Ivermectin Prophylaxis Used for Covid-19(cureus.com)
cureus.com
Ivermectin Prophylaxis Used for Covid-19
https://www.cureus.com/articles/82162-ivermectin-prophylaxis-used-for-covid-19-a-citywide-prospective-observational-study-of-223128-subjects-using-propensity-score-matching
212 comments
> He has made countless claims like these long before any good research had been done
This could describe almost anyone working on COVID over the past 2 years
This could describe almost anyone working on COVID over the past 2 years
No, it really couldn't. If you look at the history of statements by medical professional, the claims made were reasonable advice based on the best facts available. There were improvements as information clarified — for example, people stopped worrying about spread on surfaces after it became clear that this was not happening on an noticeable scale — but the advice was generally reasonable and had plenty of scientific support (e.g. it's not controversial to say masks and ventilation help control a respiratory disease).
The Hydroxychloroquine / Ivermectin sales people picked random pharmaceuticals and started recommending them without any serious theory or evidence supporting that they worked and, far more tellingly, they were clearly uninterested in testing their faith: it was all based on anecdotes and flawed studies and, unlike real scientists, when gaps or contradictory evidence were observed they tried to confabulate explanations which supported the conclusion they already had rather than question it.
The Hydroxychloroquine / Ivermectin sales people picked random pharmaceuticals and started recommending them without any serious theory or evidence supporting that they worked and, far more tellingly, they were clearly uninterested in testing their faith: it was all based on anecdotes and flawed studies and, unlike real scientists, when gaps or contradictory evidence were observed they tried to confabulate explanations which supported the conclusion they already had rather than question it.
dionian(1)
I’m upvoting this comment simply because it’s factual, points out new information people may not know and leaves the implications to the reader.
What would be his ulterior motive? there's no money in it for him; ivermectin is dirt cheap and he doesn't produce it. If you think it is all reputational, then it would have been easier and better to salvage his reputation by just admitting his educated guess was wrong if it is in fact wrong, but more research was necessary to prove that. No one would fault him for that, and he knows that.
I think he is just sincerely convinced by the evidence and wants to help tackle the pandemic. He made multiple recommendations some of which got adopted as standard of care (ivermectin wasn't adopted), before any good research was done, simply because that was the best that could be done in a new pandemic. He has got a pretty good track record, even discounting ivermectin
Then again, there are also studies designed to undermine the evidence for off label treatments, such as the one about HCQ that was retracted from the Lancet. So if you are gonna question people's motives then at least question both sides. resistance to ivermectin may also be unscientific in nature. Pharma companies have a lot more riding on mass vaccination than Kory has on ivermectin
I think he is just sincerely convinced by the evidence and wants to help tackle the pandemic. He made multiple recommendations some of which got adopted as standard of care (ivermectin wasn't adopted), before any good research was done, simply because that was the best that could be done in a new pandemic. He has got a pretty good track record, even discounting ivermectin
Then again, there are also studies designed to undermine the evidence for off label treatments, such as the one about HCQ that was retracted from the Lancet. So if you are gonna question people's motives then at least question both sides. resistance to ivermectin may also be unscientific in nature. Pharma companies have a lot more riding on mass vaccination than Kory has on ivermectin
Well, they received 350k dollars in donations in 2020 alone.
I've also heard that they offer "consulting" to governments, such as in Brazil or India. Both used Ivermectin in their "Covid Kits". Didn't really work out, though.
>He made multiple recommendations some of which got adopted as standard of care (ivermectin wasn't adopted)
Shouldn't that show you that he might just be wrong on this one? If he was right, why wouldn't it be adopted?
>Then again, there are also studies designed to undermine the evidence for off label treatments, such as the one about HCQ that was retracted from the Lancet.
Do you have more info?
I've also heard that they offer "consulting" to governments, such as in Brazil or India. Both used Ivermectin in their "Covid Kits". Didn't really work out, though.
>He made multiple recommendations some of which got adopted as standard of care (ivermectin wasn't adopted)
Shouldn't that show you that he might just be wrong on this one? If he was right, why wouldn't it be adopted?
>Then again, there are also studies designed to undermine the evidence for off label treatments, such as the one about HCQ that was retracted from the Lancet.
Do you have more info?
$350K per year? 2 more years, and they'll cross Dr Evil's One. Million. Dollars. mark! Divide this between the several US medical professionals involved, and we're looking at life-changing payouts.
The formed the org in 2020. I'm willing to bet 2021 will have a great deal more donations. Their filings for 2021 are not yet out.
The Lancet study involved a company called Surgisphere claiming to have used ML techniques on massive datasets. Medical professionals questioned the findings and the startup founder responsible for the data refused to release it, citing confidentiality agreements, and is generally presumed to have fabricated it to generate publicity for his company. The coauthors requested its retraction. Needless to say, this study does not represent the basis for the medical profession concluding that HCQ does not work; large scale trials did that.
Ironically, it proves the exact opposite of what antivaxxers and alternate cure hypers claim it does: the medical profession was decisive about pulling apart bad studies opposing off label treatments even though it supported their supposition HCQ didn't work and was just hype; just like they've rushed to highlight the indications of likely falsified data in the preprint of this Invermectin study which of course the authors haven't retracted...
Ironically, it proves the exact opposite of what antivaxxers and alternate cure hypers claim it does: the medical profession was decisive about pulling apart bad studies opposing off label treatments even though it supported their supposition HCQ didn't work and was just hype; just like they've rushed to highlight the indications of likely falsified data in the preprint of this Invermectin study which of course the authors haven't retracted...
He has created a rather large social media presence, though I think he was booted from some platforms for perceived misinformation. They also accept donations on their website, and they list referrals to doctors on their website, not sure if there is any money exchanging hands there, although I think some of the members of the org are listed as doctor referrals.
But, not being wrong is a very powerful motivator. More powerful than money and power sometimes. I suspect he hitched his horse to the ivermectin wagon early on and has been looking for evidence to support it ever since while ignoring anything that hurts his narrative.
I have seen some of the stuff he has posted on social media in support of ivermectin and it was just woefully, obviously bunk. And I never see him respond to any of the criticism directly. It's just all a big conspiracy, oh, look over here, another thing that might support my theory...
But, not being wrong is a very powerful motivator. More powerful than money and power sometimes. I suspect he hitched his horse to the ivermectin wagon early on and has been looking for evidence to support it ever since while ignoring anything that hurts his narrative.
I have seen some of the stuff he has posted on social media in support of ivermectin and it was just woefully, obviously bunk. And I never see him respond to any of the criticism directly. It's just all a big conspiracy, oh, look over here, another thing that might support my theory...
In the us ivermectin is not cheap to take as a prophylactic.
https://m.goodrx.com/ivermectin
The vaccine is much, much cheaper.
https://m.goodrx.com/ivermectin
The vaccine is much, much cheaper.
It's not if this then that.
One is a preventative
One is a treatment.
Why is everyone so fucking broken.
One is a preventative
One is a treatment.
Why is everyone so fucking broken.
I'm given to understand it can be very helpful if you also have worms. It's good at fighting worms, that's what it is, and if you're comorbid with COVID and worms it makes pretty good sense :)
Beyond that, I suspect nah…
Beyond that, I suspect nah…
Casually announcing that everyone in this city has worms on the basis of zero evidence and deciding you can therefore ignore this paper is not the win you think it is.
"Everyone" is not necessary. That the only successful such studies are in areas with high incidences of Ivermectin-treatable parasitosis is a notable coincidence, isn't it?
Ivermectin failed in large studies with populations that didn't have worms.
Ivermectin failed in large studies with populations that didn't have worms.
Can you link a non-observational study that says so? I believe you may be conflating prophylactic and responsive medicine here.
https://ivmmeta.com provides an updated-weekly meta analysis following new publications and retractions showing significantly positive prophylactic efficacy over control in 83% of papers.
https://ivmmeta.com provides an updated-weekly meta analysis following new publications and retractions showing significantly positive prophylactic efficacy over control in 83% of papers.
Taking a look at the list of peer reviewed studies gives you a bunch of tiny, tiny population studies. I read a twitter thread from a researcher that was rather critical of the methods that site is using. Notice how the larger the study, the less effect ivm seems to have. Also, some of the largest studies actually show no or negative effect.
I think it is notable that you can go down the list of all the drugs on the right where they apply similar meta analysis to the treatments and they find that many drugs seem to be effective against covid. Even aspirin seems to treat covid effectively.
https://c19aspirin.com/meta.html
I think it is notable that you can go down the list of all the drugs on the right where they apply similar meta analysis to the treatments and they find that many drugs seem to be effective against covid. Even aspirin seems to treat covid effectively.
https://c19aspirin.com/meta.html
I don’t know why you were downvoted, so would like to add some support to this comment. Plenty of people on HN have seen this publication.
Probably Brazillian HNers. This subject became a matter of faith in Brazil.
FWIW for many it is also seems to be a matter of faith to proclaim that Ivermectin does not work, and this has been going on since the drug was first linked to the Trump camp.
The irrationality in this regard seems to match the irrationality of the concerns over masks in the pro Trump camp.
(I'm in the middle. Triple vaccinated, never took Ivermectin but find it really ugly that every single discussion about it ends in a flag, downvote and shouting competition that makes it impossible to find out what the facts are. The best I've found so far is Scott Alexanders findings but I guess there could be a lot more to learn if people weren't so busily either shouting or flaggind down the stories.)
The irrationality in this regard seems to match the irrationality of the concerns over masks in the pro Trump camp.
(I'm in the middle. Triple vaccinated, never took Ivermectin but find it really ugly that every single discussion about it ends in a flag, downvote and shouting competition that makes it impossible to find out what the facts are. The best I've found so far is Scott Alexanders findings but I guess there could be a lot more to learn if people weren't so busily either shouting or flaggind down the stories.)
^ 100%
> Ivermectin failed in large studies with populations that didn't have worms.
It has not really been studied as a prophylactic as in this study.
It has not really been studied as a prophylactic as in this study.
I had fiber internet installed a week ago. The installer and I got to talking about Covid. He said he got it and started suffering strong-but-not-hospitalish symptoms for about 2 weeks. He got ahold of Rx grade ivermectin and within 3 hours of ingesting started feeling better. His co-worker, who regularly works with cattle and administers ivermectin (getting it all over his skin inevitably), says he’s never had Covid. 2 small anecdata points, but I hear many other stories of its success and I wonder why people are so vehemently against its use.
i regularly handle doggie treats, because i have a good doggo, and i have never had covid.
the same is true for my wife. 2 small anecdata points.
if you'd like more information about our doggie treats, so as to start a prophylactic course of treatment, please let me know.
the same is true for my wife. 2 small anecdata points.
if you'd like more information about our doggie treats, so as to start a prophylactic course of treatment, please let me know.
Even if it did work, it wouldn't work within 3 hours. You probably also took a Tylenol or Advil at the same time. Or maybe it made you feel better later because you had some parasite.
Developing countries do have a higher prevalence of worms[1], as Scott Alexander discusses in his post[2] on the subject.
[1] https://journals.sagepub.com/doi/full/10.1177/20587392209599...
[2] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
[1] https://journals.sagepub.com/doi/full/10.1177/20587392209599...
[2] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
My point is that the claims in these studies are held to high standards by detractors, but when it comes to the critiques, just saying "developing countries have high prevalence of worms" is nowhere near that standard.
This is a much better take than what is being broadcast by the MSM. Ivermectin is not a dangerous drug in the dosages recommended.
By the MSM declaring Ivermectin to be dangerous, it makes their statements about the inefficiency seem suspect.
By the MSM declaring Ivermectin to be dangerous, it makes their statements about the inefficiency seem suspect.
I've taken their comments to be "Believing Ivermectin as a cure against covid is dangerous in the same sense that believing rubbing butter on your elbow is a cure against covid." (People turn down legit treatments, and are more lackadaisical about spreading it as they believe there is a universal cure)
Along with "Taking ivermectin in dosages at for the body weight of large animals puts people at high risk of overdose." (Which many people have done)
Both of those statements seem true to me.
Along with "Taking ivermectin in dosages at for the body weight of large animals puts people at high risk of overdose." (Which many people have done)
Both of those statements seem true to me.
>> is dangerous in the same sense that believing rubbing butter on your elbow is a cure against covid.
So we should follow the CDC recommended advice of not doing anything until it’s bad enough to be hospitalized as a good alternative?
>> Taking ivermectin in dosages at for the body weight of large animals puts people at high risk of overdose.
Are you talking about that single mass media article that was later completely retracted because it was discovered to have been completely made up, or are there other instances?
So we should follow the CDC recommended advice of not doing anything until it’s bad enough to be hospitalized as a good alternative?
>> Taking ivermectin in dosages at for the body weight of large animals puts people at high risk of overdose.
Are you talking about that single mass media article that was later completely retracted because it was discovered to have been completely made up, or are there other instances?
No, we should follow the CDC advice to get vaccinated, with well documented efficacy against COVID-19 mortality, rather than the popular alternative of not taking the vaccine but instead relying on self prescribing a medication thought only to be effective in treating a comorbidity you probably don't have.
> So we should follow the CDC recommended advice of not doing anything until it’s bad enough to be hospitalized as a good alternative?
I think the relevant alternative in this case might be getting vaccinated (which presumably the CDC recommends) which is sufficient to avoid hospitalisation in most cases. It's not everyone, but a lot of the people promoting ivermectin seem to be motivated by wanting to avoid the vaccine.
I think the relevant alternative in this case might be getting vaccinated (which presumably the CDC recommends) which is sufficient to avoid hospitalisation in most cases. It's not everyone, but a lot of the people promoting ivermectin seem to be motivated by wanting to avoid the vaccine.
Which CDC recommended advice are you referring to? In the USA our official treatment guidelines come from the NIH and they do recommend therapies for at least some patients prior to hospitalization.
https://www.covid19treatmentguidelines.nih.gov/
https://www.covid19treatmentguidelines.nih.gov/
Responsible media (what you call "MSM") doesn't say "Ivermectin" is dangerous.
It says it is dangerous to spread the lie that Ivermectin is useful in the treatment of Covid, especially over the proven methods and agents of prophylaxis and treatments.
You can't distinguish between "Ivermectin is dangerous" and "People took too much Ivermectin because they thought it cures Covid". Because the latter is true and happened a lot in the US. What also happens a lot in the US is that the same people who promote Ivermectin give a shit about proven vaccines, proven treatments and masks and so on.
It says it is dangerous to spread the lie that Ivermectin is useful in the treatment of Covid, especially over the proven methods and agents of prophylaxis and treatments.
You can't distinguish between "Ivermectin is dangerous" and "People took too much Ivermectin because they thought it cures Covid". Because the latter is true and happened a lot in the US. What also happens a lot in the US is that the same people who promote Ivermectin give a shit about proven vaccines, proven treatments and masks and so on.
The stories about large numbers of people overdosing ivermectin in the US were shown false both by a hospital reporting the doctor supposedly reporting the problem didn’t actually work for them as well as poison control center numbers being reported incorrectly.
Critique ivermectin but don’t do it my spreading misinformation.
Critique ivermectin but don’t do it my spreading misinformation.
Those stories were shown to be false by the MSM. The original story came from a local newspaper. http://web.archive.org/web/20210902202007/https://kfor.com/n...
CNN said it's not true. https://www.cnn.com/2021/09/07/politics/fact-check-oklahoma-... USA Today Fact Check rated the claim as false: https://www.usatoday.com/story/news/factcheck/2021/09/15/fac... AFP Fact Check false: https://factcheck.afp.com/http%253A%252F%252Fdoc.afp.com%252...
People often complain about mainstream media getting things wrong, but they generally overlook the fact that the editorless non-mainstream media gets far more stories wrong.
CNN said it's not true. https://www.cnn.com/2021/09/07/politics/fact-check-oklahoma-... USA Today Fact Check rated the claim as false: https://www.usatoday.com/story/news/factcheck/2021/09/15/fac... AFP Fact Check false: https://factcheck.afp.com/http%253A%252F%252Fdoc.afp.com%252...
People often complain about mainstream media getting things wrong, but they generally overlook the fact that the editorless non-mainstream media gets far more stories wrong.
The overdoses may have been exaggerated, but people taking the livestock version of ivm were not. You can talk to just about any livestock rancher and they can tell you how all the ivermectin suddenly became sold out everywhere soon after the narrative that it could treat covid went wide.
Just because a drug could treat pulmonary hypertension, doesn't mean it could not be effective at treating erectile dysfunction.
But there is a known reason why that drug works in both cases. The big issue with ivermectin is that there isn't any known mechanism that would help. Lab trials showed that the dosage required to kill the virus was far higher than a human would be able to take. So if it does work, it has to be through some unknown path.
Ivermectin is also apparently a potent protease inhibitor. Inhibition of protease sabotages viral replication. Does that change the picture for you?
Man, aren't people tired of reposting the same things?
This was only shown in a petri dish at very high concentrations. You could say the same about a number of chemicals which we also would not survive in that concentration.
I do not understand why people want Ivermectin to work so badly.
This was only shown in a petri dish at very high concentrations. You could say the same about a number of chemicals which we also would not survive in that concentration.
I do not understand why people want Ivermectin to work so badly.
As far as I can tell it's either a desire for a certain political team to be right, people wanting to be contrarian above all else, and a belief that if an authority says something is likely false it's a conspiracy.
Correct, but not for the reason you may think. As a non-American, I can tell you the only people around me who are really sure about this new unknown disease one way or other are those who follow the American news too much. They're really defensive about their positions as well well. It seems American media has nailed how to really brainwash the masses.
It seems to involve a story where they really shame some people for being stupid (the people don't actually have to be stupid, just should be presentable as such with loaded questions, clever editing... what have you) and then while the people are experiencing second hand embarassment for the person, feed them what they need to think to not be ridiculed in mass media like this. This seems to work way too well and it seems they use it ALL THE TIME. Almost every "comedy news show" or opinion piece seems to be formatted like this.
It seems to involve a story where they really shame some people for being stupid (the people don't actually have to be stupid, just should be presentable as such with loaded questions, clever editing... what have you) and then while the people are experiencing second hand embarassment for the person, feed them what they need to think to not be ridiculed in mass media like this. This seems to work way too well and it seems they use it ALL THE TIME. Almost every "comedy news show" or opinion piece seems to be formatted like this.
Exactly.
> I do not understand why people want Ivermectin to work so badly.
In Brazil, ivermectin working means the president was right. That's why there is such a big effort in Brazil to make it work.
In Brazil, ivermectin working means the president was right. That's why there is such a big effort in Brazil to make it work.
And India.
> You could say the same about a number of chemicals which we also would not survive in that concentration.
Yeah, look at AZT as an example.
Yeah, look at AZT as an example.
Sadly, I do.
Even if it was, (I don't know why you believe that), protease inhibitors need to match the enzymes a virus uses.
It would be very odd and surprising if a pharmaceutical with a completely different mechanism and purpose would just happen to inhibit coronavirus proteases.
It would be very odd and surprising if a pharmaceutical with a completely different mechanism and purpose would just happen to inhibit coronavirus proteases.
It's not potent against SARS-CoV-2 though. Here's a comparison with the Pfizer drug: https://www.acsh.org/news/2021/12/02/how-does-pfizers-paxlov...
Not at dosages a Human would survive.
Protease inhibitors are amazingly powerful, but also very difficult to make work in practice. Many protease inhibitors have been developed and abandoned.
At what IC50?
You’re describing use as an antiviral, comparable to paxlovid. I don’t think that is the proposed mechanism for this prophylactic ivermectin treatment.
If you have a reference you could share, that would be helpful.
> Ivermectin does inhibit the same protease that PF-07321332 does, but, as is the case for viral replication, it requires a concentration that is not achievable by oral dosing.
https://sciencebasedmedicine.org/pfizer-new-covid-19-proteas...
If you have a reference you could share, that would be helpful.
> Ivermectin does inhibit the same protease that PF-07321332 does, but, as is the case for viral replication, it requires a concentration that is not achievable by oral dosing.
https://sciencebasedmedicine.org/pfizer-new-covid-19-proteas...
What's the problem with that? Pfizer and their friends have everything riding on the idea that it never ends, none of the cheap treatments work and the only solution is to slow the spread (so that it stays around for longer) while vaccinating everyone frequently... and they are only motivated by profits.
Vaccines are far less profitable than most of their other drugs. If they were looking to get rich, they'd want something like the HIV inhibitors where each patient is buying from them on a frequent basis.
Vaccines can potentially be mandated for entire populations and funded by the US taxpayer for distribution around the world and require adjustments several times per year. The development of new related vaccines of this type is apparently quite cheap and straightforward (this was boasted about at various points over the last few years) and vaccines are also pretty unique in the way that manufacturers can effectively be immune from liability. Add in the magic word Pandemic, with careful orchestration from public health authorities and politicians I think you can have a dream combination of volume, revenue and commercial risk limitation.
Yes, as a person with a medical history of immune system disorder triggered by a vaccine, I am repeatedly astonished that the medical system and government keep claiming things we don't yet have data for, and trying to force _everyone_ to take these vaccines for which there is no legal recourse. The vaccine that gave me an auto-immune reaction is part of the established system that will allow some compensation to some victims. These new vaccines are too new, and not yet even eligible to be listed there, and so if your immune system reacts to one of the new vaccines by attacking your own body, it's not even eligible to be legally considered to give you compensation. But they're safe. Everyone should have them. Lucky you if it ruins your body or life.
I'm not sure that the distinction means much. I don't think anyone has been able to successfully collect anything from that compensation fund offered by the government in decades.
Also, those compensation schemes are run by the government. And it's worth mentioning that a lot of the research and development costs are borne by government departments as well (eg. via Fauci), but the IP is retained by those private companies. With which there is a revolving door of personnel from government and regulatory bodies. And that's before we get into the potential for vaccinations to be suppressing people's innate immunity and creating a raft of new medical conditions that would in turn require new pharmaceuticals to be developed.
Also those new pharma billionaires in the past two years say it's pretty lucrative.
The best meta-study review of Ivermectin I've seen was done by Scott Alexander [0]. He individually reviewed a few dozen studies. His take was that Ivermectin is an effective dewormer that is useful as a prophylactic when people are widely exposed to worms. Because they don't catch worms, they're in better shape to fight Covid when infected. However Ivermectin has no effect in most developed countries where the general population isn't subject to worm infections.
[0] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
[0] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
I would also read ivmmeta's response [0] and his reply [1] .
At first I walked away fairly confident at what I had read. Later when I came across the responses, things got more uncertain. The example which quickly comes to mind is that most if not all the prophylaxis studies were not reviewed in Scott's analysis.
[0] https://ivmmeta.com/#sa
[1] https://astralcodexten.substack.com/p/higlights-from-the-com...
At first I walked away fairly confident at what I had read. Later when I came across the responses, things got more uncertain. The example which quickly comes to mind is that most if not all the prophylaxis studies were not reviewed in Scott's analysis.
[0] https://ivmmeta.com/#sa
[1] https://astralcodexten.substack.com/p/higlights-from-the-com...
The Covid therapeutic and prophylactic literature has been chock full of crap studies, so you really have to be careful taking meta analysis at face value.
Some interesting discussion on this, which includes the prophylactic literature:
https://www.nature.com/articles/s41591-021-01535-y
Some interesting discussion on this, which includes the prophylactic literature:
https://www.nature.com/articles/s41591-021-01535-y
Same issue with relying on single studies, you might rely on a crap one.
Except that ivermectin has been used as antiviral well before the pandemic though. I'm not sure why people assume that doctors tried just random drugs without any rationale behind it!
He also describes one of Cadegiani's other studies with some helpful color.
I eagerly await the double-blind randomized studies that prove Scott Alexander to be correct!8-))
This is the same as posted a week ago.
The answer is the same: COVID outcomes are better without parasites. If you don't have worms, ivermectin will not help you.
The answer is the same: COVID outcomes are better without parasites. If you don't have worms, ivermectin will not help you.
Scott Alexander did some analysis of metastudy of various ivermectin studies, and came to the same conclusion.
https://astralcodexten.substack.com/p/ivermectin-much-more-t...
https://astralcodexten.substack.com/p/ivermectin-much-more-t...
Bookmarking this.
Would be interested in your response to this.
https://www.medrxiv.org/content/10.1101/2021.02.02.21250995v...
> Conclusion Our results suggest that co-infection with parasitic co-infection appears to be associated with reduced COVID-19 severity. The results suggest that parasite-driven immunomodulatory responses may mute hyperinflammation associated with severe COVID-19.
https://www.medrxiv.org/content/10.1101/2021.02.02.21250995v...
> Conclusion Our results suggest that co-infection with parasitic co-infection appears to be associated with reduced COVID-19 severity. The results suggest that parasite-driven immunomodulatory responses may mute hyperinflammation associated with severe COVID-19.
Modulating cytokine storms could be expected to result in better outcomes.
Is a worm infection the best, or a good, way to do that? If ivermectin produces better outcomes where worms are common, the reasonable guess would be "no".
Is a worm infection the best, or a good, way to do that? If ivermectin produces better outcomes where worms are common, the reasonable guess would be "no".
Maybe you should have put this qualified opinion in your original post, since you seemed to imply that you knew that parasites always led to worse outcomes.
Let's be clear, this is a speculative conclusion for Ivermectin's effect, and not at all proven.
It's interesting because it almost makes both political sides (yes, this is politics now) actually true. Ivermectin doesn't work. This is true. But it might reduce covid mortality in many third world countries, which are the studies the so called anti vaxxers claimed. They are also correct.
So... can we just say everyone was right, and maybe start killing worms across the world?
So... can we just say everyone was right, and maybe start killing worms across the world?
By the evidence, we could reasonably deduce that people who make decisions in rich countries don't give a crap about poor peoples' parasite infections or anything else, but would anyway like them to please limit breeding of new virus variants that might get back to infect rich people.
Thus, they subsidize expensive vaccines, but not cheap vermicides. But not really even enough of the vaccines. As it becomes clear that herd immunity is impossible (because of animal reservoirs, and because they provide too little vaccine anyway) I expect vaccine help to trail off.
Meanwhile, rich countries' mortality from complications of sugar overdosing absolutely dwarfs COVID-19's, but nothing can be done about that without affecting profits.
Thus, they subsidize expensive vaccines, but not cheap vermicides. But not really even enough of the vaccines. As it becomes clear that herd immunity is impossible (because of animal reservoirs, and because they provide too little vaccine anyway) I expect vaccine help to trail off.
Meanwhile, rich countries' mortality from complications of sugar overdosing absolutely dwarfs COVID-19's, but nothing can be done about that without affecting profits.
No. It's not that clear.
> If you don't have worms, ivermectin will not help you
This makes sense and is supported by some data.
> COVID outcomes are better without parasites
This dramatically understates interactions in the immune system. I can go into a longer essay, but:
1) Parasites suppress the immune system (they release chemicals to moderate immune response; otherwise, the immune system would destroy them)
2) There is some evidence that the immune system evolved to operate when suppressed by worms. Autoimmune diseases and allergies may be a symptom of worm-free life.
3) Most of the damage from COVID19 comes from the immune system and not the disease (that's true of most diseases, for that matter).
4) ... and so on.
We have absolutely no idea how ivermectin, worms, and COVID interact. It's too complex a system.
> If you don't have worms, ivermectin will not help you
This makes sense and is supported by some data.
> COVID outcomes are better without parasites
This dramatically understates interactions in the immune system. I can go into a longer essay, but:
1) Parasites suppress the immune system (they release chemicals to moderate immune response; otherwise, the immune system would destroy them)
2) There is some evidence that the immune system evolved to operate when suppressed by worms. Autoimmune diseases and allergies may be a symptom of worm-free life.
3) Most of the damage from COVID19 comes from the immune system and not the disease (that's true of most diseases, for that matter).
4) ... and so on.
We have absolutely no idea how ivermectin, worms, and COVID interact. It's too complex a system.
We have some idea, just nothing very solid.
There are lots of different parasitic worms -- maybe of more species than we have mammals -- and lots of places they infest, to lots of different degrees. That outcomes in certain places where worms are a problem seem better with vermicidal treatment suggests the net effect of, anyway, heavy infestations seen in, anyway, those places is negative.
I see a recent report that "long COVID" looks like a result of COVID stimulating expression of ancient retroviral genes long after the primary COVID infection has been suppressed.
COVID keeps on giving.
There are lots of different parasitic worms -- maybe of more species than we have mammals -- and lots of places they infest, to lots of different degrees. That outcomes in certain places where worms are a problem seem better with vermicidal treatment suggests the net effect of, anyway, heavy infestations seen in, anyway, those places is negative.
I see a recent report that "long COVID" looks like a result of COVID stimulating expression of ancient retroviral genes long after the primary COVID infection has been suppressed.
COVID keeps on giving.
So it eliminates a possible comorbidity. But you don't know, unlike other comorbidities which are known.
Are worms really that common?
In undeveloped countries.
Ascariasis: 800- 1.2 billion worldwide
https://www.cdc.gov/parasites/ascariasis/index.html
Strongyloides: 100 million
https://www.cdc.gov/parasites/strongyloides/epi.html
Cystercicosis: 50-100 million
https://pubmed.ncbi.nlm.nih.gov/25296005/
Ascariasis: 800- 1.2 billion worldwide
https://www.cdc.gov/parasites/ascariasis/index.html
Strongyloides: 100 million
https://www.cdc.gov/parasites/strongyloides/epi.html
Cystercicosis: 50-100 million
https://pubmed.ncbi.nlm.nih.gov/25296005/
Well that's another sad fact about the developing world. It sounds like treating underlying heath problems before getting COVID is a good idea in the developing world.
Treating underlying health problems exceeded their resources, many places, even before COVID. COVID has not made it easier.
Yes, particularly in India [1], and other countries with widespread poverty. Given that, it's not surprising that the promising Ivermectin studies came out of such countries - most Western researchers at the time simply didn't know, think or care about parasite prevalence as an explanation and the general public has even less knowledge as parasitic infections are incredibly rare in developed countries. And by the time it became clear, too many people already had jumped on the hype train.
[1]: https://ciff.org/news/worms-india-scale-and-success-world-le...
[1]: https://ciff.org/news/worms-india-scale-and-success-world-le...
Yes. In Brazil specially.
If that was true, wouldn't other anti-helminitics show the same effect ?
They might! But few seem very interested in others.
[deleted]
Yeah, this was a known conclusion. Parasitic infection is a comorbidity of Covid and ivermectin is very effective against parasites.
https://healthfeedback.org/claimreview/ivermectin-study-itaj...
Seems like this study may have some methodological issues.
Seems like this study may have some methodological issues.
I read this. I am no epidemiologist but it does seem like a pretty weak critique.
The core of this critique is that ivermectin may not have been used consistently among the treatment group, therefore negative results may be masked, or confounding variables may be present.
It seems that ivermectin is generally known to be safe drug for use to treat other antiviral conditions. Is the critic calling that into question? I would expect more evidence for that claim.
Furthermore every science experiment can have confounding variables, so yeah. Even in that case I would expect more of a curious response as 66% reduction in hospitalization at very low p-value is very significant. What could the confounding variables be? Could they be surveyed?
The authors of the article did look into some confounding variables and did find that people more at risk of covid self selected to be in the ivermectin group.
I would like more info about all this. I don't think it's as simple as "bad study move on".
The core of this critique is that ivermectin may not have been used consistently among the treatment group, therefore negative results may be masked, or confounding variables may be present.
It seems that ivermectin is generally known to be safe drug for use to treat other antiviral conditions. Is the critic calling that into question? I would expect more evidence for that claim.
Furthermore every science experiment can have confounding variables, so yeah. Even in that case I would expect more of a curious response as 66% reduction in hospitalization at very low p-value is very significant. What could the confounding variables be? Could they be surveyed?
The authors of the article did look into some confounding variables and did find that people more at risk of covid self selected to be in the ivermectin group.
I would like more info about all this. I don't think it's as simple as "bad study move on".
That's one of several critiques of the study; others includes the fact that it's not controlled for confounders, that the city in question had the highest COVID mortality in its state during the program, and that several of the study authors have either conflicts, bad reputations, or both. The Twitter link itself links to even more damning critiques, including some evidence of falsified data.
I read the city had high mortality from the beginning of the pandemic[0]. Would it be a bad case if the population happens to be more aged etc?
Is the falsified data just the off by one in deaths among the under 30 cohort or is there more?[1]
[0]: https://mobile.twitter.com/sean_purdy/status/147041652307654...
[1]: https://mobile.twitter.com/GidMK/status/1478975913094090752
Is the falsified data just the off by one in deaths among the under 30 cohort or is there more?[1]
[0]: https://mobile.twitter.com/sean_purdy/status/147041652307654...
[1]: https://mobile.twitter.com/GidMK/status/1478975913094090752
[0] could also be due to a high incidence of worms in the population.
> that the city in question had the highest COVID mortality in its state during the program
This is not a critique of the study really. The high mortality could be due to other factors, like an older population or less careful application of other COVID mitigations. If the latter, this study would actually be a good test case for prophylactic Ivermectin actually because the signal from any effect would be stronger.
This is not a critique of the study really. The high mortality could be due to other factors, like an older population or less careful application of other COVID mitigations. If the latter, this study would actually be a good test case for prophylactic Ivermectin actually because the signal from any effect would be stronger.
> That's one of several critiques of the study; others include[] . . . that several of the study authors have either conflicts, bad reputations, or both.
That is not a valid critique of the study. It is a potentially valid reason to adjust your Bayesian priors applicable before reading the study, but is utterly nobprobative as to whether the science is sound.
That is not a valid critique of the study. It is a potentially valid reason to adjust your Bayesian priors applicable before reading the study, but is utterly nobprobative as to whether the science is sound.
Agreed. When Pfizer studies the effectiveness of their vaccine, they also have conflicts. That doesn't impugn the results of the study, if it's well done.
No, it is a critique.
When Pfizer does it it is a critique as well.
The question is how much of a critique.
In general…
If you are dishonest about your conflict, you hide it, don’t do anything to control for it then having a conflict is a bigger critique.
If you are transparent about your conflict, honest about what it is, and take measures to control for it or add extra steps to analysis to prevent potential bias - then a conflict is a less strong critique of the study.
Critique in scientific research isn’t a binary. It isn’t “there’s one critique and it’s valid or not and if it’s valid the study is bad”. There can be critiques of ANY study. No study is perfect. But the types and the details of the critiques matter collectively to make the study better or worse.
Collectively, this study falls to the worse end. It’s not just the conflict of interest it’s the conflict of interest + the study design. The critiques of the study design are that this study is design almost exactly the way you would if you wanted to increase the appearance of effectiveness of this treatment.
When Pfizer does it it is a critique as well.
The question is how much of a critique.
In general…
If you are dishonest about your conflict, you hide it, don’t do anything to control for it then having a conflict is a bigger critique.
If you are transparent about your conflict, honest about what it is, and take measures to control for it or add extra steps to analysis to prevent potential bias - then a conflict is a less strong critique of the study.
Critique in scientific research isn’t a binary. It isn’t “there’s one critique and it’s valid or not and if it’s valid the study is bad”. There can be critiques of ANY study. No study is perfect. But the types and the details of the critiques matter collectively to make the study better or worse.
Collectively, this study falls to the worse end. It’s not just the conflict of interest it’s the conflict of interest + the study design. The critiques of the study design are that this study is design almost exactly the way you would if you wanted to increase the appearance of effectiveness of this treatment.
> Is the critic calling that into question?
Are they?
> The core of this critique is that ivermectin may not have been used consistently among the treatment group, therefore negative results may be masked, or confounding variables may be present.
Yes.
> I would like more info about all this. I don't think it's as simple as "bad study move on".
Ok:
https://twitter.com/GidMK/status/1425297498042556423
Or was that not the info you meant?
Are they?
> The core of this critique is that ivermectin may not have been used consistently among the treatment group, therefore negative results may be masked, or confounding variables may be present.
Yes.
> I would like more info about all this. I don't think it's as simple as "bad study move on".
Ok:
https://twitter.com/GidMK/status/1425297498042556423
Or was that not the info you meant?
The main point of the critique, that people didn't take it consistently, is actually strengthening the study, isn't it? Even with only a partial treatment, you still see a significant effect.
(Having said that, I don't think there's much evidence for Ivermectin overall, but this specific critique of the study seems weak.)
(Having said that, I don't think there's much evidence for Ivermectin overall, but this specific critique of the study seems weak.)
Not quite.
My wife’s an epidemiologist (and a damn grouchy methods person…I get yelled at about study design A LOT).
Her first check on any study like this is the denominator of different groups because that drives your results.
This study has sketchy as hell denominators. They artificially inflate the denominator of the ivermectin group while also shifting infections to the non ivemecrim group…that skews the infection statistics by increasing the denominator artificially.
The critique is basically saying “you are using the 139k people who said ‘sure’ when offered drugs as the denominator and you shouldn’t”
If 75% of those people didn’t take the dang drugs (that’s a hypothetical not a claim). Then you 44% decrease in infections evaporates.
This is terrible study design because of how they grouped people. They didn’t do follow up they didn’t ask whether people took the drugs (from what I can see) they didn’t have a placebo group of any form…they just offered people drugs and used those numbers to draw broad conclusions.
My wife’s an epidemiologist (and a damn grouchy methods person…I get yelled at about study design A LOT).
Her first check on any study like this is the denominator of different groups because that drives your results.
This study has sketchy as hell denominators. They artificially inflate the denominator of the ivermectin group while also shifting infections to the non ivemecrim group…that skews the infection statistics by increasing the denominator artificially.
The critique is basically saying “you are using the 139k people who said ‘sure’ when offered drugs as the denominator and you shouldn’t”
If 75% of those people didn’t take the dang drugs (that’s a hypothetical not a claim). Then you 44% decrease in infections evaporates.
This is terrible study design because of how they grouped people. They didn’t do follow up they didn’t ask whether people took the drugs (from what I can see) they didn’t have a placebo group of any form…they just offered people drugs and used those numbers to draw broad conclusions.
> I am no epidemiologist
Thank you for adding that, didn't have to read any further.
Thank you for adding that, didn't have to read any further.
Ivermectin and other anthelmintics (mebendazole, febendazole) are showing quite a bit of promise in cancer therapy. It’s been a while since I looked at it but if I recall correctly at least one mechanism of action is to promote (well, unsuppress) autophagy in diseased cells.
Regarding one of the principal authors:
>Brazil’s attorney general is investigating the possible violations of medical ethics and human rights on the recommendation of the National Research Ethics Commission (CONEP), which forms part of the CNS. The trial’s principal investigator, Flavio Cadegiani, was identified in October along with 68 others by a parliamentary inquiry into Brazil’s management of the pandemic as having committed “crimes against humanity.”
https://www.bmj.com/content/375/bmj.n2819
>Brazil’s attorney general is investigating the possible violations of medical ethics and human rights on the recommendation of the National Research Ethics Commission (CONEP), which forms part of the CNS. The trial’s principal investigator, Flavio Cadegiani, was identified in October along with 68 others by a parliamentary inquiry into Brazil’s management of the pandemic as having committed “crimes against humanity.”
https://www.bmj.com/content/375/bmj.n2819
Parasitic diseases are highly prevalent in Brazil [1].
Also, as quoted in [2], "Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases."
It seems strange that the referenced study did not consider the possible confounding factor of parasitic infection.
[1] https://pubmed.ncbi.nlm.nih.gov/34105625/ [2] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
Also, as quoted in [2], "Helminth [ie worm] infections are among the most common infectious diseases. Bradbury et al. highlight the possible negative interactions between helminth infection and COVID-19 severity in helminth-endemic regions and note that alterations in the gut microbiome associated with helminth infection appear to have systemic immunomodulatory effects. It has also been proposed that helminth co-infection may increase the morbidity and mortality of COVID-19, because the immune system cannot efficiently respond to the virus; in addition, vaccines will be less effective for these patients, but treatment and prevention of helminth infections might reduce the negative effect of COVID-19. During millennia of parasite-host coevolution helminths evolved mechanisms suppressing the host immune responses, which may mitigate vaccine efficacy and increase severity of other infectious diseases."
It seems strange that the referenced study did not consider the possible confounding factor of parasitic infection.
[1] https://pubmed.ncbi.nlm.nih.gov/34105625/ [2] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
Cool. This makes sense as a confounding factor.
For what it's worth, Itajai in southeastern region Brazil has the lowest rate of parasitic infections among the regions at 37%. (your [1])
Probably can't be equated this easily, but 37% could make up a significant chunk of the purported 66% reduction in hospitalizations.
For what it's worth, Itajai in southeastern region Brazil has the lowest rate of parasitic infections among the regions at 37%. (your [1])
Probably can't be equated this easily, but 37% could make up a significant chunk of the purported 66% reduction in hospitalizations.
This still demands investigation. The main issue is that the dosage known to be effective is higher than the dosage known to be safe. It could be that this consistent ongoing use regimen helped by increasing the tolerable concentration or boosting the effects or both.
> the dosage known to be effective is higher than the dosage known to be safe.
This is misleading a little. Only the high dose was tested in cell cultures. That does not mean that low doses are not also very effective.
In the lab, they usually use very high doses to confirm that there is any effect at all. A second set of experiments (not done yet) then calibrate to discover the minimum effective dose.
This is misleading a little. Only the high dose was tested in cell cultures. That does not mean that low doses are not also very effective.
In the lab, they usually use very high doses to confirm that there is any effect at all. A second set of experiments (not done yet) then calibrate to discover the minimum effective dose.
Cadegiani is part of the "medicos pela Vida" a Brazillian group advocating "tratamento precoce/inicial/integral". The pandemic had an hilarious course in Brazil and there are doctors indicating medicines based on their political views.
Brazil health ministry published an on-line service which suggested HCQ for newborn infants and recently they published a table putting HCQ as better than vaccines.
Beaware of Brazillian studies related to ivermectin and HCQ.
Brazil health ministry published an on-line service which suggested HCQ for newborn infants and recently they published a table putting HCQ as better than vaccines.
Beaware of Brazillian studies related to ivermectin and HCQ.
Oh, you mean Cadegiani, the same "crazy person [that] decided to put his patients on every weird medication he could think of [... and] helpfully designated some random patients in his area as a sort-of-control, and then synthetically generated a second control group"[1]? Who would have thought?
[1] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
[1] https://astralcodexten.substack.com/p/ivermectin-much-more-t...
Key points
> 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users
> In the absence of contraindications, ivermectin was offered as an optional treatment to be taken for two consecutive days every 15 days at a dose of 0.2 mg/kg/day. In cases where a participating citizen of Itajaí became ill with COVID-19, they were recommended not to use ivermectin or any other medication in early outpatient treatment
> There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95% CI, 0.31-0.63; p < 0.0001). After adjustment for residual variables, reduction in hospitalization rate was 67% (RR, 0.33; 95% CI, 023-0.66; p < 0.0001).
> Missing data from patients were clarified with patients or relatives directly, via phone or in person, by the investigators. Since this is a citywide program, all recorded data must have matched the exact number of COVID-19 cases and deaths of the city.
> An important conservative bias was present. Major risk factors for severe COVID-19 and mortality due to COVID-19, including aging, diabetes, and hypertension, were more present among ivermectin users, which may have underestimated the benefits of ivermectin
The only questionable part of this I can find is a small unfounded semi negative comment about vaccines near the end.
> lack of effectiveness of vaccines in real-life all-cause mortality analyses to date
Vaccines correlate with 5.6x reduction in hospitalization and 12x reduction in ICU cases in Ontario as of today (Jan 22 2022) so not sure where that comes from.
However their results still seem pretty clear that ivermectin helps.
I'm curious if ivermectin and vaccines compound in effectiveness. 2x effective prevention could speed things up a lot.
> 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users
> In the absence of contraindications, ivermectin was offered as an optional treatment to be taken for two consecutive days every 15 days at a dose of 0.2 mg/kg/day. In cases where a participating citizen of Itajaí became ill with COVID-19, they were recommended not to use ivermectin or any other medication in early outpatient treatment
> There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95% CI, 0.31-0.63; p < 0.0001). After adjustment for residual variables, reduction in hospitalization rate was 67% (RR, 0.33; 95% CI, 023-0.66; p < 0.0001).
> Missing data from patients were clarified with patients or relatives directly, via phone or in person, by the investigators. Since this is a citywide program, all recorded data must have matched the exact number of COVID-19 cases and deaths of the city.
> An important conservative bias was present. Major risk factors for severe COVID-19 and mortality due to COVID-19, including aging, diabetes, and hypertension, were more present among ivermectin users, which may have underestimated the benefits of ivermectin
The only questionable part of this I can find is a small unfounded semi negative comment about vaccines near the end.
> lack of effectiveness of vaccines in real-life all-cause mortality analyses to date
Vaccines correlate with 5.6x reduction in hospitalization and 12x reduction in ICU cases in Ontario as of today (Jan 22 2022) so not sure where that comes from.
However their results still seem pretty clear that ivermectin helps.
I'm curious if ivermectin and vaccines compound in effectiveness. 2x effective prevention could speed things up a lot.
They don't even know who took ivermectin. The city they studied the ivermectin protocol in had the highest rate of COVID mortalities in the state during the ivermectin protocol. Here's a long Twitter thread shredding this research (read to the end and follow the links, it gets more damning as it goes).
https://twitter.com/GidMK/status/1471320883461378048
https://twitter.com/GidMK/status/1471320883461378048
>They don't even know who took ivermectin.
It's worse than that. The city distributed the tablets and so they know how many participants came in and picked them up. Apparently, the study claims that around 200k people took the tablets, but only 136k picked up the tablets. Then after 2 weeks, only 95k picked up their next set of pills. Then by half way through the period studied in this paper, only 8k people picked up their medicine. None of that is noted in the study. That would appear to completely invalidate the whole study.
https://twitter.com/sean_purdy/status/1470410070819319809?t=...
It's worse than that. The city distributed the tablets and so they know how many participants came in and picked them up. Apparently, the study claims that around 200k people took the tablets, but only 136k picked up the tablets. Then after 2 weeks, only 95k picked up their next set of pills. Then by half way through the period studied in this paper, only 8k people picked up their medicine. None of that is noted in the study. That would appear to completely invalidate the whole study.
https://twitter.com/sean_purdy/status/1470410070819319809?t=...
I would like to know whether the people took ivermectin or not maybe via survey. The drug was very popular in Brazil, I don't imagine people would be absolutely required to go to the certain place to pick it up.
I would love to see more studies and research. But unfortunately there seems to be somewhat of "science hesitancy" for certain therapeutics.
I think there is only hesitancy because resources are limited and there are thousands of drugs out there to try. IVM has already received far more attention and resources that it likely deserves and there are lots of other drugs to study and other diseases to cure.
[deleted]
Thanks. Not sure if this critique counts as shredding. It's mostly A) needs to meet XYZ higher quality bar B) small mistakes in computations.
In this world anything can be put to a higher bar and small mistakes are expected.. etc
Is anyone aware of any ivermectin study which meets the quality bar, has no mistakes and concludes that it doesn't work? That would shred the paper to me.
As the critic you link says
> It might be useful as the very first piece of research into a medication
I wonder if/how the 2nd study will happen.
In this world anything can be put to a higher bar and small mistakes are expected.. etc
Is anyone aware of any ivermectin study which meets the quality bar, has no mistakes and concludes that it doesn't work? That would shred the paper to me.
As the critic you link says
> It might be useful as the very first piece of research into a medication
I wonder if/how the 2nd study will happen.
I'm not sure a study reporting no under 30 patient deaths in one column and under 30 patient deaths in the treated data is a "small mistake" in a study of patient mortality...
They went to all the trouble to create a huge trial and didn’t make it double-blind, placebo controlled? That is so suspect. We know how to create good experiments, so I just have little trust in bad experiments, especially at this scale.
I don’t care what the outcome is, treatments are treatments. I have no hope for a particular outcome. It’s just bad science. And I might argue bad faith science.
Potential biases: for instance in Brazil there is a very high level of prior Covid infections. What I’d previously infected people were more likely to opt in to treatment bc they are more afraid of reinfection, and the result came from reduction due to prior immunity? What if people that took the Medecine behaved differently than non-takers?
I don’t care what the outcome is, treatments are treatments. I have no hope for a particular outcome. It’s just bad science. And I might argue bad faith science.
Potential biases: for instance in Brazil there is a very high level of prior Covid infections. What I’d previously infected people were more likely to opt in to treatment bc they are more afraid of reinfection, and the result came from reduction due to prior immunity? What if people that took the Medecine behaved differently than non-takers?
The authors didn't "create a huge trial". This was just an observational study. While observational studies are less powerful than randomized controlled trials they're not necessarily bad science. Much of our current knowledge in other areas of medicine came from observational studies.
While this study is rather weak and doesn't give us any really definitive results it is a useful data point that can be rolled into future meta analyses.
While this study is rather weak and doesn't give us any really definitive results it is a useful data point that can be rolled into future meta analyses.
Are you sure?
> Results: Of the 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis: 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users.
That reads to me like 160k people participated, and 113k optionally choose to take Ivermectin as prophylaxis.
Am I missing something ?
> Results: Of the 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis: 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users.
That reads to me like 160k people participated, and 113k optionally choose to take Ivermectin as prophylaxis.
Am I missing something ?
I'm inclined to agree, but I must ask: Would you have the same standards when it comes to the vaccines?
I'm not aware of any double-blind placebo-controlled trial that is powerful enough to determine risk reduction for death or severe disease in vaccines, much less over several months.
I'm not aware of any double-blind placebo-controlled trial that is powerful enough to determine risk reduction for death or severe disease in vaccines, much less over several months.
I'm not sure I understand your statement https://www.nejm.org/doi/full/10.1056/nejmoa2035389 showed an absurdly large effect in a controlled blinded trial which was at least part of the reason emergency approval was granted.
Yes, we did observe a large effect within the first months in an immunocompetent middle-aged population, but as we all know now, that effect doesn't last very long. The placebo group has been unblinded and vaccinated, so we wouldn't know how they fared in the long run.
> but as we all know now, that effect doesn't last very long.
What, precisely, do you think we know? The vaccines were tested against the first strain so it's not surprising that they lost effectiveness at preventing infection entirely against variants like Omicron with significantly greater immune evasion but even there we still see massive benefits against severe cases. The current performance of the mRNA vaccines against Omicron is still better than many people cautioned would considered a good result for the first iteration of a vaccine created for a new virus.
What, precisely, do you think we know? The vaccines were tested against the first strain so it's not surprising that they lost effectiveness at preventing infection entirely against variants like Omicron with significantly greater immune evasion but even there we still see massive benefits against severe cases. The current performance of the mRNA vaccines against Omicron is still better than many people cautioned would considered a good result for the first iteration of a vaccine created for a new virus.
Consistent waning of efficacy against infection over time has been observed regardless of variants[1].
At the same time, we didn't see "massive benefit" against severe cases in breakthrough infections in a matched cohort study[2]. This leads me to suspect that current statistical observations do not reflect reality and may well be artifacts. Paradoxically, we're also observing increased odds of Omikron infection after (two dose) vaccination.
Furthermore, we're administering boosters even to teenagers based on good faith, not good science. Hence, there still is a need for placebo-controlled trials.
[1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410
[2] https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v...
At the same time, we didn't see "massive benefit" against severe cases in breakthrough infections in a matched cohort study[2]. This leads me to suspect that current statistical observations do not reflect reality and may well be artifacts. Paradoxically, we're also observing increased odds of Omikron infection after (two dose) vaccination.
Furthermore, we're administering boosters even to teenagers based on good faith, not good science. Hence, there still is a need for placebo-controlled trials.
[1] https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3949410
[2] https://www.medrxiv.org/content/10.1101/2021.10.26.21265508v...
New study out today shows that COVID vaccines reduce the risk of death from Omicron by 95%.
https://www.wsj.com/articles/covid-19-vaccine-booster-shot-c...
https://www.wsj.com/articles/covid-19-vaccine-booster-shot-c...
This is exactly the sort of weak observational data that I am suspicious of. That same data[1] also shows that the vaccinated are much more likely to get infected, which means either the vaccine actually enhances infectivity, or the two groups are so poorly matched that they can't be compared at all. Either way, the data is weak.
If you look at the matched cohort study I linked, vaccine efficacy against severe outcome isn't anywhere near 90%, but rather 30%-50%. If the vaccine then also fails to protect against infection, as it does with Omikron, it couldn't possibly have 95% efficacy against severe disease. What could explain this discrepancy, other than statistical shenanigans?
[1] https://assets.publishing.service.gov.uk/government/uploads/...
If you look at the matched cohort study I linked, vaccine efficacy against severe outcome isn't anywhere near 90%, but rather 30%-50%. If the vaccine then also fails to protect against infection, as it does with Omikron, it couldn't possibly have 95% efficacy against severe disease. What could explain this discrepancy, other than statistical shenanigans?
[1] https://assets.publishing.service.gov.uk/government/uploads/...
"These raw data should not be used to estimate vaccine effectiveness..."
You forgot to read this part of your source when making your cherry-picked anti-vax argument.
You forgot to read this part of your source when making your cherry-picked anti-vax argument.
[deleted]
As far as I know this was explained away with - it's too urgent and it's not ethical to have placebo controlled vaccine trials at this time, since everyone will contract covid. So we didn't have any.
The clinical trials were placebo controlled, see the sibling comment for a reference to the results, or look up the protocols on clinicaltrials.gov
The vaccine studies were placebo controlled.
The trials are ongoing, but the placebo group has long been vaccinated.
The trials lasted long enough to gather the statistical evidence needed to show that the vaccine prevented the trial group from becoming infected (and that it was highly unlikely the trial group did better due to random chance). When that point was reached, the trial was deemed sufficient and was ended/unblinded. When people are dying by the thousands every day (in the USA alone), how much longer would you have wanted the trial to go on? We found out what we wanted to know. The vaccine worked. There's no need to carry on and ask the placebo group to continue with the risk of being infected.
I'm not going to argue the ethics, I'm going to argue that these trials are under-powered and insufficient to make bold claims about vaccine efficacy. The trials are in fact not completed until the end of the year, but there is little further information to be gained after dissolution of the placebo group.
Remember, the people defending Ivermectin also argue that it's unethical to do further trials when it is "clearly effective" (according to under-powered studies). Consider that pharma companies deliberately avoid follow-up trials to avoid finding results that don't align with business interest. Remdesivir and Molnupiravir both looked promising in early trials, but were found to be rather ineffective (and dangerous) in later trials.
I don't have a problem with administering drugs/vaccines based on good faith and speculative benefit if that is declared appropriately. Just don't dress it up as "scientifically validated".
Remember, the people defending Ivermectin also argue that it's unethical to do further trials when it is "clearly effective" (according to under-powered studies). Consider that pharma companies deliberately avoid follow-up trials to avoid finding results that don't align with business interest. Remdesivir and Molnupiravir both looked promising in early trials, but were found to be rather ineffective (and dangerous) in later trials.
I don't have a problem with administering drugs/vaccines based on good faith and speculative benefit if that is declared appropriately. Just don't dress it up as "scientifically validated".
Be precise in your claims.
The evidence for covid vaccines is that they provide robust protection for months, and then protection may begin to wain.
Evidence for ivermectin is that, ehhh it might have some effect.
Those aren't the same. Trying to dress them up as similar is wrong. These two things as re not equally scientifically validated.
The evidence for covid vaccines is that they provide robust protection for months, and then protection may begin to wain.
Evidence for ivermectin is that, ehhh it might have some effect.
Those aren't the same. Trying to dress them up as similar is wrong. These two things as re not equally scientifically validated.
> The evidence for covid vaccines is that they provide robust protection for months, and then protection may begin to wain.
Hone your own advice and be precise in your claims.
There is good evidence that two doses of the vaccine were protective for at least three months, against the variants dominating 2021.
It's 2022, there is a new escape variant about and we endorsed teenagers to get a booster shot to "protect" themselves from this new variant - based on what evidence exactly?
> Evidence for ivermectin is that, ehhh it might have some effect.
There is lots of weak evidence that it's highly effective and some weak evidence that it does nothing. This adds up no good evidence for anything.
> Those aren't the same. Trying to dress them up as similar is wrong. These two things as re not equally scientifically validated.
That's not the point. The question is, do you apply the same standard to both? Do you reject weak observational data as evidence? If so, a lot of the claims about vaccine effectiveness (here and now) are not supported by evidence.
Hone your own advice and be precise in your claims.
There is good evidence that two doses of the vaccine were protective for at least three months, against the variants dominating 2021.
It's 2022, there is a new escape variant about and we endorsed teenagers to get a booster shot to "protect" themselves from this new variant - based on what evidence exactly?
> Evidence for ivermectin is that, ehhh it might have some effect.
There is lots of weak evidence that it's highly effective and some weak evidence that it does nothing. This adds up no good evidence for anything.
> Those aren't the same. Trying to dress them up as similar is wrong. These two things as re not equally scientifically validated.
That's not the point. The question is, do you apply the same standard to both? Do you reject weak observational data as evidence? If so, a lot of the claims about vaccine effectiveness (here and now) are not supported by evidence.
> Hone your own advice and be precise in your claims.
I was. The claims I made are backed by strong randomized controlled trials.
> There is good evidence that two doses of the vaccine were protective for at least three months, against the variants dominating 2021.
And also good RCT based evidence that a third dose (or perhaps just a more recent dose) provides robust protection against delta and omicron variants. The precise level of protection is different because the variants are all a little different, but the conclusion of "boosters provide robust immunity against variants" is strongly supported.
So yes, there is good evidence that boosters provide protection. There is not good evidence that ivermectin does anything.
> It's 2022, there is a new escape variant about and we endorsed teenagers to get a booster shot to "protect" themselves from this new variant - based on what evidence exactly?
To be clear, there are two reasons you run studies
1. To validate effectiveness
2. To validate safety
There's not really a reason to believe that the boosters will be less effective in teens. In fact, there's strong reason to believe that they'll be just as effective as in everyone else. You really don't need a study for this.
What you might need a study for is validating safety, which is why we break out pregnant people, teens, young kids, and adults. Those groups can have different safety impacts (kids and teens weigh less, so doses might need to be smaller to be safe!).
Except that we already know that the exact substance we're sticking in teens is safe in teens, because its half of the exact same thing as in the initial doses. So if your concern is safety, its fine, and if your concern is efficacy, well we have strong RCT evidence of efficacy. We also generally speaking know that ivermectin is safe. But, we have no evidence to its efficacy.
So I apply precisely the same standard.
I was. The claims I made are backed by strong randomized controlled trials.
> There is good evidence that two doses of the vaccine were protective for at least three months, against the variants dominating 2021.
And also good RCT based evidence that a third dose (or perhaps just a more recent dose) provides robust protection against delta and omicron variants. The precise level of protection is different because the variants are all a little different, but the conclusion of "boosters provide robust immunity against variants" is strongly supported.
So yes, there is good evidence that boosters provide protection. There is not good evidence that ivermectin does anything.
> It's 2022, there is a new escape variant about and we endorsed teenagers to get a booster shot to "protect" themselves from this new variant - based on what evidence exactly?
To be clear, there are two reasons you run studies
1. To validate effectiveness
2. To validate safety
There's not really a reason to believe that the boosters will be less effective in teens. In fact, there's strong reason to believe that they'll be just as effective as in everyone else. You really don't need a study for this.
What you might need a study for is validating safety, which is why we break out pregnant people, teens, young kids, and adults. Those groups can have different safety impacts (kids and teens weigh less, so doses might need to be smaller to be safe!).
Except that we already know that the exact substance we're sticking in teens is safe in teens, because its half of the exact same thing as in the initial doses. So if your concern is safety, its fine, and if your concern is efficacy, well we have strong RCT evidence of efficacy. We also generally speaking know that ivermectin is safe. But, we have no evidence to its efficacy.
So I apply precisely the same standard.
Please provide a link to the RCT measuring efficacy against Omikron.
> Except that we already know that the exact substance we're sticking in teens is safe in teens, because its half of the exact same thing as in the initial doses. So if your concern is safety, its fine, and if your concern is efficacy, well we have strong RCT evidence of efficacy.
My concern would be risk/benefit. As far as I'm aware, not everyone gets a half dose for the booster, but even then there's a risk for Myocarditis with the third dose, among other things. What is the additional risk reduction for an Omikron infection in a healthy young (male) teenager that has already been vaccinated with two doses? Is it really worth the risk of side-effects? There is no good data on this.
https://www.reuters.com/business/healthcare-pharmaceuticals/...
> Except that we already know that the exact substance we're sticking in teens is safe in teens, because its half of the exact same thing as in the initial doses. So if your concern is safety, its fine, and if your concern is efficacy, well we have strong RCT evidence of efficacy.
My concern would be risk/benefit. As far as I'm aware, not everyone gets a half dose for the booster, but even then there's a risk for Myocarditis with the third dose, among other things. What is the additional risk reduction for an Omikron infection in a healthy young (male) teenager that has already been vaccinated with two doses? Is it really worth the risk of side-effects? There is no good data on this.
https://www.reuters.com/business/healthcare-pharmaceuticals/...
> Please provide a link to the RCT measuring efficacy against Omikron.
Even if that's the hill you've chosen to die on, Delta is still out there and at a high prevalence especially in North America and you've admitted that the vaccine is effective but wanes, so a booster makes sense in that cost benefit regardless.
Even if that's the hill you've chosen to die on, Delta is still out there and at a high prevalence especially in North America and you've admitted that the vaccine is effective but wanes, so a booster makes sense in that cost benefit regardless.
And they don’t have any incentive to do so. Most governments, on almost any political side have decided vaccines are the solution full stop. They don’t want to be proved wrong and have no incentive to investigate. Drug companies also have no incentive.
I agree with your last sentence a lot, we can do a lot of things and administer a lot of things, just don’t say “an attack on it is an attack on science”
I agree with your last sentence a lot, we can do a lot of things and administer a lot of things, just don’t say “an attack on it is an attack on science”
One of the things that has made it hard to believe the drug companies behind the new vaccines are trustworthy is the way that they and the medical establishment has continuously claimed that these vaccines have good long-term safety, when long-term safety wasn't even something that was being tested for, and a long term hasn't yet elapsed. Such claims were being spouted by government and medical people even before the EUA was finalized, which makes the entire thing seem quite untrustworthy to anyone who was looking at the actual situation and research.
An all-too-convenient excuse, considering how many people now willingly put themselves into the control group called "anti-vaxxer".
I think all the greyed-out responses here are indicative of the problem.
I suggest the real website. Posting NIH Pubmed links tends to be used to suggest the NIH has something to do with it, when this website is just a library catalog of papers. This is a mirror maintained by a government agency.
https://www.cureus.com/articles/82162-ivermectin-prophylaxis...
or the DOI link: https://dx.doi.org/10.7759%2Fcureus.21272
https://www.cureus.com/articles/82162-ivermectin-prophylaxis...
or the DOI link: https://dx.doi.org/10.7759%2Fcureus.21272
Cureus is a bit of a weird journal, they have very fast peer review time instead relying officially on post-publication peer review
Here's a weird case on a different paper in the same journal: http://retractionwatch.com/2015/11/02/sex-addiction-article-...
In this case, the two first authors Lucy Kerr and Flavio Cadegiani are (partially?) funded by Vitamedic, a company that makes Ivermectin. That's not mentioned in the Cureus paper. It is mentioned in some of their papers, like this one: https://www.researchgate.net/publication/357313430_Ivermecti...
They seem to be based in Brazil. Given that intestinal worms are still common in Brazil it may have been that people saw a health improvement in Covid-patients after Ivermectin got rid of the worms.
Here's a weird case on a different paper in the same journal: http://retractionwatch.com/2015/11/02/sex-addiction-article-...
In this case, the two first authors Lucy Kerr and Flavio Cadegiani are (partially?) funded by Vitamedic, a company that makes Ivermectin. That's not mentioned in the Cureus paper. It is mentioned in some of their papers, like this one: https://www.researchgate.net/publication/357313430_Ivermecti...
They seem to be based in Brazil. Given that intestinal worms are still common in Brazil it may have been that people saw a health improvement in Covid-patients after Ivermectin got rid of the worms.
That you for this bit of information. There people did read suspicious.
The NIH reference makes it harder to shut down the thread.
Just to be clear, this is the same concept the parent comment is referencing.
Posting the link this way from an NIH aggregator seems designed to give the false appearance of NIH credibility to
Posting the link this way from an NIH aggregator seems designed to give the false appearance of NIH credibility to
[deleted]
>suggest the NIH has something to do with it
That is an absolutely egregious misunderstanding of what Pubmed is. Let us not take actions on the basis of misunderstandings by the clueless.
That is an absolutely egregious misunderstanding of what Pubmed is. Let us not take actions on the basis of misunderstandings by the clueless.
You are assuming a lot of knowledge in a lot of people. Let’s not dismiss people making clarifications that may not be immediately obvious to all HN readers
tamaharbor(2)
Wow this is a POS study.
> Study Group: 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis
> There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95% CI, 0.31-0.63; p < 0.0001).
Are you serious? This is such a shitty sample size you might as well be rolling dice.
Why do these studies assume people can't read
> Study Group: 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis
> There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95% CI, 0.31-0.63; p < 0.0001).
Are you serious? This is such a shitty sample size you might as well be rolling dice.
Why do these studies assume people can't read
Consider now that the Pfizer 5-11 trial was ~2000 people and didn't have a difference in symptoms or hospitialzation
Wait, 159,561 subjects is considered small? Maybe I’m not understanding what you mean
Mate, the p-value is given right there. Obviously, the difference is large enough to be highly significant.
Ever seen the pfizer data with which the fda approved the vaccine? Sample size wise you are in for a good laugh.
Dumb question
Do we all have worms and don’t realize it? I say yes.
Should we take ivermectin for quality of life improvements.. is it a medicine or vitamin?
Do we all have worms and don’t realize it? I say yes.
Should we take ivermectin for quality of life improvements.. is it a medicine or vitamin?
In Brazil worms are very common. Some people take anti-hemlminths prophylactically every 6 months.
If you think you have worms get yourslef checked. It’s all in your stool and can be easily detected.
Worms are very common in the USA and are endemic in the the southern states. As a child I had a stool test every year. I often took pills for hookworms.
As an adult no doctor has ever prescribed a stool test, even when asked about the likelihood of parasites. One doctor mumbled something to the effect that "if you have worms it will show up in the blood tests..." but I think he was full of it, as usual:
https://www.cdc.gov/parasites/references_resources/diagnosis...
I often walk or run barefoot; I don't usually use insect repellant. I eat wild berries and leaves sometimes. Bugs bite me and sting me. I am likely periodically exposed to parasites.
An annual test for parasites seems like a good idea. But, since my doctors (most whom are from Asia and should know better) do not concur, I also treat myself to anti-parasitic medications occasionally.
As an adult no doctor has ever prescribed a stool test, even when asked about the likelihood of parasites. One doctor mumbled something to the effect that "if you have worms it will show up in the blood tests..." but I think he was full of it, as usual:
https://www.cdc.gov/parasites/references_resources/diagnosis...
I often walk or run barefoot; I don't usually use insect repellant. I eat wild berries and leaves sometimes. Bugs bite me and sting me. I am likely periodically exposed to parasites.
An annual test for parasites seems like a good idea. But, since my doctors (most whom are from Asia and should know better) do not concur, I also treat myself to anti-parasitic medications occasionally.
I know it is a sensitive topic. Thats why I listen to people with experience.
https://www.youtube.com/watch?v=ufy2AweXRkc
This video was suggested on my feed a while ago. I tried to make sense of the author and his other content, but it all seems incredibly shady and snake-oily to me. But I'm a layman
Does someone care to clarify the credibility of the author and his content?
Does someone care to clarify the credibility of the author and his content?
> Does someone care to clarify the credibility of the author and his content?
What are the potential outcomes here? You're sure to find people on this site (whose credibility you also can't judge) who claim he's the antichrist and others who claim he is actual Jesus, mostly depending on what their social circle happens to believe. What do you do with that information?
That said, John Campbell is one of the few YouTube sources I've found myself continuously going back to throughout the pandemic. Like anything else, I take things he says as "Ok, now I know someone has said this", not "OK, this is a thing that I now know to be true".
What are the potential outcomes here? You're sure to find people on this site (whose credibility you also can't judge) who claim he's the antichrist and others who claim he is actual Jesus, mostly depending on what their social circle happens to believe. What do you do with that information?
That said, John Campbell is one of the few YouTube sources I've found myself continuously going back to throughout the pandemic. Like anything else, I take things he says as "Ok, now I know someone has said this", not "OK, this is a thing that I now know to be true".
From what I understand it is saying that ivermectin is useful and efficient at blocking the tool (protein scissors; protease) that the virus needs in order to spread a protein out of the cell.
The new Pfizer COVID drug is supposed to do that too but ivermectin is 0.06$ vs new Pfizer drug with a 20year patent lots of cash for a good lobbying company :)
Credibility of the author idk :s
Credibility of the author idk :s
"John L. Campbell is a British YouTuber, retired nurse educator and author of nursing textbooks who has posted a number of widely-viewed YouTube videos on his Dr. John Campbell channel commenting on the COVID-19 pandemic. In August 2020, Campbell's channel was referred to by UNICEF's regional office for Europe and Central Asia as good example of expert engagement with social media. By January 2022, his videos had been viewed more than 429 million times."
"Campbell worked as a nursing educator at the University of Cumbria, and has experience as an A&E nurse. He has also taught health workers in India and Cambodia. He is the author of Campbell's Physiology Notes and Campbell's Pathophysiology Notes nursing-related biosciences text books. A 2011 book review in Emergency Nurse magazine said Campbell's Physiology Notes was "excellent, inexpensive notes on the causes, pathophysiological changes and clinical features seen in disease processes"."[1]
To be fair, a good chunk of his Wikipedia article mention his videos about Ivermectin and how they're false claims based on some articles people have posted in response to his video, which is to be expected since anything positive said about Ivermectin is bound to have people counter it.
Dr. Campbell has posted almost 2000 videos, pretty much every day since the pandemic started (although if you sort by oldest on his channel you can see 14 year old low-res, poor audio/lighting videos[2] of him going over various medical concepts, btw, pretty interesting), where he reviews and explains probably 20+ charts and graphs and statistics and quotes and studies to the best of his understanding.
He's also human and may very well have been led down a wrong rabbit hole by his interpretation of some studies (or perhaps not, Ivermectin seems to have become one of the things that everyone decided they'll believe in its efficacy based pretty much exclusively on political party alignment).
You should always take in information with a critical eye, including Dr. Campbell. I've watched probably a hundred of his videos and I don't always agree with his conclusions 100% either, but I can't say that about anyone ever, so I don't expect that of him either. What I have seen is, especially on his more general update videos, the most comprehensive compilation of data (as digestible to a layperson as possible) for complicated medical concepts.
[1]: https://en.wikipedia.org/wiki/John_Campbell_(YouTuber)
[2]: https://youtu.be/tmkH87YPN4g
"Campbell worked as a nursing educator at the University of Cumbria, and has experience as an A&E nurse. He has also taught health workers in India and Cambodia. He is the author of Campbell's Physiology Notes and Campbell's Pathophysiology Notes nursing-related biosciences text books. A 2011 book review in Emergency Nurse magazine said Campbell's Physiology Notes was "excellent, inexpensive notes on the causes, pathophysiological changes and clinical features seen in disease processes"."[1]
To be fair, a good chunk of his Wikipedia article mention his videos about Ivermectin and how they're false claims based on some articles people have posted in response to his video, which is to be expected since anything positive said about Ivermectin is bound to have people counter it.
Dr. Campbell has posted almost 2000 videos, pretty much every day since the pandemic started (although if you sort by oldest on his channel you can see 14 year old low-res, poor audio/lighting videos[2] of him going over various medical concepts, btw, pretty interesting), where he reviews and explains probably 20+ charts and graphs and statistics and quotes and studies to the best of his understanding.
He's also human and may very well have been led down a wrong rabbit hole by his interpretation of some studies (or perhaps not, Ivermectin seems to have become one of the things that everyone decided they'll believe in its efficacy based pretty much exclusively on political party alignment).
You should always take in information with a critical eye, including Dr. Campbell. I've watched probably a hundred of his videos and I don't always agree with his conclusions 100% either, but I can't say that about anyone ever, so I don't expect that of him either. What I have seen is, especially on his more general update videos, the most comprehensive compilation of data (as digestible to a layperson as possible) for complicated medical concepts.
[1]: https://en.wikipedia.org/wiki/John_Campbell_(YouTuber)
[2]: https://youtu.be/tmkH87YPN4g
> or perhaps not, Ivermectin seems to have become one of the things that everyone decided they'll believe in its efficacy based pretty much exclusively on political party alignment).
This is something I find very funny. As someone from outside the USA, it amazes me how something like this got politicized over there. Does Ivermectin have any effect against COVID19? That should be a dialog left to scientists following the scientific method. All that craziness of "ZOMG horse dewormer" from the left (ignoring that there ARE IVM pills for humans) and "ZOMG Muh Freedom" from the right (ignoring how how virus and vaccines work) is just mudding the scientific research around the thing.
This is something I find very funny. As someone from outside the USA, it amazes me how something like this got politicized over there. Does Ivermectin have any effect against COVID19? That should be a dialog left to scientists following the scientific method. All that craziness of "ZOMG horse dewormer" from the left (ignoring that there ARE IVM pills for humans) and "ZOMG Muh Freedom" from the right (ignoring how how virus and vaccines work) is just mudding the scientific research around the thing.
Didn't even assume there was a Wikipedia entry. Thanks for the detailed answer.
Dr Campbell can explains some difficult research papers fairly well but he has one major shortcoming - he does not explain study limitations. For example he may say that this paper found that some drug works for something but he does not stress that it was in vitro study (in the lab) and this is very early to say if it even works when tested on animals. Even worse, he have done the same for results in silico i.e. computer simulations that are not even close to the real world.
The groupthink here is disappointing. Rather than be glad that a cheap and widely available drug is possibly effective at treating the effects of covid, armchair experts here instead pounce on it with attacks.
I wonder if Twitter and Facebook will suppress the study.
I wonder if Twitter and Facebook will suppress the study.
People are rightly skepctical if the same group of doctors continues to publish studies that support their opinion, while all other studies contradict their results.
Skepticism is fine but dismissively throwing it out and mocking people that want to know more because it's a politically divisive topic is not. Science is not political and should not be influenced by politics. We should be throwing more studies at this, especially if you don't trust the current researchers.
I would be gladly happy when it works. This paper does not prove that it does. It is just another one in the list of badly designed and executed studies.
Ivermectin is hawked as a COVID miracle cure within right wing circles and spoken about constantly on right wing media programs. Many millions have been convinced ivermectin will save them from COVID, discouraging vaccination and even prompting some to remove family members in critical condition from hospitals because staff refuse to prescribe the de-wormer. It’s killed people and there is an organized effort to push the drug for cynical partisan gain. So yea, it is appropriate to “pounce” on this study or at least be very clear why it is not applicable to first world countries (very few people have worms)
Do you believe it is possible you could be wrong and what data would it take for you to change your mind?
There would have to be high quality studies that showed that ivermectin worked in countries that are not beset with parasitic worms (a known COVID comorbidity). And since ivermectin in practice is pitched as an alternative to vaccination, those studies would have to show efficacy against death/hospitalization in the ballpark of full vax + boosted (ie ~95%+)
I think that is a pretty safe position to take.
I have a more moderate take. I think it is likely that ivermectin will show some therapeutic benefit against death and hospitalization, but well below the efficacy of vaccination.
If so, I think there will be interesting reactions when the NIH Activ-6 trial reads out as the American public tries to digest this. Even low double digit efficacy will mean that slow implementation and pushback will have cost 10's to 100's of thousands of American lives.
I have a more moderate take. I think it is likely that ivermectin will show some therapeutic benefit against death and hospitalization, but well below the efficacy of vaccination.
If so, I think there will be interesting reactions when the NIH Activ-6 trial reads out as the American public tries to digest this. Even low double digit efficacy will mean that slow implementation and pushback will have cost 10's to 100's of thousands of American lives.
There is no reason to believe it has that efficacy net known side effects in developed countries and if even it did, a small fraction of individuals users declined vaccination in favor of the prophylactic effects of ivermectin there would be no net benefit. Also, there is not anywhere near enough supply of ivermectin for a meaningful proportion of citizens in first world countries and that supply should go to people in countries with parasitic worms.
and here I thought we might have compatible points.
In the hypothetical where it is demonstrated to be effective, I don't think it is ethical to suppress the use of one effective treatment to incentivize uptake of another (vaccination). That is to say, we shouldn't deny treatment with an effective treatment or post exposure prophylatic because it might embolden other people to forgo an earlier intervention (vaccination).
Your supply objection is a valid concern, but not absolute. I agree populations with parasites should get first priority if their relative benefit is greater. That said, there is additional manufacturing capacity and the ability to easily expand it. If you say excess supply cannot be used, this is the same as your argument above.
In the hypothetical where it is demonstrated to be effective, I don't think it is ethical to suppress the use of one effective treatment to incentivize uptake of another (vaccination). That is to say, we shouldn't deny treatment with an effective treatment or post exposure prophylatic because it might embolden other people to forgo an earlier intervention (vaccination).
Your supply objection is a valid concern, but not absolute. I agree populations with parasites should get first priority if their relative benefit is greater. That said, there is additional manufacturing capacity and the ability to easily expand it. If you say excess supply cannot be used, this is the same as your argument above.
"Ivermectin is hawked as a COVID miracle cure within right wing circles"
Might it have anything to do with the recovery rate of patients treated by frontline doctors who prescribe it (amongst other medicines), their patients are staying off ventilators and not, you know, dying? That's a huge observation and should be incorporated into the body of clinical medicine, without politics involved.
Might it have anything to do with the recovery rate of patients treated by frontline doctors who prescribe it (amongst other medicines), their patients are staying off ventilators and not, you know, dying? That's a huge observation and should be incorporated into the body of clinical medicine, without politics involved.
That’s good enough reason to initiate more careful examination. That happened, and the conclusion was ivermectin only worked in countries where people have worms, because worms are a covid comorbidity
Yeah, that's how science works with regard to covid (i.e. tainted by politics) now, which is sad and stupid.
Ok, so you answered you own question. Ivermectin would not even be in the conversation in the United States if cynical right wing partisans and right wing media apparatus were not keeping it there for short term political gain at the expense of peoples’ lives. So it’s important to forcefully address their misleading statements and innuendo about the drug.
Alternatively, if cynical right wing partisans and right wing media apparatus had not lached on to ivermectin, it is possible that it would be frequently used as part of treatment regimens, effective or not.
Probably not
Here's a brazilian interpretation of the paper results and its findings if anyone is interested:
https://filiperafaeli.substack.com/p/ivermectina-preventiva-...
https://filiperafaeli.substack.com/p/ivermectina-preventiva-...
From the same blog:
Hidroxicloroquina para profilaxia da COVID-19 atinge o mais alto nível de evidência científica
COVID-19: um dia glorioso para a ciência brasileira. Dr Cadegiani encontra a cura pra pacientes graves. 92% de redução nas mortes
He has made countless claims like these long before any good research had been done. So he and his organization have a lot riding on proving that ivermectin works for COVID.