Ivermectin: Much More Than You Wanted to Know

This is worth reading purely for the writing alone. Scott Alexander is a treasure:<p>&gt; 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.

While reading this piece I got a little depressed that most journalism is just such utter trash compared to it. I&#x27;ve read so many articles on ivermectin and none of them gave me even ten percent of the clarity that this article gave me. Can you imagine if writing and journalism of this calibre was commonplace among practising &quot;journalists&quot;? And look at how this piece compares to the CDC&#x27;s and WHO&#x27;s science communication. It&#x27;s a shame that clear thinking and communication is so scarce.

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 &quot;looks good but you forgot...&quot;.<p>You can&#x27;t get this sort of excellent rebuttal without allowing a site like <a href="https:&#x2F;&#x2F;ivmmeta.com&#x2F;" rel="nofollow">https:&#x2F;&#x2F;ivmmeta.com&#x2F;</a> into the debate.

The real story (in my opinion) behind Ivermectin are the studies not being conducted. Here you have a ton of studies claiming to have found benefit with a worldwide, massively available drug that has practically zero risks for most people (and it&#x27;s an extremely well understood drug) and we don&#x27;t have first world countries conducting RCTs to understand it better.<p>So you have to ask yourself - when do we get high quality RCTs, who funds them and why? This to me is a clear cut indicator that we have very maligned incentives for health science. How can we be this far into a global pandemic, with all of this funding and not have multiple high quality RCTs on this drug? It&#x27;s sad to say the least. Even if Ivermectin ends up being fairly weak or completely ineffective - surely there&#x27;s something to learn here...

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?<p>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.<p>From article: “We’ve gone from 29 studies to 11, getting rid of 18 along the way. For the record, we eliminated 2&#x2F;19 for fraud, 1&#x2F;19 for severe preregistration violations, 10 for methodological problems, and 6 because Dr. Meyerowitz-Katz was suspicious of them.”

This article is a nice counterpoint to what&#x27;s felt like a trend of Scott&#x27;s writing (outside of psychology) increasingly becoming contrarianism in search of evidence. Many pieces he&#x27;s written in the last 1-2 yrs feel like he&#x27;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&#x27;s in his wheelhouse he&#x27;s great to read.

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.

&gt; People are going to fight hard against this, partly because it’s annoying and partly because of (imho exaggerated) patient privacy related concerns. Somebody’s going to try make some kind of gated thing where you have to prove you have a PhD and a “legitimate cause” before you can access the data, and that person should be fought tooth and nail...<p>I have a huge amount of respect for Scott, and the rational thinking that he shares with us. However, I&#x27;d like to make two arguments against the above.<p>1. Personally-identifiable information is protected by law over on this side of the pond. This is one of those cases where the thinking is quite different between the US and Europe. In Europe, you need to get the permission of everyone involved in the study before you can publish your data about them, if there is any chance that they can be identified from that data. In a lot of ways this is good, but one way in particular is that it encourages pre-planned proper studies, where you set it all up properly and get every participant to sign the permission sheet, which is good for science.<p>2. Sometimes absolutely full data release is overkill and inappropriate. For example, if I&#x27;m planning to publish a paper saying that mutations in a particular small region of the human genome cause a particular disease, then it is sufficient to publish the list of causative mutations. Full data release would mean publishing the entire sequencing run for the patient - that&#x27;s inappropriate because you can identify someone from it, and you also then know a huge amount of information about them - their traits and congenital conditions. A lot of journals are pushing for this, and the compromise that we seem to have reached is to store the full sequencing data in a secure repository and provide access given a really good reason. Likewise, a census will report statistics about areas of a country, but the raw data is kept back because it is deeply personal in nature.<p>So my points are that data shouldn&#x27;t go into a study unless it can be openly published, and that there are types of raw data that are too personal or voluminous to openly release, and the data derived from it should be released instead.

Love the final explanation for how ivermectin can be incidentally good for COVID-19 patients, even if it does nothing to COVID-19 directly.<p>In fact, as the author cites from another researcher, the trials are a strong piece of evidence for &quot;add[ing] ivermectin to mass drug administration programs.&quot; 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.<p>I do think the ending political metaphor doesn&#x27;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&#x27;t optimally handled by a collection of random individuals, who despite the best intentions, were unable to unite a group. Doesn&#x27;t make them bad people, or mean they have the wrong approach. Just means they weren&#x27;t ready to tackle such a difficult challenge. Positive outcomes take dedicated effort, they don&#x27;t come automatically because we assume the status quo is good enough to us immune to random chance.

This is wonderfully fun stuff to read:<p><i>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><p>I asked a few questions previously on HN about Ivermectin and got answers that killed my interest in the topic (because I don&#x27;t think it is relevant). But this piece is a delight.

In my opinion, the main crux is this: there are moneyed interests who are motivated to generate mistrust and otherization based on political parties. In the USA, Fox News has a strong incentive to inspire hatred and fear of Democratic policy, and MSNBC has a strong incentive to inspire hatred of the GOP. The same is true for Twitter, FB, NYT, WSJ, WaPo, literally any media outlet. Hatred, fear, outrage, worry, anxiety: they all drive viewers to advertisements.<p>One major example, these media groups facilitated making a huge rift on climate change belief. The fossil fuel industry saw in the GOP, and some moderate Dems like Manchin, an opportunity to create doubt and slow the transition off their fossil fuel products. Now, the GOP has leaned into anti-scientist, anti-elitist sentiment, fed by Fox News and others. They&#x27;re not totally anti-science, they still use abortion science, ivermectin science, and all the wonders of modern life...but they ARE anti-scientist, anti-elitist, anti-university.<p>And Why? We&#x27;re hating each other so media companies can make a few measly cents.

Funny how all this article ends up saying it&#x27;s all a matter of trust.<p>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.<p>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 was a fun read, but implying that a drug dealer from Kern county is related to a published researcher from Mexico just because they have the same surname is not really cool.

&gt; Even an atheist can appreciate a cathedral, and even an ivermectin skeptic should be able to appreciate this website.<p>This is well put. It&#x27;s pretty remarkable indeed.

One time I didn&#x27;t believe Scott when he wrote a &quot;More than you wanted to know&quot; article. This time, I took his word for it and scrolled (and scrolled and scrolled) to the bottom to read the summary.

&quot;It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!&quot; - 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.<p>Actual medical science, and science in general, doesn&#x27;t make claims beyond what we know for certain (or at least, we&#x27;re very explicit about the claim&#x27;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.<p>&quot;Believing science&quot;, 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.

&gt; 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<p>Why are they hiding their identity? That means that it can be anyone who does this.<p>-----------------<p>But even more important. The website also claims that each of the following individual medicines works:<p>Fluvoxamine<p>Proxalutamide<p>Iota-carrageenan<p>Molnupiravir<p>Quercetin<p>Povidone-Iodine<p>Curcumim<p>Casirivimab<p>Sotrovimab<p>Bamlanivimab<p>Nitazoxanide<p>Budesonide<p>Zinc<p>Bromhexine<p>Colchicine<p>Vitamin D<p>Aspirin<p>Favipiravir<p>Hydroxychloroquine<p>Remdesivir<p>Vitamin C<p>I find it unlikely that all those claims are true which in turn makes me question their scientific approach.

I don&#x27;t understand the point of the image of the meth seizure when discussing this study [1]. The last name is the same, but if you understand Mexican surnames, it is strongly unlikely that the two different people are in any way closely related. I like reading Scott&#x27;s writing, but this really detracts from the overall quality of the article, because it seems like a vaguely racist dig without any relevance.<p>[1]: <a href="https:&#x2F;&#x2F;www.biomedres.info&#x2F;biomedical-research&#x2F;effects-of-ivermectinazithromycincholecalciferol-combined-therapy-on-covid19-infected-patients-a-proof-of-concept-study-14435.html" rel="nofollow">https:&#x2F;&#x2F;www.biomedres.info&#x2F;biomedical-research&#x2F;effects-of-iv...</a>

<i>&quot;...everyone still PCR positive by day 7 so it was impossible to compare groups&quot;</i><p>Eh, isn&#x27;t this what a PCR-test does: detect RNA? A medicine doesn&#x27;t magically remove virus RNA. It might break down the virus or block it&#x27;s ability to reproduce but the RNA will still be detected.

With all bashing on Ivermectin, I just wonder what people think about it! First, there&#x27;s no money to be made from it - no patents, it costs cents per dose, and everybody can manufacture it! Second, it has proven anti-viral properties against HIV, HPV, etc. In general, it&#x27;s not like some crazy guy decided to use try it against SARS-CoV-2 - scientists were looking to repurpose antivirals. Plus, it has a pretty decent and long-established safety record. Compare it to Remdesivir, let&#x27;s say, which comes with terrible side effects! Also, the dosage has been pretty low and recommendations have changed - from 0.2mg&#x2F;kg now it&#x27;s 0.4-0.6mg&#x2F;kg with Delta. Pretty much all my friends who followed the I-MASK+ protocol [0], didn&#x27;t get severe course of COVID-19. Yeah, it&#x27;s anecdotal data, but there are no exceptions!<p>[0]: <a href="https:&#x2F;&#x2F;covid19criticalcare.com&#x2F;covid-19-protocols&#x2F;i-mask-plus-protocol&#x2F;" rel="nofollow">https:&#x2F;&#x2F;covid19criticalcare.com&#x2F;covid-19-protocols&#x2F;i-mask-pl...</a>

Are meta-analyses that just average all the results from all the studies less reliable than picking a paper at random?<p>I&#x27;d expect that to be the case if the bogus studies report the most dramatic results. A single bogus study out of 10 can skew the whole meta-analysis, but if you picked randomly you&#x27;d be 90% likely to get an honest one.

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.<p>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.<p>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&#x2F;or multiply out of control when other drugs necessary to recover from CVOID are given).

Such good writing. I was anxious about trying to read it all, but he kept me hooked to the end.<p>&gt; 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.<p>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.<p>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?

&gt; All the health officials in the world will shout “horse dewormer!” at you and compare you to Josef Mengele.<p>Well, as a German I feel obligated to recommend those officials to read up on Josef Mengele and then reconsider throwing that name around so casually.

I think if the IVM proponents were operating in good faith, their message would have been something like &quot;There&#x27;s some evidence that IVM can mitigate severe COVID infections, but it&#x27;s relatively weak so you shouldn&#x27;t rely on it to the exclusion of other ways of protecting yourself.&quot;<p>But that&#x27;s not what happened. IVM (like HCQ before it) is a prop, a cudgel, a red herring in the ongoing and well-funded political project to undermine faith in government and polarize the electorate

Can&#x27;t stand close minded people who can not fathom that other treatments could work from ivermectin to the upcoming pill Pfizer is putting out to something else. It&#x27;s ridiculous that their bias drives them 100% vs. being objective in that science and research takes time .. years ... time will tell and provide all of us with many treatments against COvid as there now is for the flu.<p>Politic bias blinds objectivity and it&#x27;s ridiculous for people who believe themselves to be intelligent people. Especially those who believe everything and live by their biased manipulated for profit media of choice. Here is one of many examples of the media spinning it&#x27;s bias agenda and years later getting caught <a href="https:&#x2F;&#x2F;www.axios.com&#x2F;steele-dossier-discredited-media-corrections-buzzfeed-washington-post-6b762a0b-64a9-4259-8697-298e2f04fb3e.html" rel="nofollow">https:&#x2F;&#x2F;www.axios.com&#x2F;steele-dossier-discredited-media-corre...</a> . Of course it&#x27;s happens on both sides like all that ridiculous story about Clinton pedo pizza parlor thing. The media is garbage and not to live one&#x27;s life by ... years of science is!

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?<p>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.<p>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.<p>Hell, what if there&#x27;s a correlation with elevation? It looks like there&#x27;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?

Well, at least the parasite endemic among humans sure is in decline now

The generic broad anti-viral props of ivermectin seems to have been established during the last decade <a href="https:&#x2F;&#x2F;www.sciencedirect.com&#x2F;science&#x2F;article&#x2F;pii&#x2F;S0166354220302011" rel="nofollow">https:&#x2F;&#x2F;www.sciencedirect.com&#x2F;science&#x2F;article&#x2F;pii&#x2F;S016635422...</a> so it isn&#x27;t out of the blue that it may work as anti-covid, though whether it rises to a clinical effect that i guess is the question right now. To me it looks like the small positive clinical effect reported in many places matches that generic broad anti-viral props, and it also shows that it isn&#x27;t a &quot;cure&quot;, at least not in the current form. So all this drama is kind of strange - why not prescribe to the patients who want it? Not that doctors have anything better to offer anyway, and the patients will get a deworming as a bonus.

fun (sad?) fact: Ivermectin is sold out in pharmacies in Upper Austria.<p><a href="https:&#x2F;&#x2F;www.nachrichten.at&#x2F;oberoesterreich&#x2F;entwurmungsmittel-ausverkauft;art4,3489983" rel="nofollow">https:&#x2F;&#x2F;www.nachrichten.at&#x2F;oberoesterreich&#x2F;entwurmungsmittel...</a>

Interesting read, I appreciate that the author isn&#x27;t dogmatic and is open to discussion.<p>However I think he misrepresent some anti-vaxxers: it&#x27;s not a matter of trusting science, it&#x27;s a matter of trusting scientists with heavy conflict of interest to tell the truth while most of us don&#x27;t have the required scientific knowledge to evaluate if they&#x27;re telling the truth.<p>Pfizer and Moderna combined are making more than $1000 every second (stop and calculate how much money that makes for a year, that&#x27;s mind boggling). Do they have an incentive to lie?<p>The fact that the discussion is immediately shut down and doubt isn&#x27;t allowed is a big red flag. Let me quote the author:<p>&gt; 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&#x2F;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.<p>He&#x27;s funny, but the underlying reality is very sad.<p>Add to this the power grab by politicians toward totalitarianism, color me very skeptical about the situation.

&gt; And it was! It was a fluke! A literal, physical, fluke! For my whole life, God has been placing terrible puns in my path to irritate me, and this would be the worst one ever! So it has to be true!<p>I think I don&#x27;t get the joke here. Can someone dissect it for me? (Yes, thereby killing it)<p>I love this man&#x27;s writing so much. Intelligent, empathetic, visionary, and simple. All at the same time. With no other author do I do as frequently think, &quot;this article is way too long, no way I&#x27;m going to read all this,&quot; and before I know it, I&#x27;m at the end.

The top part of the article is excellent, and literal worms as a confounding factor in trials of a deworming treatment makes a ton of sense.<p>The end of the article, where he speculates about vaccine denial, is less useful.<p>It’s kind of funny that the author spends most of the article rigorously applying the empirical and inductive scientific method, but then at the end just takes off on a flight into his own mind like some kind of ancient philosopher, finding their way by the power of thought alone.<p>It’s really easy to fool oneself into thinking that because you are smart and knowledgeable in one area, you are smart and knowledgeable in general. That’s how ego and the mind works. It turns out, that’s not how knowledge works though. You have to observe and test to build real knowledge.<p>The author, in exploring vaccine denial, would probably be better served by following the same method he did for ivermectin: exhaustively surveying the current state of scientific studies of the phenomenon, and attempting to rigorously synthesize it.

Lots of apologies are owed, none will be delivered. Glad we have an explanation.

An absolutely fantastic post. I have nothing else to add.<p>It takes the proponents arguments seriously, even as its dismantling them, but isn&#x27;t dismissive or condescending.<p>It just methodically, and earnestly, points out how they&#x27;re wrong.

&gt; There’s a video of a talk about it, but I am not going to watch it, because it is a video<p>I also never watch videos. I&#x27;d much rather read a well-written article that is searchable and actually has references to sources.

So now could a similar analysis be done for HCQ?<p>Granted, presumably patients coinfected with malaria would be far less numerous and far more obvious than those with parasites. But any other comorbidities that HCQ might affect?

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.<p>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&#x27;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.<p>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.

So the conclusion is that if you are already sick, your chances to beat COVID-19 are lower? Doesn’t this apply to many other drugs as well?

&gt; <i>I want a world where “I did a study, but I can’t show you the data” should be taken as seriously as “I determined P = NP, but I can’t show you the proof.”</i><p>The fact that this is not standard practice highlights some societal bias in favor of people in white lab coats that can&#x27;t possibly be suspected of fraud or incompetence - for it will shatter our sense of safety and control over the world.<p>People are people and power corrupts. When your publication has the power to turn you into a celebrity, skyrocket your career and land you a top paying job and speaking arrangements, the corruption potential is strong. As the author further elaborates:<p>&gt; <i>But even if it’s only 1%, these will make up much more than 1% of published studies, and much more than 1% of important ground-breaking published studies, because correct studies can only prove true things, but false studies can prove arbitrarily interesting hypotheses (did you know there was an increase in the suicide rate on days that Donald Trump tweeted?!?) and those are the ones that will get published and become famous.</i><p>&gt; <i>So if the lesson of the original replication crisis was “read the methodology” and “read the preregistration document”, this year’s lesson is “read the raw data”. Which is a bit more of an ask. Especially since most studies don’t make it available.</i>

I wish he could find a way to do this analysis blind for these kind of controversial issues.<p>I felt like he was in the hunt to end up with a certain conclusion from the beginning.<p>I felt like his article on vitamin D for covid was similar. “Looks promising but I’m going to say it doesn’t work because I take covid seriously or something”

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?<p>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.

How similar to Ivermectin is the new Pfizer covid drug?

TLDR:<p>The Summary Ivermectin doesn’t reduce mortality in COVID a significant amount (let’s say d &gt; 0.3) in the absence of comorbid parasites: 85-90% confidence<p>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<p>Fraud and data processing errors are of similar magnitude to p-hacking and methodological problems in explaining bad studies (95% confidence interval for fraud: between &gt;1% and 5% as important as methodological problems; 95% confidence interval for data processing errors: between 5% and 100% as important)<p>Probably “Trust Science” is not the right way to reach proponents of pseudoscientific medicine: ???% confidence

Some aditional context about the Szenta Fonseca et al paper: the study was based on the Hapvida insurance provider, which has been accused of forcing their doctors to prescribe the &quot;covid kit&quot; medication including chloroquine and ivermectin.<p><a href="https:&#x2F;&#x2F;oglobo.globo.com&#x2F;politica&#x2F;video-mostra-que-ministerio-da-saude-usou-hapvida-para-propagar-tratamento-sem-comprovacao-contra-covid-25226074" rel="nofollow">https:&#x2F;&#x2F;oglobo.globo.com&#x2F;politica&#x2F;video-mostra-que-ministeri...</a><p>The Hapvida data was also used by the Bolsonaro administration, to propagate a destructive political agenda in favor of &quot;early treatment&quot; and against vaccines.

so his conclusion is that ivermectin reduce mortality significantly only when patient suffer from both covid and worms?

He does a much better job of trying to relate to those &quot;not of his tribe&quot; than most do. Now I WISH he hadn&#x27;t hand waved the vaccine hesitancy by saying the data there was &quot;overwhelming&quot; without going into it at all.

&gt; <i>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.</i><p>To me such slogans are a disservice. Science should not be a matter of belief by definition.<p>This way of promoting science is what brings belief-centric discussions to an arena that cannot benefit from beliefs.<p>I remember one presidential debate in the US where the interviewer asked Trump: &quot;Do you believe the science of climate change?&quot;<p>Making such question is an absurdity and reflects the almost religious way these subjects have been considered lately.<p>No scientific field, study or conclusion should be a matter of belief.

A friend’s wife has been suffering the effects of long haul COVID-19 for about two months. A few weeks ago her doctor gave her a prescription for Ivermectin and while still very ill, she is feeling better, and the improvement happened quickly. Just one datapoint. I myself am very careful, vaccinations and I wear a quality mask when shopping. My wife and I have reduced our social circle to just about ten people who we sit down with inside for dinner.

We have multiple vaccines and two (EUA) proven oral treatments now.

Hold on, science never ends, amiright?<p>I want to focus on this article:<p><a href="https:&#x2F;&#x2F;sciencebasedmedicine.org&#x2F;pfizer-new-covid-19-protease-inhibitor-drug-is-not-just-repackaged-ivermectin&#x2F;" rel="nofollow">https:&#x2F;&#x2F;sciencebasedmedicine.org&#x2F;pfizer-new-covid-19-proteas...</a><p>Where they conclude:<p>&quot;Spoiler alert: Ivermectin does inhibit the same protease that PF-07321332 does, but, as is the case for viral replication, it requires a concentration that is not achievable by oral dosing.&quot;<p>So Ivermection COULD work. That is not me saying that, that is an scientific article debunking Ivermectin. (As an aside, the politics of this, they will not even say that yes, ivermection COULD work but the dose needed would be too high).<p>But the protease all these drugs try to inhibit is TMPRSS2. Now TMPRSS2 is made by a gene, and genetic changes affect the amount of this enzyme, leading to higher or lower function.<p><a href="https:&#x2F;&#x2F;academic.oup.com&#x2F;jid&#x2F;article&#x2F;212&#x2F;8&#x2F;1214&#x2F;2193475" rel="nofollow">https:&#x2F;&#x2F;academic.oup.com&#x2F;jid&#x2F;article&#x2F;212&#x2F;8&#x2F;1214&#x2F;2193475</a><p>These gene changes could make us more or less vulnerable to COVID in some populations:<p><a href="https:&#x2F;&#x2F;www.biorxiv.org&#x2F;content&#x2F;10.1101&#x2F;2021.10.04.463014v1" rel="nofollow">https:&#x2F;&#x2F;www.biorxiv.org&#x2F;content&#x2F;10.1101&#x2F;2021.10.04.463014v1</a><p>So, unless you filter out genetic diversity (which they never do) you will never find out the population Ivermectin MIGHT help. Maybe it would help someone like me who carries that polymorphism. Maybe that is why it seems to work well in other countries?<p>And what about checking if these patients were zinc deficient or not? Because ADAM17 uses zinc, and ADAM17 snips ACE2 off of the cell making Soluble ACE2. SARS2 will attach to this soluble ACE2 not allowing TMPRSS2 to let SARS2 into the cell.<p><a href="https:&#x2F;&#x2F;www.frontiersin.org&#x2F;files&#x2F;Articles&#x2F;576745&#x2F;fimmu-11-576745-HTML&#x2F;image_m&#x2F;fimmu-11-576745-g001.jpg" rel="nofollow">https:&#x2F;&#x2F;www.frontiersin.org&#x2F;files&#x2F;Articles&#x2F;576745&#x2F;fimmu-11-5...</a><p><a href="https:&#x2F;&#x2F;www.ahajournals.org&#x2F;cms&#x2F;asset&#x2F;36a2c66b-1ca8-43e9-944e-217a170f33fd&#x2F;hypertensionaha.120.15082.fig01.gif" rel="nofollow">https:&#x2F;&#x2F;www.ahajournals.org&#x2F;cms&#x2F;asset&#x2F;36a2c66b-1ca8-43e9-944...</a><p>So maybe, if someone has enough zinc then ivermectin, or any protease inhibitor, will be more effective at lower doses?<p>And you know that people with river blindness, the thing Ivermectin treats, have lower levels of zicn and supplementation is urged in these patients:<p><a href="http:&#x2F;&#x2F;www.sciencepub.net&#x2F;nature&#x2F;0504&#x2F;03_0312_nmorsi_serum_ns0504.pdf" rel="nofollow">http:&#x2F;&#x2F;www.sciencepub.net&#x2F;nature&#x2F;0504&#x2F;03_0312_nmorsi_serum_n...</a> (PDF)<p>&quot;The depleted mean serum trace elements in the infected volunteers than their control subjects implicated the deficiency of copper, selenuim and zinc in the pathogenesis of onchocerciasis and the need to incorporated dietary trace element supplements in management of onchocerciasis.&quot;<p>So all of those studies, IMHO, need to be thrown out.<p>This is science, no blogs here, and I have the vaccine so I am not anti-vax. So please, don&#x27;t come at me from that angle. This is a reasonable hypothesis.<p>I carry the TMPRSS2 polymorphism they mention in the article above. Yes, my experience is anecdotal, but I was discovered to have a zinc deficiency well before COVID (they had a medical reason for testing it) and supplementing with zinc ended the colds and flus I would get three times a year. It has been 10 years and I have not had only minor symptoms a few times.

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:<p>“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.”<p>Then he quotes. Their. Tweets. to tell us the ACTUAL problem with this contingent.<p>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.

Ivermectin - as unnecessary as the vaccines.

Ah yes, death is an acceptable outcome.

What I don&#x27;t understand is what is the incentive to publish fake studies to make a cheap generic (low profit) medicine look good? Even Merck, one of the manufacturers of Ivermectin claimed that the studies are invalid (then soon after announced that they are releasing a more expensive competing medicine which they have full patent rights over...). On the other hand, I know exactly what the incentives are to promote vaccines, lockdowns, bailouts, mandates and mass firings.<p>Journalists often said &quot;To find the truth, follow the money, look at the incentives.&quot; It seems that 99.9% of the money is against Ivermectin. Based on my experience working for big corporations, I wouldn&#x27;t be surprised at all if some directors organized a campaign to threaten, silence and discredit scientists who pose a threat to corporate profits. That is not far fetched at all. Anyone remember big tobacco funding studies to prove that smoking is harmless? You think corporations are less powerful today? With all that money printing and trillion dollar bailouts? With all the media censorship?<p>Big corporations managed to corrupt the legal system to get Steven Donziger jailed, why couldn&#x27;t they corrupt the medical establishment in the same way to slander research papers and researchers. How do we know the password was really just 1234... That whole story sounds made up.

&quot;The Scott Alexander article misses the whole point. Of course ivermectin on its own is not particularly helpful (unless you want to treat worms,<p>The treatment regimen the American group is recommending includes Vitamin D, Vitamin C, Zinc and a Zinc ionophore (drug that facilitates cellular absorption of Zinc). The ionophore can be Ivermectin, Hydroxychloroquine or Quercetin.<p>I have been baffled up until now why studies are not looking specifically at the combined treatment, just the ionophore, with no regard to whether it was being taken with Zinc or the other drugs. The fact that even Scott seems to have overlooked this is very concerning.<p>It&#x27;s the Zinc that inhibits replication in many viruses, and ionophores like ivermectin increase zinc absorption.&quot;<p><a href="https:&#x2F;&#x2F;marginalrevolution.com&#x2F;marginalrevolution&#x2F;2021&#x2F;11&#x2F;wednesday-assorted-links-321.html#comments" rel="nofollow">https:&#x2F;&#x2F;marginalrevolution.com&#x2F;marginalrevolution&#x2F;2021&#x2F;11&#x2F;we...</a>