Anecdotal Evidence and Wishful Thinking

Today's exhibit A in the belief in anecdotal evidence and wishful thinking is a Utah pharmacist who has stockpiled enough ingredients for hydroxychloroquine, the antimalarial drug promoted previously by President Trump (Salt Lake Tribune article here). 

Source: Salt Lake Tribune

Most disturbing in this case is that it appears to have caught the attention of the Utah Health Department and State Senate President Stuart Adams.  This despite the recommendation of the American Medical Association, American Pharmacists Association, and American Society of Health System Pharmacists discouraging hospitals and pharmacies from stockpiling the drugs and stating that there is "no incontrovertible evidence to support off-label use of medications for COVID-19.”  

Further, that recommendation explicitly cautions against the hoarding of such medication. "Stockpiling these medications—or depleting supplies with excessive, anticipatory orders—can have grave consequences for patients with conditions such as lupus or rheumatoid arthritis if the drugs are not available in the community."

I have a cautionary tale for those who wish to push treatments based on anecdotal evidence and wishful thinking.  In March of 1989, two University of Utah scientists, Stanley Pons and Martin Fleischmann, announced that they had produced cold fusion.  This was an exciting finding, one that could revolutionize energy production, but it had not been validated by the scientific process.

This morning I read a few news articles from that period and they are quite illuminating.  New York Times archives include an AP article published on August 8, 1989 entitled Utah Votes $4.5 Million for Cold Fusion Studies.  The vote was cast by the Fusion-Energy Advisory Council, which controlled $5 million appropriated by the State Legislature in April for fusion research.  With $500,000 released for patent lawyers' fees, in August 1989, the council voted to release $4.5 million for research on cold fusion at the University of Utah.  The vote was 7 to 1, with one abstention and one vote opposed, which was cast by Karen Morse, the Provost at Utah state who said "We can only have verification when a full understanding of the science is in."  

At the time, the cold fusion finding was already being questioned by scientists, although it should be noted that there were some scientists at the University of Utah and elsewhere who were promoters.  Ultimately, the cold-fusion debacle was a stain for the University of Utah and contributed to the retirement of University of Utah president Chase Peterson.  

Cold fusion provides an example of the dangers of circumventing the scientific process and rushing to support findings that have not been carefully vetted.  Perhaps we will learn that hydroxychloroquine and related drugs have some positive benefits for treatment, and I hope that's the case, but the cautious approach being expressed by the medical and pharmacy communities should be heeded until more evidence is in.