The Rise of Fringe Science, Contrarian Doctors, and the Threat to Public Health

The Rise of Fringe Science, Contrarian Doctors, & The Threat to Public Health

Dr David Robert Grimes looks at the partisan polarisation and obsession with scientists rather than science that makes us prone to medical misinformation and anti-vaccine propaganda

Even an institution as august as BBC News is not immune to lapses in judgement. Aseem Malhotra’s appearance last week is a resounding example. Ostensibly there to speak about statins, the cardiologist hijacked the interview, propagating myths about COVID vaccines to a profoundly unprepared host. His appearance drew the ire of scientists and physicians for amplifying dangerous fictions. 

Antivaccine activists were predictably invigorated, boasting of “going mainstream” with the video acquiring tens of millions of views, boosted by figures like former entertainer Russell Brand. Yet Malhotra’s turn was unsurprising to public health experts, who’ve noted his transformation to a leading UK vector of antivaccine disinformation. 

Following a deluge of complaints, the BBC quite rightly apologised for the textbook false balance antithetical to their charter. But the interview fiasco, for all its harms, is a microcosm of a far greater problem – the rise and rise of dubious expertise. Malhotra exemplifies an unedifying trend during the pandemic: the fringe scientist, commanding huge audiences and, in some other cases, substantial profits.

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The Anti-Vaccine Infodemic 

Malhotra’s pivot to antivaccine activism is hardly unique. Throughout the pandemic, fringe scientists and doctors have dominated public conversations, using their credentials to bolster outright falsehoods – and this has left us more divided, and less informed.

Since the very outset of the pandemic, a small but vocal minority of qualified doctors and scientists have embraced conspiracy theories about the pandemic, and its treatment – or propagate unhelpful alarmism. And with doctors and scientists among the most trusted members of society, this has allowed unethical and inept individuals in their ranks to leech vampirically off the legitimacy of science. 

This has been evident from the dawn of COVID-19, where bizarre but highly adopted conspiracy theories that 5G caused COVID-19, and that COVID-19 was deliberately engineered, went viral after their repetition in videos by a former physician and scientist respectively. That these canards were utterly devoid of anything remotely resembling evidence was eclipsed by the fact that seemingly qualified individuals were spreading them.

The sudden shock of the pandemic and the disruption to life caused by frantic efforts to mitigate its deadly path created a perfect vacuum where half-truths and outright lies mingled unimpeded. Fear and a desperate need to understand events led to misconceptions arising violently from this protean mist. 

The little information we had was transient and in rapid flux. And while public interest in medical science intensified rapidly, it did so sometimes without a firm understanding of what constitutes good scientific practice or even reliable information. Scientific and medical qualifications were widely seen as a proxy for reliability, but this heuristic is laced with hidden dangers. It pivots on a confusion between “science” and “scientist”. 

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Science versus Scientists

Science is a systematic method of enquiry, that makes testable predictions and updates itself based on the totality of evidence.  Scientists by contrast are people, subject to human foibles and biases. Any perceived authority they may have stems not from their qualification, but from accurately reflecting the totality of evidence. If they fail to do so, their credentials, education, and prestige are irrelevant – they are not practising science.

This is a subtle but crucial point. Science is far more than a monolithic argument from authority. As figures like Anthony Fauci became household names worldwide, this distinction became understandably blurred. But public health advice is based not on the pronouncements of individuals but represents the synthesis of up-to-date evidence scrutinised by an army of scientists worldwide. Such positions were constantly refined as new data emerged.  

Fringe scientists and doctors, by contrast, were under no such obligation to bolster their position with facts. But they also offered something that public health officials could not – an illusion of certainty. We have a deep-seated psychological need to understand the world around us and influence some control over it. 

With COVID, the science rapidly evolved as evidence emerged. With knowledge in a state of flux, uncertainty was an unavoidable if uncomfortable part of this process. But fringe figures offer the allure of simple answers to complex questions, with confidence inversely proportional to evidence.

This was evident in the furore over rumoured COVID treatments, most notoriously Ivermectin, a deworming agent. While it became quickly clear to the scientific community that the anti-parasitic was completely ineffectual for COVID infections, it was loudly evangelised by several physicians who grew substantial social media profiles for doing so. One physician went viral for hailing it as “wonder drug” before the US senate, even while their own research on the topic was retracted for data fabrication. 

Despite overwhelming evidence that Ivermectin was ineffectual, fringe figures pushing it were endorsed on massive platforms, like Joe Rogan’s hugely popular podcast.  Like the similarly ineffective Trump-endorsed hydroxychloroquine before it, unethical physicians raked in millions of dollars for promoting the drug off-label, with black markets for it appearing worldwide. 

Even though the evidence base was completely lacking, the shameless promotion of the drug by prominent social media physicians ensured that in 2021 alone, American insurers paid out over $130 million for useless and potentially harmful Ivermectin treatments. 

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Pathological Science 

So what precisely motivates such individuals to abandon the commitment to evidence that science demands? Any number of human motivations might apply; some may be misguided true believers, driven by motivated reasoning to spurious conclusions. While science demands we follow the evidence to the conclusion, pathological science occurs when one starts with a conclusion and bends the data to justify it. 

That most of those peddling suspect cures for COVID or minimising its effects tend to be demagogically antivaccine is not an unsurprising finding. Others still are seduced by admiration, infamy, and above all, money. The peddling of medical disinformation is an especially profitable endeavour, and in a crowded marketplace of charlatans, those with qualifications can abuse this to their advantage. Former physician Joseph Mercola is one especially ignoble example. Labelled as one of the “Disinformation dozen” of the pandemic by the Center for Countering Digital Hate, Mercola is worth an estimated $100 million despite numerous FDA warnings, making an estimated $1 million a year from his newsletter alone. 

But the rise of pseudo-experts is a symptom of a deeper, more enduring problem: a fundamental change in how we access and interpret information. The rise of social media has seen a marked increase in political polarization. 

As curators of our own media, we tend to disregard the fact-checking integral to traditional reporting, in turn reducing our ability to differentiate between opinion, fact, and speculation. The net result is a strange information ecosystem that elevates fringe views at the expense of more diligent reporting. Far from being impartial arbiters of information, we are disproportionately affected by stories that induce outrage and fear, even if they lack any veracity. 

Even before the pandemic, this was an emergent problem for vaccination especially. In 2019, the dark renaissance of once virtually conquered disease in Europe and America forced the WHO to declare vaccine hesitancy a top ten threat to public health. This was driven largely by anti-vaccine activism, which thrives by using frightening and completely unfounded claims to induce fear, nudging people to reject vaccination. 

The advent of COVID vaccines has seen a huge swell in antivaccine propaganda, despite these interventions saving millions of lives. This party reflects the growing polarization of the media landscape and is intrinsically tied up with ideological positions. Throughout the pandemic, fringe scientists have been repeatedly invoked as sources for those with strong opposition towards lockdowns, masks and vaccination. Despite their views being fundamentally at odds with the evidence, their mere status as scientists or physicians allows partisans to masquerade in those robes as seeming proof of their position. 

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Partisan Polarisation 

Yet for all their qualifications, fringe scientists fail to uphold the basic tenets of science, frequently embracing conspiracy theory when their claims are refuted. Even while profiteering substantially from their contrarian stances, they have the unbelievable audacity to casually dismiss the vast majority of the world’s researchers as either pawns of some nebulous “big pharma” paymaster or incompetent buffoons.

This performative outrage is so much sound and fury, a mere distraction from the inescapable reality that their positions are completely contradicted by the overwhelming weight of scientific evidence. 

No matter their angle, they share one thing in common: in pushing misinformation and scaremongering, they’ve grown massive followings. Several have become household names thanks to appearances on outlets like Joe Rogan’s show or Fox News. But fundamentally, these fringe figures weaponize the societal trust afforded to science, unduly amplifying their capacity to unleash serious harm.

Whether due to ideological capture, lust for attention, or the profits it garners, these figures abuse the trust placed in them, functioning as trojan horses for the most odious falsehoods. And ultimately, this scaremongering and dishonesty is supremely damaging to our societal understanding and trust, creating false perceptions of risk and benefits, creating false balances and polarising people needlessly. 

Far from being the brave mavericks many of these individuals play to their followers, they are merely tiresome contrarians whose mendacity sends us spiralling towards distrust and confusion. The vocal assertions of fringe figures leave us understandably frightened and distrustful, but we should never forget that totality of evidence – not credentials – matter.

To protect ourselves from the hubris of charlatans and fools, it is crucial we maintain a healthy scepticism of unevidenced claims. 

Dr David Robert Grimes is a scientist and author of ‘The Irrational Ape: Why We Fall for Disinformation, Conspiracy Theory and Propaganda’ published by Simon and Schuster UK. You can find him on Twitter: @drg1985 or Instagram: David_robert_grimes