Remember, do no harm?

Remember, do no harm?

H. HOLDEN THORP

SCIENCE

13 Oct 2022

First Release

DOI: 10.1126/science.adf3072

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When the advocacy group America’s Frontline Doctors appeared on the steps of the United States Supreme Court in 2020, falsely stating that hydroxychloroquine was a cure for COVID-19, their pronouncement was virally shared by right-wing media and soundly debunked by medical academicians. A year later, one of these frontliners, Joseph Ladapo, became the surgeon general of Florida and a faculty member at the University of Florida College of Medicine. He has continued to spread dangerous misinformation about COVID-19 while his academic colleagues are shamefully silent.

Many assumed that Ladapo’s faculty appointment was the result of political pressure by the university’s administration as it aimed to please Florida Governor Ron DeSantis. It was unsurprising that anti-vax DeSantis wanted a surgeon general with anti-science views. But it was shocking that the medical school accepted Ladapo as a colleague. Even more shocking was a statement from the university president in the Tampa Bay Times confirming that Ladapo was voted into his position by the faculty and approved through the usual procedures. Even Ladapo’s former supervisor at the University of California, Los Angeles, declined to recommend him for the position, considering his approach to COVID-19 so dangerous as to violate the Hippocratic oath to do no harm.

In his own defense, Ladapo told Politico that he was disappointed with the criticism because good science requires respect for all perspectives. “It’s OK to disagree, and I’ve had no problem with disagreement,” he said, “but what has been really disappointing is how disagreement has become a ticket or a passport to activate personal attacks.” No one would disagree that personal attacks are out of bounds, but his depiction of science is off the mark. Unequal perspectives do not deserve equal time, and challenging scientific consensus requires evidence that has been subjected to peer review and published with all the data disclosed so that the scientific community can replicate the findings. Ladapo recently has been circulating an unattributed study apparently showing that the risk of heart complications from mRNA vaccines to COVID-19 makes them harmful for males under 40. To be taken seriously, such a major challenge to scientific consensus requires rigorous review and wide evaluation of the underlying data. Nothing like that happened. “Ladapo’s dissemination of flawed data that purports a risk of cardiac death among men age 18 to 39 after mRNA vaccines was baseless, reckless, and irresponsible,” said cardiologist Eric Topol. “The risk of myocarditis in this demographic is real and notable, but all studies with close follow-up have indicated it is typically mild and fully resolves in nearly all affected.”

Ladapo has tried to initiate a scientific “debate” on Twitter about the study, saying “I love the discussion that we’ve stimulated.” This move is from page 1 of the anti-science playbook. A credentialed scientist from outside the field (Ladapo is not an infectious disease specialist and has never treated a COVID-19 patient) questions scientific consensus in a public manner that undermines trust in science. Many have played this role during the pandemic, but the pattern reaches back decades to scientists who have, for political purposes, challenged consensus on tobacco, ozone, strategic defense, and climate change.

This raises the question of what responsibility the scientific community has to condemn its members when they enable the spread of misinformation. The situation at the University of Florida creates an opportunity to wrestle with this issue. Ladapo has confirmed his doubters’ fears and has betrayed the responsibilities afforded by academic freedom and tenure. So far, the university doesn’t seem to want to wrestle with the situation. When I asked for a comment, the university health system did not specifically address the Ladapo affair but said in a statement that they continued to support recommendations from the Centers for Disease Control and Prevention on vaccination and that “peer-reviewed publications and data analyses are the gold standard in ensuring accurate conclusions are drawn from the research questions scientists are asking.” That’s far from an adequate response.

It’s easy to blame the politicians, right-wing cable TV hosts, and podcast hucksters for spreading misinformation. But is it defensible to blame these folks without also acknowledging that unchallenged members of the scientific community are making it possible for them to sow this doubt? Until the scientific community deals with misinformation from within, it cannot expect to deal with it from without.