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Comment by version_five | Hacker News Reader

I have seen an increasing amount of Ivermectin promotion recently, and at face value it looks worth pursuing. My biggest concern is the overall shady nature of many of its proponents, and specifically when I see posts or individuals that in the same breath have a strong anti-vaccine stance that and are promoting Ivermectin. Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there.

Its promising to see something in Science which I hope has a higher bar, although I'm not familiar with the blogs section

Edit: > An editorially independent blog from the publishers of Science Translational Medicine. All content is Derek’s own, and he does not in any way speak for his employer.

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They have a lot to do with each other.

The emergency use authorization for the vaccines was predicated on there being no effective approved alternatives. If there's an effective approved alternative, the vaccines lose their EUA and are back to being clinical trials until full approval.

So anti-vax people want an effective treatment to be found to invalidate the EUA. Pro-vax people don't want an effective treatment to be found because it would invalidate the EUA.

> Pro-vax people don't want an effective treatment to be found because it would invalidate the EUA.

This seems highly unlikely. Do you have a reputable source for this, because thus far I’ve only seen it as a conspiratorial anti-vax talking point.

Dexamethasone is a cheap generic drug that has been proven to reduce covid-19 mortality and is being used worldwide including in the USA. The studies showing that it worked occurred before the EUA for the vaccines was issued. It is officially recommended on https://www.covid19treatmentguidelines.nih.gov/therapies/imm...

I am not sure there is any actual proof that if ivermectin was shown to be, e.g., as effective as dexamethasone in reducing covid-19 mortality that it would stop the FDA from issuing a EUA for a vaccine. After all there is a big difference between a vaccine and a treatment anyway.

> Dexamethasone is a cheap generic drug that has been proven to reduce covid-19 mortality and is being used worldwide including in the USA. The studies showing that it worked occurred before the EUA for the vaccines was issued. It is officially recommended on [nih.gov]...

These are the same doctors that recommended the use of corticosteroids when everyone else was recommending against it.

These are the same doctors that recommended anti-coagulation treatment when everyone else was recommending against it.

These are the same doctors that identified airborne transmission of disease, the WHO is only starting to acknowledge it more than a year later.

They were ridiculed and criticised at the time for things that are now standard of care, and proved right time and time again.

They are the same doctors that are now recommending Ivermectin, and are now being censored (e.g. senate hearing removed from YouTube) and labelled as spreading medical misinformation.

https://www.youtube.com/watch?v=3UTuT9TSRFQ&t=110s

This is the same technique the Motley Fool uses for their stock picking newsletters. Make lots of predictions; highlight the ones that wound up working.

All of FLCCC's work is public, and is done with no financial conflict of interest.

Dr. Pierre Kory also testified multiple times to the senate.

He published multiple studies on the matter.

If they get it right again and again it's because they follow the data, and have actual expertise in the matter.

That said, the WHO reputation is becoming more and more tarnished day by day. That's why more and more countries are starting to ignore the WHO, and with great results.

https://covid19criticalcare.com/ivermectin-in-covid-19/epide...

https://ivmstatus.com/

Ivermectin is however being promoted both as a prophylactic and a cure - https://ivmmeta.com/ (I have no idea about the reputation of this source). With big Pharmas also relying on the internet and social media to market their medicines, it has really become quite difficult to sift through bullshit and facts. Look at all the hype before with HCQ and Remdesivir last year ...

Why do you assume that „pro-vax people“ would not want to see an effective treatment? They are „pro-vax“ because it prevents harm to them and others. Effective treatment helps with that.

No, they're pro-vax because they observe that it's the socially and professionally high-status position to take.

People are pro-vax because they want this pandemic to end! The majority of Americans have taken it and it's safe, I have taken it and feel happy knowing I won't have to worry about getting long covid. Anti-vax people are only extending this pandemic and fail at the most basic reasoning. I mean I can understand people being hesitant when the vaccines were first authorized, but now that most Americans have taken it, the idea someone would still risk COVID over getting vaccinated is insane.

Wanna know what does have high risk for long term side effects? COVID.

Not all vaccines are created equal. Grouping people in "pro/anti-vax" carries a risk of creating a huge backlash against vaccination in general, if the relatively new and unproven mRNA vaccines end up less than ideal. For example the virus mutates to bypass the very specific protein the vaccine targets, or there are serious side effects, possibly on the reproductive path, a few years down the pipeline. Consider being more specific, for example 'pro/anti mRNA Covid vaccines'.

Thank you for pointing this out. I've been vaccinated for many things, they're vaccines that we've had years of experience administering to people. I'm not anti-vax in any way. I'm not even anti-mRNA vaccines. What I am is cautious of new and rushed medicine rolled out at large scale. The chances of it going wrong don't have to be big, I just don't believe the risk is worth taking without more conclusive research. I'd have the same worries if WHO recommended everyone start taking IVM weekly for the duration of the pandemic (if I'm not mistaken almost all research on IVM has focused on short-term usage).

Politicians talking about "getting everyone medicated (or vaccinated) as soon as possible" with anything that doesn't have long-term studies should be worrying to all. And the fact that some SV companies will not allow this discourse to happen should be even more so.

I’ve heard this said, but is this accurate? Would love a source.

I find it rather troubling, lumping scepticism of these experimental, emergency authorized vaccines in the same category as existing vaccines that have had decades of use and well known safety profiles . It puts you into "yes" or "no "camps, without acknowledging potential unknown problems with these rushed vaccines. There are no long term studies.

I am not anti-vaccine, but I don't think we should be as gung-ho as we are with these vaccines, especially on young people who are at very low risk from covid. Vaccinating children seems immoral.

You think it's shady to look into a drug that is out of patent? What is the profit motive there?

> a strong anti-vaccine stance that and are promoting Ivermectin. Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there.

One of the people I know is one of these people. Pro Ivermectin and anti vaccine.

It’s tied together by their belief that COVID was overblown, an attempt by the government to seize control, or an attempt by big pharma to make piles selling COVID vaccine. Or all three.

Basically to this person, Ivermectin being a cure is proof that the government/doctors/pharma manufactured the crisis.

What connects antivax and untutored Ivermectin promotion is a generalized, reflexive, contrarian rejection of anything perceived as "establishment" science.

For some it’s also an application of the precautionary principle, and a worry that rushing into widespread application of an experimental treatment may present unknown harms. Contra to the contrarians rejecting establishment science, a secondary concern driving the precautionary perspective is a fear that if there are major medium or long term complications then it would lead to a widespread distrust of the scientific establishment itself.

The problem is that an epistemic closure around this issue has emerged for a variety of reasons, so the people who are skeptical and willing to talk about it are few in number and looking for allies, so you end up with a rather motley crew.

I’m interested in what people like Pierre Kory and Tess Lawrie say on this issue because they seem like credible people without a track record of crankery, and they’ve looked at the same evidence as the WHO and come to different conclusions. Even if they are wrong it is interesting to engrave with and figure out why. And if they are right, it would be good to figure that out sooner rather than later. But any time I stick around in the forums where their work is discussed the comments section is often overrun by unhinged wackos with different motivations.

The thing that really defeats the ivermectin argument is simply effect size (or, equivalently, drug effectiveness). For a drug to be useful, it needs to have a larger effect than existing therapies. The larger the effect, the more useful. And the larger the effect, the easier it will show up in studies.

Ivermectin's trial results are mediocre at best. So it can't be that powerful a treatment. It's probably helping a bit, or at least not hurting, but it's not a wonder drug. We'd have seen that if it were!

So then you get into the usual lines of bullshit, as we saw before with the hydroxychloroquine people. "Augment with unicorn horn dust" and "dose more" and "dose earlier" and all that. But COVID-19 is the sort of disease that is impractical to dose too early, so "must dose very early" just means "drug is useless".

Thus the facts are clear: even if ivermectin works, it isn't useful. It was a great hypothesis to test. It failed in the clinic. So it's irresponsible to continue beating against it when we have better avenues to pursue.

But Ivermectin IS a wonder drug for other things. It's been around for decades and billions of doses have been taken. It's not just some random drug.

Having said that, it remains to be seen if can work for covid too.

> It's not just some random drug.

Yes, its safety profile and production are well-established.

But as far as covid is concerned, it is some random drug. Metformin is also a wonder drug, should we bet our lives on it for covid? No? You say there are more useful things?

I really don't understand why people think this drug can work. It was trialled. It neither passed with flying colors nor flamed out. That's... pretty much what most drug candidates do. It doesn't really "remain to be seen" here: there's plenty of evidence for "doesn't move the needle".

The fact that is it’s effective at early stages does not make it useless. It could be taken prophylacticaly if you know you’re going to be in a high risk situation like a roommate tests positive.

...or you can get vaccinated first? Or actually quarantine (alone)? And I do hope you were lucky enough to stockpile it beforehand, because you'd better not be going out too often with such a test result....

It could have some covid uses, sure. But it can't change the game. Hence my label of "useless" in overall pandemic management (much like contact tracing). I admit that "almost useless" or "only useful in very niche situations" is more accurate. But it is useless 99.9% of the time.

Talking about a prophylactic use case might have made sense a year ago but makes zero sense today, when more than 50% of the adult population is vaccinated and 70-80% of many states are vaccinated while most are fully reopened without capacity limits or mask mandates.

What are we doing here? Is this really the hill they want to die on?

The world is larger than the United States

> ...or you can get vaccinated first?

Although the CDC has decided to stop counting them, breakthrough infections and even death are common among the vaccinated. There's not going to be a point where we don't need to worry about treatment unless the virus is going to go away like the Spanish flu once enough people are immune.

> And I do hope you were lucky enough to stockpile it beforehand, because you'd better not be going out too often with such a test result....

It's pretty clear from this that you have never looked into how ivermectin was used in certain Indian states or in Chiapas, where local officials readied pre-made kits which could be distributed to high risk people and those who tested positive. This would be easy enough to do in the US if we could shift the thinking on Covid away from "you have to wait until you're gasping for breath at the hospital to start any treatment other than acetaminophen."

Do you feel similarly about lockdowns being "useless" given their demonstrated inability to fully eliminate spread of the virus, and the lack of any large RCTs in support of them? I mean, I see all the same arguments made in their favor: "you have to do them early enough, you have to pair them with such-and-such other NPIs, etc"

> It's promising to see something in Science which I hope has a higher bar, although I'm not familiar with the blogs section.

I'm a regular reader of this blog. I have an specialization in Chemistry in the Secondary School, so I can vouch that his articles about Chemistry are solid (and adobe my knowledge level). I'm convinced that the articles about the pharmaceutical industry are correct, but that's a little more far away from my specialization.

About Ivermectin, someone posted a few days ago a site that collect all the favorable evidence. I read a few of the papers and in my opinion it's not convincing. The papers are studies with a small number of persons, or with a small difference or instead of the control group they compare with dubious numbers. Essentially, the same conclusion of this blog post, but I only skimmed a few papers and he probably read most of them carefully. If I were you, I'd thrust his opinions more than mine, but in this case we agree.

> have an specialization in Chemistry in the Secondary School

Not familiar with American idioms. What does this mean? Secondary School is what you go to after Primary School where I come from, but clearly you can’t mean that.

I think the OP is Brazilian (submissions include links to blog), in which case Secondary extends to 18, so equivalent to A-level in the UK for example.

Almost. I'm from Argentina. I'm not sure about the translation, and the system has changed recently, so the current information may be different.

My "Secondary School" was from 13 to 18 (6 years). https://es.wikipedia.org/wiki/Educaci%C3%B3n_Secundaria_T%C3... You had one additional year than a normal "Secondary School" here, it [1] includes normal classes in the morning but less History/Geography/Whatever and in my case more Chemistry, a lot of Chemistry. Half of the days in the afternoon we had practical classes, making Chemistry experiments. At the end, I get a the "Secondary School" degree that enables me to go to the university and also some official habilitation to run a small chemistry factory or laboratory (oversimplifying the legal details) (probably is more accurate to say that I can supervise a few persosns in a factory or a lab).

Other students instead of Chemistry classes had Masonry classes and got an habilitation to build a small house (up to 2 stories?) and other Electronic classes, ... Each School has a different specialization, a bunch of specializations.

Edit: [1] The last 4 years. And the first 2 years have also more technical classes than a usual school, but they mix other stuff like basic electricity or metalworking.

Thanks for the correction -- I think the confusion comes from "secondary" which is 11-16 in the UK, so "secondary chemistry" is fairly basic (I have it, and I know nothing of chemistry)

> a strong anti-vaccine stance that and are promoting Ivermectin

I would assume that the core of this sentiment is something like “vaccine is a semi-permanent modification of immune response while ivermectin is a temporary chemical adjustment”

I’m just guessing though.

Obviously the two things have nothing to do with each other, and frankly I can't understand what the agenda is there.

The apparently-rational argument the shady-type make that Ivermectin is so good you don't need vaccines. But I don't think any honest advocates can claim that.

The fuzzy-irrational argument is you can't "trust" the medical industrial complex 'cause they're pushing vaccines and suppressing Ivermectin.

This stuff is terrible but there's method to their madness.

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