinformation Dozen”—not only foster the spread of these myths and endanger their patients but also validate misinformation and damage trust in the medical field. At a time when we need to overcome vaccine hesitancy to increase the vaccination rate, a loss of trust in medicine is something we can’t afford. A “trust tracker” from the COVID States Project, a multidisciplinary research effort on pandemic attitudes and behavior, shows that trust in doctors and scientists has declined since April 2020, with Republicans expressing more mistrust than Democrats.

In recent months, a number of medical organizations have called on medical boards to discipline doctors who spread information. The Federation of State Medical Boards (FSMB), an umbrella organization, stated in July that doctors who do so risk “suspension or revocation of their medical license.” In September, the American Board of Family Medicine, American Board of Internal Medicine, and the American Board of Pediatrics supported that policy in a joint statement, which was followed shortly by another from the Physicians for Human Rights.

But putting this policy into practice has been a challenge, in part because the decision to penalize doctors is in the hands of state medical boards. In September, an NPR investigation found that 15 of 16 doctors known to spread misinformation online were still in good standing with their medical boards. CNN reported in October that only the state medical boards of Rhode Island and Oregon said they had disciplined doctors for violating COVID-19 policies. 

FSMB spokesperson Joe Knickrehm explained in a September interview that state boards rely on complaints filed by the public to track physicians who spread misinformation, and they simply don’t have the resources to monitor every doctor under their purview. Many state boards, he added, have reported more complaints than usual about doctors who peddle coronavirus myths. But as USA Today reported in September, state boards have disciplined fewer doctors in general during the pandemic.

There are legal challenges to enforcing this policy, too. In some states, politicians have tried to block policies that would penalize physicians for spreading misinformation. Last month, after Tennessee’s state medical board announced it would adopt such a policy, Republican lawmakers introduced two bills that would essentially protect physicians from being disciplined on the basis of their opinions. Also last month, Nebraska’s attorney general said he wouldn’t penalize doctors for prescribing ivermectin or hydroxychloroquine.

When doctors are permitted to spread misinformation, ultimately the public bears the downstream consequences, either because they believe the wrong thing or they don’t know what to believe. Neither option promotes vaccination or safe COVID-19 behaviors like masking or distancing, which are known to protect people from getting sick. The results from a recent Kaiser Family Foundation survey reflects the uncertainty that many Americans still harbor about COVID-19 and the vaccines due to misinformation. Faced with eight false statements (such as “the vaccines contain a microchip” or “ivermectin is a safe and effective treatment”), 78% of people polled either believed or weren’t sure about at least one of them. The most widely believed falsehood (38% of people polled) claimed the government is exaggerating the number of deaths from COVID-19.

Efforts are still underway to discipline doctors for spreading Covid myths: A group called No License for Disinformation, made up of doctors and other advocates, is calling on the public to file complaints against physicians who spread falsehoods about COVID-19; a useful guide for doing so can be found here. The NFL, meanwhile, has fined both Rodgers and the Packers for not following the league’s COVID-19 protocols, sending a clear message that behaviors that compromise the safety of others won’t be tolerated.

Thanks for reading, and please reach out if you have any questions or comments—I’d love to hear from you.

Stay safe out there,

Yasmin

@yeahyeahyasmin

DIGITAL HEALTH

An app for psychedelic treatment. Miami-based startup nue.life is developing a digital platform to support at-home psychedelic-assisted mental health treatment. The company raised a $3.3 million seed round this summer to develop its app and officially launched its brand this week at the national psychedelics conference Wonderland:Miami. Through the app, customers initially meet with the company’s mental health professionals, who can prescribe ketamine if it’s indicated. (Ketamine is among a handful of psychedelic drugs that have shown promise in treating depression and anxiety, and trials are underway on MDMA and psilocybin—see below!) As patients go through treatment with the drug, the app lets them access “musicologist-designed playlists, voice journals, and mood tracking” as well as reach company staff 24/7. (Fierce Biotech)

INDICATIONS

Pfizer requests booster authorization for everyone. The FDA currently authorizes Pfizer booster shots only for people over 65 and some younger adults who work in high-risk settings or have certain medical conditions. This week, the company asked the FDA to authorize boosters for all adults—a request the agency is expected to grant, in a reversal of its previous stance. Recent evidence showing that vaccine immunity wanes may be a factor in the decision, although experts are still divided on whether third shots are needed, especially when so many people worldwide have not received a single dose. 

Psilocybin breaks through treatment-resistant depression. On Tuesday, the UK-based mental wellness company Compass Pathways released results from its Phase 2 trial showing that 25-mg doses of psilocybin, together with support from therapists, reduced depressive symptoms in people with treatment-resistant depression after three weeks. Psilocybin is a naturally occurring psychedelic compound found in so-called “magic” mushrooms that, along with ketamine and MDMA, has piqued the interest of researchers with its potential to treat mental health conditions. Compass Pathways plans to start a larger Phase 3 trial in 2022. 

THE BIG PICTURE

The U.S. government and Moderna clash over the COVID-19 vaccine patent. As we previously discussed on The Capsule, Moderna’s refusal to share its COVID-19 vaccine recipe may not be legally sound, given that it was co-developed and funded by the U.S. government. This week, the New York Times revealed that the company and the National Institutes of Health have been butting heads over this for over a year: The NIH contends that three of its scientists helped develop the drug, while Moderna insists that only its scientists were involved in developing a key component of the vaccine. In a patent application the company filed in July, only Moderna’s scientists are listed as co-inventors. The outcome of this debate will determine whether the vaccine recipe can be shared around the world, which would be a huge step toward alleviating global vaccine inequity.

REQUIRED READING

Denmark ditched its COVID rules 2 months ago. Now cases are up—and restrictions are coming back, by David Meyer.

Singapore withdraws free health care for COVID patients who are ‘unvaccinated by choice’, by Grady McGregor.

Ellume recalls 2 million at-home COVID tests due to false positive risk, by Emma Court and Bloomberg.