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I heard about Ivermectin for the first time this week and was shocked how much it seemed that I had stepped into conspiracy theory land. There seemed to be an o

I heard about Ivermectin for the first time this week and was shocked how much it seemed that I had stepped into conspiracy theory land. There seemed to be an overwhelming amount of evidence over the last year that this repurposed drug is effective at treating Covid during a variety of stages (preventative, first positive test, ICU admittance, and even long haul). But since there hadn't been a randomized trial the drug had, not only been dismissed, but heavily censored over social media. I still cannot believe how much the discussion has been silenced in the same way people discuss "covid vaxx causes magnetism". The fact the interview between Bret Weinstein and Pierre Kory was banned from youtube for non-WHO/CDC/NIH approved covid treatments is a tragedy. I truly hope in the coming years the censorship of this topic will be the catalyst for allowing free speech to prevail on social media.

13415 5y ago
Without randomized trials you cannot recommend a drug because you cannot exclude confounders. It seems wrong to me to even speak of "overwhelming evidence" without a randomized trial or other sound ways to control or identify for confounders (e.g. causal models).
- mgamache 5y ago
  Actually a meta analysis can offer better evidence then a single RCT. https://ascopost.com/issues/june-10-2014/randomized-trials-vs-meta-analyses-which-is-the-better-bet/ https://ascopost.com/issues/june-10-2014/randomized-trials-v...
  - Tenoke 5y ago
    The best meta-analyses are those made out of RCTs at any rate.
  - MilnerRoute 5y ago
    Wait a minute... This post is a debate between two opposing viewpoints. So it also makes the exact opposite point: The primary difference between a randomized controlled trial and meta-analysis is that the former “provide the highest level of evidence because they contain the least amount of bias. Randomized controlled trials reduce bias, while meta-analyses increase bias." This Hacker News story is about a recent meta-analysis. But an actual randomized control trial of Ivermectin in March (on 476 patients) found the duration of symptoms on treated and untreated patients "was not significantly different." https://jamanetwork.com/journals/jama/fullarticle/2777389 https://jamanetwork.com/journals/jama/fullarticle/2777389
    - ALittleLight 5y ago
      Important thing to know about that study is they are testing time to recovery for people with mild covid. I'm not anywhere near an expert, but two things stood out to me reading this study. First, time to recover in the ivermectin group was 10 days versus 12 in the placebo. The paper calls this "not significant" but it's not clear to me whether that's statistically not significant, and if so, why wouldn't it be, or if knocking two days off recovery isn't that meaningful. The other thing I noticed reading it was that only one person out of 400 died and that person was in the placebo group. I think the Brett Weinstein response would be something like - A. Ivermectin's best benefit is as a prophylactic not a treatment. B. Ivermectin should be administered as early after onset as possible to treat, whereas here there was some delay to get people organized, enrolled in trial, etc. C. It's hard to measure effect when the disease is mild.
      - bonzini 5y ago
        > why wouldn't it be Because you only gave the average time of recovery but not the standard deviation.
        ALittleLight 5y ago
        I didn't see the standard deviation reported in the paper. Is it? I did see the innerquartile range and it was the same for both the ivermectin group and the placebo. To me that suggests that variation in outcomes is probably similar between the two groups.
        Fomite 5y ago
        They provide it in the form of a hazard ratio: "hazard ratio for resolution of symptoms, 1.07 [95% CI, 0.87 to 1.32]" So statistically, those on ivermectin recovered 1.07 times as quickly as those on placebo, but the uncertainty bounds are from 0.87 times as fact to 1.32 times as fast.
    - spadez 5y ago
      > But an actual randomized control trial of Ivermectin in March Please see this https://news.ycombinator.com/item?id=27566123 https://news.ycombinator.com/item?id=27566123
- goldemerald 5y ago
  While randomized trials are certainly the gold-standard for determining if you should give a new drug to treat an arbitrary disease, that process is far too conservative during a pandemic where a huge majority of the world cannot access proper medical care. Ivermectin is already massively produced, used throughout the world, and cheap to manufacture (compared to new anti-Covid drugs). Even months ago before the benefits were known, the risks of taking the drug were very small, especially when the treatment guidelines were to do practically nothing. Still, the many pieces of non-randomized evidence can still clearly point towards this drugs efficacy. The sudden drop in Covid cases in India as the clearest indicator to me.
  - jsnell 5y ago
    > The sudden drop in Covid cases in India as the clearest indicator to me. What's the alleged connection here? Are you claiming that some non-trivial number of patients in India were treated with this? How many, and at what point after being infected? And just how did the treatment affect the case numbers? Generally you'd expect the vast majority of secondary infections to happen before the diagnosis, not after, so a treatment seems totally irrelevant to the case numbers.
    - spadez 5y ago
      >Are you claiming that some non-trivial number of patients in India were treated with this Yes, example from two states. https://indianexpress.com/article/cities/lucknow/uttar-pradesh-government-says-ivermectin-helped-to-keep-deaths-low-7311786/ https://indianexpress.com/article/cities/lucknow/uttar-prade... https://www.news18.com/news/india/mortality-rate-much-lower-goa-govt-defends-use-of-ivermectin-for-covid-19-treatment-3786590.html https://www.news18.com/news/india/mortality-rate-much-lower-... The testimony video in this page cites examples in many other countries https://covid19criticalcare.com/ https://covid19criticalcare.com/
      - jsnell 5y ago
        I see no numbers on how many people were treated on either of the first two links, and certainly don't intend to comb through the dross on the third link. So do you actually have a number? It doesn't need to be exact, just a credible source on the order of magnitude will be enough. Are we talking a thousand, a million, or a billion here? To reduce R by a factor of 2 by the use of a prophylactic drug, you'd need to have half of the population on a regime of the drug. It seems pretty obvious that did not happen if this kind of reporting is the most impactful there is. Just think of the logistics of trying to do that! India has a population of 1.4 billion. On the other hand, if they only gave the snakeoil to e.g. a single digit number of millions of people the reduction in the number of infections would be imperceptible.
- wrycoder 5y ago
  https://sebastianrushworth.com/2021/05/09/update-on-ivermectin-for-covid-19/ https://sebastianrushworth.com/2021/05/09/update-on-ivermect... I’ve included every double-blind randomized placebo-controlled trial I could find of ivermectin as a treatment for covid. Using only double-blind placebo-controlled trials means that only the highest quality studies are included in this meta-analysis, which minimizes the risk of biases messing up the results as far as possible. In order to be included, a study also had to provide mortality data, since the goal of the meta-analysis is to see if there is any difference in mortality .... What we see is a 62% reduction in the relative risk of dying among covid patients treated with ivermectin. That would mean that ivermectin prevents roughly three out of five covid deaths. The reduction is statistically significant (p-value 0,004). In other words, the weight of evidence supporting ivermectin continues to pile up. It is now far stronger than the evidence that led to widespred use of remdesivir earlier in the pandemic, and the effect is much larger and more important (remdesivir was only ever shown to marginally decrease length of hospital stay, it was never shown to have any effect on risk of dying). I understand why pharmaceutical companies don’t like ivermectin. It’s a cheap generic drug. Even Merck, the company that invented ivermectin, is doing it’s best to destroy the drug’s reputation at the moment. This can only be explained by the fact that Merck is currently developing two expensive new covid drugs, and doesn’t want an off-patent drug, which it can no longer make any profit from, competing with them.
- Vinceo 5y ago
  Does that mean that the covid vaccines shouldn't be recommended as there's no randomized trials on their long-term effects? Just curious as I'm not well versed on this topic.
  - 13415 5y ago
    Covid vaccines have been tested with randomized trials (Phase 3 of the testing phase). Regarding "long-term", that obviously depends on how you define "long-term but there is no need to move the goalpost. Generally speaking, in evidence-based medicine drugs and vaccines are not recommended based on incomplete statistics or hunches.
void_mint 5y ago
> I truly hope in the coming years the censorship of this topic will be the catalyst for allowing free speech to prevail on social media. If someone died because of a "Take Ivermectin and you'll survive COVID" video on YouTube, who's to blame? Should YouTube not take steps to prevent the spread of misinformation that could kill people? edit Big downvotes, no response. Great system.
- Turing_Machine 5y ago
  Here's a response: YouTube is chock-full of dubious health information. But only this one got banned. Why? For the record, since I've been muzzled from responding further, I don't believe that it was "money".
  - guscost 5y ago
    And here’s the correct response to you: Money.
    - dang 5y ago
      You've posted something like 9 unsubstantive and/or flamebait comments in this thread. That has a seriously damaging effect on discussion, especially when the topic is divisive as this one is. I'm sure you don't intend that, but the effects work that way regardless of intent: https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sort=byDate&type=comment&query=troll%20effects%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor.... If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful. Note this one: "Comments should get more thoughtful and substantive, not less, as a topic gets more divisive."
      - guscost 5y ago
        I disagree strongly. Conflict-avoidant platitudes have much less substance.
desine 5y ago
You can't get EUA for the vaccines if there's a working treatment. The doctor who promoted Hydroxychloroquine and zinc treatment, Dr. Zelenko, is still banned from Twitter for spreading COVID disinformation. There's both actual conspiracies in this world, and well poisoning to damage the conversations. When you look at the amount of money these companies stand to make from producing billions of vaccinations, you should not be surprised.
- enkid 5y ago
  Source for the EUA stuff? Source that HCQ and zinc are viable treatments? The problem isn't that some of these things might be viable, the problem is we don't know which of the literally hundreds of treatments are actually going to be viable when going through the proper testing and approval process. You can't just scream conspiracy when there much better explanations
  - desine 5y ago
    >Source for the EUA stuff? https://www.fdanews.com/ext/resources/files/archives/e/Emergency-Use-Authorization.pdf https://www.fdanews.com/ext/resources/files/archives/e/Emerg... (PDF warning)(section III, the first list, point #4) >Source that HCQ and zinc are viable treatments? Dozens? Hundreds? of doctors speaking out, including videos posted to youtube, that they saw great effectiveness in the trial. The people promoting it weren't a bunch of nobodys, despite what the nightly news told you. There were plenty of frontline workers with actual experience. But that likely won't satisfy your request for a source - which is fine. We all appeal to authority as we see fit. I saw many actual doctors saying "this is effective", and I saw many large corporations working together to shut that conversation down. Do you have any evidence it's not effective?
    - belltaco 5y ago
      >Do you have any evidence it's not effective? Do you have any evidence snake oil isn't effective? Burden of proof is on the people claiming a magic cure. Anyway here are a couple of studies that show it's not effective. https://onlinelibrary.wiley.com/doi/10.1002/jmv.27122 https://onlinelibrary.wiley.com/doi/10.1002/jmv.27122 https://jamanetwork.com/journals/jama/fullarticle/2777389 https://jamanetwork.com/journals/jama/fullarticle/2777389 Here's a good take by someone that does research on new medicines. https://blogs.sciencemag.org/pipeline/archives/2021/06/07/ivermectin-as-a-covid-19-therapy https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv...
throwaway192021 5y ago
My mom is on dialysis, has diabetes and hypertension. Recently for a surgery we had to do a covid test. Dad also took the test. Both were positive. The nephrologist prescribed ivermectin for mom. She had mild fever for 3 days and recovered. Dad had no obvious symptoms and recovered(he was not prescribed ivermectin, hence did not take it). The govt doctors don't prescribe it just vitamin c, zinc and dolo. This is india btw.
boredprograming 5y ago
Many people pushing Ivermectin have a vested interest in proving the vaccines are unnecessary. It may work, but that's why you get recommendations for "vaccine made me magnetic" and other garbage like that whenever you search for videos. It's the same group that was pushing hydroxychloroquine as a miracle drug
- throwaway4good 5y ago
  It is and it is weird. What do these people (the promoters) get out of it? Attention? A more dedicated following?
  - raphlinus 5y ago
    I think the most useful lens to understand the sociology of these kinds of questions is religious belief. And there is no shortage of people out there who want to convince others of their belief. The narrative for "the Ivermectin story" is particularly compelling, as it involves brave maverick doctors working selflessly to get the word out, suppression and censorship by shadowy organizations (big pharma fearing competition, the big Internet companies just lusting after the power of thought-control), and the empowerment of people to take medical decisions into their own hands. Incidentally, this was the exact same narrative as HCQ, and is being pushed by a lot of the same people. The end of the story may turn out differently, as the evidence on HCQ is overwhelming that it doesn't work, so you only see dead-enders pushing it, but there is a good chance that Ivermectin will turn out to be at least moderately effective, though the jury is still out.
    - Heyso 5y ago
      Religious belief. Exactly. And what are your religious beliefs ? Are you sure you have none ? Is there something or someone you would never doubt ?
  - ds206 5y ago
    How about having a discussion? Not everything has to be so complicated lol
lettergram 5y ago
Ivermectin is a cheap drug, Mercer (who produces ivermectin) is trying to produce their own covid19 drug. Further, if there are viable alternative treatments we shouldn’t be using a vaccine still in phase 2/3 trials that haven’t even been tested on animals... the entire emergency use authorization is only allowed if there aren’t safe alternatives. Ivermectin is generally safe to take, and a known drug with known risks. If it was shown to be effective the vaccine rollouts should be stopped. So, there’s a lot of political and financial reasons to not publicize it.
- deleted 5y ago
  [deleted]
- fuckyah 5y ago
  And there you have it! Why is ivermectin censored? Because otherwise they had to stop administering the experimental vaxx.
- pawelmurias 5y ago
  A treatment isn't an alternative to vaccination. Millions of people have been vaccinated so we know it's safe, while tons of people have died from covid so we know it's not safe.
  - lettergram 5y ago
    This study appears to show that there is a treatment that’s ~90% effective at reducing deaths. The vaccines are not shown to be (may be) safe outside of a brief few month window (for specific classes of people). These are a new class of vaccine and there appears to be significant risk based on the cdc data (VAERS). https://austingwalters.com/covid19-vaccine-risks/ https://austingwalters.com/covid19-vaccine-risks/ To be clear none of the vaccines really completed a standard phase 2 or 3 trial. It had an abridged or expedited version that skipped things like pregnant women, etc. the vaccine is also not 100% effective, which is important as it’s a “leaky” vaccine. Meaning, we’re going to see lots of variants that get around our protection from the vaccine. That’s why treatments are important. It’s also possible we see genetic defects 2-3 years from now or an increase in cancer. We really have no idea.
ppf 5y ago
Next we'll find that the cheap and well-understood hydroxychloroquine is actually relatively effective Covid-19 treatment! It's disturbing how much the suppression of Covid "wrong-think" over the last year has resulted in useful results and information only very slowly coming out (and generally, in the process, giving a feeling of vindication to the conspiracy theorists). I have always been, and continue to be, against the idea that "this is such a novel emergency we just need to ignore all the processes that we know and trust". If anything, in those times, when we don't know what is going on, those principles are exactly the type of things we should stick to. I strongly believe it would have done us better over the past year.
- jiofih 5y ago
  > against the idea that this is such a novel emergency we just need to ignore all the processes that we know and trust There is a pretty well trodden path for new medicine to prove their effectiveness, which all Covid measures have gone through. If ivermectin, hydroxichloroquine or any other alternative drug goes through due course they would have no difficult being accepted. The reason discussions have been censored is precisely because people have been rallying around a drug like a football club before they’ve had their effectiveness scientifically proven, and demanding to skip the traditional due diligence. And for some context: this paper was submitted to a mainstream journal in March and rejected for lack of evidence. This publisher who picked it up is not exactly a reputable one (and will benefit immensely from citations of this study).
  - Nursie 5y ago
    > rallying round a drug like a football club That’s what gets to me too, and this is the major issue I had with Trump saying anything about anything. He was floundering to look like he had a plan and the moment he mentioned HCQ he turned the whole thing political. It was massively irresponsible. It should be left to medical science, which is doing pretty damn well with vaccinations and treatments like dexamethasone. If Ivermectin can be helpful that’s great, and if it’s not then never mind, let’s evaluate other things. But it seems like people need to latch onto something, and then their ego and tribal allegiances won’t let it go.
atlgator 5y ago
Whether it works or not, there's no money to be made from Ivermectin. It's a very cheap generic drug. Why else would they stamp out all possible investigations of it just to ascertain truth?
- raphlinus 5y ago
  So is dexamethasone, and that's used world-wide for seriously ill Covid patients. What's the explanation for why dexamethasone was allowed but ivermectin is being suppressed?
  - oblib 5y ago
    Basically it's been that there had been no studies to prove it works for covid. It's been used mostly in poorer countries that have had it on hand because it's relatively inexpensive. Doctors in those countries have been sharing info with each other and that's how it started being used a lot. During that time gather data for this use was begun and it's taken this long to gather enough, over enough time, to prove its efficacy according to the standards required.
    - bamboozled 5y ago
      Studies have been done and show that it is effective: https://covid19criticalcare.com/ https://covid19criticalcare.com/
  - raarts 5y ago
    Maybe because you cannot use it as a prophylactic, so it doesn't threaten EUA for vaccines?
- benmw333 5y ago
  People down vote this - they gasp saying "no way could this be true" - yet they complain about big pharma right up until the "right" virus/disease/whatever science thing comes along and their tribe picks it up and runs with it - they're now the savior. The left/right don't realize they both have faith/religion of government. These politicians do not speak for you or me. Voting only leads to consequence without recourse.
bsder 5y ago
Because ivermectin is conspiracy theory land. If you don't have a proven, understood mechanism (which ivermectin doesn't for a virus like Covid) then you have to rely on trials, and those just don't stand up. Quoting Derek Lowe on this: https://blogs.sciencemag.org/pipeline/archives/2021/06/07/ivermectin-as-a-covid-19-therapy https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv... > If you haven’t had to mess with drug discovery for a living, it’s understandable that you hear that Some Person Somewhere was very sick, took New Therapy X, and suddenly got better, and then assume that there it is, the cure has been found. But that’s not how it works. Real results stand up when you run larger, better-controlled trials, but most early results don’t turn out to be all that real. Cue the Green Jellybean XKCD: https://xkcd.com/882/ https://xkcd.com/882/
- josephcsible 5y ago
  This may explain the lack of widespread use at first, but it definitely does not explain the widespread censorship.
- kkwteh 5y ago
  There are plausible mechanisms of action of Ivermectin against the Covid virus being explored. See https://www.nature.com/articles/s41429-021-00430-5/figures/1 https://www.nature.com/articles/s41429-021-00430-5/figures/1
- Ivdg3 5y ago
  The creator of mRNA vaccines disagrees with you: > What happens to confidence in public health and USG if ivermectin turns out to be safe and effective for COVID, and the genetic vaccines turn out to have signficant safety issues? This looks like a very plausible scenario from where I sit. https://twitter.com/RWMaloneMD/status/1403836354098872322 https://twitter.com/RWMaloneMD/status/1403836354098872322
  - jacquesm 5y ago
    Mr. Malone is a very eminent scientist who has one serious problem in this particular case: he really doesn't like big pharma earning billions over what he considers to be his invention.
oblib 5y ago
I've been monitoring this for a long time now. I have ivermectin on hand for deworming my two mini burros. Of course, you're not supposed to use it on humans but they say that about fish mox too. But as time went on it was pretty clear to me that it was working to prevent covid from becoming severe in the countries that were using it for that because they had nothing much else to use. I saw many reports of it working. I also read about vitamin D, melatonin, famotidine, and aspirin helping to reduce severity of infections. So, when my wife and I got our 1st and 2nd jab of the Pfizer vaccine we took all of those and had no reaction to it at all. Our daughter took it before her first jab and had no reaction but didn't for her 2nd and she did get sick. As soon as she told us she wasn't feeling good we dosed her with those and just an hour or so later she was feeling good again. I haven't been infected and now I've reached full immunity so none of that proves anything at all but it's still been worth knowing.
- yumraj 5y ago
  How do you know that that dosing did not interfere with you developing proper immunity? In fact, CDC recommends taking fever reducing medicine only once you develop fever after a vaccine and not before vaccination for just this reason.
  - oblib 5y ago
    How do you know eating a cheese sandwich doesn't interfere? How do you know what I did doesn't improve immunity since all those things I mentioned do seem to lessen the severity of covid? One thing I do know, is that no doctor anywhere has claimed what I did lessens the effectiveness of those vaccines.
actually_a_dog 5y ago
> There seemed to be an overwhelming amount of evidence.... > ....there hadn't been a randomized trial the drug You don't see the contradiction here? Edit: because it must be made 100% obvious, clinical trial results are the definition of evidence in medical science.
- nicoburns 5y ago
  That's not really contradictory. Lots of covid treatments have been discovered in hospital settings by doctors trying desperately to find something to help their patients.
  - actually_a_dog 5y ago
    And those were later validated by evidence from clinical trials. Until clinical trials involving significant numbers of patients are available, there is not evidence according to the standards of medical science. That's the contradiction.
    - effie 5y ago
      > there is not evidence according to the standards of medical science. What the hell are you trying to say? That doctors treating patients observations can be dismissed because they don't talk the academic language or their results don't follow academic guidelines? There is more to medicine than just clinical trials. Many different things can count as evidence, even if they are not up to your academic standard. Doctors observations, population-level improvements, and studies of different cohorts. There are levels of evidence, there is strong evidence based on reports of observable ivermectin benefit to profylaxis and some benefit in treatmeant of early infections.
      - dang 5y ago
        Please don't cross into flamewar, especially on divisive topics. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
spacial 5y ago
Well, in Brazil, the president (Borsalino) is promoting ivermectin as covid treatment. I can tell you is not working at all. I doesn't help at all. I have a coworker who as using ivermectin as prophylactic and went to ICU (he is recovering now).
- innocentoldguy 5y ago
  That's weird. I just read about a study in a Japanese newspaper today stating that Ivermectin works great.
- Ivdg3 5y ago
  Sample size 1.
- loceng 5y ago
  At what dose and frequency? Was it real Ivermectin or perhaps counterfeit? What was his overall health to begin with? I fucking love HN - downvoting valid questions for criteria.
- BrissyCoder 5y ago
  How do you know he wouldn't be dead if they hadn't been taking it?
  - robbiep 5y ago
    Because a prophylactic means taking it regularly in order to avoid catching it, with the implication of the poster’s statement being that ivermectin, which carries significant risks when taken by a human at various doses, was the cause of the person going to ICU
    - argvargc 5y ago
      Exactly. Just because someone doesn't dose something correctly, doesn't mean there is necessarily anything wrong with it. Shall we ban water? Sometimes people don't dose that correctly either, and drown. What a dangerous substance!
ajb 5y ago
" But since there hadn't been a randomized trial " This is not true. A quick search shows 71 trials covering ivermectin, of which 6 of which are complete, interventional[1], and have results https://clinicaltrials.gov/ct2/results?term=ivermectin&cond=COVID-19&Search=Apply&recrs=e&age_v=&gndr=&type=&rslt= https://clinicaltrials.gov/ct2/results?term=ivermectin&cond=... [1] This should mean an RCT, but I haven't time to read through each and check they are
- PragmaticPulp 5y ago
  Yes, it has been explored, trialed, and experimented with quite significantly. The results show that there might be something there, but it’s not a miracle cure. The conspiracy angles are coming from those who have been misled into thinking it has been more successful than it really has been, which leads to confusion about why it’s not being used everywhere.
  - spfzero 5y ago
    With 0.38 risk ratio, it may well be that it should be used everywhere (except for patients already advanced enough to need mechanical ventilation, as mentioned). I don't have a reference for this but I recently read it was basically used on every tested-positive case with symptoms in Mexico City, with significantly improved results.
    - The_rationalist 5y ago
      How do you calculate the risk ratio?
      - bamboozled 5y ago
        It's been in use for about 40 years and prescribed maybe billions of times, conclusions would've been drawn from a large data set like that.
  - injb 5y ago
    > The conspiracy angles are coming from those who have been misled into thinking it has been more successful than it really has been, which leads to confusion about why it’s not being used everywhere. No, the "conspiracy angles" are coming from people who have seen youtube videos and HN posts disappearing just for discussing it.
fda_hates_u 5y ago
There would be no emergency use authorization allowed if there was an existing possible treatment. https://www.fda.gov/media/97321/download#page12 https://www.fda.gov/media/97321/download#page12 Go to page 12 in the PDF (document page 8) then read section D. Pharma companies could not distribute experimental treatments unless they lied to us about existing useful drugs. Reminder: Pfizer: Phase 3 trial estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04368728 https://clinicaltrials.gov/ct2/show/NCT04368728 Moderna: estimated end date 2022 https://clinicaltrials.gov/ct2/show/NCT04470427 https://clinicaltrials.gov/ct2/show/NCT04470427 Johnson & Johnson (it’s actually a Janssen Product which is a subsidiary of J&J): estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04505722 https://clinicaltrials.gov/ct2/show/NCT04505722 AstraZeneca: estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04516746 https://clinicaltrials.gov/ct2/show/NCT04516746
- wrycoder 5y ago
  That would depend on the efficacy of the existing possible treatment. Ivermectin is 70%, so it's not as effective as a vaccine. But it's a hell of lot better than nothing.
  - raarts 5y ago
    Doctors often combine multiple drugs/treatments. Not every single part of the combination needs to be as good as a vaccine.
  - pbak 5y ago
    You have reversed the logical sequence. You can't know how efficient a vaccine is without a trial. You need an authorization first to do that. But you wouldn't get an authorization if something exists, even "only" 70% better, because that 70% would make Covid less lethal than the yearly flu. Hence 70% is enough to block emergency vaccines trial authorization.
- javagram 5y ago
  Dexamethasone is an approved drug recommended by the FDA for treatment of Covid and it didn’t stop the vaccine EUA. The vaccines are 95-100% effective in trials, no other drug comes close.
roenxi 5y ago
> The fact the interview between Bret Weinstein and Pierre Kory was banned from youtube for non-WHO/CDC/NIH approved covid treatments is a tragedy. Banning academics from talking on a platform is a high-risk strategy. It was always possible YouTube would do more harm than good implementing their stupid policy. Note that their ban might be taking out anyone who wants to talk about Ivermectin neutrally or negatively because of the risk of being censored. It is possible (probable, even) that YouTube is now presenting a biased sample of videos sampled only from people who believe strongly enough in the drug to try and circumvent the ban. My guess is that if Ivermectin turns out to be useless despite the evidence, a lot of the buzz I've heard will have been generated by YouTube squelching debate meaning that only the pro- side even attempts to get the message out on social media. Because I've only heard of wall-to-wall positive coverage on YouTube and I don't trust the consistency.
- ratsmack 5y ago
  >Because I've only heard of wall-to-wall positive coverage on YouTube and I don't trust the consistency. Where else can it be discussed? No major media would allow it on their networks for fear of the cancel mobs coming with torches and pitchforks.
cblconfederate 5y ago
last year's reports about ivermectin were from 3rd world countries, and they were not rct. i guess that contributed to dismissing it. OTOH there was a lot of hype around remdesivir, despite it being barely effective. Pharma is really a weird world
- bhk 5y ago
  Hmmm... did YouTube ban discussion of Remdesivir and delete videos that included this guy? https://www.nbcnews.com/health/health-news/coronavirus-drug-remdesivir-shows-promise-large-trial-n1195171 https://www.nbcnews.com/health/health-news/coronavirus-drug-...
tootie 5y ago
There isn't really. There's as much evidence as we had for hydroxy chloroquine. So, some but unconvincing. And since it's been widely deployed by several desperate governments you'd think we'd know more by now. Here's a breakdown of what we've learned: https://blogs.sciencemag.org/pipeline/archives/2021/06/07/ivermectin-as-a-covid-19-therapy https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv... Here's the latest bad news: https://www.nytimes.com/2021/03/04/science/coronavirus-ivermectin-treatment.html https://www.nytimes.com/2021/03/04/science/coronavirus-iverm...
- WillPostForFood 5y ago
  Both the articles you cite mainly complain about lack of data, but they both predate the study posted here. The NY Times is 3 months old. This study may or may not be good, but neither article address that question.
  - tootie 5y ago
    The social media bans were over people making completely unjustified pronouncements about it's value. Same as the guys claiming HCQ was extremely effective when the data was completely inconclusive. Anyone saying we should widely deploy Ivermectin is spreading dangerous disinformation. Actually relevant and accurate information is being shared and published freely.
    - pbak 5y ago
      As per the latest meta study of June 6, for over on whole year, 549 authors in 60 conclusive studies published on medRxiv, Nature, Wiley (basically the usual medical research forums) during the last year => free and shared, as you asked. Malone, Weinstein, Kory and al. were banned for two videos made one and two weeks ago talking among other this of this meta study. That's hardly spreading disinformation, or am I wrong somehow ? Several point of comparison : Improvements with Ivermetcin were 76% for early treatment, 46% for late treatments, 85% for Prophylaxis for a 70% average over almost 19K patients. Ivermetcin was forbiden for Covid use in several western countries, and it's distribution forbidden to retail pharmacists (Switzerland is one). Budesonide and Remdesivir were authorized with respectively averages of 17% and 31% improvement only over 3.5K patients, and it's use promoted everywhere as the miracle drug. Dr. Raoult's initial HCQ announcement in early February was for 22 cases - very anecdotal and ridiculously insufficient. Later on, by the end of 2020 the hospital he's directing covering the southern third of France had treated 40K+ cases, with broadly similar results. We still hear the same "HCQ was debunked", somehow, and HCQ is still forbiden for Covid use in several countries.
stewbrew 5y ago
You're commenting on a metaanalysis that summarizes 15 published trials, aren't you? Maybe you should spend less time on YouTube inspired guessing. Social media isn't relevant here. YouTube is not the center of the Galaxy. Medical doctors don't make their decisions based on YouTube videos -- at least I hope so. Edit: sorry for the wrong position in the thread. Should have gone to the parent post.
- roenxi 5y ago
  > You're commenting on a metaanalysis that summarizes 15 published trials, aren't you? The worrying split here is on HN I get to read 15-study meta-analysis posted by Steph C, int13 Labs CEO. On YouTube, a PHD holder in a medical field discussing the same 15 study meta-anlysis might expect to have their video pulled. It is quite worrying that the powers-that-be at YouTube are taking this radically anti-speech approach. It isn't like studies posted on HN are automatically good and on YouTube automatically bad. The YouTubers are probably more qualified to bring attention to studies.
  - stewbrew 5y ago
    In a sea of bullshit videos, the minions who screen this stuff probably have difficulties to distinguish some phd (in what field?) choosing the wrong channel and bullshit. Anyway, the original statement was that there are no trials - this in a comment on a meta-analysis.
    - ratsmack 5y ago
      > the minions who screen this stuff That's quite an elitist statement. My belief is that a majority of the people that view videos of technical discussions have the capability to understand the context. The ones that do not grasp the subject are far more unlikely to watch the video.
      - stewbrew 5y ago
        no, it's not elitist. I assume a human does the last decision. this human doesn't care about the content of the video (like you do) but has to make a defendable decision in limited time based on limited information.
throwawaysea 5y ago
Related post from Matt Taibbi on his Substack, about Bret Weinstein with a short interview of him. With recent takedowns of his videos, many viewers are anticipating his channel will be banned outright by Google/YouTube: https://taibbi.substack.com/p/meet-the-censored-bret-weinstein https://taibbi.substack.com/p/meet-the-censored-bret-weinste...
13years 5y ago
"I heard about Ivermectin for the first time this week" This is what is extremely disturbing. This result of the control of information occurring in our society. What's more, it is not just the literal control, but the social conditioning. Within the group of those who have known for a long time, there is a reluctance to share that with anyone else as society will apply any number of taboo labels to such individuals to make them outcasts.
- manwe150 5y ago
  I heard the earth was flat only a few months ago too—it does not make either claim any more likely to be true. And FWIW, I have seen many ivermectin articles on HN (check my past comments), and all seem to say roughly the same thing, so they get rather annoying in my feed at this point.
  - 13years 5y ago
    "I heard the earth was flat only a few months ago too—it does not make either claim any more likely to be true." It is not about the validity, it is that you can not even evaluate that which you have not heard. The level of censorship varies greatly by media and platform.
    - manwe150 5y ago
      I would make the claim to be constantly evaluating the validity of statements I have not heard, and may never hear. This may sound like nonsense, but the flip-side of censorship is not excess of information but curation. If my news sources are trustworthy, then they are filtering useless information for me, while hopefully not belying my trust by censoring important information. To the other poster, my argument was supposed to be obvious: it was intended to be a simplified example to elucidate concerns by comparison.
  - pbak 5y ago
    Nice "motte-and-bailey" argument. But a little transparent, no ?

13415 5y ago

Without randomized trials you cannot recommend a drug because you cannot exclude confounders. It seems wrong to me to even speak of "overwhelming evidence" without a randomized trial or other sound ways to control or identify for confounders (e.g. causal models).

mgamache 5y ago
Actually a meta analysis can offer better evidence then a single RCT. https://ascopost.com/issues/june-10-2014/randomized-trials-vs-meta-analyses-which-is-the-better-bet/ https://ascopost.com/issues/june-10-2014/randomized-trials-v...
- Tenoke 5y ago
  The best meta-analyses are those made out of RCTs at any rate.
- MilnerRoute 5y ago
  Wait a minute... This post is a debate between two opposing viewpoints. So it also makes the exact opposite point: The primary difference between a randomized controlled trial and meta-analysis is that the former “provide the highest level of evidence because they contain the least amount of bias. Randomized controlled trials reduce bias, while meta-analyses increase bias." This Hacker News story is about a recent meta-analysis. But an actual randomized control trial of Ivermectin in March (on 476 patients) found the duration of symptoms on treated and untreated patients "was not significantly different." https://jamanetwork.com/journals/jama/fullarticle/2777389 https://jamanetwork.com/journals/jama/fullarticle/2777389
  - ALittleLight 5y ago
    Important thing to know about that study is they are testing time to recovery for people with mild covid. I'm not anywhere near an expert, but two things stood out to me reading this study. First, time to recover in the ivermectin group was 10 days versus 12 in the placebo. The paper calls this "not significant" but it's not clear to me whether that's statistically not significant, and if so, why wouldn't it be, or if knocking two days off recovery isn't that meaningful. The other thing I noticed reading it was that only one person out of 400 died and that person was in the placebo group. I think the Brett Weinstein response would be something like - A. Ivermectin's best benefit is as a prophylactic not a treatment. B. Ivermectin should be administered as early after onset as possible to treat, whereas here there was some delay to get people organized, enrolled in trial, etc. C. It's hard to measure effect when the disease is mild.
    - bonzini 5y ago
      > why wouldn't it be Because you only gave the average time of recovery but not the standard deviation.
      - ALittleLight 5y ago
        I didn't see the standard deviation reported in the paper. Is it? I did see the innerquartile range and it was the same for both the ivermectin group and the placebo. To me that suggests that variation in outcomes is probably similar between the two groups.
        Fomite 5y ago
        They provide it in the form of a hazard ratio: "hazard ratio for resolution of symptoms, 1.07 [95% CI, 0.87 to 1.32]" So statistically, those on ivermectin recovered 1.07 times as quickly as those on placebo, but the uncertainty bounds are from 0.87 times as fact to 1.32 times as fast.
  - spadez 5y ago
    > But an actual randomized control trial of Ivermectin in March Please see this https://news.ycombinator.com/item?id=27566123 https://news.ycombinator.com/item?id=27566123
goldemerald 5y ago
While randomized trials are certainly the gold-standard for determining if you should give a new drug to treat an arbitrary disease, that process is far too conservative during a pandemic where a huge majority of the world cannot access proper medical care. Ivermectin is already massively produced, used throughout the world, and cheap to manufacture (compared to new anti-Covid drugs). Even months ago before the benefits were known, the risks of taking the drug were very small, especially when the treatment guidelines were to do practically nothing. Still, the many pieces of non-randomized evidence can still clearly point towards this drugs efficacy. The sudden drop in Covid cases in India as the clearest indicator to me.
- jsnell 5y ago
  > The sudden drop in Covid cases in India as the clearest indicator to me. What's the alleged connection here? Are you claiming that some non-trivial number of patients in India were treated with this? How many, and at what point after being infected? And just how did the treatment affect the case numbers? Generally you'd expect the vast majority of secondary infections to happen before the diagnosis, not after, so a treatment seems totally irrelevant to the case numbers.
  - spadez 5y ago
    >Are you claiming that some non-trivial number of patients in India were treated with this Yes, example from two states. https://indianexpress.com/article/cities/lucknow/uttar-pradesh-government-says-ivermectin-helped-to-keep-deaths-low-7311786/ https://indianexpress.com/article/cities/lucknow/uttar-prade... https://www.news18.com/news/india/mortality-rate-much-lower-goa-govt-defends-use-of-ivermectin-for-covid-19-treatment-3786590.html https://www.news18.com/news/india/mortality-rate-much-lower-... The testimony video in this page cites examples in many other countries https://covid19criticalcare.com/ https://covid19criticalcare.com/
    - jsnell 5y ago
      I see no numbers on how many people were treated on either of the first two links, and certainly don't intend to comb through the dross on the third link. So do you actually have a number? It doesn't need to be exact, just a credible source on the order of magnitude will be enough. Are we talking a thousand, a million, or a billion here? To reduce R by a factor of 2 by the use of a prophylactic drug, you'd need to have half of the population on a regime of the drug. It seems pretty obvious that did not happen if this kind of reporting is the most impactful there is. Just think of the logistics of trying to do that! India has a population of 1.4 billion. On the other hand, if they only gave the snakeoil to e.g. a single digit number of millions of people the reduction in the number of infections would be imperceptible.
wrycoder 5y ago
https://sebastianrushworth.com/2021/05/09/update-on-ivermectin-for-covid-19/ https://sebastianrushworth.com/2021/05/09/update-on-ivermect... I’ve included every double-blind randomized placebo-controlled trial I could find of ivermectin as a treatment for covid. Using only double-blind placebo-controlled trials means that only the highest quality studies are included in this meta-analysis, which minimizes the risk of biases messing up the results as far as possible. In order to be included, a study also had to provide mortality data, since the goal of the meta-analysis is to see if there is any difference in mortality .... What we see is a 62% reduction in the relative risk of dying among covid patients treated with ivermectin. That would mean that ivermectin prevents roughly three out of five covid deaths. The reduction is statistically significant (p-value 0,004). In other words, the weight of evidence supporting ivermectin continues to pile up. It is now far stronger than the evidence that led to widespred use of remdesivir earlier in the pandemic, and the effect is much larger and more important (remdesivir was only ever shown to marginally decrease length of hospital stay, it was never shown to have any effect on risk of dying). I understand why pharmaceutical companies don’t like ivermectin. It’s a cheap generic drug. Even Merck, the company that invented ivermectin, is doing it’s best to destroy the drug’s reputation at the moment. This can only be explained by the fact that Merck is currently developing two expensive new covid drugs, and doesn’t want an off-patent drug, which it can no longer make any profit from, competing with them.
Vinceo 5y ago
Does that mean that the covid vaccines shouldn't be recommended as there's no randomized trials on their long-term effects? Just curious as I'm not well versed on this topic.
- 13415 5y ago
  Covid vaccines have been tested with randomized trials (Phase 3 of the testing phase). Regarding "long-term", that obviously depends on how you define "long-term but there is no need to move the goalpost. Generally speaking, in evidence-based medicine drugs and vaccines are not recommended based on incomplete statistics or hunches.

void_mint 5y ago

> I truly hope in the coming years the censorship of this topic will be the catalyst for allowing free speech to prevail on social media. If someone died because of a "Take Ivermectin and you'll survive COVID" video on YouTube, who's to blame? Should YouTube not take steps to prevent the spread of misinformation that could kill people? edit Big downvotes, no response. Great system.

Turing_Machine 5y ago
Here's a response: YouTube is chock-full of dubious health information. But only this one got banned. Why? For the record, since I've been muzzled from responding further, I don't believe that it was "money".
- guscost 5y ago
  And here’s the correct response to you: Money.
  - dang 5y ago
    You've posted something like 9 unsubstantive and/or flamebait comments in this thread. That has a seriously damaging effect on discussion, especially when the topic is divisive as this one is. I'm sure you don't intend that, but the effects work that way regardless of intent: https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sort=byDate&type=comment&query=troll%20effects%20by:dang https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor.... If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful. Note this one: "Comments should get more thoughtful and substantive, not less, as a topic gets more divisive."
    - guscost 5y ago
      I disagree strongly. Conflict-avoidant platitudes have much less substance.

desine 5y ago

You can't get EUA for the vaccines if there's a working treatment. The doctor who promoted Hydroxychloroquine and zinc treatment, Dr. Zelenko, is still banned from Twitter for spreading COVID disinformation. There's both actual conspiracies in this world, and well poisoning to damage the conversations. When you look at the amount of money these companies stand to make from producing billions of vaccinations, you should not be surprised.

enkid 5y ago
Source for the EUA stuff? Source that HCQ and zinc are viable treatments? The problem isn't that some of these things might be viable, the problem is we don't know which of the literally hundreds of treatments are actually going to be viable when going through the proper testing and approval process. You can't just scream conspiracy when there much better explanations
- desine 5y ago
  >Source for the EUA stuff? https://www.fdanews.com/ext/resources/files/archives/e/Emergency-Use-Authorization.pdf https://www.fdanews.com/ext/resources/files/archives/e/Emerg... (PDF warning)(section III, the first list, point #4) >Source that HCQ and zinc are viable treatments? Dozens? Hundreds? of doctors speaking out, including videos posted to youtube, that they saw great effectiveness in the trial. The people promoting it weren't a bunch of nobodys, despite what the nightly news told you. There were plenty of frontline workers with actual experience. But that likely won't satisfy your request for a source - which is fine. We all appeal to authority as we see fit. I saw many actual doctors saying "this is effective", and I saw many large corporations working together to shut that conversation down. Do you have any evidence it's not effective?
  - belltaco 5y ago
    >Do you have any evidence it's not effective? Do you have any evidence snake oil isn't effective? Burden of proof is on the people claiming a magic cure. Anyway here are a couple of studies that show it's not effective. https://onlinelibrary.wiley.com/doi/10.1002/jmv.27122 https://onlinelibrary.wiley.com/doi/10.1002/jmv.27122 https://jamanetwork.com/journals/jama/fullarticle/2777389 https://jamanetwork.com/journals/jama/fullarticle/2777389 Here's a good take by someone that does research on new medicines. https://blogs.sciencemag.org/pipeline/archives/2021/06/07/ivermectin-as-a-covid-19-therapy https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv...

throwaway192021 5y ago

My mom is on dialysis, has diabetes and hypertension. Recently for a surgery we had to do a covid test. Dad also took the test. Both were positive. The nephrologist prescribed ivermectin for mom. She had mild fever for 3 days and recovered. Dad had no obvious symptoms and recovered(he was not prescribed ivermectin, hence did not take it). The govt doctors don't prescribe it just vitamin c, zinc and dolo. This is india btw.

boredprograming 5y ago

Many people pushing Ivermectin have a vested interest in proving the vaccines are unnecessary. It may work, but that's why you get recommendations for "vaccine made me magnetic" and other garbage like that whenever you search for videos. It's the same group that was pushing hydroxychloroquine as a miracle drug

throwaway4good 5y ago
It is and it is weird. What do these people (the promoters) get out of it? Attention? A more dedicated following?
- raphlinus 5y ago
  I think the most useful lens to understand the sociology of these kinds of questions is religious belief. And there is no shortage of people out there who want to convince others of their belief. The narrative for "the Ivermectin story" is particularly compelling, as it involves brave maverick doctors working selflessly to get the word out, suppression and censorship by shadowy organizations (big pharma fearing competition, the big Internet companies just lusting after the power of thought-control), and the empowerment of people to take medical decisions into their own hands. Incidentally, this was the exact same narrative as HCQ, and is being pushed by a lot of the same people. The end of the story may turn out differently, as the evidence on HCQ is overwhelming that it doesn't work, so you only see dead-enders pushing it, but there is a good chance that Ivermectin will turn out to be at least moderately effective, though the jury is still out.
  - Heyso 5y ago
    Religious belief. Exactly. And what are your religious beliefs ? Are you sure you have none ? Is there something or someone you would never doubt ?
- ds206 5y ago
  How about having a discussion? Not everything has to be so complicated lol

lettergram 5y ago

Ivermectin is a cheap drug, Mercer (who produces ivermectin) is trying to produce their own covid19 drug. Further, if there are viable alternative treatments we shouldn’t be using a vaccine still in phase 2/3 trials that haven’t even been tested on animals... the entire emergency use authorization is only allowed if there aren’t safe alternatives. Ivermectin is generally safe to take, and a known drug with known risks. If it was shown to be effective the vaccine rollouts should be stopped. So, there’s a lot of political and financial reasons to not publicize it.

deleted 5y ago
[deleted]
fuckyah 5y ago
And there you have it! Why is ivermectin censored? Because otherwise they had to stop administering the experimental vaxx.
pawelmurias 5y ago
A treatment isn't an alternative to vaccination. Millions of people have been vaccinated so we know it's safe, while tons of people have died from covid so we know it's not safe.
- lettergram 5y ago
  This study appears to show that there is a treatment that’s ~90% effective at reducing deaths. The vaccines are not shown to be (may be) safe outside of a brief few month window (for specific classes of people). These are a new class of vaccine and there appears to be significant risk based on the cdc data (VAERS). https://austingwalters.com/covid19-vaccine-risks/ https://austingwalters.com/covid19-vaccine-risks/ To be clear none of the vaccines really completed a standard phase 2 or 3 trial. It had an abridged or expedited version that skipped things like pregnant women, etc. the vaccine is also not 100% effective, which is important as it’s a “leaky” vaccine. Meaning, we’re going to see lots of variants that get around our protection from the vaccine. That’s why treatments are important. It’s also possible we see genetic defects 2-3 years from now or an increase in cancer. We really have no idea.

ppf 5y ago

Next we'll find that the cheap and well-understood hydroxychloroquine is actually relatively effective Covid-19 treatment! It's disturbing how much the suppression of Covid "wrong-think" over the last year has resulted in useful results and information only very slowly coming out (and generally, in the process, giving a feeling of vindication to the conspiracy theorists). I have always been, and continue to be, against the idea that "this is such a novel emergency we just need to ignore all the processes that we know and trust". If anything, in those times, when we don't know what is going on, those principles are exactly the type of things we should stick to. I strongly believe it would have done us better over the past year.

jiofih 5y ago
> against the idea that this is such a novel emergency we just need to ignore all the processes that we know and trust There is a pretty well trodden path for new medicine to prove their effectiveness, which all Covid measures have gone through. If ivermectin, hydroxichloroquine or any other alternative drug goes through due course they would have no difficult being accepted. The reason discussions have been censored is precisely because people have been rallying around a drug like a football club before they’ve had their effectiveness scientifically proven, and demanding to skip the traditional due diligence. And for some context: this paper was submitted to a mainstream journal in March and rejected for lack of evidence. This publisher who picked it up is not exactly a reputable one (and will benefit immensely from citations of this study).
- Nursie 5y ago
  > rallying round a drug like a football club That’s what gets to me too, and this is the major issue I had with Trump saying anything about anything. He was floundering to look like he had a plan and the moment he mentioned HCQ he turned the whole thing political. It was massively irresponsible. It should be left to medical science, which is doing pretty damn well with vaccinations and treatments like dexamethasone. If Ivermectin can be helpful that’s great, and if it’s not then never mind, let’s evaluate other things. But it seems like people need to latch onto something, and then their ego and tribal allegiances won’t let it go.

atlgator 5y ago

Whether it works or not, there's no money to be made from Ivermectin. It's a very cheap generic drug. Why else would they stamp out all possible investigations of it just to ascertain truth?

raphlinus 5y ago
So is dexamethasone, and that's used world-wide for seriously ill Covid patients. What's the explanation for why dexamethasone was allowed but ivermectin is being suppressed?
- oblib 5y ago
  Basically it's been that there had been no studies to prove it works for covid. It's been used mostly in poorer countries that have had it on hand because it's relatively inexpensive. Doctors in those countries have been sharing info with each other and that's how it started being used a lot. During that time gather data for this use was begun and it's taken this long to gather enough, over enough time, to prove its efficacy according to the standards required.
  - bamboozled 5y ago
    Studies have been done and show that it is effective: https://covid19criticalcare.com/ https://covid19criticalcare.com/
- raarts 5y ago
  Maybe because you cannot use it as a prophylactic, so it doesn't threaten EUA for vaccines?
benmw333 5y ago
People down vote this - they gasp saying "no way could this be true" - yet they complain about big pharma right up until the "right" virus/disease/whatever science thing comes along and their tribe picks it up and runs with it - they're now the savior. The left/right don't realize they both have faith/religion of government. These politicians do not speak for you or me. Voting only leads to consequence without recourse.

bsder 5y ago

Because ivermectin is conspiracy theory land. If you don't have a proven, understood mechanism (which ivermectin doesn't for a virus like Covid) then you have to rely on trials, and those just don't stand up. Quoting Derek Lowe on this: https://blogs.sciencemag.org/pipeline/archives/2021/06/07/ivermectin-as-a-covid-19-therapy https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv... > If you haven’t had to mess with drug discovery for a living, it’s understandable that you hear that Some Person Somewhere was very sick, took New Therapy X, and suddenly got better, and then assume that there it is, the cure has been found. But that’s not how it works. Real results stand up when you run larger, better-controlled trials, but most early results don’t turn out to be all that real. Cue the Green Jellybean XKCD: https://xkcd.com/882/ https://xkcd.com/882/

josephcsible 5y ago
This may explain the lack of widespread use at first, but it definitely does not explain the widespread censorship.
kkwteh 5y ago
There are plausible mechanisms of action of Ivermectin against the Covid virus being explored. See https://www.nature.com/articles/s41429-021-00430-5/figures/1 https://www.nature.com/articles/s41429-021-00430-5/figures/1
Ivdg3 5y ago
The creator of mRNA vaccines disagrees with you: > What happens to confidence in public health and USG if ivermectin turns out to be safe and effective for COVID, and the genetic vaccines turn out to have signficant safety issues? This looks like a very plausible scenario from where I sit. https://twitter.com/RWMaloneMD/status/1403836354098872322 https://twitter.com/RWMaloneMD/status/1403836354098872322
- jacquesm 5y ago
  Mr. Malone is a very eminent scientist who has one serious problem in this particular case: he really doesn't like big pharma earning billions over what he considers to be his invention.

oblib 5y ago

I've been monitoring this for a long time now. I have ivermectin on hand for deworming my two mini burros. Of course, you're not supposed to use it on humans but they say that about fish mox too. But as time went on it was pretty clear to me that it was working to prevent covid from becoming severe in the countries that were using it for that because they had nothing much else to use. I saw many reports of it working. I also read about vitamin D, melatonin, famotidine, and aspirin helping to reduce severity of infections. So, when my wife and I got our 1st and 2nd jab of the Pfizer vaccine we took all of those and had no reaction to it at all. Our daughter took it before her first jab and had no reaction but didn't for her 2nd and she did get sick. As soon as she told us she wasn't feeling good we dosed her with those and just an hour or so later she was feeling good again. I haven't been infected and now I've reached full immunity so none of that proves anything at all but it's still been worth knowing.

yumraj 5y ago
How do you know that that dosing did not interfere with you developing proper immunity? In fact, CDC recommends taking fever reducing medicine only once you develop fever after a vaccine and not before vaccination for just this reason.
- oblib 5y ago
  How do you know eating a cheese sandwich doesn't interfere? How do you know what I did doesn't improve immunity since all those things I mentioned do seem to lessen the severity of covid? One thing I do know, is that no doctor anywhere has claimed what I did lessens the effectiveness of those vaccines.

actually_a_dog 5y ago

> There seemed to be an overwhelming amount of evidence.... > ....there hadn't been a randomized trial the drug You don't see the contradiction here? Edit: because it must be made 100% obvious, clinical trial results are the definition of evidence in medical science.

nicoburns 5y ago
That's not really contradictory. Lots of covid treatments have been discovered in hospital settings by doctors trying desperately to find something to help their patients.
- actually_a_dog 5y ago
  And those were later validated by evidence from clinical trials. Until clinical trials involving significant numbers of patients are available, there is not evidence according to the standards of medical science. That's the contradiction.
  - effie 5y ago
    > there is not evidence according to the standards of medical science. What the hell are you trying to say? That doctors treating patients observations can be dismissed because they don't talk the academic language or their results don't follow academic guidelines? There is more to medicine than just clinical trials. Many different things can count as evidence, even if they are not up to your academic standard. Doctors observations, population-level improvements, and studies of different cohorts. There are levels of evidence, there is strong evidence based on reports of observable ivermectin benefit to profylaxis and some benefit in treatmeant of early infections.
    - dang 5y ago
      Please don't cross into flamewar, especially on divisive topics. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

spacial 5y ago

Well, in Brazil, the president (Borsalino) is promoting ivermectin as covid treatment. I can tell you is not working at all. I doesn't help at all. I have a coworker who as using ivermectin as prophylactic and went to ICU (he is recovering now).

innocentoldguy 5y ago
That's weird. I just read about a study in a Japanese newspaper today stating that Ivermectin works great.
Ivdg3 5y ago
Sample size 1.
loceng 5y ago
At what dose and frequency? Was it real Ivermectin or perhaps counterfeit? What was his overall health to begin with? I fucking love HN - downvoting valid questions for criteria.
BrissyCoder 5y ago
How do you know he wouldn't be dead if they hadn't been taking it?
- robbiep 5y ago
  Because a prophylactic means taking it regularly in order to avoid catching it, with the implication of the poster’s statement being that ivermectin, which carries significant risks when taken by a human at various doses, was the cause of the person going to ICU
  - argvargc 5y ago
    Exactly. Just because someone doesn't dose something correctly, doesn't mean there is necessarily anything wrong with it. Shall we ban water? Sometimes people don't dose that correctly either, and drown. What a dangerous substance!

ajb 5y ago

" But since there hadn't been a randomized trial " This is not true. A quick search shows 71 trials covering ivermectin, of which 6 of which are complete, interventional[1], and have results https://clinicaltrials.gov/ct2/results?term=ivermectin&cond=COVID-19&Search=Apply&recrs=e&age_v=&gndr=&type=&rslt= https://clinicaltrials.gov/ct2/results?term=ivermectin&cond=... [1] This should mean an RCT, but I haven't time to read through each and check they are

PragmaticPulp 5y ago
Yes, it has been explored, trialed, and experimented with quite significantly. The results show that there might be something there, but it’s not a miracle cure. The conspiracy angles are coming from those who have been misled into thinking it has been more successful than it really has been, which leads to confusion about why it’s not being used everywhere.
- spfzero 5y ago
  With 0.38 risk ratio, it may well be that it should be used everywhere (except for patients already advanced enough to need mechanical ventilation, as mentioned). I don't have a reference for this but I recently read it was basically used on every tested-positive case with symptoms in Mexico City, with significantly improved results.
  - The_rationalist 5y ago
    How do you calculate the risk ratio?
    - bamboozled 5y ago
      It's been in use for about 40 years and prescribed maybe billions of times, conclusions would've been drawn from a large data set like that.
- injb 5y ago
  > The conspiracy angles are coming from those who have been misled into thinking it has been more successful than it really has been, which leads to confusion about why it’s not being used everywhere. No, the "conspiracy angles" are coming from people who have seen youtube videos and HN posts disappearing just for discussing it.

fda_hates_u 5y ago

There would be no emergency use authorization allowed if there was an existing possible treatment. https://www.fda.gov/media/97321/download#page12 https://www.fda.gov/media/97321/download#page12 Go to page 12 in the PDF (document page 8) then read section D. Pharma companies could not distribute experimental treatments unless they lied to us about existing useful drugs. Reminder: Pfizer: Phase 3 trial estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04368728 https://clinicaltrials.gov/ct2/show/NCT04368728 Moderna: estimated end date 2022 https://clinicaltrials.gov/ct2/show/NCT04470427 https://clinicaltrials.gov/ct2/show/NCT04470427 Johnson & Johnson (it’s actually a Janssen Product which is a subsidiary of J&J): estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04505722 https://clinicaltrials.gov/ct2/show/NCT04505722 AstraZeneca: estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04516746 https://clinicaltrials.gov/ct2/show/NCT04516746

wrycoder 5y ago
That would depend on the efficacy of the existing possible treatment. Ivermectin is 70%, so it's not as effective as a vaccine. But it's a hell of lot better than nothing.
- raarts 5y ago
  Doctors often combine multiple drugs/treatments. Not every single part of the combination needs to be as good as a vaccine.
- pbak 5y ago
  You have reversed the logical sequence. You can't know how efficient a vaccine is without a trial. You need an authorization first to do that. But you wouldn't get an authorization if something exists, even "only" 70% better, because that 70% would make Covid less lethal than the yearly flu. Hence 70% is enough to block emergency vaccines trial authorization.
javagram 5y ago
Dexamethasone is an approved drug recommended by the FDA for treatment of Covid and it didn’t stop the vaccine EUA. The vaccines are 95-100% effective in trials, no other drug comes close.

roenxi 5y ago

> The fact the interview between Bret Weinstein and Pierre Kory was banned from youtube for non-WHO/CDC/NIH approved covid treatments is a tragedy. Banning academics from talking on a platform is a high-risk strategy. It was always possible YouTube would do more harm than good implementing their stupid policy. Note that their ban might be taking out anyone who wants to talk about Ivermectin neutrally or negatively because of the risk of being censored. It is possible (probable, even) that YouTube is now presenting a biased sample of videos sampled only from people who believe strongly enough in the drug to try and circumvent the ban. My guess is that if Ivermectin turns out to be useless despite the evidence, a lot of the buzz I've heard will have been generated by YouTube squelching debate meaning that only the pro- side even attempts to get the message out on social media. Because I've only heard of wall-to-wall positive coverage on YouTube and I don't trust the consistency.

ratsmack 5y ago
>Because I've only heard of wall-to-wall positive coverage on YouTube and I don't trust the consistency. Where else can it be discussed? No major media would allow it on their networks for fear of the cancel mobs coming with torches and pitchforks.

cblconfederate 5y ago

last year's reports about ivermectin were from 3rd world countries, and they were not rct. i guess that contributed to dismissing it. OTOH there was a lot of hype around remdesivir, despite it being barely effective. Pharma is really a weird world

bhk 5y ago
Hmmm... did YouTube ban discussion of Remdesivir and delete videos that included this guy? https://www.nbcnews.com/health/health-news/coronavirus-drug-remdesivir-shows-promise-large-trial-n1195171 https://www.nbcnews.com/health/health-news/coronavirus-drug-...

tootie 5y ago

There isn't really. There's as much evidence as we had for hydroxy chloroquine. So, some but unconvincing. And since it's been widely deployed by several desperate governments you'd think we'd know more by now. Here's a breakdown of what we've learned: https://blogs.sciencemag.org/pipeline/archives/2021/06/07/ivermectin-as-a-covid-19-therapy https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv... Here's the latest bad news: https://www.nytimes.com/2021/03/04/science/coronavirus-ivermectin-treatment.html https://www.nytimes.com/2021/03/04/science/coronavirus-iverm...

WillPostForFood 5y ago
Both the articles you cite mainly complain about lack of data, but they both predate the study posted here. The NY Times is 3 months old. This study may or may not be good, but neither article address that question.
- tootie 5y ago
  The social media bans were over people making completely unjustified pronouncements about it's value. Same as the guys claiming HCQ was extremely effective when the data was completely inconclusive. Anyone saying we should widely deploy Ivermectin is spreading dangerous disinformation. Actually relevant and accurate information is being shared and published freely.
  - pbak 5y ago
    As per the latest meta study of June 6, for over on whole year, 549 authors in 60 conclusive studies published on medRxiv, Nature, Wiley (basically the usual medical research forums) during the last year => free and shared, as you asked. Malone, Weinstein, Kory and al. were banned for two videos made one and two weeks ago talking among other this of this meta study. That's hardly spreading disinformation, or am I wrong somehow ? Several point of comparison : Improvements with Ivermetcin were 76% for early treatment, 46% for late treatments, 85% for Prophylaxis for a 70% average over almost 19K patients. Ivermetcin was forbiden for Covid use in several western countries, and it's distribution forbidden to retail pharmacists (Switzerland is one). Budesonide and Remdesivir were authorized with respectively averages of 17% and 31% improvement only over 3.5K patients, and it's use promoted everywhere as the miracle drug. Dr. Raoult's initial HCQ announcement in early February was for 22 cases - very anecdotal and ridiculously insufficient. Later on, by the end of 2020 the hospital he's directing covering the southern third of France had treated 40K+ cases, with broadly similar results. We still hear the same "HCQ was debunked", somehow, and HCQ is still forbiden for Covid use in several countries.

stewbrew 5y ago

You're commenting on a metaanalysis that summarizes 15 published trials, aren't you? Maybe you should spend less time on YouTube inspired guessing. Social media isn't relevant here. YouTube is not the center of the Galaxy. Medical doctors don't make their decisions based on YouTube videos -- at least I hope so. Edit: sorry for the wrong position in the thread. Should have gone to the parent post.

roenxi 5y ago
> You're commenting on a metaanalysis that summarizes 15 published trials, aren't you? The worrying split here is on HN I get to read 15-study meta-analysis posted by Steph C, int13 Labs CEO. On YouTube, a PHD holder in a medical field discussing the same 15 study meta-anlysis might expect to have their video pulled. It is quite worrying that the powers-that-be at YouTube are taking this radically anti-speech approach. It isn't like studies posted on HN are automatically good and on YouTube automatically bad. The YouTubers are probably more qualified to bring attention to studies.
- stewbrew 5y ago
  In a sea of bullshit videos, the minions who screen this stuff probably have difficulties to distinguish some phd (in what field?) choosing the wrong channel and bullshit. Anyway, the original statement was that there are no trials - this in a comment on a meta-analysis.
  - ratsmack 5y ago
    > the minions who screen this stuff That's quite an elitist statement. My belief is that a majority of the people that view videos of technical discussions have the capability to understand the context. The ones that do not grasp the subject are far more unlikely to watch the video.
    - stewbrew 5y ago
      no, it's not elitist. I assume a human does the last decision. this human doesn't care about the content of the video (like you do) but has to make a defendable decision in limited time based on limited information.

throwawaysea 5y ago

Related post from Matt Taibbi on his Substack, about Bret Weinstein with a short interview of him. With recent takedowns of his videos, many viewers are anticipating his channel will be banned outright by Google/YouTube: https://taibbi.substack.com/p/meet-the-censored-bret-weinstein https://taibbi.substack.com/p/meet-the-censored-bret-weinste...

13years 5y ago

"I heard about Ivermectin for the first time this week" This is what is extremely disturbing. This result of the control of information occurring in our society. What's more, it is not just the literal control, but the social conditioning. Within the group of those who have known for a long time, there is a reluctance to share that with anyone else as society will apply any number of taboo labels to such individuals to make them outcasts.

manwe150 5y ago
I heard the earth was flat only a few months ago too—it does not make either claim any more likely to be true. And FWIW, I have seen many ivermectin articles on HN (check my past comments), and all seem to say roughly the same thing, so they get rather annoying in my feed at this point.
- 13years 5y ago
  "I heard the earth was flat only a few months ago too—it does not make either claim any more likely to be true." It is not about the validity, it is that you can not even evaluate that which you have not heard. The level of censorship varies greatly by media and platform.
  - manwe150 5y ago
    I would make the claim to be constantly evaluating the validity of statements I have not heard, and may never hear. This may sound like nonsense, but the flip-side of censorship is not excess of information but curation. If my news sources are trustworthy, then they are filtering useless information for me, while hopefully not belying my trust by censoring important information. To the other poster, my argument was supposed to be obvious: it was intended to be a simplified example to elucidate concerns by comparison.
- pbak 5y ago
  Nice "motte-and-bailey" argument. But a little transparent, no ?