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Internet Searches for Unproven COVID-19 Therapies in the United States

Educational Objective
To understand how social media increases openness to try unproven COVID-19 therapies.
1 Credit CME

There are no highly effective prescription drug therapies supported by any reliable evidence for the ongoing coronavirus disease 2019 (COVID-19) pandemic of severe acute respiratory syndrome coronavirus 2. However, fears among the public can lead to searches for unproven therapies. Therefore, when several high-profile figures, including entrepreneur Elon Musk and President Donald Trump, endorsed the use of chloroquine, a malarial prophylaxis drug, and hydroxychloroquine (with the antibiotic azithromycin), a lupus and rheumatoid arthritis treatment, to treat COVID-19, it drew massive public attention that could shape individual decision-making.

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Article Information

Accepted for Publication: April 9, 2020.

Corresponding Author: John W. Ayers, PhD, MA, Division of Infectious Diseases and Global Health, Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Dr, 333 CRSF, La Jolla, CA 92093 (ayers.john.w@gmail.com).

Published Online: April 29, 2020. doi:10.1001/jamainternmed.2020.1764

Author Contributions: Dr Ayers had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Liu, Dredze, Ayers.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Liu, Caputi, Dredze, Ayers.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Liu, Caputi.

Administrative, technical, or material support: Liu, Caputi, Dredze.

Study supervision: Dredze, Kesselheim.

Other: Ayers.

Conflict of Interest Disclosures: Dr Ayers reports receiving grants from the Burroughs Wellcome Fund and the University of California Office of the President, as well as nonfinancial support from the Division of Infectious Diseases and Global Health of the University of California, San Diego; he also owns equity in Directing Medicine, Health Watcher, and Good Analytics, which are companies that advise on the use of digital data for public health surveillance. Mr Caputi reports receiving personal fees from Good Analytics. Dr Dredze reports holding equity in Good Analytics and has received consulting fees from Directing Medicine; he has also received payments from Sickweather, which uses social media for infectious disease monitoring, and Bloomberg LP. Dr Kesselheim reports receiving grants from Arnold Ventures and the Harvard-MIT Center of Regulatory Science. No other disclosures are reported.

Disclaimer: The content of this article is solely the responsibility of the authors and does not necessarily reflect the position or policy of their employers and collaborating institutions.

References
1.
Liu  J , Cao  R , Xu  M ,  et al.  Hydroxychloroquine, a less toxic derivative of chloroquine, is effective in inhibiting SARS-CoV-2 infection in vitro.   Cell Discov. 2020;6(1):16. doi:10.1038/s41421-020-0156-0 PubMedGoogle ScholarCrossref
2.
White  NJ .  Cardiotoxicity of antimalarial drugs.   Lancet Infect Dis. 2007;7(8):549-558. doi:10.1016/S1473-3099(07)70187-1 PubMedGoogle ScholarCrossref
3.
Vigdor  N . Man fatally poisons himself while self-medicating for coronavirus, doctor says. New York Times. March 24, 2020. Accessed April 17, 2020. https://www.nytimes.com/2020/03/24/us/chloroquine-poisoning-coronavirus.html.
4.
Ayers  JW , Althouse  BM , Dredze  M .  Could behavioral medicine lead the web data revolution?   JAMA. 2014;311(14):1399-1400. doi:10.1001/jama.2014.1505 PubMedGoogle ScholarCrossref
5.
Hyndman  RJ , Khandakar  Y .  Automatic time series forecasting: the forecast package for R.   J Stat Softw. 2008. doi:10.18637/jss.v027.i03 Google Scholar
6.
Yazdany  J , Kim  AHJ .  Use of hydroxychloroquine and chloroquine during the COVID-19 pandemic: what every clinician should know.   Ann Intern Med. Published online March 31, 2020. doi:10.7326/M20-1334Google Scholar
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