True Confessions of The COVID Nineteen

Our hospital’s OpEd Project cohort of nineteen intrepid healthcare provider-writers, affectionately self-dubbed The COVID Nineteen, co-wrote a recent Newsweek essay titled Coming Clean About Hydroxychloroquine. I am so proud of this piece because it speaks with honesty and vulnerability to medical issues near and dear to my heart: Doctors messing up, admitting it, and saying sorry; and the imperfectly perfect scientific method.

This piece started with a text chain between me and one of the other docs in the group. Hemal Sampat and I were both fed up and frustrated with the proliferation of dangerous misinformation about Hydroxychloroquine (AKA HCQ) as a COVID-19 treatment. A video posted by a group of “Frontline Doctors” touting the miracle cure was making the rounds, and Hemal had posted a brief factual rebuttal post on Facebook.

Have you considered transforming your HCQ post into an essay? I texted. As it turned out, we both had considered penning such an essay, but neither of us was enthused about being targeted by the HCQ cultists. Personally, I’ve already been through this with the antivaxxer crowd, and this seems to be the same crowd.

So I suggested that he pitch it to The COVID Nineteen, and promised to rally support from within the group. He did, and it took off from there! We had all been fielding requests for this pretty useless and potentially harmful drug and were feeling beaten down by the rampant medical mistrust out there these days. We wanted to stand top and speak our truth.

At first, some of us (like me) wanted to compile the data from randomized clinical trials on HCQ. But others (like Lucas Marinacci) pointed out: Data don’t change people’s minds, they really don’t, not anymore. A factual rebuttal wouldn’t cut it. Instead, we needed to dive deep down into where the medical mistrust had come from, and own our part of it. He took the lead on the writing, and yup, the first part of this piece is a true confession of sorts:

“The COVID-19 pandemic has revealed much about health care and our society. We have a crisis of trust and truth; it can be hard to know who to rely on. To help restore our faith in one another, it’s important that we health care providers admit something out loud: We often get it wrong.

In the case of coronavirus, first we said no masks, but now we say masks for everyone. First we said no to steroids, especially if you are very sick, now we say yes to steroids, but only if you’re sick enough.

And at first we said HCQ might work. In fact, some providers were guilty of self-prescribing and hoarding it. Now we say it doesn’t work for COVID-19 and could actually do harm. But not everyone believes us, including the president and several members of his administration, as well as many of our own patients.

We in health care are quick to dismiss our mixed messages by saying, “Oh, that’s just how science works.” And, yes, science is a messy process. But that’s not the only reason we get things wrong. The truth is, we’re human and influenced by more than just science.”

Yes, we’re human, and we go into some detail about exactly how human we are. Some of us thought maybe we were going too far. But it’s all true.

After our confession, we explain a little about how science works, but we tried to do this in real language and relate it back to the pandemic as much as possible. Here is the crux statement:

“We rely on the scientific method not as a matter of faith, but because it works. It has provided us all of the marvels in modern medicine that have increased longevity and reduced suffering. It also helps us identify and avoid succumbing to our own biases and potential conflicts of interest.

Like us, science is not infallible. A large number of papers related to COVID-19 were published and then had to be retracted, many for glaring oversights. But instead of decreasing credibility, the willingness to correct course and call out questionable research, identify outright fraud and hold editorial boards accountable is a sign of a healthy, self-policing scientific community.“

The whole essay is not overly long, so check it out! If you’d like to read more material like this, honest and evidence-based, let me know your ideas!