4 ms·

There would have to be high quality studies that showed that ivermectin worked in countries that are not beset with parasitic worms (a known COVID comorbidity).

There would have to be high quality studies that showed that ivermectin worked in countries that are not beset with parasitic worms (a known COVID comorbidity). And since ivermectin in practice is pitched as an alternative to vaccination, those studies would have to show efficacy against death/hospitalization in the ballpark of full vax + boosted (ie ~95%+)

s1artibartfast 5y ago
I think that is a pretty safe position to take. I have a more moderate take. I think it is likely that ivermectin will show some therapeutic benefit against death and hospitalization, but well below the efficacy of vaccination. If so, I think there will be interesting reactions when the NIH Activ-6 trial reads out as the American public tries to digest this. Even low double digit efficacy will mean that slow implementation and pushback will have cost 10's to 100's of thousands of American lives.
- xadhominemx 5y ago
  There is no reason to believe it has that efficacy net known side effects in developed countries and if even it did, a small fraction of individuals users declined vaccination in favor of the prophylactic effects of ivermectin there would be no net benefit. Also, there is not anywhere near enough supply of ivermectin for a meaningful proportion of citizens in first world countries and that supply should go to people in countries with parasitic worms.
  - s1artibartfast 5y ago
    and here I thought we might have compatible points. In the hypothetical where it is demonstrated to be effective, I don't think it is ethical to suppress the use of one effective treatment to incentivize uptake of another (vaccination). That is to say, we shouldn't deny treatment with an effective treatment or post exposure prophylatic because it might embolden other people to forgo an earlier intervention (vaccination). Your supply objection is a valid concern, but not absolute. I agree populations with parasites should get first priority if their relative benefit is greater. That said, there is additional manufacturing capacity and the ability to easily expand it. If you say excess supply cannot be used, this is the same as your argument above.

s1artibartfast 5y ago

I think that is a pretty safe position to take. I have a more moderate take. I think it is likely that ivermectin will show some therapeutic benefit against death and hospitalization, but well below the efficacy of vaccination. If so, I think there will be interesting reactions when the NIH Activ-6 trial reads out as the American public tries to digest this. Even low double digit efficacy will mean that slow implementation and pushback will have cost 10's to 100's of thousands of American lives.

xadhominemx 5y ago
There is no reason to believe it has that efficacy net known side effects in developed countries and if even it did, a small fraction of individuals users declined vaccination in favor of the prophylactic effects of ivermectin there would be no net benefit. Also, there is not anywhere near enough supply of ivermectin for a meaningful proportion of citizens in first world countries and that supply should go to people in countries with parasitic worms.
- s1artibartfast 5y ago
  and here I thought we might have compatible points. In the hypothetical where it is demonstrated to be effective, I don't think it is ethical to suppress the use of one effective treatment to incentivize uptake of another (vaccination). That is to say, we shouldn't deny treatment with an effective treatment or post exposure prophylatic because it might embolden other people to forgo an earlier intervention (vaccination). Your supply objection is a valid concern, but not absolute. I agree populations with parasites should get first priority if their relative benefit is greater. That said, there is additional manufacturing capacity and the ability to easily expand it. If you say excess supply cannot be used, this is the same as your argument above.