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COVID-19: has EBM been replaced by hype-based medicine?
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  1. Margaret McCartney
  1. Fulton Street Medical Centre, Glasgow, UK
  1. Correspondence to Dr Margaret McCartney, Fulton Street Medical Centre, Glasgow, UK; mgtmmccartney{at}gmail.com

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When Donald Trump said that he had a ‘good feeling’ about hydroxychloroquine in the treatment of COVID-19, I had a bad feeling. In the midst of a pandemic, we are in a period of instability, which brings the potential of benefit—a loosening of bureaucratic restrictions—and risks—again, a loosening of bureaucratic restrictions. The situation is dramatic and understandably frightening. Emotions are high. No one is safe. Because we are in the middle of a pandemic, the argument goes, we cannot wait for trials. We feel compelled to do something.1 We cannot allow people to die before randomised controlled trials are reported: we are urged to act. The inference is that the slow-footed are effectively killing family, colleagues, friends. It is usually easier and more popular to do something visibly and quickly than not. Of the influenza pandemic that followed the First World War, George Soper, a sanitation engineer wrote, in the journal Science in 1919: ‘if doubt arises as to the probable efficacy of measures which seem so lacking in specificity it must be remembered that it is better for the public morale to be doing something than nothing and the general health will not suffer for the additional care which is given it’. …

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