We've been besieged by incessant Covid-19 news 24/7. Beyond a doubt, all we're getting is one-side and in sound-bytes and simplified slogans repeated over and over, with no thoughtful critical analysis or balanced perspectives. Worse, the emotional stories and claims grow bigger and more sensational and  over-the-top every week. This is not journalism or health educational communications, this is marketing publicity 101.  

Disreputable Covid-19 news stories have become the norm. They've become so ubiquitous, we've become  desensitized as to what is right and wrong anymore. We have cartoon characters scaring children about  making Grandma sick, and even videos of Santa Claus getting Covid-19 and being rushed to the hospital  before Christmas. A recent news broadcast by every Gray Television station across Texas – from Wichita  Falls to Lubbock – and around the country from Anchorage to Honolulu and every market in between −  sunk to a new low. It was so shameful and outrageous, it violated every ethical principle for medical and  communication professionals.  

When it comes to the Covid-19 panic, as board-certified psychiatrist, Dr. Mark McDonald, explained,  people have become so terrorized and traumatized, they're unable to think clearly, reason or process  accurate and factual information even when it's available. Instead, people are driven by fear. The scares  and alarms instilled by media and government have become so entrenched, he said, many Americans have  reached a state of delusional psychosis. This widespread collective delusion, is unlike anything most  health professionals have ever witnessed. People are being hurt.  

While scare tactics have been used when there's a clear public health emergency, whether such tactics are ever morally okay or appropriate is questionable, even when reserved to motivate people to adopt  behaviors that are soundly scientifically proven. Professor Nurit Guttman at Tel Aviv University, a  distinguished expert on ethical issues in health communications, authored a seminal paper that spoke to  the behavior of the doctor who made this dramatized video and the news stations that broadcast it. She reminds us what it means to be ethical when sharing health information. 

A New Low in Broadcast News 

On November 25, a news story aired depicting a heavily garbed doctor shining a laryngoscope into the camera and threatening, “I hope, that the last moments of your life don’t look like this, because, this is what you’ll see at the end of your life" if everyone doesn't don’t start wearing masks, practice social distancing and wash hands frequently. I don’t want to be the last person that looks in your frightened eyes." He went on to add, “I promise you, this is what your mother, or your father, or your children, when they get Covid disease, will see at the end of their life." 

This broadcast reminds us that even a $7.2 billion media corporation with high powered CEO's earning  nearly $9 million salaries and $21 million in company stock, isn't guided by doing the right thing when  stories with shock value are sure to draw viewers and bring advertising dollars. It also reminds us that we  can't rely on impressive credentials or prestigious positions for information that can be trusted.  

Behind the mask, face shield and camera was Kenneth Remy, a doctor with Washington University Pediatric Department, working at St. Louis area hospitals. The source of this broadcast was a Twitter tweet he'd made a few days earlier, viewed 241,000 times and went viral in media around the world. His  university colleagues and employers apparently saw no problem with his tweet.  

According to ethical principles, as outlined by Professor Guttman, however, it was extremely  problematic. As she said, the morality of conduct when communicating health information especially  creates ethical issues when techniques, such as highly emotional appeals, exaggerations, omissions, 

provocative tactics or the use of children, are applied. This goes for medical and communication  professionals and any official position entrusted by the public to know the facts and act in their best  interests. 

∙ The most important obligation when one aims to better people's health, when it comes to ethical  principles, is to avoid doing harm. "This moral obligation is considered by some ethicists as the  foremost ethical maxim for healthcare providers since the days of Hippocrates," she wrote. When  a communication might directly or indirectly harm people, whether on a physiological,  psychological, social or cultural level − such as people becoming especially anxious − this falls  under violating the axiom, "do no harm."  

Another moral imperative is respecting people's intrinsic right to autonomy and the right to make  their own decisions on matters that affect them, she said. "Ethical issues associated with respect  for autonomy and privacy typically concern the use of persuasive arguments that might be  considered manipulative, or the use of graphic material such as mutilated bodies or human  suffering that might offend people or expose them to issues or sights to which they do not want to  be exposed." 

"Being truthful is one of the tenets of Western morality that is assumed to be shared universally.  Concealment or misrepresentation of what is believed to be true, even for what is considered a  good cause, is considered an infringement on the ethical principle of respect for autonomy," she  stressed. In health promotions, "inaccuracies or exaggerations are often represented in slogans or  visual images." Morality calls for health communications to allow and acknowledge alternative  concepts, and engage in open discussions about them, she added. In other words, health information that is honest and truthful gives all sides of an issue. This separates it from  propaganda and marketing which serves to manipulate people into believing something, and  pressure them to act or buy something that benefits someone else. 

Using commercial marketing strategies and coercive measures raise a host of ethical concerns,  she explained. Labeling, shaming and stigmatizing people who do or do not engage in certain  practices as being responsible for a specific health problem is a significant ethical problem.  Messages that "imply that illness or disability results from the failure to adopt a so-called  responsible lifestyle and that irresponsible individuals are responsible for the adverse outcome" are especially detrimental.  

Using shock tactics may be popular, but their use is also strongly contested and raises serious  ethical concerns, according to ethical principles. They gain audience attention and are profitable  for media, but create anxiety and distress; conflict with social values; and can result in anger,  retreat, guilt, passivity and despondency. 

∙ The obligation to sincerity and hidden agendas is absolute, she explained. It is a moral imperative  to make clear the goals and motives of those who are likely to benefit from the health promotion  message. 

Even the American Medical Association's Code of Medical Ethics, which has degenerated over recent  decades, specifically addresses Physicians in the Media and states that physicians who engage public  concerns through the media have an obligation to uphold the ethical standards of the profession.  Physicians "should ensure that the medical information they provide is accurate, appropriately conveys  known risks and benefits… and is based 'on valid scientific evidence.'" It is "ethically inappropriate for  physicians to publicly recommend behaviors or interventions that are not scientifically well grounded" 

and they have a responsibility "to acknowledge when there is lack of consensus within the profession."  They should also avoid appearances that create or may be perceived to have a conflict of interest, and any  conflict "should be disclosed."  

Every medical professional has a responsibility to keep abreast and understand sound, credible scientific  research, as opposed to pop science and biased claims. Those that do, recognize that the strongest body of  evidence continues to not support the efficacy for the general public to wear masks and social distance in  reducing respiratory viral transmission. Not only did Remy violate ethics in his tactics and not discussing  all sides of the issue or alternative evidence, he failed to disclose potential conflicts of interest in keeping  pandemic fears heightened.  

A October 26, 2020 article in the Journal of Clinical Investigation disclosed that Remy has  patents pending for an Elispot Assay, an antibody testing method for cytokine-secreting cells.  o Incidentally, deaths from cytokine storm (a very rare complication recognized for decades that can occur with a number of infections, rheumatic diseases, cancers and medical  interventions) has dominated Covid-19 scares. These same Washington University researchers published last month in Science Advances their findings that Covid-19 patients  are actually less inflamed than seasonal flu patients. This balancing information didn't make  the news to help lessen Covid-19 panic.  

Remy is also a lead investigator for RevImmune, a privately held pharmaceutical company based  in Paris, France and Bethesda, MD that's been trying to market its Interleukin-7 (CYT107) for  septic patients, still in early development phase two trials. 

It just began recruiting for another phase two trial using its experimental drug on lymphopenic Covid-19 patients. Remy promoted this trial in media just a week before his  Twitter video. 

Take Home Advice 

Keeping one fact in mind can help all of us not become victimized by the scares and prompt us to dig deeper to learn the facts for ourselves, discover what is really going on, and decide what is best for us and  our loved ones: the infection fatality rate (IFR). 

"Based on the latest surveillance data and scientific knowledge," according to the Centers for  Disease Control and Prevention (CDC), the IFR is so low, it translated to 99.99% of young people  to 99.5% of older adults, and 94.6% of elderly even over age 70, NOT dying.  

As of October 2020, the estimated global IFR, was revised even lower − to 0.15-0.20% across  all ages, and only 0.03-0.04% in those <70 years old.  

Knowing the IFR, people cannot possibly be dropping dead in the streets from Covid-19 or stacking  up in refrigerated morgue trucks outside overwhelmed hospitals, as media depicts. 

Experienced medical professionals know that hospitals are always busier during the winter cold and flu  season. Hospitals are packed, with patients being treated in hallways and even tents, and staff working  overtime… as in 2018! Yet, every winter we haven't had 24/7 panic and nonstop threatening health  messages; weren't forced to wear masks; kept locked down; ordered to cancel Christmas or else; and  tested en-masse with positive specimens reported hour-by-hour in the news. 

If health news was honest, media would be reporting hospital occupancy rates during past viral seasons to  help people put numbers into perspective and better understand endemic seasonal viruses. Why aren't  they? It would not be surprising if our hospitals are generally less busy than this time last year, and if  even ICU occupancies are lower, as they are in the UK. According to the latest HHS hospital capacity  report, U.S. hospitals are at 75% occupancy, 63% for ICU beds, and 14.82% of patients test "positive" for  Covid-19. 

We have medical professionals continually appearing on the news with frantic claims, and horror tales of  death and dying. It's not only shameful, deceptive and unprofessional. It's unethical. 

Sandy Szwarc, BSN, RN is a health and science writer who lives in the great state of Texas.