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Fake news times fake news is fake news squared — which is to say, it goes viral. It multiplies like a virus, which multiplies like fake news.

Then the equation gets complicated. What’s fake news times a viral epidemic?

“Unfortunately,” says Weekly Playboy magazine this month, “there’s no quarantining fake news.”

It’s as vast as the imagination, and the imagination is very vast indeed, as vast as cyberspace, where we read, for example, that nearly 10 million people have died from the coronavirus now known as COVID-19. In Chinese cities, corpses pile up on the streets, rotting where they succumbed. In Osaka, a Chinese tourist en route to hospital ran away before being tested, his or her whereabouts currently unknown.

It’s all over the internet — posted, tweeted, retweeted; the more outrageous, the more read and spread. Do people really believe it? Why not, when reality is no less fantastic? Lies and coverups in high places have long schooled people in low places to believe nothing, which is a mere step away from believing everything, or anything — the more improbable, the more probably true; the more sinister, the truer to life as we know it.

It’s all Bill Gates’ fault. He cornered the market on a COVID-19 vaccine, and is busy stoking up its value while it’s in development, spreading predictions of 65 million deaths, slavering over the bloated profits to come. Or no, not Gates; China — the virus leaked from a secret chemical weapons plant. Weekly Playboy at this point throws up its hands: “Who can say positively it’s not true?”

This much, at least, we may venture. The death toll worldwide has surpassed 2,000, high enough and soaring, but nowhere near 10 million. Corpses are not rotting en masse in the streets in China. The online photos that seem to show them doing so were taken six years ago, Weekly Playboy reports, citing the British newspaper Daily Mail, at an arts festival in Germany, featuring (among other things, presumably) celebrants lying down and playing dead.

Gates is innocent. Whether China does or does not have secret chemical weapons plants is a question beyond the scope of this article, but the evidence as it now stands pinpoints a livestock market in Wuhan as the epidemic’s ground zero.

Fear naturally begets exaggeration, which begets more fear and more exaggeration — an endless spiral. Medieval epidemics mobilized priests and monks; modern ones, scientists. Medieval common people aided the priests with prayers of their own. We today do what we can, while scientists struggle against time to discover a cure. Weekly Playboy scours the internet. Tea is preventative, says some chatter. Better still, the urine of children under 8. If you can swallow that, you can swallow anything.

Fake and real news merge over the Olympics. High on Playboy’s fake news list are reports of pending cancellation. The International Olympic Committee and the World Health Organization are in talks heading in that direction. They’re (apparently) not — but seriously, what of the Summer Games? Will it be business as usual? Shukan Post magazine this month reminds us that the SARS epidemic of 2002-03 raged eight months. Figuring the same eight months here too, COVID-19 will still be at large when the Olympics bring together some 10 million people from all over the world. The terrifying potential of that needs no elaboration. Fake news can go on vacation. Real news will be improbable enough.

There’s fake and fake. We fake fraudulently, or mischievously, or mistakenly, as when, deceived ourselves, we deceive others. Sometimes we deceive in order to do good. Apropos is a striking headline in the January issue of Bungei Shunju magazine: “Why I sell fake medicine.”

That’s perhaps too literal a translation. What the company Naoki Mizuguchi founded in 2014 manufactures and sells is placebo medicine. Placebos look like medicine, taste like medicine and may be prescribed like medicine, but are not medicine. They have no medicinal effect. The “placebo effect” is psychological. You’re assured it works, you believe it works — it works! You feel better! You’re cured! Fake? Fraud?

Not, certainly, when they’re used in clinical testing to measure the effectiveness of newly developed real drugs. But Mizuguchi’s prime clients are caregivers. They, at least, know what his company is up to — its name says it all: Placebo Pharmaceutical.

The infirm elderly in particular, he writes in Bungei Shunju, are eager consumers of medicine, always pressing their doctors for more pills, higher dosages. Such is their eagerness to recover what time and age have all too often, and often irretrievably, deprived them of — well-being, mobility, freedom from pain.

They ask too much. Medication eases chronic symptoms but doesn’t cure them. Meeting patients’ demands for higher dosages risks dangerous side effects. “Caregivers explain this,” Mizuguchi says, “but patients in pain or disabled can be impervious to persuasion.”

If a placebo satisfies the patient without doing harm, does the deception involved render the business unethical? One might well be inclined to stretch a point and let it pass. And yet there is an ethical problem. Mizuguchi raises it himself. What about “informed consent?”

An older generation of doctors scorned to descend to their patients’ level. They commanded, and patients obeyed — contentedly, for the most part; secure in their faith that doctors knew their business. Informed consent, unknown then, is generally unquestioned now. Patients are not dictated to. They and their doctors discuss and agree on treatment, following sufficient explanation from doctors enabling patients to intelligently decide their own medical fates.

“Prescribing placebos,” Mizuguchi acknowledges, “violates the principle of informed consent.” Well, what is one to do? If you say frankly to the patient, “This is a placebo, it has no medicinal effect,” you destroy the placebo effect.

And if you limit fake news, do you destroy freedom of speech?

Playboy urges healthy skepticism. “Don’t instantly believe everything you read,” it says. “Don’t instantly retweet.” Pause. Count to 10. Check the facts — with the NPO FactCheck Initiative Japan, for example. The facts are grim enough. They need no ghoulish embellishment.

Big in Japan is a weekly column that focuses on issues being discussed by domestic media organizations. Michael Hoffman’s latest book is an essay collection titled “Fuji, Sinai, Olympos.”

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