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Ivermectin: Much More Than You Wanted to Know

• dadboddilf2 5y ago
  seriously you are overthinking this: get jabbed
• daxfohl 5y ago
  So now could a similar analysis be done for HCQ? Granted, presumably patients coinfected with malaria would be far less numerous and far more obvious than those with parasites. But any other comorbidities that HCQ might affect?
• mint2 5y ago
  Okay it was too long for me and I got side tracked. Is his opinion in the end that ivermectin helps if you have worms? I got to the point where he talked about the studies showing no benefit were all from areas with low prevalence of worms and the studies showing benefits were all places with high prevalence of worms.
  • robbedpeter 5y ago
    It looks like it definitely helps if worms are a problem, and maybe possibly helps without, to the extent that further research is justified, but not so much that we should dose the world with ivermectin just in case.
    • bayesian_horse 5y ago
      And I would add that there are now two drugs who are known to work better, in addition to monoclonal antibodies and multiple vaccines with more than 7 billion doses administered for over a year... Ivermectin MIGHT work... but really... let's move on.
      • The_rationalist 5y ago
        Thymalin is by far the most effective treatment, people 1re simply too scientifically illiterate to realize it
      • robbedpeter 5y ago
        The bit most people are interested in is the potential prophylactic effect, not so much treatment once you have it (at least the people who are following the science and not buying into the weird cute claims.) It having an apparent antiviral effect during treatment indicates there's a possibility for mechanism of action that can prevent catching covid. It might be noise in the data, but studying it in large trials is justified imo.
        • bayesian_horse 5y ago
          A prophylactic effect would be, pardon me, stupid. There is even less evidence for that, and the vaccines clearly work better. Also you'd need to take Ivermectin continously for the next few years?? Compounding the cost and potential risks from sideeffects. Ivermectin is quite safe, but there are some risks, all drugs can go wrong every once in a while.
          • robbedpeter 5y ago
            You're not pardoned. You could have edited that, but decided not being rude wasn't worth the effort of deleting a single sentence? Maybe just don't write the first condescending thing that pops into your mind. If ivermectin worked as an antiviral prophylactic, it's another tool to use with better stability in storage and transportation, it's cheaper, and immediately useful for places that don't have refrigeration or access to vaccines, or can't use them for medical reasons. It could be effective against coronaviruses generally, which would be great. It would also probably mean a novel mechanism of action which could lead to new drugs. From a purely scientific standpoint, it's a wonderful thing to get more out of microbe based medicines since they're so easy to culture. Iterating over different chemistry using crispr solves many manufacturing issues, and makes drug r&d vastly more accessible around the world. A determined high school science geek could produce ivermectin, but mrna vaccines require multi million dollar labs. The evidence isn't strong, to be perfectly clear, but the payoff is more than just a "stupid" less effective vaccine alternative.
• tehjoker 5y ago
  We have multiple vaccines and two (EUA) proven oral treatments now.
  • cbg0 5y ago
    Yes, but the sneaky government is offering those freely, so that's very suspicious to some folks that would rather have "the good stuff" off of the black market.
    • havkd 5y ago
      Ivermectin is completely safe (even if it doesn’t work). The rest of treatments, well, we will know in a few years or decades.
      • cbg0 5y ago
        It's actually not, as it can induce temporary blindness if you overdose on it.
        • s-lambert 5y ago
          But overdose is a relative term, is it actually easy to overdose on ivermectin? Depending on the drug and how much a typical dosage is, overdosing could be a simple mistake like taking a second pill or be a ludicrous amount like eating hundreds of pills.
          • jacquesm 5y ago
            The people who are actively promoting this stuff are exactly the people who would be at risk of overdosing on it. Because it doesn't help. So they'll take more.
          • ufo 5y ago
            It's easy to overdose. A typical use of ivermectin for antiparasitic effect is a one-time dose with a single pill. But for so-called covid prevention, people have been taking higher doses for a prolonged period of time. There have been reported cases of people who had to get a liver transplant due to ivermectin misuse.
• junon 5y ago
  > Even an atheist can appreciate a cathedral, and even an ivermectin skeptic should be able to appreciate this website. This is well put. It's pretty remarkable indeed.
• OGforces 5y ago
  This guy is a brain genius according to a subset of the web and he spends this much real estate on invermectin and blesses us with this gem: “Mainstream medicine has reacted with slogans like ‘believe Science’. I don’t know if those kinds of slogans ever help, but they’re especially unhelpful here. A quick look at ivermectin supporters shows their problem is they believed Science too much.” Then he quotes. Their. Tweets. to tell us the ACTUAL problem with this contingent. Talk about unhelpful. My man has less expertise in abnormal psych than the average sex worker and conflates his ability to dissect standard issue science publications with expertise in sociology (Nate Silver suffers from similar delusions of grandeur, and also writes insufferable, unhelpful, overconfident political diagnoses). I’d rather he didn’t amplify what he published, and I think it was not worth his time.
• pchristensen 5y ago
  One time I didn't believe Scott when he wrote a "More than you wanted to know" article. This time, I took his word for it and scrolled (and scrolled and scrolled) to the bottom to read the summary.
• roenxi 5y ago
  This is exactly the sort of thing that YouTube, Twitter, et al are suppressing. Someone thoughtfully listening seriously to what the proponents of Ivermectin are saying, weighing it up and saying "looks good but you forgot...". You can't get this sort of excellent rebuttal without allowing a site like https://ivmmeta.com/ https://ivmmeta.com/ into the debate.
  • jacquesm 5y ago
    Meanwhile, ivmmeta.com will get passed on from person to person that wants to sustain their delusion and the website here will be preaching to the choir.
    • roenxi 5y ago
      I changed my mind. I was making pro-Ivermectin comments just yesterday. This is the first serious anti-Ivermectin argument I've seen.
      • bayesian_horse 5y ago
        "Most scientists/doctors believe it to not work against Covid-19" wasn't a serious argument for you? It is a strange phenomenon that people are so ready to disagree with people who spent decades achieving exactly that kind of knowledge.
        • roenxi 5y ago
          That literally isn't an argument. It is a statement. And if anyone who said "many scientists/doctors believe it to work against Covid-19" is getting banned, then that statement has 0 signal. As Scott points out in this article, without knowing about the parasitic worm situation https://ivmmeta.com/ https://ivmmeta.com/ is both reasonable and moderately convincing.
          • jacquesm 5y ago
            This article doesn't move the needle at all for those that have a basic understanding of the mechanisms at work and who don't fall for the first conspiracy theory that gets lobbed their way. What you should do instead is to listen to your medical authorities who even if they do make mistakes have your best interests at heart, contrary to those that are pushing the quackery in an attempt to further destabilize our societies. You made yourself a willing collaborator in that, something to think about.
• robbedpeter 5y ago
  This is great. It also underscores a methodological opportunity - is there a way to group together a huge amount of studies, regardless of disease or treatment, and create a semantic association graph that takes things like climate, culture, geography, and the like into account? You could rank researchers and institutions and locations in order to weight contributions to meta-studies, but you would be also able to associate confounders like parasites almost immediately. I have to imagine it would be the ultimate tool in identifying novel uses for existing drugs. If this could be done with open source software, it could be a killer app for scihub. Medicine, nutrition, chemical processes, energy science, all sorts of things could benefit the world. Hell, what if there's a correlation with elevation? It looks like there's a lower death rate at higher elevation - how much air pressure is the threshold for viruses getting into lungs? Could a strong coughing fit at sea level be more dangerous than one at the summit of everest? Does less coughing occur in low humidity, low dust places?
  • astrange 5y ago
    If there was such a tool, you wouldn't be able to use it for much because you'd have to preregister all your searches.
• beebmam 5y ago
  "It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!" - I know this is said tongue-in-cheek, but this mischaracterizes the medical scientists who have been working themselves to the bone trying to understand this virus and disease. Actual medical science, and science in general, doesn't make claims beyond what we know for certain (or at least, we're very explicit about the claim's certainty). And what we know for certain in medical science is actually quite small. People, both for clout and for profit, make up bullshit when there are gaps in knowledge. "Believing science", as stated a few times in this article, should actually be framed as: reserving judgement until we have evidence. We should have a bit more respect and patience for the process of acquiring actual knowledge. And people who make claims beyond what we actually know should be held accountable culturally (and financially) for being liars.
  • robbedpeter 5y ago
    "A lot of what you're seeing as attacks on me, quite frankly, are attacks on science, because all of the things that I have spoken about, consistently from the very beginning, have been fundamentally based on science," "And that’s the reason why I say people who then criticize me about that are actually criticizing science" It's a problem with differentiating science from the scientists, and when someone mistakes themselves for an arbiter of truth, they damage public trust in science as a concept. The scientific method, big S Science, is the best tool humans have. People are fallible, flawed, arrogant, tribal idiots, and Science lets us rise above our weakness. Criticizing Fauci for being a weaselly political hack, repeatedly lying in public "for the greater good", lashing out with the above claims, and other serious ethical defects are fine - he's human. He is also capable and trained in understanding scientific data, and is undeniably an expert. However, as he has made so abundantly clear, he's lost perspective and recognition of his own flaws and biases, and doubled down on the politicization of science and the pandemic response. We need apolitical dispassionate scientists with the understanding that they as people are separate from their studies and recommendations. When the scientist starts lying to the public for reasons that amount to "I know better" or "the public is too stupid or incompetent to handle the truth," it undermines Science. "Believe Science" should be a no-brainer. It shouldn't be a team blue political slogan, or used to defend personal failings - both of which are despicable.
• deleted 5y ago
  [deleted]
• mike_h 5y ago
  His alien thought experiment in the “Political Takeaway” section at the bottom is a masterpiece. If you’ve struggled to explain where science lost democracy, this must be as crisp as it’ll ever be described.
  • raxxorrax 5y ago
    It got political, but he still doesn't capture the gist and whole of the argument. You cannot argue against an imaginary position which he still espouses. There are just democrats and conservatives for him. That is a deep socialization which depending on age might be a permanent affliction. But that isn't reflective of every position against a vaccination (or additional measures), it is more the explanation of a naive child. There are millions of reasons that could drive people to not play along: - Don't trust doctors - Don't trust politicians - Don't trust media - Has environment that shares the same opinions, difficult to go against the grain - There a doctors critical of methods like lockdown and even the vaccine itself - There a doctors that warned against vaccinating within a pandemic and their predictions became true to a degree - Countries that didn't lock down came decently through the pandemic if they had otherwise good healthcare - We combine vaccination with secondary measures like passes and mandatory health controls - Covid is endemic and you will get it anyway, we still see different rules for vaccinated/unvaccinated people - There are people unreasonably afraid of Covid - People throw away liberties for questionable safety and will still end up getting Covid in the end - ... Most of it is indeed a trust issue, but the problem is that there are currently few people in the public sphere that deserve that trust. I am vaccinated, I make this statement because there are fearful people that demand that you justify yourself. I am not really inclined to accommodate them, there is a saying that "the smarter one gives in" and this is clearly a case like that. Ivermectin wouldn't be the wonder cure, if criticism of it would be more analyzed in a way the author did. It is a good step. This is getting to a principled discussion if you just ban other voices.
    • jacquesm 5y ago
      This isn't an accident or a simple case of being wrong: this is a case of a fairly orchestrated campaign. That it has a lot of footsoldiers that aren't aware that they are being used is a real pity and a problem. The big question to me is how will we deal with the next round of bullshit cures that is undoubtedly waiting in the wings to play on those exact same feelings? Are people going to do this again, or will they wise up after having been played twice already?
• xenadu02 5y ago
  tl;dr: A lot of ivermectin COVID studies are garbage. When you throw them out it seems like there might be a mild positive correlation but that depends on your methodology. But when you look at the bigger picture the decent positive studies often come from areas of the world where parasitic worms are prevalent. There is a specific parasitic worm Strongyloides stercoralis that multiplies out of control sometimes causing death when corticosteroids are taken - the exact kind of corticosteroids that improve survivability for those with COVID. For good quality studies ivermectin seems positive for COVID in areas with high parasitic worm infection rates and negative for areas without such infections, though more data is needed. This seems like a tidy answer because it shows everyone got part of the story wrong and it has a plausible mechanism of action which was previously lacking (ivermectin kills parasitic worms that suppress the immune system and/or multiply out of control when other drugs necessary to recover from CVOID are given).
  • tzs 5y ago
    > But when you look at the bigger picture the decent positive studies often come from areas of the world where parasitic worms are prevalent. I bet someone could make decent money selling parasitic worm eggs or larvae or whatever the heck it is that gets into people that causes a parasitic worm infection so that people can infest themselves when they get COVID symptoms in order to make the ivermectin they then take more effective. A depressingly large number of the people that end up on /r/HermanCainAward as nominees or winners would believe that is reasonable.
• DoreenMichele 5y ago
  This is wonderfully fun stuff to read: This is from ivmmeta.com, part of a sprawling empire of big professional-looking sites promoting unorthodox coronavirus treatments. I have no idea who runs it - they’ve very reasonably kept their identity secret - but my hat is off to them...Putting aside the question of accuracy and grading only on presentation and scale, this is the most impressive act of science communication I have ever seen. I asked a few questions previously on HN about Ivermectin and got answers that killed my interest in the topic (because I don't think it is relevant). But this piece is a delight.
  • Cthulhu_ 5y ago
    I want to know who's behind those sites, the fact that nobody knows who's behind them is shady. Or is having sites pushing meta-studies about anything normal and I just missed it?
    • jack_pp 5y ago
      Is it so shady to mask your identity when so many people have been crucified for even hinting ivermectin might be beneficial?
      • weeblewobble 5y ago
        like who?
        • h3rsko 5y ago
          Joe rogan, aaron rodgers?
          • weeblewobble 5y ago
            Those two guys seem to be doing just fine.
    • deleted 5y ago
      [deleted]
• jmnicolas 5y ago
  Interesting read, I appreciate that the author isn't dogmatic and is open to discussion. However I think he misrepresent some anti-vaxxers: it's not a matter of trusting science, it's a matter of trusting scientists with heavy conflict of interest to tell the truth while most of us don't have the required scientific knowledge to evaluate if they're telling the truth. Pfizer and Moderna combined are making more than $1000 every second (stop and calculate how much money that makes for a year, that's mind boggling). Do they have an incentive to lie? The fact that the discussion is immediately shut down and doubt isn't allowed is a big red flag. Let me quote the author: > Here this question is especially tough, because, uh, if you say anything in favor of ivermectin you will be cast out of civilization and thrown into the circle of social hell reserved for Klan members and 1/6 insurrectionists. All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. But good doctors aren’t supposed to care about such things. Your only goal is to save your patient. Nothing else matters. He's funny, but the underlying reality is very sad. Add to this the power grab by politicians toward totalitarianism, color me very skeptical about the situation.
  • jesterson 5y ago
    > However I think he misrepresent some anti-vaxxers: it's not a matter of trusting science, it's a matter of trusting scientists with heavy conflict of interest to tell the truth while most of us don't have the required scientific knowledge to evaluate if they're telling the truth. That's an excellent point - unfortunately people who are easily labeled as "anti-vaxxers" and perceived as uneducated anti-scince crowd quite often happen to be the people who just don't digest unsubstantiated narratives easily, which actually is a right way to listen to people and companies with potential conflict of interest. A number of people (myself included) would perhaps pay less attention to ivermectin as in covid drug if crowd would really take it and do studies instead of just publicly mocking people who are trying to look into it. That attitude makes people think there is an agenda behind and big pharma revenues makes all of us think it's not entirely untrue. Regrettably a lot of people related to science forget that science is not a blind belief in authority but actually quite the opposite - question authority in everything.
    • 5y ago
• whiterock 5y ago
  fun (sad?) fact: Ivermectin is sold out in pharmacies in Upper Austria. https://www.nachrichten.at/oberoesterreich/entwurmungsmittel-ausverkauft;art4,3489983 https://www.nachrichten.at/oberoesterreich/entwurmungsmittel...
• yxwvut 5y ago
  This article is a nice counterpoint to what's felt like a trend of Scott's writing (outside of psychology) increasingly becoming contrarianism in search of evidence. Many pieces he's written in the last 1-2 yrs feel like he'll use some back-of-the-envelope calculation to get some ballpark (associative) estimate of some relationship and then base a worldview around it (or work backwards from the latter to the former), decades of causal inference and economics literature be damned. I guess maybe the delineation is social science vs medical science topics. When he's in his wheelhouse he's great to read.
  • unanswered 5y ago
    > contrarianism in search of evidence But that is literally what this article is, and Scott admits as much! He says that he chose worms as the most "trollish" possible response, despite a lack of any strong evidence at all that worms are the answer.
    • jacquesm 5y ago
      The funny thing is that for all of their supposed smarts the bulk of the commenters in favor of the 'new' worm theory are jumping on it, just like they jumped on Ivermectin in the first place. It is in a way an interesting experience to see this happen in real-time.
      • unanswered 5y ago
        If they're anything like me, they've always wanted the ivermectin thing to be worms-at-best-crap-at-worst, but have refused to accept "shut up and stop listening to the wrong science" as evidence in favor of that proposition. From that perspective their behavior is not only rational, it's far more rational and pro-science than the mainstream. Not surprising given who the audience is.
    • yxwvut 5y ago
      You’re totally right. I was more referring to his review of the merits of the various studies, which as a statistician I actually agreed with - I mostly read the article to understand the history of these studies, having no prior familiarity beyond the high level understanding that the evidence was weak. I expected this article to largely be pro-ivermectin-as-underdog given that the mainstream opinion is that it isn't, but I suppose this fits even more. His claim that it’s all able to be chalked up to worms is dubious at best - selection bias of one form or another (publication, metric selection, etc) seems substantially more likely. Sure enough, though his readership is credulously adopting this theory just as easily as they adopt his other contrarian points.
• EdwardDiego 5y ago
  My step-son was recently prescribed a small one off dose of ivermectin by a dermatologist to deal with a rather resistant case of scabies he acquired at a sports tournament. It took the pharmacy a couple of days to source, because signficant controls had to be put in place around prescribing it due to well, I'm just going to say what I think - the amazing capacity for the Internet to deliver dumbassery to people who are open to it, thanks to the algorithms implemented by Google and Facebook. The current dominance of algorithmic social media is going to make a fascinating history book one day. Right now it feels somewhat dystopian how easily misinformation is spread online because it yields a high engagement metric.
  • jacquesm 5y ago
    Yes, and what's more: how easy it is to enlist people to push such a bullshit story further than it would ever go on its own. That is the really bad side of this, the weaponizing of social media to do real world harm to entire populations.
  • radu_floricica 5y ago
    Did you read the article? One of the main points was that it's not dumbassery. You have multiple studies saying a drug works, being contradicted by experts that have been wrong multiple time this year and have a vested interest in what they're claiming. This is the opposite of dumb. It turned out not to be true, but such is life - not all the correct choices are also true in the end. It's also counterproductive in so many ways to call this dumb. And it's making yourself a huge disfavor by believing that everything you see online but disagree with is automatically misinformation.
    • EdwardDiego 5y ago
      People seeking out medication because they think it's a prophylactic for Covid-19 is not what any of those studies covered.
      • radu_floricica 5y ago
        The irony of the situation is that it _is_ a mild-to-moderate prophylactic for severe Covid. In countries where parasites are endemic it's a significant difference to enter covid with parasites, or having gotten rid of them previously with a course of Ivermectin. Comment section is pretty Western-centric in behaving as if the article proves Ivermectin doesn't work. The fact that we know (or are pretty sure we know) what the mechanism of action is doesn't make it "not work", it just makes it another tool in the box.
• viktorcode 5y ago
  Well, at least the parasite endemic among humans sure is in decline now
  • DoreenMichele 5y ago
    Or, alternately, the incidence of drug-resistant parasitic infections is on the upswing due to misuse of the drug.
    • radu_floricica 5y ago
      It would be polite to come with sources or arguments for this, especially in this conversation. Occam says that taking an anti-parasitic drug will lead to less parasites. You can't just put second order effects on the table and claim it's a coin toss.
      • DoreenMichele 5y ago
        Occam's razor, Ockham's razor, Ocham's razor (Latin: novacula Occami), also known as the principle of parsimony or the law of parsimony (Latin: lex parsimoniae), is the problem-solving principle that "entities should not be multiplied beyond necessity",sometimes inaccurately paraphrased as "the simplest explanation is usually the best one." Similarly, in science, Occam's razor is used as an abductive heuristic in the development of theoretical models rather than as a rigorous arbiter between candidate models.[5][6] In the scientific method, Occam's razor is not considered an irrefutable principle of logic or a scientific result; the preference for simplicity in the scientific method is based on the falsifiability criterion. https://en.m.wikipedia.org/wiki/Occam's_razor https://en.m.wikipedia.org/wiki/Occam's_razor Coincidentally: https://news.ycombinator.com/item?id=29250580 https://news.ycombinator.com/item?id=29250580
    • h2odragon 5y ago
      I've read of growing Ivermectin resistance in some kinds of worms but not they kinds that were well targeted by it in the first place, just the ones that had good survival rates already. No citations, sorry; this was reading i did years ago. Might find references in tapeworm treatment discussion.
• Joking_Phantom 5y ago
  Love the final explanation for how ivermectin can be incidentally good for COVID-19 patients, even if it does nothing to COVID-19 directly. In fact, as the author cites from another researcher, the trials are a strong piece of evidence for "add[ing] ivermectin to mass drug administration programs." In other words, global medical welfare, where we just give everyone a bunch of a cheap and effective medications to counteract the most prolific diseases. In addition to reducing mortality from diseases targeted by the medication, it will probably reduce incidental mortality when people contract multiple conditions at once. I.e. getting ivermectin for a detected COVID-19 infection has a 10% chance of helping you, because you have a 10% chance of having an undetected worm infection that will kill you if your immune system is suppressed by drugs that are used to prevent COVID-19 from killing you. I do think the ending political metaphor doesn't quite fit, however. I see more parallels with workplace politics than an alien invasion, for why our societies have become so divided on relatively meaningless issues. Uniting disparate factions to work towards a common goal is an uphill battle that sees more failure than success, most often in our workplaces. To me, the ivermectin drama was just another example of an emergent situation that wasn't optimally handled by a collection of random individuals, who despite the best intentions, were unable to unite a group. Doesn't make them bad people, or mean they have the wrong approach. Just means they weren't ready to tackle such a difficult challenge. Positive outcomes take dedicated effort, they don't come automatically because we assume the status quo is good enough to us immune to random chance.
  • jacquesm 5y ago
    That depends on the side effects and the dose required+. So no, you can't just draw that conclusion. + edit: , etc... Thanks Cthulhu_.
    • Cthulhu_ 5y ago
      And of course whether parasites can adapt to become resistant (?) to the treatments.
      • jacquesm 5y ago
• Shank 5y ago
  This is worth reading purely for the writing alone. Scott Alexander is a treasure: > As best I can tell, this is some kind of Egyptian trial. It might or might not be an RCT; it says stuff like “Patients were self-allocated to the treatment groups; the first 3 days of the week for the intervention arm while the other 3 days for symptomatic treatment”. Were they self-allocated in the sense that they got to choose? Doesn’t that mean it’s not random? Aren’t there seven days in a week? These are among the many questions that Elalfy et al do not answer for us.
  • jmcgough 5y ago
    Oh, no wonder this was so entertaining to read, didn't even catch that this was astral codex. I laughed out loud at Cadegiani et al: > A crazy person decided to put his patients on every weird medication he could think of, and 585 subjects ended up on a combination of ivermectin, hydroxychloroquine, azithromycin, and nitazoxanide, with dutasteride and spironolactone "optionally offered" and vitamin D, vitamin C, zinc, apixaban, rivaraxoban, enoxaparin, and glucocorticoids "added according to clinical judgment". There was no control group, but the author helpfully designated some random patients in his area as a sort-of-control, and then synthetically generated a second control group based on “a precise estimative based on a thorough and structured review of articles indexed in PubMed and MEDLINE and statements by official government agencies and specific medical societies”.
  • WithinReason 5y ago
    The patients got Sunday off of course
    • thyrsus 5y ago
      If the study was in Egypt, that would have been Friday.
      • avs733 5y ago
        based on logic and statistics, that would be true based on the rest of study design I'm less confident
• bsaul 5y ago
  Funny how all this article ends up saying it's all a matter of trust. Which is exactly what medecine has always been about, and why ultimately you end up getting prescriptions by you own doctor, that you have a bound with and that you trust. The most insane thing that happened with this pandemic ( at least in europe) is how we decided to throw all this through the window and let states impose medical decisions on people and their children, not realizing people were still considering them highly incompetent in general.
  • mewpmewp2 5y ago
    It's about what makes money. There's no money to be made from Ivermectin as you can't patent it. Money is what orchestrates the studies and the PR for any medicine.
    • jacquesm 5y ago
      Again... really, please just stop.
      • throwawayacc2 5y ago
        Why? I think he has a point. We live in a society that is geared around profit. That is literally how our society functions. Economic activity is incentivised by the profit motive, important national metrics like GDP focus primarily on profit driven output and growth, even engineering or medical problems are often framed in economic terms like cost/benefit. I think it’s silly in this kind of context to ignore the profit motive.
        • jacquesm 5y ago
          [flagged]
          • orbifold 5y ago
            The (western) COVID vaccine manufacturers still make ~1000$/s in profit from them. Gates / BMGF are invested in literally almost all of them, even the obscure Indian ones, not just Moderna and BionTech
• robocat 5y ago
  With a meta-analysis, if you detect a high number of fraudulent studies, shouldn’t that negatively affect your trust of the studies which you didn’t detect any problem with? Let us imagine you looked at 100 papers, and you could tell 99 of them had severe problems, and one looked OK. That information would make you suspicious that the one paper also had severe problems, but that you just didn’t detect the problems. From article: “We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2/19 for fraud, 1/19 for severe preregistration violations, 10 for methodological problems, and 6 because Dr. Meyerowitz-Katz was suspicious of them.”
  • jacquesm 5y ago
    A good rule is to simply wait. Bad science has a way of being negated over the longer term. But if you want results today you could always try to replicate the experiment (which is one of the reasons why asking scientists to show their data in raw from should be mandatory in my opinion).
    • capableweb 5y ago
      > Bad science has a way of being negated over the longer term. Humans started to experiment with Lobotomy around 1930s and it wasn't until after 1950s that we started to realize that it probably did more harm than good. António Egas Moniz even won a Nobel Prize for "discovery of the therapeutic value of leucotomy in certain psychoses". Yes, bad science will probably be negated over long term, but what about the harm it does during those years? Can't we find a way to reduce the harm of experimental science? Maybe things aren't that long as my example today, but I still feel we can do more to prevent bad science in the first place.
      • jacquesm 5y ago
        If you can improve on the scientific method I'm sure lots of people would be very happy but for now it is the best we've got, the results speak for themselves. Science makes mistakes, all the time. But it does learn from those mistakes. The harm done during the intervening years is terrible, but likely a price we can not avoid. A bigger problem in my opinion is the degree to which science allows itself to be 'bought' by commerce, for instance in the case of smoking, climate change denial and other major issues that end up harming lots of people in very concrete ways. The man or woman in the white coat has a lot of authority and squandering that by throwing the scientific method out of the window to be replaced by a stack of green bills is a real problem.
• lolspace 5y ago
  > This is from ivmmeta.com, part of a sprawling empire of big professional-looking sites promoting unorthodox coronavirus treatments. I have no idea who runs it - they’ve very reasonably kept their identity secret Why are they hiding their identity? That means that it can be anyone who does this. ----------------- But even more important. The website also claims that each of the following individual medicines works: Fluvoxamine Proxalutamide Iota-carrageenan Molnupiravir Quercetin Povidone-Iodine Curcumim Casirivimab Sotrovimab Bamlanivimab Nitazoxanide Budesonide Zinc Bromhexine Colchicine Vitamin D Aspirin Favipiravir Hydroxychloroquine Remdesivir Vitamin C I find it unlikely that all those claims are true which in turn makes me question their scientific approach.
  • WithinReason 5y ago
    The problem is likely to be with the scientific approach of the studies included (they are not filtered) than the meta-analysis itself.
    • shkkmo 5y ago
      The article points out several ways that ivmmeta's meta-analysis may be flawed: > Meyerowitz-Katz accuses ivmmeta of cherry-picking what statistic to use for their forest plot. That is, if a study measures ten outcomes, they sometimes take the most pro-ivermectin outcome. > (how come I’m finding a bunch of things on the edge of significance, but the original ivmmeta site found a lot of extremely significant things? Because they combined ratios, such that “one death in placebo, zero in ivermectin” looked like a nigh-infinite benefit for ivermectin, whereas I’m combining raw numbers. Given that there is a lot of complexity and debate on how to integrate studies with disparate primary outcomesbane measures, the fault may indeed lie with the ivmmeta analysis methodology.
• shusaku 5y ago
  Such good writing. I was anxious about trying to read it all, but he kept me hooked to the end. > I think it’s important to address ivermectin support on its own terms - as a potentially plausible scientific theory in a debris field of confusing evidence, which should be debated to the usual standards of scientific debate. I’ve tried to do that above. This is also how I’ve kind of tried to view things, yet I continue to be disappointed. The studies shown here were way worse than I imagined. Just like when someone in my personal life says to me they’re skeptical of the vaccines. I want to take them seriously, I’m waiting for them to talk to give well reasoned arguments about hard choices and uncertainty, but it ends up being arguments one can dismiss with five minutes of research. I predict that over the next 100 years bioethics will dominate the discourse. I want people to be ready to challenge the status quo and experts going forward. But covid has really shown that we’re not even remotely prepared. What will it take, four years of mandatory biology and philosophy for high school students?
  • esun 5y ago
    Maybe even just an intro to stats course in early high school would help?
  • native_samples 5y ago
    What arguments do they give you?
• tdrdt 5y ago
  "...everyone still PCR positive by day 7 so it was impossible to compare groups" Eh, isn't this what a PCR-test does: detect RNA? A medicine doesn't magically remove virus RNA. It might break down the virus or block it's ability to reproduce but the RNA will still be detected.
• Tycho 5y ago
  How similar to Ivermectin is the new Pfizer covid drug?
  • pjc50 5y ago
    Paxlovid: https://en.wikipedia.org/wiki/PF-07321332 https://en.wikipedia.org/wiki/PF-07321332 protease inhibitor; Ivermectin: https://en.wikipedia.org/wiki/Ivermectin https://en.wikipedia.org/wiki/Ivermectin binds to chloride channels and is a nerve poison for invertebrates. The molecular layouts look completely different.
    • gardnr 5y ago
      This study shows Ivermectin functions as a protease inhibitor https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996102/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7996102/ Here is the fact check evaluation from Reuters: https://www.reuters.com/article/factcheck-coronavirus-pfizer-idUSL1N2R11T5 https://www.reuters.com/article/factcheck-coronavirus-pfizer...
      • pjc50 5y ago
        Yes, and that fact check evaluates to "false"?
        • gardnr 5y ago
          Yeah. Reuters says it’s false. John Campbell, a retired nurse with a PhD in philosophy was fact checked on it as well. He has a response video: https://youtu.be/ObTAOvgd_JE https://youtu.be/ObTAOvgd_JE It doesn’t really matter given that ivermectin is not effective.
          • HamburgerEmoji 5y ago
            > It doesn’t really matter given that ivermectin is not effective. Unfortunately, you're in disagreement with doctors who have personally saved thousands of lives. Ask the people who came up with the MATH+ protocol if ivermectin could just be discarded. They'll say no. https://covid19criticalcare.com/wp-content/uploads/2021/01/FLCCC-Alliance-MATHplus-Protocol-ENGLISH.pdf https://covid19criticalcare.com/wp-content/uploads/2021/01/F...
• low_tech_love 5y ago
  It was a fun read, but implying that a drug dealer from Kern county is related to a published researcher from Mexico just because they have the same surname is not really cool.
  • comicjk 5y ago
    I agree. I wonder, though - the author has written a lot about political signaling and trust. I wouldn't put it past him to add a joke that's deliberately anathema to liberals, in order to relax the hackles of the conservatives he's trying to convince to use real medicine.
    • s1artibartfast 5y ago
      Why do you think the joke could be joke could be viewed as anathema to liberals in particular? I was trying to dissect this comment and couldn't figure out the political angle.
      • comicjk 5y ago
        It's not liberal vs conservative in a policy sense, but in a cultural sense, much more important for signaling. I think many liberals (I include myself) would say it's racially tinged to joke that a doctor and a drug dealer must be related because they have the same Spanish name.
        • s1artibartfast 5y ago
          I see, so it separates the people that assume that it is an example of racial profiling because there is a POC involved? Is the assumption that the person being mocked is singled out because of their Spanish last name.
          • comicjk 5y ago
            Something like that, sure. Apart from the question of whether the joke is good or bad, I think it's pretty clear from the reactions here that it has a political valence.
• yholio 5y ago
  > I want a world where “I did a study, but I can’t show you the data” should be taken as seriously as “I determined P = NP, but I can’t show you the proof.” The fact that this is not standard practice highlights some societal bias in favor of people in white lab coats that can't possibly be suspected of fraud or incompetence - for it will shatter our sense of safety and control over the world. People are people and power corrupts. When your publication has the power to turn you into a celebrity, skyrocket your career and land you a top paying job and speaking arrangements, the corruption potential is strong. As the author further elaborates: > But even if it’s only 1%, these will make up much more than 1% of published studies, and much more than 1% of important ground-breaking published studies, because correct studies can only prove true things, but false studies can prove arbitrarily interesting hypotheses (did you know there was an increase in the suicide rate on days that Donald Trump tweeted?!?) and those are the ones that will get published and become famous. > So if the lesson of the original replication crisis was “read the methodology” and “read the preregistration document”, this year’s lesson is “read the raw data”. Which is a bit more of an ask. Especially since most studies don’t make it available.
• drcongo 5y ago
  Wow, some ivermectin propaganda on Substack. Fetch me a fainting couch.
• rmbyrro 5y ago
  > Mainstream medicine has reacted with slogans like “believe Science”. I don’t know if those kinds of slogans ever help, but they’re especially unhelpful here. To me such slogans are a disservice. Science should not be a matter of belief by definition. This way of promoting science is what brings belief-centric discussions to an arena that cannot benefit from beliefs. I remember one presidential debate in the US where the interviewer asked Trump: "Do you believe the science of climate change?" Making such question is an absurdity and reflects the almost religious way these subjects have been considered lately. No scientific field, study or conclusion should be a matter of belief.
  • notahacker 5y ago
    Science is a means of approaching beliefs. Science is not the philosophical position that we should be agnostic about the existence of gravity or magnitude of gravitational forces. Unlike other means of reaching beliefs, science supposes there is little reason to hold a belief that cannot be supported by induction from experimental data, and that a correctly set up experiment can falsify previously held beliefs and require the theory to be updated. A corollary of this is that stuff generally isn't to be believed simply because a very old book and much revered book says so (which is bad news for Aristotle's speculation as well as monotheism, but somewhat better news for Newton's laws because there are practical working applications of them). But when it comes to anthropogenic climate change or vaccine efficacy the evidence very much is there - people can either believe it is probably true or demonstrate their superior understanding of why evidence actually doesn't support the hypothesis (ideally by counter example, but pointing out confounding factors that have been missed is a start). Either approach is consistent with science, though only the latter will further scientific knowledge. An approach to formulating beliefs which isn't consistent with science is the prior that if scientists virtually all agree on the evidence base for something, the contrarian theory is probably right.
    • rmbyrro 5y ago
      It seems we think very much the same. Given the historical background, I just think it would be better to use words such as knowledge, understanding, thinking, rationale, instead of belief.
• csee 5y ago
  While reading this piece I got a little depressed that most journalism is just such utter trash compared to it. I've read so many articles on ivermectin and none of them gave me even ten percent of the clarity that this article gave me. Can you imagine if writing and journalism of this calibre was commonplace among practising "journalists"? And look at how this piece compares to the CDC's and WHO's science communication. It's a shame that clear thinking and communication is so scarce.
  • BurningFrog 5y ago
    I think the simple fact is that people with this scientific literacy and ability have much better career option than becoming journalists. This was true before the profession entered the death spiral of the last 1-2 decades, and is extremely true now.
  • jacquesm 5y ago
    This is a huge factor. Dumbing things down creates a dumber audience. If you look at newscasts and newspapers from the 70's and compare them to today the difference is amazing.
    • api 5y ago
      There are a lot of conspiracy theories about this but I think it’s just a race to the bottom in search of the largest audience. It seems to still be getting worse. I remember cable news being tolerable 10 years ago. Now when I see it at an airport or something I can almost feel the ice pick ramming up into my brain and swishing around.
      • jacquesm 5y ago
        Whenever I visit people and they have the TV on I'm fascinated that the people that produce that crap think they can get away with it, it is so blatantly manipulative and often downright false. And then I realize they do. They get away with it all the time.
  • astrange 5y ago
• 271828182846 5y ago
  > All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele. Well, as a German I feel obligated to recommend those officials to read up on Josef Mengele and then reconsider throwing that name around so casually.
  • JohnWhigham 5y ago
    Blame the Twitterati for the normalization of calling people "Nazis" over slight political disagreements.
    • jacquesm 5y ago
      Usenet wants a word.
    • jmull 5y ago
      It's a Twitter thing now, but it might be useful to understand that it predates Twitter. E.g., "Goodwin's Law" is supposed to have been coined in 1990, and of course it was a pretty well established phenomenon to earn a coined term. I know from first-hand experience it was happening on BBS's and newsgroups in the '80s. I would be more surprised than not if it wasn't happening before then too. (And if you want to generalize slightly, calling someone a Nazi is simply a current way of demonizing your opponent. People have been demonizing their opponents since well before there were Nazis.)
      • h2odragon 5y ago
        I think we ought to re-invigorate "Philistines" as the term for "people who disagree with us even though we haven't listened to what they said". It's got a better flavor, ya'know? and the whole historical angle should appeal to the kiddies.
  • rory 5y ago
    He means it as a metaphor for "they'll say you're extremely evil," and Mengele is the most evil scientist that's also a household name. Treating any name like it's Voldemort isn't a helpful norm for a society to uphold. I'm pretty sure Scott is Jewish, so I imagine he's aware of Mengele's work.
• podgaj 5y ago
  Hold on, science never ends, amiright? I want to focus on this article: https://sciencebasedmedicine.org/pfizer-new-covid-19-protease-inhibitor-drug-is-not-just-repackaged-ivermectin/ https://sciencebasedmedicine.org/pfizer-new-covid-19-proteas... Where they conclude: "Spoiler alert: 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." So Ivermection COULD work. That is not me saying that, that is an scientific article debunking Ivermectin. (As an aside, the politics of this, they will not even say that yes, ivermection COULD work but the dose needed would be too high). But the protease all these drugs try to inhibit is TMPRSS2. Now TMPRSS2 is made by a gene, and genetic changes affect the amount of this enzyme, leading to higher or lower function. https://academic.oup.com/jid/article/212/8/1214/2193475 https://academic.oup.com/jid/article/212/8/1214/2193475 These gene changes could make us more or less vulnerable to COVID in some populations: https://www.biorxiv.org/content/10.1101/2021.10.04.463014v1 https://www.biorxiv.org/content/10.1101/2021.10.04.463014v1 So, unless you filter out genetic diversity (which they never do) you will never find out the population Ivermectin MIGHT help. Maybe it would help someone like me who carries that polymorphism. Maybe that is why it seems to work well in other countries? And what about checking if these patients were zinc deficient or not? Because ADAM17 uses zinc, and ADAM17 snips ACE2 off of the cell making Soluble ACE2. SARS2 will attach to this soluble ACE2 not allowing TMPRSS2 to let SARS2 into the cell. https://www.frontiersin.org/files/Articles/576745/fimmu-11-576745-HTML/image_m/fimmu-11-576745-g001.jpg https://www.frontiersin.org/files/Articles/576745/fimmu-11-5... https://www.ahajournals.org/cms/asset/36a2c66b-1ca8-43e9-944e-217a170f33fd/hypertensionaha.120.15082.fig01.gif https://www.ahajournals.org/cms/asset/36a2c66b-1ca8-43e9-944... So maybe, if someone has enough zinc then ivermectin, or any protease inhibitor, will be more effective at lower doses? And you know that people with river blindness, the thing Ivermectin treats, have lower levels of zicn and supplementation is urged in these patients: http://www.sciencepub.net/nature/0504/03_0312_nmorsi_serum_ns0504.pdf http://www.sciencepub.net/nature/0504/03_0312_nmorsi_serum_n... (PDF) "The depleted mean serum trace elements in the infected volunteers than their control subjects implicated the deficiency of copper, selenuim and zinc in the pathogenesis of onchocerciasis and the need to incorporated dietary trace element supplements in management of onchocerciasis." So all of those studies, IMHO, need to be thrown out. This is science, no blogs here, and I have the vaccine so I am not anti-vax. So please, don't come at me from that angle. This is a reasonable hypothesis. I carry the TMPRSS2 polymorphism they mention in the article above. Yes, my experience is anecdotal, but I was discovered to have a zinc deficiency well before COVID (they had a medical reason for testing it) and supplementing with zinc ended the colds and flus I would get three times a year. It has been 10 years and I have not had only minor symptoms a few times.
• mrfusion 5y ago
  I wish he could find a way to do this analysis blind for these kind of controversial issues. I felt like he was in the hunt to end up with a certain conclusion from the beginning. I felt like his article on vitamin D for covid was similar. “Looks promising but I’m going to say it doesn’t work because I take covid seriously or something”
  • xtracto 5y ago
    I agree. I read through the whole review of each article and on several of them the author tries hard to discredit them but doesn't find a reason so he just concludes with some witty question seeding FUD. Like the Mexican one: he just says he doubts it because it was made in Mexico? A lot of his cars, software and food is made in Mexico.
• darkerside 5y ago
  > And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true! I think I don't get the joke here. Can someone dissect it for me? (Yes, thereby killing it) I love this man's writing so much. Intelligent, empathetic, visionary, and simple. All at the same time. With no other author do I do as frequently think, "this article is way too long, no way I'm going to read all this," and before I know it, I'm at the end.
  • snowwrestler 5y ago
    Fluke is a type of worm
    • BurningFrog 5y ago
      Oh, wow. I had no idea! https://www.merriam-webster.com/dictionary/liver%20fluke https://www.merriam-webster.com/dictionary/liver%20fluke
    • deleted 5y ago
      [deleted]
• snowwrestler 5y ago
  The top part of the article is excellent, and literal worms as a confounding factor in trials of a deworming treatment makes a ton of sense. The end of the article, where he speculates about vaccine denial, is less useful. It’s kind of funny that the author spends most of the article rigorously applying the empirical and inductive scientific method, but then at the end just takes off on a flight into his own mind like some kind of ancient philosopher, finding their way by the power of thought alone. It’s really easy to fool oneself into thinking that because you are smart and knowledgeable in one area, you are smart and knowledgeable in general. That’s how ego and the mind works. It turns out, that’s not how knowledge works though. You have to observe and test to build real knowledge. The author, in exploring vaccine denial, would probably be better served by following the same method he did for ivermectin: exhaustively surveying the current state of scientific studies of the phenomenon, and attempting to rigorously synthesize it.
  • bsdetector 5y ago
    > The top part of the article is excellent, and literal worms as a confounding factor in trials of a deworming treatment makes a ton of sense. The blogger's idea is supported by 9 data points, 7 or 8 that kind of match the hypothesis when plotted on an at least somewhat arbitrary axis. Not a statistics expert, but pretty sure you could find many things that correlate that well. It's a tempting idea that a 'horse dewormer' works by deworming because people believed to be idiots turn out to be idiots, faith in institutions is unshaken, and everything makes sense. But ivermectin has been and is being investigated for efficacy against many single-strand RNA viruses so 'deworming' is only one possible explanation and must be supported by actual evidence.
• cryptica 5y ago
  What I don't understand is what is the incentive to publish fake studies to make a cheap generic (low profit) medicine look good? Even Merck, one of the manufacturers of Ivermectin claimed that the studies are invalid (then soon after announced that they are releasing a more expensive competing medicine which they have full patent rights over...). On the other hand, I know exactly what the incentives are to promote vaccines, lockdowns, bailouts, mandates and mass firings. Journalists often said "To find the truth, follow the money, look at the incentives." It seems that 99.9% of the money is against Ivermectin. Based on my experience working for big corporations, I wouldn't be surprised at all if some directors organized a campaign to threaten, silence and discredit scientists who pose a threat to corporate profits. That is not far fetched at all. Anyone remember big tobacco funding studies to prove that smoking is harmless? You think corporations are less powerful today? With all that money printing and trillion dollar bailouts? With all the media censorship? Big corporations managed to corrupt the legal system to get Steven Donziger jailed, why couldn't they corrupt the medical establishment in the same way to slander research papers and researchers. How do we know the password was really just 1234... That whole story sounds made up.
• WhompingWindows 5y ago
  In my opinion, the main crux is this: there are moneyed interests who are motivated to generate mistrust and otherization based on political parties. In the USA, Fox News has a strong incentive to inspire hatred and fear of Democratic policy, and MSNBC has a strong incentive to inspire hatred of the GOP. The same is true for Twitter, FB, NYT, WSJ, WaPo, literally any media outlet. Hatred, fear, outrage, worry, anxiety: they all drive viewers to advertisements. One major example, these media groups facilitated making a huge rift on climate change belief. The fossil fuel industry saw in the GOP, and some moderate Dems like Manchin, an opportunity to create doubt and slow the transition off their fossil fuel products. Now, the GOP has leaned into anti-scientist, anti-elitist sentiment, fed by Fox News and others. They're not totally anti-science, they still use abortion science, ivermectin science, and all the wonders of modern life...but they ARE anti-scientist, anti-elitist, anti-university. And Why? We're hating each other so media companies can make a few measly cents.
  • philosopher1234 5y ago
    We do not live in a society with two equal sides. The GOP has made destroying democracy/hating "the media" core to their platform, as opposed to centering their platform on some sort of policy goal. Do democrats hate the GOP? Sure, but their coalition is not nearly as structurally oriented around this fact.
    • mgamache 5y ago
      The 2020 DNC platform was Orange Man Bad.
      • philosopher1234 5y ago
        Anti-democracy is bad.
      • saalweachter 5y ago
        https://democrats.org/where-we-stand/party-platform/ https://democrats.org/where-we-stand/party-platform/
• mark_l_watson 5y ago
  A friend’s wife has been suffering the effects of long haul COVID-19 for about two months. A few weeks ago her doctor gave her a prescription for Ivermectin and while still very ill, she is feeling better, and the improvement happened quickly. Just one datapoint. I myself am very careful, vaccinations and I wear a quality mask when shopping. My wife and I have reduced our social circle to just about ten people who we sit down with inside for dinner.
  • shkkmo 5y ago
    Any possibility that part of her long covid symptoms were due to an undiagnosed parasitic worm infection that got worse due to the covid treatment's immune suppression?
• tacobelllover99 5y ago
  Didn't realize this was reddit now?
• gfodor 5y ago
  Lots of apologies are owed, none will be delivered. Glad we have an explanation.
• toolz 5y ago
  The real story (in my opinion) behind Ivermectin are the studies not being conducted. Here you have a ton of studies claiming to have found benefit with a worldwide, massively available drug that has practically zero risks for most people (and it's an extremely well understood drug) and we don't have first world countries conducting RCTs to understand it better. So you have to ask yourself - when do we get high quality RCTs, who funds them and why? This to me is a clear cut indicator that we have very maligned incentives for health science. How can we be this far into a global pandemic, with all of this funding and not have multiple high quality RCTs on this drug? It's sad to say the least. Even if Ivermectin ends up being fairly weak or completely ineffective - surely there's something to learn here...
  • peakaboo 5y ago
    About 1.5 years ago, ivermectin was discussed in "conspiracy" channels like Reddit, and many people were helped by it. The mass media ignored it for over a year and when they did started covering it, they said it was a horse dewormer. The fact is, what people think is trustworthy news today is pure propaganda. You cannot make an informed decision based on what you read in the mass media.. It's all completely controlled, supporting whatever the big corporations wants to push on you.
    • lalaland1125 5y ago
      > About 1.5 years ago, ivermectin was discussed in "conspiracy" channels like Reddit, and many people were helped by it. How were they helped by it when the evidence shows that it doesn't work for COVID-19?
      • toolz 5y ago
        how did you read this article and somehow come to the conclusion that ivermectin doesn't work for covid-19?
        • throwawaycuriou 5y ago
          Happy opposite day. Aside from all the other words, it ends in summary with a first item of 'Ivermectin doesn’t reduce mortality in COVID a significant amount'.
• tristor 5y ago
  I don't understand the point of the image of the meth seizure when discussing this study [1]. The last name is the same, but if you understand Mexican surnames, it is strongly unlikely that the two different people are in any way closely related. I like reading Scott's writing, but this really detracts from the overall quality of the article, because it seems like a vaguely racist dig without any relevance. [1]: https://www.biomedres.info/biomedical-research/effects-of-ivermectinazithromycincholecalciferol-combined-therapy-on-covid19-infected-patients-a-proof-of-concept-study-14435.html https://www.biomedres.info/biomedical-research/effects-of-iv...
  • djrogers 5y ago
    It can be poor writing, intentional obfuscation, misdirection, or a lot of other things, but to jump to racism just because the subject is from a different country than the author is pretty unfair.
  • BurningFrog 5y ago
    I took it as just a joke.
  • 0des 5y ago
    > "vaugely racist" Take that somewhere else.
    • ogma 5y ago
      Eat shit moron.
  • joenot443 5y ago
    It's not racist. If it's a joke that didn't land for you, that's fine, but calling it racist is incorrect and deliberately inflammatory.
  • Wolf_Larsen 5y ago
    You may be a good candidate for Ivermectin, sir. I believe you have worms in your brain. https://www.census.gov/quickfacts/fact/table/bakersfieldcitycalifornia/AGE295219 https://www.census.gov/quickfacts/fact/table/bakersfieldcity...
• nmz 5y ago
  Ah yes, death is an acceptable outcome.
• skyde 5y ago
  so his conclusion is that ivermectin reduce mortality significantly only when patient suffer from both covid and worms?
• mmcnl 5y ago
  > There’s a video of a talk about it, but I am not going to watch it, because it is a video I also never watch videos. I'd much rather read a well-written article that is searchable and actually has references to sources.
• ufo 5y ago
  Some aditional context about the Szenta Fonseca et al paper: the study was based on the Hapvida insurance provider, which has been accused of forcing their doctors to prescribe the "covid kit" medication including chloroquine and ivermectin. https://oglobo.globo.com/politica/video-mostra-que-ministerio-da-saude-usou-hapvida-para-propagar-tratamento-sem-comprovacao-contra-covid-25226074 https://oglobo.globo.com/politica/video-mostra-que-ministeri... The Hapvida data was also used by the Bolsonaro administration, to propagate a destructive political agenda in favor of "early treatment" and against vaccines.
• tlb 5y ago
  Are meta-analyses that just average all the results from all the studies less reliable than picking a paper at random? I'd expect that to be the case if the bogus studies report the most dramatic results. A single bogus study out of 10 can skew the whole meta-analysis, but if you picked randomly you'd be 90% likely to get an honest one.
  • kadoban 5y ago
    Based on the article, most papers are complete shit. So, at least in this subject area, that seems like a still bad strategy.
• paul7986 5y ago
  Can't stand close minded people who can not fathom that other treatments could work from ivermectin to the upcoming pill Pfizer is putting out to something else. It's ridiculous that their bias drives them 100% vs. being objective in that science and research takes time .. years ... time will tell and provide all of us with many treatments against COvid as there now is for the flu. Politic bias blinds objectivity and it's ridiculous for people who believe themselves to be intelligent people. Especially those who believe everything and live by their biased manipulated for profit media of choice. Here is one of many examples of the media spinning it's bias agenda and years later getting caught https://www.axios.com/steele-dossier-discredited-media-corrections-buzzfeed-washington-post-6b762a0b-64a9-4259-8697-298e2f04fb3e.html https://www.axios.com/steele-dossier-discredited-media-corre... . Of course it's happens on both sides like all that ridiculous story about Clinton pedo pizza parlor thing. The media is garbage and not to live one's life by ... years of science is!
• mnw21cam 5y ago
  > People are going to fight hard against this, partly because it’s annoying and partly because of (imho exaggerated) patient privacy related concerns. Somebody’s going to try make some kind of gated thing where you have to prove you have a PhD and a “legitimate cause” before you can access the data, and that person should be fought tooth and nail... I have a huge amount of respect for Scott, and the rational thinking that he shares with us. However, I'd like to make two arguments against the above. 1. Personally-identifiable information is protected by law over on this side of the pond. This is one of those cases where the thinking is quite different between the US and Europe. In Europe, you need to get the permission of everyone involved in the study before you can publish your data about them, if there is any chance that they can be identified from that data. In a lot of ways this is good, but one way in particular is that it encourages pre-planned proper studies, where you set it all up properly and get every participant to sign the permission sheet, which is good for science. 2. Sometimes absolutely full data release is overkill and inappropriate. For example, if I'm planning to publish a paper saying that mutations in a particular small region of the human genome cause a particular disease, then it is sufficient to publish the list of causative mutations. Full data release would mean publishing the entire sequencing run for the patient - that's inappropriate because you can identify someone from it, and you also then know a huge amount of information about them - their traits and congenital conditions. A lot of journals are pushing for this, and the compromise that we seem to have reached is to store the full sequencing data in a secure repository and provide access given a really good reason. Likewise, a census will report statistics about areas of a country, but the raw data is kept back because it is deeply personal in nature. So my points are that data shouldn't go into a study unless it can be openly published, and that there are types of raw data that are too personal or voluminous to openly release, and the data derived from it should be released instead.
  • hervature 5y ago
    > This is one of those cases where the thinking is quite different between the US and Europe. In Europe, you need to get the permission of everyone involved in the study before you can publish your data about them, if there is any chance that they can be identified from that data. In the US there are all sorts of protections for research subjects both in terms of potential harm and privacy. In fact, there are mechanisms to be exempt on keeping consent documentation if that is the primary mechanism in which the subject could be harmed (for instance, in a data leak). His thinking is contentious at best and would generally be regarded as unethical. People seeking medical treatment should not have to agree to have their raw data disclosed and this falls under the undue influence principle of ethical research.
• heywherelogingo 5y ago
  Ivermectin - as unnecessary as the vaccines.
• Wolf_Larsen 5y ago
  "The Scott Alexander article misses the whole point. Of course ivermectin on its own is not particularly helpful (unless you want to treat worms, The treatment regimen the American group is recommending includes Vitamin D, Vitamin C, Zinc and a Zinc ionophore (drug that facilitates cellular absorption of Zinc). The ionophore can be Ivermectin, Hydroxychloroquine or Quercetin. I have been baffled up until now why studies are not looking specifically at the combined treatment, just the ionophore, with no regard to whether it was being taken with Zinc or the other drugs. The fact that even Scott seems to have overlooked this is very concerning. It's the Zinc that inhibits replication in many viruses, and ionophores like ivermectin increase zinc absorption." https://marginalrevolution.com/marginalrevolution/2021/11/wednesday-assorted-links-321.html#comments https://marginalrevolution.com/marginalrevolution/2021/11/we...
  • _djo_ 5y ago
    Studies have looked at the supposed I-MASK and MATH+ protocols, or at least similar combinations of Ivermectin and Zinc, and found no benefit there either. Anecdotally I also know a half a dozen people who were doing the I-MASK protocol because they believed the FLCCC and got severe enough COVID to be committed to ICU. Two had to be ventilated. They weren't in particularly high risk groups and their outcomes seemed identical to acquaintances who were taking nothing. This is a dead horse. Stop flogging it.
    • WorshipTheState 5y ago
      Anecdotally I also know a half a dozen people who were doing the I-MASK protocol because they believed the FLCCC and got severe enough COVID to be committed to ICU. That is an in-credible statement. A half a dozen, that you know, in the ICU, that did I-MASK. Amazing!
• andrewclunn 5y ago
  He does a much better job of trying to relate to those "not of his tribe" than most do. Now I WISH he hadn't hand waved the vaccine hesitancy by saying the data there was "overwhelming" without going into it at all.
• etchalon 5y ago
  An absolutely fantastic post. I have nothing else to add. It takes the proponents arguments seriously, even as its dismantling them, but isn't dismissive or condescending. It just methodically, and earnestly, points out how they're wrong.
• he0001 5y ago
  So the conclusion is that if you are already sick, your chances to beat COVID-19 are lower? Doesn’t this apply to many other drugs as well?
• marcodiego 5y ago
  TLDR: The Summary Ivermectin doesn’t reduce mortality in COVID a significant amount (let’s say d > 0.3) in the absence of comorbid parasites: 85-90% confidence Parasitic worms are a significant confounder in some ivermectin studies, such that they made them get a positive result even when honest and methodologically sound: 50% confidence Fraud and data processing errors are of similar magnitude to p-hacking and methodological problems in explaining bad studies (95% confidence interval for fraud: between >1% and 5% as important as methodological problems; 95% confidence interval for data processing errors: between 5% and 100% as important) Probably “Trust Science” is not the right way to reach proponents of pseudoscientific medicine: ???% confidence
• trhway 5y ago
  The generic broad anti-viral props of ivermectin seems to have been established during the last decade https://www.sciencedirect.com/science/article/pii/S0166354220302011 https://www.sciencedirect.com/science/article/pii/S016635422... so it isn't out of the blue that it may work as anti-covid, though whether it rises to a clinical effect that i guess is the question right now. To me it looks like the small positive clinical effect reported in many places matches that generic broad anti-viral props, and it also shows that it isn't a "cure", at least not in the current form. So all this drama is kind of strange - why not prescribe to the patients who want it? Not that doctors have anything better to offer anyway, and the patients will get a deworming as a bonus.
• nikolay 5y ago
  With all bashing on Ivermectin, I just wonder what people think about it! First, there's no money to be made from it - no patents, it costs cents per dose, and everybody can manufacture it! Second, it has proven anti-viral properties against HIV, HPV, etc. In general, it's not like some crazy guy decided to use try it against SARS-CoV-2 - scientists were looking to repurpose antivirals. Plus, it has a pretty decent and long-established safety record. Compare it to Remdesivir, let's say, which comes with terrible side effects! Also, the dosage has been pretty low and recommendations have changed - from 0.2mg/kg now it's 0.4-0.6mg/kg with Delta. Pretty much all my friends who followed the I-MASK+ protocol [0], didn't get severe course of COVID-19. Yeah, it's anecdotal data, but there are no exceptions! [0]: https://covid19criticalcare.com/covid-19-protocols/i-mask-plus-protocol/ https://covid19criticalcare.com/covid-19-protocols/i-mask-pl...
• fithisux 5y ago
  [flagged]
• weeblewobble 5y ago
  I think if the IVM proponents were operating in good faith, their message would have been something like "There's some evidence that IVM can mitigate severe COVID infections, but it's relatively weak so you shouldn't rely on it to the exclusion of other ways of protecting yourself." But that's not what happened. IVM (like HCQ before it) is a prop, a cudgel, a red herring in the ongoing and well-funded political project to undermine faith in government and polarize the electorate