Scott Alexander's correction on ivermectin and its meaning for the rationalists

The "rationalist community" is morbidly fascinating in their tendency to be so self-important while also having a deficit of self-awareness. The author of this piece can't understand why an internet-famous blogger/Substack writer that he follows doesn't have time to drop everything and debate the minutia of a blog post he wrong last year on a topic that has long since been settled. Note that Scott did listen to him, work through his reasoning, and update his blog with a note about it, but that didn't satisfy the author:

> Step 6: Semi-Permeable Membranes

> One thing that shocked me was how hard it was to discuss even a simple thing with Scott, even when he knew I could have made a big deal about this without giving him an opportunity to make whatever correction he thought appropriate. It felt like communicating through a straw. I get the sense that Scott is busy. Busy and/or surrounded by people who think the world of him; a community of readers that compliment his writing early and often.

This piece also shares several other characteristics of "rationalist" writings: Unnecessarily long and rambling prose, flowery language and dramatic subsection titles when basic text would suffice, hedging in the middle of the article in case the author turns out to be incorrect, and a relentless insistence that the conversation revolve around their experience and some perceived sleights instead of letting the argument stand alone.

Regardless, this seems like a silly diatribe after the medical community has already investigated the Ivermectin idea to great lengths and at massive scale and concluded that any effects it might have are too small to be worth pursuing. It's weird to see someone writing volumes about re-litigating last years' amateur scientist social media battles.

This author is either obsessed with Ivermectin and the TOGETHER trial or playing a game to pander his Substack to a certain audience who loves this content. His first post was only a month ago but he's already written 11 articles suggesting errors and alluding to conspiracy theories.

You know those jokes about "how do you know someone is a vegan/PhD"?

Well, how do you know someone is a rationalist? Don't worry, he will tell you soon that he's "updating".

I guess 'rationalism', as a name, calls a certain kind of person out of the ether:

1. They like rationality, and feel it's opposed by 'irrationality'.

2. They want to be part of some 'rational group'.

3. They're ignorant enough not to know the name is already taken.

4. They're ignorant enough not to know that the name means pretty much the opposite of what they believe. (A real rationalist, for instance, probably wouldn't be interested in modern science).

5. They're ignorant enough not to know that 'rational' and 'irrational' are usually demarcate lines of social hierarchy, not lines of theoretical commitment.

This is an attractive pitch, so obviously, loads of people jump on. I think the main thing that's nice about it is that no real work is called for. Every smart white kid from a nice background has been called 'logical' or 'rational' at some point, because (5), so it's a value they identify with. It's a young group, full of energy, because the internet is biased young, and young people go for (2) through (5).

I didn't read this and suddenly think "oh my god- the whole establishment is wrong! How thankful I am that some rational person has done the hard math for me to explain why ivermectin is a magic cure".

The current medical opinion is that ivermectin only appears to have an effect when it's actually treating an underlying condition (parasitic infection). I don't see that changing any time soon; certainly nobody has shown any truly strong data that resisted multiple attempts at falsification supported ivermectin being really effective against COVID, itself.

As a biologist who works with data- it's realyl easy for smart people to read studies and totally fool themselves. That's what I think happened here.