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.
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.
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 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.
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.
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.
Not the idea of Ivermectin as prophylactic is stupid, but believing this is the case, as many people clearly do, in my opinion merits that verdict.
Beyond the social media hype there is almost no rational reason to believe that. I even have a problem with writing "almost no", because I don't really trust what I've seen in that regard on face value.
Anything that edges you closer to an optimum health state is also beneficial to a certain degree to avoid corona infection.
So zinc and vitamine D which enhance and modulate the immune system are recommended.
It's not as clearcut as you make it seem. The current vaccines lose their effectiveness over time and are significantly less effective against the delta variant to start with.
For instance Vitamin D helps decrease the risk of a cytokine storm after a (corona) infection, and not overreact. (have no references at hand currently, sorry).
True, but it should be seen as an additional layer to the Swiss cheese model of pandemic defense.
The vaccine is the main component, by far, but its number of holes are increasing.
That's a very suspicious way of framing it. The "holes" seem to be mostly the people who don't want to get the vaccine at all. These are the ones responsible for most of the spread and for most of the consequences.
"Significantly less effective" is still a lot higher than most new vaccines and higher than the prophylactics you propose.
The loss in effectiveness isn't even that big of a deal. It only really matters for those most at risk. And it's hard to say how much longer the third dose will last, but knowing how the immune system works, I'd guess it will be more than 6 months, provided there is no escape mutation. Delta isn't an escape variant, btw, it's just a really fast worker. It gets up and running inside the body so fast, that even the remembered response takes a while to catch up. That's why the third shot, which reestablishes active, circulating antibody levels, is so effective: Now the virus is knocked out before getting started, and the usual infection dose, before replication, isn't enough to cause trouble.
>Delta isn't an escape variant, btw, it's just a really fast worker.
It's faster, more transmissable, infectious, shorter incubation period and a 1000fold increase in generated virus particles compared to other variants.
But is also has mutations in its spike and nucleocapsid that warrant developing new vaccines, certainly when it's at the moment the dominant strain by far and even more virulent variations are to be expected.
As far as I know new vaccines may be in the pipeline, but the current vaccines work so well against the delta variant that it's not worth switching.
It will take a lot of time to gather enough data to confirm any new vaccine as actually being better and safer than Comirnaty against Delta... Just saying "This vaccines was especially designed for this" isn't enough.
>but the current vaccines work so well against the delta variant that it's not worth switching.
I disagree. The number of deaths has only been decreased fivefold when comparing first wave and 4th wave in Belgium. And yes, there are fully vaccinated people who are dying.
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.
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.
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/ into the debate.
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.
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/ is both reasonable and moderately convincing.
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.
> who even if they do make mistakes have your best interests at heart
They, like every other person, have their own best interest at heart, which, if you're lucky, aligns with yours. "Just listen to the authorities" is probably the worst advice ever given.
In the case of a pandemic it is probably pretty good advice, unless you are of the opinion that your authorities are acting against your interest.
The problem with this pandemic is that a lot of people in places of power have made mistakes, sometimes really bad ones (for instance, such as pursuing herd immunity) rather than to follow the WHO expert advice. This could easily be construed as authorities acting against your best interests and in fact in quite a few places people have died that need not have died at all.
But there is a difference between 'political authorities' and 'medical authorities', the WHO has been fairly consistent and sensible in their advice to date, what political authorities locally do with that advice is another matter entirely, that runs the gamut of Bolsonaro to Boris Johnson to Jacinda Ardern and everything in between.
Yeah, I agree, that in the case of a pandemic, the health authorities interests are pretty well aligned with a member of the general public. However, there are always issues in this kind of situation when the authorities got it wrong. In a political environment, changing course is seen as an admission of being wrong, and a loss of face. So we continue on with the initial policy. We are currently facing this problem as all experts seem to agree that covid will be endemic, but we are still flailing around with (increasingly half-assed) prevention measures as if we are still going to stop the virus. I disagree that pursuing herd immunity was a bad decision. With every day the pandemic drags on, Sweden's decision is looking better and better.
Agreed that there is a lot of ego involved, and that certainly doesn't help. In NL we have a couple of nice examples of that.
Pursuing herd immunity is a viable strategy only if you can actually achieve it.
Sweden has done far worse than their neighbors in this respect. But given the fact that it drags on all you can say is that as long as we don't treat this as a global problem your local measures matter less than you think.
Countries that did fantastically well early on showed it could be done, but because they were the exception eventually they too became overwhelmed through imported cases. If that had not happened, which would have required a more synchronized approach, then the total damage would be a fraction of what it is today.
And this isn't over yet, not by far and it is a much harder problem now than it was in March last year.
Denmark, Finland, Norway and Iceland all did considerably better, and have demographics and local conditions that are closer together than comparing Sweden with the rest of Europe. It's a thinly populated Nordic country, so the comparison material should be countries that match those criteria, not the average of the EU, which runs the gamut of high density extremely interconnected countries with major airline hubs all the way to vast emptiness with the occasional city.
In addition to that, it's worth pointing out that even the architect of the Swedish policy defending his strategy acknowledges it would have been dramatically worse if Swedes hadn't mostly worked from home and observed social distancing anyway (i.e. the exact opposite of what most anti-lockdown campaigners want). Also, they imposed strict external travel restrictions to ensure they never imported as many cases as the worse-performing European countries did, and deployed all sorts of restrictions short of lockdosn like banning gatherings of 8 people or more. It's really not the poster child for muh freedom
In 10 years, when most of the dust has settled, we'll be able to explain what we saw in Sweden and the surrounding countries as a combination of population density, interactions, medical policy, and randomness. It's hardly fair to consider only a small number of variables in cases like these.
That mirrors my expectation. Which by the way is a pet peeve of mine: the reliance on the 'R0' factor for reporting in the press, R0 is something you can at best establish when an epidemic has run its course, but it is being treated as this magic wheel that we can turn to ensure a desirable level of infections, which is complete madness, it's an output, and a delayed one at that, not an input.
I think many people have learned the limits of science, public health, and mainstream scientific reporting over the past few years. It has repeatedly exposed that the way people think about causality is not consistent with scientific thought. R0 is just one of many examples.
Yeah, but here's my prediction for what we'll find: In one way it was pretty random that it was precisely Sweden that adopted such stupid medical policies versus covid; in another, given what we know of these countries' larger political environment and post-WW2 history, it was perhaps to be expected.
"You don't need to wear masks" was bad advice from well-meaning people who should've known better. The researchers who did know better couldn't push past deeply-entrenched anti-miasma attitudes quickly enough.
"Use social distancing and isolation to avoid COVID and get vaccinated as quickly as possible" is good advice from well-meaning people who do know better. Sorry it's unpleasant, but if the USA behaved rationally, there wouldn't be 750K+ dead today.
Sweden readily admits that its approach was a terrible mistake. It's just not as embarrassingly bad as other countries, particularly ones that, with sensible leaders, should have done much better (UK, USA).
Spot on. The developed world really has no excuses.
Mixed messaging by people in the media undercut a lot of support for the countermeasures, which was then further amplified using social media to pretend that scientists are divided in their opinions when in fact they weren't, except for a few lone holdouts, who - yay controversy - were given a disproportionate amount of airtime.
Nobody in their right mind would have predicted before the pandemic that some of the most developed countries in the world will have some of the highest death counts.
I fear this will be deeply ingrained in the social consciousness and lead to further divisiveness down the line.
This is true, at least, it is for me. I never expected that my country (far down the list in population) would be in the top 30 countries for COVID cases. Disappointment doesn't begin to describe it.
> Sweden readily admits that its approach was a terrible mistake.
It does?!? Funny, how can I have totally missed something as big as that?
I'm a Swedish "expat"; I have now lived abroad for just a little longer than I lived in Sweden (26 vs 26.5 years), but I've always followed Swedish media and I still travel there regularly. All I've seen is some hemming and hawing about "Perhaps not totally optimal"; far from any flat-out admission of "terrible mistake". And when I spent a long weekend there three weeks ago, the populace at large certainly didn't seem aware of any such thing.
> The epidemiologist behind Sweden’s controversial decision to forgo a mandatory lockdown conceded for the first time that more restrictions might have helped prevent a surge in coronavirus-related deaths.
I think that actually the countries that have successfully fought covid (PRC, Taiwan, Vietnam, South Korea, New Zealand as you mention, Thailand, Singapore, Australia, Iceland, etc.) have done so in significant part by violating the WHO expert advice to, for example, permit unrestricted travel. Your country and mine have about 100 times more deaths per capita than any country in that list, perhaps because they followed the WHO's advice.
Throughout the pandemic the experts, including the WHO, have been very frequently wrong. That doesn't necessarily mean you'll be better off following advice from secret messages encoded for you in game show hosts, or, worse, Donald Trump's actual opinions. But blind faith in experts hardly seems to be justified.
The government has been destabilizing societies through surveillance, one housing crisis after another, inflation, unchecked immigration to keep wages down, lying about masks, lying about gain of function funding, lying about herd immunity, lying about vaccine effectiveness and countless corruption scandals.
Lockdowns have caused people to gain 10 kg on average, which increases their risk for many diseases, including Covid-19. That alone shows you that the medical authorities do not have you best interests at heart. They want to keep ICU beds free for the gerontocracy.
Sweden, which did none of that, now enjoys low Covid-19 numbers and fatalities.
Ivermectin, while probably useless but harmless, is a complete side show. It is used by the mainstream to create an illusion of conspiracy theorists and Deplorables and to divert from actual issues.
Sweden, the country where the authorities apologized for messing up, that Sweden?
People on average gained 10 kg? Really, I have no idea where you get this nonsense but clearly you are not interested in a factual debate but in one that gives you what you want: the ability to ignore this pandemic as though it doesn't exit.
There are no ICU beds for the gerontocracy, there are simply ICU beds, and there is a limited number of them, they will have a COVID patient in them or someone else, and in case of surplus they might be free.
The medical authorities and the politicians should not be confused.
"APA’s survey of U.S. adults, conducted in late February 2021 by The Harris Poll, shows that a majority of adults (61%) experienced undesired weight changes (weight gain or loss) since the pandemic started, with 42% reporting they gained more weight than they intended. Of those, they gained an average of 29 pounds (the median amount gained was 15 pounds) and 10% said they gained more than 50 pounds, the poll found."
61 percent could have gone either up or down, and 42% said they gained more weight than they intended, of those that gained some gained more than 10 kg, and a smaller fraction gained more than 50 pounds.
So, what does this say:
(1) that people should adapt their eating habits to their needs
(2) that it is possible to lose weight and to gain weight unintended (which is something that isn't really news, see also: weight watchers and the whole weight loss industry)
(3) that the study did not correct for what would have been the result of the poll had COVID not happen
(4) that the word 'lockdown' that you ascribe to the cause does not appear in the article text, but the word 'stress' does
and finally
(5) that you link to this article because you think it supports your statement above when in fact that really isn't the case.
Spain had 14,8% excess mortality than in normal years, Germany had 2,4% less dead, Sweden had 3% more dead. These numbers are adjusted for demographic changes. Sweden now looks pretty solid as well as Spain regarding new cases.
Sure, if you just compare it to Norway and Finland, it is very true that Sweden has worse values, more than 3 times as many dead at minimum. But the answer if it was the correct or wrong choice will be answered after the current seasonal outbreak or in a few years.
edit: Just looked it up again, Spain and Sweden are currently leading with Kosovo for having the lowest case incidence in Europe. Gibraltar has the highest and everyone is vaccinated there. I remember the articles about Gibraltar being the first immune country. They now have cancelled many official events.
The Community of Madrid is the succession tax haven of the country, so loads of people go live there their last years so their families aren't taxed on the inherited wealth.
Combine with the regional government short of condemning to death the elderly in nursing homes by refusing to hospitalize them[0], but I guess it's fine since they forgave themselves [1].
Add to the mix that the healthcare access hasn't kept up to handle what Madrid brought to itself, and then you obtain these numbers [2].
TL;DR: during the first wave, while most regions had peak excess deaths of 10-50%, Madrid had 200%, at the same time as being one of the most populous. In the rest of the periods, Madrid has been usually at the lead as well.
With Madrid removed the numbers are in line with Germany and Sweden.
You may disregard my pseudonymous self’s statement, but one of my children had a weird disease, which I managed to figure out watching YouTube videos of similar symptoms and reading Wikipedia (at first, then pubmed etc)
Over 40 doctors, most of them MD/PhDs, from 4 of the 10 top ranked hospitals in the world for the relevant issue, told me I’m an idiot, because that disease is a 1:10,000,000 thing, it can’t be the cause. It’s probably a virus and I should just go home and wait a few weeks.
And after 3 months (10 days of which were in-patient) and 40 or so specialists, and 5 hospitals), a doctor looked at all the data and said “of course you are right, we start treatment tomorrow” and we did.
All it cost was some irreversible brain and CNS damage, a few years at home - not much, right?
And through the years and some Facebook groups, I’ve met other parents in similar situations. Some had a 5 year delay in diagnosis because it’s a rare disease, stories about the medical system incredibly similar. That’s 5 years of irreversible brain damage and general suffering. Also, it’s more likely severely under diagnosed and actually more like 1:1,000,000
It was just the beginning of a journey. An eye opening one about incompetence and incentives.
The assumption that health authorities in particular (and authorities in general) have your best interest at heart, and are competent, are severely lacking in evidence. You might not have been bitten by that, and I’m happy for you that you weren’t.
Health authorities and professionals optimize for a lot of things, that only sometimes coincide with your interests as an individual. E.g. they might prefer you stay sick than get better, if there’s a 1:10,000 chance you’ll sue them (regardless of merit). I am intimately familiar with such a case.
Of note, the pharmaceutical industry, which is intimately intertwined with regulatory agencies and health authorities, is incentivized to make you a paying regular customer (Office 365) rather than selling you a one time product. Unfortunately, that means managed chronic illness rather than cure.
Which is not to say HCQ or IVM or whatever are the cure. But the idea of “trusting the authorities” is something you only do until it bites you hard.
And for every story like yours - and I know of a few of those - there are examples of people who were absolutely convinced that their child had 'x' or 'y' when it in fact wasn't the case. It is great that you had the perseverance to see this through, and unfortunately it isn't rare at all that local medical care is not up to speed with rare diseases or misdiagnosing a rare disease as a more common one.
I lost a sister (at the ripe old age of 23) to such a case so I'm quite familiar with the territory. In spite of that the default for me is to follow what my doctors tell me, and only if it doesn't work would I start to read up more and to try to come up with suggestions, but not with diagnosis.
Health authorities preferring you to stay sick rather than to get better should re-read the oath of the medical profession, that's despicable.
And agreed that there is a lot wrong in mixing business and health care, but those are the kind of setups that we apparently favor. I recall a doctor here in NL remarking to me that money and health are mutually exclusive, because if doctors have to make decisions based on finance they are immediately transgressing their oath. I can see his point, but I also understand basic resource allocation issues and the medical profession does not operate in a vacuum.
Indeed, the oath is a theatre prop and not much more.
I reside in Israel these days, which has a system similar to NL ttbomk. The doctors that treat you (in the public system) are not incentivized other than to cure you, except perhaps through the occasional marketing cruise.
But high up ministry of health people have been indicted (including through corona) for pushing and in some cases mandating useless treatments after receiving a bribe.
The doctor at the hospital just got the memo “the recommended treatment in case of x is y”.
These indictments are for what can actually be proved. I’m sure there are more cases that have not been found, and also in other countries.
The only one who really has your best interests in my mind is yourself; if you are capable of doing research, you are likely more qualified for your own situation than specialists.
WHO recommends against remdesivir. FDA and IMOH promote it as a wonderdrug. Who would you trust?
Why would you trust a local GP? They are almost certainly the least knowledgeable person in the chain of authority from which you could choose to trust. They will either follow the guidelines or their anecdotal experience. You could read the research papers and the guidelines yourself and have a better understanding of the issue than a given GP. For anything rare, you could probably read the subreddit about the diagnosis and get more trustworthy advice than from a GP.
No, but he is in that chain of authority, and I'm not and if he passes on advice based on what he knows in general and what he knows about me I take it that he's not doing that because he wants to diminish the size of his practice.
I could read the research papers and the guidelines, but for that I would first need a medical degree in the relevant (sub)fields, figure out who is and who isn't telling the truth/stacking the deck/fudging the data/angling for funding and so on and then finally I'd have to weigh those papers and all of their contradictions and arrive at some conclusion. The chances of me getting that wrong are just as high as the chances of my GP debugging a piece of software by reading papers about debugging.
For rare diseases the job of a GP is not to diagnose but to pass you on to someone who can. You also have the right to a second opinion here in case you don't trust the advice that you are getting and finally, you can ask for arbitrage if you are then still not happy.
That said, plenty of errors are made, but I don't think the software industry has any right to speak about mistakes made in other fields, our own house has been on fire for the last three decades in that respect and the only thing we've done to deal with it is to avow any responsibility.
The divergence is not as big as in the US then, but your incentives are still not perfectly aligned.
If you want to outsource your health decisions to someone else, who may be more knowledgeable in general, but may be less knowledgeable on any specific matter you dive into, and whose incentives are only generally aligned with yours - by all means do.
I don't, and this has paid great dividends for me so far. People who are capable of reading and understanding research (not all are), and have the ability to reach far out to well informed people and consult with them (not all can), are also likely to be in this situation -- and those people potentially lose dearly for not doing so.
This is a good example of how ill-equipped most people are to forming their own opinions about things this complex.
The WHO recommends against using remdesivir in hospitalized patients -- which is very different from your claim! The FDA and others make their cutoff point slightly but not substantially later, e.g. remdisivir isn't indicated when a hospitalized patient is on high-flow oxygen. Their disagreement isn't one of substance, just one of scope, and all doctors treating Covid know the rationale behind each cutoff point.
But instead any of that nuance, people say things like the "WHO disagrees with FDA" and decide that both are useless so they should take medical advice from morons with podcasts?
You are arguing against a point I didn't make, and supporting the point I was trying to make.
I actually read the papers on remdesivir, and as a result decided that I will not take it if offered, whether hospitalized or not, because of my risk/reward preferences, which may or may not align with the doctor's or the system's.
In Israel (where I now reside), AFAIK, they are happily administering it to hospitalized covid patients; at least, they were giving it out a lot until they started treating with regeneron. Now, Israel has its own definition for requiring hospitalization than the WHO or the FDA (e.g. SpO2<94% is considered severe and requiring hospitalization -- if you have a positive PCR test).
Do you think the doctors treating covid are actually aware of the minute differences between WHO, FDA, IMOH definitions? I checked with a couple I know. They have no idea.
I think you need to be careful to distinguish between two different kinds of failures of the medical system here.
In your anecdote, you suffered a failure to diagnose, and specifically, a failure to diagnose a rare disease.
This is unfortunate, and bad, and a problem to try to figure out, but it is a completely different sort of failure than what other people are proposing for HCQ or IVM, that there is a highly effective and inexpensive treatment that the medical establishment is failing to recognize despite apparently having such clear evidence in its favor that people on Facebook can understand it.
In that story, which is very long and has all kind of hollywood quality twists (and heros, and villains), there was a highly effective and (relatively, ~$10K overall) cheap treatment, where the official treatment was $30K/month with potential for stopping at some point, but most kids are on it for years before they can stop.
The diagnostic failure was just the beginning.
(And, unlike the HCQ/IVM case, which I don't support and is in general speculative - the guy responsible for the official recommendation was actually convicted for taking bribes from the company making the treatment. I won't divulge any details, because that will de-anonymize me - the disease is rare enough that people in the field know each other and all the cases).
p.s: That treatment (in combination) is also used for other, similar diseases, each is rare, but overall it was a lucrative market for the drug company.
In my opinion it should be an argument, especially for people who don't have that expertise.
Also, even the "moderately convincing" evidence is in my opinion not nearly enough. It might be if Covid-19 were a modestly important disease with only a few labs and clinics running working on it. But it's not. Throw enough shit against the wall, eventually something will stick by chance. This is a globally distributed experiment, and it is impossible to control for publication bias and all quality issues...
The only reason to think why Ivermectin should work against Sars-Cov-2 is because it has shown some action in cell cultures at ridiculously high doses, and maybe there have been other anti-viral interactions in the literature. For widespread use, there needs to be more and better evidence, especially given the currently available vaccines and treatments.
It is only a fallacy when you are an expert as well, but when you are a layperson in a field and you are discarding real expert opinions because you don't like them you don't get to claim that their opinions are arguments from authority and therefore by definition fallacies. Maybe actually read that wikipedia page instead of just linking to it?
This seems to be a common and recurring theme: my opinion is worth as much as the opinion of an expert in the field because their argument can be discarded as an argument from authority. But they are an authority and I'll be happy to believe them compared to believing you, who are not active in their field at all.
"I'm no medical anything but I do have extensive academic and statistical training."
But you forgot that that only applies to those fields that you actually know something about, otherwise this is about as transparent an appeal to authority as one can make. Who cares about your extensive academic and statistical training if you start off with nonsense? Garbage in, garbage out, no matter how good the program is.
> It is only a fallacy when you are an expert as well...
This is wrong to the point where you really might want to take a deep breath. The point of experts is they have thought about a field more and are better at making sound arguments in that field. "Most scientists/doctors believe..." is literally, exactly and unambiguously a fallacious argument. The only thing that matters is why they would believe that.
And if that why is "statistical significance", I'm friends with enough doctors to know I'm better at interpreting stats than they are. If the answer they go to is parasitic worms then yeah, that is why they are experts and I'm not. It is a compelling argument.
I stand by my comments and disagree that they make the point you want them to. The 1st isn't even about medical opinion if you read it closely, it is scepticism of politics.
No, if you are not a doctor your opinion on any of this doesn't matter at all, it's that simple.
Probability dictates that any doctor - let alone most doctors' - opinion trumps yours and everybody else that parrots you, because they will be right far more often than you about medical things.
You may be better at interpreting the statistics than your doctor friends but you are not better at medicine, are not wired into their world as much as they are and in fact are most likely blabbing nonsense.
You can stand by your comments but that just proves my original point: that you consider your own opinion to be a higher one than someone trained in the field that you have an opinion on. See your other comment in this thread regarding how medicine prescription works, it doesn't but that isn't going to stop you from being convinced and it would not surprise me if you felt that that doctor is making an argument from authority.
Suggestion: assume that you are a layperson in medicine, act accordingly. And go get vaccinated if you haven't been already, and ask your doctor if they thinks that's a good idea, rather than to believe me, yet another stranger on the internet.
And I suspect you would have had the same conviction about smoking had you lived in the 1960s and noticed that many doctors recommended smoking.
No, it does matter why a doctor believes what they believe. The vast majority of them just follow the official top down advice. And some actors, notably tobacco and pharmaceutical industries, have been using that to subvert science (to great effect and profit) for decades.
Which, again, I note, is not a statement about IVM or HCQ or Cominraty - it’s about the reasons for your own convictions, which seem to completely ignore decades of evidence.
It does not at all matter that doctors know better than me about 99% of medical things. When I have a specific issue, it is far more likely I can know more about it by spending 100 hours studying, than a trained doctor does without studying. It is likely he would know more than me if he spent 5 hours, but it is very unlikely that he has.
I haven’t disagreed with doctor about many things in my life. But in the 3 or so things which I found vitally important to research, and in which I came to a different conclusion than the specialists, I was proven right.
In the 1960's smoking was already considered very bad for your health, in fact a large 1951 study amongst the doctors themselves pretty much proved that, but that didn't stop lobbying and advertising by the Tobacco companies, including the use of actors posing as doctors from continuing to push the false narrative and if not for some pretty heavy legal restrictions they would still be doing this today (and they still do, in some countries).
And real doctors promoting smoking goes back much further than that, all the way to the early 1900's.
It's that kind of activity that undermines the authority the profession, but it's the wrong conclusion to make that if doctors were wrong about smoking they are also wrong about everything else. Usually they are not.
> but it's the wrong conclusion to make that if doctors were wrong about smoking they are also wrong about everything else. Usually they are not.
Indeed. And usually, there is no significant objection to the medical consensus, so it is irrelevant the "all medical advice" space.
The interesting (from my perspective, but also from an information theoretic one) things are those about which there is disagreement. And the "usually right" on those subjects goes down significantly - perhaps it's still "usually", but maybe it's just 60% rather than the 99% of the "right" things which inspire people to blindly believe doctors about everything. And perhaps it's just 20%; We'll likely know about today's status only in 30 years.
For example, there is still consensus about statin use to reduce cardiac problems through cholesterol lowering. I looked a little into that; the evidence is severely lacking, especially if you consider all cause mortality rather than just "lowering myocardial infraction risk" (which you can achieve 100% with Cyanide!). I have informally surveyed about 20 doctors, of which one was a cardiologist. Everyone other than the cardiologist was convinced statins are the best thing since sliced bread, have no risks, and excellent efficiency. Not one of them actually knew much about, e.g. statin effect on all cause mortality, or much of anything else related to statins except the official line and up-to-date (the service) summaries. The cardiologist still thought statins were a good thing, but was much more reserved about recommending them to anyone with high blood lipids, because he actually read the research and had actual experience (and discussions with informed colleagues).
>No, if you are not a doctor your opinion on any of this doesn't matter at all, it's that simple.
>Probability dictates that any doctor - let alone most doctors' - opinion trumps yours and everybody else that parrots you, because they will be right far more often than you about medical things.
You really have not spent much time around doctors, I think. Doctors (GPs) know about as much on a topic as someone who Googles the current country guidelines. For anything novel, I'd trust a statistician over a GP to interpret data every time.
I've spent enough time around doctors to know that as long as you have something obvious they'll make the right diagnosis, and that if it is something rare they might get it right. But for GPs that doesn't really matter: they don't diagnose unless it is something simple, they just pass you on to the relevant expert after performing their filter function to avoid hypochondriacs from clogging the system.
Don't like it? Get a second opinion. Don't like that? Request a review. Don't like that? Self medicate to your hearts content, or go with crystals, aromatherapy or whatever you believe works. But don't go around the interwebs spouting your self derived conclusion from papers that you barely - if at all - understood as fact.
Because that's the rub: the people who were all over Vitamin-D, Bleach, HCQ and lately Ivermectin were just looking for excuses not to vaccinate and that is a problem, none of these miracle cures were miracle cures, they weren't even cures. At best they were no-ops, at worst they harmed the health of those that received them. By amplifying these messages thousands of people have needlessly died.
But Ivermectin seems to have run its course. I predict a new miracle cure with a new champion somewhere in the next couple of months, just like Vitamin-D and HCQ before it.
"The point of experts is they have thought about a field more and are better at making sound arguments in that field."
This is an excellent point. It is so good that I think it may serve as the definition of an expert: An expert is someone who is better at making sound arguments in that field. Sound arguments being what matters and not the person making the argument, just as the calculations matter more than the mathematician.
Most of that wikipedia article is devoted to pointing out that most of the time "argument from authority" is legitimate.
And to the extent that the article does say that even a legitimate authority needs to present an argument, in this context, they have!
Like the situation here is medical experts have said "hmm these studies that appear to show ivermectin's effectiveness are fraudulent and suspicious".
Like, with the exception of the complete theory that ivermectin studies in some nations are naturally confounded by the presence of worms, the arguments he's made about the unreliability of the ivermectin data is the mainstream argument about the unreliability of ivermectin data. He even cites a number of experts whose analysis he sometimes relies on!
It would be a fallacy to say "this argument is necessarily true because an authority claimed it was so", but it isn't a fallacy to say "this authority in this subject claimed it was so and it far more probable that they know what they are talking about than you, who are not an authority in this subject."
No it isn't, it's full of obvious fraud! That's what the entire rest of the article points out. And they put an unwarranted warning against one of the few non-fraudulent studies because it doesn't go their way:
[re: Lopez-Medina et al]
> "I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work."
That's the nearest Scott gets to directly accusing ivmmeta of fraud.
The ivermectin manufacturers, researchers receiving funding from pharmaceutical company or the government, or the ivmmeta.com website itself (I see no third party ads or assets at all -- not even GA)?
Meanwhile, back at the Pfizer ranch, they just bought a few small countries for cash.
The base rate in medicine is around 10% of studies being fraudulent [0]. That is roughly the rate that Scott came to in the 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").
It might be that the list is riddled with fraud, but it isn't obviously so. I'm comfortable with many of the studies having methodological errors - that is why it is called "low quality evidence" instead of "high quality evidence" - and I assume the base rate for badly done studies is quite high.
Most scientists/doctors believed at one point that ulcers were caused by "stress". My father lost half his stomach to an ulcer surgery. Nowadays ulcers are cured with antibiotics in the span of a week. Don't put much stock in what crowds "believe" to be true, _especially_ when _not_ believing it means they can't work in their field.
That's science working as intended: theories getting replaced by better theories. There is plenty that we are probably going to find out more about in the future that will invalidate some of what we believe today to be true. But that's fine, as long as we stick to the scientific method that will all come out, even if it takes a while. Science has brought us further in 400 years than anything that came before. Right now it has given us vaccines, which are the best way to deal with COVID-19, and the anti-vaxx crowd and the pro-hydrochloroquine and pro-ivermectin crowd show large overlap.
Fortunately during the polio years we didn't have the internet, the carnage would have been incredible.
Sure, but my point is "consensus" doesn't necessarily mean "truth", even though the vast majority of people use the terms interchangeably. "Everyone but one person is wrong" is a situation we've seen numerous times before in the history of science. And when the matters of social acceptability, prestige, politics, and just plain ability to make a living enter into the consideration, very, very few people would even be willing to challenge the status quo. I wouldn't. I have mouths to feed.
I'm fully resigned to the fact that we won't know for sure if Ivermectin helps with any of this shit for at least another decade until tensions subside. Could be that millions of people died while they didn't have to. Could be that it's total horseshit. There's no way to know, and "consensus" means next to nothing in these circumstances.
The consensus in the medical world is that if there is a link it is extremely weak, far weaker than you'd need to establish that 'millions died while they didn't have to' as you write, and that if it works it probably needs very high doses, higher than considered safe.
At the same time, we have vaccines, which do work (though the slow roll-out and the many, many hold outs certainly don't help, as well as that it leaves the question of how to deal with children for the moment mostly unanswered).
And propagating this Ivermectine (and Hydroxychloroquine as the predecessor) nonsense has caused a lot of people to forego their vaccinations. And that does have very clear effects.
So even if consensus doesn't mean truth typically it is the experts that go against the grain with hard proof in their pocket that win out over the long term.
It is very rarely going to happen that new scientific truth will come from conspiracy theorists rather than from the establishment, though I guess if you live long enough that too will one day happen.
I agree with both of you. We can't 100% argue that the prevailing wisdom is infallible because of real examples of the opposite occurring rarely, like the ulcer case. However, on the balance I prefer to go with prevailing wisdom. It's a judgement call that requires a human to detail with probabilities and humans are very bad at probabilities.
> has caused a lot of people to forego their vaccinations
Citation needed. I think people forego vaccinations due primarily to how hard they are being pushed, and due to almost 2 years of pretty much nonstop incoherence (or even outright lies sometimes) from the health authorities and the press worldwide.
Case in point: we're still being told by talking heads that "vaccines can stop covid" whereas the reality is nothing can stop it - it's endemic. And that was clear to any sane person back in February of 2020.
There would have been no carnage with polio. Vaccines have a demonstrable and long lasting effect and the disease is more severe for all age groups, so people would have taken the vaccine.
Yeah, I knew a guy who got his legs destroyed by it. Given how well the polio vaccine is tolerated, and how grim the prognosis is without it, I don't think there'd be any issues with vaccine adoption. Measles one could argue either way - the disease is far less severe in most people.
Because people will happily discard evidence that contradicts that which they want to believe. There is apparently something attractive about 'miracle cure suppressed by vested interests' that pretty much guarantees its spread. All you need to do is plant the seed with some gullible people and they'll run with it and parrot it to everybody that will listen, doing a boatload of damage in the process.
Between hydroxychloroquine and Ivermectine you are (worldwide) probably looking at a few hundred thousand extra people dead because they (or in some cases their leaders) chose to believe that bullshit rather than to get vaccinated.
I don't think we adopted handwashing because of him.
Actually, the reason people didn't believe him is interesting because they were using an earlier scientific method - he didn't have a good explanation for the mechanism, so they dismissed it with "correlation is not causation". We're better at using things whose mechanism we don't understand now, like Tylenol.
There is a whole industry in off-label use of medicine, and there are also quite a few studies that try to move off-label use to on-label use once the link is clear.
What is interesting (to me) is that which we now consider to be common sense was at one point controversial.
We did adopt his methods, but many years and hundreds of deaths too late, and not before declaring him insane for his beliefs and putting him in an asylum.
What I'm saying is that authority has a dark side. Sometimes the establishment is actually wrong. Regardless of right or wrong, it always chooses to erase its critics. Some of us disagree with the erasure, even in cases where the critics are wrong.
Yes, so you trust in the scientific method in the long term and in the expert consensus in the short term.
The thing where the case you linked went off the rails for me is that there was no downside to trying his methods earlier, but ego got in the way, and ego is by definition unscientific. But people will be people, that you won't be able to fix, I'm afraid.
This is the first anti-Ivermectin argument that you want to believe, but there have been many serious anti-Ivermectin arguments in the past. It's just that you don't have the background knowledge to digest them, but that doesn't stop you from wanting to believe that there is some kind of miracle cure that 'they' are suppressing.
Now consider that this is just one example of a class of such issues and that there is an enormous echo chamber for such bullshit which extends right into hackernews.
The way it works:
- posit some bullshit miracle cure
- recruit useful idiots to help promote the issue, sow division
- downplay all of the arguments against, make it seem like it is the establishment that does this
- eventually, give up and move on to the next miracle cure
- go back to step one
It is interesting to see that it is the same people that over-and-over-again allow themselves to be recruited like this. Note that you were making 'pro-Ivermectin comments just yesterday' without knowing what you are talking about.
Why were you making those comments?
What were you trying to achieve by amplifying something that made no sense?
Don't you feel any responsibility for pushing such stories when the end result can be that people end up harming themselves or others on account of this?
> This is the first anti-Ivermectin argument that you want to believe...
I discounted a highly biased echo chamber in social media and more traditional media and went with 30-odd studies that appear to have been assembled in good faith even now. I changed my mind immediately on seeing "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".
You are describing how you want me to be thinking, not how I am thinking.
I have a pretty good memory for comment histories and you've been pushing this for far more than it is worth.
That this single article would change your mind is fortunate, but I do not suspect that to hold true for the bulk of the conspiracy peddlers that remain.
Isn't this an example of some rigid and ineffective thinking patterns?
Article publishes sound arguments, doesn't talk down to the audience, admits problems with appeals to authority... and converts a conspiracy believer!
...No way, there is no way that can possibly work, the others are way too dumb, and the convert is a bad person... basically anything to just go back to pretending appeals to authority work. Despite clear evidence to the contrary. Or lamenting that they don't. I'm drawing some parallels with miracle cures here ;)
I've been following with some amazement the number of conspiracy peddlers on HN for the last 18 months or so and one case of conversion isn't going to make me overly happy. It is a bit like the story about the lie getting halfway around the world before the truth puts their shoes on, in the extreme long term the truth will come out, meanwhile, the damage is done. This guy until yesterday wanted his mother to take some ivermectin, 'just in case'. I want my mother to take her doctors advice, not mine.
You could try spreading the truth instead of bullying people? I do care about my mothers health you know. And if a doctor isn't convinced by a large number of studies I want them to explain why not rather than call me a conspiracy peddler.
The way someone gets ivermectin is to walk a doctor through the evidence they've seen and then ask them to prescribe it.
If you care about your mothers' health then you shouldn't engage in quackery.
> The way someone gets ivermectin is to walk a doctor through the evidence they've seen and then ask them to prescribe it.
That is factually incorrect, no doctor in their right mind will allow the patients to effectively prescribe their own controversial and in some cases downright dangerous medicine.
I am a doc. I am also a medical researcher, but you (and most other people here) _have_ to realize that the vast majority of practicing MDs are _not_ scientists, and understand almost nothing when reading medical studies. And that's fine, because it's not their job. The profession is bound by guidelines and expert opinion. Experts do research, formulate guidelines, and guidelines get applied by practitioners. And no, that absolutely does not mean you know better than the average doc because you've read 10 studies. That's telling a highly specialized labourer that you know the job better because you've read 0.0001% of the theory.
The dissonance here is intense. On the one hand, "practicing MDs ... understand almost nothing when reading medical studies", but also I don't "know better than the average doc [just] because [I've] read 10 studies."
Is the idea that doctors deserve deference because they are conditioned to submit to guidelines formulated by experts?
There is a lack of consensus on many long-standing, common medical questions, much less novel diseases. When I ask my GP about prostate screening, for example, he lays out the current state of research as best he can, but delegates the decision to me. Why is the COVID situation different, given that experts are still fighting through a figurative fog of war?
Great point. Perhaps the idea is that neither you nor the avg doc can conclude much from reading 10 studies. Therefore, defer to the experts?
As to why the COVID situation is different, presumably because prostate cancer screening affects only you (and perhaps your family in the case of a true/false positive/negative diagnosis), and COVID represents a threat to everyone around you, and everyone around them, etc.
Your GP may try to lay out the state of research before you, but that does not change the fact that he/she will do one of those things:
1. Treat you according to guidelines/expert opinion, should you choose to.
2. Give you the opportunity to participate in a relevant study.
But _never ever_ will your GP formulate an experimental treatment plan based on his own research. Not GP's job, and big risk of liability. Your GP has at best a cursory view of the research happening in a certain field. COVID is different due to several good and bad reasons: hugely politicized, confusing messages from experts, and most of all novelty. 'Lack of medical consensus' usually means 'several treatments backed by experts are available', not 'do what you like'. COVID is too new for the dust around expert debates to have settled. That's what makes it different.
As someone who is actually an expert in a subfield of medicine, not only do doctors not understand it at all, but the experts making guidelines often recommend the exact opposite of what is the best treatment for the patient, usually for liability reasons, but occasionally for true lack of understanding. The quality of research is so poor that often times there are more flawed studies showing X than proper studies which would show ~X. Other times there is no research on the matter at all, and the conventional wisdom (even among experts!) is incorrect. For fields where practice and theory diverge, like an experimental surgery with sparse research, the surgeons know that the guidelines are useless.
What you yourself _have_ to realize is that the expert researchers who are in a position to create and inform guidelines are themselves not some kind of 'super-experts' who know everything better than normal experts. They're just researchers in a political position in a bureaucracy.
I don't exaggerate when I say that an average HN reader could write better guidelines for patient outcomes in my subfield, with no prior training, simply by reading a few studies and observing a practice.
Now, does any of this apply to internal medicine, specifically covid? Probably not. But when the data is anything other than crystal clear, you should not assume the expert guidelines are anything more than some guesses by guys in a room. The consequence of knowing this is that all guidelines and consensus is suspect until you see the data yourself, like TFA outlines. In this case it seems true that Ivermectin doesn't cure covid. But with my experience, the exact opposite result could have been shown and I would not be surprised whatsoever; experts saying it doesn't work does not constitute in my eyes anything other than noise until the data is clear.
I'm not saying that experts are doing a stellar job or that they're special in any way, far from it. I have slaved enough under 'true experts' to know the extent of the catastrophe. We even had a truly spectacular example of failure at the start of the pandemic with the 'intubate early and withhold steroids' expert opinion. This particular one, I won't ever forget.
What I'm saying is only that:
- on average, experts do spectacularly better than Joe Schmoe. Including science degree holders thinking they understand medical studies while missing the whole political and social context of the field.
- it's not the job of field practitioners to prescribe experimental therapies, and those people cannot do better than follow expert opinion and guidelines.
But I actually agree with you on all points, especially regarding flawed research and understanding. Which makes people basing opinions solely on papers without any practical knowledge of the field wrong all the more often. Does it make it a good idea for people to go and try on their own the thing they read about in the last issue of 'covid today'? I don't think so.
>on average, experts do spectacularly better than Joe Schmoe. Including science degree holders thinking they understand medical studies while missing the whole political and social context of the field.
I'm saying that, when the data is unclear and Joe is thorough, I don't even think that's true. Or at least it's not spectacularly better. My point is that for something like Ivermectin where the data was initially null and even now isn't super clear, the word of experts was basically meaningless. Trust them if you don't care enough to look into it, but if you're Joe I'd say just go ahead and believe whatever you understand to be correct until there's a better consensus.
Your Joe is the average HN reader. My Joe is my average patient. I completely agree that the word of experts is meaningless on matters where dust had no time to settle. I however maintain that practitioners have to follow guidelines and experts regardless because I believe in the principle (if not the current application) of evidence-based medicine, and that Joe should not be allowed free access to any drug he wants to prevent frequent self harm.
I don't know about that. I'd rather see all of this stuff disappear from youtube and to deny the conspiracy sphere its oxygen than to let this run its course. The damage is very real. Experts tend to communicate via scientific papers and symposia, not via youtube, that's aimed squarely at the masses only a very small fraction of which has the capacity to interpret what they are hearing, but almost all of them have the capacity to filter that to select the bits that they like or that they feel support their pet desired outcomes.
The damage caused by mis- and dis-information is real, but suppressing dissenting voices (even comically mistaken ones and bad actors) destroys institutional credibility, which is far worse in the long run.
The medical profession gets it wrong with some regularity, but this Ivermectin thing fell out of the sky without any support, and was touted as the miracle cure that big pharma was withholding in order to protect their profits.
So even if the data is unclear we can safely conclude that it isn't a miracle cure and never was. And Joe Schmoe here isn't talking about some condition that he's been walking around with for a while and has studied extensively, Joe Schmoe here is a guy who believes doing your own research is watching youtube videos by people who have done their own research reading a bunch of papers without understanding any of it.
The problem is that that gets in the way of achieving the goal: beating this pandemic, and that isn't going to happen with ivermectin. (Or HCQ for that matter).
But why do you even assume that it works? The doctor might not be able to disprove it because disproving is fundamentally hard and may not even be possible. But the direction that makes sense is that we prove if something does work/has an effect.
The zero hypothesis is the long standing default, that a random thing will not cure this illness. The alternative hypothesis is that it does cure it and then we can analyze the results based on the results of a fair trial.
As an engineer, sometimes I say "ship it!" to code that doesn't make me happy but works and solves a real problem.
Edit: I meant this to go with debating techniques, not cures. There are people for whom no amount of saying "why can't you just listen to Dr. Fauci" is going to work. We can say they are bad people, but that doesn't work very well for getting them to agree either.
You are right to call out above that there were other anti-Ivermectin arguments before and roenxi might not have had the background to understand them. That's exactly the point: here we have an argument that he can understand, and it's effective. This is good science journalism. The kind that doesn't work (too much moralizing or too confusing for the general audience) is bad journalism.
I hope that that only goes for things that you can oversee the risks of and that you would refrain from giving medical advice to your relatives assuming that you are not a doctor.
"move fast and break stuff" is the wrong attitude for medicine and aerospace.
But a solution is better than no solution, and of all the countermeasures that we had available in March 2020 we only used a fraction.
As to your edit: no, here we have an argument that he thinks he understands, that's not the same thing. The argument as presented is at best a hypothesis, it isn't proof of anything, just one more theory that may or may not end up being the right one explaining the sometimes observed effect, assuming it really was observed in the first place.
This is precisely what makes this discussion so tiring: people will be swayed one way or the other based on arguments that they have no way of understanding unless they were trained in that particular field.
Unfortunately, there are plenty of politicians that fall into the same trap, leading to terrible examples of wishful thinking, outright quackery and conspiracy amplification. The harm that this is causing is substantial.
So even if this article swayed one person I'm pretty sure you'll be able to find people who get the opposite out of it, because hey 'x' has now joined the establishment, must have sold out.
"Sold out" is a real problem. More people than we want to admit see corruption coupled with big media as a enemy, not a thing to be trusted. Many ordinary people flat out do not know when to trust, so they don't.
They then seek others and continue to have conversations, and they find others lacking trust resonates and that opens the door for a lot of BS normally and easily seen.
Just an example of the difficulty we now face:
Hiding YouTube dislikes will, among other effects, serve to help big corporate media compete against new media.
Hiding the dislikes also breeds more mistrust. This is unavoidable no matter how reasoned the move is.
Public trust in corporate media is really low, and the younger a potential user of that media is the worse those metrics are.
Had that same media held more closely to journalism, rather than access journalism, which is essentially a sales job, the trust problems we struggle with today would not have grown into the chronic problem it all is today.
You identified politicians committing similar abuse of the public trust.
Look at Russiagate. Basically, it flat out did not happen the way many believed it did. Back when that started, many and myself included went to the original documents, saw speculation and in some cases saw it helpfully color coded, and turned on the news only to see all that elevated to fact.
That scared me frankly.
What can one conclude?
I do not see how judging others helps right now. Not saying anyone did here, but I am saying that is happening a lot and when it happens the door for good info to find it's way home gets closed. Advocates render their efforts far less potent.
Secondly, the lack of trust really can't be assigned to people. We have a lot of "they are stupid" type discussion, judgement and rationalization going on and very little of that is helpful.
ie: 70 million people voted for...
The people who had a far better position of authority and trust denigrated that themselves, and for dollars and ratings.
All that is a real mess!
How can authorities, who have abused public trust be counted on to fact check and improve on misinformation without amplifying the already chronic trust problems they created?
In a more basic sense, how can we improve on public trust at all?
I am not sure how that is done quickly.
Longer term, we need media that makes informing people a priority. And doing that likely means a move away from the current AD and access based media we have now.
Given how things are right now, the more important thing is to avoid judgement of others and encourage more and better information exchange. We will not know what reaches people, until it does.
Once it does, we need those people to continue seeking better information so we see more people making better choices more of the time.
I have slowly come to the conclusion that maybe we grew up a bit too fast with respect to media and social media in particular. In the past change to society came slow and we could internalize and stabilize it before the next round of changes appeared.
Now the changes are coming so fast and are so drastic that we as society - including our legal system - have no way of keeping up with it. Technology routinely moves from one phase to the next before the legal framework has caught up with it. This translates into effectively operating without a legal framework for a very important chunk of society.
That's dangerous territory. I don't have any solutions and I'm sure that there are plenty of people that disagree with me but I've gone from a technophile to being very skeptical about the degree to which I allow tech into my life. Familiarity breeds contempt, or something to that effect.
However, and as a thought exercise, say we did not go down the Citizens United path after Reagan repealed the Fairness Doctrine, and Clinton Telecommunications Act of 1996.
Social media viewed through that lens, one where both the public interest is a thing we recognize must at least compete with profit, and the public trust is recognized and maintained as the high value part of our Democracy it is.
I do not disagree with you about tech and the law being behind. And right now we remain in a particularly difficult time due to so many legislators not understanding tech well enough to perform their role as well as it needs to be performed.
That said, our difficulty right now is greatly exacerbated by basic policy priority shifts that happened well in advance of tech.
Owning that is particularly difficult too. Money and markets are a higher priority than the public interest is, and that is true for government as well as big media.
The vacuum was there and significant, leaving tech, social media to rapidly expand into it.
Had that time been one of more robust public trust, social media would have to compete much harder, and regulation may well have both been more effective as well as earlier, more robust in its positive impact.
That will be true for very large numbers of people. Not their fault at all. It simply does not happen that a population all ends up able to sort these kinds of things out.
Implying they should is fine in the sense of self improvement, but as policy? Nope.
Perhaps it is time we, as concerned people, begin to take much harder look at our national priorities and demand the public interest be far better served than it is today.
Having done that, and sadly we are no where close to the basic consensus needed, we will find painful discussions like this one are a lot less frequent.
Know what I did not see in this exchange?
"Yes! You got there. How can we reach more people and help get past this?"
Feels a lot more like, "better late than never, and you need to do much better."
This is a blogger who took time out of their day to do this. Why do you have to be catered to to be convinced? The blogger didn't produce any new data, it was already there, you chose to ignore it, or rather, picked something else to be convinced by.
It's not bullying or "talking down to" to simply ignore bullshit, it's effective use of your time.
I was never an ivermectin proponent — although I thought the "horse dewormer" rhetoric was self-defeating, because it's obviously and well-known to be also a human dewormer (amongst other parasites), and the "horse" part just seemed to be played up to make ivermectin supporters look stupid — but this article is indeed the first one I've seen to make the parasite-COVID-comorbidity argument. It's not, in fact, the first time that argument has been made... But it seems like the first time that link was made was within the last month, as the blog post links to the following Twitter thread from a medical researcher: https://twitter.com/AviBittMD/status/1456376484180922368
It's not ridiculous to me that this blog post would be someone's first encounter with that argument, considering how recent the link is.
I have a little bit of experience with reading lots of research papers about COVID safety measures, and coming to the opposite conclusion of medical experts: in early 2020 I read lots of papers on masks, and tried to convince most of my family to mask up even when the CDC said that masks didn't work. I happened to be right, and to my parents, I now look like a smart and forward-thinking, science-driven person. But that's only because I was right! I could see someone doing the same with the ivermectin studies, and while it appears that they were wrong, I don't think it deserves dismissal or derision — especially when it comes from someone willing to change their mind and admit they were wrong when presented with compelling evidence to the contrary.
Please provide sources that "many people" are using horse doses. I only hear of well known people such as Joe Rogan and Aaron Rodgers using human-prescribed pill form ivermectin.
On the contrary, the majority of people who called poison control were "worried well" who had no symptoms. And I think "not a lot in absolute numbers" is really underselling it: the total number of "reported exposure cases" was 459 in a country of 330 million people, up from 133 cases the previous month (before people started thinking ivermectin was a suppressed miracle cure). That's one out of every million people. Of those, zero died.
By way of comparison, every year, two out of every million people in the US die by falling out of bed.
There were many news articles stating this that were corrected for grossly exaggerating the situation. I would suggest going back and re-reading the source material to see if it has been updated or has disappeared.
What’s a better practice is to explain the rationale per situation, what is known and what is not known. The right turned science into a culture war flashpoint, which meant the left blindly preaches “believe in science” as if it’s about faith. This is all very disingenuous and not at all what science is actually about.
It’s very unfortunate that Covid started under trump because being anti-science was part of his marketing message to his base, many because of the risk to certain jobs with caring about climate change (aka the great “hoax”) and the association of science/medicine and abortion.
Unfortunately explaining the rationale in a way that people can comprehend and not tune out is very very difficult, and far more time consuming than whatever 2 syllables Trump could come up with as a retort.
> The right turned science into a culture war flashpoint, which meant the left blindly preaches “believe in science” as if it’s about faith.
These two perspectives are not equivalent opposites though.
"Believe in science" is not a religious statement.
It is a shorthand for "trust in the scientific institutions that have proven their track record via decades of public health progress, and not in anti-scientific rhetoric with a culture war agenda".
That concept wasn't even controversial on most of the political right until their recent nationalist turn.
Knowledge and understanding of the world is constantly growing. There are endless examples of how scientists and other intellectuals have a current paradigm of how something must work, only to be disproven in the future (usually by someone who gets castigated until held up years later). So to say 'believe in science' is actually dogma. It makes me cringe when I see it as a political banner, or along side signs like 'in this house we believe in....' It would be more accurate to say 'the scientific method works', but it really only works in the long run. At any point in time our understanding is incomplete and erroneous.
The facts are out there, whether you believe it or not, and eventually the scientific method will catch up.
Of course if you're not a trained scientist, then it's hard to appreciate how the scientific method works, and that even when we're very sure of something, true scientists will always hedge their statements. This will be misinterpreted by those who are outside this world as there being more gray than actually exists, and those with an agenda will drive a truck right through it.
No, people who will amplify bullshit because they want to believe in miracles rather than to face the music. As long as it is just about yourself go wild, do whatever you want. But keep your mental viruses to yourself, lest they destroy the lives of others.
May I ask, completely sincerely, what approach you would settle on for trying to discriminate truth from fiction if you believed you couldn't get reliable information from reading 30-odd studies?
Isn't the correct answer to wait for more reliable studies? Which is what most "anti-ivermectin" folks were saying to begin with? If your primary goal is to have a miracle cure in hand that would allow you to push back against vaccine mandates, then this approach probably won't sit well. But if you are interesting in actually finding truth, than waiting for larger, more robust studies was the answer.
Why wait? Why not take ivermectin as a precautionary therapeutic given it is well tolerated with low risk of side effects?
There's a chasm between the epistemic question of "does this drug really work?" and the pragmatic question of "does a risk-reward analysis under uncertainty say that I should take this mostly safe drug that might slightly reduce my covid severity?"
FWIW, I wouldn't take ivermectin either as a prophylactic or therapeutic, the evidence just isn't strong enough, but I don't really fault anyone that would add it into the stack of treatments upon a diagnosis in the hopes of a small net benefit.
> given it is well tolerated with low risk of side effects
That's not a given, that depends on the patient, the dose and a host of other factors. You may well end up harming someone significantly. You are in no position to proscribe any kind of medication to someone else unless you happen to be a licensed practitioner.
While it's true that virtually any substance has a toxic dose, avoiding that dose is straightforward for drugs as well-known and widely-used as ivermectin. There is no risk of harming someone significantly. (There's also, I think, no chance of being effective against covid at safe doses.)
It is true, but unfortunate, that in many societies only licensed practitioners are in a position to prescribe (or proscribe) most drugs. That's a policy that does some good but also an enormous amount of harm.
What other prophylactic treatments do you take in your life before or after COVID? Because in my lifetime I can think of only a small number of classes of general prophylactic treatments I've ever seen a small number of groups of people take.
- Silicon valley rationalist types taking stacks of vitamins despite having no evidence on bioavailability because they are generally without side effects and who knows, you might live forever. I think the consensus on this now is that more or less this is not a useful practice, though I am unaware of any evidence for it being unsafe.
- Prophylactic hormone replacement therapy in middle aged women, which was eventually generally recognized as unsafe because of unexpected cancer risks not initially understood.
- Prophylactic breast self-examination, mammograms, and prostate exams based solely on age, the former of which have been significantly dialed back over the last decade because the risk of false positives or catching slow-growing low risk cancers causes a net negative from the treatment. I don't know what the state of prostate exam research is.
- Prophylactic aspirin for heart stuff: we seem to go back and forth on this, but the last I read was that actually there's mounting concern about chronic low-dose aspiring. At the very least, it's not obvious this is doing anything.
- Statin treatment in response to mild elevated blood pressure with no symptom of disease; not exactly prophylactic, but close in the sense that it's about advance management of expected disease. And last I read, researchers were increasingly recommending dialing back statin treatment for minorly elevated blood pressure because of, again, unforseen side effects.
So I just mention this to say that what I take from your post is "the precautionary principle suggests giving more weight to prophylaxis with no known side effects" and what I take from major medical stories in my lifetime is "no known side effects almost always turns out to involve side effects in the end, and that has to be part of the precautionary principle as well".
And I should note all of the above prophylaxis is based on clearly defined treatment regimens and physician supervision, not the kind of wild west ordering various formulations of ivermectin at unknown doses with or without medical supervision on an ad hoc basis.
I said I don't fault people for using it as a precautionary therapeutic upon diagnosis.
I didn't say that I don't fault people for taking it as a prophylactic. I do fault people for doing that because the side effects of long term use are less known, as you say.
It occurs to me that I didn't mention PReP for HIV, which is obviously effective in what it does. I do tend to think of the direct risk in a PReP context as more severe, and also PReP requires active management of a physician's care, so it is a bit different than the thing being discussed, but it's also a counterexample to my point and so in charity I decided to add it in this reply.
I took chloroquine as a prophylactic treatment. Not against covid, obviously; against malaria. Also, I took prophylactic treatments for measles, mumps, rubella, tetanus, polio, and another dozen or so diseases. I'm currently taking vitamin D; my original justification for this was as a prophylactic against covid, but now it's just a prophylactic against hypovitaminosis D.
I had alarming symptoms after the chloroquine treatments, and regret having done it. But nobody would ever put chloroquine in the "no known side effects" bucket.
> FWIW, I wouldn't take ivermectin either as a prophylactic or therapeutic, the evidence just isn't strong enough, but I don't really fault anyone that would add it into the stack of treatments upon a diagnosis in the hopes of a small net benefit.
If you're familiar with software development, this is akin to "there's a bug in my codebase and I'm just going to add a bunch of code that probably won't affect anything in the hope that it will fix the bug".
Meds shouldn't be administered in this way. It just ads noise to the system and will complicate things down the road.
You make a good point even though I take supplements such as vitamin d, etc. I would argue that the human body is already so complex that troubleshooting it similar to how we troubleshoot software is not a fair comparison because software is easier in a relative sense!
Why not using a de-wormer against a virus? Well, because that's what vaccines are there for. And we do have rather effective ones by now. All of which have a low risk of side effects as well.
Using ivermectin as a therapeutic and getting the vaccine are not mutually exclusive.
Also, I don't like your first sentence, it's a rhetorical gotcha that is actually not in line with the medical establishment's thinking on ivermectin's hypothesized mechanism of action:
The issue is that folks who are taking ivermectin are doing it in lieu of getting vaccinated. If you get vaccinated and want to take ivermectin for the heck of it, no one is going to stop you. But if you claim that ivermectin is a miracle cure for covid and as such vaccines are no longer necessary, then that is a problem.
Why not pray for satan with a goat sacrifice? That also doesn’t harm you and has similar quality of evidence for working. But my point is that there are literally infinite things that could cure covid, but in the end only empirical evidence is meaningful. But we have to choose our “fights” and methods with not even a probably way of effect are more than likely useless.
And that touches on another problem: all of this Ivermectin (and HCQ before it) bullshit takes funding away from studies that might turn up something useful. The only reason these drugs are even studied at this point is because they are so well publicized, even if there is approximately zero proof that they actually work.
If they were miracle drugs as described the effect would be so large that those studies would be unnecessary. But here we are, and study it we will.
Again, stop saying "proof". You're misusing this word. It really seems like you have an ideological axe to grind. There is not "zero proof". Did you read the article? What you are saying and your level of confidence seem detached from the article's contents.
There is tentative evidence of a small to medium effect, but the quality of that evidence is low and that quality is insufficient to recommend use. This then deserves more attention and resources to figure out if it's real and why there's an effect. That's how science works.
Contrary to your claims here, scientists aren't studying it because some cranks on the internet propped it up. They're studying it because some field doctors had positive anecdotal experiences and some early studies showed promise.
As you've said, the medical establishment really wants to end the pandemic. Which is why they're looking into this drug, among many others.
Reading 30 studies certainly seems to be a bad way to learn anything unless you're conducting a meta-analysis of them. For one thing, you'd get tired. But just shoving 30 pieces of information into your head and forgetting some of them doesn't help you find out which of them were correct.
Especially in a field in which you are not trained, do not have the background knowledge required to understand the various qualifications and established best practices in. That gap can be absolutely enormous, even for fields that are peripherally related. Specialization is there for a reason, the body of knowledge that we now command is way too large for any single individual to absorb to a substantial depth.
Suggesting that there's no way someone could have the mental stamina to read 30 papers, over the course of two years, is completely ridiculous, insulting, and invalidates your viewpoint, in my opinion.
Why are you assuming they tried to read it in one sitting? Nothing remotely suggests that in the comment thread. All we know is that they read 30 papers sometime within the last two years or so. You chose a perspective, and just reinforced it, that they were incapable of extracting anything useful from reading those papers, which is insulting. It could be that they read a paper every couple of days, or perhaps when they became available. For some reason, it seems you've already decided that they're incompetent.
In short: papers lie, and grad school teaches you to read around the lies. Papers lie because people are competitive (you lose your job if you aren't publishing), want their narrative to be true (don't we all), and the people reading the papers professionally know how to interpret them.
Pretty sad, but that's what we've ended up with. It was incentivized for.
If the 30-odd studies are chosen adversarially to persuade you to believe something that isn't true, probably asking someone more trustworthy for relevant studies would be a good idea.
If you're not familiar with the field the studies are in, it might be a good idea to rely on the opinion of someone who is; unfortunately, this means you have to judge whose opinion to rely on, which puts you in the position of trying to guess who's really familiar with the field. It's going to be hard for you to do better at this than just believing whatever is most popular.
It is obvious that ivmmeta.com is picking up something that is a real signal. The only question is a signal of what. Fraud? Bias by the site authors? One of many complex statistical effects? A working drug?
There were loud, even unreasonable, voices in the debate but nobody was raising an actual problem with the results. Ivermectin has a respectable safety profile. "Maybe it works, no obvious downside" was a reasonable position.
It was always a long shot, the evidence was weak. But loudest voices in the anti-ivermectin crowd are people like, eg, jacquesm in this thread. A lot of bluster, a smidge of bullying and a weak-sauce appeal to authority for why statistical evidence should be ignored. And YouTube et al. believe it to be convincing evidence or they wouldn't bother to censor discussion of it. If that is the opposition then they don't seem to have uncovered a methodological problem yet or they'd raise it.
But Scott raises an interesting theory that would be enough to explain ivmmeta.com. Since it was only ever weak evidence that is enough for me to change my mind.
> many serious anti-Ivermectin arguments in the past
I haven't seen any of these. I just run into irrational and offensive people like you that accuse me of wanting to drink bleach when I bring up the topic of Ivermectin.
This article removed all doubt for me. I needed to see the thought process while pouring over the studies.
You shouldn't make so many assumptions about people based on your political bias. Some people want to understand. That doesn't make them foolish or antivaxers.
So go study medicine, assuming you have 10 years to burn and are willing to take a massive pay cut.
The average HN'er probably knows how to program a computer and some of them may even know how to program one well.
If a guy that runs a fishing boat with not even the most basic idea about programming, hardware, software, satellite systems, general relativity and integrating all of the above into a working solution came to them with a request to really understand how his GPS works before he would put it to use we'd likely tell them to just trust the experts.
The experts involved in building / maintaining GPS haven't admitted to lying to him about it to preserve the use of GPS for people deemed more important, gone back and forth on whether or not he needs to use two GPS devices (instead of one) for the safety of others, and those experts' recommendations haven't led to policies that have destroyed the livelihoods of his or his friends' families--sometimes with unclear ties to actual societal well-being.
It's not quite the same. The people who build / maintain GPS have a lot more reason to trust them, and as a result, people do.
Until a while ago, if I recall correctly. GPS was <<lying>>. Its accuracy was deliberately hobbled to within tens of meters in order to prevent it being used for destructive purposes, I believe.
Saying "your location is somewhere within X, up to ~5 meters" isn't lying. It's not even a half truth, but it's still pretty far from the point here.
It's trusted because it's been far more trustworthy than public health guidance and policy. And the same goes for airplanes, brake pads, and other tired comparisons. Trusting one does not imply one should trust all other proclaimed experts in all other fields in all other contexts.
Not sure that’s the most comforting analogy to pick. GPS is maintained and controlled by the US military. They can shut it off, used to secretly make it intentionally inaccurate, have dual-band devices to protect against failures of GPS by using competitors, etc
Perhaps, although I didn't pick the analogy, and even accepting at face value what you're saying: clearly there is justifiably a much higher level of trust in GPS than public health advice, and for good reason: its scope is limited and it's had a much better track record.
The argument you are making is directly addressed in the article.
> So “believe experts”? That would have been better advice in this case. But the experts have beclowned themselves again and again throughout this pandemic, from the first stirrings of “anyone who worries about coronavirus reaching the US is dog-whistling anti-Chinese racism”, to the Surgeon-General tweeting “Don’t wear a face mask”, to government campaigns focusing entirely on hand-washing (HEPA filters? What are those?) Not only would a recommendation to trust experts be misleading, I don’t even think you could make it work. People would notice how often the experts were wrong, and your public awareness campaign would come to naught.
> But also: one of the data detectives who exposed some fraudulent ivermectin papers was a medical student, which puts him somewhere between pond scum and hookworms on the Medical Establishment Totem Pole. Some of the people whose studies he helped sink were distinguished Professors of Medicine and heads of Health Institutes. If anyone interprets “trust experts” as “mere medical students must not publicly challenge heads of Health Institutes”, then we’ve accidentally thrown the fundamental principle of science out with the bathwater. But Pierre Kory, spiritual leader of the Ivermectin Jihad, is a distinguished critical care doctor. What heuristic tells us “Medical students should be allowed to publicly challenge heads of Health Institutes” but not “Distinguished critical care doctors should be allowed to publicly challenge the CDC”?
I think it is horribly demeaning to respond to someone asking how GPS work by saying "you can't try to understand without years of training, just trust us." That is exactly the kind of response that alienates people and fosters mistrust.
Dinstinguished critical care doctors who go to Caribbean medical schools who have to pay hospitals to accept their graduates as residents probably should be given short shrift at first when challenging the CDC.
Really, in a just world that guy would lose his license to practice medicine. I find it interesting that 'the lone voice' has such a power over 'the establishment', as though the lone voice is always right because they're the underdog.
There is an excellent movie about the theme of an infectious disease where some blogger/journalist goes all out on promoting 'Forsythia', a medication that does absolutely nothing against the disease, but that - using the exact same mechanisms as Ivermectin, HCQ and others - gets promoted to the hilt. I'm not sure if this is life imitating art or some kind of coincidence but it is uncanny to which degree the stories overlap:
Sam Harris mentioned this theory of it being pointless to engage people who have their own theories because you'll be faced with a never ending stream of "yeah but did you read this random 90 page paper on X?" and all kinds of other questions even the best professional can't counter without wasting huge amounts of time.
It's great you changed your mind but I bet there's plenty of people who haven't. Like I wonder what Bret Weinstein now thinks.
That is lazy. Indeed, there is no point in refuting a random 90 page paper. However, a good professional should be able to quickly summarize the state of the area touched by the paper and provide a short list of key citations and publications. A good professional should also be able to say "this is outside of my area of expertise" and point to the general direction of where expert feedback can be sought.
Edit: I probably wrote this comment to aggresively, which is ironic given that that is what I am arguing against. My apologies.
When you see someone you disagree with convinced by an argument, I think that should be an occasion for celebration and joy! People changing their minds to what you believe to be true is the only way to get change. It needs to be encouraged and people who manage to do this need recognition.
Changing your mind in polarized situations is hard! People who manage it did something impressive. Heck, even people who are willing to listen to the other side deserve recognition.
You saw someone who changed their mind, and you chastised them for not having changed their mind earlier, and for having been wrong before. That is rather counter-productive. Instead, be happy with the conversion. If you want more interaction, ask them why they believed the other thing before. Less importantly, ask them what changed their mind.
I'm happy with their conversion but realize that the reason why they became converted is actually false: they now claim they are convinced by facts they very obviously still do not understand. Besides, probably the only reason they allowed themselves to be convinced is because of the fig leaf handed by the article in being able to claim to 'have been right all along'.
> Less importantly, ask them what changed their mind.
They wrote about that in this thread, and it proves that they do not understand the basic argument made, at all. As converts go, it's a pretty sad case.
The author of this article did a fantastic job, but all it has done for me is to show how hard it is for people to digest information and to draw meaningful conclusions from it.
On another note: this is why I'm not particularly hopeful about humanity getting their act together with respect to climate change.
Not to mention, the thing the article eventually points out; that ivermectin had the most efficacy in areas that also have large populations suffering from parasites, isn't new.
Nothing this article says is new. This is all old hat.
>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
That simply armchair science blogging psychiatrist's hypothesis. He even admits as much,
>But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!
None of the studies looked at worms. It is correlation == causation logical fallacy to conclude this based only on speculation. If you want to start arguing with that approach there is no bottom as there are just as many correlation == causation counter examples like https://i0.wp.com/noqreport.com/wp-content/uploads/2021/09/I...
You simply cannot dismiss that Ivermectin only works because worms until you have studies proving that. You can only say that it works, but you're not sure about why. Good to see that even after he cherry picked all the studies as hard as he could, he still had to reach this basic conclusion.
As the blog post indicates, there is data proving a positive effect. That's not in question. The author is simply speculating why that is the case at this point, the specific reason for the positive effect.
> As the blog post indicates, there is data proving a positive effect.
No, there is data that might point to a positive effect, that's something completely different than data that proves a positive effect.
Note that this is exactly how these things happen, someone writes something with a particular audience in mind and then others will come along, cherry pick it, distort it and then pass it on as fact. You are step #1 of the Chinese Whispers game and it has already meaningfully changed.
Personally I'm naturally skeptical of any suggested COVID treatments because they tend to be trendy. Before ivermectin, it was hydroxychloroquine. And before hydroxychloroquine, it was vitamin D, melatonin, and diluted bleach. And before that it was that it was only harmful to people who lead unhealthy lifestyles: It was less a disease and more like cosmic justice for living an indulgent, gluttonous sedentary lifestyle.
Meanwhile over the last 11 months most of the vaccines have been extremely effective at reducing hospitalization and death. My 3yo son caught COVID from one of his classmates at preschool - my wife and I are fully vaccinated - and we were both able to avoid an infection while under quarantine with our son.
It would be hilarious if just like this argues fairly convincingly for ivermectin, all of those (well, the first two) actually turned out to be true, but only for malaria infected and vitamin D deficient patients.
There is little evidence of such analysis being suppressed. I think it is just relatively rare, because it is a lot of work and takes particular skill.
Most people who care about this research are indeed crackpots, unfortunately. Those who aren't have mostly moved on from Ivermectin because they have better things to do. Ivermectin is being tested in large RCTs, as it should. If it works, it will be used. If it doesn't, it won't. Until we know, doctors will do what works.
Because 'works' in a medical context is a boolean that encompasses everything from 'order of magnitude lower chances of death' (effective vaccines) to '1% relative reduction in death' (off-label use of some random drug not intended to target improvement in COVID recovery), so the focus has naturally been on finding treatments with high effect sizes and distributing them as quickly as possible. Not to mention the herd immunity element to vaccines.
Going through one of those studies from https://ivmmeta.com/ on YouTube would be a risky proposition for a YouTuber. It goes against YouTube's medical misinformation policy [0]. It is pretty clear that a study with that sort of effect size could encourage someone to take Ivermectin. Particularly the "Categorical claims that Ivermectin is an effective treatment for COVID-19
" would be a worry depending on how the censors feel that day. They'd potentially be arguing a technicality against some Silicon Valley type with an axe to grind.
Despite the fact that it appears those studies were honest, and picking up an actual factual effect. Now it turns out, laughably in hindsight, that the effect is probably whether people had parasites or not and I hadn't thought of that. But it isn't obvious how I'm going to figure that out without someone pointing it out to me. Ideally on YouTube where there are some really good channels covering COVID, often with actual doctors involved.
No-one else seems to have figured it out either, given I've seen lots of people shouting at each other and none suggested it as a possibility.
Exactly. But all we have a slew of low grade anecdata masquerading as studies and a very large machine magnifying that into 'cheap miracle cure suppressed by MSM and big pharma'.
Nope, it's not against the medical misinformation policy.
But that's a fine point in that case. And most people who talk about these studies will violate the policy by a wide margin, rather than doing a well rounded analysis.
You can't deliberately encourage people to take Ivermectin. But JUST citing a study wouldn't do that. Especially not with all the debunking of the other stuff.
> Nope, it's not against the medical misinformation policy.
"I have reviewed these studies, they seem sound and there are no real downsides to taking Ivermectin. I can't think of any reason not to take it. I don't recommend taking it, maybe I haven't thought of something" is a position a reasonable person could come to after browsing through the available evidence. Are you absolutely sure a video like that would be kosher on YouTube?
It sounds extremely disingenuous to me, just typing it out.
But most of them aren't sound. Those that aren't are still weak evidence and not really block-buster. Also, "there are no real downsides" is misinformation. If you let on that you are an expert when you aren't, and say "I reviewed them" then that's misinformation. Some is in the gray area, but even the gray area actually causes the kind of harm these policies try to prevent.
There really are no real downsides to taking ivermectin at its usual therapeutic doses. I'm not an expert, but ivermectin is well enough understood that I don't need to be an expert to know that. That's why there are regularly ivermectin programs that dose literally every single person in a town with ivermectin for a month or so as a parasite extermination campaign.
(I have somewhat less confidence in my second opinion about ivermectin, which is that precisely because it's so safe, it's vanishingly unlikely to have antiviral effects at those doses. That's something I could easily be wrong about because I'm not an expert.)
Unfortunately at the 'usual therapeutic doses' there is no effect at all, you're looking at a substantial increase. The biggest direct proof for anti-viral effect was an in vitro study at substantially elevated levels.
> Now it turns out, laughably in hindsight, that the effect is probably whether people had parasites or not and I hadn't thought of that.
Your eagerness to jump on to this idea (which is a cool theory, and isn't meritless, but it should be stressed is a theory that a psychiatrist and social commentator came up with) makes me think you should be wary of how personally susceptible you are to what I'm going to call "fetishization of contrarianism". It's fun to be right, and fun to be right when other people are wrong. It's cool.
But its easy to move from "I don't implicitly value what experts say" to "I implicitly distrust so-called experts", which you appear to be doing throughout this and other threads. You've further jumped from what could uncharitably be called a conspiracy theory to a counter-conspiracy theory. Scott even presents his idea as, essentially a conspiracy theory:
> It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!
"everyone was wrong", look at me, I'm right, here's a fantastic narrative that perfectly ties up all the loose ends. He looks smart and cool. And you do too[1] if you agree with him. But, to keep on theme, this is a brain worm. (and since we're on a Scott Alexander post, I'll tie this into the broader theme of rationalism) And it's a brain worm that I think a lot of people who otherwise think they're rational/rationalist fall for. The conventional wisdom is, usually, mostly right. Not always all the way right, and sometimes really wrong. But usually, it's most of the way there.
This makes alternate modes of thinking really boring, because despite all the fancy self-reflection and attempts to be superior, you're going to draw relatively few conclusions that are all that different from the mainstream. So what's the point? Either you do all this work for a marginal gain, or...or...or, well what if the conventional wisdom is actually wrong a lot more often? What if the experts are misleading us? What if the experts fall into thinking traps that make them wrong all the time? We shouldn't just disregard the experts, we should actively distrust them and assume the opposite! This opens up lots of possibilities for cool ideas. Incredibly compelling narratives, narratives where you can say that everyone else was wrong, and you were right. You can be a hero, or at least feel like one. Outsmarting the experts is cool, and knowing things first is cool. It's cool. And the "problem" with this is that sometimes you'll be right. The government is spying on citizens illegally. Snowden was right. And Ivermectin might have a small effect on covid, and even cooler it might be due to worms! But there have been tons of quack covid cures (HCQ, bleach, silver, etc.) and not every conspiracy theory about the government is true, even if the narrative would be cooler, because we distrust the government and the profit motives of these corporations, and that makes us want to distrust everything they do.
But the world is more boring than that, and even though the contrary opinion is true sometimes, usually it isn't.
[1]: Another, potentially equally compelling take here is that Scott's presentation here has allowed you to change your mind without admitting (even to yourself) that you were wrong! Because as he presents it, you weren't "wrong". We really, really dislike doing that, but this way you don't have to. The data did/does show an an effect for Ivermectin. You were right. That the effect was due to a "global" confounding factor allows you to change your conclusion without admitting that you were wrong in how you did the analysis. Like, whether or not you were wrong, the people who disagreed with you were right: it's unlikely that it would be helpful for your mother or whomever to take Ivermectin. The rational thing to do here woul...
> Those who aren't have mostly moved on from Ivermectin because they have better things to do. Ivermectin is being tested in large RCTs, as it should. If it works, it will be used. If it doesn't, it won't. Until we know, doctors will do what works.
Dr. John Campbell posted a video that was "fact checked" by facebook which he calmly dismantles in the video below. Facebook puts up a big warning if you see it or post it. Soft censorship is still censorship.
Doctors are are much more trades/crafts people than scientists. Among the several I know personally and/or professionally, few are current with the latest research, or even know how to interpret it. They follow the treatment manuals they're provided, which do the best they can with the information available at the time. At the beginning of COVID, the manuals had to make many decisions on incomplete data; none of the drugs they recommended early on are still in use.
Most of the world understands this. It's mostly in the USA that we deify doctors. Few have first-year statistics competency, or can critically read a publication. And that's fine - it's not their profession.
I wonder if YouTube would have been better to implement a no medical advice policy. Not a no advice which runs contrary to the official guidelines policy.
This is going to the heart of the problem: Youtube has replaced TV, and what people see on TV they tend believe to be real, and even if they don't believe that at the moment they see it they may well remember it as fact later on.
I think youtube is great for showing people DIY stuff, for home videos and so on, but it has clearly allowed itself to be hijacked as a platform for politics and it was/is ill prepared for the attempt at weaponizing the immense audience that it commands.
This is maybe true. But I have seen more than a few dubious COVID articles gain traction on HN. There are several times I have tried to clarify basic statistical points as well. So it’s not a given that it would have been flagged/dead.
Ivermectin pushers are such a mysterious group, its a generic drug cheap drug, there is no apparent personal incentives for whoever is pushing it. It seems to be a result of the fractured us vs them conspiratorial types who truly believe they are doing good in the world.
The thing is, 99 out of 100 people repeating conspiracy theories don’t have a single coherent thought behind the whole thing.
It will be a straw man, but it is statistically like that:
They may start by how research grants decide the results of studies and thus your study is one of those payed ones, but then jump ship and go that this sea snake extrude homeopathy will treat covid, just go look it up yourself, and then even if there is a “paper” for that, it is from goddamn Atlantis with no peer-review and was tested on 2 parrots.
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?
"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.
"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.
The attacks on Fauci are despicable. Note that he's anything but a weaselly political hack, but he did get replaced by one during the Trump reign. The man has more integrity than the bulk of that particular administration.
I'm honestly baffled by this. The man literally lied to the public and openly admitted to lying. There are plenty of legitimate criticisms of Fauci, and plenty of reasons to be question whether public health officials should be lying to the public about public health.
Maybe you think Fauci changed his mind based on new evidence on mask effectiveness, but he literally says he advised against masks due to a fear of PPE shortages, and not due to changing evidence. So either way he lied: either he lied about mask effectiveness thus spreading health misinformation, or he lied about why he advised against wearing masks thus undermining public trust in his advice.
Fauci admits to moving the goalposts on vaccination rates and explains it's because of his "gut feeling that the country is finally ready to hear what he really thinks":
I could dissect these even further and point out numerous other instances, but these are egregious enough to undermine public trust IMO. Public health officials should not be deceiving the public, they should be above reproach.
And your parents told you that if you ate spinach you'd be just as strong as Popeye. Were they lying? Yes, absolutely. Were they wrong? No, eating greens is good for you.
You have a peculiar standard for truth, it seems to depend on which side of the debate someone is for the person to be held to the 'lily white' standard or the 'can shoot someone on broadway and get away with it' standard.
Riddle me this: If Fauci had said 'masks work but we need you all to hang back and not buy them because we need them for the medical profession' resulting in a mass run on masks resulting in even larger numbers of death in care workers how would you view him? Is there any way in which according to you he could have discharged his duty without engaging in lies (white or otherwise) to get to a desired effect without further collateral damage?
> And your parents told you that if you ate spinach you'd be just as strong as Popeye. Were they lying? Yes, absolutely. Were they wrong? No, eating greens is good for you.
Yes, they were wrong to lie. Not that your false equivalence is in any way relevant because Fauci is a public servant of the people, and parents are not servants of their children.
> You have a peculiar standard for truth, it seems to depend on which side of the debate someone is for the person to be held to the 'lily white' standard or the 'can shoot someone on broadway and get away with it' standard.
There's nothing peculiar about wanting public health officials to not deceive the public about public health, which is their duty. What bizarro world do you live in where this is ok? In no other country on Earth did public health officials do this, even though they were facing their own PPE shortages.
> If Fauci had said 'masks work but we need you all to hang back and not buy them because we need them for the medical profession' resulting in a mass run on masks resulting in even larger numbers of death in care workers how would you view him?
I would view him as an honest public health official who did his duty, which is how I view the public health officials in my country who didn't lie to us, and where no such disaster happened.
> Is there any way in which according to you he could have discharged his duty without engaging in lies (white or otherwise) to get to a desired effect without further collateral damage?
Yes, and this has been explained ad-nauseum by people with legitimate criticisms of Fauci, although of course, even such legitimate criticisms are simply brushed off as partisan posturing, just like you're trying to do now.
During the PPE shortages, there was plenty of coverage about how to make your own mask. Plenty of commercial outlets voluntarily limited PPE purchases. Non-binding recommendations from public health officials could have encouraged such policies, and also provided official guides on making masks until PPE supplies were replenished.
Now I want you to look in the mirror and ask why you're trying to cover for him? What public purpose does it serve? This public servant lied to the public, and has lost the public trust even according to polls. The only people covering for him are die hard Democrats because he gave Trump the proverbial middle finger. Is that "credential" really more important for a public health official than the public trust?
> Actual medical science, and science in general, doesn't make claims beyond what we know for certain
Medical science made the claim that multiple sclerosis was "female hysteria," until imaging technology was able to see the damage. A doctor I know today claims that a lot of patients symptoms are really psychological and everyone at work is annoyed when they come in. When I brought up the case of multiple sclerosis, and maybe many patients have disorders which are not known to medical science because they are dismissed in the same way, I was met with a "that's ridiculous" defense. When I pressed further and ask for evidence on that point, I was given the fact that these patients with unexplained symptoms are highly correlated with anxiety. When I asked if having an undiagnosed medical disorder, and being told by doctors who clearly don't want to help you, and are clearly annoyed you are there, that it's all in your head might give someone anxiety, it was not well received. Medical science comes to all kinds of BS conclusions about the unknown without a shred of evidence.
>Actual medical science, and science in general, doesn't make claims beyond what we know for certain
What would you say about the FDA's recent approval of aduhelm? Do we know that it works "for certain"? Or is the FDA not part of the medical science establishment?
The FDA's scientific committee nearly unanimously voted against aduhelm. The political side of the FDA overruled that consensus to give preliminary approval, which has been thoroughly panned by a large portion of the medical and scientific community, prompted three resignations from said committee, and has prompted a Congressional investigation.
Aduhelm's approval basically came about in violation of the FDA's processes, so it's hopefully merely a one-off example of corruption rather than a harbinger of the death of science at the FDA.
"Actual medical science, and science in general, doesn't make claims beyond what we know for certain"
Unfortunately I read papers that do this, all the time. Science in general not only makes claims well beyond what's known for certain but does it so consistently that vast numbers of people, including many scientists themselves, have lost sight of the scientific method and have normalized bad, unscientific behaviour.
And this is ultimately how you end up with more than half of all drug trials being fraudulent or useless ...
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.
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.
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?
Maybe, although without further evidence accusation of conspiracies will fly back into your face.
The site might look professional, but it still could just be another true believer. If you frenetically ban the content, more people will believe the message and more importantly disbelieve yours since it "obviously" cannot stand scrutiny.
And there are real problems here, the infrastructure to censor certain message on social media got quite effective and to believe tech companies as government contractors won't use it to spread falsehoods is naive. Not by conspiracy, it is just a dynamic government will certainly show.
I think like he said, it is all trust. Without trust, people are wary of your motivations. When you are in that position, having the people you don't trust do things like promote the narrative of "trust science" just looks like they are using scientists as mouthpieces to co-opt their trust to push a narrative. Moderating misinformation looks like censorship, mandates look like coercion, etc.
Overall it was just a colossal failure of communication by policy makers, who had already eroded most of their trust before the pandemic, which then got exacerbated by contemporary journalism that felt like it had no qualms about making everything as divisive as possible for engagement.
I don't think people have lost trust in science, but politicians using "science" in this way of communication are doing a pretty good job of trying to erode that trust.
Not to be adversarial, but there have definitely been a few instances which are just censorship and not moderating misinformation. And there are definitely some hot topics on which I will flat out ignore research, because I know only some conclusions are allowed and publishable.
I think it's pointless to discuss specific examples - my point is, it's not only an issue of managing trust, because the science doesn't deserve that trust.
No you are absolutely correct, I was just illustrating the disconnect between what people think they are communicating and what it actually comes across as.
There is a degree of nuance that is definitely lost when people say to trust the science, which is to say that the rigorous process is what is generally trusted, but that isn't how it is communicated which is why "trusting the science" is probably a slogan that does more harm than benefit. For example it is sort of tone deaf to say that now, after how science experts have handled the first part of the pandemic, or how science has been used to justify things like the oversubscribing of opioids, or what they have said regarding nutrition (sugars vs fats), or carbon emissions and even smoking in the past. Politicizing science taints science more than it benefits politicians, but since they don't bear the costs of that erosion of trust, they will continue to politicize it.
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).
> 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.
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.
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?
The paragraph you quoted is, alone, pretty much enough to dismiss this entire article outright. It shows such a reckless disregard for critical thinking that it is impossible to trust anything that comes after it.
He sees a slick and well-presented site on a topic that is not only politically fraught, but well known to have a massive propaganda effort behind it, and he just completely refuses to even consider questioning it as a source? That is reckless beyond words.
Right—it's like saying "I don't know who the bank robber was—they've very reasonably kept their identity secret." Sure, it's reasonable for a bank robber to get keep their identity secret, because they're doing something shady.
The paragraph quoted is making a point about how to effectively present and communicate scientific topics, not ascribing dependability.
Indeed, the entire article is a systematic rebuttal of ivmmeta's claims. Rebuttals are more convincing if you treat the topic in good faith rather than assuming fraud from the outset.
I don't understand how you can see this as "reckless beyond words" when it seems like exactly the sort of systematic analysis that we need more of.
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.
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.
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.
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.
One of the popular memes posted to social media among the future /r/HermanCainAward nominee set is that if the government was really offering COVID vaccination for our own good then whey aren't they offering free chemotherapy and insulin?
99% of the time when you can tell from their other posts what politicians and parties they vote for, it is the politicians and parties that work tirelessly to block any attempt to have the government provide chemotherapy and insulin.
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.
> 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.
I still don't know whether Ivermectin works or not, but mainstream media calling it horse paste is absolutely disingenuous and what increases distrust from me. It's as if they are incapable of understanding that same substance could be used for multiple species for multiple different conditions and in fact it has been used for multiple species.
So anyone calling it horse paste, horse medicine or even focusing on that makes me question their intelligence.
How many people who believe Ivermectin works are actually doing that? Are there differences besides dosage and is it possible to split that dosage for appropriate human levels?
I don't know numbers, but there are credible reports of farming supply companies starting to restrict sales (so greater than zero, but I haven't a clue how many).
Differences can be that not all the preparations contain only the one active ingredient. Dosing appears to be whole other kettle of fish, because understandably people have no idea what a therapeutic or prophylactic dose actually might be - because as far as we know there isn't one for coronavirus.
Two of my relatives are running Covid wards in a rural part of the country, and they are filled with people who had their vets get them IVM or who had picked it up off the shelf. My next door neighbor told me he had his dog’s vet write him a prescription. You can guess his political persuasion and vaccine status.
That's so sad. And the proponents of that BS will happily continue to push it, what's in it for them I'll never understand. It's like a very indirect way of trying to kill people.
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"
A number of people—probably not including myself, if I'm honest—would take this statement more seriously if it wasn't a complaint that a thing which has already happened, and continues to happen, isn't happening.
Seriously. There are trials for any number of medications underway, including Ivermectin. There is, at the point, no evidence whatsoever to suggest it is being unreasonably withheld in any way. The cult of "magic miracle cure" that has built up around this one particular drug is fucking terrifying
Since when removing misinformation that can cause harm is censorship?
If I had any say I would absolutely remove all your posts that are spreading the same lies, you are literally killing people by furthering a specific agenda and trying to convince people that the vaccines are dangerous and ivermectin is the only cure.
It’s honestly shameful that hacker news is letting this happen.
Something that you (or anyone else) insubstantiatedly label as misinformation may just not be so. That's pure censorship - "I think this is wrong, therefore it has to be removed". That's the rigidity and simplemindedness as opposed to intellectual curiosity, doesn't spark intellectual discussion and creates echo chambers of people regurgitating the same narratives over and over.
Fortunately people sharing your approach are not having any say here so we keep HackerNews a civilised place where all opinions expressed without arrogance are having light of day.
You may be well right here, but it seems like there is significant difference what everyone is considering as "actual proof", hence definition of what is misinformation and what's not becomes very vague.
Ok, I'll take a stab at this then: 'misinformation is the spreading of information that is known to be false'. That doesn't assign any kind of state-of-mind to the person doing it, it could be because they're useful idiots, griefers, state operators and so on.
Of course that kicks the can down the road: what exactly is known to be false and what is not? But we have a pretty good idea in the case of the flat earth and I think that other cases will lend themselves to such analysis. Holocaust denial is a nice example, Hillary Clinton running a pedophile network from a pizza joint is another. 5G phone network used for mind control and so on.
All of these share the trait that reasonable people would - I assume, true - agree that these things are not true and that those that spread this do not have our best interests at heart, either through stupidity or malice.
Somehow society managed to take an entirely new, experimental medical technology, run trials and launch it to the world population in < 12 months yet it's been nearly 24 months now and there are zero - zero - large scale useful studies of ivermectin produced by the western medical establishment.
As I was reading the article, this is really what leaped out at me. There are lots of people and doctors who think ivermectin works. It's clearly a question worth investigating. Why are all the studies based on 50 people in Bangladesh?
That, in turn, is very strongly connected to the cost of running drug trials that will get past the FDA and patent rights. So it's not surprising that people end up being very cynical about this.
Studies have been done. It has been found lacking. You're getting mocked because you're blind to this and sticking to something that bad actors are touting as a miracle cure, while science and medicine move on in the search for things that actually help.
The way you have responded is a perfect illustration of the crowd we are talking about.
You are trying to make a personal offence and claims without any references. That sounds like a blind repeating of the narrative, even if it wasn't intended to be so.
I'm not "trying to make a personal offence", I am explaining why you may find people mock you. Your view of the situation on the ground is incorrect. The studies you are claiming have not been done are a mere google search away. In fact in this case the link at the top of the HN discussion contains a lot of relevant information.
Here's the major question I have for folks like yourself who are still on about ivermectin though - why?
Why are you invested in this one particular pharmaceutical? What is it that makes you think this specific chemical, which has been looked at and found not to be particularly beneficial for covid use, stands out from the other things which have been looked at and not found useful? Why are we allowed to dismiss and move on from them but not from this?
I wasn't soliciting for an explanation why people are trying to mock - too much studying of psychology provided enough information to answer this question. The answer, as it may come at a surprise for you, is not related to plausibility of statements. But that's totally different matter.
As for your question, let me give you a very simple answer. As a layman in certain area, I see few facts - several families who I know in person chose to take Ivermectin as part of their treatment when family member contracted covid. All of them successfully recovered from covid.
And at the same time, a person I know lost 2 legs shortly after "safe" jab due to blood cloths. Doctor said that if he wouldn't intervene and put him in ICU, he would be dead by now. Another person got cardiac arrest after jab (being 24yo) and was paid a lump sum (more than $200k) by government to suck it up and keep his mouth shut.
Certainly I am not going to draw any conclusions from those observations. Except one - why Ivermectin is so actively dismissed and the pharma jabs are so actively promoted? There is clearly some evidence ivermectin does help, but we have no means to know at what extend or at what price. This atmosphere of ignorance and narrative-pushing has nothing in common with intellectual curiosity, which is something we have to use when dealing with challenges like covid. Sadly not many of us are capable of that.
> several families who I know in person chose to take Ivermectin as part of their treatment when family member contracted covid. All of them successfully recovered from covid.
Are you aware that this doesn't constitute any sort of evidence about ivermectin's effectiveness?
> a person I know lost 2 legs shortly after "safe" jab due to blood cloths.
Are you aware that coronavirus causes clotting much more frequently than the vaccine? I'm sorry for your friend, but if this were commonplace then every other person in the street would be an amputee, given how many billions of doses have been administered.
> Another person got cardiac arrest after jab (being 24yo) and was paid a lump sum (more than $200k) by government to suck it up and keep his mouth shut.
So how do you know about it? Wasn't a very good gag order then was it if you know and are spreading it on the internet? I'm just going to say it - I don't believe this story.
> why Ivermectin is so actively dismissed and the pharma jabs are so actively promoted?
Well because Ivermectin hasn't been shown to do anything for covid, but quacks are promoting it online. The vaccines, on the other hand, have been tested and found to be a useful way to reduce the consequences of the pandemic. A pandemic that's killed millions so far. So those are pushed. I mean seriously - how weird is that? Who would ever think, something that's been shown to help in a worldwide health crisis, and it's being pushed!
By the way, ivermectin is a pharma product too.
> There is clearly some evidence ivermectin does help
Where do you draw this from? This is not clear at all, this is a bland assertion.
> This atmosphere of ignorance and narrative-pushing has nothing in common with intellectual curiosity
I agree - you have shown no intellectual curiosity there, asking for studies to be done that have already taken place and you could easily find, and throwing vague allusions about cover-ups around. This isn't intellectual curiosity, it's clinging to a conspiratorial narrative. Perhaps you could use your knowledge of psychology to figure out why you prefer this narrative.
My apologies for jumping into this discussion. Not going to tolerate arrogance and inability to listen. All the best in life and apologies once again. Dixi.
Singapore government. There is a special fund for people who got severe health complications due to vaccination and as far as I know, it’s being used quite often. Although, personally i can only speak about the case I have mentioned.
Long answer - quite a significant number of people are resistant to vaccines, particularly to mrna-based ones. Government offered voluntary vaccination and managed to vaccinate around 50%, after that different coercion and segregation measures (mandating without actually mandating) were used to raise the number to 94% (among eligible population).
Disappointment is starting to grow lately because despite total vaccination there is no removal of restrictions. While being reasonably open with data, government still plays with it - once vaccinated ppl become constituting majority of cases among fatalities they just stopped reporting how many vacc/unvaxx were among fatalities. This leaves people frustrated and disappointed in govt approach to tackle covid, particularly in this "vaccinate everyone" idea.
A lot of resistance spotted in people 60+, younger generation mostly just goes for shots.
Interesting that younger generation is willing to go for the shots, according to my impression danger curve for the shots compared to covid is vaccines better for elderly, and worse for young. Not to mention all the unknown health implications for the future if spike protein can increase chances of cancer or similar.
I wonder if older gen has seen enough to not take everything at face value.
You are spot on. Older generation knows if government pushes something too hard, that's most likely not going to bring any good. Older people more willing to accept traditional vaccines like Sinovac/Sinopharm instead of mrna.
Younger generation remained hesitant but government insinuated huge social pressure in schools and colleges. My spouse's 14yo son was initially very resistant to vaccines and we supported it, but immense peer and school pressure pushed him to get the jab.
Additionally government mandated vaccination in cafes and dining venues so younger generation just sees it as obstacle for fun and getting it easily. At younger age you don't think about long-term effects.
Not sure you're reading it right there - "I think this basically agrees with my analyses above - the trends really are in ivermectin’s favor, but once you eliminate all the questionable studies there are too few studies left to have enough statistical power to reach significance."
So I'll revise - studies have been done, but no conclusions about positive efficacy can be supported.
"I think the conventional wisdom - that the most extreme ivermectin supporters were mostly gullible rubes who were bamboozled by pseudoscience - was basically accurate."
> 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.
I don't think i've ever mocked any ivermectine taker (at least not for taking a medecine that may help some of his problems), and most "vaxxed" didn't either. And i'm aware than not all unvaccinated people are anti-vax (my brother is waiting for the Valneva himself). But as long as people tell me "look at the data", i will send them the data from the least vaccinated country in europe, Bulgaria (i even have a quick link on my phone), and ask them to explain to me their mortality rates, and grin a little. I'm not really mocking them, i just like seeing people trying to justify themselves, i find it fascinating. Note that i like seeing this in the "i fucking love science" crowd as well (people really have trouble explaining the moon's crescents, it is really funny), but as this is a novelty, it have more potential.
Mind boggling? $1k/s is around $31 billion. First of all, just Pfizer brought in more money than that last year -- around $10 billion more. But let's set that aside for now, because they're slated to bring in twice as much this year.
You think Pfizer and Moderna are somehow coordinating a global censorship campaign to defend that income? Sure, Pfizer's projects $82 billion in revenue is real money. But it's less than half of Amazon's income. Facebook brings that much in every year. Apple and AT&T crush these numbers, but nobody's going around deleting every tweet about how Mac OS has gone downhill or AT&T's cell service sucks.
In other words, it's just not enough money to have this kind of pull. Even if Pfizer and Moderna were lying their asses off to everyone who would listen, they just don't have the cash to buy off every medical expert and microbiologist of any standing -- and even if they did, the relevant government agencies can't accept hush money and aren't particularly interested in advancing some cartoonish corporate ruse.
Biological and medical research is a competitive field; most of these people slogged through six or eight years of underpaid postdoctoral work just to build the qualifications to participate in meaningful research as PI. Are there crooks who will take a check to parrot a party line? Sure. Is that common enough to enable the kind of overwhelming consensus we see today? Absolutely not ... but let's say I'm wrong: there just isn't enough money to pull it off.
This is why the current crop of conspiracy nuts insists the scheme isn't just about profits but also about some kind of vague assault on unspecified civil liberties -- it's necessary to ascribe actual evil to the movitation before it's even remotely believeable.
Supposedly they are not buying everyone off. Look, 2008 happened, why couldn't similar thing that happened in financial industry happen in medicine industry?
The motivations, rushing of everything could be just aligned enough to cause all of this. Safety studies excluding some participants, some important data. All you'd have to pay off is to exclude certain data, for which there are ALREADY reports coming out for. For example Maddie de Garay's injuries excluded, there's report of someone else's vaccine injury being excluded from the original study.
BMJ coming up with the article of falsified data etc.
The way Pfizer reportedly conducted side effect studies. E.g. asking participants to report their side effects on 7th day in the app without any freeform text or custom symptoms - only predetermined symptoms. For any custom symptom you had to contact the doctors, who may have just ignored you or determined your symptoms to be irrelevant since they didn't have motivation or time to deal with you.
Pfizer just pressuring subcontractors just enough for them to provide data that favours vaccine safety, and there's just not enough time to double check everything so all of it just flies by.
Mainstream media has reported absolutely none of it. None of the excluded participants, nothing about the BMJ article. Nothing about how Pfizer conducted the studies. Everyone is clueless about that. There's already so much PR built towards hating "anti-vaxxers" and considering them uneducated and unintellectual, so the word "vaccine" is already associated in everyone's mind as something good, safe and effective. The PR is already there, you just have to work out something that you could call "vaccine", and help out people in the current very desperate situation.
Very few are actually closely looking into the data and there are actually plenty of scientists and doctors talking about it, but they are getting debunked using very superficial arguments and just finding anything slightly wrong or misleading about what they are saying and they are immediately considered "debunked".
Similarly during 2008, very few people were predicting this crash and everyone just wanted to pretend together that everything was going well. All the experts, economists etc. And human anatomy is somehow simpler than financial system?
> "Sometimes these people even have a specific theory for why elites are covering up ivermectin, like that pharma companies want you to use more expensive patented drugs instead. This theory is extremely plausible. Pharma companies are always trying to convince people to use expensive patented drugs instead of equally good generic alternatives. Ivermectin believers probably heard about this from the many, many good articles by responsible news outlets, discussing the many, many times pharma companies have tried to trick people into using more expensive patented medications. Like this ACSH article about Nexium. Or my article on esketamine. Given that dozens of studies said a drug worked, and elites continued to deny it worked, and there are well-known times where elites lie about drugs in order to make money, it was an incredibly reasonable inference that this was one of those times.
> If you have a lot of experience with pharma, you know who lies and who doesn’t, and you know what lies they’re willing to tell and which ones they shrink back from. As far as I know, no reputable scientist has ever come out and said ‘esketamine definitely works better than regular ketamine’. The regulatory system just heavily implied it.
> I claim that with ivermectin, even the people who don’t usually lie were saying it was ineffective, and they were saying it more directly and decisively than liars usually do. But most people can’t translate Pharma → English fluently enough to know where the space of “things people routinely lie about and nobody worries about it too much” ends. So they incredibly reasonably assume anything could be a lie. And if you don’t know which statements about pharmaceuticals are lies, “the one that has dozens of studies contradicting it” is a pretty good heuristic!"
> I claim that with ivermectin, even the people who don’t usually lie were saying it was ineffective, and they were saying it more directly and decisively than liars usually do. But most people can’t translate Pharma → English fluently enough to know where the space of “things people routinely lie about and nobody worries about it too much” ends. So they incredibly reasonably assume anything could be a lie. And if you don’t know which statements about pharmaceuticals are lies, “the one that has dozens of studies contradicting it” is a pretty good heuristic!"
We currently have a unique situation. Never in the world have scientists, experts or doctors been as pressured to direct people to current vaccines. There's a clear risk to losing your credibility and your job if you were to contradict. Even if you were to think that something may be wrong, it would be a herculean task for you to prove it and is it really worth it to sacrifice your career and everything else? Maybe you are just 50/50 or 80% sure, and incase of that 20% uncertainty you definitely don't want to risk your life work.
Also chicken and an egg problem. Anyone who claims current vaccines are unsafe or ineffective are discredited, so after they have made their claim you can just call them misinformation spreaders and tell again "no credible scientist has said X" and if that credible scientist says X, you will just stop considering them as credible.
But my point is more oriented towards vaccines than Ivermectin honestly. I'm not a proponent of Ivermectin, but I'm just trying to discuss what results might current motivations in the world yield, and I believe it's definitely possible that Ivermectin COULD be improperly discredited in current ecosystem of everything.
With all the social pressures, dire situation, debates being blocked, people labelled immediately misinformation spreaders if their conclusions don't fit the mainstream narrative, I would say very many untruths are possible.
I myself can't trust MSM at all any longer, and I am 95% sure that vaccines are not as safe and effective as MSM is trying to portray them as. I don't know exactly how unsafe or how ineffective they are, but that's mostly because proper debate is not allowed. Until this clears up, I'm going to skip on vaccines.
> Would excess deaths in summer in 0 - 45 age group, in Europe be compelling or is there some other explanation to those?
I don't know, what figures are you referring to and what do you think those are evidence of?
> For preventing spread ineffectiveness, would Gibraltar being #2 in the World by infection rate while having 99% vaccination be compelling?
Taken in isolation, not particularly, no. What you appear to have there is some vaguely formed speculation.
> For waning hospital and death protection would Israel data be compelling?
Be specific, what claims are you making and what evidence do you think backs them up?
> What about countless anecdotal stories of similar persistent adverse effects and VAERS reports?
Perhaps you could count them, and investigate to understand if the anecdotes and VAERS reports are true or not, and at what rate they occur. VAERS is by design a catch-all and self-reported, so the data there is interesting but not necessarily trustworthy. Anecdotes are not data, after all.
I have scanned through so many forums reading anecdotal stories, also downloaded VAERS data, and I definitely see a pattern, but this is not enough of compelling evidence for anyone.
But let's just focus on what could be causing excess deaths during summer.
See 0-14 age group excess mortality growth during summer (EU approved vaccines for 12+ in May). There has been similar rate variance in winters, but this can be explained by bad flu seasons, there's no such variance ever during summer. If vaccines really were the cause, it means only 12-14 group should be affecting the rate, this means that with 0-11 the growth could be 4x that assuming linear relation.
Also see 15-44 excess which has never been climbing that fast and is much higher than previously in total. You can also include other years from 2016 to compare.
These may not be vaccines, but what is causing this then and why specifically in younger demographics?
I'm honestly looking to understand what could be the explanation here.
VAERS data is not verified, as I said, it's self reported. It's useful but not necessarily great for basing hunches on.
According to your graph, excess mortality for ages 0-14 for this year is lower than it was in 2019, before the vaccine or the pandemic hit. And the excess mortality in the 15-44 age group is maybe 5000 people across 28 countries. Without knowing the variance in previous years, which is not given in those graphs, that's meaningless and could easily be down to the disease itself. I personally know a lot of people in this age group who have come down with the disease now, as they are starting to go out and socialise a lot more than they were a year ago. It's hard to see how the 'normal range' is calculated on the pooled deaths graphs as there only appears to be about 4 years data there, which is not a lot to go on.
So as I said before, what you have here is vague speculation. You can't tell from there that anything unusual is necessarily going on at all, let alone what might be causing it.
But it did give him what he was looking for: a reason not to get vaccinated. All of the above is just that: justification for that decision, and once looked at through that lens it makes a lot more sense.
What you are saying is that I made the decision first and then looked for the material?
I was strongly pro-vax before that, and I was debating anti-vax people.
Why would I want to make such a decision that would make me be hated by so many, stress me out of my mind, make people think I'm some sort of anti-science or anti-intellectual, etc?
If covid vaccines are truly safe and effective, I would have 0 motivation to believe in some sort of conspiracy, or not take it.
which doesn't mean kids were vaccinated at any relevant rate at that point. In plenty places they only started that August or thereabouts. There has been some talk of delayed infections with various things due to school closures etc before, I do not know if that had any relevant impact on death rates though, but would explain why they shifted to later in the year.
> and why specifically in younger demographics?
Looking at the 44+ ranges, those are way more above or close to "substantial increase" - as you would expect with them at being higher risk from covid. Higher vaccination rates help, but aren't entirely stopping it. Potentially also some other medical factors, not aware of any good data on them (i.e. delayed treatments, risky delayed treatments now happening, ...)
> Also see 15-44 excess
Delta is affecting them more, for at least part summer you can't assume them to be vaccinated yet (and even today, in the badly hit places the vaccination rates are far from perfect - here in Germany "people in hospital" and "percentage unvaccinated" correlates quite well between regions). Delayed treatments again might hit here too, again unsure if relevant.
Could there be something hidden in there: sure. But it doesn't seem all that obvious that anything is weird about these numbers.
Can't answer to detaro either, so answering in my own comments. Delta and covid waves on average went really low during summer, so it should have less effect.
But maybe delayed treatments, risky delayed treatments now happening could have something to do with it potentially. Also there were talks about child suicides.
I can't reply to your last comment because it's too deep, so I'll comment here:
> According to your graph, excess mortality for ages 0-14 for this year is lower than it was in 2019, before the vaccine or the pandemic hit. And the excess mortality in the 15-44 age group is maybe 5000 people across 28 countries
See week 18-42, for 0-14 age group. Yes it has barely got to 2019 levels, but consider that beginning of year they died much less due to lockdowns, so summer high rate was enough to make up for 2019 where both winters the starting and ending saw very high climb. Again, it's about having that type of velocity during summer, not winters. It's 500-800 children compared to other summers. Since 3 millions of vaccinations given out it could mean around 1 out of 6,000 deaths per vaccination.
So all in all, it wouldn't be possible for me to prove it even if vaccine was causing a lot of harm? Because what else can I use besides excess deaths (as much data that as it's possible to gather), adverse event reporting tools etc, anecdotal stories. There's just no way.
To myself, there are too many signs pointing towards it, but I guess there's no point to really crusade at all even if it is causing harm.
> Since 3 millions of vaccinations given out it could mean around 1 out of 6,000 deaths per vaccination.
It could, or it could mean something else entirely, and it could be within normal trends. Which is what it looks like to me if all cause mortality is lower than 2019 levels.
> So all in all, it wouldn't be possible for me to prove it even if vaccine was causing a lot of harm?
Not from this data, no.
> Because what else can I use besides excess deaths (as much data that as it's possible to gather), adverse event reporting tools etc, anecdotal stories. There's just no way.
Real research and analysis, not "I looked at some very high level graphs with fairly shallow data and decided that it fit my preconceptions".
If you're thinking "I don't have easy access to that information, and I don't have the time or the funding to investigate", you're quite right. Medical researchers will have to carry the can here.
> If you're thinking "I don't have easy access to that information, and I don't have the time or the funding to investigate", you're quite right. Medical researchers will have to carry the can here.
Yeah, unfortunately, I've lost all my trust in anything that comes in from mainstream. I was to vaccinate myself, but then I found contradicting information, and from there I couldn't stop going to the rabbit hole, because this doesn't make sense. Mathematically and statistically if mainstream was only telling truth, what I'm seeing should be impossible.
It's a terrible situation for me to be in as it stresses me daily, ruins my focus and depresses me. Either I'm crazy and worried about nothing or things generally in the world are not going well and people are in mass hypnosis. Neither is a good side to be in.
> I was to vaccinate myself, but then I found contradicting information, and from there I couldn't stop going to the rabbit hole, because this doesn't make sense.
Dodged a bullet there! How fortunate that you went to look for contradicting information, what are the chances?
Not sure what you mean here? I didn't have bias towards being anti-vaxx. In fact I was arguing with anti-vaxxers before and doing calculations how many lives would 1 vaccinated person save during summer given different R values, vaccine efficiencies etc.
Either the VAERS data is broadly accurate, and the COVID vaccines are the most dangerous vaccines ever released (which is not to say they aren't helpful in some populations); or the VAERS data is all just useless unverified anecdotes like you're saying, and so there is no useful system in the US to monitor patient- or doctor-reported adverse events at all, in which case nobody can effectively claim that they are safe for any event that happens more than 1/(number of people in the trials). Which is it? If the VAERS data is all garbage, and someone claims on Telegram that the vaccine gave them lupus or cirrhosis or something, I guess I can't go on VAERS and see that there aren't reported events beyond population baseline, then, and I'll have to take them at their word?
I have seen enough video stories to believe those anecdotal stories and VAERS, where people got a vaccine complication and nobody believed them, everyone gaslighted them and considered them anti-vaxxers - even though they did take the vaccine. Text based stories, you can never tell, but with video stories you can at least understand their sincerity. And after that it's possible to notice patterns within anecdotal reports as well.
And mainstream media has not talked about these side effects at all so I fully believe side effects are not being reported and what are reported is probably with less frequency, it's just difficult for me to tell what the exact frequencies of different side effects are.
I have got pretty obsessed now with trying to understand what the frequencies are, there's so much conflicting information.
If I had to guess I'd guess that there's some sort of age cut-off where harm may be greater than benefits. It would also highly depend on how social person you are and how much in risk situations, as if you are someone that works remotely, doesn't go out at all, and not in a risk group, then I don't think there's point in taking the vaccine.
VAERS will report all of the cases reported in, it is prior to analysis and once the analysis is done the final tally looks completely different. Any possible relation is reported (or actually, should be reported) to VAERS, so if you die the day after you took the vaccin, you will be listed there, whether or not that had anything to do with your vaccination will be determined later on.
For another viewpoint: if everybody was vaccinated there would be 7000 people dying the day after they got vaccinated for the USA alone. But that wouldn't mean anything at all, the big question is which of those deaths would not have happened if the vaccine had not been administered. So interpreting VAERS data in any other way than relative day-to-day is not very useful absent further background into those particular cases.
The "relative" interpretation of the VAERS data looks worse for the COVID vaccines than almost any other interpretation. There have been more adverse events reported in the past year for the COVID vaccines than for all other vaccines combined since the database's inception in 1990.
A drive? Every child born in the US is recommended to take 15+ doses of various vaccines. Most of them are required to enter public school. Multiple new vaccines (like HPV and shingles) have been launched with millions of doses delivered in the same time period.
As you are probably aware: people tend to die somewhere between 50 and 100 with high regularity, leading to more entries in VAERS if large numbers of people in that age range are vaccinated.
It's children that have not been vaccinated in large numbers this time around.
> 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.
But you don't have to trust only scientists directly or indirectly employed by those companies. There are plenty of subject-matter experts who work for competitors or are tenured in academia who would have very little to lose from criticising the rollout.
> who would have very little to lose from criticising the rollout
I beg to differ, here is an example: Luc Montagnier, a Nobel prize recipient, has been completely marginalized after emitting doubts about vaccine safety and is now absolutely inaudible in anything mainstream.
It's just an example, there are several more. Anybody that saw how he was treated probably though really hard before emitting any dissenting opinion in public.
Hm the main content of a scientists life in my experience is really not measured by mainstream media appearances. And if anything, he is probably more known now than before [0], so even in the sense of crude 'celebrity status', he saw a net gain.
Ah yes, academia, that famous bastion of free thought where success is totally unconnected to whether your colleagues like you and nobody ever gets cancelled. One where, as the fine article points out, 95% of biology professors vote Democrat.
Academia is the last segment of society I trust on these topics.
For better or worse, companies generally don't directly criticize their competitors products and especially won't make claims they're unsafe. That said, it's conceivable that with reforms to tort law, this could be incentivized in a reasonable way.
Call me a sheep, but if your distrust of other people runs so deep that you can't trust any source of scientific knowledge, from within or without academia, I feel a great sadness for you. Some scepticism is always needed but this seems like throwing out the baby with the bathwater.
I'm a discerning sceptic. I trust science that has been proven through successful application. I feel sorry for people who have to read academic papers as part of their job in order to find science that they could apply, partly because that used to be a part of my job and after the novelty wore off it was a miserable task. Science is best paired with real world engineering - academia can do this but the least trustworthy fields e.g. those that rely entirely on modelling, never do.
The fraction of science that can ever be applied to engineering is vanishingly small though. How will you ever get to that kind of standard for things like astrophysics, particle physics, mathematics, most of biology? Do you really think the big bang, evolution, Fermat's theorem etc are bogus because they haven't been proven by "real world engineering"?
I completely agree that there is a lot of bogus stuff coming out, like the perennial "hyper efficient solar cell developed in a lab" press release that bubbles up on HN every now and then. But that is just a tiny piece of science if you ask me. Also blaming 'cancel culture' for this seems lazy , there are misaligned incentives but they are more subtle.
Particle physics has to a large extent become engineering: particle accelerators, nuclear reactors, radiotherapy for cancer. Evolution has been applied many times, most famously, to create SARS-CoV-2 right before it escaped from a lab ;)
As for the rest - well, who knows? Do I trust big bang theory? No, not really. I seem to recall it's inconsistent with various other measurements, hence the need for the enigmatic dark matter. But it doesn't matter or affect my life at all so I can easily choose not to trust it and who cares.
Where the problems start is when activists/politicians force me to "trust" self-proclaimed science that has never been through rigorous market-based mechanisms to weed out the crap. Epidemiology. Climatology. Virology. Standards in these fields are rock bottom low because nobody is at risk of losing their jobs if they're wrong, yet, I cannot simply evaluate this "science" and opt out.
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.
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.
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.
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.
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.
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.
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.
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.
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.
It's already a known cure for worms, it's what it's usually prescribed for. And reducing parasite load helps the immune system.
What it isn't, is a drug that objectively protects against Covid. Yet we have American media claiming it as such, and people selling clothing to the British with the slogan "Ivermectin. Safe. Lo-cost[sic]. Beats Covid."
Many other things also help the immune system. Adequate sleep. Balanced diet. Less stress. But I don't see any news pundits obsessing about why doctors aren't prescribing celery.
Incidentally, you're right about my throwing labels around not exactly helping things - I'd edit my comment to change it if I was still within the edit window.
Indeed. I never knew how many people I followed on Twitter are white supremacist, Nazi, Russian assets until few years ago. Apparently, they're everywhere.
No they're not. That's you being biased against information you dislike and then justifying its "falseness" by attaching whatever -ist label makes you feel better.
Thinking that white supremacists and Nazis are running all over the place in 2021 is pure bs propaganda being pushed by our media.
Is your point here to suggest that belief in alternative COVID treatments means you're a racist bigot?
The ironic part of this is that Ivermectin is not FDA approved for the treatment of scabies.
Your doctor was prescribing it off label, based on personal judgement that it has therapeutic effect. That is not to say it doesn't work for scabies, I hope it worked for you.
I feel this just underscores the silliness of criticizing doctors for assessing the literature and prescribing drugs they think would benefit their patients.
Indeed, but the literature on ivermectin for scabies is rather consistent - it works. Whereas the literature on ivermectin as a prophylatic for Covid is...well, still in dramatic flux, and there's some very strong conflicts of interest from some of the authors involved.
I was reading the original meta-analysis[1] by the group Scott mentioned here:
> One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies.
And looked into one of the studies authors, and well, it was interesting. Her submission here[2] claims that 2402 people have died due to COVID vaccinations (I'm assuming this was a 2020 submission, as the number of deaths in VigiAccess is farrrr higher now) based on data from the VigiAccess database, which has a massive disclaimer.
> The information on this website relates to potential side effects; that is, symptoms and other circumstances that have been observed following the use of a medicinal product, but which may or may not be related to or caused by that product . Information in VigiAccess on potential side effects should not be interpreted as meaning that the medicinal product or its active substance either caused the observed effect or is unsafe to use. Confirming a causal link is a complex process that requires a thorough scientific assessment and detailed evaluation of all available data. The information on this website, therefore, does not reflect any confirmed link between a medicinal product and a side effect .
And on her company's website, there's a link to a Gofundme, but if you click it you get redirected to a PDF that's... also interesting.
> After 5 months on-line, an account review and a handsome profit from our campaign, GoFundMe have cancelled our account! No notification, no warning, no explanation given. Just summarily pulled. What indecent cowards!
It then links at the bottom to an organisation she founded that accepts donations and sells sweet ivermectin swag.[3]
On this, the CDC mention it as a last resort[1]. What's the role of FDA approval for usages of a drug in American law? Is my understanding correct that it's perfectly legal for physicians to prescribe off label, but you couldn't market ivermectin for the treatment of scabies to the public?
You can't sell a drug unless it has at least one approval. Manufacturers can't advertise or say that it treats anything but the approved illness. Doctors can usually prescribe an approved drug for any other illness. Insurance may give people trouble for unapproved prescriptions.
Covid has further completed this, as pharmacies have started to refuse filling some prescriptions despite doctors orders.
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.
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.
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.
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.
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.
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.
> 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
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.
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 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.
>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.
I think this is an extremely jaded take, resulting from growing up in a post-antibiotics society. The risk factor for those "scary antibiotic-resistant infections" is still an order of magnitude less than the class of diseases antibiotics almost totally eliminated. In the 30 years following penicillin's discovery, deaths from bacterial infection dropped from accounting for over 22% of all deaths to just 6% [1] (MRSA deaths, by comparison, currently represent less than half a percent). "End of disease" may be hyperbole, but between antibiotics and vaccines, infectious diseases were almost totally knocked off the leading causes of death.
The only reason why we even have antibiotic resistant bacteria is because they keep getting prescribed, because they're so damn useful. "Medical stuff" does, in fact, work like that, to some extent.
The major reason why we have antibiotic resistant bacteria is because we use literal tons of the stuff for meat production and too many countries have too lax controls for antibiotic use in humans, which means they are taken for things were they don't help, or are not necessary, and are taken in the wrong dosage and for the wrong duration.
Exactly, if we only used it when there was a chance of it being effective that would be that, but instead your average cow is a walking antibiotic laboratory.
I simply misparsed "those treatments" in your comment, thinking that they referred to antibiotics, which this threat is about after all. I'm aware that Malaria is not a bacterial infection.
That’s certainly already the case. Ivermectin has lost effectiveness against particularly insidious parasites such as Haemonchus Contortus (barber pole worm). We’ve resorted to other treatments such as Moxidectin, Levamisole, etc, all of which are more expensive and harder to dose safely and effectively.
I can totally understand how Ivermectin got its following— it’s an amazing general purpose medicine around the farm. I generally use it responsibly by verifying the presence of parasites before administering (which can be literally any animal on the farm with almost any parasite) … but then there are times such as when my daughter had a single pet chicken (among many healthy ones) that wasn’t looking so hot … Whereas previously I’d just dispatch the animal and be done with it, now I give a dose of Ivermectin and isolate for a few days before calling in the grim reaper. So far the success rate is something like 90% where now my 9 year old daughter administers it herself. While I acknowledge this isn’t the most responsible, I can imagine others have had similar experiences which explain some of the popularity of Ivermectin with rural folk.
It obviously cannot. But the issue isn't giving it to animals without any parasites, it is in giving it to animals with parasites but that do not need the anti-parasitic in order to recover. Once you have determined that the animal is sick enough to need treatment and that the sickness is most likely caused by the parasites, then you can make the decision that the risk of furthering resistance is outweighed by the need to treat the animal. If you have determined that there is no chance the animal has parasites, then there's no risk of furthering resistance but also no need to give the treatment.
I think this largely right, but resistance generally does not just evolve in the animals "that do not need it to recover", as all parasites/bacteria are more likely die in that case, but in more extensive cases where some of the parasites/bacteria survive and there are more reproductive events that can introduce a resistant genetic variation. This is why some consider that people not completing the full course of antibiotics- only taking them until they feel better, may be a greater contributor.
In nature, both the antiparasitic and the parasite will have a tendency to end up in places that you don't necessarily want them to be for the purposes of motivated hypothetical reasoning.
aka the chicken will urinate out some amount of ivermectin, unprocessed by the chicken, and then some amount will make it elsewhere that will allow for natural selection to take place (eggs or wherever). Once is infinitesimal, but give every animal some ivermectin for funsies, and you've now bred ivermectin resistance.
The drug may end up in the manure, and the parasites may encounter it there at a marginally-lethal dose. When the parasite progresses further in its life cycle, its offspring may be resistant when they infect the next livestock animal.
Most parasites have a life-cycle that includes time spent outside the preferred host animal, including in zoonotic species that may not have symptomatic infections. They may acquire resistance in any stage, in any place they encountered the drug.
There's an issue with collies and collie-derived dog breeds; used to be warnings (even mentioned in an episode of "House"). But. Most of the lines running around today are the ones that weren't sensitive and didn't die from ivermectin. So it's no longer such an issue.
Widespread administration does lead to the development of resistant parasites. That's not an hypothetical, that's what you see on any farm if you prolong the treatment for too long.
It's always recommended that you cycle through different anti-parasite treatments.
I’m certainly no expert but isn’t the evolutionary timescale for parasites considerably longer than for bacteria? That would presumably lead to quite different consequences (though of course the evolutionary pressure, and thus the risk, is still there).
> I'm rather unsettled to see it lauded here on HN.
What are you against exactly? What are you saying?
What does Ivermectin have to do with antibiotics? Antibiotics can produce resistant in diseases that the body would cure naturally. A popular use of Ivermectin is to kill worms in humans, they do not just disappear naturally.
Ivermectin treats many fucking evil parasitic infections. Why are you restricting it from poor people? We use it on livestock all the time. I've used it on my goats. Google pictures of onchocerciasis, it's just evil (looking, nothing is actually evil)
It's easy to find articles about "Mass treatment with ivermectin: an underutilized public health strategy" https://apps.who.int/iris/handle/10665/269206 (This is the World Health Organisation)
> 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.
You seem to be blaming locals and saying tough luck.
I don't treat my goats that badly. We do watch worm load in the goats (FAMACHA), to cut back on resistance, exactly the same as any "global medical welfare" would... however that relates to human beings.
The CDC estimates that _at least_ 30% of all anti-biotic prescriptions are inappropriately prescribed. I'd wager an over-prescription of Ivermectin (that by some unknown characteristic appears it would save massive numbers of lives) isn't likely to evolve parasites (which evolve much more slowly than bacteria to begin with) to be resistant in a dangerously meaningful way given what we see with bacteria resistance.
This is of course just a gut feeling and not a studied understanding.
I'm curious whether a similar mechanism would apply to the COVID vaccines? Can someone with some expertise in the area help clarify if this is the case? Are we accidentally creating vaccine resistant COVID strains with mass vaccination similar to how mass ivermectin creates ivermectin resistant parasites?
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.
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.
> 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.
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.
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.
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”.
> This is worth reading purely for the writing alone. Scott Alexander is a treasure
This post is a breath of fresh air for the blog and feels refreshingly well-researched. Between that and the unquestionable popularity of COVID-related discussion, it’s no wonder this article is popular.
Scott is undeniably a good blog writer with an entertaining writing style that resonates with his reader base. However, I’ve become disillusioned with a lot of his other recent writings like the “Great Families” post in which he presented a lot of conjecture that pandered to his core readership without any research or evidence to support it. Specifically, his position that genetics are the primary explanation for “Great Families” while ignoring obvious heritability of things like wealth and social status. Even the old Slate Star Codex and new Astral Codex Ten communities started calling him out on it after that article.
Scott’s writings are undeniably entertaining and usually quite fun to read, but I’ve long since learned to read them more critically because his writings have a way of projecting a sort of humble confidence while either hedging any statements so much that little is actually communicated, or sometimes inserting conjecture or feelings with a lot of linguistic window dressing such that it’s easy to mistake it for fact.
I hope this article is a sign that the writings are shifting more toward the old-school, heavily-researched style that made the blog so popular.
> ignoring obvious heritability of things like wealth and social status
He addresses that in the section section - besides the intro, he leads with it:
"the next generation becomes semi-famous fashion designers and TV personalities and journalists, which seem like typical jobs for people who are well-connected and good at performing class, but don't need to be amazingly bright. Sometimes they become politicians, another job which benefits from lots of name recognition.
But I've tried to avoid mentioning these careers, and focus on actually impressive achievements that are hard to fake. And also, none of these families except the Tagores were fantastically rich; there are thousands or millions of families richer than they are who don’t have any of their accomplishments. For example, Cornelius Vanderbilt's many descendants are famous only for being very rich and doing rich people things very well (one of them won a yachting prize; another was an art collector; a third was Anderson Cooper)."
True, but that's an example of the endless hedging I mentioned: His writing style is very good at throwing in little counter examples here and there to give a "both sides" type impression, but then he pokes holes in the counter-arguments in the build-up to the conclusion he actually wants to present.
If you read a few paragraphs past your quote, Scott comes right out and declares the "genetics" is the explanation that he thinks is correct:
> The other obvious answer is “genetics!” I think this one is right
He then applies some softball counter-arguments to the genetics argument to hedge and give the "both sides" treatment. However, the article is clearly structured to give a tour of possible arguments while subtly giving the most credence and the least hedging to the genetics argument. Combined with the not-so-subtle declaration from Scott that "I think this one is right" in the middle of the article, he expertly walks the reader into the conclusion he wants while making them feel like they came to that conclusion on their own after an objective tour of the research.
Agreed. This sort of thing is also present in this very article, in the end. When he postulates the alien theory, he starts off with an interesting and sensible premise, but then completely goes off the rails. COVID isn't analogous to a quantum memetic disease, which a 'human' cannot hope to grasp, it's analogous to a really, really bad flu that spreads like wildfire and kills and maims a lot of people. These aren't concepts that are inconceivable to a 'human', the 'humans' are just closing their eyes and ears to what they don't want to see and hear.
There are many other problems with that analogy, but they all sum up to making the 'humans' seem way more reasonable than reality affords them.
Does his theory communicate something interesting? Yes. Is it nearly as impactful as he makes it sound? Hell, no.
I think the fact is that he presents himself as speaking from a highly informed, relatively unbiased presentation of a subject he finds interesting. In fact, he is arguing for a position. Reading an article meant to be informative vs reading an article meant to convince you of a position are two very different things.
The ideal is that an author is unbiased before seeing the evidence, then forms an opinion based on the strength of the evidence. An article that chronicles such a journey, presenting an opinion but also the strongest counter-arguments to that opinion, is about the best one can hope for in scientific writing.
I mean, it's hard to be informed and also not have a position. I think the best you can do is read an article about the information that convinced the author (and the information that made them less confident).
Most of the writing is fantastic, but I'm very disappointed by the take that "everyone was wrong", by the implication that doctors didn't know they should treat for worms before giving immunosuppressants. Guess what, doctors in the developing world already knew that, it was always the standard practice on Brazilian hospitals. In fact, ivermectin was in very high demand in hospitals before it was suspected to be a Covid19 treatment. That whole paragraph reads like some really bad exceptionalism (it it doesn't exist here it doesn't exist).
Because it was not related to Covid. If someone with heart problems is admitted with Covid they will receive their heart medications in the hospital, that doesn't mean that now heart medication is a Covid medication, so doesn't get mentioned in studies. The same goes for dewormer, it was in normal use against worms. Only after people started believing that it could be a treatment for Covid, that it started being studied for that (with different protocols). And then we found out that it is just a dewormer like we thought in the beginning.
Except in this case the dewormer is the central focus of the study. The relationship between worms in the population and its influence on covid outcomes makes that highly relevant to the publications. If it's known to be present in the general public, then not controlling for that in your study is just shoddy science.
Ivermectin being cheap and widely available is really important here. Something like that- instead of a novel vaccine made with novel tech in very specific first world factories- is very attractive to cash strapped governments and public health systems.
The everyone-was-wrong part was about scientists missing the worm connection when looking at the aggregate data, not about practicing doctors and worm treatments.
I actually come from one of those so-called Great Families. Three generations back, there were 3 siblings who all had national or smaller success in creative, financial, and mathematical fields, including one who won a nobel prize. Many of their descendants also had successes, although of a more modest variety.
However, in my generation, there were lots of money problems. And they did what money problems tend to do -- delay, deny, disappoint, cause health problems, and make everything harder.
The "brains," such as they were, were still there. If we take the usual markers* of intelligence there were Ivy League admissions, Fulbright scholarships, and so on. But for me at least, not having affordable healthcare at age 20 impacted my life much more in a negative way than getting a 5 on the Calculus AP impacted it in a positive way.
I'm much less interested in the concept of inherited genius than I am in universal health insurance and free college.
*Which are themselves problematic, and often merely markers of class, but it's the best I can do here for a HN comment
This is super interesting, because it actually makes the case for 'old money' taking better care of the rest of the world, not for the benefit of the rest of the world but for their downstream.
> The fraud-hunters have examined this paper closely and are unable to find any signs of fraud. I think this paper is legitimate and that its findings need to be seriously considered. ... And there’s always the chance it was a fluke, right? Can something have a p-value less than 0.001 and still be a fluke?
...
> And it was! It was a fluke! A literal, physical, fluke!
Edit: If you like puns and this writing, you'll likely enjoy some of Scott's other works, like "The Study of Anglophysics" [1] and (especially if you're at least passingly familiar with Judaism and Kabbalah) Unsong [2].
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.
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.
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.
No it's not. What you are saying is everything is biased by money, therefore I can't trust anyone. What people are telling you is that you don't really understand the bias, not that the bias doesn't exist.
Have I missed anything? I don’t think the discussion is about vaccines. For what is worth, I think both the vaccines and ivermectin work. I just think multinational profit driven companies are more incentivised to promote vaccines, which generate a huge profit, over ivermectin which doesn’t make that much of a profit.
If you think ivermectin works then you are essentially disqualified because as the article linked here nicely explains there are some hypothesis about how it might work if it works but there is no proof, in which case the medical establishment would be all over it, because they too want this pandemic to end asap.
Whether they could make more profit off this probably factors for some people but on the whole the medical profession is result driven.
Don't use the word "proof". That's a word that's only appropriate in deductive disciplines like mathematics.
Also let's accurately represent what the article is saying:
"Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence."
This to me reads consistent with "ivermectin has a reasonably good chance of working a little bit but it isn't conclusive.", which is in contrast to your statement that thinking ivermectin works is equal to quackery.
Personally I think it's either a very small effect or no effect at all, but I don't think the quackery designation fits for people who simply believe that there's some small benefit there (although I do think that label fits for those that think it can replace vaccines)
You can think ivermectin works just fine. But what you shouldn't do is pass that on to others as fact in a game of Chinese whispers that ends with 'MSM and big pharma are in cahoots to deny us this cheap medicine that really works against COVID to protect the profits of big pharma'.
And that's exactly how it goes.
Quackery: "dishonest practices and claims to have special knowledge and skill in some field, typically medicine."
You don't have the knowledge, you don't have the skill, so don't go around giving advice about non-proven cures (or in fact, about any cures).
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
Yes. But compared to what this crisis has cost us to date that is a very small drop in the bucket. think trillions, not billions. And it's not over yet. And Gates has so much money he's probably invested in the whole F500. But the whole Gates/Soros/whichever bogeyman you want to add here story is getting a bit long in the tooth.
Yeah it also lead to trillions in wealth increase of the ultra rich. There also is a difference between deliberately investing in vaccine companies and then publicly advocation for patent protections to remain in place and buying a vanguard etf. Just because someone is the target of Crazy conspiracies doesn’t make their behavior less reprehensible.
"Sometimes these people even have a specific theory for why elites are covering up ivermectin, like that pharma companies want you to use more expensive patented drugs instead. This theory is extremely plausible. Pharma companies are always trying to convince people to use expensive patented drugs instead of equally good generic alternatives. Ivermectin believers probably heard about this from the many, many good articles by responsible news outlets, discussing the many, many times pharma companies have tried to trick people into using more expensive patented medications. Like this ACSH article about Nexium. Or my article on esketamine. Given that dozens of studies said a drug worked, and elites continued to deny it worked, and there are well-known times where elites lie about drugs in order to make money, it was an incredibly reasonable inference that this was one of those times.
If you have a lot of experience with pharma, you know who lies and who doesn’t, and you know what lies they’re willing to tell and which ones they shrink back from. As far as I know, no reputable scientist has ever come out and said ‘esketamine definitely works better than regular ketamine’. The regulatory system just heavily implied it."
There are medical bodies staffed by professionals that study these matters, and the states (should) base their decisions on what their findings are. To me the problems starts when decision makers and then the general population start trusting fringe conclusions and trying to interpret medical data when they have no training to do so.
When a new cure for cancer is found, we don't expect the minister of health to recommend or advise its use to the general public on TV, do we ? We assume professional MD will learn about it via their regular channel, and recommend the treatments on patients that they judge relevant.
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.”
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).
> 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.
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.
They're saying, instead of waiting 18 months to figure out the best decision for you and your family instead of jumping to a conclusion based on political affiliation correlated to the part of the country you happen to live in, wait 20 years because science iz kewl.
> I asked him about his decision-making, and he listed a combination of serious statistical errors and small red flags adding up. I was pretty uncomfortable with most of these studies myself, so I will err on the side of severity, and remove all studies that either I or Dr. Meyerowitz-Katz disliked
From further up, though we don't _quite_ know the details, but it's not like he went "Oh well some random person disagrees with them so better throw them out"
If "With a meta-analysis, if you detect a high number of fraudulent studies..." applied here, perhaps so. But most of those eliminated were not for fraud, in fact only 2 were for fraud, the rest were flawed in ways which, I'm afraid, is equally common (or nearly so) in studies on any other topic. Also, not all of the studies he threw out showed ivermectin working, I recall at least one showed the opposite but that doesn't mean we throw out all studies showing ivermectin doesn't work.
Also, the whole point of the exercise is what do you find if you apply good statistical and methodological rigor, but don't have any anti-ivermectin bias.
> 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.
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.
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?
"...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.
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
It doesn’t really matter given that ivermectin is not effective.
> 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.
> Pfizer’s drug has protease inhibitor activity like ivermectin, but they are a very different kettle of fish on a variety of levels
and
> Dr Walter explained that PF-07321332 is a “direct acting antiviral drug”, while ivermectin “has multiple mechanisms of action on animal and human cells as well as some serendipitous antiviral activity”.
This sounds much more like "yes, but" to me than "false". And indeed, the rating given is not "false" but "Missing context". The headline is certainly accurate (ivermectin is not the same drug as Pfizermectin) but also fake news in that it is a strawman; no one has claimed that they are literally the same drug.
The interesting claim, if clearly stated, is "The mechanism of action of Pfizermectin for treating COVID-19 is as a protease inhibitor. Ivermectin is, among other antiparisitic effects which are usually more interesting, also a protease inhibitor." That claim is validated by the evidence given in the fact-check.
Moreover it's worth calling out a known lie in the fact-check (which is included entirely gratuitously as it doesn't have anything to do with the headline or the verdict or even my "interesting claim" above): "some of [the mechanisms of action of Ivermectin] could have unwanted, even dangerous side effects." Ivermectin is on the WHO list of essential medicines and is considered extremely safe, with just one known complication related to a particular parasitic infection IIRC. I can only imagine that the reporter, having not gotten any definitive proof for the desired 'false' verdict from Dr Walter, pushed and prodded until eliciting this absurd and false but politically expedient statement.
I wonder how Dr Walter would describe the difference between "animal and human cells". The statement makes it sound like he's a Young Earth creationist.
One criticism[1] of the above linked study, the one that states Ivermectin acts as a 3CL protease inhibitor, is that it uses an "in silico approach" (computer simulation).
The way that we know PF-07321332 is a 3CL protease inhibitor is via an "in silico approach".
It's important to note that the dosage of Ivermectin required to act as a protease inhibitor would be way above the accepted levels for human use.
Even still, this "animal/horse drug" rhetoric along with asymmetric acceptance of evidence is what lead me to want to understand more about the ivermectin controversy. It smells more like propaganda than science. Then, the sheer number of studies showing positive outcomes made it hard for me to accept that all the science was bad. Astral Codex did a great job of explaining why the studies were flawed.
Sure, and I almost edited my original comment when I made it to clarify that as far as we know, Ivermectin isn't a very good protease inhibitor. That's what the fact-check should have said. Instead, we were fed a pile of garbage because the garbage sounds more comforting to those who emotionally need Ivermectin to be horse medicine.
But I don't think that Scott has done more than offer a suggestion as to how the studies might be flawed; no matter how compelling the suggestion, it isn't evidence. Otherwise you're just consuming more nicely-dressed garbage, which is even more dangerous because you get to feel superior to those consuming the normal garbage.
What would constitute good evidence for the worms theory is, you know, a study actually studying that. Otherwise the theory is just assuming that a lot of the people benefited by Ivermectin do have worms, when that hasn't even been measured.
The worm theory was amusing but that's not what changed my mind. For me, it was "The Studies" section where Scott goes over each study and discussed why they were deemed to be low quality or suspect.
But... he didn't? Most of the studies he found no fault with. This seems to be a striking example of alternate facts you have picked up from the same article...
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[ 0.25 ms ] story [ 648 ms ] threadThis is well put. It's pretty remarkable indeed.
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.
Ivermectin MIGHT work... but really... let's move on.
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.
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.
Beyond the social media hype there is almost no rational reason to believe that. I even have a problem with writing "almost no", because I don't really trust what I've seen in that regard on face value.
Also a free drug that probably doesn't work isn't all that competitive...
So zinc and vitamine D which enhance and modulate the immune system are recommended.
It's not as clearcut as you make it seem. The current vaccines lose their effectiveness over time and are significantly less effective against the delta variant to start with.
The loss in effectiveness isn't even that big of a deal. It only really matters for those most at risk. And it's hard to say how much longer the third dose will last, but knowing how the immune system works, I'd guess it will be more than 6 months, provided there is no escape mutation. Delta isn't an escape variant, btw, it's just a really fast worker. It gets up and running inside the body so fast, that even the remembered response takes a while to catch up. That's why the third shot, which reestablishes active, circulating antibody levels, is so effective: Now the virus is knocked out before getting started, and the usual infection dose, before replication, isn't enough to cause trouble.
>Delta isn't an escape variant, btw, it's just a really fast worker.
It's faster, more transmissable, infectious, shorter incubation period and a 1000fold increase in generated virus particles compared to other variants.
But is also has mutations in its spike and nucleocapsid that warrant developing new vaccines, certainly when it's at the moment the dominant strain by far and even more virulent variations are to be expected.
It will take a lot of time to gather enough data to confirm any new vaccine as actually being better and safer than Comirnaty against Delta... Just saying "This vaccines was especially designed for this" isn't enough.
I disagree. The number of deaths has only been decreased fivefold when comparing first wave and 4th wave in Belgium. And yes, there are fully vaccinated people who are dying.
“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.
You can't get this sort of excellent rebuttal without allowing a site like https://ivmmeta.com/ into the debate.
This is the first serious anti-Ivermectin argument I've seen.
It is a strange phenomenon that people are so ready to disagree with people who spent decades achieving exactly that kind of knowledge.
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/ is both reasonable and moderately convincing.
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.
They, like every other person, have their own best interest at heart, which, if you're lucky, aligns with yours. "Just listen to the authorities" is probably the worst advice ever given.
The problem with this pandemic is that a lot of people in places of power have made mistakes, sometimes really bad ones (for instance, such as pursuing herd immunity) rather than to follow the WHO expert advice. This could easily be construed as authorities acting against your best interests and in fact in quite a few places people have died that need not have died at all.
But there is a difference between 'political authorities' and 'medical authorities', the WHO has been fairly consistent and sensible in their advice to date, what political authorities locally do with that advice is another matter entirely, that runs the gamut of Bolsonaro to Boris Johnson to Jacinda Ardern and everything in between.
Pursuing herd immunity is a viable strategy only if you can actually achieve it.
Sweden has done far worse than their neighbors in this respect. But given the fact that it drags on all you can say is that as long as we don't treat this as a global problem your local measures matter less than you think.
Countries that did fantastically well early on showed it could be done, but because they were the exception eventually they too became overwhelmed through imported cases. If that had not happened, which would have required a more synchronized approach, then the total damage would be a fraction of what it is today.
And this isn't over yet, not by far and it is a much harder problem now than it was in March last year.
https://www.statista.com/statistics/1111779/coronavirus-deat...
Denmark, Finland, Norway and Iceland all did considerably better, and have demographics and local conditions that are closer together than comparing Sweden with the rest of Europe. It's a thinly populated Nordic country, so the comparison material should be countries that match those criteria, not the average of the EU, which runs the gamut of high density extremely interconnected countries with major airline hubs all the way to vast emptiness with the occasional city.
It's an easy mistake to make though.
https://www.worldometers.info/coronavirus/country/netherland...
"Use social distancing and isolation to avoid COVID and get vaccinated as quickly as possible" is good advice from well-meaning people who do know better. Sorry it's unpleasant, but if the USA behaved rationally, there wouldn't be 750K+ dead today.
Sweden readily admits that its approach was a terrible mistake. It's just not as embarrassingly bad as other countries, particularly ones that, with sensible leaders, should have done much better (UK, USA).
Mixed messaging by people in the media undercut a lot of support for the countermeasures, which was then further amplified using social media to pretend that scientists are divided in their opinions when in fact they weren't, except for a few lone holdouts, who - yay controversy - were given a disproportionate amount of airtime.
It does?!? Funny, how can I have totally missed something as big as that?
I'm a Swedish "expat"; I have now lived abroad for just a little longer than I lived in Sweden (26 vs 26.5 years), but I've always followed Swedish media and I still travel there regularly. All I've seen is some hemming and hawing about "Perhaps not totally optimal"; far from any flat-out admission of "terrible mistake". And when I spent a long weekend there three weeks ago, the populace at large certainly didn't seem aware of any such thing.
Got any handy links to this admission by Sweden?
https://www.wsj.com/articles/scientist-behind-swedens-no-loc...
> The epidemiologist behind Sweden’s controversial decision to forgo a mandatory lockdown conceded for the first time that more restrictions might have helped prevent a surge in coronavirus-related deaths.
Throughout the pandemic the experts, including the WHO, have been very frequently wrong. That doesn't necessarily mean you'll be better off following advice from secret messages encoded for you in game show hosts, or, worse, Donald Trump's actual opinions. But blind faith in experts hardly seems to be justified.
Lockdowns have caused people to gain 10 kg on average, which increases their risk for many diseases, including Covid-19. That alone shows you that the medical authorities do not have you best interests at heart. They want to keep ICU beds free for the gerontocracy.
Sweden, which did none of that, now enjoys low Covid-19 numbers and fatalities.
Ivermectin, while probably useless but harmless, is a complete side show. It is used by the mainstream to create an illusion of conspiracy theorists and Deplorables and to divert from actual issues.
People on average gained 10 kg? Really, I have no idea where you get this nonsense but clearly you are not interested in a factual debate but in one that gives you what you want: the ability to ignore this pandemic as though it doesn't exit.
There are no ICU beds for the gerontocracy, there are simply ICU beds, and there is a limited number of them, they will have a COVID patient in them or someone else, and in case of surplus they might be free.
The medical authorities and the politicians should not be confused.
https://www.apa.org/news/press/releases/2021/03/one-year-pan...
"APA’s survey of U.S. adults, conducted in late February 2021 by The Harris Poll, shows that a majority of adults (61%) experienced undesired weight changes (weight gain or loss) since the pandemic started, with 42% reporting they gained more weight than they intended. Of those, they gained an average of 29 pounds (the median amount gained was 15 pounds) and 10% said they gained more than 50 pounds, the poll found."
61 percent could have gone either up or down, and 42% said they gained more weight than they intended, of those that gained some gained more than 10 kg, and a smaller fraction gained more than 50 pounds.
So, what does this say:
(1) that people should adapt their eating habits to their needs
(2) that it is possible to lose weight and to gain weight unintended (which is something that isn't really news, see also: weight watchers and the whole weight loss industry)
(3) that the study did not correct for what would have been the result of the poll had COVID not happen
(4) that the word 'lockdown' that you ascribe to the cause does not appear in the article text, but the word 'stress' does
and finally
(5) that you link to this article because you think it supports your statement above when in fact that really isn't the case.
https://www.statista.com/statistics/1257041/average-weight-g...
Sure, if you just compare it to Norway and Finland, it is very true that Sweden has worse values, more than 3 times as many dead at minimum. But the answer if it was the correct or wrong choice will be answered after the current seasonal outbreak or in a few years.
edit: Just looked it up again, Spain and Sweden are currently leading with Kosovo for having the lowest case incidence in Europe. Gibraltar has the highest and everyone is vaccinated there. I remember the articles about Gibraltar being the first immune country. They now have cancelled many official events.
The Community of Madrid is the succession tax haven of the country, so loads of people go live there their last years so their families aren't taxed on the inherited wealth.
Combine with the regional government short of condemning to death the elderly in nursing homes by refusing to hospitalize them[0], but I guess it's fine since they forgave themselves [1].
Add to the mix that the healthcare access hasn't kept up to handle what Madrid brought to itself, and then you obtain these numbers [2].
TL;DR: during the first wave, while most regions had peak excess deaths of 10-50%, Madrid had 200%, at the same time as being one of the most populous. In the rest of the periods, Madrid has been usually at the lead as well.
With Madrid removed the numbers are in line with Germany and Sweden.
[0] https://elpais.com/espana/madrid/2020-06-08/la-comunidad-de-...
[1] https://www.lahoradigital.com/noticia/32918/madrid/la-invest...
[2] https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPu...
More like 6 (Finland) and ~10? (Norway), by my calculations.
Over 40 doctors, most of them MD/PhDs, from 4 of the 10 top ranked hospitals in the world for the relevant issue, told me I’m an idiot, because that disease is a 1:10,000,000 thing, it can’t be the cause. It’s probably a virus and I should just go home and wait a few weeks.
And after 3 months (10 days of which were in-patient) and 40 or so specialists, and 5 hospitals), a doctor looked at all the data and said “of course you are right, we start treatment tomorrow” and we did.
All it cost was some irreversible brain and CNS damage, a few years at home - not much, right?
And through the years and some Facebook groups, I’ve met other parents in similar situations. Some had a 5 year delay in diagnosis because it’s a rare disease, stories about the medical system incredibly similar. That’s 5 years of irreversible brain damage and general suffering. Also, it’s more likely severely under diagnosed and actually more like 1:1,000,000
It was just the beginning of a journey. An eye opening one about incompetence and incentives.
The assumption that health authorities in particular (and authorities in general) have your best interest at heart, and are competent, are severely lacking in evidence. You might not have been bitten by that, and I’m happy for you that you weren’t.
Health authorities and professionals optimize for a lot of things, that only sometimes coincide with your interests as an individual. E.g. they might prefer you stay sick than get better, if there’s a 1:10,000 chance you’ll sue them (regardless of merit). I am intimately familiar with such a case.
Of note, the pharmaceutical industry, which is intimately intertwined with regulatory agencies and health authorities, is incentivized to make you a paying regular customer (Office 365) rather than selling you a one time product. Unfortunately, that means managed chronic illness rather than cure.
Which is not to say HCQ or IVM or whatever are the cure. But the idea of “trusting the authorities” is something you only do until it bites you hard.
I lost a sister (at the ripe old age of 23) to such a case so I'm quite familiar with the territory. In spite of that the default for me is to follow what my doctors tell me, and only if it doesn't work would I start to read up more and to try to come up with suggestions, but not with diagnosis.
Health authorities preferring you to stay sick rather than to get better should re-read the oath of the medical profession, that's despicable.
And agreed that there is a lot wrong in mixing business and health care, but those are the kind of setups that we apparently favor. I recall a doctor here in NL remarking to me that money and health are mutually exclusive, because if doctors have to make decisions based on finance they are immediately transgressing their oath. I can see his point, but I also understand basic resource allocation issues and the medical profession does not operate in a vacuum.
These are hard problems.
I reside in Israel these days, which has a system similar to NL ttbomk. The doctors that treat you (in the public system) are not incentivized other than to cure you, except perhaps through the occasional marketing cruise.
But high up ministry of health people have been indicted (including through corona) for pushing and in some cases mandating useless treatments after receiving a bribe.
The doctor at the hospital just got the memo “the recommended treatment in case of x is y”.
These indictments are for what can actually be proved. I’m sure there are more cases that have not been found, and also in other countries.
The only one who really has your best interests in my mind is yourself; if you are capable of doing research, you are likely more qualified for your own situation than specialists.
WHO recommends against remdesivir. FDA and IMOH promote it as a wonderdrug. Who would you trust?
My GP.
I could read the research papers and the guidelines, but for that I would first need a medical degree in the relevant (sub)fields, figure out who is and who isn't telling the truth/stacking the deck/fudging the data/angling for funding and so on and then finally I'd have to weigh those papers and all of their contradictions and arrive at some conclusion. The chances of me getting that wrong are just as high as the chances of my GP debugging a piece of software by reading papers about debugging.
For rare diseases the job of a GP is not to diagnose but to pass you on to someone who can. You also have the right to a second opinion here in case you don't trust the advice that you are getting and finally, you can ask for arbitrage if you are then still not happy.
That said, plenty of errors are made, but I don't think the software industry has any right to speak about mistakes made in other fields, our own house has been on fire for the last three decades in that respect and the only thing we've done to deal with it is to avow any responsibility.
But very likely (especially in the US, but also in other places), his considerations have to do with not increasing his malpractice insurance premium.
Your and his interests are not aligned. And that chasm is larger than anyone likes to admit.
If you want to outsource your health decisions to someone else, who may be more knowledgeable in general, but may be less knowledgeable on any specific matter you dive into, and whose incentives are only generally aligned with yours - by all means do.
I don't, and this has paid great dividends for me so far. People who are capable of reading and understanding research (not all are), and have the ability to reach far out to well informed people and consult with them (not all can), are also likely to be in this situation -- and those people potentially lose dearly for not doing so.
The WHO recommends against using remdesivir in hospitalized patients -- which is very different from your claim! The FDA and others make their cutoff point slightly but not substantially later, e.g. remdisivir isn't indicated when a hospitalized patient is on high-flow oxygen. Their disagreement isn't one of substance, just one of scope, and all doctors treating Covid know the rationale behind each cutoff point.
But instead any of that nuance, people say things like the "WHO disagrees with FDA" and decide that both are useless so they should take medical advice from morons with podcasts?
I actually read the papers on remdesivir, and as a result decided that I will not take it if offered, whether hospitalized or not, because of my risk/reward preferences, which may or may not align with the doctor's or the system's.
In Israel (where I now reside), AFAIK, they are happily administering it to hospitalized covid patients; at least, they were giving it out a lot until they started treating with regeneron. Now, Israel has its own definition for requiring hospitalization than the WHO or the FDA (e.g. SpO2<94% is considered severe and requiring hospitalization -- if you have a positive PCR test).
Do you think the doctors treating covid are actually aware of the minute differences between WHO, FDA, IMOH definitions? I checked with a couple I know. They have no idea.
In your anecdote, you suffered a failure to diagnose, and specifically, a failure to diagnose a rare disease.
This is unfortunate, and bad, and a problem to try to figure out, but it is a completely different sort of failure than what other people are proposing for HCQ or IVM, that there is a highly effective and inexpensive treatment that the medical establishment is failing to recognize despite apparently having such clear evidence in its favor that people on Facebook can understand it.
The diagnostic failure was just the beginning.
(And, unlike the HCQ/IVM case, which I don't support and is in general speculative - the guy responsible for the official recommendation was actually convicted for taking bribes from the company making the treatment. I won't divulge any details, because that will de-anonymize me - the disease is rare enough that people in the field know each other and all the cases).
p.s: That treatment (in combination) is also used for other, similar diseases, each is rare, but overall it was a lucrative market for the drug company.
Also, even the "moderately convincing" evidence is in my opinion not nearly enough. It might be if Covid-19 were a modestly important disease with only a few labs and clinics running working on it. But it's not. Throw enough shit against the wall, eventually something will stick by chance. This is a globally distributed experiment, and it is impossible to control for publication bias and all quality issues...
The only reason to think why Ivermectin should work against Sars-Cov-2 is because it has shown some action in cell cultures at ridiculously high doses, and maybe there have been other anti-viral interactions in the literature. For widespread use, there needs to be more and better evidence, especially given the currently available vaccines and treatments.
It is a fallacy. https://en.wikipedia.org/wiki/Argument_from_authority . To make an argument, there needs to be an argument.
This seems to be a common and recurring theme: my opinion is worth as much as the opinion of an expert in the field because their argument can be discarded as an argument from authority. But they are an authority and I'll be happy to believe them compared to believing you, who are not active in their field at all.
See:
https://news.ycombinator.com/item?id=28067406
and
https://news.ycombinator.com/item?id=29235584
"I'm no medical anything but I do have extensive academic and statistical training."
But you forgot that that only applies to those fields that you actually know something about, otherwise this is about as transparent an appeal to authority as one can make. Who cares about your extensive academic and statistical training if you start off with nonsense? Garbage in, garbage out, no matter how good the program is.
This is wrong to the point where you really might want to take a deep breath. The point of experts is they have thought about a field more and are better at making sound arguments in that field. "Most scientists/doctors believe..." is literally, exactly and unambiguously a fallacious argument. The only thing that matters is why they would believe that.
And if that why is "statistical significance", I'm friends with enough doctors to know I'm better at interpreting stats than they are. If the answer they go to is parasitic worms then yeah, that is why they are experts and I'm not. It is a compelling argument.
I stand by my comments and disagree that they make the point you want them to. The 1st isn't even about medical opinion if you read it closely, it is scepticism of politics.
Probability dictates that any doctor - let alone most doctors' - opinion trumps yours and everybody else that parrots you, because they will be right far more often than you about medical things.
You may be better at interpreting the statistics than your doctor friends but you are not better at medicine, are not wired into their world as much as they are and in fact are most likely blabbing nonsense.
You can stand by your comments but that just proves my original point: that you consider your own opinion to be a higher one than someone trained in the field that you have an opinion on. See your other comment in this thread regarding how medicine prescription works, it doesn't but that isn't going to stop you from being convinced and it would not surprise me if you felt that that doctor is making an argument from authority.
Suggestion: assume that you are a layperson in medicine, act accordingly. And go get vaccinated if you haven't been already, and ask your doctor if they thinks that's a good idea, rather than to believe me, yet another stranger on the internet.
And I suspect you would have had the same conviction about smoking had you lived in the 1960s and noticed that many doctors recommended smoking.
No, it does matter why a doctor believes what they believe. The vast majority of them just follow the official top down advice. And some actors, notably tobacco and pharmaceutical industries, have been using that to subvert science (to great effect and profit) for decades.
Which, again, I note, is not a statement about IVM or HCQ or Cominraty - it’s about the reasons for your own convictions, which seem to completely ignore decades of evidence.
It does not at all matter that doctors know better than me about 99% of medical things. When I have a specific issue, it is far more likely I can know more about it by spending 100 hours studying, than a trained doctor does without studying. It is likely he would know more than me if he spent 5 hours, but it is very unlikely that he has.
I haven’t disagreed with doctor about many things in my life. But in the 3 or so things which I found vitally important to research, and in which I came to a different conclusion than the specialists, I was proven right.
And real doctors promoting smoking goes back much further than that, all the way to the early 1900's.
It's that kind of activity that undermines the authority the profession, but it's the wrong conclusion to make that if doctors were wrong about smoking they are also wrong about everything else. Usually they are not.
https://www.rgare.com/knowledge-center/media/articles/smokin...
Indeed. And usually, there is no significant objection to the medical consensus, so it is irrelevant the "all medical advice" space.
The interesting (from my perspective, but also from an information theoretic one) things are those about which there is disagreement. And the "usually right" on those subjects goes down significantly - perhaps it's still "usually", but maybe it's just 60% rather than the 99% of the "right" things which inspire people to blindly believe doctors about everything. And perhaps it's just 20%; We'll likely know about today's status only in 30 years.
For example, there is still consensus about statin use to reduce cardiac problems through cholesterol lowering. I looked a little into that; the evidence is severely lacking, especially if you consider all cause mortality rather than just "lowering myocardial infraction risk" (which you can achieve 100% with Cyanide!). I have informally surveyed about 20 doctors, of which one was a cardiologist. Everyone other than the cardiologist was convinced statins are the best thing since sliced bread, have no risks, and excellent efficiency. Not one of them actually knew much about, e.g. statin effect on all cause mortality, or much of anything else related to statins except the official line and up-to-date (the service) summaries. The cardiologist still thought statins were a good thing, but was much more reserved about recommending them to anyone with high blood lipids, because he actually read the research and had actual experience (and discussions with informed colleagues).
"If you are not a logician your opinion on fallacies doesn't matter at all."
>Probability dictates that any doctor - let alone most doctors' - opinion trumps yours and everybody else that parrots you, because they will be right far more often than you about medical things.
You really have not spent much time around doctors, I think. Doctors (GPs) know about as much on a topic as someone who Googles the current country guidelines. For anything novel, I'd trust a statistician over a GP to interpret data every time.
Don't like it? Get a second opinion. Don't like that? Request a review. Don't like that? Self medicate to your hearts content, or go with crystals, aromatherapy or whatever you believe works. But don't go around the interwebs spouting your self derived conclusion from papers that you barely - if at all - understood as fact.
Because that's the rub: the people who were all over Vitamin-D, Bleach, HCQ and lately Ivermectin were just looking for excuses not to vaccinate and that is a problem, none of these miracle cures were miracle cures, they weren't even cures. At best they were no-ops, at worst they harmed the health of those that received them. By amplifying these messages thousands of people have needlessly died.
But Ivermectin seems to have run its course. I predict a new miracle cure with a new champion somewhere in the next couple of months, just like Vitamin-D and HCQ before it.
This is an excellent point. It is so good that I think it may serve as the definition of an expert: An expert is someone who is better at making sound arguments in that field. Sound arguments being what matters and not the person making the argument, just as the calculations matter more than the mathematician.
And to the extent that the article does say that even a legitimate authority needs to present an argument, in this context, they have!
Like the situation here is medical experts have said "hmm these studies that appear to show ivermectin's effectiveness are fraudulent and suspicious".
Like, with the exception of the complete theory that ivermectin studies in some nations are naturally confounded by the presence of worms, the arguments he's made about the unreliability of the ivermectin data is the mainstream argument about the unreliability of ivermectin data. He even cites a number of experts whose analysis he sometimes relies on!
No it isn't, it's full of obvious fraud! That's what the entire rest of the article points out. And they put an unwarranted warning against one of the few non-fraudulent studies because it doesn't go their way:
[re: Lopez-Medina et al]
> "I’m making a big deal of this because ivmmeta.com - the really impressive meta-analysis site I’ve been going off of - puts a special warning letter underneath their discussion of this study, urging us not to trust it. They don’t do this for any of the other ones we’ve addressed so far - not the one by the guy whose other studies were all frauds, not the one where 50% of 21 people had headaches, not the unrandomized one where the groups were completely different before the experiment started, not even the one by the guy accused of crimes against humanity. Only this one. This makes me a lot less charitable to ivmmeta than I would otherwise be; I think it’s hard to choose this particular warning letter strategy out of well-intentioned commitment to truth. They just really don’t like this big study that shows ivermectin doesn’t work."
That's the nearest Scott gets to directly accusing ivmmeta of fraud.
That's a pretty sensational claim.
Who benefits from this fraud?
The ivermectin manufacturers, researchers receiving funding from pharmaceutical company or the government, or the ivmmeta.com website itself (I see no third party ads or assets at all -- not even GA)?
Meanwhile, back at the Pfizer ranch, they just bought a few small countries for cash.
It might be that the list is riddled with fraud, but it isn't obviously so. I'm comfortable with many of the studies having methodological errors - that is why it is called "low quality evidence" instead of "high quality evidence" - and I assume the base rate for badly done studies is quite high.
[0] https://en.wikipedia.org/wiki/Replication_crisis#In_medicine
Fortunately during the polio years we didn't have the internet, the carnage would have been incredible.
I'm fully resigned to the fact that we won't know for sure if Ivermectin helps with any of this shit for at least another decade until tensions subside. Could be that millions of people died while they didn't have to. Could be that it's total horseshit. There's no way to know, and "consensus" means next to nothing in these circumstances.
At the same time, we have vaccines, which do work (though the slow roll-out and the many, many hold outs certainly don't help, as well as that it leaves the question of how to deal with children for the moment mostly unanswered).
And propagating this Ivermectine (and Hydroxychloroquine as the predecessor) nonsense has caused a lot of people to forego their vaccinations. And that does have very clear effects.
So even if consensus doesn't mean truth typically it is the experts that go against the grain with hard proof in their pocket that win out over the long term.
It is very rarely going to happen that new scientific truth will come from conspiracy theorists rather than from the establishment, though I guess if you live long enough that too will one day happen.
Citation needed. I think people forego vaccinations due primarily to how hard they are being pushed, and due to almost 2 years of pretty much nonstop incoherence (or even outright lies sometimes) from the health authorities and the press worldwide.
Case in point: we're still being told by talking heads that "vaccines can stop covid" whereas the reality is nothing can stop it - it's endemic. And that was clear to any sane person back in February of 2020.
Polio, measles etc. are entirely different.
Who is spreading the misinformation that all ulcers are caused by H. Pillory?
Between hydroxychloroquine and Ivermectine you are (worldwide) probably looking at a few hundred thousand extra people dead because they (or in some cases their leaders) chose to believe that bullshit rather than to get vaccinated.
Actually, the reason people didn't believe him is interesting because they were using an earlier scientific method - he didn't have a good explanation for the mechanism, so they dismissed it with "correlation is not causation". We're better at using things whose mechanism we don't understand now, like Tylenol.
What is interesting (to me) is that which we now consider to be common sense was at one point controversial.
We did adopt his methods, but many years and hundreds of deaths too late, and not before declaring him insane for his beliefs and putting him in an asylum.
What I'm saying is that authority has a dark side. Sometimes the establishment is actually wrong. Regardless of right or wrong, it always chooses to erase its critics. Some of us disagree with the erasure, even in cases where the critics are wrong.
The thing where the case you linked went off the rails for me is that there was no downside to trying his methods earlier, but ego got in the way, and ego is by definition unscientific. But people will be people, that you won't be able to fix, I'm afraid.
Now consider that this is just one example of a class of such issues and that there is an enormous echo chamber for such bullshit which extends right into hackernews.
The way it works:
- posit some bullshit miracle cure
- recruit useful idiots to help promote the issue, sow division
- downplay all of the arguments against, make it seem like it is the establishment that does this
- eventually, give up and move on to the next miracle cure
- go back to step one
It is interesting to see that it is the same people that over-and-over-again allow themselves to be recruited like this. Note that you were making 'pro-Ivermectin comments just yesterday' without knowing what you are talking about.
Why were you making those comments?
What were you trying to achieve by amplifying something that made no sense?
Don't you feel any responsibility for pushing such stories when the end result can be that people end up harming themselves or others on account of this?
I discounted a highly biased echo chamber in social media and more traditional media and went with 30-odd studies that appear to have been assembled in good faith even now. I changed my mind immediately on seeing "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".
You are describing how you want me to be thinking, not how I am thinking.
That this single article would change your mind is fortunate, but I do not suspect that to hold true for the bulk of the conspiracy peddlers that remain.
Article publishes sound arguments, doesn't talk down to the audience, admits problems with appeals to authority... and converts a conspiracy believer!
...No way, there is no way that can possibly work, the others are way too dumb, and the convert is a bad person... basically anything to just go back to pretending appeals to authority work. Despite clear evidence to the contrary. Or lamenting that they don't. I'm drawing some parallels with miracle cures here ;)
edit: just one exhibit: https://news.ycombinator.com/threads?id=mewpmewp2
The way someone gets ivermectin is to walk a doctor through the evidence they've seen and then ask them to prescribe it.
> The way someone gets ivermectin is to walk a doctor through the evidence they've seen and then ask them to prescribe it.
That is factually incorrect, no doctor in their right mind will allow the patients to effectively prescribe their own controversial and in some cases downright dangerous medicine.
I am being dead serious here. Confused.
And to be clear, it should not work that way at all.
I think it does work that way a lot more than many of us would care to admit.
Happy to be shown I am wrong.
The rest of the world considers it as illegal it is harmful / unethical.
Is the idea that doctors deserve deference because they are conditioned to submit to guidelines formulated by experts?
There is a lack of consensus on many long-standing, common medical questions, much less novel diseases. When I ask my GP about prostate screening, for example, he lays out the current state of research as best he can, but delegates the decision to me. Why is the COVID situation different, given that experts are still fighting through a figurative fog of war?
As to why the COVID situation is different, presumably because prostate cancer screening affects only you (and perhaps your family in the case of a true/false positive/negative diagnosis), and COVID represents a threat to everyone around you, and everyone around them, etc.
- There is no expert consensus (on treatments, etiology, etc.).
- Consensus exists, but the level of consensus is overstated.
- There is broad consensus, but with relatively low confidence.
A generalized public health threat like a pandemic doesn't change the epistemological calculus, nor the sociology of knowledge.
- there a consensus, it is broad and it has good experimental support and high confidence
1. Treat you according to guidelines/expert opinion, should you choose to.
2. Give you the opportunity to participate in a relevant study.
But _never ever_ will your GP formulate an experimental treatment plan based on his own research. Not GP's job, and big risk of liability. Your GP has at best a cursory view of the research happening in a certain field. COVID is different due to several good and bad reasons: hugely politicized, confusing messages from experts, and most of all novelty. 'Lack of medical consensus' usually means 'several treatments backed by experts are available', not 'do what you like'. COVID is too new for the dust around expert debates to have settled. That's what makes it different.
What you yourself _have_ to realize is that the expert researchers who are in a position to create and inform guidelines are themselves not some kind of 'super-experts' who know everything better than normal experts. They're just researchers in a political position in a bureaucracy.
I don't exaggerate when I say that an average HN reader could write better guidelines for patient outcomes in my subfield, with no prior training, simply by reading a few studies and observing a practice.
Now, does any of this apply to internal medicine, specifically covid? Probably not. But when the data is anything other than crystal clear, you should not assume the expert guidelines are anything more than some guesses by guys in a room. The consequence of knowing this is that all guidelines and consensus is suspect until you see the data yourself, like TFA outlines. In this case it seems true that Ivermectin doesn't cure covid. But with my experience, the exact opposite result could have been shown and I would not be surprised whatsoever; experts saying it doesn't work does not constitute in my eyes anything other than noise until the data is clear.
What I'm saying is only that:
- on average, experts do spectacularly better than Joe Schmoe. Including science degree holders thinking they understand medical studies while missing the whole political and social context of the field.
- it's not the job of field practitioners to prescribe experimental therapies, and those people cannot do better than follow expert opinion and guidelines.
But I actually agree with you on all points, especially regarding flawed research and understanding. Which makes people basing opinions solely on papers without any practical knowledge of the field wrong all the more often. Does it make it a good idea for people to go and try on their own the thing they read about in the last issue of 'covid today'? I don't think so.
I'm saying that, when the data is unclear and Joe is thorough, I don't even think that's true. Or at least it's not spectacularly better. My point is that for something like Ivermectin where the data was initially null and even now isn't super clear, the word of experts was basically meaningless. Trust them if you don't care enough to look into it, but if you're Joe I'd say just go ahead and believe whatever you understand to be correct until there's a better consensus.
So even if the data is unclear we can safely conclude that it isn't a miracle cure and never was. And Joe Schmoe here isn't talking about some condition that he's been walking around with for a while and has studied extensively, Joe Schmoe here is a guy who believes doing your own research is watching youtube videos by people who have done their own research reading a bunch of papers without understanding any of it.
The problem is that that gets in the way of achieving the goal: beating this pandemic, and that isn't going to happen with ivermectin. (Or HCQ for that matter).
The zero hypothesis is the long standing default, that a random thing will not cure this illness. The alternative hypothesis is that it does cure it and then we can analyze the results based on the results of a fair trial.
Edit: I meant this to go with debating techniques, not cures. There are people for whom no amount of saying "why can't you just listen to Dr. Fauci" is going to work. We can say they are bad people, but that doesn't work very well for getting them to agree either.
You are right to call out above that there were other anti-Ivermectin arguments before and roenxi might not have had the background to understand them. That's exactly the point: here we have an argument that he can understand, and it's effective. This is good science journalism. The kind that doesn't work (too much moralizing or too confusing for the general audience) is bad journalism.
"move fast and break stuff" is the wrong attitude for medicine and aerospace.
But a solution is better than no solution, and of all the countermeasures that we had available in March 2020 we only used a fraction.
See:
https://www.youtube.com/watch?v=AqRHH6e-y6I
note the date on that video.
As to your edit: no, here we have an argument that he thinks he understands, that's not the same thing. The argument as presented is at best a hypothesis, it isn't proof of anything, just one more theory that may or may not end up being the right one explaining the sometimes observed effect, assuming it really was observed in the first place.
This is precisely what makes this discussion so tiring: people will be swayed one way or the other based on arguments that they have no way of understanding unless they were trained in that particular field.
Unfortunately, there are plenty of politicians that fall into the same trap, leading to terrible examples of wishful thinking, outright quackery and conspiracy amplification. The harm that this is causing is substantial.
So even if this article swayed one person I'm pretty sure you'll be able to find people who get the opposite out of it, because hey 'x' has now joined the establishment, must have sold out.
They then seek others and continue to have conversations, and they find others lacking trust resonates and that opens the door for a lot of BS normally and easily seen.
Just an example of the difficulty we now face:
Hiding YouTube dislikes will, among other effects, serve to help big corporate media compete against new media.
Hiding the dislikes also breeds more mistrust. This is unavoidable no matter how reasoned the move is.
Public trust in corporate media is really low, and the younger a potential user of that media is the worse those metrics are.
Had that same media held more closely to journalism, rather than access journalism, which is essentially a sales job, the trust problems we struggle with today would not have grown into the chronic problem it all is today.
You identified politicians committing similar abuse of the public trust.
Look at Russiagate. Basically, it flat out did not happen the way many believed it did. Back when that started, many and myself included went to the original documents, saw speculation and in some cases saw it helpfully color coded, and turned on the news only to see all that elevated to fact.
That scared me frankly.
What can one conclude?
I do not see how judging others helps right now. Not saying anyone did here, but I am saying that is happening a lot and when it happens the door for good info to find it's way home gets closed. Advocates render their efforts far less potent.
Secondly, the lack of trust really can't be assigned to people. We have a lot of "they are stupid" type discussion, judgement and rationalization going on and very little of that is helpful.
ie: 70 million people voted for...
The people who had a far better position of authority and trust denigrated that themselves, and for dollars and ratings.
All that is a real mess!
How can authorities, who have abused public trust be counted on to fact check and improve on misinformation without amplifying the already chronic trust problems they created?
In a more basic sense, how can we improve on public trust at all?
I am not sure how that is done quickly.
Longer term, we need media that makes informing people a priority. And doing that likely means a move away from the current AD and access based media we have now.
Given how things are right now, the more important thing is to avoid judgement of others and encourage more and better information exchange. We will not know what reaches people, until it does.
Once it does, we need those people to continue seeking better information so we see more people making better choices more of the time.
Now the changes are coming so fast and are so drastic that we as society - including our legal system - have no way of keeping up with it. Technology routinely moves from one phase to the next before the legal framework has caught up with it. This translates into effectively operating without a legal framework for a very important chunk of society.
That's dangerous territory. I don't have any solutions and I'm sure that there are plenty of people that disagree with me but I've gone from a technophile to being very skeptical about the degree to which I allow tech into my life. Familiarity breeds contempt, or something to that effect.
However, and as a thought exercise, say we did not go down the Citizens United path after Reagan repealed the Fairness Doctrine, and Clinton Telecommunications Act of 1996.
Social media viewed through that lens, one where both the public interest is a thing we recognize must at least compete with profit, and the public trust is recognized and maintained as the high value part of our Democracy it is.
I do not disagree with you about tech and the law being behind. And right now we remain in a particularly difficult time due to so many legislators not understanding tech well enough to perform their role as well as it needs to be performed.
That said, our difficulty right now is greatly exacerbated by basic policy priority shifts that happened well in advance of tech.
Owning that is particularly difficult too. Money and markets are a higher priority than the public interest is, and that is true for government as well as big media.
The vacuum was there and significant, leaving tech, social media to rapidly expand into it.
Had that time been one of more robust public trust, social media would have to compete much harder, and regulation may well have both been more effective as well as earlier, more robust in its positive impact.
"Thinks they understand"
That will be true for very large numbers of people. Not their fault at all. It simply does not happen that a population all ends up able to sort these kinds of things out.
Implying they should is fine in the sense of self improvement, but as policy? Nope.
Perhaps it is time we, as concerned people, begin to take much harder look at our national priorities and demand the public interest be far better served than it is today.
Having done that, and sadly we are no where close to the basic consensus needed, we will find painful discussions like this one are a lot less frequent.
Know what I did not see in this exchange?
"Yes! You got there. How can we reach more people and help get past this?"
Feels a lot more like, "better late than never, and you need to do much better."
It's not bullying or "talking down to" to simply ignore bullshit, it's effective use of your time.
I was never an ivermectin proponent — although I thought the "horse dewormer" rhetoric was self-defeating, because it's obviously and well-known to be also a human dewormer (amongst other parasites), and the "horse" part just seemed to be played up to make ivermectin supporters look stupid — but this article is indeed the first one I've seen to make the parasite-COVID-comorbidity argument. It's not, in fact, the first time that argument has been made... But it seems like the first time that link was made was within the last month, as the blog post links to the following Twitter thread from a medical researcher: https://twitter.com/AviBittMD/status/1456376484180922368
It's not ridiculous to me that this blog post would be someone's first encounter with that argument, considering how recent the link is.
I have a little bit of experience with reading lots of research papers about COVID safety measures, and coming to the opposite conclusion of medical experts: in early 2020 I read lots of papers on masks, and tried to convince most of my family to mask up even when the CDC said that masks didn't work. I happened to be right, and to my parents, I now look like a smart and forward-thinking, science-driven person. But that's only because I was right! I could see someone doing the same with the ivermectin studies, and while it appears that they were wrong, I don't think it deserves dismissal or derision — especially when it comes from someone willing to change their mind and admit they were wrong when presented with compelling evidence to the contrary.
It's not a lot in absolute numbers, but it probably hides a sizable amount of cases not serious enough to get to poison control.
By way of comparison, every year, two out of every million people in the US die by falling out of bed.
Because the introduced question was regarding characterization of proponents, not the rate injury.
It’s very unfortunate that Covid started under trump because being anti-science was part of his marketing message to his base, many because of the risk to certain jobs with caring about climate change (aka the great “hoax”) and the association of science/medicine and abortion.
Unfortunately explaining the rationale in a way that people can comprehend and not tune out is very very difficult, and far more time consuming than whatever 2 syllables Trump could come up with as a retort.
These two perspectives are not equivalent opposites though.
"Believe in science" is not a religious statement.
It is a shorthand for "trust in the scientific institutions that have proven their track record via decades of public health progress, and not in anti-scientific rhetoric with a culture war agenda".
That concept wasn't even controversial on most of the political right until their recent nationalist turn.
The facts are out there, whether you believe it or not, and eventually the scientific method will catch up.
Of course if you're not a trained scientist, then it's hard to appreciate how the scientific method works, and that even when we're very sure of something, true scientists will always hedge their statements. This will be misinterpreted by those who are outside this world as there being more gray than actually exists, and those with an agenda will drive a truck right through it.
There's a chasm between the epistemic question of "does this drug really work?" and the pragmatic question of "does a risk-reward analysis under uncertainty say that I should take this mostly safe drug that might slightly reduce my covid severity?"
FWIW, I wouldn't take ivermectin either as a prophylactic or therapeutic, the evidence just isn't strong enough, but I don't really fault anyone that would add it into the stack of treatments upon a diagnosis in the hopes of a small net benefit.
That's not a given, that depends on the patient, the dose and a host of other factors. You may well end up harming someone significantly. You are in no position to proscribe any kind of medication to someone else unless you happen to be a licensed practitioner.
It is true, but unfortunate, that in many societies only licensed practitioners are in a position to prescribe (or proscribe) most drugs. That's a policy that does some good but also an enormous amount of harm.
https://news.ycombinator.com/item?id=29262479
- Silicon valley rationalist types taking stacks of vitamins despite having no evidence on bioavailability because they are generally without side effects and who knows, you might live forever. I think the consensus on this now is that more or less this is not a useful practice, though I am unaware of any evidence for it being unsafe.
- Prophylactic hormone replacement therapy in middle aged women, which was eventually generally recognized as unsafe because of unexpected cancer risks not initially understood.
- Prophylactic breast self-examination, mammograms, and prostate exams based solely on age, the former of which have been significantly dialed back over the last decade because the risk of false positives or catching slow-growing low risk cancers causes a net negative from the treatment. I don't know what the state of prostate exam research is.
- Prophylactic aspirin for heart stuff: we seem to go back and forth on this, but the last I read was that actually there's mounting concern about chronic low-dose aspiring. At the very least, it's not obvious this is doing anything.
- Statin treatment in response to mild elevated blood pressure with no symptom of disease; not exactly prophylactic, but close in the sense that it's about advance management of expected disease. And last I read, researchers were increasingly recommending dialing back statin treatment for minorly elevated blood pressure because of, again, unforseen side effects.
So I just mention this to say that what I take from your post is "the precautionary principle suggests giving more weight to prophylaxis with no known side effects" and what I take from major medical stories in my lifetime is "no known side effects almost always turns out to involve side effects in the end, and that has to be part of the precautionary principle as well".
And I should note all of the above prophylaxis is based on clearly defined treatment regimens and physician supervision, not the kind of wild west ordering various formulations of ivermectin at unknown doses with or without medical supervision on an ad hoc basis.
I didn't say that I don't fault people for taking it as a prophylactic. I do fault people for doing that because the side effects of long term use are less known, as you say.
I had alarming symptoms after the chloroquine treatments, and regret having done it. But nobody would ever put chloroquine in the "no known side effects" bucket.
If you're familiar with software development, this is akin to "there's a bug in my codebase and I'm just going to add a bunch of code that probably won't affect anything in the hope that it will fix the bug".
Meds shouldn't be administered in this way. It just ads noise to the system and will complicate things down the road.
Also, I don't like your first sentence, it's a rhetorical gotcha that is actually not in line with the medical establishment's thinking on ivermectin's hypothesized mechanism of action:
https://www.covid19treatmentguidelines.nih.gov/therapies/ant...
If they were miracle drugs as described the effect would be so large that those studies would be unnecessary. But here we are, and study it we will.
There is tentative evidence of a small to medium effect, but the quality of that evidence is low and that quality is insufficient to recommend use. This then deserves more attention and resources to figure out if it's real and why there's an effect. That's how science works.
Contrary to your claims here, scientists aren't studying it because some cranks on the internet propped it up. They're studying it because some field doctors had positive anecdotal experiences and some early studies showed promise.
As you've said, the medical establishment really wants to end the pandemic. Which is why they're looking into this drug, among many others.
Suggesting that there's no way someone could have the mental stamina to read 30 papers, over the course of two years, is completely ridiculous, insulting, and invalidates your viewpoint, in my opinion.
Pretty sad, but that's what we've ended up with. It was incentivized for.
If you're not familiar with the field the studies are in, it might be a good idea to rely on the opinion of someone who is; unfortunately, this means you have to judge whose opinion to rely on, which puts you in the position of trying to guess who's really familiar with the field. It's going to be hard for you to do better at this than just believing whatever is most popular.
Scott Alexander wrote a post about this actually: https://slatestarcodex.com/2019/06/03/repost-epistemic-learn...
There were loud, even unreasonable, voices in the debate but nobody was raising an actual problem with the results. Ivermectin has a respectable safety profile. "Maybe it works, no obvious downside" was a reasonable position.
It was always a long shot, the evidence was weak. But loudest voices in the anti-ivermectin crowd are people like, eg, jacquesm in this thread. A lot of bluster, a smidge of bullying and a weak-sauce appeal to authority for why statistical evidence should be ignored. And YouTube et al. believe it to be convincing evidence or they wouldn't bother to censor discussion of it. If that is the opposition then they don't seem to have uncovered a methodological problem yet or they'd raise it.
But Scott raises an interesting theory that would be enough to explain ivmmeta.com. Since it was only ever weak evidence that is enough for me to change my mind.
The establishment very clearly does do this, and it's why the whole playbook you listed works in the first place.
I haven't seen any of these. I just run into irrational and offensive people like you that accuse me of wanting to drink bleach when I bring up the topic of Ivermectin.
This article removed all doubt for me. I needed to see the thought process while pouring over the studies.
You shouldn't make so many assumptions about people based on your political bias. Some people want to understand. That doesn't make them foolish or antivaxers.
So go study medicine, assuming you have 10 years to burn and are willing to take a massive pay cut.
The average HN'er probably knows how to program a computer and some of them may even know how to program one well.
If a guy that runs a fishing boat with not even the most basic idea about programming, hardware, software, satellite systems, general relativity and integrating all of the above into a working solution came to them with a request to really understand how his GPS works before he would put it to use we'd likely tell them to just trust the experts.
It's not quite the same. The people who build / maintain GPS have a lot more reason to trust them, and as a result, people do.
Until a while ago, if I recall correctly. GPS was <<lying>>. Its accuracy was deliberately hobbled to within tens of meters in order to prevent it being used for destructive purposes, I believe.
Did the GPS system know your position with a much greater accuracy ?
Yes.
Did the GPS system by design not provide this accurate information and instead sent something less accurate?
Yes.
How do you call that thing where you tell a partial truth? At best, a half truth.
For example the US government remarks about masks in February 2020 (I think it was February), were partly true.
It's trusted because it's been far more trustworthy than public health guidance and policy. And the same goes for airplanes, brake pads, and other tired comparisons. Trusting one does not imply one should trust all other proclaimed experts in all other fields in all other contexts.
That's a tautology. It's more trustworthy because it hasn't been politicized.
For things that aren't so obvious, the explanations need to be made more clearly.
> So “believe experts”? That would have been better advice in this case. But the experts have beclowned themselves again and again throughout this pandemic, from the first stirrings of “anyone who worries about coronavirus reaching the US is dog-whistling anti-Chinese racism”, to the Surgeon-General tweeting “Don’t wear a face mask”, to government campaigns focusing entirely on hand-washing (HEPA filters? What are those?) Not only would a recommendation to trust experts be misleading, I don’t even think you could make it work. People would notice how often the experts were wrong, and your public awareness campaign would come to naught.
> But also: one of the data detectives who exposed some fraudulent ivermectin papers was a medical student, which puts him somewhere between pond scum and hookworms on the Medical Establishment Totem Pole. Some of the people whose studies he helped sink were distinguished Professors of Medicine and heads of Health Institutes. If anyone interprets “trust experts” as “mere medical students must not publicly challenge heads of Health Institutes”, then we’ve accidentally thrown the fundamental principle of science out with the bathwater. But Pierre Kory, spiritual leader of the Ivermectin Jihad, is a distinguished critical care doctor. What heuristic tells us “Medical students should be allowed to publicly challenge heads of Health Institutes” but not “Distinguished critical care doctors should be allowed to publicly challenge the CDC”?
I think it is horribly demeaning to respond to someone asking how GPS work by saying "you can't try to understand without years of training, just trust us." That is exactly the kind of response that alienates people and fosters mistrust.
https://en.wikipedia.org/wiki/Pierre_Kory
Really, in a just world that guy would lose his license to practice medicine. I find it interesting that 'the lone voice' has such a power over 'the establishment', as though the lone voice is always right because they're the underdog.
There is an excellent movie about the theme of an infectious disease where some blogger/journalist goes all out on promoting 'Forsythia', a medication that does absolutely nothing against the disease, but that - using the exact same mechanisms as Ivermectin, HCQ and others - gets promoted to the hilt. I'm not sure if this is life imitating art or some kind of coincidence but it is uncanny to which degree the stories overlap:
https://www.imdb.com/title/tt1598778/
We so want to believe in that miracle cure that big pharma is denying us.
I mean, that's half the job of a professional programmer right there.
It's great you changed your mind but I bet there's plenty of people who haven't. Like I wonder what Bret Weinstein now thinks.
When you see someone you disagree with convinced by an argument, I think that should be an occasion for celebration and joy! People changing their minds to what you believe to be true is the only way to get change. It needs to be encouraged and people who manage to do this need recognition.
Changing your mind in polarized situations is hard! People who manage it did something impressive. Heck, even people who are willing to listen to the other side deserve recognition.
You saw someone who changed their mind, and you chastised them for not having changed their mind earlier, and for having been wrong before. That is rather counter-productive. Instead, be happy with the conversion. If you want more interaction, ask them why they believed the other thing before. Less importantly, ask them what changed their mind.
> Less importantly, ask them what changed their mind.
They wrote about that in this thread, and it proves that they do not understand the basic argument made, at all. As converts go, it's a pretty sad case.
The author of this article did a fantastic job, but all it has done for me is to show how hard it is for people to digest information and to draw meaningful conclusions from it.
On another note: this is why I'm not particularly hopeful about humanity getting their act together with respect to climate change.
Nothing this article says is new. This is all old hat.
That simply armchair science blogging psychiatrist's hypothesis. He even admits as much,
>But this theory feels right to me. It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!
None of the studies looked at worms. It is correlation == causation logical fallacy to conclude this based only on speculation. If you want to start arguing with that approach there is no bottom as there are just as many correlation == causation counter examples like https://i0.wp.com/noqreport.com/wp-content/uploads/2021/09/I...
You simply cannot dismiss that Ivermectin only works because worms until you have studies proving that. You can only say that it works, but you're not sure about why. Good to see that even after he cherry picked all the studies as hard as he could, he still had to reach this basic conclusion.
No, there is data that might point to a positive effect, that's something completely different than data that proves a positive effect.
Note that this is exactly how these things happen, someone writes something with a particular audience in mind and then others will come along, cherry pick it, distort it and then pass it on as fact. You are step #1 of the Chinese Whispers game and it has already meaningfully changed.
Meanwhile over the last 11 months most of the vaccines have been extremely effective at reducing hospitalization and death. My 3yo son caught COVID from one of his classmates at preschool - my wife and I are fully vaccinated - and we were both able to avoid an infection while under quarantine with our son.
Most people who care about this research are indeed crackpots, unfortunately. Those who aren't have mostly moved on from Ivermectin because they have better things to do. Ivermectin is being tested in large RCTs, as it should. If it works, it will be used. If it doesn't, it won't. Until we know, doctors will do what works.
In the meantime, pharma companies can extract their profits from the more expensive vaccines.
I’m not a conspiracy theorist, but genuinely curious why these trials are so far behind the vaccine trials?
Despite the fact that it appears those studies were honest, and picking up an actual factual effect. Now it turns out, laughably in hindsight, that the effect is probably whether people had parasites or not and I hadn't thought of that. But it isn't obvious how I'm going to figure that out without someone pointing it out to me. Ideally on YouTube where there are some really good channels covering COVID, often with actual doctors involved.
No-one else seems to have figured it out either, given I've seen lots of people shouting at each other and none suggested it as a possibility.
[0] https://support.google.com/youtube/answer/9891785?hl=en
No, that's just a hypothesis. To move that to 'probably' would require a very carefully designed study.
But that's a fine point in that case. And most people who talk about these studies will violate the policy by a wide margin, rather than doing a well rounded analysis.
You can't deliberately encourage people to take Ivermectin. But JUST citing a study wouldn't do that. Especially not with all the debunking of the other stuff.
"I have reviewed these studies, they seem sound and there are no real downsides to taking Ivermectin. I can't think of any reason not to take it. I don't recommend taking it, maybe I haven't thought of something" is a position a reasonable person could come to after browsing through the available evidence. Are you absolutely sure a video like that would be kosher on YouTube?
It sounds extremely disingenuous to me, just typing it out.
I can't speak for Youtube, but that's my take.
(I have somewhat less confidence in my second opinion about ivermectin, which is that precisely because it's so safe, it's vanishingly unlikely to have antiviral effects at those doses. That's something I could easily be wrong about because I'm not an expert.)
Your eagerness to jump on to this idea (which is a cool theory, and isn't meritless, but it should be stressed is a theory that a psychiatrist and social commentator came up with) makes me think you should be wary of how personally susceptible you are to what I'm going to call "fetishization of contrarianism". It's fun to be right, and fun to be right when other people are wrong. It's cool.
But its easy to move from "I don't implicitly value what experts say" to "I implicitly distrust so-called experts", which you appear to be doing throughout this and other threads. You've further jumped from what could uncharitably be called a conspiracy theory to a counter-conspiracy theory. Scott even presents his idea as, essentially a conspiracy theory:
> It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!
"everyone was wrong", look at me, I'm right, here's a fantastic narrative that perfectly ties up all the loose ends. He looks smart and cool. And you do too[1] if you agree with him. But, to keep on theme, this is a brain worm. (and since we're on a Scott Alexander post, I'll tie this into the broader theme of rationalism) And it's a brain worm that I think a lot of people who otherwise think they're rational/rationalist fall for. The conventional wisdom is, usually, mostly right. Not always all the way right, and sometimes really wrong. But usually, it's most of the way there.
This makes alternate modes of thinking really boring, because despite all the fancy self-reflection and attempts to be superior, you're going to draw relatively few conclusions that are all that different from the mainstream. So what's the point? Either you do all this work for a marginal gain, or...or...or, well what if the conventional wisdom is actually wrong a lot more often? What if the experts are misleading us? What if the experts fall into thinking traps that make them wrong all the time? We shouldn't just disregard the experts, we should actively distrust them and assume the opposite! This opens up lots of possibilities for cool ideas. Incredibly compelling narratives, narratives where you can say that everyone else was wrong, and you were right. You can be a hero, or at least feel like one. Outsmarting the experts is cool, and knowing things first is cool. It's cool. And the "problem" with this is that sometimes you'll be right. The government is spying on citizens illegally. Snowden was right. And Ivermectin might have a small effect on covid, and even cooler it might be due to worms! But there have been tons of quack covid cures (HCQ, bleach, silver, etc.) and not every conspiracy theory about the government is true, even if the narrative would be cooler, because we distrust the government and the profit motives of these corporations, and that makes us want to distrust everything they do.
But the world is more boring than that, and even though the contrary opinion is true sometimes, usually it isn't.
[1]: Another, potentially equally compelling take here is that Scott's presentation here has allowed you to change your mind without admitting (even to yourself) that you were wrong! Because as he presents it, you weren't "wrong". We really, really dislike doing that, but this way you don't have to. The data did/does show an an effect for Ivermectin. You were right. That the effect was due to a "global" confounding factor allows you to change your conclusion without admitting that you were wrong in how you did the analysis. Like, whether or not you were wrong, the people who disagreed with you were right: it's unlikely that it would be helpful for your mother or whomever to take Ivermectin. The rational thing to do here woul...
...
>Most people who care about this research are indeed crackpots, unfortunately.
Where is the evidence to support this statement?
> Those who aren't have mostly moved on from Ivermectin because they have better things to do. Ivermectin is being tested in large RCTs, as it should. If it works, it will be used. If it doesn't, it won't. Until we know, doctors will do what works.
https://www.youtube.com/watch?v=ObTAOvgd_JE
Why did this post get flagged on HN?
https://imgur.com/a/GgDVfNe
Please think about that for a while...
Most of the world understands this. It's mostly in the USA that we deify doctors. Few have first-year statistics competency, or can critically read a publication. And that's fine - it's not their profession.
I think youtube is great for showing people DIY stuff, for home videos and so on, but it has clearly allowed itself to be hijacked as a platform for politics and it was/is ill prepared for the attempt at weaponizing the immense audience that it commands.
I fear that if it had any name except Scott Alexander's attached to it, it would have been flagged/dead on here within a few minutes as well.
It will be a straw man, but it is statistically like that:
They may start by how research grants decide the results of studies and thus your study is one of those payed ones, but then jump ship and go that this sea snake extrude homeopathy will treat covid, just go look it up yourself, and then even if there is a “paper” for that, it is from goddamn Atlantis with no peer-review and was tested on 2 parrots.
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?
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.
"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.
Proof please
Maybe you think Fauci changed his mind based on new evidence on mask effectiveness, but he literally says he advised against masks due to a fear of PPE shortages, and not due to changing evidence. So either way he lied: either he lied about mask effectiveness thus spreading health misinformation, or he lied about why he advised against wearing masks thus undermining public trust in his advice.
Fauci admits to moving the goalposts on vaccination rates and explains it's because of his "gut feeling that the country is finally ready to hear what he really thinks":
https://www.nytimes.com/2020/12/24/health/herd-immunity-covi...
I could dissect these even further and point out numerous other instances, but these are egregious enough to undermine public trust IMO. Public health officials should not be deceiving the public, they should be above reproach.
You have a peculiar standard for truth, it seems to depend on which side of the debate someone is for the person to be held to the 'lily white' standard or the 'can shoot someone on broadway and get away with it' standard.
Riddle me this: If Fauci had said 'masks work but we need you all to hang back and not buy them because we need them for the medical profession' resulting in a mass run on masks resulting in even larger numbers of death in care workers how would you view him? Is there any way in which according to you he could have discharged his duty without engaging in lies (white or otherwise) to get to a desired effect without further collateral damage?
Yes, they were wrong to lie. Not that your false equivalence is in any way relevant because Fauci is a public servant of the people, and parents are not servants of their children.
> You have a peculiar standard for truth, it seems to depend on which side of the debate someone is for the person to be held to the 'lily white' standard or the 'can shoot someone on broadway and get away with it' standard.
There's nothing peculiar about wanting public health officials to not deceive the public about public health, which is their duty. What bizarro world do you live in where this is ok? In no other country on Earth did public health officials do this, even though they were facing their own PPE shortages.
> If Fauci had said 'masks work but we need you all to hang back and not buy them because we need them for the medical profession' resulting in a mass run on masks resulting in even larger numbers of death in care workers how would you view him?
I would view him as an honest public health official who did his duty, which is how I view the public health officials in my country who didn't lie to us, and where no such disaster happened.
> Is there any way in which according to you he could have discharged his duty without engaging in lies (white or otherwise) to get to a desired effect without further collateral damage?
Yes, and this has been explained ad-nauseum by people with legitimate criticisms of Fauci, although of course, even such legitimate criticisms are simply brushed off as partisan posturing, just like you're trying to do now.
During the PPE shortages, there was plenty of coverage about how to make your own mask. Plenty of commercial outlets voluntarily limited PPE purchases. Non-binding recommendations from public health officials could have encouraged such policies, and also provided official guides on making masks until PPE supplies were replenished.
Now I want you to look in the mirror and ask why you're trying to cover for him? What public purpose does it serve? This public servant lied to the public, and has lost the public trust even according to polls. The only people covering for him are die hard Democrats because he gave Trump the proverbial middle finger. Is that "credential" really more important for a public health official than the public trust?
Personally his first reasonings were more sound and his later backtrack was a lie.
Whichever one you believe, one of them was a lie, admitted by him.
Medical science made the claim that multiple sclerosis was "female hysteria," until imaging technology was able to see the damage. A doctor I know today claims that a lot of patients symptoms are really psychological and everyone at work is annoyed when they come in. When I brought up the case of multiple sclerosis, and maybe many patients have disorders which are not known to medical science because they are dismissed in the same way, I was met with a "that's ridiculous" defense. When I pressed further and ask for evidence on that point, I was given the fact that these patients with unexplained symptoms are highly correlated with anxiety. When I asked if having an undiagnosed medical disorder, and being told by doctors who clearly don't want to help you, and are clearly annoyed you are there, that it's all in your head might give someone anxiety, it was not well received. Medical science comes to all kinds of BS conclusions about the unknown without a shred of evidence.
What would you say about the FDA's recent approval of aduhelm? Do we know that it works "for certain"? Or is the FDA not part of the medical science establishment?
Aduhelm's approval basically came about in violation of the FDA's processes, so it's hopefully merely a one-off example of corruption rather than a harbinger of the death of science at the FDA.
Unfortunately I read papers that do this, all the time. Science in general not only makes claims well beyond what's known for certain but does it so consistently that vast numbers of people, including many scientists themselves, have lost sight of the scientific method and have normalized bad, unscientific behaviour.
And this is ultimately how you end up with more than half of all drug trials being fraudulent or useless ...
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.
The site might look professional, but it still could just be another true believer. If you frenetically ban the content, more people will believe the message and more importantly disbelieve yours since it "obviously" cannot stand scrutiny.
And there are real problems here, the infrastructure to censor certain message on social media got quite effective and to believe tech companies as government contractors won't use it to spread falsehoods is naive. Not by conspiracy, it is just a dynamic government will certainly show.
Overall it was just a colossal failure of communication by policy makers, who had already eroded most of their trust before the pandemic, which then got exacerbated by contemporary journalism that felt like it had no qualms about making everything as divisive as possible for engagement.
I don't think people have lost trust in science, but politicians using "science" in this way of communication are doing a pretty good job of trying to erode that trust.
Not to be adversarial, but there have definitely been a few instances which are just censorship and not moderating misinformation. And there are definitely some hot topics on which I will flat out ignore research, because I know only some conclusions are allowed and publishable.
I think it's pointless to discuss specific examples - my point is, it's not only an issue of managing trust, because the science doesn't deserve that trust.
There is a degree of nuance that is definitely lost when people say to trust the science, which is to say that the rigorous process is what is generally trusted, but that isn't how it is communicated which is why "trusting the science" is probably a slogan that does more harm than benefit. For example it is sort of tone deaf to say that now, after how science experts have handled the first part of the pandemic, or how science has been used to justify things like the oversubscribing of opioids, or what they have said regarding nutrition (sugars vs fats), or carbon emissions and even smoking in the past. Politicizing science taints science more than it benefits politicians, but since they don't bear the costs of that erosion of trust, they will continue to politicize it.
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).
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.
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.
He sees a slick and well-presented site on a topic that is not only politically fraught, but well known to have a massive propaganda effort behind it, and he just completely refuses to even consider questioning it as a source? That is reckless beyond words.
I don't think that paragraph is as complimentary as you do.
Indeed, the entire article is a systematic rebuttal of ivmmeta's claims. Rebuttals are more convincing if you treat the topic in good faith rather than assuming fraud from the outset.
I don't understand how you can see this as "reckless beyond words" when it seems like exactly the sort of systematic analysis that we need more of.
> Putting aside the question of accuracy and grading only on presentation and scale
99% of the time when you can tell from their other posts what politicians and parties they vote for, it is the politicians and parties that work tirelessly to block any attempt to have the government provide chemotherapy and insulin.
If by oral treatment you're talking about Pfizer's drug, it works the same way ivermectin does, except not as effectively. https://www.youtube.com/watch?v=ufy2AweXRkc
As of now, I don't see a single mention of protease in either the article, or this HN thread.
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.
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.
So anyone calling it horse paste, horse medicine or even focusing on that makes me question their intelligence.
Sure, it's used in humans too. But there are people dosing with equine supplies.
Differences can be that not all the preparations contain only the one active ingredient. Dosing appears to be whole other kettle of fish, because understandably people have no idea what a therapeutic or prophylactic dose actually might be - because as far as we know there isn't one for coronavirus.
A number of people—probably not including myself, if I'm honest—would take this statement more seriously if it wasn't a complaint that a thing which has already happened, and continues to happen, isn't happening.
Seriously. There are trials for any number of medications underway, including Ivermectin. There is, at the point, no evidence whatsoever to suggest it is being unreasonably withheld in any way. The cult of "magic miracle cure" that has built up around this one particular drug is fucking terrifying
There is a plenty of evidence for that. We can start with censorship of ivermectin on social platforms.
> The cult of "magic miracle cure" that has built up around this one particular drug is fucking terrifying
That's a perfect definition for people believing in phizer and moderna.
That's not evidence that scientific information about ivermectin is being withheld.
> That's a perfect definition for people believing in phizer and moderna.
Not really. For a start nobody thinks it's a cure.
Fortunately people sharing your approach are not having any say here so we keep HackerNews a civilised place where all opinions expressed without arrogance are having light of day.
Of course that kicks the can down the road: what exactly is known to be false and what is not? But we have a pretty good idea in the case of the flat earth and I think that other cases will lend themselves to such analysis. Holocaust denial is a nice example, Hillary Clinton running a pedophile network from a pizza joint is another. 5G phone network used for mind control and so on.
All of these share the trait that reasonable people would - I assume, true - agree that these things are not true and that those that spread this do not have our best interests at heart, either through stupidity or malice.
As I was reading the article, this is really what leaped out at me. There are lots of people and doctors who think ivermectin works. It's clearly a question worth investigating. Why are all the studies based on 50 people in Bangladesh?
That, in turn, is very strongly connected to the cost of running drug trials that will get past the FDA and patent rights. So it's not surprising that people end up being very cynical about this.
https://clinicaltrials.gov/ct2/show/NCT04885530
IT is slower than most would like, but it is one of many in a long list of publicly funded studies.
https://www.nih.gov/research-training/medical-research-initi...
Like dexamethasone, remdesivir etc etc
You are trying to make a personal offence and claims without any references. That sounds like a blind repeating of the narrative, even if it wasn't intended to be so.
Here's the major question I have for folks like yourself who are still on about ivermectin though - why?
Why are you invested in this one particular pharmaceutical? What is it that makes you think this specific chemical, which has been looked at and found not to be particularly beneficial for covid use, stands out from the other things which have been looked at and not found useful? Why are we allowed to dismiss and move on from them but not from this?
As for your question, let me give you a very simple answer. As a layman in certain area, I see few facts - several families who I know in person chose to take Ivermectin as part of their treatment when family member contracted covid. All of them successfully recovered from covid.
And at the same time, a person I know lost 2 legs shortly after "safe" jab due to blood cloths. Doctor said that if he wouldn't intervene and put him in ICU, he would be dead by now. Another person got cardiac arrest after jab (being 24yo) and was paid a lump sum (more than $200k) by government to suck it up and keep his mouth shut.
Certainly I am not going to draw any conclusions from those observations. Except one - why Ivermectin is so actively dismissed and the pharma jabs are so actively promoted? There is clearly some evidence ivermectin does help, but we have no means to know at what extend or at what price. This atmosphere of ignorance and narrative-pushing has nothing in common with intellectual curiosity, which is something we have to use when dealing with challenges like covid. Sadly not many of us are capable of that.
Are you aware that this doesn't constitute any sort of evidence about ivermectin's effectiveness?
> a person I know lost 2 legs shortly after "safe" jab due to blood cloths.
Are you aware that coronavirus causes clotting much more frequently than the vaccine? I'm sorry for your friend, but if this were commonplace then every other person in the street would be an amputee, given how many billions of doses have been administered.
> Another person got cardiac arrest after jab (being 24yo) and was paid a lump sum (more than $200k) by government to suck it up and keep his mouth shut.
So how do you know about it? Wasn't a very good gag order then was it if you know and are spreading it on the internet? I'm just going to say it - I don't believe this story.
> why Ivermectin is so actively dismissed and the pharma jabs are so actively promoted?
Well because Ivermectin hasn't been shown to do anything for covid, but quacks are promoting it online. The vaccines, on the other hand, have been tested and found to be a useful way to reduce the consequences of the pandemic. A pandemic that's killed millions so far. So those are pushed. I mean seriously - how weird is that? Who would ever think, something that's been shown to help in a worldwide health crisis, and it's being pushed!
By the way, ivermectin is a pharma product too.
> There is clearly some evidence ivermectin does help
Where do you draw this from? This is not clear at all, this is a bland assertion.
> This atmosphere of ignorance and narrative-pushing has nothing in common with intellectual curiosity
I agree - you have shown no intellectual curiosity there, asking for studies to be done that have already taken place and you could easily find, and throwing vague allusions about cover-ups around. This isn't intellectual curiosity, it's clinging to a conspiratorial narrative. Perhaps you could use your knowledge of psychology to figure out why you prefer this narrative.
I'm aware of frequent vaccine complications, but haven't heard of government doing any payouts.
Long answer - quite a significant number of people are resistant to vaccines, particularly to mrna-based ones. Government offered voluntary vaccination and managed to vaccinate around 50%, after that different coercion and segregation measures (mandating without actually mandating) were used to raise the number to 94% (among eligible population).
Disappointment is starting to grow lately because despite total vaccination there is no removal of restrictions. While being reasonably open with data, government still plays with it - once vaccinated ppl become constituting majority of cases among fatalities they just stopped reporting how many vacc/unvaxx were among fatalities. This leaves people frustrated and disappointed in govt approach to tackle covid, particularly in this "vaccinate everyone" idea.
A lot of resistance spotted in people 60+, younger generation mostly just goes for shots.
I wonder if older gen has seen enough to not take everything at face value.
Younger generation remained hesitant but government insinuated huge social pressure in schools and colleges. My spouse's 14yo son was initially very resistant to vaccines and we supported it, but immense peer and school pressure pushed him to get the jab.
Additionally government mandated vaccination in cafes and dining venues so younger generation just sees it as obstacle for fun and getting it easily. At younger age you don't think about long-term effects.
TFA found that more reliable studies found it was helpful than not. You are the one who is anti-science.
So I'll revise - studies have been done, but no conclusions about positive efficacy can be supported.
"I think the conventional wisdom - that the most extreme ivermectin supporters were mostly gullible rubes who were bamboozled by pseudoscience - was basically accurate."
I don't think i've ever mocked any ivermectine taker (at least not for taking a medecine that may help some of his problems), and most "vaxxed" didn't either. And i'm aware than not all unvaccinated people are anti-vax (my brother is waiting for the Valneva himself). But as long as people tell me "look at the data", i will send them the data from the least vaccinated country in europe, Bulgaria (i even have a quick link on my phone), and ask them to explain to me their mortality rates, and grin a little. I'm not really mocking them, i just like seeing people trying to justify themselves, i find it fascinating. Note that i like seeing this in the "i fucking love science" crowd as well (people really have trouble explaining the moon's crescents, it is really funny), but as this is a novelty, it have more potential.
If you don't have that difficulty then you probably haven't thought about it long enough - yet.
You think Pfizer and Moderna are somehow coordinating a global censorship campaign to defend that income? Sure, Pfizer's projects $82 billion in revenue is real money. But it's less than half of Amazon's income. Facebook brings that much in every year. Apple and AT&T crush these numbers, but nobody's going around deleting every tweet about how Mac OS has gone downhill or AT&T's cell service sucks.
In other words, it's just not enough money to have this kind of pull. Even if Pfizer and Moderna were lying their asses off to everyone who would listen, they just don't have the cash to buy off every medical expert and microbiologist of any standing -- and even if they did, the relevant government agencies can't accept hush money and aren't particularly interested in advancing some cartoonish corporate ruse.
Biological and medical research is a competitive field; most of these people slogged through six or eight years of underpaid postdoctoral work just to build the qualifications to participate in meaningful research as PI. Are there crooks who will take a check to parrot a party line? Sure. Is that common enough to enable the kind of overwhelming consensus we see today? Absolutely not ... but let's say I'm wrong: there just isn't enough money to pull it off.
This is why the current crop of conspiracy nuts insists the scheme isn't just about profits but also about some kind of vague assault on unspecified civil liberties -- it's necessary to ascribe actual evil to the movitation before it's even remotely believeable.
The motivations, rushing of everything could be just aligned enough to cause all of this. Safety studies excluding some participants, some important data. All you'd have to pay off is to exclude certain data, for which there are ALREADY reports coming out for. For example Maddie de Garay's injuries excluded, there's report of someone else's vaccine injury being excluded from the original study.
BMJ coming up with the article of falsified data etc.
The way Pfizer reportedly conducted side effect studies. E.g. asking participants to report their side effects on 7th day in the app without any freeform text or custom symptoms - only predetermined symptoms. For any custom symptom you had to contact the doctors, who may have just ignored you or determined your symptoms to be irrelevant since they didn't have motivation or time to deal with you.
Pfizer just pressuring subcontractors just enough for them to provide data that favours vaccine safety, and there's just not enough time to double check everything so all of it just flies by.
Mainstream media has reported absolutely none of it. None of the excluded participants, nothing about the BMJ article. Nothing about how Pfizer conducted the studies. Everyone is clueless about that. There's already so much PR built towards hating "anti-vaxxers" and considering them uneducated and unintellectual, so the word "vaccine" is already associated in everyone's mind as something good, safe and effective. The PR is already there, you just have to work out something that you could call "vaccine", and help out people in the current very desperate situation.
Very few are actually closely looking into the data and there are actually plenty of scientists and doctors talking about it, but they are getting debunked using very superficial arguments and just finding anything slightly wrong or misleading about what they are saying and they are immediately considered "debunked".
Similarly during 2008, very few people were predicting this crash and everyone just wanted to pretend together that everything was going well. All the experts, economists etc. And human anatomy is somehow simpler than financial system?
> "Sometimes these people even have a specific theory for why elites are covering up ivermectin, like that pharma companies want you to use more expensive patented drugs instead. This theory is extremely plausible. Pharma companies are always trying to convince people to use expensive patented drugs instead of equally good generic alternatives. Ivermectin believers probably heard about this from the many, many good articles by responsible news outlets, discussing the many, many times pharma companies have tried to trick people into using more expensive patented medications. Like this ACSH article about Nexium. Or my article on esketamine. Given that dozens of studies said a drug worked, and elites continued to deny it worked, and there are well-known times where elites lie about drugs in order to make money, it was an incredibly reasonable inference that this was one of those times.
> If you have a lot of experience with pharma, you know who lies and who doesn’t, and you know what lies they’re willing to tell and which ones they shrink back from. As far as I know, no reputable scientist has ever come out and said ‘esketamine definitely works better than regular ketamine’. The regulatory system just heavily implied it.
> I claim that with ivermectin, even the people who don’t usually lie were saying it was ineffective, and they were saying it more directly and decisively than liars usually do. But most people can’t translate Pharma → English fluently enough to know where the space of “things people routinely lie about and nobody worries about it too much” ends. So they incredibly reasonably assume anything could be a lie. And if you don’t know which statements about pharmaceuticals are lies, “the one that has dozens of studies contradicting it” is a pretty good heuristic!"
> I claim that with ivermectin, even the people who don’t usually lie were saying it was ineffective, and they were saying it more directly and decisively than liars usually do. But most people can’t translate Pharma → English fluently enough to know where the space of “things people routinely lie about and nobody worries about it too much” ends. So they incredibly reasonably assume anything could be a lie. And if you don’t know which statements about pharmaceuticals are lies, “the one that has dozens of studies contradicting it” is a pretty good heuristic!"
We currently have a unique situation. Never in the world have scientists, experts or doctors been as pressured to direct people to current vaccines. There's a clear risk to losing your credibility and your job if you were to contradict. Even if you were to think that something may be wrong, it would be a herculean task for you to prove it and is it really worth it to sacrifice your career and everything else? Maybe you are just 50/50 or 80% sure, and incase of that 20% uncertainty you definitely don't want to risk your life work.
Also chicken and an egg problem. Anyone who claims current vaccines are unsafe or ineffective are discredited, so after they have made their claim you can just call them misinformation spreaders and tell again "no credible scientist has said X" and if that credible scientist says X, you will just stop considering them as credible.
But my point is more oriented towards vaccines than Ivermectin honestly. I'm not a proponent of Ivermectin, but I'm just trying to discuss what results might current motivations in the world yield, and I believe it's definitely possible that Ivermectin COULD be improperly discredited in current ecosystem of everything.
With all the social pressures, dire situation, debates being blocked, people labelled immediately misinformation spreaders if their conclusions don't fit the mainstream narrative, I would say very many untruths are possible.
I myself can't trust MSM at all any longer, and I am 95% sure that vaccines are not as safe and effective as MSM is trying to portray them as. I don't know exactly how unsafe or how ineffective they are, but that's mostly because proper debate is not allowed. Until this clears up, I'm going to skip on vaccines.
Needs to come up with some compelling evidence. That's what your evaluation is missing.
Would excess deaths in summer in 0 - 45 age group, in Europe be compelling or is there some other explanation to those?
For preventing spread ineffectiveness, would Gibraltar being #2 in the World by infection rate while having 99% vaccination be compelling?
For waning hospital and death protection would Israel data be compelling?
What about countless anecdotal stories of similar persistent adverse effects and VAERS reports?
If none of that is evidence, then even if this vaccine was unsafe, it would be virtually impossible to prove that, no?
I don't know, what figures are you referring to and what do you think those are evidence of?
> For preventing spread ineffectiveness, would Gibraltar being #2 in the World by infection rate while having 99% vaccination be compelling?
Taken in isolation, not particularly, no. What you appear to have there is some vaguely formed speculation.
> For waning hospital and death protection would Israel data be compelling?
Be specific, what claims are you making and what evidence do you think backs them up?
> What about countless anecdotal stories of similar persistent adverse effects and VAERS reports?
Perhaps you could count them, and investigate to understand if the anecdotes and VAERS reports are true or not, and at what rate they occur. VAERS is by design a catch-all and self-reported, so the data there is interesting but not necessarily trustworthy. Anecdotes are not data, after all.
But let's just focus on what could be causing excess deaths during summer.
Source:
https://www.euromomo.eu/graphs-and-maps/
Scroll to Excess Mortality
See 0-14 age group excess mortality growth during summer (EU approved vaccines for 12+ in May). There has been similar rate variance in winters, but this can be explained by bad flu seasons, there's no such variance ever during summer. If vaccines really were the cause, it means only 12-14 group should be affecting the rate, this means that with 0-11 the growth could be 4x that assuming linear relation.
Also see 15-44 excess which has never been climbing that fast and is much higher than previously in total. You can also include other years from 2016 to compare.
These may not be vaccines, but what is causing this then and why specifically in younger demographics?
I'm honestly looking to understand what could be the explanation here.
According to your graph, excess mortality for ages 0-14 for this year is lower than it was in 2019, before the vaccine or the pandemic hit. And the excess mortality in the 15-44 age group is maybe 5000 people across 28 countries. Without knowing the variance in previous years, which is not given in those graphs, that's meaningless and could easily be down to the disease itself. I personally know a lot of people in this age group who have come down with the disease now, as they are starting to go out and socialise a lot more than they were a year ago. It's hard to see how the 'normal range' is calculated on the pooled deaths graphs as there only appears to be about 4 years data there, which is not a lot to go on.
So as I said before, what you have here is vague speculation. You can't tell from there that anything unusual is necessarily going on at all, let alone what might be causing it.
I was strongly pro-vax before that, and I was debating anti-vax people.
Why would I want to make such a decision that would make me be hated by so many, stress me out of my mind, make people think I'm some sort of anti-science or anti-intellectual, etc?
If covid vaccines are truly safe and effective, I would have 0 motivation to believe in some sort of conspiracy, or not take it.
which doesn't mean kids were vaccinated at any relevant rate at that point. In plenty places they only started that August or thereabouts. There has been some talk of delayed infections with various things due to school closures etc before, I do not know if that had any relevant impact on death rates though, but would explain why they shifted to later in the year.
> and why specifically in younger demographics?
Looking at the 44+ ranges, those are way more above or close to "substantial increase" - as you would expect with them at being higher risk from covid. Higher vaccination rates help, but aren't entirely stopping it. Potentially also some other medical factors, not aware of any good data on them (i.e. delayed treatments, risky delayed treatments now happening, ...)
> Also see 15-44 excess
Delta is affecting them more, for at least part summer you can't assume them to be vaccinated yet (and even today, in the badly hit places the vaccination rates are far from perfect - here in Germany "people in hospital" and "percentage unvaccinated" correlates quite well between regions). Delayed treatments again might hit here too, again unsure if relevant.
Could there be something hidden in there: sure. But it doesn't seem all that obvious that anything is weird about these numbers.
But maybe delayed treatments, risky delayed treatments now happening could have something to do with it potentially. Also there were talks about child suicides.
> According to your graph, excess mortality for ages 0-14 for this year is lower than it was in 2019, before the vaccine or the pandemic hit. And the excess mortality in the 15-44 age group is maybe 5000 people across 28 countries
See week 18-42, for 0-14 age group. Yes it has barely got to 2019 levels, but consider that beginning of year they died much less due to lockdowns, so summer high rate was enough to make up for 2019 where both winters the starting and ending saw very high climb. Again, it's about having that type of velocity during summer, not winters. It's 500-800 children compared to other summers. Since 3 millions of vaccinations given out it could mean around 1 out of 6,000 deaths per vaccination.
So all in all, it wouldn't be possible for me to prove it even if vaccine was causing a lot of harm? Because what else can I use besides excess deaths (as much data that as it's possible to gather), adverse event reporting tools etc, anecdotal stories. There's just no way.
To myself, there are too many signs pointing towards it, but I guess there's no point to really crusade at all even if it is causing harm.
It could, or it could mean something else entirely, and it could be within normal trends. Which is what it looks like to me if all cause mortality is lower than 2019 levels.
> So all in all, it wouldn't be possible for me to prove it even if vaccine was causing a lot of harm?
Not from this data, no.
> Because what else can I use besides excess deaths (as much data that as it's possible to gather), adverse event reporting tools etc, anecdotal stories. There's just no way.
Real research and analysis, not "I looked at some very high level graphs with fairly shallow data and decided that it fit my preconceptions".
If you're thinking "I don't have easy access to that information, and I don't have the time or the funding to investigate", you're quite right. Medical researchers will have to carry the can here.
Yeah, unfortunately, I've lost all my trust in anything that comes in from mainstream. I was to vaccinate myself, but then I found contradicting information, and from there I couldn't stop going to the rabbit hole, because this doesn't make sense. Mathematically and statistically if mainstream was only telling truth, what I'm seeing should be impossible.
It's a terrible situation for me to be in as it stresses me daily, ruins my focus and depresses me. Either I'm crazy and worried about nothing or things generally in the world are not going well and people are in mass hypnosis. Neither is a good side to be in.
Dodged a bullet there! How fortunate that you went to look for contradicting information, what are the chances?
...what you've identified is not enough to draw any conclusions from, at all.
> Either I'm crazy and worried about nothing
This one. The vaccine is not killing people in significant numbers, but the virus is. Stop worrying, get vaccinated, get on with life.
And mainstream media has not talked about these side effects at all so I fully believe side effects are not being reported and what are reported is probably with less frequency, it's just difficult for me to tell what the exact frequencies of different side effects are.
I have got pretty obsessed now with trying to understand what the frequencies are, there's so much conflicting information.
If I had to guess I'd guess that there's some sort of age cut-off where harm may be greater than benefits. It would also highly depend on how social person you are and how much in risk situations, as if you are someone that works remotely, doesn't go out at all, and not in a risk group, then I don't think there's point in taking the vaccine.
For another viewpoint: if everybody was vaccinated there would be 7000 people dying the day after they got vaccinated for the USA alone. But that wouldn't mean anything at all, the big question is which of those deaths would not have happened if the vaccine had not been administered. So interpreting VAERS data in any other way than relative day-to-day is not very useful absent further background into those particular cases.
It's children that have not been vaccinated in large numbers this time around.
https://www.youtube.com/watch?v=B5_gpJW7Euo
Or testimonial from Maddie de Garay's mother, also about how the trial for children was performed?
This article: https://www.bmj.com/content/375/bmj.n2635
And how many others have not come forward or been censored?
But you don't have to trust only scientists directly or indirectly employed by those companies. There are plenty of subject-matter experts who work for competitors or are tenured in academia who would have very little to lose from criticising the rollout.
I beg to differ, here is an example: Luc Montagnier, a Nobel prize recipient, has been completely marginalized after emitting doubts about vaccine safety and is now absolutely inaudible in anything mainstream.
It's just an example, there are several more. Anybody that saw how he was treated probably though really hard before emitting any dissenting opinion in public.
It feels like the Inquisition.
[0] https://trends.google.de/trends/explore?date=all&q=Luc%20Mon...
Academia is the last segment of society I trust on these topics.
I completely agree that there is a lot of bogus stuff coming out, like the perennial "hyper efficient solar cell developed in a lab" press release that bubbles up on HN every now and then. But that is just a tiny piece of science if you ask me. Also blaming 'cancel culture' for this seems lazy , there are misaligned incentives but they are more subtle.
As for the rest - well, who knows? Do I trust big bang theory? No, not really. I seem to recall it's inconsistent with various other measurements, hence the need for the enigmatic dark matter. But it doesn't matter or affect my life at all so I can easily choose not to trust it and who cares.
Where the problems start is when activists/politicians force me to "trust" self-proclaimed science that has never been through rigorous market-based mechanisms to weed out the crap. Epidemiology. Climatology. Virology. Standards in these fields are rock bottom low because nobody is at risk of losing their jobs if they're wrong, yet, I cannot simply evaluate this "science" and opt out.
https://www.nachrichten.at/oberoesterreich/entwurmungsmittel...
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.
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.
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.
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.
What it isn't, is a drug that objectively protects against Covid. Yet we have American media claiming it as such, and people selling clothing to the British with the slogan "Ivermectin. Safe. Lo-cost[sic]. Beats Covid."
Many other things also help the immune system. Adequate sleep. Balanced diet. Less stress. But I don't see any news pundits obsessing about why doctors aren't prescribing celery.
Thinking that white supremacists and Nazis are running all over the place in 2021 is pure bs propaganda being pushed by our media.
Is your point here to suggest that belief in alternative COVID treatments means you're a racist bigot?
Proof please.
Your doctor was prescribing it off label, based on personal judgement that it has therapeutic effect. That is not to say it doesn't work for scabies, I hope it worked for you.
https://www.medsafe.govt.nz/profs/datasheet/s/Stromectoltab....
I was reading the original meta-analysis[1] by the group Scott mentioned here:
> One of them later revised their results to exclude Elgazzar and still found strong efficacy for ivermectin, but they still included Niaee and some other dubious studies.
And looked into one of the studies authors, and well, it was interesting. Her submission here[2] claims that 2402 people have died due to COVID vaccinations (I'm assuming this was a 2020 submission, as the number of deaths in VigiAccess is farrrr higher now) based on data from the VigiAccess database, which has a massive disclaimer.
> The information on this website relates to potential side effects; that is, symptoms and other circumstances that have been observed following the use of a medicinal product, but which may or may not be related to or caused by that product . Information in VigiAccess on potential side effects should not be interpreted as meaning that the medicinal product or its active substance either caused the observed effect or is unsafe to use. Confirming a causal link is a complex process that requires a thorough scientific assessment and detailed evaluation of all available data. The information on this website, therefore, does not reflect any confirmed link between a medicinal product and a side effect .
And on her company's website, there's a link to a Gofundme, but if you click it you get redirected to a PDF that's... also interesting.
> After 5 months on-line, an account review and a handsome profit from our campaign, GoFundMe have cancelled our account! No notification, no warning, no explanation given. Just summarily pulled. What indecent cowards!
It then links at the bottom to an organisation she founded that accepts donations and sells sweet ivermectin swag.[3]
Sadly only ships to the UK though.
[1]: https://pubmed.ncbi.nlm.nih.gov/34145166/
[2]: https://committees.parliament.uk/writtenevidence/36858/pdf/
[3]: https://bird-group.org/birdstore/
[1]: https://www.cdc.gov/parasites/scabies/health_professionals/m...
You can't sell a drug unless it has at least one approval. Manufacturers can't advertise or say that it treats anything but the approved illness. Doctors can usually prescribe an approved drug for any other illness. Insurance may give people trouble for unapproved prescriptions.
Covid has further completed this, as pharmacies have started to refuse filling some prescriptions despite doctors orders.
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
Coincidentally:
https://news.ycombinator.com/item?id=29250580
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.
+ edit: , etc...
Thanks Cthulhu_.
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.
> 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
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.
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.
I think this is an extremely jaded take, resulting from growing up in a post-antibiotics society. The risk factor for those "scary antibiotic-resistant infections" is still an order of magnitude less than the class of diseases antibiotics almost totally eliminated. In the 30 years following penicillin's discovery, deaths from bacterial infection dropped from accounting for over 22% of all deaths to just 6% [1] (MRSA deaths, by comparison, currently represent less than half a percent). "End of disease" may be hyperbole, but between antibiotics and vaccines, infectious diseases were almost totally knocked off the leading causes of death.
The only reason why we even have antibiotic resistant bacteria is because they keep getting prescribed, because they're so damn useful. "Medical stuff" does, in fact, work like that, to some extent.
[1] https://dash.harvard.edu/bitstream/handle/1/8889467/Gottfrie...
Anti-malarial medications are not antibiotics. Malaria has never responded to any antibiotic, to my knowledge. Maybe you don't know what malaria is?
Well, until 2020. Then we had another infectious disease. Which is why we're having this conversation.
I fully agree with this view above.
I can totally understand how Ivermectin got its following— it’s an amazing general purpose medicine around the farm. I generally use it responsibly by verifying the presence of parasites before administering (which can be literally any animal on the farm with almost any parasite) … but then there are times such as when my daughter had a single pet chicken (among many healthy ones) that wasn’t looking so hot … Whereas previously I’d just dispatch the animal and be done with it, now I give a dose of Ivermectin and isolate for a few days before calling in the grim reaper. So far the success rate is something like 90% where now my 9 year old daughter administers it herself. While I acknowledge this isn’t the most responsible, I can imagine others have had similar experiences which explain some of the popularity of Ivermectin with rural folk.
Most parasites have a life-cycle that includes time spent outside the preferred host animal, including in zoonotic species that may not have symptomatic infections. They may acquire resistance in any stage, in any place they encountered the drug.
It's always recommended that you cycle through different anti-parasite treatments.
What are you against exactly? What are you saying?
What does Ivermectin have to do with antibiotics? Antibiotics can produce resistant in diseases that the body would cure naturally. A popular use of Ivermectin is to kill worms in humans, they do not just disappear naturally.
Ivermectin treats many fucking evil parasitic infections. Why are you restricting it from poor people? We use it on livestock all the time. I've used it on my goats. Google pictures of onchocerciasis, it's just evil (looking, nothing is actually evil)
It's easy to find articles about "Mass treatment with ivermectin: an underutilized public health strategy" https://apps.who.int/iris/handle/10665/269206 (This is the World Health Organisation)
> 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.
You seem to be blaming locals and saying tough luck.
I don't treat my goats that badly. We do watch worm load in the goats (FAMACHA), to cut back on resistance, exactly the same as any "global medical welfare" would... however that relates to human beings.
This is of course just a gut feeling and not a studied understanding.
I see what you did there.
But note that it's a much easier point to make from a region where parasitic worms don't exist.
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.
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.
https://www.cdc.gov/media/releases/2014/p0508-npi.html
> 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.
> 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”.
based on the rest of study design I'm less confident
This post is a breath of fresh air for the blog and feels refreshingly well-researched. Between that and the unquestionable popularity of COVID-related discussion, it’s no wonder this article is popular.
Scott is undeniably a good blog writer with an entertaining writing style that resonates with his reader base. However, I’ve become disillusioned with a lot of his other recent writings like the “Great Families” post in which he presented a lot of conjecture that pandered to his core readership without any research or evidence to support it. Specifically, his position that genetics are the primary explanation for “Great Families” while ignoring obvious heritability of things like wealth and social status. Even the old Slate Star Codex and new Astral Codex Ten communities started calling him out on it after that article.
Scott’s writings are undeniably entertaining and usually quite fun to read, but I’ve long since learned to read them more critically because his writings have a way of projecting a sort of humble confidence while either hedging any statements so much that little is actually communicated, or sometimes inserting conjecture or feelings with a lot of linguistic window dressing such that it’s easy to mistake it for fact.
I hope this article is a sign that the writings are shifting more toward the old-school, heavily-researched style that made the blog so popular.
He addresses that in the section section - besides the intro, he leads with it:
"the next generation becomes semi-famous fashion designers and TV personalities and journalists, which seem like typical jobs for people who are well-connected and good at performing class, but don't need to be amazingly bright. Sometimes they become politicians, another job which benefits from lots of name recognition.
But I've tried to avoid mentioning these careers, and focus on actually impressive achievements that are hard to fake. And also, none of these families except the Tagores were fantastically rich; there are thousands or millions of families richer than they are who don’t have any of their accomplishments. For example, Cornelius Vanderbilt's many descendants are famous only for being very rich and doing rich people things very well (one of them won a yachting prize; another was an art collector; a third was Anderson Cooper)."
If you read a few paragraphs past your quote, Scott comes right out and declares the "genetics" is the explanation that he thinks is correct:
> The other obvious answer is “genetics!” I think this one is right
He then applies some softball counter-arguments to the genetics argument to hedge and give the "both sides" treatment. However, the article is clearly structured to give a tour of possible arguments while subtly giving the most credence and the least hedging to the genetics argument. Combined with the not-so-subtle declaration from Scott that "I think this one is right" in the middle of the article, he expertly walks the reader into the conclusion he wants while making them feel like they came to that conclusion on their own after an objective tour of the research.
There are many other problems with that analogy, but they all sum up to making the 'humans' seem way more reasonable than reality affords them.
Does his theory communicate something interesting? Yes. Is it nearly as impactful as he makes it sound? Hell, no.
However, in my generation, there were lots of money problems. And they did what money problems tend to do -- delay, deny, disappoint, cause health problems, and make everything harder.
The "brains," such as they were, were still there. If we take the usual markers* of intelligence there were Ivy League admissions, Fulbright scholarships, and so on. But for me at least, not having affordable healthcare at age 20 impacted my life much more in a negative way than getting a 5 on the Calculus AP impacted it in a positive way.
I'm much less interested in the concept of inherited genius than I am in universal health insurance and free college.
*Which are themselves problematic, and often merely markers of class, but it's the best I can do here for a HN comment
> The fraud-hunters have examined this paper closely and are unable to find any signs of fraud. I think this paper is legitimate and that its findings need to be seriously considered. ... And there’s always the chance it was a fluke, right? Can something have a p-value less than 0.001 and still be a fluke?
...
> And it was! It was a fluke! A literal, physical, fluke!
Edit: If you like puns and this writing, you'll likely enjoy some of Scott's other works, like "The Study of Anglophysics" [1] and (especially if you're at least passingly familiar with Judaism and Kabbalah) Unsong [2].
[1]: https://slatestarcodex.com/2014/04/03/the-study-of-anglophys...
[2]: https://unsongbook.com/
Also in the SPOILER reveal, you could just quote ”And it was!” to show you enjoyed the setup and delayed gratification pun w/o tipping the whole game.
‘Twas a gem though.
Albendazole is also considered for treating covid.
edit : hm, I think I remember Dr. House making the fluke joke ...
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.
https://news.ycombinator.com/item?id=29250789
https://news.ycombinator.com/item?id=29140325
https://news.ycombinator.com/item?id=29140176
and so on.
I'd also be curious if any studies could be made on needle aspiration being important or not.
I said that.
> therefore I can't trust anyone
I did not say that.
> What people are telling you is that you don't really understand the bias,
What I don't understand about it?
Whether they could make more profit off this probably factors for some people but on the whole the medical profession is result driven.
Also let's accurately represent what the article is saying:
"Again and again, more people are surviving (or avoiding complications) when they get the drug. It’s a pattern strong enough to common-sensically notice. But there isn’t an undeniable, unbreachable fortress of evidence."
This to me reads consistent with "ivermectin has a reasonably good chance of working a little bit but it isn't conclusive.", which is in contrast to your statement that thinking ivermectin works is equal to quackery.
Personally I think it's either a very small effect or no effect at all, but I don't think the quackery designation fits for people who simply believe that there's some small benefit there (although I do think that label fits for those that think it can replace vaccines)
And that's exactly how it goes.
Quackery: "dishonest practices and claims to have special knowledge and skill in some field, typically medicine."
You don't have the knowledge, you don't have the skill, so don't go around giving advice about non-proven cures (or in fact, about any cures).
If you have a lot of experience with pharma, you know who lies and who doesn’t, and you know what lies they’re willing to tell and which ones they shrink back from. As far as I know, no reputable scientist has ever come out and said ‘esketamine definitely works better than regular ketamine’. The regulatory system just heavily implied it."
Just a reminder that while snake oil was a "patent medicine" there were never any actual patents involved.
When a new cure for cancer is found, we don't expect the minister of health to recommend or advise its use to the general public on TV, do we ? We assume professional MD will learn about it via their regular channel, and recommend the treatments on patients that they judge relevant.
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.”
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.
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.
That's a bit frightening, of course someone would be suspicious if results were going against his/her opinions
From further up, though we don't _quite_ know the details, but it's not like he went "Oh well some random person disagrees with them so better throw them out"
Also, the whole point of the exercise is what do you find if you apply good statistical and methodological rigor, but don't have any anti-ivermectin bias.
That... seems like cherry-picking for the results you are looking for.
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.
> 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.
> 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?
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.
Ivermectin: https://en.wikipedia.org/wiki/Ivermectin binds to chloride channels and is a nerve poison for invertebrates.
The molecular layouts look completely different.
Here is the fact check evaluation from Reuters: https://www.reuters.com/article/factcheck-coronavirus-pfizer...
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/F...
> Pfizer’s drug has protease inhibitor activity like ivermectin, but they are a very different kettle of fish on a variety of levels
and
> Dr Walter explained that PF-07321332 is a “direct acting antiviral drug”, while ivermectin “has multiple mechanisms of action on animal and human cells as well as some serendipitous antiviral activity”.
This sounds much more like "yes, but" to me than "false". And indeed, the rating given is not "false" but "Missing context". The headline is certainly accurate (ivermectin is not the same drug as Pfizermectin) but also fake news in that it is a strawman; no one has claimed that they are literally the same drug.
The interesting claim, if clearly stated, is "The mechanism of action of Pfizermectin for treating COVID-19 is as a protease inhibitor. Ivermectin is, among other antiparisitic effects which are usually more interesting, also a protease inhibitor." That claim is validated by the evidence given in the fact-check.
Moreover it's worth calling out a known lie in the fact-check (which is included entirely gratuitously as it doesn't have anything to do with the headline or the verdict or even my "interesting claim" above): "some of [the mechanisms of action of Ivermectin] could have unwanted, even dangerous side effects." Ivermectin is on the WHO list of essential medicines and is considered extremely safe, with just one known complication related to a particular parasitic infection IIRC. I can only imagine that the reporter, having not gotten any definitive proof for the desired 'false' verdict from Dr Walter, pushed and prodded until eliciting this absurd and false but politically expedient statement.
One criticism[1] of the above linked study, the one that states Ivermectin acts as a 3CL protease inhibitor, is that it uses an "in silico approach" (computer simulation).
The way that we know PF-07321332 is a 3CL protease inhibitor is via an "in silico approach".
It's important to note that the dosage of Ivermectin required to act as a protease inhibitor would be way above the accepted levels for human use.
Even still, this "animal/horse drug" rhetoric along with asymmetric acceptance of evidence is what lead me to want to understand more about the ivermectin controversy. It smells more like propaganda than science. Then, the sheer number of studies showing positive outcomes made it hard for me to accept that all the science was bad. Astral Codex did a great job of explaining why the studies were flawed.
[1]: https://www.factcheck.org/2021/10/scicheck-merck-pfizer-covi...
But I don't think that Scott has done more than offer a suggestion as to how the studies might be flawed; no matter how compelling the suggestion, it isn't evidence. Otherwise you're just consuming more nicely-dressed garbage, which is even more dangerous because you get to feel superior to those consuming the normal garbage.
What would constitute good evidence for the worms theory is, you know, a study actually studying that. Otherwise the theory is just assuming that a lot of the people benefited by Ivermectin do have worms, when that hasn't even been measured.