In South America, a toxic chemical is being touted as a miracle cure for Covid-19. How did the mistaken belief in its powers take hold?

The flyer had thousands of shares on Facebook. It requested people to do something that, amid a pandemic, sounded outrageous: go to a square and protest elbow-to-elbow with a bunch of strangers. Yet, dozens of residents of Lima, the capital of Peru, left their homes the morning of 28 July 2020, and met in one of the city’s biggest parks to do just that. In their minds, they were not only not risking their own lives, but saving the lives of many others.

The protest was organized by an organisation called Comusav, a Spanish acronym for 'Global Coalition for Health and Life'. They said they were defending their rights to life and health, but their true cause was demanding their government accept a toxic chemical as a treatment for Covid-19.

Chlorine dioxide, the apparent cure they were clamouring for, is not only ineffective against Covid-19, but it can cause life-threatening dehydration and acute liver failure. It is considered hazardous for human consumption by health authorities all over the world, including those in Peru. Its promoters have had face-offs with doctors and have even been prosecuted by authorities for years, but the coronavirus pandemic gave them their biggest showcase so far.      

Interest in chlorine dioxide on Google skyrocketed in 2020, and hundreds of pages offering it began to appear in social media. Several celebrities endorsed it in their social media profiles, and some even managed to win mainstream media coverage by praising of its alleged properties. Andreas Kalcker, one of its biggest promoters, has been invited to talk about it by well-meaning journalists, legislators and academics not only in Peru, but also in neighbouring countries such as Colombia and Bolivia.

How did a substance the Federal Drug Administration (FDA) says "is the same as drinking bleach" trigger such a movement in Latin America? Social media had something to do with it, but also psychological traits and marketing techniques that have been around for a long time.

A simple solution

Chlorine dioxide was not the only fake cure to gain popularity as the world scrambled for ways to combat the pandemic. Other substances, like hydroxychloroquine, interferon, ivermectin, or azithromycin were also touted as possible ways to prevent getting the virus or suffering its worst effects. None of them, it turned out, showed any conclusive results against Covid-19.

"The narrative of fake cures is fed by hope, by this idea that 'we finally found the solution'," says Laura Merchan, a researcher from the Democracy Observatory in the University of the Andes in Bogota, who studied how false information about fake cures spread on Facebook in Colombia.

This was especially true early on in the pandemic, when scientists knew a lot less about the virus and it was not clear that a vaccine would appear soon. "All these drugs have legitimate uses, and in all of them there was a piece of evidence that suggested they might work," says Merchan. In a situation defined by its uncertainty, these drugs promised a simple way out – hence their appeal.

This is perhaps the oldest medical marketing trick in the book. Back in Renaissance Italy, town squares were packed with charlatans who sold all kinds of concoctions by exaggerating their therapeutic claims. In a time long before the development of sanctioned, effective medicines for most illnesses, street peddlers could offer a way out of the complexity, says David Gentilcore, a historian in University of Venice Ca’Foscari who has extensively studied charlatans' role in the history of medicine.

"A charlatan can come along and say, 'Oh, you have a fever, I have a simple remedy: You take a spoon, a spoonful of this every morning with a glass of wine and it'll put you right. It'll work on anybody, any time of the year, any age,'" explains Gentilcore.

This is also why in many cases "these cures were used as political instruments", Merchan says. Leaders like former US president Donald Trump and Brazilian president Jair Bolsonaro have promoted chloroquine as a cheap and widely available prophylactic against the virus. Soon enough, their supporters on social media started to claim its efficacy – using the digital infrastructures also used for pushing other types of disinformation and abusing political opponents. 

Since these political social media 'machines' excel at putting the same messages many times in front of people, they exploit what is known as the illusory truth effect – one of the top mechanisms that make people believe in false information.

"The brain tends to mistake familiarity for fluency: there's a lot of research that shows that the faster you process something, the more familiar you are with it, the more likely you are to believe it," says Sander van der Linden, a researcher from University of Cambridge who focuses on the psychology of misinformation. "The more misinformation is repeated, the more likely you are to think that it is true."

And there is a lot of false content about Covid-19 on social media. While it is very difficult to pin down a precise number, there are several figures which show how pervasive it can be. A survey by broadcasting regulator Ofcom in the UK shows that 54% of respondents have seen social media content labelled as untrue; and Facebook's most recent report, from April 2020, says the social network labelled more than 50 million pieces of content with fact-checking warnings, meant to alert users they contain false or misleading information.

Conspiratorial thinking

While most other substances were hyped out of the misunderstanding of scientific evidence, "chlorine dioxide works a lot more like a conspiracy theory", says Merchan.

In 2006, a former scientologist named Jim Humble published a book touting it as a Miracle Mineral Solution, or MMS, and claiming it helped curing malaria cases in Africa. Since then, it has been promoted as a cure for multiple diseases, from acne to autism to HIV. As MMS gained popularity on fringe health circles worldwide, it attracted the attention of health authorities. The FDA published its first warning about it in 2010.

In a blog post in 2010, Humble wrote he found a solution: "Forming a church of health and healing." It was all about evading oversight: "If handled properly a church can protect us from vaccinations that we don't want, from forced insurance, and from many things that a government might want to use to oppress us." Humble created the Genesis II church with Mark Grenon, who became one of the substance's top promoters.

In 2016, a news report showed Grenon saying conspiratorial falsities in a church event, like the 11 September planes were "holograms created by the government", or that "chemtrails" were poisonous. Humble also has his fair share of bizarre claims on the record: he said he is a billion-year-old god from the Andromeda galaxy who asked to be put in charge of taking care of the Earth.

Other chlorine dioxide enthusiasts are also keen on conspiratorial thinking, like Luis Lopez, from Peru. While talking to the BBC, he said he believed public health measures like mandatory masks make people sick, and that the whole pandemic is an effort to depopulate the Earth.

Lopez tells me the pandemic forced him to close his business, so he took on manufacturing and selling the substance "because it works". He says he makes the equivalent of £580 ($820) in a good day, more than three times the monthly minimum wage in his country.

How did people like Lopez fall down the rabbit hole? "What we think might be happening is that these are people who feel distrustful of authority, basically are more likely to lean on the conspiratorial side of things," says van der Linden.

Another plausible explanation might have to do with how conspiracy theories exploit reasoning errors we are all prone to make. Van der Linden explains that "believers often commit what's called a conjunction fallacy", meaning they wrongly judge a specific set of conditions as more probable than a single general one. "The probability of a conspiracy actually being true is, of course, very low, but the way that it's framed makes things seem more plausible than they actually are." (Read more about why people believe conspiracy theories.)

Other factors that researchers have identified to make people more susceptible to misinformation and conspiracy theories are poor literacy and numeracy skills, a sense of distrust of medical institutions, and a self-perceived minority status. "Perceiving themselves as a minority is pretty predictive of people’s conspiratorial beliefs," says van der Linden.

Lopez says he was convinced to take chlorine dioxide by videos he saw on social media, but he also claims that it is difficult to recruit new people just by sending them content online. "You have to talk to each person," he says.

The jury is still out on the role social media plays on spreading conspiracy theories. There is research which associates a greater use of social media with more conspiratorial thinking, but other scholars remind us that conspiracy theories were out there long before the internet.

Still, Facebook and YouTube have taken down a lot of content from organisations like Comusav, and pledged to exclude all content that might cause harm. But when the content is deplatformed it does not disappear – it just goes somewhere else, like messaging apps that are impossible to moderate at scale, or video platforms with lax content moderation policies.

Putting on a show

Kalcker, the chlorine dioxide promoter who rubs shoulders with some parts of the Latin American establishment, knows how to put on a show. He delivers his speeches in perfect Spanish – with just a very slight German accent – often wearing a white coat and showing lab equipment in the background.

Many of the videos he and others make promoting the substance make grandiose claims, and strive to sound and look scientific: they talk about protocols, dosages, and chemical reactions with a fluency many doctors do not have.

Lopez, in turn, often sells the thing by telling his own story. "I got Covid, got very ill and needed oxygen. But I was taking it for some time, and the virus left my body in a week." When asked why did he get sick despite taking chlorine dioxide, he says he stopped before getting Covid. His claims sound outrageous: he also says his rhinitis and constant ear infections have been cured for life.

Both tactics are similar to those the Italian charlatans used centuries ago. On the one hand, they put on a show on the piazzas to be noticed among other merchants. "The first description we ever have in any European language of puppets on a string is a description of a charlatan troupe," says Gentilcore.

Another thing they did was publishing personal stories of people who they claimed they cured. "Some of them published pamphlets where they'll give the names of people that were cured by them, which will include names that people will recognise."

But there is a key difference, he explains. The word "charlatan" did not have the pejorative meaning it has today, as it referred to the act of selling by putting up a show, "to talk up your thing and do it from a stage". Furthermore, the concoctions charlatans sold were not only approved by the authorities, but also were not so different from the remedies official medicine practitioners of the time would offer.

Modern day charlatans today may be skirting far closer to illegal activity. Kalcker has had standoffs with the Spanish police, who briefly detained him in 2012 (Kalcker says on his website he has no criminal record in Spain and did not respond to questions from the BBC). Grenon was arrested in Colombia in August 2020, and is due to be extradited to the US, where he faces charges of conspiracy to commit fraud and criminal contempt.
The people from Comusav did not have permission to do the protest, but they managed to get their point across the higher spheres of the country
But some loyalists just do not care. On the day of the Lima protest, a journalist recorded a livestream from her radio station’s Facebook page. The images showed a small, harmless gathering, animated by the timid cries of someone with a megaphone.

"Protests do not work. You give people a flier, they skim through it and throw it away," says Luis, who was not there but organised other similar demonstrations in another Peruvian city.

Half of the people who reacted to the transmission on Facebook used the "Haha" button. Yet, the reporter suddenly changed her tone: "Look out! The police detained one of the protestors!"

The people from Comusav did not have permission to hold the protest, but they managed to get their point across the higher spheres of the country. Despite the repeated health warnings, the conclusive evidence that it does not help to prevent or treat Covid-19, and the legal problems of some of its promoters, the Peruvian congress decided to set up a committee to "investigate the possible positive and negative effects of chlorine dioxide". 

The promoter of the committee, congressman Posemoscrowte Chagua, has been accused of sharing conspiracy theories in Congress and did not backed up his proposal with robust evidence, reported Peruvian paper El Comercio. When contacted by the BBC, Chagua conceded that there is no evidence supporting the use of chlorine dioxide for treating Covid-19, but said the commission will examine "successful experiences" medical doctors have had with it in several countries, although he did not provide any evidence of such research results.

The commission is unlikely to change the country’s official stance towards the poison, but this is not the real problem many see with the Congress’s decision. The commission “opens a space to pseudoscience and fake news,” tweeted Alberto de Belahunde, another Peruvian congressman. “It sends an awful message to a citizenry desperate for solutions.”

BBC

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