But then came the Delta variant, and the vaccine resisters, and the state efforts to ban mask and vaccine mandates — and suddenly what once felt like the beginning of the end revealed itself to be a momentary pause.
Two features of modern American life seem most to blame for the angry distrust and intractable division that surround us: the dissemination machine of social media and the rejection of fact-based sources of information by many on the right, particularly among politicians and media.
We are living in a dangerously unprecedented moment.
That this is not novel does not mean we should be less alarmed.
Medicine shows: a traveling carnival of 19th-century misinformation
Kickapoo Indian Sagwa could do it all: heal the blood, the liver, the stomach and even the kidneys. Purportedly based on a proprietary blend of ingredients developed by Indigenous healers — and patented by White salesmen — sagwa was sold in the late 19th century as a panacea: you drank it to cure whatever ailed you. And to make it even more appealing (and profitable), it was sold not only through wordy advertisements in newspapers and almanacs but in traveling spectacles featuring performances by Native actors.
And the concoctions rarely faced scientific scrutiny. Usually made up of alcohol and other drugs, like cannabis, opium or cocaine, these brews ranged from mildly narcotic to wildly dangerous, feeding addictions and slowly poisoning their users.
So successful was it, that many print publications grew dependent on patent-medicine advertising. That included tabloids and almanacs as well as newspapers and magazines. While it was an era before objectivity became central to the journalism profession, some of these publications promised their readers news and trustworthy information while also serving as vehicles for the rampant spread of medical misinformation.
The deep-pocketed industry also embedded itself in the world of politics, especially as state legislatures started to weigh the idea of regulating patent medicine.
It took repeated exposés by activists and journalists to move the needle on patent medicine regulation. The landmark investigation was Samuel Hopkins Adams’s “The Great American Fraud,” which ran as a series of articles in Collier’s magazine in 1905.
Adams argued that when Americans consume patent medicines, they “swallow huge quantities of alcohol, an appalling amount of opiates and narcotics, a wide assortment of varied drugs ranging from powerful and dangerous heart depressants to insidious liver stimulants; and, in excess of all other ingredients, undiluted fraud.”
Two conditions that allowed for the dismantling of patent medicine in the early 20th century are at the center of debates about Covid misinformation in the 21st: the rise of professionalized medicine and drug regulation and the prioritizing of expertise and objectivity in public debate and mainstream media.
Those conditions had historically helped to define distinctions between a sphere of trusted expertise and a sphere of conjecture and conspiracy — a delineation that has broken down in the US in recent years, thanks to the massive expansion of partisan media outlets and the rise of social media.
But in the 20th century, that distinction conferred some clear advantages.
Where the fluoridation conspiracies notably did not win much coverage was in the pages of the mainstream press. The notion that fluoride was a communist plot was met with scorn and mockery, an attitude best captured in the 1964 film “Dr. Strangelove,” with its nutty protagonist railing against communists and fluoridation.
Fluoride conspiracists were convinced that elites and enemies sought to control them through public health policy, an idea central to today’s Covid conspiracies about vaccine passports and vaccine and mask mandates. There is even a communism through line for those who believe the pandemic itself was a plot by the Chinese government to weaken the United States.
But industries peddling more mainstream products with greater resources than the anti-fluoride movement have learned to fight science with science, coopting the language and logic of medical expertise while manipulating the methods of scientific experimentation.
Rebranding misinformation as ‘science’
That was the cost of competing on the scientific plane: motives, techniques and data were all subject to verification, and if enough government institutions and medical organizations agreed that the tobacco industry’s data was wrong, journalists would report it, and Americans would tend to believe it. It was not a perfect system for identifying medical misinformation, but it had the makings of a pretty good one.
Misinformation can be treated, but we really need a cure
The historic battles over patent medicines, fluoridation and tobacco show how medical misinformation spreads and thrives, particularly in the hands of bad faith actors supported by mass media and entrenched political interests. But these are not tidy stories of scientific triumph.
The victories that activists and scientists won against medical misinformation took place in an era in which science and expertise carried significant weight in public debates over public health, making it possible (if not quick or easy) to combat medical misinformation.
In the past, medical misinformation has been best combated by rigorous regulation, a refusal to amplify untrue claims, and the construction of trustworthy systems of validating and sharing medical knowledge that aren’t driven by financial or political interest.
These are not easy to achieve — especially when one political party is implacably opposed to them — but they offer a path forward from the treacherous medical misinformation that has prolonged the ravages of this pandemic.