Search interest in alleged COVID-19 treatments over the pandemic period: the impact of mass news media

BackgroundDuring a public health emergency, interest in unsafe or illegitimate medications can delay appropriate treatment and foster medical mistrust. MethodsWe obtained daily US-based Google Search Trends and Media Cloud data from 2019-2022 to assess the relationship between search interest and media coverage in three purported COVID-19 treatments: hydroxychloroquine, ivermectin, and remdesivir. ResultsSearch interest and media coverage of all COVID-19 treatments were significantly elevated during the study period; search interest was highest for ivermectin (6.0 out of 100; interquartile range [IQR]: 1.9-9.9), while media covered hydroxychloroquine most frequently (0.05% of all articles published; IQR: 0.02-0.13%). Anomaly detection of both data sources identified several points of higher-than-expected activity; anomalies in search interest and media coverage showed similar patterns within treatments. There were distinct patterns of media coverage - while the plurality of sources for all treatments were considered "Left" or "Left Leaning", ivermectin was covered by the highest number of "Right"-biased sources and remdesivir had the highest coverage by "Center" or "unbiased" sources. When assessing the co-occurrence of words and phrases in media sources covering each of the treatments, there were distinct qualitative difference in the categories of words appearing alongside the drugs. Specifically, ivermectin appeared to be reported more frequently in association with specific individuals than media mentioning the other drugs. In google searches, people seemed most interested in understanding what hydroxychloroquine is and the uses of ivermectin (e.g., "for humans", "for dogs"). We found significant associations between media coverage and search interest for all three treatments. Media coverage had the strongest impact on same-day search interest for remdesivir (199.7% increase, 95% CI: 179.2, 221.6) and hydroxychloroquine (182.6% increase, 95% CI: 172.8, 192.7); interest dropped significantly 1 and 2 days after media coverage of these treatments. Interest in ivermectin was lower overall (105.0% increase, 95% CI: 97.9, 112.3) but stayed elevated even 2 days after media coverage. When evaluating the separate impact of search interest on media coverage, the associations were much weaker for all three treatments and all lagged conditions. ConclusionsDuring a public health emergency, the information that populations access can directly influence health-seeking behaviors, with potentially life-threatening consequences. More broadly, positive media coverage of unsafe or unapproved medications can deter individuals from trusting and accessing safe alternatives that are more likely to be efficacious in preventing disease progression. Given the strong association between treatment-related news media coverage and public interest in said treatments, our results suggest that news media serve as a powerful mechanism for experts to inform the landscape of public opinion and to reach audiences during future public health emergencies.