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

> I am saying that those communities of experts have decided that the question of ivermectin’s effectiveness is effectively settled.

Trials[1] don't tend to be run on settled science, so it really does seem that you've taken a position based on political arguments.

> I also never said shut down disagreement. That’s a straw man you created. Anti-vax is not a good-intentioned disagreement

You've said to shut down disagreement based on a standard that requires mind reading. How is that effectively any different from shutting down disagreement? That old Chomsky quote about Stalin being for free speech he agreed with come to mind.

> Allowing pseudoscience to flourish under some strange argument that their positions are as scientifically valid as actual science, is, frankly, nonsense.

This is an actual straw man, by the way, the comment you're replying to made no such faulty conflation.

Since mind reading is back in fashion I will do some clairvoyancy and predict that I will be labelled anti-vaxx for defending the mere possibility of disagreement and dissent. Now there's a problem with a non-zero number of the HN community you should be concerned about.

[1] https://www.principletrial.org/

Not really disagreeing that a pharmacist might know more about the drugs than a doctor. I wasn't warned about the potential side effects of Ciprofloxacin once, just told it was an "antibiotic" by the specialist I saw, and the pharmacist did clue me in about some side effects, which I promptly had some of the worst ones after a single pill. I might not have made the connection it was a bad reaction to the pills without their warning, at least not so quickly. I continued to have side effects off and on for years afterwards.

I learned my lesson and now do my own research before just taking any medicine a doctor wants to prescribe now.

But I still don't think pharmacists should be able to just override the decision of a doctor. Make sure the person is fully informed of potential dangers, side effects and correct usage, sure, but not override the doctor. The doctor has had an opportunity to examine and talk to the patient at length, multiple times over multiple visits, and know their history and specific needs, the pharmacist doesn't know any of that background and are most likely just making assumptions.

I mean if it's literal rat poison or a dose guaranteed to kill the person is being prescribed, maybe they can hold off on fulfilling it and alert authorities, but otherwise?

Opioids are a major problem, as there are addicts that cycle doctors to get multiple prescriptions so some doctors might not realize it's being overprescribed, but that's a matter of addiction and abuse and I don't know how a pharmacist is expected to know when it's being abused or not, unless they're getting them all filled at the same pharmacy. Again, they're not spending enough time with these people to know what their situation is. The most interaction I have with my pharmacist is "Picking up a prescription." "Verify your address please?" "My address." "Okay this has these side effects and you should only have it after a meal." "Okay thanks." Yeah that's totally enough for them to make a medical decision on my behalf. /s

If anything, I think them deciding when to withhold medicine could make them MORE liable, not less, because they're inserting themself into the decision process. What if their withholding fulfillment of a prescription results in that person dying? If the doctor said yes and they said no, that seems to open up room for litigation to me.

> I will re-post some thoughts I have previously shared from John P.A. Ioannidis who is a professor of medicine and thoughtful critic of medical research

https://en.wikipedia.org/wiki/John_Ioannidis#COVID-19

> In an editorial on STAT published March 17, 2020, Ioannidis called the global response to the COVID-19 pandemic a "once-in-a-century evidence fiasco" and wrote that lockdowns were likely an overreaction to unreliable data.[14] He estimated that the coronavirus could cause 10,000 U.S. deaths if it infected 1% of the U.S. population, and argued that more data was needed to determine if the virus would spread more.[28][5][14] The virus in fact eventually infected far more people, and would cause more than 600,000 deaths in the U.S.[29][28][5] Marc Lipsitch, Director of the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health, objected to Ioannidis's characterization of the global response in a reply that was published on STAT the next day after Ioannidis's.[30]

> Ioannidis widely promoted a study of which he had been co-author, "COVID-19 Antibody Seroprevalence in Santa Clara County, California", released as a preprint on April 17, 2020. It asserted that Santa Clara County's number of infections was between 50 and 85 times higher than the official count, putting the virus's fatality rate as low as 0.1% to 0.2%.[n 1][32][29] Ioannidis concluded from the study that the coronavirus is "not the apocalyptic problem we thought".[33] The message found favor with right-wing media outlets, but the paper drew criticism from a number of epidemiologists who said its testing was inaccurate and its methods were sloppy.

Okay then.

Nothing like spending a career picking apart people's research and then generating absolutely garbage research outside your field of expertise, that is widely criticized by people who are actually the experts in that field...as being inaccurate and sloppy.

COVID hit, dude went all Don Quixote seeing conspiracies everywhere, and then generated a paper that suited his personal biases...

I see this a lot and it's very strange to see super smart people such as yourself conflate with . We cannot observe long-term effects through number of people.

That and politics. The frontline group was also involved in the Hydroxychloroquine debacle, and they were selected specifically by political actors as a pro-trump solution to the pandemic.

With any of these politically connected things, there’s always a mix of grift, political opportunism, and true believers.