Agnotology (the study of deliberate spreading of confusion)

Throughout the pandemic, it has been saddening how science has been hijacked. Arguments around herd immunity exemplify this: proponents claimed that acquiring immunity by infection was fine for most people and also that communities were well on their way to achieving herd immunity[1] . The messages supporting this approach downplayed the dangers for those with high risks of exposure or severe illness. Herd immunity reduces the risk of contracting a disease but does not prevent it for non-immune people, or those previously exposed, vaccinated or both [2] . That is, the generation and sustaining of herd immunity carries a substantive element of risk that needs to be managed. Rather, the term 'herd effect' is proposed, defined as: "the reduction of infection or disease in the unimmunised segment as a result of immunising a proportion of the population"[3] .

Evidence Manipulation

Dilution of evidence for commercial or political affiliations is also common and prevalent in nutrition information. For instance, the non-profit International Life Sciences Institute , (which looks very impressive) based in Washington DC, funded by leading companies in the food and chemical industries, promotes doubt/uncertainty about science that links ultra-processed foods with health concerns, and provides experts to promote personal responsibility rather than regulations on junk food in policies to combat obesity. In effect, diverting attention from the industrial production of foods as a changeable factor to one of personal decision making.

This influence is so powerful and persuasive that public-health researchers consider it a distinct area of study known as ‘commercial determinants of health ’[4] . They cover three main areas:

1.??????They relate to unhealthy commodities that are contributing to ill-health;

2.??????they include business, market and political practices that are harmful to health and used to sell these commodities and secure a favourable policy environment;

3.??????they include the global drivers of ill-health, such as market-driven economies and globalisation, that have facilitated the use of such harmful practices.

A review of corporate determinants of health also highlights how media ownership can shape coverage and frame whether health is seen as a matter of ‘personal responsibility’, which suits corporate interests, or a communal and governmental responsibility [5] . This has a key role in whether individual decisions are cast as a matter of ‘freedom’ versus ‘solidarity’, and regulations as restriction or protection. Naturally, there is a position where both elements are required for the best health outcomes.

Recent publications on the usefulness of Vitamin C and Zinc in the reduction of symptoms and preservation of life for people infected with SARS-Cov-2 have barely made mainstream press. Whereas the recently released drug by Pfizer called Molnupiravir has been front-page news[6] .

New Medications Vs Old Nutrients

Unquestionably, medications that preserve life, and reduce risk, are to be welcomed, but not without appropriate scrutiny [7] . Our colleague Dr Vasquez has prepared a short overview of the study looking at this medication, compared to ones looking at Vitamin D[8] . This initial review highlights the top-down approach to drugs first, rather than nutrients first in the collective mindset – It’s easy to see how this is so embedded but simply because it’s the way it’s done, should not exclude comparable messaging about Vitamins D & C , and the mineral Zinc [9] ,[10] .

Provoking outrage and controversy help misleading arguments to spread and creates a space where positive but commercially less valuable news is suppressed and in turn serves to manufacture doubt and uncertainty. As well documented in anti-vaccine movements and climate denial, controversy around one article can generate attention that legitimises problematic arguments.

Emotional Outcomes

This can provoke negative feelings and as we all inherited the tendency to focus on the negative from our ancestors, it can become problematic. They were consistently vigilant and on the lookout for danger to stay alive. This caused our brains to become wired towards expecting the worst.

“negative events elicit more rapid and more prominent responses than non-negative events”[11]

Those who survived passed on those genes, as explained by Cacioppo & Berntson in 1999 [12] .

Among other things, they explain why we often:

·????????Recall and think about insults more than compliments;

·????????Respond more – emotionally and physically – to adverse stimuli;

·????????Dwell on unpleasant or traumatic events more than pleasant ones; and

·????????Focus our attention more quickly on negative rather than positive information.

Negative bias can still be helpful in some circumstances but, as we grow and society develops, this hard-wired tendency is not as useful as it once was.

Cognitive Restructuring

Negativity biases have been linked to numerous psychological disorders, such as depression and anxiety [13] . When you catch yourself taking a negative view of situations, it often helps to practice cognitive restructuring by reframing the event or experience.

The next time you experience or create a positive moment, take a little longer than you usually would to enjoy it. Engage fully in the good sensations, happy thoughts, and pleasant emotions that you feel and make a note of what you enjoyed about it.

When you return home, why not reflect on what just happened and turn the savouring skill into a habit. To assist the reprogramming, it may also be helpful to make use of a natural mechanism for mood enhancement via the use of Saffron extract [14] . This safe, quick-acting and non-addictive plant extract has many studies supporting its effectiveness in enhancing mood and well-being [15] .

Uncertainty

At the back of these comments lies uncertainty, and comfort with knowledge held and knowledge yet to be acquired, cognitive bias, time and peers, all have a role to play, in the generation of agnotological events. This is further determined by each person’s tolerance to uncertainty.

If this is an area you may wish to explore further, the Uncertainty Experts , have a web-based programme that offers the opportunity to assess your tolerance – why not explore?

References

[1] The false promise of herd immunity for COVID-19 Oct 21 – 2021 Nature https://www.nature.com/articles/d41586-020-02948-4

[2] Michela Antonelli, Rose S Penfold, Jordi Merino, Carole H Sudre, Erika Molteni, Sarah Berry, Liane S Canas, Mark S Graham, Kerstin Klaser, Marc Modat, Benjamin Murray, Eric Kerfoot, Liyuan Chen, Jie Deng, Marc F ?sterdahl, Nathan J Cheetham, David A Drew, Long H Nguyen, Joan Capdevila Pujol, Christina Hu, Somesh Selvachandran, Lorenzo Polidori, Anna May, Jonathan Wolf, Andrew T Chan, Alexander Hammers, Emma L Duncan, Tim D Spector, Sebastien Ourselin, Claire J Steves, Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study, The Lancet Infectious Diseases, 2021,

[3] John TJ, Samuel R. Herd immunity and herd effect: new insights and definitions. Eur J Epidemiol. 2000;16(7):601-6.

[4] Mialon M. An overview of the commercial determinants of health. Global Health. 2020;16(1):74. Published 2020 Aug 17.

[5] Martin McKee and David Stuckler, 2018: Revisiting the Corporate and Commercial Determinants of Health American Journal of Public Health 108, 1167_1170

[6] Mahase E. Covid-19: UK becomes first country to authorise antiviral molnupiravir BMJ 2021; 375 :n2697 doi:10.1136/bmj.n2697

[7] Singh AK, Singh A, Singh R, Misra A. Molnupiravir in COVID-19: A systematic review of literature. Diabetes Metab Syndr. 2021 Oct 30;15(6):102329.

[8] Dr Alex Vasquez, reviews the initial paper on Molnupiravir and Vitamin D https://vimeo.com/642977316

[9] Holford, P.; Carr, A.C.; Zawari, M.; Vizcaychipi, M.P. Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence. Life 2021, 11, 1166

[10] Hunter J, Arentz S, Goldenberg J, et al Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials BMJ Open 2021;11:e047474

[11] Carretié L, Mercado F, Tapia M, Hinojosa JA. Emotion, attention, and the 'negativity bias', studied through event-related potentials. Int J Psychophysiol. 2001 May;41(1):75-85.

[12] Cacioppo, J. T., & Berntson, G. G. (1999). The affect system: Architecture and operating characteristics. Current Directions in Psychological Science, 8(5), 133

[13] Riskind J H, Looming vulnerability to threat: A cognitive paradigm for anxiety, Behaviour Research and Therapy, Volume 35, Issue 8, 1997, Pages 685-702

[14] Lu C, Ke L, Li J, Zhao H, Lu T, Mentis AFA, Wang Y, Wang Z, Polissiou MG, Tang L, Tang H, Yang K. Saffron (Crocus sativus L.) and health outcomes: a meta-research review of meta-analyses and an evidence mapping study. Phytomedicine. 2021 Oct;91:153699.

[15] Warnick SJ Jr, Mehdi L, Kowalkowski J. Wait-there's evidence for that? Integrative medicine treatments for major depressive disorder. Int J Psychiatry Med. 2021 Sep;56(5):334-343.?