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COVID-19 antivirals and vaccines (Megathread)


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I find that the type of person who actually reads studies doesn’t tend to be the same type of person avoiding vaccines or masks and rushing off to take hydroxychloroquine… erm… ivermectin or whatever other snake oil gets peddled next by extremists and fascists. 

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9 hours ago, CharonY said:

This is what most of the conspiracy bullshitters are stating. The reality is that it is only an issue because for some reasons certain folks run off to dose themselves with horse dewormer rather than using a vaccine that has gone through trials and has been shown to be safe and effective with currently a sample size going in the billion of dosages. Hardly any other medication has that much data available.

I disagree.  There's several factors at play that supersede the statements you made:

First, in developed countries, there is widespread derision and condescension of those who use Ivermectin, or any other alternative treatment, such that it precludes actual objective analysis or sober discussion about the possible merits of alternative treatments.  It's become en vogue in the West of late to ridicule and pillory those who choose any option other than vaccination, a kind of self righteousness that isn't productive to exploring different treatment options.  The knee jerk response is to refer to drugs like Ivermectin, which have been used safely for decades, as "snake oil", or classify it solely as a dewormer.  This type of inaccurate framing is unhelpful.

Part of this stems from political partisan nonsense.  Every article on Ivermectin seems to immediately mention Tucker Carlson, Sean Hannity, and Laura Ingraham, as if these individuals are at all relevant to the conversation.  Let's dispense with the partisan nonsense and focus on the actual drug.  Ivermectin has been used safely to treat various human parasitic infestations for decades.  It is extremely cheap to produce, making it ideal for lower income countries with fledgling healthcare systems.  So far many front line physicians in the US and worldwide have prescribed it and reported positive results. 

Ivermectin is a medication that is used to treat parasite infestations. In humans, this includes head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis, and lymphatic filariasis.

Source:  https://en.wikipedia.org/wiki/Ivermectin

Second, the reason the current dialogue is counterproductive is because it ignores what actual data there may be.  Millions of people around the world, especially in South America and India have been, and are already, taking Ivermectin.  What is their experience?  How effective has treatment been for them?  We don't know because it's not considered a priority to study Ivermectin in countries with an abundance of vaccines.  And those American physicians who have prescribed Ivermectin and seen positive results?  They face censorship on internet platforms like youtube and Facebook, and potential character assassination in the media, if they're mentioned at all.  Personally, I trust the word of a front line physician more than some pundit in the media, but that's just me. 

This article about Ivermectin use in Peru shows it's widespread acceptance there:

“Of about 10 people who come, I’d say 8 have taken ivermectin and cannot participate in the study,” says Patricia García, a global-health researcher at Cayetano Heredia University in Lima and a former health minister for Peru who is running one of the 40 clinical trials worldwide that are currently testing the drug. “This has been an odyssey.”

Source: https://www.nature.com/articles/d41586-020-02958-2

Third, there's the intellectually dishonest framing that the drug is inherently dangerous.  "It's something for animals" - seems to be the mantra - despite the fact that Ivermectin has been used safely on humans for over four decades, and is extremely affordable.  Many developed countries are woefully under-vaccinated, due to a dearth of supply, and so they have to use what works for them.  Who are we to cast aspersions on them for doing so? 

Further, in the US, the drug is being used safely.  Out of hundreds of thousands of Ivermectin prescriptions written so far this year in the United States, only 96 people  (8% of 1,200 calls to poison control) have been hospitalized with any sort of complication arising from the drug, which was probably due to their independent misuse of it.  That's far less than the number of adverse reactions that have been reported from experimental (and non-FDA approved) vaccine use.

"Calls about ivermectin exposure to poison control centers around the country jumped to five times normal levels in July, according to data from the American Association of Poison Control Centers. About a third of nearly 1,200 calls so far this year involved people referred for medical treatment, and about 8 percent were ultimately admitted to a hospital, said Alvin Bronstein, who leads the association’s national data system."

Source:  https://www.washingtonpost.com/health/2021/09/01/ivermectin-covid-treatment/

Fourth, the vaccines haven't proven to be a silver bullet, at least not yet.  Many countries with near total vaccination coverage are seeing a surge in breakthrough infections from Delta.   Any treatment that works to halt the tide should be used: this includes alternatives like Ivermectin.  Again, developing countries are already using alternative treatments; they're not waiting around to be given permission from rich countries.  

Finally, there's the elephant in the room: the conflict of interest with big Pharma.  Any possible treatment that is generic (i.e. cheap) such as Ivermectin is a direct competitor to their profits from vaccines.  Big Pharma is one of the most powerful lobbies in the US - they spend billions each year to influence the public discourse, legislation, and anything else related to their products.  They have a direct interest in having no competition to vaccines - be it Ivermectin or other treatments - unless of course, they develop it themselves and can make money from it.     

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17 minutes ago, Alex_Krycek said:

in developed countries, there is widespread derision and condescension of those who use Ivermectin,

Because they’re fucking idiots who refuse to take the easiest most well evidenced and effective path toward bringing this pandemic to an end 

17 minutes ago, Alex_Krycek said:

Fourth, the vaccines haven't proven to be a silver bullet, at least not yet

Here again, idiocy of this magnitude is no longer acceptable. 
 

1cef6a78-09d9-48aa-a7c3-dff46ea2a1ed-vox

Edited by iNow
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24 minutes ago, Alex_Krycek said:

First, in developed countries, there is widespread derision and condescension of those who use Ivermectin, or any other alternative treatment, such that it precludes actual objective analysis or sober discussion about the possible merits of alternative treatments.  It's become en vogue in the West of late to ridicule and pillory those who choose any option other than vaccination, a kind of self righteousness that isn't productive to exploring different treatment options.  The knee jerk response is to refer to drugs like Ivermectin, which have been used safely for decades, as "snake oil", or classify it solely as a dewormer.  This type of inaccurate framing is unhelpful.

Part of this stems from political partisan nonsense.  Every article on Ivermectin seems to immediately mention Tucker Carlson, Sean Hannity, and Laura Ingraham, as if these individuals are at all relevant to the conversation.  Let's dispense with the partisan nonsense and focus on the actual drug.  Ivermectin has been used safely to treat various human parasitic infestations for decades.  It is extremely cheap to produce, making it ideal for lower income countries with fledgling healthcare systems.  So far many front line physicians in the US and worldwide have prescribed it and reported positive results. 

This is utter nonsense. If that was the case why did developed countries fund several studies to look into efficacy of ivermectin? The big issue is that the performance was ultimately disappointing. The dewormer comment is also because people are actually buying formulation for deworming cattle for self-medication. In other words, it is not a knee jerk response but a very accurate description of what folks are doing.

 

Quote

Second, the reason the current dialogue is counterproductive is because it ignores what actual data there may be.  Millions of people around the world, especially in South America and India have been, and are already, taking Ivermectin.  What is their experience?  How effective has treatment been for them?  We don't know because it's not considered a priority to study Ivermectin in countries with an abundance of vaccines.  And those American physicians who have prescribed Ivermectin and seen positive results?  They face censorship on internet platforms like youtube and Facebook, and potential character assassination in the media, if they're mentioned at all.  Personally, I trust the word of a front line physician more than some pundit in the media, but that's just me. 

In your own link you can read why the study is problematic, and it is not because of censorship. It is because we need ideally controlled setups in order to look at efficacy. Yes people are taking it out of desperation but what is the evidence that it actually works? As I mentioned, controlled trials found no effects, some studies were retracted because the data sets were faulty. Employing a new drug should generally be a high bar to pass, at best you are wasting everyone's time, at worst you could make the situation worse. Even taken the small cohort data into account right now the evidence for a beneficial effect of ivermectin is at best moderate and if the ongoing trials see no increase in effectiveness, it is unlikely to see more traction. In other words, the hype around it is not supported by data. Just because many folks are taking it tells us nothing about its effectiveness. Has anyone for example seen that active case numbers in Peru are inversely correlated with use of the drug? If not that is not evidence.

Quote

Third, there's the intellectually dishonest framing that the drug is inherently dangerous.  "It's something for animals" - seems to be the mantra - despite the fact that Ivermectin has been used safely on humans for over four decades, and is extremely affordable.  Many developed countries are woefully under-vaccinated, due to a dearth of supply, and so they have to use what works for them.  Who are we to cast aspersions on them for doing so? 

Even if it is not dangerous a drug has to perform. Otherwise you can peddle vitamin C, hydroxychloroquine and so on. Especially in the US folks are not taking it because they cannot get the vaccine. They take it because folks peddle it as something instead of vaccine. And that is where the danger is. I can understand desperate folks trying everything, even if it does not work. But in a community where the drug is actually plenty, this is just plain stupid.

Moreover, if folks take an ineffective drug and believe that they are protected and therefore engage in risky behaviour, well that is going to drive cases upward. The whole thing is just a stupid endeavour in conspiracies. The ever present desire to be pertaining to some exotic knowledge where only few enlightened folks have access to (but not invest any work in even trying to understand how clinical trials are set up and how to evaluate the evidence). Any lack of evidence is then explained by the evil mainstream (also called science) who is just somehow suppress research groups... somehow (but apparently not before giving them money to research it in the first place). We all know by now that this is just a convenient way to brush away evidence and jus supplant evidence with narratives. It would be funny  if it wasn't driving needless deaths and making the life of health care workers a living hell. 

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1 hour ago, iNow said:

Because they’re fucking idiots who refuse to take the easiest most well evidenced and effective path toward bringing this pandemic to an end 

This type of response is exactly what I'm talking about.  Thanks for proving my point.

1 hour ago, iNow said:

 

Here again, idiocy of this magnitude is no longer acceptable. 
 

https://www.science.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta

2120531434_ScreenShot2021-09-03at10_59_18.thumb.png.f957ee14ae754eb73a56362ff34ae405.png

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8 minutes ago, Alex_Krycek said:

Thanks for proving my point.

You’re welcome. Now, shut up and go get vaccinated if you haven’t already. 

9 minutes ago, Alex_Krycek said:

2120531434_ScreenShot2021-09-03at10_59_18.thumb.png.f957ee14ae754eb73a56362ff34ae405.png

Golly. Now… Imagine just how profoundly worse it would be without them having been vaccinated. 

I’m all out of shits to give, buddy. You’re a moron if you think you’re on the right side of this one. 

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What is your point? That vaccines are not 100% protective? We know that and have been discussing it in various threads. In Israel most of the severe breakthrough cases are folks with additional health complications, whereas the hospitalized folks without previous issues or younger persons were mostly vaccinated.

Quote

We are hardly seeing young vaccinated people in severe condition," said Balicer.

In the UK, doctors described similar characteristics among vaccinated patients who fall severely ill.

 

"In those people who come in, because of their age, because of their co-morbidities, they might be people that you would expect that the vaccine is not quite so efficacious as other age groups," said Tom Wingfield, a clinical lecturer at the Liverpool School of Tropical Medicine.

A new surge in U.S. coronavirus cases and deaths has been fueled by Delta, particularly in states where vaccination rates remain low. Among vaccinated patients who become infected, there is evidence of older people being hit harder.

In Texas, 92% of the vaccine breakthrough cases that resulted in death were in people over the age of 60 and 75% had a known underlying condition that put them at high risk from COVID-19, according to a public health department spokesperson.

So yes, additional treatment options would be great and I have mentioned a few that are actually at least moderately effective and being used. So why promote something with much less evidence? What is the thought process behind it? I mean why not promote Vitamin D instead? At least it is cheaper and has other health benefits especially if the population has deficits in that regard.

Or how about getting regular sleep and a good diet. I mean those would also lower risk to quite some degree. And if we talk about overall morbidity the net effect is likely higher than ivermectin. I really wonder who is making money with this drug at this point, this obsession cannot be organic.

 

Something to read about it here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050401/

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At that time, the wonder drug was starting to peak in sales everywhere, and from then on we noticed a sharp increase in the number of reports dealing with the prescription of an unconfirmed therapy. In June 2020, right in the middle of the first COVID-19 wave, the sales of IVM skyrocketed as 12 million packages were sold in Brazil alone (www.iqvia.com). The record sales were also related to the decision of mayors of three cities totaling 300,000 people, who have organized a voluntary mass treatment recommending three tablets of 6 mg of IVM on three occasions 15 days apart. Moreover, the population of Peru were also encouraged by their former President Mr. Martín Vizcarra to take IVM (https://elcomercio.pe/politica/martin-vizcarra-recomienda-uso-de-ivermectina-pese-a-falta-de-evidencia-cientifica-covid-19-coronavirus-nczg-noticia/). The medical and political decision for these and other mass treatments were misleadingly based on prevention, the possible reduction in hospitalization time, and the reduction in the total number of deaths. In a similar vein, countries that did not produce IVM in LATAM and Africa (approx. 500 million people) were desperate to obtain IVM at US$3.5 a package. Unfortunately, and after all these investments, the shape of COVID-19 curves did not exhibit any modification when comparing groups of treated and untreated people from the same area (Office of the Secretary of Health: https://www.saude.pr.gov.br/Pagina/Coronavirus-COVID-19).

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IVM may have contributed to this terrible situation since a team of infectologists described that more than 90% of the patients in the ICU admitted to having taken IVM as a preventive treatment for COVID-19 in the state of Rio Grande do Norte (The Intercept - https://theintercept.com/2021/03/19/cfm-290-mil-mortos-por-covid-19/?fbclid=IwAR2rdKPymgbPJqZWvpHad0E-XFKB3YUghE_N9OKr9SCwb8EuKwzSrl6ty_w) and at INCOR in São Paulo, Brazil.

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Although the above modelling exercises are valuable, we see that after almost a year since the in vitro publication of IVM efficacy, communities are still being used as the experimental unit, wrongly assessing an unconfirmed drug in fast-declining national health systems. It is particularly important to mention the lack of scientific or clinical pharmacology follow-ups as a number of toxic effects of IVM overuse have been observed after 35 consecutive weeks of treatment or even with the use of ten times the antiparasitic therapeutic dose. Patients are showing signs of diarrhea, dizziness, abdominal pain, and vomiting, which are now being reported as common side-effects (above 5–10%) that have never been seen in such high frequency (please remember the 12-million IVM packages sold in a month). In addition to that, physicians are reporting increasing numbers of IVM-related hepatitis (12 cases in 3 months in the state of Bahia) including the need for organ transplant, hitting the desperate health system even harder.

 

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1 hour ago, CharonY said:

This is utter nonsense. If that was the case why did developed countries fund several studies to look into efficacy of ivermectin? The big issue is that the performance was ultimately disappointing.

Do you have links to those studies?

1 hour ago, CharonY said:

The dewormer comment is also because people are actually buying formulation for deworming cattle for self-medication. In other words, it is not a knee jerk response but a very accurate description of what folks are doing.

Probably a small minority.  But as usual, the outliers seem to get all the attention in campaign to dismiss the entire group.  

1 hour ago, CharonY said:

In your own link you can read why the study is problematic, and it is not because of censorship. It is because we need ideally controlled setups in order to look at efficacy. Yes people are taking it out of desperation but what is the evidence that it actually works? As I mentioned, controlled trials found no effects, some studies were retracted because the data sets were faulty.

 

Post links to those studies please.

1 hour ago, CharonY said:

 Just because many folks are taking it tells us nothing about its effectiveness. Has anyone for example seen that active case numbers in Peru are inversely correlated with use of the drug? If not that is not evidence.

Which is why more studies should be conducted.  

1 hour ago, CharonY said:

Even if it is not dangerous a drug has to perform. Otherwise you can peddle vitamin C, hydroxychloroquine and so on. Especially in the US folks are not taking it because they cannot get the vaccine. They take it because folks peddle it as something instead of vaccine. And that is where the danger is. I can understand desperate folks trying everything, even if it does not work. But in a community where the drug is actually plenty, this is just plain stupid.

Or it can be used as an alternative treatment for breakthrough infections, until other treatments that are in the pipeline make it to market.  I think its fully justifiable for a member of the public who was repeatedly told that vaccines will protect them from Covid and then becomes infected again to consider all possible options.  

1 hour ago, CharonY said:

Moreover, if folks take an ineffective drug and believe that they are protected and therefore engage in risky behaviour, well that is going to drive cases upward. The whole thing is just a stupid endeavour in conspiracies. The ever present desire to be pertaining to some exotic knowledge where only few enlightened folks have access to (but not invest any work in even trying to understand how clinical trials are set up and how to evaluate the evidence).

I disagree.  There's a lot we still don't know about how to treat Covid. Treatment and prevention are both crucial.  Yes, take the vaccine if you have access to it: 100%.  However, many do not have access and need something that works in the meantime.  In the near future, there may be a vaccine that offers no immunity from a new variant.  That is an entirely plausible scenario based on recent events.  So the vaccine may not end up being a panacea; all options should be considered.  

1 hour ago, CharonY said:

Any lack of evidence is then explained by the evil mainstream (also called science) who is just somehow suppress research groups... somehow (but apparently not before giving them money to research it in the first place). We all know by now that this is just a convenient way to brush away evidence and jus supplant evidence with narratives. It would be funny  if it wasn't driving needless deaths and making the life of health care workers a living hell. 

I don't think it's that esoteric.  I see it more as group think on both sides.  The entire discussion is extremely emotionally charged and polarized, and there isn't much room for nuanced debate.  

8 minutes ago, iNow said:

You’re welcome. Now, shut up and go get vaccinated if you haven’t already. 

Golly. Now… Imagine just how profoundly worse it would be without them having been vaccinated. 

I’m all out of shits to give, buddy. You’re a moron if you think you’re on the right side of this one. 

I'm not interested in your emotional outbursts, or being told to "shut up".

If you have something to contribute to the debate, do so.

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2 minutes ago, Alex_Krycek said:

I'm not interested in your emotional outbursts, or being told to "shut up".

I guess it sure is a good thing I never told you to shut up. Let’s add lying and problems with reading comprehension to the list of reasons your opinion lacks value. 

Just now, Alex_Krycek said:

This thread is about debating the efficacy of Ivermectin.  

There’s literally no debate. It’s not effective, at least not in context of successfully slowing the spread of this pandemic and treating Covid. 

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Some interesting research reported on the NIH website:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/

Conclusions:

Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.

Source:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/

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Jesus, dude. “Interesting” is how female friends describe to each other blind dates of questionable character, attractiveness, and intelligence.

Just take the damned vaccine. You’re basically drowning and refusing the life vest 17 people are throwing you bc once some uninformed uneducated crank somewhere in a place that doesn’t matter once said to you one time that “blue magnets can help you float in choppy waters during hurricanes”… so you keep brushing aside all those 17 people with life vests in search of this nonexistent and nonhelpful blue magnet.   

It’s like someone is asking you what 2 + 2 equals and the answer you keep giving over and over and over again is “banana, but only when it’s purple.” No, dipshit. 2 + 2 = 4. 

1cef6a78-09d9-48aa-a7c3-dff46ea2a1ed-vox

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7 minutes ago, iNow said:

Jesus, dude. “Interesting” is how female friends describe to each other blind dates of questionable character, attractiveness, and intelligence.

Somewhat of an odd analogy, but anyway.  

7 minutes ago, iNow said:

Just take the damned vaccine. You’re basically drowning and refusing the life vest 17 people are throwing you bc once some uninformed uneducated crank somewhere in a place that doesn’t matter once said to you one time that “blue magnets can help you float in choppy waters during hurricanes”… so you keep brushing aside all those 17 people with life vests in search of this nonexistent and nonhelpful blue magnet.   

Are you calling these authors "uninformed uneducated cranks?

Andrew Bryant, MSc,1,* Theresa A. Lawrie, MBBCh, PhD,2 Therese Dowswell, PhD,2 Edmund J. Fordham, PhD,2 Scott Mitchell, MBChB, MRCS,3 Sarah R. Hill, PhD,1 and Tony C. Tham, MD, FRCP4

Should their research and subsequent conclusions not be considered?

7 minutes ago, iNow said:

It’s like someone is asking you what 2 + 2 equals and the answer you keep giving over and over and over again is “banana, but only when it’s purple.” No, dipshit. 2 + 2 = 4. 

Again, this discussion is about Ivermectin and research pertaining to it - not us getting emotional and calling each other names.

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39 minutes ago, Alex_Krycek said:

Are you calling these authors "uninformed uneducated cranks?

No. I’m saying the mRNA vaccine is quite obviously better than any sheep dewormer promulgated by Fox News and which one buys at a feed store.  

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Have you ever seen the movie Idiocracy? One of the storylines was that they were killing their crops and starving because they kept "watering" them with a Gatorade-like product called Brawndo. After all, it had electrolytes... it's got what plants crave! 

But then all the plants died and they were starving as a community. They just needed to use water and the plants would be fine, but nope... they just kept using the Brawndo / Gatorade and the plants just kept dying.

Well, that's kinda how I see this whole conversation we're having about ivermectin (or hydroxychloroquine or whatever the next snake oil happens to be). You're basically watering your garden with Gatorade by taking that stuff and the plants just keep dying...

It's like you got a cut and refuse to use neosporin and a bandaid, and are choosing instead to seal it with metallic spray paint and elmers glue. It's this ridiculous and absurd style of thinking that's causing this pandemic to continue and get worse. 

So, here's a thought... Just use water for your plants... just use the neosporin! This isn't exactly rocket science... just get the vaccine. 

10 hours ago, iNow said:

I guess it sure is a good thing I never told you to shut up

Here I was wrong and obviously did. I withdraw this particular comment, but not the others. I am basically saying to just get vaccinated already.

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9 hours ago, Alex_Krycek said:

Somewhat of an odd analogy, but anyway.  

Are you calling these authors "uninformed uneducated cranks?

Andrew Bryant, MSc,1,* Theresa A. Lawrie, MBBCh, PhD,2 Therese Dowswell, PhD,2 Edmund J. Fordham, PhD,2 Scott Mitchell, MBChB, MRCS,3 Sarah R. Hill, PhD,1 and Tony C. Tham, MD, FRCP4

Should their research and subsequent conclusions not be considered?

Again, this discussion is about Ivermectin and research pertaining to it - not us getting emotional and calling each other names.

!

Moderator Note

If you are going to complain about this, then it might be best if you, too, refrained from pejorative behavior, like the insinuation that iNow called the researchers uninformed uneducated cranks (which is not a reasonable reading of their analogy) or the attack on the media in your OP.  

 
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13 hours ago, Alex_Krycek said:

This type of response is exactly what I'm talking about.  Thanks for proving my point.

https://www.science.org/news/2021/08/grim-warning-israel-vaccination-blunts-does-not-defeat-delta

2120531434_ScreenShot2021-09-03at10_59_18.thumb.png.f957ee14ae754eb73a56362ff34ae405.png

If 100% of the people were vaccinated the virus would still cause some infections- no vaccine is perfect.

And you could then publish scaremongering stats that say "everybody in hospital with covid was vaccinated".

And you could even try to imply that the vaccine makes people more susceptible.
Bu that would be a lie, wouldn't it?

 

In Israel the vaccination level is pretty close to 100% so anyone with any sense would realise that many or most of the cases were going to be among people who were vaccinated (especially since the elderly tend to be more susceptible and more likely to be vaccinated.

So that graph doesn't show any problem with the vaccine.


 

12 hours ago, Alex_Krycek said:

Should their research and subsequent conclusions not be considered?

It should be considered in context.

The contexts is that the other trials of ivermectin did not show it to work.

The trials (and lived experience of people protected by) the vaccine shows it to be quite effective.

 

If you only have money for one, go for the vaccine.
If that is not available, buy a mask; it's not very good, but it's better than horse wormer.

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10 hours ago, Alex_Krycek said:

Some interesting research reported on the NIH website:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/

Conclusions:

Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.

Source:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/

Excellent, so I suppose you have dispensed with the notion that somehow there is a cabal restricting ivermectin research, considering that there are sufficiently around to actually try to make a meta-analysis? 

There was another earlier meta-analysis of randomized controlled trials. And as the author noted, many of the studies had sub-optimal quality https://doi.org/10.1002/14651858.CD015017.pub2, which is not terribly surprising for initial (and often limited) trials.

Quote

Based on the current very low‐ to low‐certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent COVID‐19. The completed studies are small and few are considered high quality. Several studies are underway that may produce clearer answers in review updates. Overall, the reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID‐19 outside of well‐designed randomized trials.

If you look at the paper you linked in detail, you will note that especially for prophylaxis they had 3 trials and highlighted that it only has low-certainty evidence of reduction. Even worse, one of the tree trials used for the evaluation was recently withdrawn (at least temporarily). So as a whole there is not a much to shake that particular conclusion.

However, even if we ignore these issues for now, as I mentioned earlier, the data (in part due to the quality of data) suggests at best that a bigger controlled trial is needed to figure out effects rather than jumping the fence and ingesting it because of some positive outcomes.

As mentioned before, this is not how drug research works. If every initial study was indicative of effectiveness, we would have cured all sorts of cancer a couple of thousand times by now.

The good news is that the TOGETHER trial with 1,500 participants could provide some answers.  Unfortunately the outcome is not published yet, but in a virtual symposium I attended one of the PIs has mentioned earlier last month that a couple of drugs where dropped out because they did not show benefits over placebos, including metformin and ivermectin. I am not sure whether that talk is public (though I suspect it somewhere) but I do not have a link saved. My notes only say that relative risk was 0.91 (0.69-1.19)and mortality relative risk is 0.82 (0.44-1.52), so no significant effect over placebo (well and that fluvoxamine showed promise, but for some reasons folks are not demanding its use in droves. I wonder why).

 

2 hours ago, iNow said:

Have you ever seen the movie Idiocracy?

I think it was a prophetic documentary. When I was younger I thought the future could be a Neuromancer-esque dystopia. Instead, we have this.

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I appreciated @CharonY's point that one might just as well promote vitamin D or melatonin,  for immune support,  which have a clearer causal path in reducing severe illness than does ivermectin.   In some places,  turmeric (curcumin) was promoted as protective in its immune-boosting properties.   I would make a guess none of these are as protective against grave lung problems,  re covid,  as reducing PM pollution and urban air pollution generally.    Not only do small particulates harm lungs and vascular linings,  but they can ferry viral particles if they get into more enclosed spaces.   

 

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1 hour ago, John Cuthber said:

If you only have money for one, go for the vaccine.

Agreed, though it’s free (at least in the US), which makes people still refusing to take it that much more infuriating. 

1 hour ago, CharonY said:

I think it was a prophetic documentary. When I was younger I thought the future could be a Neuromancer-esque dystopia. Instead, we have this

Too many people are treating it like a how-to guide

4 minutes ago, TheVat said:

Not only do small particulates harm lungs and vascular linings,  but they can ferry viral particles if they get into more enclosed spaces.   

 

In fact, they’ve found covid to be spreading more rapidly with all of the wild fires in the western US since the virus can grab ahold of the smoke particles and fly farther. 

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3 minutes ago, TheVat said:

I appreciated @CharonY's point that one might just as well promote vitamin D or melatonin,  for immune support,  which have a clearer causal path in reducing severe illness than does ivermectin.   In some places,  turmeric (curcumin) was promoted as protective in its immune-boosting properties.   I would make a guess none of these are as protective against grave lung problems,  re covid,  as reducing PM pollution and urban air pollution generally.    Not only do small particulates harm lungs and vascular linings,  but they can ferry viral particles if they get into more enclosed spaces.   

 

Yes indeed, controlled studies have shown little to no effect of supplements on overall outcome. However, overall improvement of well-being by life choices (diet, exercise) environmental health and so on, all have positive properties for many diseases as they can improve our ability to combat and survive infections and associated complications. Unfortunately well-being is also often coupled to income. 

Also unfortunately folks (and I am guilty of that as well, especially with respect to sleep) folks often neglect overall well-being and focus on drugs as primary measure. I.e. fix things when broken, instead of not breaking it in the first place.

 

 

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2 hours ago, iNow said:

Too many people are treating it like a how-to guide

I am still waiting for someone jumping out of the closet and tell me it was all just a joke. I even cleaned out said closet to make it easier but still no luck.

 

2 hours ago, iNow said:

In fact, they’ve found covid to be spreading more rapidly with all of the wild fires in the western US since the virus can grab ahold of the smoke particles and fly farther. 

Really? I find that somewhat surprising. The only things I have seen so far was mostly related to increased mortality due to PM2.5 exposure. Do you have a report at hand by any chance?

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1 hour ago, CharonY said:

Really? I find that somewhat surprising. The only things I have seen so far was mostly related to increased mortality due to PM2.5 exposure. Do you have a report at hand by any chance?

Your framing of this is definitely more accurate than mine. The particulate matter (PM2.5) is leading to worse outcomes and increased infection in the lungs / increased inflammation across the immune system. I suspect you’ve seen this, but here’s a study saying same:

https://www.science.org/doi/10.1126/sciadv.abi8789

Where my view came from was commentary on that story above from doctors and related experts on the news. They suggested that the particles in the smoke offer a platform for the virus to move greater distances than it would in clear air. A bit like larger raindrops form on grains of pollen than by themselves… 

However, if the ability of Covid to transport more easily in US wildfire smoke has been studied, then I’m not easily able to find where right now so will withdraw my confidence above and suggest it as an interesting possibility that deserves study.

In the meantime… This study touches on how bioaerosols and airborne pathogens enjoy easier spread amid polluted air, but I’m not certain Covid fits that same bill (or if instead Covid would simply “die” whereas the bacteria or fungi this team studied would not… I’m unclear if the particulates are equally a vector for Covid in the same way they are with the others)

https://pubs.acs.org/doi/10.1021/es4048472

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Thanks iNow, I have indeed seen the study. I am a bit skeptical that the viral particles would remain intact under the conditions, certain bacteria and certainly spores would have much higher resilience compared to them. But thank for clearing that up. 

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