How conservative media helped the President promote dangerous use of hydroxychloroquine is a media literacy wake-up call

The Washington Post published a story this morning about a preliminary study of 96,000 patients that showed that using hydroxychloroquine, an anti-malaria drug promoted by President Trump (and against the advice of the CDC) as a possible treatment for COVID-19, is linked to higher death rates in coronavirus patients.

If we are ever going to level-up on media literacy, what the Trump administration and Fox News did to promote hydroxychloroquine should be a wakeup call. This was a dangerous moment created by a cynical political play and intermixed with a dangerous media approach. So it’s worth thumping on this one more time.

First, a caveat. The science on this is still evolving, and we will learn more; that’s how science works. More rigorous peer review is coming, but finding public health threats mean you disclose findings now. So you look at the trend lines of multiple studies saying this drug is dangerous to COVID patients. In this case the public health threat isn’t about the drug. It’s about the President and the top-rated cable TV news outlet working together to promote the use of hydroxychloroquine as a “game-changer” against all caution.

This incident is about information and its power to persuade.

Nobody in their right mind would have though to start taking this drug until a doctor in NY started to experiment on his patients with it, then promoted it after limited results with a small population in an uncontrolled experiment. It caught the attention of right-wing media, and it was off to the races.

Even the NYT got breathless. “Simple country doctor” is one hell of a framing device to jab a thumb in the eye of real, methodical science. The story was more skeptical than that, but the up-front framing taps into rural vs. urban stereotypes that bounds a lot of our politics in the U.S.

But that was just one story. What followed was a couple weeks of hydroxychloroquine being promoted as a possible treatment on Fox News. WaPo captured those few weeks of madness pretty well here.

But the Fox News promotion came while President Trump was pushing it publicly. Crucially, he never said it was going to work. What he did was tout the swirling coverage of it with a “what do you have to lose by trying?” approach.

So let’s stop here and reflect. A doctor believes this drug experiment is working well and promotes it by trying to get the attention of the President rather than scientists who can confirm. The resulting coverage, from independent to partisan media, unpacks the issue.

There is a material difference between the kind of coverage NYT did vs. that of partisan outlets with an agenda of making Trump look good, but put that aside. The volume of coverage is the point. People are talking. That gives Trump license to continue softly promoting the drug.

You have to see right-wing media’s role here as amplifier. They led the charge with their “hey we’re just asking questions here!” shtick, which is irresponsible as hell because they weren’t interested in where the truth led. The point was debate, and a view aligned with POTUS.

And the danger of that happening goes beyond the news today about the drug’s danger. There was a predictable run on hydroxychloroquine that led to a shortage, meaning it wasn’t available for patients who needed it for non-COVID approved therapies such as lupus. And we saw reports of it being used experimentally without informed consent in places such as nursing homes.

So we are dealing with a dangerous setup. A POTUS prone to promoting quack medicine because he’s desperate to give any kind of hope, a news outlet that functions as his propaganda arm, and a public that has to deal with the effects of this.

One of the roles of propaganda is to reinforce messages from those in power through soft entry points. In this case, anecdotal storytelling. The public at large, many aren’t thinking critically or don’t have enough base knowledge to ask hard questions of those early stories.

Cause-and-effect sleight of hand can be powerful in a time of worry. People took it, they got better. More rigorous coverage asks about control groups, methodology, how large the sample is. It allows for the possibility of other explanations and tries to rule those factors out.

Instead we got “correlation equals causation” which violates research methods 101. And it wasn’t even statistical correlation. It was anecdotal!

Propaganda is most seductive when the public is least resistant to it. We were locked away, bored and/or worried about income and the future. Suddenly a doctor has a silver bullet cure, POTUS promotes it, and media that is credible to a large chunk of the populace buys in.

Note these people with the microphone were largely careful to not say it was a cure. They were just asking questions, asking you to fill in gaps and think it was a cure. The duped public is always the pawn.

So what can we learn?

First, Fox News gets dumped on for being a right-wing outlet. For the record, I don’t mind ideological news outlets. I think they’re fine in a broad ecosystem. But understanding their role requires nuance.

The news side is the news side; it uses conservative framing but journalistic methods. That’s how you get Neil Cavuto telling people not to take the drug, breaking with the administration message and warning his audience that taking the drug could kill them.

But the pundit shows are different. That’s where you get Fox And Friends constantly doing pro-hydroxychloroquine segments with Dr. Oz and Laura Ingraham pushing it on her Fox News evening show.

Some separate the pundit and news stuff on Fox. They are different, but to a lot of viewers it’s all the same stew. They don’t see the difference, they see the brand. The coverage coming from that brand was different than independent media, much more aligned with Trump’s message.

Second, important to see the evisceration of the line between ideological media and the presidency. Past GOP presidents kept conservative media at arm’s length at least in public. With Trump, the political goals of the White House largely align with conservative media coverage.

Third, you have to realize that cable news audiences have partisan loyalties. There is a built in audience of loyalists for Fox content. They aren’t seeking out other sides of the story, and when they encounter it they have built-in narratives to resist counter-messaging.

“Liberal media”

“Deep state media”

“Fake news”

“They hate Trump”

These are some of the messages that they’ve been fed by conservative media, in some cases for decades, and they have become an article of faith for many conservatives. It’s their shield against other views.

Because of this, we have to see the danger of the moment. We have a President willing to push dangerous quack medicine, a conservative news system ready to promote his statements in lockstep, and a segment of the public ready to gobble it up uncritically.

The easy analysis is POTUS and Fox will be culpable for what comes next, for the dangerous choices the audience will make. And I’d agree with that.

But can we talk about media literacy needs here for a second?

Media literacy isn’t trying to promote a particular view. One of its major goals is to get you to critically question news and information that matches your own views.

But the common thread there is they don’t know what good journalism looks like. They assume it means unbiased or objective because that’s what they’ve heard, but they don’t know what it means (and largely are dismayed to discover me telling them such things are impossible).

The way I talk about it: that you become a better advocate for your beliefs because your sourcing is good.

One thing I run into as an educator, even with college students, is difficulty in evaluating sources. They genuinely struggle with the lines between hard news coverage, punditry, editorials, columnists, and sites driven to promote a point of view.

But the common thread there is they don’t know what good journalism looks like. They assume it means unbiased or objective because that’s what they’ve heard, but they don’t know what it means (and largely are dismayed to discover me telling them such things are impossible).

I continue to point students to the better way, that journalism is not at its core objective, but rather a set of methodologies that allow journalists to interrogate and account for bias. My students study the 10 principles found in Kovach & Rosenstiel’s excellent “The Elements Of Journalism”:

1. Journalism’ first obligation is to the truth.

2. Its first loyalty is to citizens.

3. Its essence is a discipline of verification.

4. Its practitioners must maintain an independence from those they cover.

5. It must serve as an independent monitor of power.

6. It must provide a forum for public criticism and compromise.

7. It must strive to make the significant interesting and relevant.

8. It must keep the news comprehensive and in proportion.

9. Its practitioners have an obligation to exercise their personal conscience.

10. Citizens, too, have rights and responsibilities when it comes to the news.

The three I focus most on: truth as the ultimate end, a storytelling that emphasizes serving the interests of the public (citizens), and a methodology built around only telling the public what you can corroborate and verify.

It’s the why, the who, and the how of journalism.

Through that lens, it was pretty easy to spot how ludicrous Fox’s coverage was early on. “Just asking questions” isn’t pursuit of truth, particularly when couched in a debate format full of hot bluster designed to not get answers. It wasn’t journalism, it never was.

A media literate public would have tools to judge that coverage accordingly and push back (or tune out).

A quick exercise: Think about the past couple months during our sheltering in place. How many times did you encounter a video or post from a doctor promoting a view that cut against the majoritarian view promoted by public health officials, usually questioning the numbers or the science or the need to stay at home? Now ask:

• How you dealt with the term “doctor.”
• What was their specialty? Did it remotely relate to epidemiology?
• What separates a practicing doctor from a research scientist who uses data analysis?
• Did you ask about their methods?
• How did they gather their data?
• How did they ensure it was reliable?
• How did they analyze it?
• What monetary stake might they have in promoting a particular view? Does that stake matter?

These are all questions you’d ask if you were critically evaluating information. We should do this with all information, of course, but consensus gets a different kind of scrutiny than someone out on an island promoting a different view. Not just because it’s different, but also because in a market economy there is a competitive advantage in selling people something different, particularly if that something plays to what people desperately want to hear. Peddling false hope is a long con.

But here’s what you instinctively know: people shared a lot of those videos because “doctor” was enough credibility for them. And that’s how the Bakersfield doctors video (I’m not going to link to it; it’s pure hucksterism at work) went viral even though it did not stand up to the scrutiny found in the questions above.

My solution for this has always been the same. Teach media literacy in K-12 as a set of critical thinking skills rooted in what news is and is not. The public needs a more formal education on what journalism is and what its role is. I’d like to require it in college too, but I think I’d have to amass more power than I should reasonably have to make it happen.

The goal is to educate consumers how to evaluate what they see. But there is another layer here worth adding, one rooted in the reality of social networks: we need to be trained in how to resist viral propaganda we encounter in those spaces, and push back.

One of the media techniques we need for the 21st century is how to effectively argue and persuade online, to take our knowledge and share it effectively. Not to win arguments, but rather to push people to think more critically about information they’re encountering and promoting. In this case, it would save lives.

Facebook remains ground zero. It is a hotbed of viral misinformation, unwittingly spread by legions of users who don’t think critically about information they encounter. The platform has a widespread misinformation and propaganda problem, and in times like this it bleeds into becoming a public health crisis.

Knowing the techniques of journalism can help with this. It teaches its practitioners how to gather reams of information, analyze, synthesize, and write it for audience. (side note: a journalism degree is one of the most flexible degrees you can earn; it teaches skills in high demand).

This quote from Esther Wojcicki (source) is one of my favorites:

Journalism is the subject of the future. It’s the curriculum for the 21st century and it’s because, just look at what a journalist learns to do. First, they learn to collect information from multiple sources, they can be online, they can be in interviews, and then you have to take all that information, all that data, and figure out what’s most important. And I can tell you, that’s really, really hard for most people. They cannot figure out what’s most important in all the information they collect. And so this is a skill that students develop.

So this whole hydroxychloroquine thing is a big moment for us. It revealed some systemic fraud in our news system, and in our politics. But we have ways to fix it. Let’s do that.

Jeremy Littau is an associate professor of journalism and communication at Lehigh University. He studies activism and jounalism in the context of social networks and digital culture.