Scientific evidence of the efficacy of the unproven COVID-19 therapies hydroxychloroquine, remdesivir, and convalescent plasma was often presented in US news stories in the first months of the pandemic, but scientific uncertainty was commonly omitted and only rarely appeared in headlines or ledes, with possible implications for public health, researchers reported yesterday in JMIR Infodemiology.
In addition, many claims of their effectiveness came from celebrities and politicians. For example, of the 79% of the 236 studied claims about hydroxychloroquine championed by nonexperts, 97% were from then-US President Donald Trump.
During the study period, the unproven medications were being tested in clinical trials. All three received US Food and Drug Administration (FDA) emergency use authorization (EUA) for clinical use in COVID-19 patients, although the EUA for hydroxychloroquine was revoked in June 2020.
"The accurate reporting of scientific evidence and uncertainty is the collective responsibility of multiple professionals including reporters, editors, public health officials, and medical and scientific experts," wrote the Mayo Clinic– and Wake Forest University–led study team.
Evidence rarely cited prominently
The researchers analyzed 479 media discussions on hydroxychloroquine (antimalarial), remdesivir (antiviral), and COVID-19 convalescent plasma (antibody-rich blood donated by survivors) published or aired from January to July 2020, before the development of proven drugs and vaccines. Of the 479 discussions, 449 were news reports (191 print, 172 online, 52 television transcripts, and 34 online videos).
News reports primarily discussed hydroxychloroquine (67%), followed by remdesivir (27%) and convalescent plasma (13%). Stories mainly focused on the safety or effectiveness of hydroxychloroquine (61%) and remdesivir (47%), while those on convalescent plasma typically addressed economics, distribution, and allocation (40%).
Most stories (67%) cited scientific data, but only 24% mentioned scientific publications. Evidence was cited in 67% of discussions and was most common in stories on hydroxychloroquine (78%), followed by remdesivir (63%) and convalescent plasma (21%).
The most-cited source of safety and effectiveness claims on remdesivir was federal or state government (35%), while physicians or scientists were the sources of 38% of convalescent plasma claims. A total of 79% of hydroxychloroquine claims were from a "prominent person," 97% of which were Trump. Other well-known people cited included Jair Bolsonaro (then president of Brazil) and Nancy Pelosi (then speaker of the US House of Representatives).
Among text-based news stories citing scientific evidence, 22% discussed it in the headline, and 51% mentioned it in the lede, but details rarely appeared in headlines (6%) or ledes (26%). Of the 99 text-based stories that cited limitations, discussions of those limitations were rarely found in headlines (2%) or ledes (9%).
Very little coverage depicted any drug as safe, but 75% of news stories on remdesivir and 66% on convalescent plasma generally portrayed them as effective. Only 14% of stories on hydroxychloroquine depicted it as effective, while 56% mentioned related safety warnings or adverse effects (56%).
Presenting science as an iterative process
The authors acknowledged the responsibility and difficulty of sifting through a constant barrage of claims and misinformation on a newly emerged virus that scientists were struggling to understand. "Journalists covering COVID-19 faced an extraordinarily challenging task of keeping the public informed in a hyper-politicized climate filled with misinformation and reliance on unsubstantiated science," senior author Zubin Master, PhD, of Wake Forest, said in a university news release.
