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1/16/2021

The Election Conspiracy: The Dire Consequences of Living in an Alternate Reality and What We Can Do About It

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As I have discussed before, our brains seem to be wired to filter and process our perception of reality based on expectations that we have about the nature of said reality. This may actually be beneficial as it serves as a mechanism to reduce the vast complexity of the world around us to a basic set of actionable premises that guide our response to life-changing events or forces that we don’t control or even sometimes understand. Of course, the problem with this approach is that we may not see or accept those things that don’t fit our expectations and we end up creating and living in an alternate reality. But what happens when this alternate reality collides with the actual reality? You would expect people to change their minds, right? Unfortunately this is not often the case.
 
I have previously mentioned several specific reasons why people create and believe in conspiracy theories ranging from feeling safe, reducing uncertainty, and gaining control over their environment to developing and maintaining a positive image of one’s self or group. But I think one general reason why people create and accept conspiracy theories is to explain the discrepancy between their world view and reality. Nowadays there are millions of people in the United States living in alternate realities and accepting and spreading conspiracy theories to explain away the evidence that indicates their world view is wrong.
 
Thus, flat Earthers claim that the evidence the Earth is round is fake and part of a conspiracy to hide the truth.  Antivaxxers claim that pharmaceutical companies are hiding the evidence that vaccines are not safe and cause autism and other diseases. Global warming denialists claim that scientists and the organizations that fund them are faking the evidence for global warming. Creationists deny evolution and claim that atheists aligned with powerful secular interests are attacking religion. Chemtrail proponents allege the government is spraying us with dangerous chemicals. 911 deniers claim the government was responsible for the collapse of the World Trade Center buildings. COVID-19 severity deniers claim that liberals and left leaning organizations colluding with the scientific and medical establishment are exaggerating the impact of COVID-19 and trying to control people using lockdowns, masks, and social distancing.
 
The latest addition to this list is the individuals that advocate the “election conspiracy”. These are individuals who have the false belief the election was stolen from President Trump by a vast group of republican and democratic election officials, governors, congressmen, and judges colluding with voting machine corporations, the “deep state” and foreign nations. I do not include this group of conspiracy believers here lightly. Although normally I don’t address political issues in my blog, the evidence that the election president Trump lost was not a fraud, as a he claims, is just too overwhelming to ignore or dismiss as a mere “opinion”. Dozens of election officials both Republicans and Democrats, along with recounts, audits, and courts, as well as assessments by fact checkers and government agencies did not find instances of fraud large enough to overturn the election.
 
Belief in conspiracy theories has consequences at the level of the individual and society, and I think the severity of these consequences depends on two variables. One is the nature and scope of the conspiracy theory being embraced. Flat Earth proponents may only get laughed at, while antivaxxers may influence some people to not vaccinate their children who may then catch a serious disease. COVID-19 denialists may lead people to forgo masks and other mitigation measures that may put them and their loved ones at risk of being infected, while global warming denial activists may hinder urgently needed action on climate change. The other variable that may determine the severity of the consequences of embracing a conspiracy theory is the level of militancy it inspires and the extent to which its followers may become radicalized and willing to act on the premises of the conspiracy to the detriment of their own lives and wellbeing. The poster children for this last variable are the advocates of the “election conspiracy”.
​
PictureTear gas being used on rioters n4ear the Capitol









​On January 6th the whole nation watched in shock as a mob stormed the US Capitol building while the electoral votes of the American people were being counted. The individuals that did this were so certain that the system had failed them that they were willing to risk everything for their actions. Now many of them have been identified and arrested. They are losing their jobs and businesses, and are being placed on no-fly lists and subjected to non-stop harassment and threats. One of them was shot, and three others died from medical emergencies suffered during the riot. Their actions, besides destruction of government property and damage to American democracy, led to the death of one Capitol police officer and the injuring  and abuse of dozens of others. We shudder at the thought of what would have happened if this mob of individuals had been able to get hold of the members of congress inside the Capitol. It has been documented that several people in the mob were shouting “hang Mike Pence” (the vice president) as well as threats to others.
 
The election conspiracy is a clear example of the dire consequences of living in an alternate reality immunized from facts and evidence. In this state of mind, people’s emotions and fears can be inflamed and manipulated to advance political or social goals in a process akin to selling them snake oil. And the people most susceptible to be victims of snake oil salesmen are those living in these alternate realities.
 
So how do we deal with this?
 
Whereas the more radicalized conspiracy believers may be too far gone to be helped, there is a larger mass of people that is unsure about accepting the conspiracy. Some aspects of the conspiracy make sense to them but they are turned off by other aspects. These people are not conspiracy theory believers, but they are conspiracy theory agnostics. I think that these conspiracy agnostics are the people we should talk with. We should address their concerns seriously with evidence and within a framework of respect for their views. But we also need to find what I call “converts” among the ranks of the conspiracy theory believers. Converts are people that have come to their senses having analyzed what they said and did and rejected the conspiracy. These are people that the conspiracy theory agnostics (and even some believers) can identify with. These converts should become the spokespersons against the conspiracy.
 
We may not be able to eliminate the conspiracy, but maybe we can reduce its spread.

 
The photograph by of tear gas being used on rioters outside the capitol by Tyler Merbler is used here under an Attribution 2.0 Generic (CC BY 2.0) license.

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6/19/2020

One Hundred Percent Efficacy!

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I had an exchange on Twitter with people alleging that doctors are finding that the drug hydroxychloroquine is 100% effective against COVID-19 and posting videos of patients claiming they had been cured by this drug. I tried to explain that this evidence is not valid and provided a link to one of my previous posts that addressed these claims. Then I stated that we need to wait for the results of the clinical trials. The response I got was that if doctors and their patients have tried it and are convinced it works, then that’s all the evidence we need.
 
Unfortunately, this is simply not true. Even before hydroxychloroquine came along, the majority of patients hospitalized with COVID-19 would survive. If all patients are treated with hydroxychloroquine, then how do we know which patients got better because of the drug and which got better because they were going to get better anyway, or because of other treatments? In an uncontrolled clinical environment in the middle of a pandemic, patients are not randomized into matched groups and their treatments controlled and blinded to exclude placebo effects and other biases. Patient testimonials and doctor’s opinions are valuable to design clinical trials, but they have many shortcomings and should never be used to establish whether a drug works or not. All doctors know (or should know) this.
 
However, the main point of this post is not to address the claim that hydroxychloroquine is 100% effective against COVID-19, but rather the attitude of scientists towards such claims, especially when they are reported using the media instead of the regular scientific channels.
 
Scientists know that products or therapies that are 100% effective are rare, and this is even more so in the case of major diseases like COVID-19. Some vaccines, hormones like insulin, or a few antibiotics have approached this level of effectiveness, but this is not very common for most other compounds or drugs. About 86% of the drugs tested in clinical trials are found not to be effective and are not approved. Claims of 100% efficacy for a drug or therapy will trigger a strong (and warranted) skeptical response from most scientists.
​
PictureQuack
I have been around a while, and I have read many investigations into multiple bogus claims regarding miracle cures or procedures promoted by quacks. One of the characteristics of these individuals is that they inflate the claims they make regarding the efficacy of their products or therapies beyond the bounds of credibility. If these fraudsters wanted to be believable, they would probably look up the percentage cure rate of the best science-sanctioned therapy and then inflate the claims for their products or therapies by a few percentage points to make them look significantly better but not impossibly so. However, the target audience of these individuals is not scientists but the general public, which has no experience with scientific research or clinical trials and their nuances.
 
As I have explained before, the best way to promote a bogus product or therapy is to make your audience assimilate your product as part of their identity. If you can achieve this, your audience will be impervious to evidence that the product does not work. This is because any attack on your product will be viewed by the members of your audience as a personal attack on themselves. From this vantage point, it is unfortunate that the president of the United States has promoted the use of hydroxychloroquine. In the current politically charged atmosphere, I am concerned that this identity-forming process seems to be coalescing around the notion that if you don’t accept that hydroxychloroquine works, then you are against the president and thus part of a left-wing conspiracy. It is then all too easy for unscrupulous individuals to exploit this situation by linking themselves to the “pro-president” audience and peddle hydroxychloroquine or other as yet unproven drugs or therapies for COVID-19. If their claims are questioned, all they have to do is argue they are being attacked by the same system that their audience believes is against them and the president.
 
I was skeptical about hydroxychloroquine from the beginning, not because the president promoted it, but because the data for its effectiveness was weak. Thus when I hear these claims for 100% effectiveness of hydroxychloroquine (or any other drug or therapy for that matter), this immediately raises a red flag, and I close my mind to them. This may not seem the scientific thing to do, but remember that keeping your mind too open can be dangerous. As far as I’m concerned, like the late astronomer Carl Sagan said, “Extraordinary claims require extraordinary evidence.”, and the burden of proof is on those individuals who make these claims. It is up to them to produce high-quality evidence to support that what they claim is true, and, seriously, with a 100% success rate this should not prove too difficult, right?
 
At this point you may argue that even if the effectiveness of hydroxychloroquine is less than 100%, but something like 80%, or 50% or 30%, that would still be significant and important. My answer to this is, yes, but this HAS to be established by well-designed clinical trials. At the moment, many clinical trials of hydroxychloroquine are ongoing, and several of these trials are sufficiently well-designed to yield unambiguous results. As I write this, among the best trials completed so far, one has indicated that hydroxychloroquine does not work as a prophylactic against COVID-19, and another has indicated that hydroxychloroquine does not reduce the risk of death among patients hospitalized with COVID-19. The FDA recently revoked its emergency use authorization of hydroxychloroquine, because based on the available evidence it’s unlikely to be effective in treating COVID-19 and any potential benefit from its use outweighs the potential risks.
 
Many of these trials were designed to address the initial claims for hydroxychloroquine being very effective when administered alone or with certain antibiotics. A new claim has been made that hydroxychloroquine is only effective when it is administered with zinc, and new clinical trials are being performed to evaluate this possibility. As I stated above, I am skeptical about hydroxychloroquine, but I don’t want to be right, I want to save lives, and I hope the combination of hydroxychloroquine with zinc works. However, the public has to understand and accept the need to perform clinical trials and stop relying on testimonials and other anecdotal evidence.
 
Image of a quack doctor selling remedies from his caravan; satirizing Gladstone's advocacy of the Home Rule Bill in Parliament is a Chromolithograph by T. Merry, 1889, and comes from the Welcome Collection. The image was modified and used here under an Attribution 4.0 International (CC BY 4.0) license, and no endorsement by the licensor is implied.

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1/4/2018

How to Sell Snake Oil

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In this post I present a step by step procedure that can be used nowadays to sell snake oil (i.e. a bogus product).
​
Picture
Step 1: First and foremost you need a product. This can be something tangible like a chemical substance, a procedure, or a therapy of dubious value, or even an unqualified candidate for public office. However it can also be something intangible like a fringe belief or ideology, or a questionable social engineering initiative.
 
Step 2: Regardless of whether you know for sure your product is a fraud, try to transcend this knowledge and convince yourself of the opposite. The human mind has a near bottomless capacity to fool itself: make use of that! Create excuses for the shortcomings of your product, rationalize failures, move the goalposts, concentrate on any real or perceived positives and blow them out of proportion. Force yourself to believe in your product. When people look into your eyes they need to see honesty, certainty, passion, and trustworthiness. Those who master this step can actually become convinced that they are not selling snake oil at all!
 
Step 3: In the old days once you had a product you would proceed to identify the target audience. Although this is still a valid step, a more effective approach is to first identify those entities that have the power to expose your product to be a sham and even prohibit you from implementing or selling it. Examples of some such entities can be the scientific establishment, regulatory government entities like the FDA, the news media, fact checkers, consumer watchdog groups, etc.

 Step 4: Proceed to identify your target audience. This step has often been difficult, but having performed step 3 first, this is now more straightforward. All you have to do is find the people that view with suspicion or contempt those entities that can be a danger to your product. The process of finding these individuals is made easier nowadays by the internet. You can gain access to webpages and blogs from many groups and individuals who are engaged in attacking their favorite boogeyman. Among these groups and individuals identify those that would be the most likely users of your product. Most snake oil salespersons find their target audiences in the social extremes such as the uneducated, or those with an education who think they know more than the experts. Befriend key segments of your target audience. Join their groups, go to their events, attend their churches, take up their causes, create goodwill, and while doing this never forget that tried and true ageless trick: tell them what they want to hear.
 
Step 5: Having identified the entities that will seek to reveal the truth about your product, and having identified and infiltrated the community of individuals who loathe them, you now have to create a nefarious intent or conspiracy theory. This is important because your product will be attacked with evidence and facts. You need to be able to disavow these attacks by claiming that the entities attacking your product have some ulterior motive divorced from the truth. These conspiracy theories normally include a version of the “powers-that-be-screwing-the-little-guy” approach. For example, scientists aligned with pharmaceutical companies to discredit cheaper alternative therapies, the liberal or conservative media in conspiracy with political elites to spread fake news and maintain the status quo, right-wing groups affiliated with corporate interests to oppress working class people, left-wing groups affiliated with environmental extremist to limit people’s rights, etc.
 
Step 6: Begin promoting your product to your target audience. Hire a lawyer to make sure you are following the laws, but identify and exploit the grey areas and loopholes in the regulations. Be vague! Try to avoid specific statements that can be used to pin you down, but when possible present opinions as facts, misinform, exaggerate, use innuendo, half-truths, out of context citations, and pick and choose studies or testimonials that support your product. Ask people to keep an "open mind". Talk the talk and create a believable impression that your are also walking the walk. Use social media and conventional methods to promote your product. However, don’t overdo it! Don’t say or write something that will make you toxic to wider audiences. When in doubt bite your tongue. Learn the ways of the weasel.


Picture
Step 7: When the attacks against your product begin, unleash the conspiracy theory within your target audience along with a barrage of attacks against your critics labelling them dishonest, corrupt, enemies of the people, and other useful epithets. Claim that you are being unfairly targeted and persecuted, and seek the help of your target audience. Invoke the right of the people to make up their minds unhindered by interference from government and other entities. Invoke community standards. Invoke states’ rights. Invoke in general any principle valued by your target audience that will give you an edge in the struggle. Link the viability of your product in some way, no matter how convoluted, to the survival of the way of life, values, and families of your target audience. Exploit the slippery slope principle (i.e. if your product goes, they are next). Appeal to their most alarmist basic instincts. Manipulate their emotions, stoke their fears, stir their passions, and whip them up into frenzy.
​
The key thing to understand is that what you are trying to achieve is to create a sense of identity of your target audience with your product. The beauty of this approach is that, if you achieve this, truth and facts will become irrelevant! Any attack on your product will be seen by your target audience as a personal attack on themselves. If you make your product part of their identity, asking them to accept the possibility that your product is bogus is akin to asking them to commit suicide. They won’t even consider it. The best location to place the chains to bind people are not the wrists but the mind.
 
Step 8: Widen your reach. Ask celebrities admired by your target audience to endorse your product. If applicable, contract an “independent organization” (nudge-nudge, wink-wink) to test your product and then broadcast the undoubtedly positive results. Team up with other like-minded snake oil salespersons to support each other. Hobnob and network with the power brokers supported by your target audience. Unless you are already selling a political candidate, it is very useful to link your product to politics. Remember that politics often is about winning, not about the truth. If elected representatives perceive that they will get more votes if they support your struggle, then you may have allies. Ask your target audience to write to their congressmen and to go to town hall meetings to bring up the issue of the attacks against your product. Donate to political campaigns. Even more effective than politics is to associate your product with religion. This may be more or less difficult to do depending on the nature of your product, but if you can accomplish it, it’s a Godsend!
 
Step 9: Along the way don’t forget to save for a rainy day, preferably in bank accounts or assets that cannot be seized by the government. Avoid a lifestyle of excess luxury (there will be time for that later), and cultivate an image of modesty and genuine interest in the “good” of the people. Ride your product through all of its business cycle and either go on to sell other products, or cash in and reap your rewards.
 
Step 0: This is the most difficult, but also the most important and vital step of the whole sequence, and one which should be carried out before you perform any of the above steps. This step involves asking yourself if you really want to manipulate people and smear the truth. Selling snake oil is not a victimless activity. In one way or another you will be damaging the lives of countless individuals and communities. Do you really want to exploit people and trample common decency and basic human values for a chance to gain riches, prestige, and power?
​
If the answer is yes, proceed to step 1.


The figures are in the public domain. National Library of Medicine, Varieties of Medical Ephemera, Medical Show.

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