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Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

nature.com

141–150 of 493 posts

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#141
post #138

With all the criticism of the mRNA and other COVID vaccines, which actually do have science backing them up, what is the science that would make ivermectin actually work? It's an antiparasitic drug. I see a lot of criticism of the COVID vaccines, especially from the right, but then they are fine taking hydroxychloroquine or ivermectin if there is any glimmer of hope that they will work. I just don't get it. Maybe, ju…

Here is an article from May 2020 about 15 drugs [1], including hydroxychloroquine and ivermectin, that were being looked into to see if they might help COVID. It goes into the mechanisms that led researchers to believe they were worth looking at. [1] https://www.nature.com/articles/d41591-020-00019-9 Edit: Oops...forgot to link the article. Added.

[deleted]

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#142
post #92

Earlier quoted context omitted.

People are literally taking horse formulations of ivermectin because doctors are rightfully refusing to prescribe ivermectin for an off label and ineffective use. Oh, and the access to this medicine is “marginalized” BECAUSE IT DOESNT WORK TO TREAT COVID. We generally do not expect doctors to prescribe medicine that will not work or is not appropriate for the patients condition. Complaining about their access being m…

In fairness, I see no reason why anyone should be blocked from buying any drug they want, whether it be ivermectin or heroin. The consequence of this restriction is that a subset of the prospective customers will settle for a potentially (more) dangerous alternative source, whether that be horse formulations or black market heroin cut with fentanyl. It's also a valid point that unproven and disproven aren't equivalen…

(As the GP) I really appreciate and generally agree with your perspective, but:

> the idea that there's some kind of widespread anti-Republican medical discrimination or corruption going on

is a total mischaracterization of what I was saying. In fact, it's essentially pulled from thin air.

The corruption of the news media is in their choice to mock and literally laugh at people sick from veterinary iver because kicking the out-group is popular with their audience (read $$). They do this instead of explaining (in a meaningful way) how we got here, and what steps we can take to make the situation better.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#143
post #138

With all the criticism of the mRNA and other COVID vaccines, which actually do have science backing them up, what is the science that would make ivermectin actually work? It's an antiparasitic drug. I see a lot of criticism of the COVID vaccines, especially from the right, but then they are fine taking hydroxychloroquine or ivermectin if there is any glimmer of hope that they will work. I just don't get it. Maybe, ju…

Here is an article from May 2020 about 15 drugs [1], including hydroxychloroquine and ivermectin, that were being looked into to see if they might help COVID. It goes into the mechanisms that led researchers to believe they were worth looking at. [1] https://www.nature.com/articles/d41591-020-00019-9 Edit: Oops...forgot to link the article. Added.

Interesting, thanks.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#144
post #49

Earlier quoted context omitted.

> The vast majority of the studies about Ivermectin have been observational, run by front-line clinicians. OK, so weak evidence. > Prior to 2020, basically everyone on earth agreed (including the WHO, who STILL agrees) that front-line clinicians and observational studies are excellent signals that can lead to scientific investigations that can lead to medical breakthroughs. Sure-- weak/crappy evidence and practitione…

Calling the investigatory and experiential evidence of thousands of highly-trained doctors (some of whom pioneered the standard of care for covid) as "weak evidence" is something that only somebody carrying water for large pharmaceutical companies would say. Doctors in my area are prescribing IVM to treat covid because in their experience and that of their peers IT WORKS. They have fewer deaths, fewer complications.…

> "The only science is real is expensive science done by large corporations!"

The only science that's real when it comes to public health is the science done across large enough populations and with enough methodology to rule out many confounding issues.

That tends to cost money, indeed.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#145
post #57

Earlier quoted context omitted.

> People take ivermectin instead of vaccinating or complying with NPIs Doing one thing but not another doesn't imply you're doing one thing instead of another. Do you truly believe the people ODing on ivermectin would be lining up for vaccinations if it didn't exist?

I don't know what this is supposed to mean, but a close family member took ivermectin instead of being vaccinated, and caught a serious case.

It's pretty simple: had ivermectin not existed, would that person have gotten vaccinated?

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#146
post #104

Earlier quoted context omitted.

I get where you are coming from, but I think that there is a nuance that you have missed. Like many, many drugs - and vaccines - ivemectin has some unpleasant and dangerous side effects in some people rarely. You can see these if you look the drug up : https://www.medicalnewstoday.com/articles/ivermectin-oral-ta... for example. The point is that if this drug did help people make it through covid (like the vaccines do…

All of this is for the patient and their doctor to decide. Not the pharmacist. Not the FDA.

They're [often] using the horse formulation because their doctor said no.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#147
post #113

Earlier quoted context omitted.

People are literally taking horse formulations of ivermectin because doctors are rightfully refusing to prescribe ivermectin for an off label and ineffective use. Oh, and the access to this medicine is “marginalized” BECAUSE IT DOESNT WORK TO TREAT COVID. We generally do not expect doctors to prescribe medicine that will not work or is not appropriate for the patients condition. Complaining about their access being m…

First of all, trying out random substances or applying existing medicines to different illnesses is exactly how doctors and the pharma industry operate. It's not like doctors actually always understand what is going on; for example, I think even the precise mechanism of anesthetics isn't well understood yet. So people volunteer to test a human approved drug for a different application. I don't believe in Ivermectin s…

> First of all, trying out random substances or applying existing medicines to different illnesses is exactly how doctors and the pharma industry operate.

Sure, but with methodology and metrics to allow the separation of actual effects from placebo, and in some cases even just enough methodology to be able to measure anything at all.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#148

Earlier quoted context omitted.

Fish antibiotics might be fine, but since they aren't regulated for human consumption it's more of a gamble. Plenty of chemicals that don't hurt fish that the manufacturer therefore won't be testing for that can be harmful to a human. But more importantly in the case of antibiotics: how do you know amoxicillin is the right one for what ails you? There are multiple antibiotics for multiple bacteria, and applying the w…

> how do you know amoxicillin is the right one for what ails you? In our case, that's what the doctor prescribes for my wife's chronic sinus infections whenever she asks one about them, and I've been stocking it as a goto first antibiotic for veterinary use since i started caring for my animals 30yr ago. In anyone else's case, there's no great barrier to educating yourself about what you put in your body and why, and…

> Doctors are consultants, not priests.

Oh man you couldn't be more spot on. There's no magic in what doctors do and how doctors prescribe a medication. There are two advantages that a doctor can have over an educated layman: 1) Experience: the number of cases they have seen and thus can make an educated inference to what is going on. 2) Their knowledge of anatomy (all they studied during their 4-6 years education).

Having been living with a chronic condition for more than 20 years, having gone to more than 10 specialists in 3 different countries and countless of studies I've seen the limitation of Medical Doctors (they are human beens at the end). There comes a time when you get to see that you understand your body better than any doctor could.

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#149
post #89

Earlier quoted context omitted.

#2 is for sure bviously preferable, but Good Luck With That. Once you get below the top N% in intelligence levels (5%-20% in my experience), the ability to 1) understand any kind of complex systems, 2) read, understand, contextualize and retain data, and maintain any rigorous logical thinking structure (e.g., keeping previously eliminated options eliminated) declines rapidly. The result is that, despite having absolu…

People at my state university would occasionally toss out the catchphrase "Ds get degrees!". It made me sad. I agree at minimum more people need to fail classes. If you want to be nice, counter by allowing more attempts.

>>counter by allowing more attempts

Excellent idea - retake any class once for nominal cost (and you've already got the textbooks).

Re: Lesson of ivermectin: meta-analyses based on summary data alone are unreliable

#150

With all the criticism of the mRNA and other COVID vaccines, which actually do have science backing them up, what is the science that would make ivermectin actually work? It's an antiparasitic drug. I see a lot of criticism of the COVID vaccines, especially from the right, but then they are fine taking hydroxychloroquine or ivermectin if there is any glimmer of hope that they will work. I just don't get it. Maybe, ju…

Something being designed to help people doesn't make it good. There's reason to believe vaccinating using a non-sterilizing vaccine during a pandemic exerts an evolutionary pressure on the virus that will lead to the vaccine becoming ineffective and the the virus endemic. Considering the current effectiveness of the vaccines a fully vaccinated population will be worse off than a fully recovered population (though the population that did not recover may find this rather morbid). See natural immunity vs vaccine-induced immunity research in Israel.

It's a lot harder to say how a fully vaccinated population will fare compared to a fully unvaccinated population. In the short term the unvaccinated population will certainly fare worse (more sick, more dead), but at a population level they will develop a stronger, longer lasting immunity and exert no mono-directional pressure. While in the fully vaccinated population, as long as the R0 is over 1 (which looks to be the case) the virus will be driven towards escape variants, it might not matter how many more people remain asymptomatic or how many fewer people die when new variants keep driving the pandemic forward and render the vaccines ineffective. It's population-level immunity that ends pandemics, immunity works very different on a population level than on an individual level.

Rather ironically if it turns out that this is indeed the case, then the people getting the vaccine are the "selfish" ones (protecting themselves short term from serious disease/death at the long term cost of the wider population) rather than the ones refusing the vaccine. Of course that's not entirely fair because people are doing it with the best of intentions and not out of "selfishness". I'm pointing this out more to demonstrate that things just aren't as simple as the media likes to portray it, i.e. with the non-vaccinated as the "selfish" ones.

If it turns out that vaccination campaigns do indeed do more harm to the population long-term than good (something we'll likely only know for certain after the pandemic is over or, more likely at this point, has become endemic), then medicine such as Ivermectin, even if only marginally effective at combating COVID starts to look a lot more interesting because it does not exert those same pressures on the virus.

There's several other ways the vaccines could end up hurting us in the long term, such OAS (Original Antigenic Sin) or ADE (Anti-body Dependent Enhancement), although it's looking really good on those fronts right now so I'm not worried about those.

The discourse going on at the moment on in general is really cancerous (even on HN sadly). As much as I find people who believe that there is no virus, or that vaccines are made to kill people, or following health advice from random internet sensations to be ridiculous, I find myself far more worried by the lack of intelligent discussion and the instant demonization and name-calling of anyone who asks questions that are critical of the vaccination campaigns. A large part of that I think is that the anti-vaxxers have been given so much media-attention (negative) that people assume anyone putting forward critical opinions "must be one those" and can be dismissed without notice.

No one knows what time will tell. Maybe this only has a one-in-a-thousand chance of ending up being the case. But I think it would be wise for people pushing for mandates to think about how society will look back at the COVID19 pandemic in say 50 years, if it turns out that the vaccination campaigns had a net-negative long-term effect. Is that really a risk we are willing to take? My take is that it would be wise to keep safe in any way we can: mask up, disinfect, get sun, keep fit, socialize responsibly, etc. And to avoid radical action before the science is settled, and vaccine mandates are radical. Science has a long history of settling on wrong for a while before getting it right, let's give it some time.

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