Mind over matter is a very real phenomenon in medicine.
A clinical placebo is a treatment that has no intended therapeutic effect. In a clinical trial, a placebo could be a saline formulation that is typically inert when injected. Or, the placebo could be the formulated mix of salts and leftover impurities that are present with the vaccine under investigation minus the active ingredient (vaccine).
In using a placebo while testing vaccine trials investigators want to eliminate any thoughts, views, emotions, and expectations as much as possible. Study participants will not know (they will be blind) to what treatment they receive, and often so will most of the investigators (double-blind).
The key objective of a placebo is to allow the participant to believe they have received the medicine being tested. The placebo effect is a beneficial health outcome resulting from a person’s anticipation that an intervention will help. How a health care provider interacts with a patient also may bring about a positive response that’s independent of any specific treatment.
It is my view that if we had a more positive outlook on the likelihood that you will be just fine if you get the virus and treat it properly than we would all be living happier lives. Having more people believe they have taken a Covid-19 vaccine might have an amazingly positive effect on society.
What is the nocebo effect?
We are understanding more and more about how nocebo effects work. Emotionally charged negative information from an authoritative source can make someone expect a negative symptom such as pain or breathlessness. Then, like a self-fulfilling prophecy, the expectation itself can cause the symptom. These expectations are associated with the production of neurotransmitters that induce an increased sensitivity to pain and a wide variety of other symptoms. Fear and anxiety heighten this process.
A fascinating study examined the impact of the placebo effect in 84 trials of nerve pain treatments that took place over the prior 23 years. The researchers found that the placebo effect has become remarkably stronger, but this observation was only noted in U.S. studies. Why? One theory is that the flood of direct-to-consumer drug advertising in the U.S. (which is not allowed in most other countries) increases patients’ expectations that medication will help them. Stronger and higher expectations of a drug’s effectiveness may translate into a bigger placebo effect.
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