You're being duped. Here's how to spot it.

It struck me recently that anti-vaxxers, quacks, dictators, populists, and other would-be autocrats all follow the same playbook. They all want to sell you something for their own personal gain, and all of them are willing to lie to get what they want.

These lies have a purpose, and it’s rarely good.

Let's look at a few of the most damaging lies from recent events, starting with medicine and then moving on to politics. (Lies are in italics.)

If you believe that vaccines don't work, you've been duped.

If you believe that vaccines cause autism, you've been duped.

Vaccines are the greatest invention in the history of medicine. They've saved billions of lives, dramatically increased human life expectancy, and in many ways enabled the growth of civilization itself. The Covid-19 vaccines are more than 90% effective, and without them we'd have no chance to end the pandemic.

And yet many anti-vaxxers claim that vaccines don't work. They also claim there's a massive conspiracy to hide the (extremely rare) harms caused by vaccines. 

The anti-vax movement is led by people like Andrew Wakefield, Robert F. Kennedy Jr, Joe Mercola (whom I wrote about  in 2010, in 2014, and last year), and other members of the Disinformation Dozen who use social media to spread vaccine misinformation. They make a great deal of money selling books, seminars, and (in the case of Mercola) bogus treatments for the diseases that vaccines prevent. These people simply make stuff up and then demand that scientists devote time to disproving it. 

Science doesn’t work that way. If you make a claim, you first have to prove it, by producing evidence and rigorously-done studies that go through peer review. You can't just throw out garbage claims and insist that other people do the work of disproving them. Nope.

If you believe that ivermectin is a cure for Covid-19, you've been duped. 

As I’ve explained in this column, ivermectin doesn’t help at all in treating Covid-19, and it’s dangerous if you take too much of it. But if you prefer to get medical advice from right-wing zealots like Tucker Carlson, go ahead.

If you believe that hydroxychloroquine is a cure for Covid-19, you've been duped.

The misinformation about hydroxychloroquine started with an egocentric French microbiologist, who posted an over-the-top video claiming he had the solution to Covid-19, a claim that was quickly debunked. That didn’t stop politicians and right-wing television pundits from promoting it, even as evidence emerged that it was nonsense.

Hawkers of ivermectin, hydroxychloroquine, and other fake Covid-19 cures have profited by claiming, first, that the government is lying and that vaccines don't work, and second, that they have a truly effective treatment that they can sell you. This is a double lie, but a necessary one, because if they can't convince you that vaccines don't work, then they won't be able to sell your their snake oil. 

For instance, a sketchy right-wing group called America’s Frontline Doctors (which is not, despite the name, a group of doctors working on the front lines of any disease) was selling $90 online “consultations” where they provided prescriptions for ivermectin. The $90 didn’t include the cost of the drug: it’s just a fee that went straight into their pockets.

By the way, if you've been duped about a Covid-19 cure, you’re in good company. Early in the pandemic, doctors at Yale Medical School were duped into believing that hydroxychloroquine was an effective Covid-19 treatment, as I explained at the time. They figured out their error eventually, but not before they boldly advertised their treatment protocol on their website and via Twitter.

Now let’s look at a few examples in the political realm.

If you believe that Trump won the 2020 election, you've been duped.

This is utterly false, of course: Biden won by over 7 million votes, and he won the Electoral College 306-232. Trump is a loser, and his Big Lie is possibly the worst case of being a sore loser in the history of politics. And yet, according to some polls, 60% of Republicans believe his latest lie (or at least that's what they tell pollsters). They’ve been duped.

Trump lied over 30,000 times during the course of his presidency, as was documented, painfully, by the Washington Post, and he's still doing it. This frequent lying is part of a strategy to "flood the zone with shit," as Trump minion Steve Bannon openly boasted a couple of years ago. The idea is to make up lies far faster than the opposition can shoot them down. After all, it's easy to make up a claim when you don't have to produce any evidence, and it takes much longer to disprove it. If you take these people seriously and try to play their game, they will always win–because by the time you debunk one lie, they've produced ten more.

If you believe that Ukraine is threatening war against Russia, you've been duped. 

As I write this, Vladimir Putin is flooding his own citizens with a huge lie, trying to convince them that Ukraine is threatening war against Russia, when just the opposite is true: Russia has sent over 100,000 troops to its border with Ukraine, while Ukraine has done nothing of the sort.

If you don't believe that Russians helped shoot down Malaysia Air flight MH17 in 2010, you've been duped.

A few years ago, after Putin's soldiers near the Ukrainian border shot down a civilian Malaysian Airlines plane, killing hundreds of innocent civilians, he used the Russian media to publish multiple confusing theories, all of them simply made up, to convince his audience that Russian soldiers had nothing to do with it. An independent investigation concluded that a Russian missile, shot from a base in Russia, downed the plane. And yet many Russians today are still unaware of this.

If you believe any of Putin’s claims about Ukraine, you've been duped. 

And yet because Putin controls all the media in Russia, it is likely that many Russians do believe him. He's also claiming, falsely, that many Ukrainians actually want Russia to take over their country.

Politicians, quacks, and pseudoscientists are all con artists. They lie to gain money, power, and fame. Some of them lie without any sign of discomfort whatsoever, a trait that is characteristic of sociopaths. To people who find lying uncomfortable–which is most people–the boldness of these lies in itself is convincing.

In skeptical circles, this strategy is called the "Gish gallop," named after a creationist who used this strategy in debates where he challenged the theory of evolution. His idea was to put out so many lies and half-truths that his opponent would simply be overwhelmed. In a live debate, this tactic can be particularly effective when the audience doesn't know the topic well. 

One way to combat con artists is to expose how much they’ve gained at other people’s expense. Vladimir Putin is not only powerful, but he’s also incredibly wealthy, as a result of stealing many of his own country's assets. Putin’s biggest political foe, Alexey Navalny, released a video that showed a $1.35 billion palace that Putin built for himself, paid for with money that Putin had stolen from his own people:

Navalny got very popular in Russia. Putin first poisoned and nearly killed him, and now is holding Navalny in prison. It’s not likely Navalny will survive.

Here in the U.S., Donald Trump profited in countless ways, documented in excruciating detail by the Washington Post and the New York Times, by using the tools of government to direct business to his hotels and resorts. As just one example, hundreds of companies and foreign officials stayed at the Trump Hotel in D.C. during Trump’s presidency, in what was essentially an open bribe to the sitting President.

How can one avoid being duped?

First, always ask what the person has to gain. If they’re making money or gaining power from their claims, we should be skeptical.

Second, look at the reliability of the source. When someone lies constantly, we really can’t believe anything they say. At this point, virtually nothing claimed by some of the people I’ve highlighted in this column (Trump, Putin, Wakefield, Mercola) can be trusted.

Third, question the expertise of the source. When Tucker Carlson spews out claims about ivermectin, you shouldn't believe a word of it. When politicians make claims about science and medicine, they rarely know what they're talking about. (There are exceptions, but they are infrequent.) 

Even when the claims come from a scientists, there are plenty of reasons to be skeptical. Modern science has thousands of specializations, for good reason: biology, medicine, physics, chemistry, and other disciplines are amazingly complex. So if you want to know about global warming, don't ask a doctor. If you want to know about vaccines, don’t ask a biophysicist, even if he has a Nobel Prize, and certainly don’t ask a surgeon who’s running for political office. And for answers to any of these questions, don't ask a politician.

Masks do work, but mask policies are another thing entirely.

The use of masks to prevent the spread of Covid-19 has been controversial almost since the beginning of the pandemic, two years ago.

The U.S. Surgeon General made a huge early blunder, in February of 2020, when he recommended against masks, tweeting that

“masks are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

That self-contradictory tweet was later deleted, but it caused a tremendous amount of confusion. After all, if masks don’t work, then why is it so important that healthcare workers have them?

Masks do work. The evidence is overwhelming that masks, if properly worn, “substantially reduce exhaled respiratory droplets and aerosols from infected wearers and reduce exposure of uninfected wearers to these particles,” as described in a CDC publication last year.

The idea that masks should help prevent infections is intuitively obvious: Covid-19 spreads through the transmission of viral particles from an infected person. These particles travel through the air, as numerous studies have shown, just like many other infectious diseases. If you can stop the spread of the viral particles themselves, then (obviously) you stop the virus from infecting people.

However, evidence emerged early on in the pandemic that cloth masks and standard surgical masks were not very effective, because they allowed viral particles to leak out (and in). The SARS-CoV-2 virus is really tiny, and it can slip through the gaps in these masks.

In other words, some masks work better than others.

In June of 2020, a large study published in The Lancet reported that N95 masks were far superior at preventing transmission of Covid-19. That study found that “face mask use could result in a large reduction in risk of infection, with stronger associations with N95 or similar respirators compared with disposable surgical masks.” They reported an overall risk reduction of 85%, with N95 masks conferring a 96% reduction but surgical masks just 67%.

It’s easy to find studies showing how to make masks even more effective: make sure they fit very snugly, tightening them around the head or ears if necessary. Medical professionals who follow these guidelines have had very few infections, despite being exposed daily to sick patients. (Johns Hopkins Hospital, part of my own university, has reported almost no infections among its medical staff caused by exposure to patients.)

This all makes perfect sense. After all, if masks didn’t work, then doctors and nurses would have to be unbelievably self-sacrificing (even more than they are already) to treat Covid-19 patients. Fortunately, though, a properly worn N95 mask does an excellent job at protecting the wearer against infection.

One problem that often goes unmentioned, though, is that the better the mask, the harder it is to breathe. This too is pretty obvious: if you make it harder for tiny particles to get in or out, then of course it’s harder to breathe. Snug-fitting N95 masks are, simply put, uncomfortable.

Mask policies are the real problem. Even though masks work, getting millions of people to wear them, and wear them consistently and properly, is a far greater challenge. A casual stroll through any indoor space where masks are required–and we’ve all done this–will reveal many people whose masks don’t cover their noses, or whose masks are clearly very loose, or who might not be wearing masks at all, despite the rules.

Why don’t people wear their masks? This too shouldn’t be a mystery. Many people, young and old, simply don’t like being told what to do, so when a local government says they have to wear masks, they resent it. And governments (or large companies) have a habit of creating one-size-fits-all policies that are don’t make sense for some people. The simplest mask mandates (simplest to explain and enforce, that is) say that everyone should wear a mask all the time, or that everyone should wear a mask indoors.

For example, in Baltimore everyone has to wear a mask indoors, but restaurants are open. Thus diners must wear a mask from the entrance to their table, and then they can eat their dinner, mask-free, for as long as they wish. This doesn’t make much sense.

And what about people who are vaccinated and free from any Covid-19 symptoms? Nope, no exceptions, according to every mask mandate I’ve heard of. Naturally, that is frustrating to some people. No one should find this surprising.

In reaction to mask requirements, many people, particularly on the political right, have proclaimed that “masks don’t work.” While some of them might believe this–in which case they are just wrong–what they might really be talking about is masking policies, and in that sense they are right. If you can’t get nearly everyone to wear an N95 mask, then you can’t realistically control the spread of the virus.

We’ve seen how this works in the U.S.: despite widely varying mask policies, the Omicron variant has swept through every single state in the country, including those with strict mandates. Some places, like New York City, were hit earlier despite having fairly strict mask policies. States with no masking requirements and those that banned mask mandates (such as Florida, Georgia, South Carolina, and Tennessee), were hit later and just as hard.

One reason that masking policies don’t work–although masks themselves do work–is that it’s just really inconvenient to wear a mask all the time.

So people continue to wear masks badly, or to refuse to wear them at all. Does this mean we should give up? No, not exactly. But we might have to limit strict masking rules to places where truly vulnerable people are present, such as hospitals and senior care homes. Large-scale mask mandates are just not working, and there’s probably little we can do to change that in a free society.

A far, far more effective way to control the virus is through vaccination. As Eric Topol pointed out recently with an elegant graphic: “How to reduce your chance of dying from Covid by 99%? Get vaccinated and a booster.”