Red Line Trains

Bright Red Lines: Fact, Speculation, and Misinformation

There’s nothing like the high stakes of a pandemic to remind us of danger from blurring the bright red lines separating fact, speculation, and misinformation. This is because an emerging pandemic presents us with ambiguity. But our human nature detests ambiguity. We crave certainty. Without facts to lean upon, we speculate about what might be true. That’s important because speculation is the first step toward finding answers. However, speculation becomes misinformation when we confuse it with fact. That happens quite easily through the bias of familiarity.

A supposition, if repeated often enough, can be mistaken for a fact and thus turn into misinformation. And misinformation can be deadly in dealing with a health threat.

The Case of Ibuprofen

Two weeks ago, researchers published a letter in Lancet Respiratory Medicine, speculating that an enzyme – ACE2 – might increase the risk for bad outcomes with COVID-19. Among the drugs that can increase ACE2 enzyme levels is  ibuprofen, something that’s effective for treating fevers and pain. Thus, ibuprofen might logically be used to treat the fever that comes with a coronavirus infection.

Almost immediately, based on this speculation, alarms sounded. The French Ministry of Health warned of “serious adverse events.” Quickly after that, WHO recommended against using ibuprofen in patients that might have COVID-19.

Next came more thoughtful responses. The University of Basel, where the research letter originated, sent out a clarification. This concern was a “suspicion, expressly formulated as a hypothesis,” it said. Not medical advice. WHO reversed itself, tweeting that “it does not recommend against the use of ibuprofen.” All this transpired in less than a week.

Acting on Speculation

We have a long history of acting on speculation in another pandemic – obesity. In the 1980s, speculation that low-fat diets had “unique merits” for weight control became embedded in nutrition policy. It took two decades to figure out that the speculation was wrong – a big fat lie. Similarly, speculation that sugar is the bad actor in our diets has gone viral and become a preoccupation in nutrition policy to address obesity.

So we’ve been driving sugar consumption down for the last two decades. And yet, obesity prevalence continues to grow. Certainly too much sugar, just like too much fat, is not good. But we have no evidence that cutting the population’s consumption of sugar, by itself, is going to reverse obesity trends.

The bottom line here is simple. We need to pay attention to the bright red lines between fact, speculation, and misinformation. “Hunches” are not good enough for solving health problems. We need facts and science.

Click here for more about the case of ibuprofen and COVID-19. For excellent perspective on the virtue of critical thinking for distinguishing speculation from fact, click here.

Red Line Trains, photograph © hans-johnson / flickr

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March 27, 2020

2 Responses to “Bright Red Lines: Fact, Speculation, and Misinformation”

  1. March 27, 2020 at 8:14 am, Joe Gitchell said:

    Ted – thank you for integrating these various threads together, including historical approaches to obesity. We seem to be making the same mistakes in some kind of manic replication exercise.

    I can’t resist noting the parallels to so much of the situation around nicotine and vaping, including how it has been woven in to “health” communications around COVID19 and conflated with smoking.

    For folks interested in more, I’ve got a two useful links in my two-tweet thread here:

    Stay safe and away from people!


    My employer, PinneyAssociates, provides consulting services on tobacco harm minimization on an exclusive basis to JUUL Labs, Inc., a manufacturer of nicotine vaping products. I also own an interest in an improved nicotine gum that has neither been developed nor commercialized.

  2. March 27, 2020 at 12:02 pm, Stephen Phillips said:

    Science always is smashing pedestals
    Conjecture and refutation
    It is the very nature of the personality of science
    Prudence therefore requires maintaining a healthy skepticism
    Twain said, “When you are as confident as a Christian with four aces; watch-out.”
    Kool-aid may be an easily available thirst quencher but there may be other beverages that can better satisfy your thirst.