Covid-19 has closed stores, but snake oil is still for sale

FEAR is overcoming reason as the threat of the coronavirus spreads.

After hearing US President Donald Trump say, without scientific evidence, that the antimalarial drug chloroquine could be a "game-changer" in the fight against Covid-19, an Arizona man died and his wife was left in critical condition after they swallowed a form of the chemical used to clean fish tanks called chloroquine phosphate. The same day, a government official reported that three men in Nigeria had overdosed on chloroquine, and warnings against taking this medicine were made public.

As physicians, our advice is based on medical evidence that weighs the benefits of a medicine or treatment against its potential harms, such as a medication's side-effects or a surgical procedure's complications. This rigorous decision-making is backed by research from peer-reviewed clinical trials, and is subject to government oversight. It's dangerous for people with no medical licence or training or understanding of science to promote the effectiveness of unproven treatments.

The efficacy of chloroquine and its derivatives deserves rapid scientific study, and, rightly, there are ongoing clinical trials. However, the off-label use of these medicines against Covid-19 outside of a monitored clinical trial and without proper cardiac testing, could cause an abnormal heart rhythm and even death. These medications are also used in the long-term treatment of other medical conditions, including lupus and rheumatoid arthritis, and increased use against Covid-19 may lead to shortages for those who need it chronically. Even more concerning is the increasing number of sham products and nonsense regimens emerging as Covid-19 treatments. Such therapies are pure snake oil, conjuring visions of street corner salesmen telling folks to "step right up" and try their newest elixir.

Interestingly, snake oil itself may not have been a total sham originally. Introduced to America by Chinese railroad workers in the 1800s, it was made from a Chinese water snake whose oil contains high concentrations of omega-3 fatty acids, and may have been effective in treating arthritic pain. As news of this treatment spread, a man named Clark Stanley began selling his own Snake Oil Liniment. While he claimed his balm was made from oil from American rattlesnakes, it reportedly contained no snake oil whatsoever, thus beginning a tradition of medical cons.

The latter half of the 1800s saw a steep rise in the sale of similar unproven treatments, known as "patent medicine", the purported benefits of which included everything from "lame back" and "contracted cords" to "female problems" and venereal disease. The Pure Food and Drug Act of 1906 signalled the beginning of the end of these patent medicines.

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Even now though, products labelled dietary supplements skirt the US Food and Drug Administration's drug regulations by claiming to be food, and therefore not requiring FDA approval to be sold. It is the company's responsibility to make sure its products are safe and that any claims are true, not the FDA's. Everyone should be very wary of dietary supplement health claims, particularly those claims of miraculous immunity from viral threats.

DANGEROUS CLAIMS

A vivid example can be understood from the following fictional conversation: In the movie Contagion about a fictional epidemic, a character played by Jude Law peddles a false cure called Forsythia during an interview with Dr Sanjay Gupta, saying it's known to be effective even though it doesn't appear on the website of the federal Centers for Disease Control and Prevention (CDC).

"On your blog you also wrote that the World Health Organisation is somehow in bed with pharmaceutical companies," Dr Gupta says. "Because they are," the charlatan responds. "That's who stands to gain from this. They're working hand in glove."

Claims like that are common among conspiracy theorists, and they're particularly dangerous at a time when people are looking for sources of hope and someone they can trust - and both are in short supply.

But these untested and unproven treatments, often promoted on social media, may be toxic. Examples circulating online include drinking household bleach and using cocaine. Other recommendations for killing the virus, like gargling vinegar, eating garlic, or using a hairdryer to blow hot air into your nose, hurt people by providing a false sense of security. If a person believes that garlic or vinegar prevents infection, they are more likely to take part in risky behaviour that may ultimately get them infected with the virus.

The US government is recognising the growing risk from snake oil salesmen. The FBI has made its first arrest for fraud, charging a man who has 2.4 million Instagram followers with selling pills he said could cure or prevent Covid-19. The New York State attorney general issued a cease-and-desist letter against the televangelist Jim Bakker, who is also being sued by the state of Missouri for falsely claiming his Silver Solution could cure Covid-19.

"The pandemic is dangerous enough without wrongdoers seeking to profit from public panic and this sort of conduct cannot be tolerated," attorney general William Barr told federal prosecutors.

These prosecutions against snake oil salesmen should be swift and severe.

And you need to help yourself: If you read or see something online or on TV that purports to prevent or cure Covid-19, go to reputable resources such as the CDC, which provide evidence-based recommendations. Do not take the practice of medicine into your own hands, seek guidance from physicians who care about you. NYTIMES