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Social media platforms are struggling to contain a new round of coronavirus conspiracy theories thanks, in part, to Donald Trump.

On Monday night, the president retweeted multiple accounts that posted a video falsely claiming that hydroxychloroquine cured Covid-19, including one tweet from his son, Donald Trump Jr. Many of those tweets were later removed, and Twitter suspended several of the users behind them, including Trump’s son, for 12 hours. But the video itself has continued to spread across social media platforms, raising fresh questions about how companies like Facebook and Twitter handle misinformation.

The video in question, which Trump Jr. called a “must watch,” features Houston doctor Stella Immanuel, who claimed that a combination of hydroxychloroquine, zinc, and the antibiotic Zithromax was a “cure” for the coronavirus and that “you don’t need to wear a mask.” The Food and Drug Administration (FDA) has said that hydroxychloroquine is “unlikely to produce an antiviral effect,” and the Centers for Disease Control and Prevention (CDC) recommends wearing masks to stop the spread of the virus. The video of Immanuel quickly went viral, drawing millions of views on Facebook, Twitter, and YouTube in a matter of hours.

The event itself also had some political support. Immanuel was speaking at a gathering called the “White Coat Summit,” held on Monday by a group called America’s Frontline Doctors. The press conference, which was held on the steps of the Supreme Court, was organized by right-wing group Tea Party Patriots and also featured Rep. Ralph Norman (R-SC). A spokesperson for Norman told Recode that he didn’t know ahead of time what Immanuel was going to say.

“While the Congressman does not agree with her statement on the use of masks, and certainly has no expertise in medications, he strongly believes that she has a right to say what she came to say without being censored by big tech,” Rep. Norman’s spokesperson said.

According to the Daily Beast, Immanuel has a history of strange medical claims, including that fibroids and cysts are caused by having sex with demons in dreams and that alien DNA is being used in medical treatments. Records from the Texas Medical Board show that Immanuel, who was trained as a pediatrician, is a licensed physician with a practice in Houston that has the same address as her own church, Firepower Ministries. Immanuel’s sermons, several of which are hosted on her YouTube channel, include messages of support for President Trump. Most of those videos have only a few thousand views.

Why this specific video about hydroxychloroquine went viral so quickly is likely a combination of the high profile of the right-wing personalities and publications that shared it and the controversial subject matter. Although Twitter attracted attention by suspending Donald Trump Jr.’s account for posting the video of Immanuel’s speech, the source of the virality appears to be conservative publication Breitbart, which shared the video of Immanuel’s speech to its 4.7 million Facebook followers. Facebook later removed the post, but not before it got millions of views on the platform.

“We’ve removed this video for violating our policies that prohibit false claims about cures for Covid-19, since no such cure currently exists,” a Facebook spokesperson told Recode in a statement. “Under this policy, we remove posts that make claims like this video did that hydroxychloroquine is an absolute cure for Covid-19. From April to June we removed more than 7 million pieces of content on Facebook and Instagram for violating this policy and have shown messages to people who have reacted to, commented on or shared this kind of content.”

YouTube also says it has taken steps to remove the video. “We have removed the video for violating our COVID-19 misinformation policies,” a spokesperson for Google, which owns YouTube, told Recode.

The Breitbart detail is especially problematic for Facebook. The social network drew criticism after it named Breitbart as a partner in its Facebook News initiative, which involved collecting trusted news sources in a dedicated tab. Once described by co-founder Steve Bannon as “a platform for the alt-right,” Breitbart is also known to spread misinformation. A Facebook spokesperson confirmed to Recode that Breitbart is still eligible to appear in the News tab — meaning it could appear in peoples’ individual News tabs — but its content has never appeared in the top stories feature, which is what’s curated by Facebook employees.

Meanwhile, hydroxychloroquine continues to be the source of many conspiracy theories, so one might expect social media companies to be prepared to halt the spread of dubious content related to the topic. But it’s not entirely clear where any of these social media platforms draw the line between actionable misinformation and allowable claims about hydroxychloroquine.

Facebook has generally tried to take a mostly hands-off stance when it comes to the president’s posts. The company did remove campaign ads that promoted a “census” that was not the official census and that featured imagery associated with Nazis, but it declined to act on a Trump post that said “when the looting starts, the shooting starts” in reference to nationwide anti-police brutality protests. To date, Facebook has not deleted any of Trump’s posts related to hydroxychloroquine.

Twitter has been more aggressive in its dealings with the president. The company first fact-checked Trump in May, applying a warning label to two tweets that included misinformation about voting by mail. A Trump tweet that included the same “shooting … looting” language that was in his Facebook post also received a warning label. In this week’s incident involving the Immanuel video, several tweets that were retweeted by President Trump have been deleted, although others claiming that hydroxychloroquine can treat the coronavirus remain up as of publication (Twitter did not respond to comment about this).

Some might argue that any posts claiming that hydroxychloroquine is a cure for Covid-19 should get flagged for misinformation, if only because most scientific studies tells us that the drug doesn’t make a difference. Much like wearing masks, however, the use of hydroxychloroquine has become politicized.

Typically used to prevent malaria and treat certain autoimmune disorders, hydroxychloroquine was identified as a potential treatment for coronavirus after a February report from a French doctor claimed that a combination of the drug and Zithromax cured 100 percent of his small sample size of coronavirus patients. Despite later, more in-depth studies that have shown the drug combination has no apparent impact on the virus, conservative pundits and then the president seized on the idea that the drug might be some sort of cure. That has not proven true after more research. The National Institutes of Health halted its clinical trials of the drug on June 20, and the FDA revoked its emergency use authorization of hydroxychloroquine on July 1. Yet claims that hydroxychloroquine is an effective treatment for Covid-19 persist, with Trump claiming he took a two-week course of the drug in May.

Again, Twitter has taken an assertive approach when it comes to misinformation about Covid-19 treatments. Following the virality of the Immanuel video, the company made “Hydroxychloroquine is not an effective treatment for COVID-19, according to the FDA” one of its trending topics. Incidentally, this happened just hours after Trump castigated Twitter for never featuring “good” trends about him, calling the omission “illegal.” Twitter did not append a fact-check to that tweet, but there is no American law that says social media platforms have to feature good trending topics about the president.

As is often the case with social media companies moderating users who violate their policies, some are accusing Facebook and Twitter of censorship. Immanuel complained on Monday evening that her Facebook profile page and videos had been removed, threatening that the entire platform would “be down in Jesus name” if they were not restored. She then went silent for about 13 hours. By Tuesday afternoon, she was back, and tweeted her video again. It gained 104,000 views and 11,200 retweets in 90 minutes and has yet to be removed.

Update 5:30 pm ET July 28, 2020: This post has been updated to include a statement from Facebook.

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