During the last pandemic, Americans who chose to forgo vaccination were hard hit by COVID. In response, some self-medicated with ivermectin. While this drug is best known as a horse de-wormer, it is also used to treat humans for a variety of conditions and many medications are used to treat conditions they were not originally intended to treat. Viagra is a famous example of this. As such, the idea of re-purposing a medication is not itself foolish. But there are obvious problems with taking ivermectin to treat COVID. The most obvious one is that there is not a good reason to believe that the drug is effective; people would be better off seeking established treatment. Another problem is the matter of dosing as the drug can have serious side-effects even at the correct dosage. Since I am not a medical doctor, my main concern is not with the medical aspects of the drug, but with epistemology. That is, I am interested in why people believed they should take the drug when there is credible evidence it would work. Though the analysis will focus on ivermectin, the same mechanisms work broadly in belief formation.
Those who were most likely to use the drug were people in areas hit hard by COVID and subject to anti-vaccine and anti-mask messages from politicians and pundits. These two factors are related: when people do not get vaccinated and do not take precautions against infection, then they are more likely to get infected. This is why there was such a clear correlation between COVID infection rates and the level of Trump support in an area. Republican political thought embraces authoritarianism and rejects of expertise. Conservatives also want to “own the libs” by rejecting their beliefs and making liberals mad. Many liberals wanted people to get vaccinated and wear masks, so “owning the libs” put a person at greater risk for COVID. Once a person got infected, they needed treatment. But why did they chose ivermectin over proven methods? This seems to be the result of how the right’s base forms their beliefs.
The right’s base seems especially vulnerable to grifters and thus inclined to believe what grifters tell them. This is not because they are less intelligent or less capable than liberals; rather it seems to result from two main factors. The first is that the American right tends to be more authoritarian and thus more inclined to believe when an authority figure tells them to believe. The second is that the American right has long waged war on critical thinking and expertise. Hence people on the right are less inclined to use critical thinking tools effectively in certain contexts and are likely to dismiss experts who they do not regard as trusted authority figures.
While ivermectin was studied scientifically, there is currently no evidence that it can effectively treat COVID. But a small and growing industry arose for providing people with unproven or discredited treatments for COVID. While some might be well-intentioned, much of it is grifting at the expense of those who have been systematically misled. As such, people believe ivermectin can help them because authority figures have told them they should believe it. But, of course, there is the question of why ivermectin was chosen.
One likely reason is that ivermectin has been shown to impede the replication of the virus. Someone who is misled by wishful thinking would probably not consider the matter further; but it is important to note that this test was conducted in the laboratory using high concentrations of the drug that probably exceeded what a human could safely use. To use an analogy, this is like saying that fire is effective in killing the virus. While this is true, it does not make it an effective treatment in humans. As such, there is a bit of truth to the claim that ivermectin can affect the virus. For some reason, certain people seem to consistently reason poorly in such contexts; I am inclined to chalk this up to wishful thinking.
There is also the fact that a single, unpublished paper influenced some countries to include the drug in their treatment guidelines. However, this paper was never published because the method used to gather the data is both irregular and unreliable. The company that gathered the data, Surgisphere, is already notorious for its role in scandals involving hydroxychloroquine studies. People seem to tend to believe the first thing they hear about something, especially if they want it to be true, hence this discredited paper held considerable influence. This is like the case in which those who think vaccines are linked to autism still believe in a long discredited study by a discredited doctor.
One might attempt to respond to this by arguing that there are other papers showing the effectiveness of ivermectin. While this would be a reasonable response if these papers were based on good data, they are not. As has been shown, they suffer from serious errors. But, once again, this does not seem to matter. People such as Preston Smiles, Sidney Powell and Joe Rogan promoted the drug and, of course, Fox News personalities praised it. It was hydroxychloroquine 2.0. This takes us back to the appeal to authoritarianism fallacy: people believed because authority figures told them to believe. There is also a fallacious appeal to authority in effect. For example, Joe Rogan is a talk show host and not a doctor; yet people believe him because he is a celebrity.
People might also be motivated to accept the “evidence” of bad data and poor methods because doing so can feel rebellious. By rejecting the methodology of the experts, they can see themselves as making up their own minds…by accepting what politicians and celebrities tell them. There might also haven been a conspiracy theory element at work as well; the idea that “they” do not want people to know about ivermectin (or whatever) and hence they want to believe it works.
Ivermectin became another front in the culture war. It must be said that the left contributed to the fight by mocking those who used the drug. But when it became a political battle, the base doubled down and defended it, despite a lack of evidence. That is, they professed to believe because doing so is the stance of their tribe.
There were efforts to conduct clinical trials of the drug, but these were bizarrely been met with hostility and threats from ivermectin proponents. On the positive side, there will be some data available from the people self-medicating. Unfortunately, it will not be very good data because it will mostly be a collection of self-reported anecdotes. Once again, the culture war of the right hurt people. Although, as always, some profited.
From the standpoint of reliably forming true beliefs, this approach is the opposite of what a person should take. Believing medical claims based on political authorities, grifters and celebrities is not a reliable way to have true beliefs. Accepting flawed studies as evidence is, by definition, a bad idea from the standpoint of believing true things. But these belief forming mechanisms do have advantages.
Politicians, celebrities, and grifters obviously benefit from their base forming beliefs this way. Those who form the beliefs also get something out of it; they can feel the pleasure of expressing their loyalty, the reassurance of wishful thinking, the warm glow of unity with their tribe, and the hot fire of angering the other tribe. And in the end, isn’t that all that really matters to some people?