Carl Abraham

Carl Abraham

Carl Abraham, M.D.

My friend just let me know that there are cures for COVID-19 that will save millions of lives and that we all should be taking them. Truly, anything that helps us get out of the miserable situation we are in is worth looking into, so I read the piece she shared.

I’ve read many studies on these treatments. The first of these were published early in the pandemic and suggested the therapy worked. However, as subsequent studies became available that were better designed, it turned out these therapies did not work and some were potentially harmful.

When I got back to my friend to let her know, she clung to the paragraphs she had read on a non-scientific website by someone who had no relation to the studies that I had read. And she was spreading this information as much as possible.

I understand why that is. Science is confusing and the rate of publication – and prepublication – of studies about COVID-19 has multiplied the confusion so much that most of us who are – by profession – supposed to keep up, devote significant time and resources doing so.

Normally, physicians need to stay abreast of several thousand peer-reviewed journal articles published each year. Usually, studies that are smaller, less expensive and less difficult to perform are done first. It may take years to organize and perform the larger, more expensive and more complex studies, some of which validate or invalidate previous studies. Physicians are used to learning and incorporating new and possibly conflicting information at that pace.

The number of COVID-19 articles – both published and prepublication – released since March of this year is more than 36,000. Thirty-six thousand! The cycle of small study followed by larger study is happening in a matter of months if not weeks. The result is the mixing of information within the same space in time, and since there are so many studies being done and articles available about the same aspects of COVID-19, some have seen only part of the information available.

Add in the anxiety, heartbreak, broken plans, social isolation and a general fear of the unknown, it is easy to see why we are all having such trouble drinking from this fire hose of information.

Before you tell everyone that they need to be taking garlic, vitamins, micronutrients (such as zinc), hydroxychloroquine or steroids, that masks don’t save lives and that unchecked transmission in younger folks will not result in a devastating economic downturn due to absenteeism, lost lives and lifelong, debilitating effects of heart, lung and kidney injury in survivors of severe disease, let’s try to sort through the facts and the myths.

Know that research studies are not opinion. They are published in peer-reviewed medical journals and have varying levels of significance. Suppose a study for a medication is shown to be effective in preventing death from COVID-19. If the study is well-designed and the results are shown to be significant, we presume those results – the medication’s effect of preventing death from COVID-19 – are true.

Isn’t everything that’s published in a medical journal significant? Well, that is the goal and researchers try very hard to make it so, but just like TV and social media, not everything that is published in medical journals turns out to be true. If a study is not well-designed, is published before much is known about a new disease (as was the case of COVID-19) or is simply a description of one patient (a case report) or more than one patient (a case series), the study needs to be interpreted very carefully.

It is most likely that more information will be published. We need to be ready to replace the results of less significant studies with the results of studies that are better designed and are published when we know and understand a lot more about the subject than when the disease first presented itself. That is what is happening now as we better understand COVID-19.

The public needs to understand that medical professionals and scientists, just like everyone else, hate the current situation in which we find ourselves. We also experience ill effects of the interventions and none of us want social isolation, lockdowns, economic consequences and the illness and deaths that COVID-19 has caused. We all want it to end with the least amount of death and suffering as possible.

However, the best intentions do not relieve us of the responsibility for the consequence of the information we disseminate. I have seen time and time again obvious examples of persons clinging to old, outdated information despite newer, more significant data that has shown older information to be premature and incorrect.

“This is just like the flu.” It isn’t.

“The virus isn’t spread in aerosols.” It is.

“The virus doesn’t live for long on surfaces.” It does.

“Cloth masks don’t decrease transmission.” They do.

“Vitamin D, zinc, hydroxychloroquine, azithromycin all cure COVID-19.” They don’t.

“Don’t go to your doctor’s office to get treatment for your chronic illness or vaccinate your children.” For goodness sake, please do.

“Listen to the people who aren’t scientists explain how to deal with a devastating pandemic.” Please don’t.

“It was safe to reopen.” It wasn’t.

Educate yourself. It is then you will see that almost every time we try to second guess this virus, we are wrong. Every time we are divided in ways that prevent collaboration, the virus thrives. Every time we politicize the issue, we lose more lives.

And every time we keep making these mistakes, we are less and less prepared for the next pandemic, one that may be so deadly that it makes COVID-19 look like the flu.

Be well and be safe. I look forward to celebrating with you when this is all over.

Carl Abraham, M.D., is an assistant professor of clinical medicine at NYIT College of Osteopathic Medicine at Arkansas State University and an infectious disease specialist.