Fake News

Admittingly, I do feel envious of Jenny Nicholls’ great incipit  for her article on “Misinfodemic: When fake news costs lives” just published on January issue of North & South, “In the West, the misinformation caused terror. In Africa, it cost lives.”  Jenny is right. We are so closed in our stubborn parochialism not to understand that the issue of fake news is far from being an issue only for affluent countries. On the contrary, cures such as “homeopathy, coffee, raw onions and saltwater”, only to mention those mentioned by Jenny, could cause actual disasters in low income countries, for instance when people treat Ebola through these remedies. Also, Jenny is right when she describes epidemics of misinformation as though they were true infectious outbreaks. Cultural outbreaks follow the same rules of microbiological outbreaks and they could be even more dangerous. “Memes—whether about cute animals or health-related misinformation—spread like viruses: mutating, shifting, and adapting rapidly until one idea finds an optimal form and spreads quickly. What we have yet to develop are effective ways to identify, test, and vaccinate against these misinfo-memes. One of the great challenges ahead is identifying a memetic theory of disease that takes into account how digital virality and its surprising, unexpected spread can in turn have real-world public-health effects. Until that happens, we should expect more misinfodemics that endanger outbreaks of measles, Ebola, and tooth decay, where public-health practitioners must simultaneously battle the spread of disease and the spread of misinformation.”

However, fighting misinformation memes could turn out being more difficult than one might expect. Chance would have it that the very same day when Jenny published her article, Johns Hopkins Medicine and Sheppard Pratt Health System announced the outcome of a new research, which  shows that “people in the study with schizophrenia also have higher levels of antibodies against the Epstein-Barr virus (EBV), a herpes virus that causes infectious mononucleosis, so-called mono. Researchers proposed two explanations for the association of heightened immune responses in patients with schizophrenia and EBV infection: schizophrenia might alter the immune systems of these patients and make them more susceptible to EBV, or EBV infection might increase the risk of schizophrenia”. The main investigator, Dr. Robert Yolken, a professor of pediatrics at the Johns Hopkins, is not all new with viral theories of mental diseases. In 2001, he argued that schizophrenia was caused by a retrovirus and stated  "Our ultimate hope is that we can interfere with the retrovirus by preventing it from becoming active. If we can do that, it may give doctors another method of treating schizophrenia." In 2015, Dr. Yolken discovered a virus which made people stupid, by changing the way genes are expressed in an area of the brain responsible for memory and other higher brain functions, “This is a striking example – stated Yolken - showing that the ‘innocuous’ microorganisms we carry can affect behavior and cognition”. Always in 2015,  Robert Yolken observed that cat ownership in childhood is significantly more common in families in which the child later becomes seriously mentally ill, concluding that Toxoplasma infections were critical to develop mental diseases.  Finally, in 2018, Dr. Yolken had another great insight, because he discovered that “data from more than 1,000 people with and without psychiatric problems showed those hospitalized for mania (hyperactivity, euphoria, and insomnia) were three-and-a-half times more likely to have ever eaten meats cured with nitrates as those who had no history of any mental disorder” and he concluded that  “There’s growing evidence that germs in the intestines can influence the brain. This work on nitrates opens the door for future studies on how that may be happening.”

Now, one could simply conclude that statistics are like guns, they should never be handled by children and morons, but the issue is more worrisome. Indeed, it is easy to make fun of anti-vax activists and homeopathic doctors, but one should make fun also of Johns Hopkins. Fake news supported by institutional medicine are still more dangerous than fake news invented by charlatans because they instil the idea that there is no difference between science and pseudo-science.

Associations are not causal explanations, they can be (and often are) explained by confounding variables. Believing that two statistically associated things are also causally linked is a well-known fallacy.  This is more evident in a discipline like psychiatry where our knowledge is still quite vague. “The researchers conducted a study among 743 people—432 with a schizophrenia diagnosis and 311 without a history of a psychiatric disorder to serve as a control group.” Let me pose two basic questions, (1) do you think that schizophrenia diagnosis is evidence-based like, e.g., diagnosis of breast cancer or heart failure, or alike? (2) do you think that the absence of a history of psychiatric disorders is enough to argue that the control group was free from sub-clinic or non-diagnosed psychiatric disorders? If you answer “no” to one or both questions, most Dr. Yolken’s findings become unsubstantiated.