7 ms·

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 aut

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
    There are probably many other factors that I should have listed there, my bad, I did not mean to make an exhaustive list, in fact the opposite, that's the first two things that came to mind.
DoreenMichele 5y ago
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. When they invented antibiotics, people began predicting "the end of disease." Fast forward a few decades and we have the rise of scary antibiotic-resistant infections. Medical stuff doesn't work the way most people would like to imagine it does. This sounds like a terrible thing to conclude. I'm rather unsettled to see it lauded here on HN.
- darrenf 5y ago
  > When they invented antibiotics, people began predicting "the end of disease." Fast forward a few decades and we have the rise of scary antibiotic-resistant infections. > Medical stuff doesn't work the way most people would like to imagine it does. This sounds like a terrible thing to conclude. I'm rather unsettled to see it lauded here on HN. Indeed, this exact thing is headline news in the UK today from our Health Security Agency - don't take antibiotics unless you definitely have something treatable by them: https://www.bbc.co.uk/news/health-59310099 https://www.bbc.co.uk/news/health-59310099
  - DoreenMichele 5y ago
    Parasites are notoriously hard to treat. They are harder to treat than bacterial infection. Places with lots of parasitic infections need better infrastructure and general hygiene to prevent infection. They don't need all the locals actively breeding drug-resistant parasites. Parasites are enough of a nightmare without cavalierly passing out drugs for funsies.
    - yorwba 5y ago
      The WHO's guideline for "preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups" https://apps.who.int/iris/handle/10665/258983 https://apps.who.int/iris/handle/10665/258983 isn't about "passing out drugs for funsies". They recommend mass drug administration for at-risk groups because hundreds of millions of people are suffering from parasitic worm infections that can easily be treated with a single dose of a cheap anthelmintic drug, but diagnosing every single case beforehand would be much more expensive. Of course improving hygiene to prevent infection is important (that's also stressed in the guideline), but that will take much longer, while mass drug administration has immediate benefits. Fear of drug resistance isn't a good reason to withhold treatment from people who really need it. The WHO's much more sensible strategy is to encourage research into alternative drugs in case drug resistance becomes a significant concern.
raverbashing 5y ago
For real, prophylaxis of enteral worms should have been more popular in developed countries. It's amazing how hygiene practices are sometimes poor and tropical diseases are unknown in developed countries But then you go visit somewhere and/or some animal product is imported in questionable ways and you get a worm. Which for 95% of people will be mildly inconsequential but it might also cause problems.
- jacquesm 5y ago
  This is the basis for many religious food taboos.
vmception 5y ago
This is interesting, it is similar to how doctors just include gonorrhea treatment for women that expect to bear children. Instead of embarrassing any particular woman who would suddenly have something to explain to the partner, they just give it to many amongst the cocktail of various other obscure sounding drugs.
Veelox 5y ago
> I do think the ending political metaphor doesn't quite fit, however. Literally none of my immediate family has gotten the vaccine. I know several more people who haven't gotten it. I have been reading Scott since around 2015. I would say I sit in an interesting intersection of worlds for this issue. While the facts of the metaphor are slightly off, I think Scott got the emotional feeling exactly correct. There are hostile aliens who actively gone against my interests in the past, they have been wrong before, their is a good chance they could use this for their own gain. That is exactly how my parents feel.
WhompingWindows 5y ago
I think you should clarify that Ivermectin works better in higher-worm-prevalence areas. It's not remotely true that 10% of Americans have undetected worms. The praised study in the post highlights 12.5% as "high" prevalence, so 10% would be nearly high -- not true in the developed world.
- naasking 5y ago
  According to the CDC, 3.7 million people in the US are infected with Trichomoniasis. That's at least 10%. https://www.cdc.gov/media/releases/2014/p0508-npi.html https://www.cdc.gov/media/releases/2014/p0508-npi.html
  - Jefenry 5y ago
    I think you missed a decimal place. There's very nearly 333 million people in the US, so 3.7 million infected is 1.1%
  - blitzar 5y ago
    3.7/329.5 != 10%
    - naasking 5y ago
      Haha, math fail.
- Joking_Phantom 5y ago
  10% is a token number for argument's sake, not any rate based on reality
nisegami 5y ago
I have unironically been advocating for this approach with Metformin in my country. I think it'd have incredible positive effects.

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
  There are probably many other factors that I should have listed there, my bad, I did not mean to make an exhaustive list, in fact the opposite, that's the first two things that came to mind.

DoreenMichele 5y ago

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. When they invented antibiotics, people began predicting "the end of disease." Fast forward a few decades and we have the rise of scary antibiotic-resistant infections. Medical stuff doesn't work the way most people would like to imagine it does. This sounds like a terrible thing to conclude. I'm rather unsettled to see it lauded here on HN.

darrenf 5y ago
> When they invented antibiotics, people began predicting "the end of disease." Fast forward a few decades and we have the rise of scary antibiotic-resistant infections. > Medical stuff doesn't work the way most people would like to imagine it does. This sounds like a terrible thing to conclude. I'm rather unsettled to see it lauded here on HN. Indeed, this exact thing is headline news in the UK today from our Health Security Agency - don't take antibiotics unless you definitely have something treatable by them: https://www.bbc.co.uk/news/health-59310099 https://www.bbc.co.uk/news/health-59310099
- DoreenMichele 5y ago
  Parasites are notoriously hard to treat. They are harder to treat than bacterial infection. Places with lots of parasitic infections need better infrastructure and general hygiene to prevent infection. They don't need all the locals actively breeding drug-resistant parasites. Parasites are enough of a nightmare without cavalierly passing out drugs for funsies.
  - yorwba 5y ago
    The WHO's guideline for "preventive chemotherapy to control soil-transmitted helminth infections in at-risk population groups" https://apps.who.int/iris/handle/10665/258983 https://apps.who.int/iris/handle/10665/258983 isn't about "passing out drugs for funsies". They recommend mass drug administration for at-risk groups because hundreds of millions of people are suffering from parasitic worm infections that can easily be treated with a single dose of a cheap anthelmintic drug, but diagnosing every single case beforehand would be much more expensive. Of course improving hygiene to prevent infection is important (that's also stressed in the guideline), but that will take much longer, while mass drug administration has immediate benefits. Fear of drug resistance isn't a good reason to withhold treatment from people who really need it. The WHO's much more sensible strategy is to encourage research into alternative drugs in case drug resistance becomes a significant concern.

raverbashing 5y ago

For real, prophylaxis of enteral worms should have been more popular in developed countries. It's amazing how hygiene practices are sometimes poor and tropical diseases are unknown in developed countries But then you go visit somewhere and/or some animal product is imported in questionable ways and you get a worm. Which for 95% of people will be mildly inconsequential but it might also cause problems.

jacquesm 5y ago
This is the basis for many religious food taboos.

vmception 5y ago

This is interesting, it is similar to how doctors just include gonorrhea treatment for women that expect to bear children. Instead of embarrassing any particular woman who would suddenly have something to explain to the partner, they just give it to many amongst the cocktail of various other obscure sounding drugs.

Veelox 5y ago

> I do think the ending political metaphor doesn't quite fit, however. Literally none of my immediate family has gotten the vaccine. I know several more people who haven't gotten it. I have been reading Scott since around 2015. I would say I sit in an interesting intersection of worlds for this issue. While the facts of the metaphor are slightly off, I think Scott got the emotional feeling exactly correct. There are hostile aliens who actively gone against my interests in the past, they have been wrong before, their is a good chance they could use this for their own gain. That is exactly how my parents feel.

WhompingWindows 5y ago

I think you should clarify that Ivermectin works better in higher-worm-prevalence areas. It's not remotely true that 10% of Americans have undetected worms. The praised study in the post highlights 12.5% as "high" prevalence, so 10% would be nearly high -- not true in the developed world.

naasking 5y ago
According to the CDC, 3.7 million people in the US are infected with Trichomoniasis. That's at least 10%. https://www.cdc.gov/media/releases/2014/p0508-npi.html https://www.cdc.gov/media/releases/2014/p0508-npi.html
- Jefenry 5y ago
  I think you missed a decimal place. There's very nearly 333 million people in the US, so 3.7 million infected is 1.1%
- blitzar 5y ago
  3.7/329.5 != 10%
  - naasking 5y ago
    Haha, math fail.
Joking_Phantom 5y ago
10% is a token number for argument's sake, not any rate based on reality

nisegami 5y ago

I have unironically been advocating for this approach with Metformin in my country. I think it'd have incredible positive effects.