2 ms·

That's a literacy issue. Internet literacy can be taught. If the CDC or NIH had posted established and well-developed protocols for things like lung clearance,

That's a literacy issue. Internet literacy can be taught. If the CDC or NIH had posted established and well-developed protocols for things like lung clearance, then you educate people that "Ivermectin is not being recommended by reliable sources. Here are the home care recommendations from reliable sources." Lung clearance at home is not some concept I invented. It gets routinely prescribed and taught for patients with serious, incurable lung issues.

Traubenfuchs 4y ago
> "Ivermectin is not being recommended by reliable sources. Adding to that all communications regarding ivermectin and other crazy people miracle drugs, it should have been communicated that "Ivermectin is generally safe for human consumption. Ivermectin is highly dangerous if taken in single dosages above xxx mg/kg or longer than yyy days. There must be at least zzz hours between individual dosages of Ivermectin. Do not take more than vvv mg/kg a day. If you violate any of the advice given here, side effects might include: x, y, z, allergic shock, death, neurotoxicity." Instead those hell bent on taking it were ridiculed and ostracized, taking it in secret and an uncontrolled fashion. They could have been both forced and allowed to get in in pharmacies, with the condition of them also taking an information pamphlet or something -instead they went for more difficult to dose formulation directed at large animals.
- deleted 4y ago
  [deleted]
- pjc50 4y ago
  If you ask a pharmacy about off-label use of a drug, they are going to tell you "no", not to advise you how to take something you don't need. It might even be a breach of their license conditions to do otherwise.
  - DoreenMichele 4y ago
    20 percent of all prescriptions are written for uses not approved by the FDA. https://www.drugwatch.com/health/off-label-drug-use/ https://www.drugwatch.com/health/off-label-drug-use/
    - KSteffensen 4y ago
      Minor nitpick, prescriptions are written by doctors, with a medical degree, rather than pharmacists with a degree in pharmaceutical science dealing mostly with analytical chemistry and biochemistry.
      - DoreenMichele 4y ago
        My understanding is that policies vary from one country to the next. I'm American. My understanding is that in the US you need a prescription from a licensed healthcare professional to get medication from a pharmacy. This usually means a doctor but in some states a physician's assistant may have the authority to write prescriptions. In the US, if it doesn't require a prescription, it is sold over the counter, though they may check your ID to see if you are a legal adult for some things. I have heard anecdotally that in other countries pharmacists can sometimes dispense medication without a prescription. HN is a very international discussion space. This fairly often leads to people speaking past each other as their comments may well be rooted in a completely different set of assumptions and mental models about how such things work.
  - Traubenfuchs 4y ago
    Then we need better, more humane laws for this topic. What's so hard about saying "Regulations force me to say and I personally believe that you should not take this medication, but if you insist on taking it please observe the following rules or you risk death and disability." Meanwhile people regularly and irreparably blow up their livers with paracetamol and no one gives a damn.
    - pjc50 4y ago
      Paracetamol is weird; it's clearly been grandfathered in as you'd never get it approved now. The UK sells it without a prescription, but you're not allowed by the shop (often enforced by the POS software!) to buy too much at once. Then there's cocodamol, where in an effort to avoid "addiction" issues the relatively safe opiates are cut with relatively low-LD50 paracetamol. I don't think an informational campaign would have helped with the ivermectin problem. Underlying that was the conspiracist belief that people were lying to them. Why would they believe a safety leaflet?
      - pas 4y ago
        They got their hands on ivermectin anyway. Sure, making it easier to try would have lead to more abuses. However, in theory thats why people have GPs or PCPs, to oversee their treatment. Yes, they were overloaded (as they always are), but if people want to try a treatment, in general we shouldn't say no. We should enroll them in a trial, etc. And we should say no when we have enough data to be sure that it's very unlikely to work, and still, in general fighting scammers/fraudsters and various snakeoil salesfolk should be done through prosecution of those who knowingly make false statements, thereby intentionally defrauding vulnerable people, not through right to sell shit. (And yes, this is a very hairy topic, because everything is fucking expensive when it comes to medicine. But that's one more reason to streamline it instead of having a cottage industry is these trial runners hemorrhage money into a thousand pockets.)
      - notahacker 4y ago
        > I don't think an informational campaign would have helped with the ivermectin problem. Underlying that was the conspiracist belief that people were lying to them. Why would they believe a safety leaflet? And also afaik the biggest problem with Invermectin wasn't that people were overdosing on it, it's that they were treating it as a prophylactic or potential miracle cure which meant they didn't have to worry about catching or spreading COVID (or get vaccinated, when the vaccines were introduced). "Homeopathy doesn't cure HIV, but here are the dosages of homeopathic remedies which people looking to manage their HIV status with homeopathy rather than antiretroviral drugs and condoms should take", said no public health information campaign ever Afaik Invermectin has all the safety information regarding its dosages on the packet anyway (at least the packets designed for human use...). Doesn't mean people getting health advice from people shouting about the evils of the medical profession on talk radio or Facebook necessarily acknowledged them.
Nextgrid 4y ago
> Internet literacy can be taught. Can it? We've been trying for 20+ years. Not to mention that while it used to be purely a literacy problem, nowadays various commercial interests benefit from users being tech-illiterate and are incentivised to perpetuate this lack of literacy, all the way towards dumbing down UIs and removing advanced features so that people can no longer become literate even if they wanted to. Hell, the spread of medical misinformation benefits the platforms on which it happens as it generates plenty of "engagement" so short of regulation with actual teeth (which won't happen due to government incompetence, regulatory capture or lobbying), I don't see why the situation would ever change.
- pjc50 4y ago
  > the spread of medical misinformation benefits the platforms on which it happens as it generates plenty of "engagement" There was a great paper which I can't find now about the link between the "supplement" industry, whose products range from the ineffective to the actually dangerous, and aren't regulated by the FDA, and the rightwing channels that tend to advertise them.
  - mikrotikker 4y ago
    Its not just a right wing problem, there's plenty of crazy hippies pushing turps and jilly juice.
    - nibbleshifter 4y ago
      Some of the more insane people I know (antivax etc) are moderate to hard left. The polarization affected both ends of the spectrum it seems.
      - mikrotikker 4y ago
        Did you notice all the famous people who were saying they wouldn't take the trump vax, and poo pooing it, and then once he was gone suddenly they were calling anyone who didn't want it a racist?
KSteffensen 4y ago
I disagree that what you call internet literacy can be taught. In my opinion people fundamentally disagree what the 'reliable sources' are and some (many?) actively distrust the official recommendations. With that analysis internet literacy becomes a question of showing people that official recommendations are not actively trying to trick you into doing something harmful to yourself. How will that be done when nobody trusts any official authority, be it government, universities, news media or anything else? This trust will take generations to re-build and currently it doesn't seem like anybody thinks it's even a priority.
LarsDu88 4y ago
Literacy? Just a sampling of educated people who were pushing this bullshit: Elon Musk (Stanford grad school dropout), Dr Drew (USC MD), Bret Weinstein (UMich PhD), Harvey Risch (Yale). The figures above are reasonably educated and should know better but all share a political leaning that the social media recommender ML systems latch on. If there is a literacy that can be taught, we need to start agreeing on what that literacy looks like
- DoreenMichele 4y ago
  As far as I know, Elon Musk has no medical background. Wikipedia tells me he has degrees in economics and physics and was a cofounder of PayPal. I'm less familiar with the other three you list and in the interest of brevity won't bother to profile each of them. Medical internet literacy absolutely includes educating people that wealth, fame and a willingness to generously and frequently share your personal opinions about everything under the sun, whether you have any expertise or not, does not make you someone people should take medical advice from, especially during a pandemic.

Traubenfuchs 4y ago

> "Ivermectin is not being recommended by reliable sources. Adding to that all communications regarding ivermectin and other crazy people miracle drugs, it should have been communicated that "Ivermectin is generally safe for human consumption. Ivermectin is highly dangerous if taken in single dosages above xxx mg/kg or longer than yyy days. There must be at least zzz hours between individual dosages of Ivermectin. Do not take more than vvv mg/kg a day. If you violate any of the advice given here, side effects might include: x, y, z, allergic shock, death, neurotoxicity." Instead those hell bent on taking it were ridiculed and ostracized, taking it in secret and an uncontrolled fashion. They could have been both forced and allowed to get in in pharmacies, with the condition of them also taking an information pamphlet or something -instead they went for more difficult to dose formulation directed at large animals.

deleted 4y ago
[deleted]
pjc50 4y ago
If you ask a pharmacy about off-label use of a drug, they are going to tell you "no", not to advise you how to take something you don't need. It might even be a breach of their license conditions to do otherwise.
- DoreenMichele 4y ago
  20 percent of all prescriptions are written for uses not approved by the FDA. https://www.drugwatch.com/health/off-label-drug-use/ https://www.drugwatch.com/health/off-label-drug-use/
  - KSteffensen 4y ago
    Minor nitpick, prescriptions are written by doctors, with a medical degree, rather than pharmacists with a degree in pharmaceutical science dealing mostly with analytical chemistry and biochemistry.
    - DoreenMichele 4y ago
      My understanding is that policies vary from one country to the next. I'm American. My understanding is that in the US you need a prescription from a licensed healthcare professional to get medication from a pharmacy. This usually means a doctor but in some states a physician's assistant may have the authority to write prescriptions. In the US, if it doesn't require a prescription, it is sold over the counter, though they may check your ID to see if you are a legal adult for some things. I have heard anecdotally that in other countries pharmacists can sometimes dispense medication without a prescription. HN is a very international discussion space. This fairly often leads to people speaking past each other as their comments may well be rooted in a completely different set of assumptions and mental models about how such things work.
- Traubenfuchs 4y ago
  Then we need better, more humane laws for this topic. What's so hard about saying "Regulations force me to say and I personally believe that you should not take this medication, but if you insist on taking it please observe the following rules or you risk death and disability." Meanwhile people regularly and irreparably blow up their livers with paracetamol and no one gives a damn.
  - pjc50 4y ago
    Paracetamol is weird; it's clearly been grandfathered in as you'd never get it approved now. The UK sells it without a prescription, but you're not allowed by the shop (often enforced by the POS software!) to buy too much at once. Then there's cocodamol, where in an effort to avoid "addiction" issues the relatively safe opiates are cut with relatively low-LD50 paracetamol. I don't think an informational campaign would have helped with the ivermectin problem. Underlying that was the conspiracist belief that people were lying to them. Why would they believe a safety leaflet?
    - pas 4y ago
      They got their hands on ivermectin anyway. Sure, making it easier to try would have lead to more abuses. However, in theory thats why people have GPs or PCPs, to oversee their treatment. Yes, they were overloaded (as they always are), but if people want to try a treatment, in general we shouldn't say no. We should enroll them in a trial, etc. And we should say no when we have enough data to be sure that it's very unlikely to work, and still, in general fighting scammers/fraudsters and various snakeoil salesfolk should be done through prosecution of those who knowingly make false statements, thereby intentionally defrauding vulnerable people, not through right to sell shit. (And yes, this is a very hairy topic, because everything is fucking expensive when it comes to medicine. But that's one more reason to streamline it instead of having a cottage industry is these trial runners hemorrhage money into a thousand pockets.)
    - notahacker 4y ago
      > I don't think an informational campaign would have helped with the ivermectin problem. Underlying that was the conspiracist belief that people were lying to them. Why would they believe a safety leaflet? And also afaik the biggest problem with Invermectin wasn't that people were overdosing on it, it's that they were treating it as a prophylactic or potential miracle cure which meant they didn't have to worry about catching or spreading COVID (or get vaccinated, when the vaccines were introduced). "Homeopathy doesn't cure HIV, but here are the dosages of homeopathic remedies which people looking to manage their HIV status with homeopathy rather than antiretroviral drugs and condoms should take", said no public health information campaign ever Afaik Invermectin has all the safety information regarding its dosages on the packet anyway (at least the packets designed for human use...). Doesn't mean people getting health advice from people shouting about the evils of the medical profession on talk radio or Facebook necessarily acknowledged them.

Nextgrid 4y ago

> Internet literacy can be taught. Can it? We've been trying for 20+ years. Not to mention that while it used to be purely a literacy problem, nowadays various commercial interests benefit from users being tech-illiterate and are incentivised to perpetuate this lack of literacy, all the way towards dumbing down UIs and removing advanced features so that people can no longer become literate even if they wanted to. Hell, the spread of medical misinformation benefits the platforms on which it happens as it generates plenty of "engagement" so short of regulation with actual teeth (which won't happen due to government incompetence, regulatory capture or lobbying), I don't see why the situation would ever change.

pjc50 4y ago
> the spread of medical misinformation benefits the platforms on which it happens as it generates plenty of "engagement" There was a great paper which I can't find now about the link between the "supplement" industry, whose products range from the ineffective to the actually dangerous, and aren't regulated by the FDA, and the rightwing channels that tend to advertise them.
- mikrotikker 4y ago
  Its not just a right wing problem, there's plenty of crazy hippies pushing turps and jilly juice.
  - nibbleshifter 4y ago
    Some of the more insane people I know (antivax etc) are moderate to hard left. The polarization affected both ends of the spectrum it seems.
    - mikrotikker 4y ago
      Did you notice all the famous people who were saying they wouldn't take the trump vax, and poo pooing it, and then once he was gone suddenly they were calling anyone who didn't want it a racist?

KSteffensen 4y ago

I disagree that what you call internet literacy can be taught. In my opinion people fundamentally disagree what the 'reliable sources' are and some (many?) actively distrust the official recommendations. With that analysis internet literacy becomes a question of showing people that official recommendations are not actively trying to trick you into doing something harmful to yourself. How will that be done when nobody trusts any official authority, be it government, universities, news media or anything else? This trust will take generations to re-build and currently it doesn't seem like anybody thinks it's even a priority.

LarsDu88 4y ago

Literacy? Just a sampling of educated people who were pushing this bullshit: Elon Musk (Stanford grad school dropout), Dr Drew (USC MD), Bret Weinstein (UMich PhD), Harvey Risch (Yale). The figures above are reasonably educated and should know better but all share a political leaning that the social media recommender ML systems latch on. If there is a literacy that can be taught, we need to start agreeing on what that literacy looks like

DoreenMichele 4y ago
As far as I know, Elon Musk has no medical background. Wikipedia tells me he has degrees in economics and physics and was a cofounder of PayPal. I'm less familiar with the other three you list and in the interest of brevity won't bother to profile each of them. Medical internet literacy absolutely includes educating people that wealth, fame and a willingness to generously and frequently share your personal opinions about everything under the sun, whether you have any expertise or not, does not make you someone people should take medical advice from, especially during a pandemic.