By Rene Soria Saucedo MD, MPH, PhD
Bolivia, the poorest country in South America according to GDP per capita, reported its first coronavirus case on March 10th and went into lockdown almost immediately. The measure was never fully implemented, as about 70% of the economy remains informal which means most Bolivians earn their wages daily. If they do not go out to work, there is a high chance they go hungry. As a result of incomplete social distancing between people, coronavirus cases soon started to climb and Bolivia’s precarious health system was rapidly overwhelmed. Parallel to COVID-19, Bolivia was suffering the worst dengue outbreak of the last two decades, which made the situation even worse.
The lack of health services, especially for the poor, plus decades-long distrust of the health sector (health institutions are still considered in most rural areas an elitist institution that ultimately wants to halt reproductive rights by sterilizing women), plus an incredibly weak education system, created a perfect storm for the indiscriminate use of “miraculous” solutions to treat COVID-19. This included the infamous Chlorine Dioxide, a.k.a “Mineral Miracle Solution.” Such products are banned for human consumption in several countries because of the high risk of poison when ingested.
As the virus spread, conspiracy theories flourished and became mainstream in Bolivia. The main targets: the WHO (ex: the organization is in cahoots with the Chinese government to sell billions of vaccine doses against a man-made virus); Bill Gates (ex: the main vaccine producer aims to implant us with chips to track us); the pharmaceutical industry (ex: they are hiding cheap and effective treatments because they want to sell an expensive vaccine), to name a few.
Bolivians in a vulnerable state of mind – it is never easy to watch people on TV dying on the streets because of insufficient hospital beds and respirators – were ideal targets of “health merchants,” unscrupulous charlatans that make a living by selling fraudulent products in countries with weak regulatory systems. Certain deceptive messages worked their way into Bolivia’s psyche and festered: Chlorine Dioxide prevents and cures COVID-19 in 100% of cases, and this is the medicine for the poor that your government doesn’t want you to know about, and 10 testimonies confirm it works.
Most Bolivians are unfamiliar with scientific terms such as “robust study design,” “cause and effect,” and “correlation is not causation.” For many people, watching a person on TV that looked and spoke like a scientist (white skin, beard, blue eyes, white coat, talking from a laboratory) was enough to convince them of the effectiveness of this floor disinfectant. In addition, the conspiracy theories mentioned above fit perfectly with the merchants’ message, accusing the scientific community of blocking them from sharing the “miracle news” because of its impact on the economic interests of Bill Gates, China, and multinational companies.
As of today, at least three of the main public universities are producing Chlorine Dioxide for massive distribution to anyone that “wants it,” and the Bolivian congress has approved its use for COVID-19. As a result, early evidence from hospitals warns of an increase in cases compatible with Chlorine Dioxide poisoning, further complicating the heroic work of health professionals in hospitals.
There is no question that COVID-19 is a scary thing. It is natural to be scared and to look for an effective treatment. But if we find one, we need to have the tools to evaluate what we have found, especially if our source is social media. For public health purposes, owning the narrative and responding quickly is of the essence. Even though Bolivia’s Ministry of Health banned the use of Chlorine Dioxide for human consumption, their response came almost a month late.
Public health communicators must prepare real-time responses and fight against pseudoscientific claims with vigor. Future public health workers need training that equips them to fight back their biases, evaluate scientific claims and communicate reliable information to the most at-risk people. Ultimately, what is happening in Bolivia is a cautionary tale for countries to urgently invest in health literacy training, for the public in general and health workers in particular. The scientific method is not perfect, but it works.