6 ms·

Ivermectin has been know about since April 2020 when the Caly paper showed in-vitro that at high doses, ivermectin had anti-viral properties (sars-cov-2 sends p

Ivermectin has been know about since April 2020 when the Caly paper showed in-vitro that at high doses, ivermectin had anti-viral properties (sars-cov-2 sends proteins into the cell nucleus to turn off your immune response (interferon)). However, western scientists thought this anti-viral effect was implausible (https://www.microbe.tv/twiv/twiv-599/ https://www.microbe.tv/twiv/twiv-599/) - they were mostly correct as the effect is most likely immunomodulatory (Melo et al). Thus, NO clinicial trials of Ivermectin have been completed in the West (apart from a tiny 20 person trial in Barcelona). In contrast, the developing world has completed 30 randomized controlled trials (RCTs) and 60 trials in total - https://ivmmeta.com/ https://ivmmeta.com/. Ivermectin is safe (a WHO approved essential medicine), so we only care about efficacy. It is safer than paracetamol and has been taken billions of times. No trial completed to date has shown that it does not have a positive effect. Most trials have shown statistically significance on the most important clinical outcomes - hospitalization and death. Ivermectin works best when given early. It is transforming treatment and having incredible success in places like Uttar Pradesh (200+ million inhabitants, with only 38 new cases and 1 death yesterday - https://www.covid19india.org/ https://www.covid19india.org/). So, Ivermectin is an enormous threat to the Pharma industry. Merck (who discovered Ivermectin and help cure river blindness by donating it) are down-talking it, so they can bring Molpuvanir to market (they got a couple of billion from the US govt for this recently). Vaccine manufacturers run negative ads on google against Ivermectin (https://www.biznews.com/thought-leaders/2021/05/12/mailbox-ivermectin https://www.biznews.com/thought-leaders/2021/05/12/mailbox-i...). AND the person who discovered the fake data in the trial linked was supposedly a masters student, but he runs an investigative service and the level of sophistication in finding the data showed higher involvement - https://trialsitenews.com/ivermectin-study-appears-fraudulent-but-not-a-surgisphere-moment/?utm_source=pocket_mylist https://trialsitenews.com/ivermectin-study-appears-fraudulen.... This is like the tobacco industry funding scientific trials. We already had a discredited Jama paper (https://jamaletter.com/ https://jamaletter.com/) on Ivermectin/Covid. So they can do it, but I really hope the truth on Ivermectin - that it is an effective treatment for Covid - comes out. Otherwise, I will despair for society and advocate revolutionary change. However, the 2 big western trials being funded are being funded by the vaccine manufacturers (indirectly, of course), via Macmaster Univ (Gates-funded) and Oxford (Gates funded). RCTs can be designed to not succeed (it can't fail with Ivermectin, only not shown huge effect), and these are designed so - Bill * Caly et al - https://www.sciencedirect.com/science/article/pii/S0166354220302011 https://www.sciencedirect.com/science/article/pii/S016635422... * Melo et al - https://research.pasteur.fr/fr/publication/attenuation-of-clinical-and-immunological-outcomes-during-sars-cov-2-infection-by-ivermectin/ https://research.pasteur.fr/fr/publication/attenuation-of-cl... https://sebastianrushworth.com/2021/05/09/update-on-ivermectin-for-covid-19/ https://sebastianrushworth.com/2021/05/09/update-on-ivermect...

me_again 5y ago
I don't know whether ivermectin is an effective, let alone transformative, treatment for covid. I certainly hope it is! We could all do with some good news. I don't have time or expertise to evaluate, let alone conduct, clinical trial methodologies or meta-analyses, so I have to rely on secondary sources. The institutional consensus (from WHO, etc) is that the treatment is unproven, and further research is required. https://www.who.int/news-room/feature-stories/detail/who-advises-that-ivermectin-only-be-used-to-treat-covid-19-within-clinical-trials https://www.who.int/news-room/feature-stories/detail/who-adv... It is apparent that there is a community (ivmmeta, BIRD, FLCCC) who strongly disagree and believe that ivermectin efficacy is already proven. So the question becomes: who to believe? We definitely have historical examples of astroturfing, regulatory capture, etc occurring - such as oil companies going to enormous lengths to muddy the science around climate change. And we also have recent examples (HCQ is the obvious one) where a large number of people became very excited about a treatment which has, I think, been fairly conclusively shown to be ineffective. I have no magic method to determine which of these is the case this time, but my money is on IVM being a washout after further research. I am skeptical of the BIRD folks, because they are acting and talking like a pressure group, not an open-minded body. I frankly doubt their impartiality when evaluating the evidence - I'm not alleging a nefarious purpose, just the omnipresent danger of becoming too attached to your pet hypothesis. To paraphrase your statement, I hope the truth on ivermectin comes out. And I hope it is an effective treatment. But these are two separate hopes. BTW: You're providing an example here of how, once you start looking at a particular issue with a conspiracy mindset, you can easily construct an impervious epistemic bubble. The large trials cannot be trusted because they have been designed to fail; shadowy forces lie behind the doubts cast on the Elgazzar trial; and so on. This is not to say that conspiracies never exist. But it is worth asking yourself: what could I learn at this point which would change my mind?
- jamesblonde 5y ago
  You're implying I have selective bias in the evidence I put forward. However, you have only put forward a hunch - "my money is on". Your method of critique is post-modern - you have your evidence, they have their evidence. But that is not true. There are no studies (apart from one) that show Ivermectin is not effective - it's just the effect level that differs between them. There are now 30 RCTs! When you know that Ivermectin works best when given early and at higher (but safe!) doses, you can design studies that show a lower effect level. Just give it late at low doses on a healthy cohort. Then you conclude "Ivermectin has no effect". But meta analyses account for variances between RCTs - and they show it works. If you look at the MacMaster and Oxford trials - it allows participants who have had first sympthoms of Covid up to 14 days ago, from age 30. And they only dose for the first 2/3 days at 200/300 mcg/kg, respectively. We know from the meta analyses there is a dose response, and ivermectin has safety data with over 1200 mcg/kg. So, yes, you can design a RCT to give the answer you want - if you are incentivized to do so. Show me the incentive and i will show you the outcome.

me_again 5y ago

I don't know whether ivermectin is an effective, let alone transformative, treatment for covid. I certainly hope it is! We could all do with some good news. I don't have time or expertise to evaluate, let alone conduct, clinical trial methodologies or meta-analyses, so I have to rely on secondary sources. The institutional consensus (from WHO, etc) is that the treatment is unproven, and further research is required. https://www.who.int/news-room/feature-stories/detail/who-advises-that-ivermectin-only-be-used-to-treat-covid-19-within-clinical-trials https://www.who.int/news-room/feature-stories/detail/who-adv... It is apparent that there is a community (ivmmeta, BIRD, FLCCC) who strongly disagree and believe that ivermectin efficacy is already proven. So the question becomes: who to believe? We definitely have historical examples of astroturfing, regulatory capture, etc occurring - such as oil companies going to enormous lengths to muddy the science around climate change. And we also have recent examples (HCQ is the obvious one) where a large number of people became very excited about a treatment which has, I think, been fairly conclusively shown to be ineffective. I have no magic method to determine which of these is the case this time, but my money is on IVM being a washout after further research. I am skeptical of the BIRD folks, because they are acting and talking like a pressure group, not an open-minded body. I frankly doubt their impartiality when evaluating the evidence - I'm not alleging a nefarious purpose, just the omnipresent danger of becoming too attached to your pet hypothesis. To paraphrase your statement, I hope the truth on ivermectin comes out. And I hope it is an effective treatment. But these are two separate hopes. BTW: You're providing an example here of how, once you start looking at a particular issue with a conspiracy mindset, you can easily construct an impervious epistemic bubble. The large trials cannot be trusted because they have been designed to fail; shadowy forces lie behind the doubts cast on the Elgazzar trial; and so on. This is not to say that conspiracies never exist. But it is worth asking yourself: what could I learn at this point which would change my mind?

jamesblonde 5y ago
You're implying I have selective bias in the evidence I put forward. However, you have only put forward a hunch - "my money is on". Your method of critique is post-modern - you have your evidence, they have their evidence. But that is not true. There are no studies (apart from one) that show Ivermectin is not effective - it's just the effect level that differs between them. There are now 30 RCTs! When you know that Ivermectin works best when given early and at higher (but safe!) doses, you can design studies that show a lower effect level. Just give it late at low doses on a healthy cohort. Then you conclude "Ivermectin has no effect". But meta analyses account for variances between RCTs - and they show it works. If you look at the MacMaster and Oxford trials - it allows participants who have had first sympthoms of Covid up to 14 days ago, from age 30. And they only dose for the first 2/3 days at 200/300 mcg/kg, respectively. We know from the meta analyses there is a dose response, and ivermectin has safety data with over 1200 mcg/kg. So, yes, you can design a RCT to give the answer you want - if you are incentivized to do so. Show me the incentive and i will show you the outcome.