June 13, 2021
hanging on to biases
An interesting report a few days ago informed us that the State of Oklahoma recently liquidated their cache of hydroxychloroquine stockpiled in April 2020, hoping to save lives from COVID-19. Despite no data supporting its use at the time, they bet on the rumors and disinformation that it worked. Fortunately, the state was able to get a refund of 2.6 million dollars a year later. Data since then has shown hydroxychloroquine can harm and does not help patients. Despite that data, people are still touting its effectiveness.
That is a form of anchoring bias which affects decision making. These and other biases are a big reason we are fighting vaccine hesitancy. Biases make people more vulnerable to disinformation on social media. As Steve Goodman wrote in his song Turnpike Tom “Remember that you only fall for lies and stories when you really want to.”
Last week I had a difficult conversation with a patient and her husband about COVID vaccines. They are convinced that the vaccines are dangerous, that COVID-19 is not, and that I should write a letter exempting her from vaccination, which is required for her return to work. I declined, telling them the risks to her and her co-workers of COVID-19 outweigh any theoretical risk of the vaccines. They were unwilling to review data and science from the scientific sources I use, asking me to instead look at their sources of information, which were full of unvalidated claims, similar to the hydroxychloroquine claims still being touted. They were not happy about my response, but I felt my only ethical choice was to say no. Not a fun conversation and ended without satisfaction.
A recent study showed that experiencing rudeness can increase anchoring bias. This can lead to missed diagnosis if you are a physician, because we can focus on a specific diagnosis and not consider other causes. This is an intriguing observation when I think about my experience with patients. If I have had an intense and difficult interaction just before I see a patient, I often focus on one possible diagnosis and can miss alternative causes of symptoms. This potentially translates to the real world where we all are susceptible to rude interactions and the subsequent angst it gives us, having a downstream effect.
Cognitive dissonance has played a huge role in the pandemic as well; and will continue to do so. Somehow, we are able to overlook reality and cling to our original ideas and beliefs. Belonging can also affect how many people make choices. They opt to keep their beliefs because their friends or families do, rather than accept a different position, despite the cognitive dissonance they are feeling. This makes influencing people’s minds challenging, since their biases and their need to belong influence are barriers.
We all need reminders on how to spot fake news and remain aware that the truth can be hard to discern. Especially when we hear that most of the disinformation and conspiracy theories are spread initially by only the same 12 people, many of whom do not have our best interests in mind..
We all need to keep open minds, when possible. More data becomes available, recommendations change, goals altered, reality suddenly shifts. Now that UFO’s are finally admitted to be real, Sasquatch may be found next.
Wash your hands, cover your nose when inside, and be kind and open to new ideas, but beware your sources.
And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.
https://www.medpagetoday.com/special-reports/exclusives/92533
https://www.medpagetoday.com/infectiousdisease/covid19/87066
https://www.washingtonpost.com/politics/sen-johnson-youtube-coronavirus-medicine/2021/06/11/1055ce46-caf0-11eb-81b1-34796c7393af_story.html
https://en.wikipedia.org/wiki/Anchoring_(cognitive_bias)
https://www.sciencedaily.com/releases/2021/06/210610173949.htm
https://www.scientificamerican.com/article/biases-make-people-vulnerable-to-misinformation-spread-by-social-media/
https://www.theatlantic.com/ideas/archive/2020/07/role-cognitive-dissonance-pandemic/614074/
https://www.nytimes.com/2021/05/07/world/asia/misinformation-disinformation-fake-news.html
https://www.visualcapitalist.com/how-to-spot-fake-news/
https://www.mdlinx.com/news/most-anti-vaccine-conspiracies-online-come-from-the-same-12-people-study-shows/5GVUf6pCxZExIBRtwSyvsI
https://www.seattletimes.com/nation-world/judge-dismisses-lawsuit-filed-by-houston-hospital-employees-who-refused-covid-19-vaccine/
https://www.washingtonpost.com/technology/2021/05/17/guo-wengui-disinformation-steve-bannon/
https://www.washingtonpost.com/nation/2021/05/17/ufo-sightings-navy-ryan-graves/
https://www.nytimes.com/2021/05/13/opinion/ufos-aliens-space.html