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How risky is this therapy?
Anticoagulants and anti-platelets increase the chance of hemorrhage in the brain.

So while they prevent ischemic stroke and help with circulation, they might cause hemorrhagic stroke. The dose and time duration has to be carefully adjusted. It’s a slippery slope in dealing with cerebrovascular accidents.

Anti platelets (specially Aspirin 80 and Clopidogrel) are less risky than anticoagulants (such as heparin or warfarin).

>a group of vocal doctors who get ignored or suppressed by the media

You make it sound so ominous. But if you look them up they have gotten a ton of coverage from all kinds of media. Pierre Kory et. al. has also published (and are still publishing) numerous articles in (non hoax/predatory) science journals. Sure they are critiqued, but that is what happens when you go against a majority opinion (disciplinary not popular).

> You make it sound so ominous

It is like a group of folks only recently discovered the marketing value of being "banned". A lot of them apparently just noticed punk rock this decade, I guess.

And so you get amazing spectacles like Bari Weiss whining about being shut of out public discourse... in the NYT and WSJ. I'm sure many of her intellectual adversaries would love to be shunned to a similar degree.

Talking about bans is not an open debate about an actual subject - it's just more dodging/suppression of dissenting opinion.

Discourse around dissent of the popular narrative is simply not allowed and indeed you are doing the same. Deflecting to talking about bans/access, rather than the pro's/con's of treatments other than just the vaccines for COVID. Gives people like you the comfort of being open minded without actually being open minded.

> Discourse around dissent of the popular narrative is simply not allowed

What are you talking about? You're dissenting right here. People do it in the national press daily, as they have been for literally years now on this particular topic.

No, what certain people don't like is that their preferred narratives aren't taken as seriously as they want. So whining about "suppressing dissent" is a more palatable explanation for their butthurt, whether sincere (as you might be) or manufactured (like I was pointing to).

My high-school band didn't suck after all. We were suppressed!

Dissenting and getting downvoted, kind of proving the point.

My experience living in a county and working in an industry that are both dominated by one particular way of thinking given to them by authority figures (CDC, New York Times, etc.) is that if you step outside that way of thinking and pose fairly innocuous questions that challenge it, two things happen: you lose all credibility, and you get called pretty bad things (racist, conspiracist, etc). That alone is pretty detrimental to pushing the envelope with hard conversations.

I have no doubt (and hear) that what I personally experience is also happening across the media and entertainment industry resulting in groupthink even inside the rooms that are supposed to be doing journalism and asking the hard questions that criticize and question authority.

As I type these words, it's almost as if the root of this is whether you trust those in "authoritative" roles, or not. And fear for ones health turns us against each other if we feel like those authoritative figures are either helping, or hurting.

Anyways. If you think what Bari does is whine, that's too bad. Of the growing band of "counter-narrative" folks (Glenn Greenwald, Bari, Matt Taibi, Russell Brand, etc.) she's rock solid in her reporting and I oftentimes feel like she's doing what journalism should be doing. Spend a bit more time actually reading (or listening) to her. She covers a gambit of topics.

> getting downvoted

In the US, you're entitled to free speech. You're not entitled to respect, or even an audience.

And I'm sorry, but if getting downvoted is political oppression to you, you need to grow some skin.

> She covers a gambit of topics.

I have read her. She's a boring and repetitive replacement-level whiner who's built a brand appealing to people with certain kinds of insecurities.

You're entitled to your opinion about someones work and that's fine, but I would hardly call her work repetitive, whining, or an appeal to insecurity. When people get "cancelled", she interviews them to get their side of the story (Winston Marshall). When someone writes what seems like pretty groundbreaking work using experience from years at the CIA, she interviews them (Martin Gurri - Revolt of the Public). When everyone ostracized the Central Park Karen, she interviewed a friend who had interviewed Amy Cooper while she was basically in hiding to get the other side of the story.

Feels like journalism to me.

Currently the Japanese ministry of health recommends that ivermectin only be used as a potential COVID treatment in clinical trials. It's not otherwise authorized. Some physicians do prescribe it off label, and it's possible that could have affected the course of the pandemic in Japan, but at this point we have no reliable data either way.

https://www.japantimes.co.jp/news/2021/12/21/national/iverme...

On that logic, if that's the case, then shouldn't a responsible "mainstream" media (CNN, NY Times, WaPo, etc.) be talking about these published papers by Pierre Kory et al. even if positioned as "minority viewpoints"? Instead what we tend to see is fact checkers springing into action and media continuing to only push a single "majority" narrative further dividing all of us instead of uniting us together to have open dialogue and letting the best ideas win in the public space.

It's all so bizarre.

This is such a silly line of argument -- If someone writes a paper that says "the sky is pink" -- you would afford them no airtime at all, even as "minority viewpoints". These doctors are quacks, they get as much mainstream media coverage as quacks deserve.
Listening to Robert Malone and numerous other scientists like Anders Tegnell and Dr. Peter McCoullough and other people with credentials that make your credentials look like those of an HVAC technician, it's strange that the HVAC technician would call them quacks.

Just because you have the main stream media on your side doesn't mean your narrative isn't 'the sky is pink'.

It could mean the emperor wears no clothes but is too unaware to see it.

It's not the 'narrative' thats on the side of vaccines and actual useful therapeutics -- it's the vast majority of science.

You sound exactly like my elderly obese neighbor whose rationale for not getting vaccinated is "all those doctors who aren't getting it have to know something I don't". If 99% of scientists and doctors are on one side, and you need to resort to credentialism instead of actual research to prop up those who are on the other, you're not really standing on solid ground.

If ivermectin worked, it would have had signal in any of the dozens of trials we've run. If Malone had anything useful to say, he wouldn't be hanging out with Steve Bannon and Tucker Carlson and lying about "inventing MRNA and DNA vaccines" and whether vaccines are cytotoxic. These people are frauds and we'd all be better for saying that plainly.

Labotomies won the Nobel price.

You're trading appeal to authority for appeal to the crowd.

Both are logical fallacies.

Most smart doctors and scientists are reserving judegment at this point, because all of this is happening in real time, so any data to make a rational decision is incomplete. Smart people would know better.

It's hubris to have the confidence that you and the mainstream media do about a novel virus and a novel vaccine using novel vaccine technology.

And it's really bad to shut out dissenting opinions from public discourse especially when they're subject matter experts.

New Orleans had full confidence in it's levees backed by 99% of the scientists and engineers in the area, then Hurricane Katrina happened. People reported leaks in the levee's years before it happened and were ignored.

There are so many questions and conflicting or inconsistent data in the mainstream narrative. The fact that the media doesn't report anything conflicting is a huge red flag for me.

Whether Ivermectin works or masks work or quarantine works...it's all irrelevant.

If you haven't learned that this is an endemic virus by now and that people need to make their own decisions and not be co-erced by big government to follow a questionable narrative built on incomplete data, ...your HVAC technician and your obese neighbor might be smarter than you.

Just for my own curiosity I clicked on your link. The I-MASK+ protocol also currently recommends Ivermectin (and if you don't have ivermectin, use black cumin seed), mouthwash, and a half dozen different vitamins for prevention and early treatment.
There is some clinical evidence to support curcumin as a prophylactic or treatment for COVID-19. The evidence so far is weak, but it's cheap and has no real side effects at normal dosage so from a risk versus reward standpoint it may be worth a look.

https://www.frontiersin.org/articles/10.3389/fphar.2021.6693...

Fair enough, but outside of the ivermectin misinformation, it feels a lot like busywork, giving people agency and a feeling of having done something when they haven't.
Where is the busywork? Other than ivermectin, the other recommended interventions also have at least some clinical evidence and no major negative side effects for those that choose to use them. Have you actually analyzed each of them within a risk versus reward framework?
I'd argue that doing a list of things with the argument of "might as well" is the definition of busywork.
Huh. This is interesting. I also have some fatigue, but my most obvious long-covid symptom is heart pain/strain which is aggravated by either an elevated heart rate or dehydration.

I'm no expert, but intuitively this would seem to provide a good explanation of those symptoms.

I'm hopeful that research into whatever "long covid" syndrome is/isn't leads to excellent new medical knowledge that applies to much more than just COVID edge-cases.

I suddenly got similar symptoms since getting a nasty version of strep throat last October. Notably I had an elevated fever (>102F) for quite a few days straight. I've never had COVID but I did get the mRNA vaccines + booster.

Since that fever, my heart goes into light arrhythmia all too frequently. It used to be maybe once or twice a year I'd notice 1-3 seconds of "off-beat" heart pattern. All of of a sudden it's a few times a week. I'm also getting older (entering mid 30's now), live in some of the worst air quality in the US (next to a bunch of chemical plants which are frequently releasing quantities of ethylene oxide/mercaptans/styrenes/acrylates/etc), and haven't been exercising much at all the past few years (largely due to air quality issues). My diet isn't the best either, but I incorporate a lot of fresh salmon which keeps my blood pressure down, triglycerides low, and HDL really quite high.

There's probably more I could do to help myself using just current medical knowledge, but additional knowledge and medical practices are always, always welcome IMO.

Tell your doctor about your symptoms and then ask for an ECG. You want to know if you have an underlying heart condition. Depending on what you find, there may be options that will eliminate your arrhythmias.
Anecdotally, I also had arrhythmia and after a few months and visits to doctors I figured out it was the type of coffee I drank. Changed back (from Espresso so standard) and the arrythmia was gone. YMMV
I agree, if you think you are having arrhythmias you should see a cardiologist as the first step. Try to exhaust the well-known medical avenues before considering that your health problems are from an unknown cause. Strep infections in particular can have cardiac effects (rheumatic heart disease).
I had similar symptoms in January 2019, I went to Urgent Care and then the ER because of heart arrhythmia, I felt sick, but no major fever. I put it down to anxiety (never suffered with before), but part of me wonders if it was COVID.

Out of curiosity, where do you live? I too live next to a bunch of chemical/steel plants and have been tracking air quality, weather, traffic, etc. https://millerbeach.community in Gary for a few years. Winds from North>South produce the best air quality, E>W or W>E produce worse, same with S>N.

Propublica has some excellent research published lately (it's an entire series of articles based on one primary analysis): https://www.propublica.org/article/toxmap-poison-in-the-air

It's based on somewhat-voluntarily reported data, rather than measured air samples. Mainly because we don't have effective air monitoring stations in anywhere near enough density to any kind of useful data science.

There was no COVID in January 2019. However there are a zillion other infectious diseases and other medical conditions that can cause cardiac symptoms.
You might be interested in reading this (very long, amateur, pseudononymous, non-peer-reviewed) analysis theorizing "SARS-CoV-2 presence in China as far back as March 2018." [0]

[0] https://theethicalskeptic.com/2021/11/15/chinas-ccp-conceale...

You'd be more informed (less uninformed in reality) reading a tabloid about bigfoot on the moon than whatever the hell that is.
Do you have any substantive critique to offer of the various lemmas established throughout the piece, which refers to itself as “an argument and petition for plurality under Ockham’s Razor?”

Or do you rely solely on appeals to authority when filtering signal from noise? I’ve noticed throughout this pandemic that many arguments supported on such a weak basis have later been disproven or severely undercut by further evidence.

Some examples: the virus likely leaked from a lab (at some time); masks reduce transmission; the virus is airborne; there is no sterilizing vaccine; vaccinated people can catch and transmit Covid; vaccines have waning efficacy; “fully vaccinated” will eventually turn to “recently vaccinated;” the mRNA vaccines can lead to myocarditis to such a degree that their risk may not outweigh their benefit for some age groups; a variant will eventually emerge with a high degree of immune escape…

There are many examples of conspiracy theories becoming mainstream narrative months later. So while many of them remain conspiracy theories, and the information environment continues to be overwhelmingly noisy, it seems imprudent to discount a source based on appeal to an authority that has been so consistently wrong, sometimes even willfully so (like when CDC lied that “masks don’t work” in order to save them for healthcare workers).

Are there any conspiracy theories you don't believe or do you just assume they're all equally plausible?

It's a workday and I'm busy but I'll grant you one substantive critique; the OP heavily relies on "mutations per year" as a metric to derive how plausible it is that something like Omicron could have mutated in the timeframe necessary.

Does it strike you as a bit suspect to rely on a mutations/time period, and completely ignore the number of infections? It should. The rate of mutations/year is a useful metric for determining the average mutation rate between two different viruses given certainty of their dates -- it's not at all useful for "aging" a specific variant because the calculation is independent of the number of infections.

We're in the midst of a pandemic with hundreds of millions of infections, so the selection pressure for more "fit" viruses is immense. OP tries to get around this by claiming that the rate of mutation that we've actually measured (which is an order of magnitude higher than his assumption!) is suspect and would "extinguish SARS COV2 within a season" but that's just gibberish.

> Are there any conspiracy theories you don't believe

I don’t like words like “believe” that imply a reliance on faith. I seek truth through evidence and my goal is to filter signal from noise.

> Does it strike you as a bit suspect to rely on a mutations/time period, and completely ignore the number of infections?

I’m far from a virologist, but I think OP’s postulation around mutation frequency is a bit more subtle than simply N / time.

See Exhibit [7.7] for example, which makes it visually clear just how distinct omicron is from any other variant. I’m not qualified to speculate beyond this, but it seems OP is saying a bit more than “there are a lot of mutations” – indeed, he spends multiple sections disambiguating the evidence of pure volume of mutations from that of phylogenetic distance. Still, you may have a point — maybe it only takes one mutation into a new dominant “clade” to produce such distinction, with any subsequent mutation being of little surprise given the prevalence established by the first one.

> It's a workday and I'm busy

On this we can agree.

[7.7] https://i0.wp.com/theethicalskeptic.com/wp-content/uploads/2...

For a very long time I've held a theory that the general pandemonium due to the mischaracterization of the media regarding the danger of the virus to the average person resulted in substantially more voluntary hospital admissions than would have otherwise occurred, thus reducing availability for those who actually needed to be hospitalized, thus increasing deaths.

I, and nearly every colleague in the downtown San Francisco office I worked at, contracted Covid in early January 2020. There should be no doubt that there was already widespread community transmission in California in late 2019. Yet, strangely, "hospital capacity" did not become a concern until right after the U.S. declared a nationwide state of emergency in March.

Why was it not a problem in the nearly 4 months prior? I believe many people were convinced that the virus was far more dangerous than it was, and voluntarily began seeking hospitalization when none was actually needed.

I have a recommendation for you:

You need to exercise. You are in your mid-thirties now. It's a big problem if you don't. But you have bad air quality where you live. I've dealt with this myself in the past.

A relatively inexpensive solution that I recommend for anyone in areas with poor air quality is to build your own filter fans. Get a standard box fan, get a furnace filter that has HEPA ratings, duct tape the furnace filter to the back of the fan. One of these in a whole house does a good job. Put three of them in there and it's crazy how big of a difference it makes. My wife has respiratory issues and my son has asthma. My wife had to be hospitalized twice for wildfire smoke in my neighborhood. Once I started doing the filter fan trick the issues went away. You can then work out in your home. Used cardio equipment is ridiculously easy to come by. I purchased a reflex punching bag for my basement a few months ago and it's the best piece of cardio equipment I've ever gotten. Doesn't take up too much space wasn't too expensive either.

I applaud you on your diet though. You definitely have a good grasp of the metrics that matter. Low triglycerides and high HDL are crucial, and good for you keeping that blood pressure solid. That diet is clearly doing good things for you.

Just keep in mind that exercise does great things for mental health by relieving stress via hormones.

One side note:

You may have contracted covid and never known it. The only reason I knew I caught it back in February of 2021 was because of my complete loss of sense of smell. If not for that single symptom I would have never known I had it. It didn't impact me in any other way. My wife and kids caught it as well and had absolutely no symptoms. They only knew they caught it because they got tested along with me.

>Get a standard box fan, get a furnace filter that has HEPA ratings, duct tape the furnace filter to the back of the fan.

Please be very careful with this. This significantly strains the motor of your average cheap box fan, and hot motors tend to die faster and can get hot enough to melt plastic and start fires.

I'd really recommend an actual air purifier instead, especially if it will run while you're asleep or not at home.

I always run it on the lowest setting, but yes, you need to be careful. Good point.
I appreciate this. I used to row competitively through high school and college, so I do consider myself an "athlete" as an identity, but non-practicing. I recently lost 30 lbs (6'0" from 200lbs to 170 lbs) over the past year through diet, but need to exercise.

Your advice for air filters is good general advice, IMO. I have a 700 sqft apartment with:

1x Honeywell HPA300 (rated for 465 sqft)

6x Coway AP-1512HH (each rated for 361 sqft)

1x Honeywell HPA100 (rated for 155 sqft)

I also have a Honeywell FPR 10 filter on the HVAC air return. So, over 2800 sqft of CADR-rated filtering for a 700 sqft apartment. Activated carbon pre-filters are changed every 2 weeks and the HEPA filter is changed once a month. We spend about $400/mo on filters, on top of $1,100/month rent.

Unfortunately, HEPA filtration does little for the type of air contamination that we're dealing with. Ethylene oxide is more like a "VOC" than a "PM2.5". The activated carbon filters help a bit, but are "used up" very quickly (1-2 days IME). The HEPA filters do very little/nothing for VOC contamination as far as we can tell.

Indeed, it is time to move away. I am in one of the most heavily-affected featured areas in this article[0]. However, my wife and I work in the chemicals industry, so we have personal experience identifying most of the compounds by smell and have unusual awareness of their effects vs. most of the nearby citizens.

0: https://www.propublica.org/article/toxmap-poison-in-the-air

Wow. Just wow.

Really terrible to hear this. You aren't fucking around with this, but it's still not enough. $400 a month on filters is insane.

Thanks for that article. Very eye-opening.

I hope you get out of there soon, but I can't imagine the guilt you feel for the citizens left behind. Horrible.

You can use more than one filter. I've heard it called a Corsi box: https://www.texairfilters.com/a-variation-on-the-box-fan-wit...

Basically, you're making a cube. One side is the box fan, with the intake coming from the inside of the cube. The other sides are taped together filters. It significantly reduces the strain on the motor of the fan, and you can use the cube for a long time before replacing the filters, since each one is filtering so much less air.

"Ethylene oxide/mercaptans/styrenes/acrylates" are chemical pollutants and thus won't be taken care of by particulate filters. You need something like an activated carbon filter for that.
Do they sell any furnace filters capable of stopping these?
Well it's more like neutralizing as opposed to filtering, and sure there probably are some aimed at people with central air that want to reduce VOCs. I believe I've seen standalone filters in the context of plant growing. And perhaps there are carbon aquarium filters that would work for DIY? I myself just went for some off the shelf air "purifiers", which have a prefilter + particulate filter + carbon filter stack. It's the path of overpaying for a fan and gimmicky replacements, but they're quiet, automatically ramp up speed for high VOCs, and didn't require me to DIY something for once.
> I've never had COVID but I did get the mRNA vaccines + booster.

> my heart goes into light arrhythmia all too frequently. It used to be maybe once or twice a year I'd notice 1-3 seconds of "off-beat" heart pattern. All of of a sudden it's a few times a week. I'm also getting older (entering mid 30's now)

This is my situation exactly, starting a few weeks after getting my second booster (Moderna). I've read enough anecdotes and news reports to believe there are many people dealing with this:

https://www.cbc.ca/news/canada/ottawa/myocarditis-ottawa-mrn...

https://ottawacitizen.com/news/local-news/she-thought-she-wa...

It gradually improved (enough to stop waking me up), but I still get a lot more "off-beats" than I used to. Got my third booster recently (Pfizer), so far no major regressions.

> Got my third booster recently

Out of curiosity, if you noticed these negative side-effects affecting the health of your heart after the second shot, why did you choose to proceed to get a third shot?

Not the parent poster, but I stopped after first Pfizer dose due to chest pain that lasted for three weeks. My entire family and all my coworkers berated me to get the second dose. Not saying parents friends/family did that to them, but there is a subset of people that don’t believe you should opt out of the vaccine if you have adverse reactions.

Lesson learned in honestly answering “are you fully vaccinated”. I still get told I should do it 8 months later.

Are you sure it's caused by COVID, or perhaps ever since you were sick you were exercising less?

I had similar symptoms to what you describe after just not being very active for quite a while, but it resolved after I did regular cardio (cycling) for a while and ate better.

I noted:

> I've never had COVID.I did get the mRNA vaccines + booster.

Regardless of root cause, probably just need to exercise more. See a doctor for good measure. Could be age/underlying condition, but exercise improves most of these things.

I had heart arrhythmia after a full-blown covid. The 1-3 seconds of strange patterns sound very familiar.

It slowly resolved itself after some 4-6 months, but not on its own, I needed small dosage of Concor prescribed by the cardiologist.

Any one of us could have had an asymptomatic SARS-CoV-2 infection without knowing it. But there are myriad different medical conditions that can cause arythmia.
Dehydration is not a symptom, it's a cause. Just drink more.
I think I’m going to start taking aspirin. Oddly enough I took that a few times because I didn’t have ibuprofen and I do feel like it helped a lot with the weird long symptoms I am experiencing.

I’m triple vaccinated before anyone asks. I haven’t tested positive for Covid on rapid tests but a lot of people seem to be in the boat I’m in right now.

"I think I’m going to start taking aspirin"

In the UK there is a large, ongoing clinical trial called 'RECOVER' to test different COVID treaments for hospitalised COVID patients. One of the trials included giving hospitalised patients aspirin. The trial was not looking at the treatment of long-covid symptoms (at least not directly in hospital patients).

"A total of 7351 patients were randomised to aspirin 150 mg once daily and compared with 7541 patients randomised to usual care alone. There was no evidence that aspirin treatment reduced mortality."

Link: RECOVERY trial finds aspirin does not improve survival for patients hospitalised with COVID-19: https://www.recoverytrial.net/news/recovery-trial-finds-aspi...

If aspirin doesn't improve survival, does that mean it also will not help with COVID symptoms?
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It feels to me that the medical community at large looks almost exclusively at data regarding severe cases. I'm certainly no medical expert but it seems reasonable to me that the treatments for someone who is literally dying from COVID could be completely orthogonal from those who are in the early stages of the infection. My understanding of severe cases is that the body is no longer or not only fighting the virus but also it's own immune response amongst other things (e.g. blood clotting). And that outcomes are mostly determined by how well the individual is able to weather the storm of their own immune system attacking them. I would not expect aspirin or similar treatments to have much effect when the patient has gotten to this point. Thought certainly, there could be some treatments that help which would prevent this from happening in the first place.

And, I'm aware of the research (and money) being poured into antivirals. Of course that's a thing. I'm sure there are billions if not trillions to be made off a pill you "simply take daily" to prevent the "severe and long covid." The headlines write themselves. But I seriously wonder what research is being done on "mild" covid cases using more cheap/traditional medicines. I know where I live, the doctors don't even talk to you unless your case gets severe - basically once you need oxygen supplementation. Prior to that, you're told to stay home and rest. I'm not even sure they create a record in their medical system.

>> It feels to me that the medical community at large looks almost exclusively at data regarding severe cases. I'm certainly no medical expert but it seems reasonable to me that the treatments for someone who is literally dying from COVID could be completely orthogonal from those who are in the early stages of the infection.

This seems to be a problem with every account of "treatment X doesn't work". They wait until someone is half dead, use X, patient dies at same rate as without X, conclude X is worthless. "preventive" or "protective" are different words than "curative" and that seems to get overlooked in a lot of cases.

Doctor A: When I see someone with Covid Symptoms I give XYZ and they never end up in the hospital.

ER Doctor: We've tried X,Y, and Z in every combination with patients on ventilators and none of that saves them with any statistical significance.

They can both be correct.

Obviously the medical community is aware of this.

Take for example the very recent approval of Molnupiravir:

https://www.bbc.co.uk/news/health-59163899

https://www.nejm.org/doi/full/10.1056/NEJMoa2116044

We conducted a phase 3, double-blind, randomized, placebo-controlled trial to evaluate the efficacy and safety of treatment with molnupiravir started within 5 days after the onset of signs or symptoms in nonhospitalized, unvaccinated adults with mild-to-moderate, laboratory-confirmed Covid-19 and at least one risk factor for severe Covid-19 illness.

The challenge is that you don’t necessary want to be often taking lots of drugs “just in case,” since they can have their own long-term issues (just browse the other comments here for discussion).

Also, adverse-drug interactions is potentially a a major killer already in the US, sometimes from doctors making mistakes, and often from people using OTC drugs outside of their safe regime.

So then, we might wait until it is clear that intervention is necessary, but now the intervention also probably needs to be much more aggressive.

And besides, we do have a pretty good preventative/protective option already in vaccines. It is only when breakthrough cases lead to hospitalization that we then need to pull out the backup strategies, otherwise, we’ve seen that statistically our primed immune systems are usually pretty good at dealing with it on their own.

Thank you for the study.

I’m not worried about mortality so much as getting over the strange long effects I’m feeling. I see this study as well.

https://www.webmd.com/lung/news/20210315/low-dose-aspirin-ma...

> But Magen's group found that people who'd already been taking low-dose aspirin to reduce their risk of heart disease had a 29% lower risk of contracting COVID-19 compared to those who didn't take aspirin, and that rates of aspirin use were much lower among COVID-19 patients than among those who didn't get infected.

>Among people who did get COVID-19, the time it took for SARS-CoV-2 PCR test results to go from positive to negative was significantly shorter among those who used aspirin, and the duration of their disease was two-three days shorter, depending upon preexisting health conditions.

>> RECOVERY trial finds aspirin does not improve survival for patients hospitalised with COVID-19

How is survival defined? Do they mean "gets released from hospital vs. dies in hospital"? Because it seems a lot of things that can reduce severity of Covid (including vitamin D for example) don't change much at the last minute when you're at deaths door.

In this case, we're talking about long Covid symptoms so it would seem a reduction in 1-year mortality should be the deciding factor (since Severe Covid patients who "survive" still have significantly increase mortality over the next year).

He's not talking about using aspirin as a treatment for when you are hospitalised due to covid.
This doesn't feel super applicable. The body in the middle of a COVID infection vs months later is in a VERY different state. Also I don't even know if there's any mortality data for long COVID; it could just provide quality of life degradation.
I saw an observational study tracking hospitalized (but nominally surviving) Covid patients for a year where a far higher number died (of various causes) than the base rate in the population [sorry I can’t find a link now in a few minutes of searching]. Some of this is selection bias (people who get bad Covid cases tend to be in worse shape to begin with), but I would expect the after-effects of Covid to cause significantly increased mortality. We’ll have much better data about this in a few years.
>I think I’m going to start taking aspirin.

Hmm, this is probably hardcore anecdata and off topic but a friend of mine who got Corona pretty bad (but not hospital bad) said that once he took Aspirin his symptoms weren't that bad anymore.

I mean everyone should consult their doctor before doing something like this, but it seems reasonable that a disease which damages the body through blood clots would be alleviated by a drug which thins the blood.
I assume you have read the hint that the authors left in the introduction for people like you:

"Such a regime must only be followed under strict and qualified medical guidance to obviate any dangers, especially haemorrhagic bleeding, and of the therapy as a whole."

Well yes I’m doing a very light version of the protocol, no industrial strength anticoagulants. :)
So likely you won't meet the "better than placebo" threshold.
A placebo is frequently better than nothing and sometimes better than the real thing. I can even work if you know that it's a placebo !

Also placebo are getting stronger https://drdavidhamilton.com/the-placebo-effect-is-getting-st... ;)

Mechanistically, placebo can only work on psychosomatic symptoms. There isn't any magic going on. If the problem is in your head, then thoughts can maybe help.
Your head largely controls the rest of your body. If you take a placebo that you expect to make you angry, your levels of adrenaline will likely rise. There are all sorts of measurable, physiological changes that can be induced by placebo.
The world you see, touch, hear, smell and taste exists only in your head.
The recent paper on brain memory in immune response suggests this is no longer common wisdom. We just don't know. Evolution twists a lot of random wires together.
My favourite drug to take for the placebo effect is water.
I just got the booster shot today, previous times I had a weird headache and a new vein (felt it pulsing, didn't have it before) popped up in the white part of my eye (it's still there after 6 months), second time I had minor heart palpitations the day after so I'm kinda worried this time. Would taking Aspirin help prevent any kind of weirdness like that? I need to know asap so I can take it before anything potentially starts happening.
Vaccines are not Covid.

Even the inactivated virus ones. They're just a very small viral load with an adjuvant to enhance immune response.

The mRNA vaccines create spike proteins which are fully functional and will bind to ACE2 receptors. The only real difference is that the mRNA vaccine spike proteins don't cleave off their connectors and litter your blood with extra trash and also won't flex down to the cell wall. But any cell randomly getting a spike protein tag-alone likely will no longer be a fully functioning cell.
Yes! And I think it's fair to assume that the vaccine spike can distribute widely throughout your body. Long covid and a subset of vaccine injury cases are very hard to distinguish. They present the same symptoms.
Why? We can hypothesize anything, but we shouldn’t just assume everything. The manufacturers made changes to the RNA sequence to reduce the ability to leave the cell, and then tested it in animal studies to confirm.
As OP indicates, it can still bind to ACE-2 and that changes the way these cells behave. Peristalsis in your veins is changed when the endothelial cells which have ACE2 are hit with spike (vaccine origin or covid origin) for instance.

I think there's enough evidence out there that spike from vaccines circulate widely. I can dig it up if you want?

You are welcome to look for evidence, but OP is also wrong about the spike protein being "fully functional" in the vaccine. The spike protein sequence was modified in many ways in creating the vaccine, including to prevent it from undergoing the conformal change upon encountering ACE2 which would normally then cause the virus to then enter a cell.

For a sample reference: https://journals.asm.org/doi/10.1128/JVI.00203-21

> But any cell randomly getting a spike protein tag-alone likely will no longer be a fully functioning cell.

Do you actually have any evidence to back this up? Cells have a myriad of receptor sites, and single bindings without other resultant activity are highly unlikely to cause the cell significant damage.

The side effects of the vaccines have nothing to do with the vaccine particles themselves and everything to do with your body's immune response.

Typically speaking the immune system will clear away cells with abnormal stuff on their membranes but I don't know about this specific case.
Unfortunately I think any anti inflammatory is not recommended when you get a vaccine. You want the immune system to be fully armed. That is my recollection from googling when I got my vaccines.

Just hang in there you’ll feel better soon.

The clotting in covid is fibrin based not platelet.

If aspirin did anything for covid you'd be seeing it on the news every single day for the past two years.

Have you read [0] already? This might give you an idea what might be going on with Ivermectin. Summary: parasite infections are widespread in some parts of the world. Treatment for Covid surpresses overzealous parts of the immune system which, unfortunately, makes the patient vulnerable to these parasite infections which in turn can kill the patient. Giving someone Ivermectin before treating them for Covid solves the problem by killing the parasites first. Therefore Ivermectin decreases the risk of death with Covid (not by).

[0] https://astralcodexten.substack.com/p/ivermectin-much-more-t...

Budedenide was shown to help significantly if given early. So does fluvoxamine. And sufficient vitamin D3 level seems to work well as a prophylactic.

And yet there’s hardly any mention of them, let alone “everyday”.

If you read only positive analysis of those supplements/drugs, they always seem positive. Except they aren't doing what you think because you don't hear when they don't work.

https://www.covid19treatmentguidelines.nih.gov/tables/fluvox...

     "No difference between arms in time to symptom resolution"

     "Fluvoxamine did not impact time to symptom resolution"
No, I read both positive and negative reviews when I can find them. I have not yet found negative reviews for budesenide (though some may exist). I did for fluv.

But I also found for remdesivir, which in the US and Israel is given like candy. My point being “hear about it everyday” is more related to politics and agenda than actual efficiency.

I believe this was attempted at the start of covid once doctors saw some of the initial mechanisms. I want to say they stopped this because it caused downstream problems and complications with covid but I can't recall what. I believe it was Dr. Roger Seheult and another doctor discussing this on Medcram but he releases so many videos I can't find the specific one.
I clot like crazy. Micro and bigger ones. stroke symptoms in 48 hours without meds. Prescription blood thinners solve symptoms extremely well.

I couldn’t handle side effects, so I switched to Aspirin. It mostly works. But not as well. Side effects aren’t as bad. Doctors are pissed. But quality of life matters.

Long-term ibuprofen use has a lot of its own problems, like gastrointestinal bleeds and interference with androgen production.
80 mg/day aspirin generally has been shown to be safe long term, though it does increase irritation of the stomach. Maybe taking it with food will help that.

I would absolutely NOT do the same with ibuprofen or any other NSAID. All other NSAIDs but aspirin have been shown to reduce blood vessel elasticity after habitual use. Adopting any med for regular use is not something to take lightly.

"Ibuprofen, aspirin, and COX-2s all belong to the class of medicines called nonsteroidal anti-inflammatory drugs (NSAIDs). Most of them boost blood pressure and can counteract the effect of some blood-pressure drugs. They can also impair blood vessels' ability to relax and may stimulate the growth of smooth muscle cells inside arteries. All these changes can contribute to the artery-clogging process known as atherosclerosis."

https://www.health.harvard.edu/press_releases/nsaid-side-eff...

Just got off daily naproxen (aleve) after ~6-7 years. Sanctioned by my doctor but was an important milestone stop taking it all the time. I dont know where it lays on the spectrum of safety amongst other NSAIDs but I sure am glad to not need it all the time anymore.
Are there by chance any similar tests on long covid patients using the enzymes Serrapeptase and Nattokinase? Or any of the other 30 or so related enzymes? Asking because Natto has the nice side benefit of binding to ACE2 and it is super easy to acquire. These enzymes are also Fibrinolytics.

As a related question, how is Japan doing in terms of long covid cases relative to everywhere else? They eat a lot of Natto.

Thanks for this comment, I found it very interesting and now I want to learn about it all. Thanks :)
Why would fibrinolytics have any therapeutic effect? They are not anti coagulants (i.e. serine protease inhibitors), and work via an entirely different mechanism.
Absolutely not anti-coagulants. They work in conjunction with them to break up clots and absolutely have many different mechanisms. I use six of those mechanisms for controlling blood pressure.

The article topic covers fibrin amyloid microclots which is precisely what many surgeons have used these enzymes for in addition to removing scar tissue from the vasculature. On a side note this is a very divided and heated topic within the different groups of heart surgeons.

You're specifically using compounds like nattokinase to control blood pressure?

Would be interested in hearing what your approach here is, or any literature you could share.

You're specifically using compounds like nattokinase to control blood pressure?

Correct.

Here [1] is one of the studies though there are quite a few on nih.gov that vary in results and P-value. In full disclosure I use much higher FU's than what is used in their test and have been using it for a long time building up to those levels so my risks are lower. I use this in combination with vascular de-calcification methods and other molecules that break down plaques.

I don't have any of them handy but you can also find some videos that talk about the different mechanisms that Natto interact with that affect BP. It is surprisingly not what one might expect. While it does bind to ACE2 that has a very insignificant role in BP. The biggest effect comes from how it changes a feedback mechanism in a peptide chain. I was taken aback when I learned how many roles peptides play in mammals well beyond tissue repair.

On a fun side note Natto also has an effect on von Willebrand factor which is also plays a significant role in covid.

I should of course add that I am not a doctor and this is not medical advise. Enzymes can break down scar tissue, plaques and more. These come with some risk of bleeding and stroke - one must study the risks and discuss with their doctors that will likely give them blank stares until they say "orally bioavailable tissue plasminogen activator" which is not entirely correct but it will help them understand the intent and might tickle their curiosity.

[1] - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5066864/

Interesting. Seems I have a new rabbit hole to investigate. Thanks for the response.
Could covid not actually be just a disease?

Maybe it's a disease + chronic unhealth. Due to age, pollution, obesity, bad diet, sitting on yr butt too much and/or etc

Nearly all diseases are worse if you're in bad health to begin with. That doesn't make them "not just diseases".
Well if they have no symptoms then they aren't really diseases, right?

And there are a thousand species of varmint that inhabit our body without helping or hurting anyway.

So yes, massive unhealth can definitely spell the difference there.

I'm not following. For some people a cold can have basically no symptoms and can even spread asymptomatically, and for most people it's just an irritation, but for the especially vulnerable it can kill. Would you argue that the common cold is also not a disease?
The key word here is "for some". If nobody gets a symptom then it isn't a disease. If only a very few get a symptom then maybe we call it a disease and maybe we call it something else.

A disease requires some minimum proportion of the infected to feel it. Otherwise it's just commensalism or something.

Therefore, as the general health shifts, so does what we call our relationship with that varmint.

I'm still confused, because I don't know how that connects to your question "Could covid not actually be just a disease?", because it clearly is as it's affecting people. If we assume that the cold is a disease so is COVID, by the same criteria. Is the cold not just a disease? If so, what is just a disease?
It's a pretty simple idea. I'm having doubts about this "confusion".
Fair enough. I think you're throwing a weird "disease" distinction and then moralizing angle into COVID which doesn't make any sense. We didn't just hit some sort of health critical mass for illness. COVID is its own beast and it's hurting a ton of people and implying it's people's fault for eating junk is bizarre.
The moral trip is all yours.
So is long covid post-thrombotic syndrome like in patients that survive pulmonary embolisms?
The link between microclots and long COVID is new to me and fascinating. Anecdotally, this gels with some of the symptoms I've seen in friends/family. My father had reduced motility in his arm-- where he'd broken it many years before--for many months after recovering from COVID. Then one random day, after he'd strained himself a bit, he noticed the pain/restriction completely gone, and the skin had turned slightly black in the region where it used to hurt. Not a doctor, but feels like something related to a microclot? He described the pain as almost like a twisted nerve or vein.

This HN post talks more about the link: https://news.ycombinator.com/item?id=29808020

One of my more bizarre long COVID symptoms was blood vessel leakage on my feet. One day a month or so after getting over COVID my feet started noticeably swelling. I was worried I had a clot in my leg so I went to the ER but sonogram came out fine. Turns out I had worn too-tight shoes the day before and the vessels in my feet had swelled/leaked. This was my same pair of shoes I had always worn at same tightness (they were running shoes that I had always slipped on and off, never tied or untied) so I knew that it had to be COVID related.
Why do you know it had to be COVID related? Many conditions can cause swollen feet.
Because I had been wearing those same shoes for years with the exact same level of tightness and never in my life had swollen feet problem before. The bruising was also following the lines of the shoes which is how it was discovered it was related to the shoe tightness
None of that implies that COVID was the cause. It could just be a coincidence.
> Correlation doesn't imply causation, but it does waggle its eyebrows suggestively and gesture furtively while mouthing 'look over there'.

Randall Munroe, https://xkcd.com/552/ (mouseover text)

I feel like the two different definitions of "imply" (formal vs colloquial) make "correlation doesn't imply causation" simultaneously true and false. On one hand, correlation doesn't necessarily demonstrate causation, but on the other hand (like the comment says) it does suggest fertile ground for research.
We also don't make all our decisions in life based upon research.

If I eat something and it upsets my stomach, I'm not going to commission a study on it. I'm just gonna avoid eating it.

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Everything can be a coincidence, it's not an helpful line of inquiry when discussing personal experience. If the man experiences a once in a lifetime health issue after having caught a virus with symptoms that bear similarities to that issue and with all other factors remaining constant, that's as much validation as you're going to get from someone's personal experience.
It's reasonable to wonder if the illness you just recovered from is causing some ongoing symptoms, especially when many other people are experiencing ongoing morbidity from that illness.

In the end, when it comes to individual cases of anything (even conditions we have a very strong understanding of), all we can rely upon is guesswork. (e.g. even if we know A causes significantly increased rates of B in study populations based on RCT evidence, it still doesn't tell us for any given person with A & B that their A caused B).

Someone else in my family had a similar symptom after the vaccine ; legs were swollen, and then the night after, her legs became black/bruised! But it went back to normal shortly.
I was diagnosed with micro clots a couple years before covid. My symptoms mirror long covid exactly.

Blood thinners resolved.

When I got covid all the symptoms came back. I had to double my blood thinners for six months.

Actual cause is Factor 5 Leiden. But seems to cause exact same sort of issues.

Sounds exactly like chronic fatigue syndrome, I don't know why we keep calling it Long COVID while we have a name for it.

https://www.nhs.uk/conditions/chronic-fatigue-syndrome-cfs/ > Suggested causes or triggers for ME/CFS include: > viral infections, such as glandular fever > bacterial infections, such as pneumonia > problems with the immune system > a hormone imbalance > your genes – ME/CFS seems to be more common in some families

I have a friend who got CFS out of nowhere (shortly before the 2 years to flatten the curve started, no COVID involved) and it's bad, there is no cure and it's incredibly disruptive. At the same time, it's hard for people to take you seriously and not just call you lazy.

Hopefully this study goes somewhere and we'll find a cure for CFS.

I hope so too. I recognized the symptoms (in myself) as soon as I started reading the abstract.

---

from the link cdrini posted above, which is a Guardian article by one of the authors of the study in the original post.[0]

"Even those without long Covid could benefit from such research, as symptoms noted in long Covid patients show many similarities to those seen in chronic and viral-related illnesses including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – another disease that has been dismissed as “psychological” for decades. Just because we have not yet identified a biomarker for long Covid does not mean biomarkers do not exist. We just need to look harder."

[0] https://news.ycombinator.com/item?id=29808020

PS. Hope the post is done correctly, it's my first one here.

If you're interested in Biomarkers for Long Covid and ME/CFS, look up Chronic Inflammatory Response Syndrome (CIRS). MMP-9, MSH, ACTH, TGF-beta 1, Cortisol, Glutathione, and Vasoactive Intestinal Peptide are a few of them. Lots of research here that was started by illnesses triggered by mold mycotoxins and lyme disease - the initial trigger is different than Covid - but the end result in terms of biomarkers and dysregulation in the body is the same. Doctors have been using these protocols to successfully treat patients for a few years now, but it just hasn't trickled down to the mainstream medical community or the medical schools yet.

Further reading:

- https://www.survivingmold.com/Publications/2493-Treatable_me...

- https://www.survivingmold.com/docs/Shoemakers_Protocol_for_p...

- https://www.survivingmold.com/Publications/CIRS_diagnostic_p...

Tell your friend to look into dysautonomia. There are some cutting edge treatments for chronic fatigue syndrome, they just haven't become mainstream knowledge yet.

The two most effective approaches are using neuroplasticity exercises to retrain the limbic system (cheap, but time consuming - an hour a day for 6 months): https://ansrewire.com/ https://retrainingthebrain.com/

Or doing microcurrent neurofeedback (costs ~$150 a session, do one session a week for a couple months): https://microcurrentneurofeedback.com/

Essentially you have got to get the brain producing the proper amount and type of brain waves again, and then once you have that, slowly work back into exercising while trying to avoid triggers and push / crash cycles.

Ctrl+f placebo - Phrase not found. Such a waste.
This is a big hammer. Please note this section:

"A proton pump inhibitor (PPI) pantoprazole 40 mg/day was also prescribed for gastric protection. Such a regime must only be followed under strict and qualified medical guidance to obviate any dangers, especially haemorrhagic bleeding, and of the therapy as a whole."

Induced hemophilia is no joke.

Do people really get holes in their stomach often enough that this regiment would cause them to bleed to death?
Yes. Absolutely. GI issues are some of the most common medical problems. Ucers, polyps, sores, diverticula...
My dad got a hole in his stomach from taking too much Advil (ibuprofen) for pain related to a broken vertebra.
jeez. NSAIDs can do some nasty stuff when taken regularly. Most people just pop 'em like candy.
To be clear in case it's not clear to others, the PPI is not the 'regime' that creates the risk of bleeding, it's the thing you take to provide some stomach protection against the damage/potential damage from the other drugs.
Right. PPIs are available without prescriptions in the US, and are considered very low risk medications.
Using PPIs for a short duration is safe, using PPIs chronically is not safe and the risks have to be weighted very carefully. It's by far the most intervened on medications by clinical pharmacists (usually discontinuing for inappropriate use)
Maybe. Here's a skeptical view: "Despite a large number of studies, the overall quality of evidence for adverse effects of long-term use of PPIs is low to very low." [0]

[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/

10 years ago, as a young post-grad I spent a ridiculous amount of hours analyzing ALL the published peer-reviewed literature on the pros/cons of PPI prophylaxis for CVD patients and published my results in a peer reviewed article. I am literally the expert in that topic lol. Here is a nice paper[0] by Adly (me!), et al. I am biased, but I find it to be very comprehensive (and an excellent cure for insomnia!)

[0]: https://pubmed.ncbi.nlm.nih.gov/23386069/

Awesome, what else can you teach us about PPI that isn’t mainstream knowledge
On the other hand, it has been linked to much higher rates of autoimmunities:

https://doi.org/10.3389/fimmu.2021.736036

Many of those autoimmune disorders cause pain and inflammation. And many pain relievers and anti-inflammatories can cause damage to the stomach lining, which leads to a prescription for a PPI. I don't see any accounting for this possibility in the paper (that ADs cause PPIs, rather than vice versa).
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> Induced hemophilia is no joke.

Note that this is one of the possible side effect mentionned in Pfizer documentation of their covid vaccine, reported in article research articles like [1], and it doesn't seem to bother too much people.

[1] https://pubmed.ncbi.nlm.nih.gov/33783953/

I don't see where the research article mentions a link to Pfizer (i.e.: acknowledgement, confirmed side effect, etc.) and googling the terms + "pfizer" brings up no official documentation about it.
yikes, PPI's. As a GERD sufferer thats come off PPI's after years of use, I wonder if non GERD sufferers will get the "kick back" when they come off the PPI's.
So 24 patients reported relief of symtoms. It would occur to me that a placebo effect could account for this. A study with a control group would hold greater validity in my mind. This seems purely anecdoctal despite academic styling.
Placebo effect accounts for changes in their blood markers for micro clots? I'm a big believer in the power of the mind, but this seems a stretch.
The point is that without a control group there's no way to know.
That's not strictly true. Consider our complete set of medical knowledge today. What percentage of that knowledge came from studies with control groups?
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When experimenting with new treatments, a control group is very important. Otherwise the study could be biased in favor or against the treatment. Even when a control group is present, a poorly-designed experiment could later turn out to be problematic, such as the Diethylstilbestrol (DES) medical tragedy (https://en.wikipedia.org/wiki/Diethylstilbestrol). In that case, studies that were in favor of the treatment were poorly-designed and used historical controls instead of contemporaneous ones.
I suspect nobody would argue that lack of a control group is better, but this should still be a good lead for something to look at more deeply. It's not like it gives you no information.
It's about the fraction of that medical knowledge is likely to be revised when considering new controlled studies.
Over a sufficiently long time horizon the fraction of medical knowledge likely to be revised approaches 1. That includes all knowledge generated from controlled studies.
No, there is a way to know, just not the way you want to know.
Ad hoc trials? Aka testing in production.
Observational studies, which are much more frequent than randomized trials and just as effective, if not more.
Even with a control group, there's no way to know.
I drove to Germany to see the machines. Spoke to the doc admistering it. It's a potentially painful almost full day procedure. We discussed the placebo thing. I'm not an expert on medical ethics but personally I would not want to be intubated (potentially wrong word) into that thing for hours and not get treatment.
It could also simply be time. To me this is obviously a small study that should be followed up (quickly) with a double blind, randomized trial. Until then, I'd be hesitant to put a bunch of ppl on anticoagulants.
My advice, don't prescribe people anticoagulants until you're satisfied it's safe for your patients.
It's a preprint that has already been criticized by peers

It's resolving a symptom, not the cause and there's no long-term followup to see if the results stuck around.

What are the critics saying?
Can you please link to discussion (positive or negative) by knowledgeable commentators? Genuinely interested.
It was my understanding that the existence of “long covid” is still debated as there hasn’t been any real evidence for it other than patient anecdotes.
Most any serious viral infection can potentially cause post-viral fatigue syndrome. We've known that for decades and COVID-19 is nothing special in that regard.

https://pubmed.ncbi.nlm.nih.gov/3063394/

But many cases of "long covid" appear to be psychosomatic.

https://jamanetwork.com/journals/jamainternalmedicine/fullar...

And that's why this result is exciting - not only is it promising for long covid, but also for post-viral fatigue syndrome and chronic fatigue syndrome.
An old friend of mine has long covid, the real deal, but she was also sick in covid for months in 2020. What she has matches post-viral fatigue syndrome perfectly, and she's getting care for it, from realistic doctors who've been saying that recovery is gonna be slow but steady. She's better now, a year later.

And then, just as you say, there's "long covid", which is a large number of people who have very generic ailments, and if you start digging into the numbers, you realize it's all self-reported bullshit, where a good chunk of the sufferers haven't even been diagnosed with covid in the first place! Their symptoms match depression very well, though.

It's extremely frustrating watching people like my friend getting ridiculed for having an imaginary disease. She doesn't. And at the same time it's even more frustrating watching a relatively huge number of psychosomatic hypochondriacs getting all the attention and using up the wrong kind of healthcare resources, just because a lot of people are using long covid for generating fear porn and want it to be worse than it is.

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It has a strong following on HN. Personally, I haven’t heard about it anywhere else.
The news media is kind of fickle about coverage about anything that doesn't get more ad revenue/impressions. Everyone's filter-bubble affects what they see. At least last July it got a minor boost of awareness from the White House:

https://www.washingtonpost.com/politics/biden-ada-long-covid...

Medically it just seems to fall outside the flowcharts of modern medicine where an "easy fix" or "procedure" is not prescribed. Going outside of the "acceptable medicine" of what insurance will cover is practically a unicorn event. So you'll see a lot of doctors just calling it "anxiety." Functionally, Long Haul Covid has become a huge cash bonus to medicine as sufferers get referred (passed around) from specialist to specialist for more testing and diagnostics that nearly always comes up as "normal."

About the only good news about this situation is very likely once they really get the studies done (and they're going to have to do it, because there will be millions of people suffering from this) they are likely also going to find how to help people with chronic fatigue syndrome (CFS) since all the long hauling symptoms appear to over lap. CFS sufferers already have had the feeling of being ignored/ridiculed by medicine for decades.

I'd urge anyone suffering long covid to take a look at the FLCCC protocol for treating it. Results were immediate for myself and I've seen tens of others that have followed it resolve their issues.

https://covid19criticalcare.com/covid-19-protocols/i-recover...

Is this the FLCCC that pushes ivermectin (a fine worm killer, but no panacea) for covid?
Ivermectin has many modes of action. It's been recognized as a potent anti viral long before covid.

For instance, see Ivermectin is a specific inhibitor of importin α/β-mediated nuclear import able to inhibit replication of HIV-1 and dengue virus.

Ivermectin is a potent inhibitor of flavivirus replication specifically targeting NS3 helicase activity: new prospects for an old drug.

A screen of FDA-approved drugs for inhibitors of Zika virus infection.

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Yes - a bunch of discredited quacks (with multiple papers now retracted for the terrible quality of their science) causing enormous headaches for every practicing doctor and nurse having to treat the unvaccinated "Facebook Researchers" who end up in the hospital trying to get their useless cocktail of meds.
What specifically in the linked protocol do you disagree with?
I don't need to do a line-by-line rebuttal of a Covid protocol my HVAC technician wrote -- though he likely did more to help the pandemic by changing out HEPA air filters than the Front Link covid quacks did with their awful advice and martyr complex.

If someone is catastrophically and unapologetically wrong on problem 1a, you don't really need to pay attention to their solution to problem 1b.

Ok, so just ad hominem then I guess. Lazy and a disservice to yourself and anyone suffering from this.
Sometimes the timing is just great -- how about the fact that the protocol was designed by several grifters selling fraudulent "long Covid" tests and charging people thousands of dollars for tele-health visits where they then lie about lab tests and prescribe drugs that don't remotely work.

Just published now:

https://www.motherjones.com/politics/2022/01/desperate-patie...

These people should be in prison.

I didn't suggest anyone use IncellDX or covid long haulers.com. Just because Bruce Patterson had his name associated with the flccc doesn't prove anything about it's viability. Keep trying.
If the fact that fraudulent grifters developed the treatment protocol you're advocating for, I'm not sure where to go from there. (Not just Patterson, but Yogendra too -- it's not just "his name associated" with flccc -- he and yogendera are two of the primary authors of the protocol!)

And if I understand your timeline right --- you think a single dose of the vaccine gave you "long covid" symptoms? So you're going to rely on the long-covid treatment path, even though you've never had the virus? Yikes man..

Yikes man indeed. Hard to describe how desperate I was back then. If you read the protocol, you'd see where they describe how a subset of vaccine injury and long covid essential present and are treated identically.

My story: got all the long covid symptoms, started eight hours after the AZ vaccine. Tested negative twice on pcr. 3.5 months with little improvement. Optometrist noted blood heme in eye, had a clot removed from forehead vein recently. Both of those noted within a week or three of vaccine date. At the 3.5 month date I started that protocol, first with ivermectin. Within five hours I felt better than I had in the past three months and then in five days brain fog, sob, headaches, extreme fatigue, heart issues, high blood pressure all resolved. I quit the daily dose of ivm then and started prednisone for remaining lung inflammation. (Describe this like extreme asthma, any deep inhalation would trigger coughing). That worked. I still have a bit of a dry like congestion that lingers (8 months since vax).

Maybe I caught covid same time frame as vax but the two negative tests seem to not support that. The symptoms certainly presented right after the shot. They very clearly resolved a few hours after the ivermectin. It was like a light switch. My wife noticed improvement in my color even.

What do you think of this pre print from December? https://www.researchgate.net/publication/357313430_Ivermecti...
Haven't seen it - but via the acknowledgements, its lead scientists are being paid by a producer of Ivermectin and the program was instituted by the quack mayor who previously said rectal ozone administration could treat covid? My hopes aren't high.

Also, why did it take over a year to publish when the study ran from July-Dec 2020?

Started reading it now, and what? Why can't these people do real science?

> "Although study design, IRB approval, and data analysis occurred after completion of the voluntary prophylaxis program, all data were collected prospectively in real-time with mandated reporting to the registry of all events as they occurred during the citywide governmental COVID-19 prevention with ivermectin program"

https://www.nydailynews.com/coronavirus/ny-brazilian-mayor-t...

And what now -- the 2nd author is facing prison for massive ethics violations running a different covid study?

https://sei.saude.gov.br/sei/controlador_externo.php?acao=do...

The advocates for IVM are consistently some of the worst acting scientists on the planet. It's a real disservice to their stated goal that they're all so incompetent.

Yeah that's brutal. Hard for me to reconcile it all given my personal experience with it.
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Super not helpful. Also, some of your points could be debated (fluvoxamine recently, statins in trials, vitamin C, etc). But overall the tone makes it hard to have a civil discussion.
It's my contention that it's actively harmful to truth, science, and public health when we pretend like there's value in having a "civil conversation" with bad faith actors.

There's no benefit to cosplaying as Socrates when there is no data point or research result that could change the mind of these weird conspiracy theorists. If a well-done study came out tomorrow that demonstrated Ivermectin worked to help Covid patients, it would literally be in every hospital's protocol tomorrow.

On the opposite side, these charlatans have been promoting IVM since March 2020 with absolutely no evidence of efficacy (often at the expense of convincing people to not get vaccinated). What little evidence has come out has only weakened the case for it as a treatment, and yet, they're still promoting it as fervently as ever.

If you want a long-covid treatment protocol, you should absolutely look somewhere else aside from the pages of the most stubbornly wrong people in this whole pandemic. They've shown repeatedly that they don't care about updating their priors when there's contradictory evidence. At least the HCQ dorks have mostly retired to complaining about cancel culture.

I personally formed a three person reading group with 2 friends (one chemistry PhD and one retired tech CEO that's a longevity genius) and we read a stack of these papers end to end and even attempted to fumble through a recalcution of a meta-analysis following the retraction of one paper.

Before personally taking the medicine we spent 1.5 weeks reading everything we could find. Straight from Google Scholar or pubmed. Respectfully, I disagree with you. But that's based on my own reading and I'm not an MD or medical professional.

I would say, a) it is very common in certain countries, and like hey, they awarded the Nobel Prize in Medicine partially for it in 2015, but b) we have to agree to disagree here, were just too far apart on tone. But respect your point of view.

Ivermectin is a fine anti-parasite, and plausibly has a mechanism of action that could benefit specific patients infected with specific viruses. Unfortunately for all of us, it has no measurable benefit on Covid. As shown again and again.

We have hundreds of millions of active infections, it's dead-simple to do research studies to determine whether something prevents hospitalization, or shortens length-of-stay, etc etc. You don't have to spend weeks of your life reading primary materials -- here's the EUA for Paxlovid (Section 14):

https://www.fda.gov/media/155050/download

A pre-registered RCT, with specific endpoints and statistically significant evidence that it lowers viral load, and prevents hospitalization and death. It only took 4 months from study enrollment -> results to see how effective it was. Paxlovid works! Hurray! IVM doesn't. Rats.

Good faith individuals would move on and investigate something else that could help humanity but admitting you were wrong doesn't get you invited onto Joe Rogan so here we are, with people still referencing their nonsense.

If anyone is interested in the data available on ivermectin for COVID, and whether it works, you can find a lot of it here: https://c19ivermectin.com/
I found Scott Alexander's review to be very informative: https://astralcodexten.substack.com/p/ivermectin-much-more-t...
I read all that a while back. It is good and about all you can get out of it is to conclude that ivermectin needs more study. Unfortunately its off patent and won't get much $$$ thrown at it. Its getting hard to ignore the growing mass of people that have just said, hey, this is obviously safe and I'll just try it. And holy sh-t it worked! (that's my story...).
If ivermectin actually worked, pharma companies would just make a new version with a slightly different structure and patent/sell that formula instead.
No they wouldn't, because it would be trivially outcompeted by current ivermectin which can be had for very, very cheaply.
Then why hasn't the same thing happened to ketamine for the treatment of depression?

Ketamine is widely available and cheap, but the FDA approved esketamine (the S enantiomer of ketamine) and gave the pharma companies a patent for the formulation so they would fund the clinical trials that are needed for it to be used as a treatment of depression.

Esketamine is much, much more expensive than ketamine, and essentially the same molecule, yet it hasn't been 'outcompeted' by ketamine (in the context of treating depression).

Because the new ivermectin (newermectin) would be specifically authorised and used to treat covid, it would have a niche advantage over ivermectin. Ivermectin would still dominate treating parasites, but there would still be good money in developing newermectin.

Does anyone know if microclots have ever been investigated in relation to other post-viral disorders?
Although never formally diagnosed I'm pretty sure I have/had long covid. I had mild covid in the summer, and it never fully went away, but what was left was inability to recall facts, brutal short term memory, and waking up with pounding pounding head aches that would not go away no matter how much Tylenol I took. Honestly it was awful, working was so difficult. It started to clear up about 2 months ago, around the same time I switch from Tylenol to Advil, and also started rubbing high CBD cream on my head daily. Headaches are now at about once a week, and last a lot less time, memory is getting better. I also decided to spend long period of time listening to familiar music from high school and college. My memory is pretty auditory, I thought maybe it would somehow help with recall. There was a time there that I genuinely worried about getting back to normal in terms of being able to work hard. I'm not exactly sure what this paper is about, but I'd love to get back to normal. :\",
I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all. All my patients got a higher dose of Lovenox (anticoagulant) as soon as they hit the unit.

The trick is balancing risk vs. benefits. Anticoagulants and antiplatelet will kill a 30 yo healthy person who slips on ice and hit his head. Your mild concussions are now massive brain bleeds.

> I was rounding in the ICU when COVID hit, we knew this 2 weeks in - so not new information at all.

Sorry, what? You’re telling us that you were treating long COVID patients in the ICU when the pandemic started?

I don’t know if you misspoke or misread the headline or what, but in no way is it possibly true that you were treating long COVID with anything in the ICU at the beginning of the pandemic, or any time for that matter.

I can tell you with absolute certainty that there are circles of of the web which knew incredible amounts of very accurate and precise details about COVID in Feb/March of 2020. The early mistreatments accounted for vast amounts of preventable deaths while people proposing the eventual correct solutions were deplatformed
1. I would love some actually citations rather than a hand-wavey claim that sounds like conspiracy theory. This sounds like you’re talking about hydroxychloroquine.

2. None of this matters to the claim I addressed. Long COVID it’s not something that would be treated in an ICU. It’s also not something that even had a name “when COVID hit”.

The problem the paper is addressing is fibrin micro clots, which occurs in long Covid. This also occurs in acute Covid. The treatment is similar - anti coagulation. We (doctors) knew this from the beginning (1). Chill out bubba.

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7378457/

Attached article was written during initial outbreak

I find this to be such a bizarre statement. “What causes long COVID?” has been a common question for a year and a half now. Someone publishes results indicating it might be X and treatable with Y and we get a couple of people chiming in with “yeah, we knew that already”.

You knew the solution to long COVID and just kept it quiet? The NIH was publishing guidance to give anticoagulants to hospitalized acute COVID patients but just neglected to tell people the cure to long COVID?

I’ve got no dispute that you knew to give hospitalized patients anticoagulants early on. My statement is that this is a different thing than knowing to treat long COVID with a related protocol. This study hasn’t even been published yet, has it? This is a preprint we’re discussing. Have there been a bunch of other studies showing this is a viable treatment I’m unaware of (this is certainly possible)? Or is this new data?

All your question marks makes brain hurt.

This study is not establishing a new treatment protocol by any means. It’s also a tiny number of people.

This study raises the question maybe we should design bigger trials to investigate treating long COVID with blood thinners.

> This study is not establishing a new treatment protocol by any means.

So this was a known treatment protocol? That’s interesting. I hadn’t heard much about long COVID that wasn’t “we have no real idea”.

One of the underlying problems of COVID is an excessive immune system response, which we have known for 10+ years that it leads to coagulation issues. Long COVID or acute COVID - it is fundamentally your body fighting a battle in the wrong way. So, in that specific way, COVID is COVID.
So…you misspoke?

I also find this a really odd line to draw. The fact that treating ICU patients with anticoagulants is standard does not automatically mean it’s useful for long COVID patients. If it turns out that it’s useful, awesome, but it’s not obvious a priori.

I didn't see them misspeak. They just clarified. Their follow up statement was right in line with their original.

Pretty cool that they're ahead of the curve on this.

Even if they didn't know about long covid officially, they followed the known science up to that point, and this is incompletely but interesting new data that's showing it's helping more than possibly known at the time.

They’re not ahead of the curve. This long COVID treatment experiment is new and they equated it with an entirely different treatment. Saying “we knew this 2 weeks in” is dismissive and absurd. Knowing that NIH recommends anticoagulants for acute hospitalized COVID is entirely different than knowing that anticoagulants are useful for treating long COVID.

If someone published a study that CTE resolves with a month of Tylenol supplementation, this would be huge news. The fact that acute concussion pain is treated with Tylenol in no way implies this result.

They stated they knew from the scientific literature that anticoagulants were beneficial so I'm assuming they werent referring to long covid but to just general efficacy against covid, because long covid hadn't been discovered yet.

In that sense they were ahead of the curve because its looking like it is helpful with long covid as well, which is great news!

Very interesting study.

I am an expert in the field of clotting mechanics (US NIH funded research / vascular surgery fellow). Not sure why they chose TEG to monitor coagulation status - it does not reflect well changes from any of the drugs used in the study.

It would be interesting to see the results broken down by gender - females respond much differently to aspirin and have less of a survival benefit than males (don’t get me started, many of the initial trials in the 60’s with aspirin were done with mostly males).

Also, in my own research - we have found that aspirin “softens” clots which allows platelets to squeeze pathological clots to smaller sizes, which allows more recannalization of thrombosed vessels and thus less ischemia - would be interesting to see if that same MOA happens here.

I always take aspirin before flights to avoid DVT due to chronic venous insufficiency and ankle swelling.

Do you recommend aspirin to thin blood for flights where I am sitting with legs bent and pressure from the seat underneath the leg pressing into the skin contributing to clotting?