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Comment by goldemerald | Hacker News Reader

I heard about Ivermectin for the first time this week and was shocked how much it seemed that I had stepped into conspiracy theory land. There seemed to be an overwhelming amount of evidence over the last year that this repurposed drug is effective at treating Covid during a variety of stages (preventative, first positive test, ICU admittance, and even long haul). But since there hadn't been a randomized trial the drug had, not only been dismissed, but heavily censored over social media. I still cannot believe how much the discussion has been silenced in the same way people discuss "covid vaxx causes magnetism". The fact the interview between Bret Weinstein and Pierre Kory was banned from youtube for non-WHO/CDC/NIH approved covid treatments is a tragedy. I truly hope in the coming years the censorship of this topic will be the catalyst for allowing free speech to prevail on social media.

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> The fact the interview between Bret Weinstein and Pierre Kory was banned from youtube for non-WHO/CDC/NIH approved covid treatments is a tragedy.

Banning academics from talking on a platform is a high-risk strategy. It was always possible YouTube would do more harm than good implementing their stupid policy.

Note that their ban might be taking out anyone who wants to talk about Ivermectin neutrally or negatively because of the risk of being censored. It is possible (probable, even) that YouTube is now presenting a biased sample of videos sampled only from people who believe strongly enough in the drug to try and circumvent the ban.

My guess is that if Ivermectin turns out to be useless despite the evidence, a lot of the buzz I've heard will have been generated by YouTube squelching debate meaning that only the pro- side even attempts to get the message out on social media. Because I've only heard of wall-to-wall positive coverage on YouTube and I don't trust the consistency.

>Because I've only heard of wall-to-wall positive coverage on YouTube and I don't trust the consistency.

Where else can it be discussed? No major media would allow it on their networks for fear of the cancel mobs coming with torches and pitchforks.

" But since there hadn't been a randomized trial " This is not true. A quick search shows 71 trials covering ivermectin, of which 6 of which are complete, interventional[1], and have results

https://clinicaltrials.gov/ct2/results?term=ivermectin&cond=...

[1] This should mean an RCT, but I haven't time to read through each and check they are

Yes, it has been explored, trialed, and experimented with quite significantly.

The results show that there might be something there, but it’s not a miracle cure.

The conspiracy angles are coming from those who have been misled into thinking it has been more successful than it really has been, which leads to confusion about why it’s not being used everywhere.

> The conspiracy angles are coming from those who have been misled into thinking it has been more successful than it really has been, which leads to confusion about why it’s not being used everywhere.

No, the "conspiracy angles" are coming from people who have seen youtube videos and HN posts disappearing just for discussing it.

Well a lot of people with biochem background also have a lot of skepticism about it too.

Ivermectin works by interrupting nerve function of helminths(parasites). covid is a virus, not a multicellular organism with nerves.

I'm not saying ivermectin is useless, but why it would work for covid doesn't make sense (yet at least). Maybe it has some other mechanism to slow down covid that isn't fully understood.

there were some studies that seemed to show that it shrank melanomas. my guess is it is triggering the immune system response. but i just write software, so dont go chugging horse dewormer instead of seeing a doctor because this smart guy on hn said it would get rid of your melanoma.

This. A lot of things generate a broad immune response that would probably improve mild to moderate cases of just about anything. My gf secretly switched my usual horse dewormer for Sanka. On the third day I ate the postman, but I haven't had covid since.

You don't seem to know what you're talking about.

The mechanism by which Ivermectin works does make sense, and has been well-established. Look up any of the many binding studies on pubmed for example.

Regardless of this, the results of the great many RCT's speak for themselves.

https://ivmmeta.com

"but why it would work for covid doesn't make sense"

This is the way many treatments work. For example, hydroxychloroquine was a treatment for malaria, but doctors found that some patients with autoimmune disease had their symptoms lessened or eliminated as they were treated for malaria.

So, it has become a milder treatment for autoimmune disease in some cases. The scientific community doesn't 100% understand why it's effective for autoimmune disease, but there you go. It seems to work in many cases.

I say this not as an expert, but as someone who has taken it and it has worked for me. I don't care that the mechanism is unexplained.

The mechanism has now been published in Nature. https://www.nature.com/articles/s41429-021-00430-5

Here's a good overview of why posts disappear:

https://taibbi.substack.com/p/why-has-ivermectin-become-a-di...

I would like this translated into normal English. This is the basis of the argument of why posts disappear from the article, and I don't understand what the author is trying to say at all:

> One of the challenges of the pandemic period is the degree to which science has become intertwined with politics. Arguments about the efficacy of mask use or ventilators, or the viability of repurposed drugs like hydroxychloroquine or ivermectin, or even the pandemic’s origins, were quashed from the jump in the American commercial press, which committed itself to a regime of simplified insta-takes made opposite to Donald Trump’s comments. With a few exceptions, Internet censors generally tracked with this conventional wisdom, which had the effect of moving conspiracy theories and real scientific debates alike far underground.

Matt Taibbi supposes (in that paragraph) that their motivation in censoring scientific discussion of Ivermectin's effectiveness was to be "opposite to Donald Trump's comments" and thus to conform to one's own ideological tribe ... because if you don't conform, you risk being cancelled, don't you? And he bemoans that politics has corrupted real science and driven actual scientific debate underground.

Refer also to the Solomon Asch conformity experiment which occurred during a previous episode of cancel culture called "McCarthyism".

There are other theories. Some people have supposed that the motivations have to do with the money that big pharma would lose if they couldn't sell their vaccines because a safe and effective alternative was already available and proven, and therefore the conditions of the emergency use authorizations for the vaccines would become void. But nobody has any smoking gun evidence here that I'm aware of, it's just a plausible motivation.

Some people might believe so strongly that vaccines are the only possible savior of humanity that anything which detracts from the success of the vaccine campaign will be devastating, and so they do what they can to shut it down. Bret argues this is illogical if Ivermectin works because all forms of immunity work together to build herd immunity. But logic is unfortunately lost on far too many people.

More far fetched ideas include influence campaigns from foreign powers who aim to see America defeated. If they can influence the right people in the right way at the right time, they might be able to prolong the pandemic in America.

I'm sure there are even more hypotheses as to why such censorship is being attempted.

I can see how that might prove difficult for a non-native speaker. Here's a version written in less fancy English.

During COVID times, scientists have become political. Many scientific arguments were not written about in the American media, because journalists assumed that the truth was the opposite of whatever Donald Trump was saying. Tech firms mostly did the same thing. This means discussion of conspiracy theories and real scientific debates have both been suppressed, and now take place "underground" i.e. in non-mainstream forums.

With 0.38 risk ratio, it may well be that it should be used everywhere (except for patients already advanced enough to need mechanical ventilation, as mentioned).

I don't have a reference for this but I recently read it was basically used on every tested-positive case with symptoms in Mexico City, with significantly improved results.

How do you calculate the risk ratio?

It's been in use for about 40 years and prescribed maybe billions of times, conclusions would've been drawn from a large data set like that.

There would be no emergency use authorization allowed if there was an existing possible treatment.

https://www.fda.gov/media/97321/download#page12

Go to page 12 in the PDF (document page 8) then read section D.

Pharma companies could not distribute experimental treatments unless they lied to us about existing useful drugs. Reminder:

Pfizer: Phase 3 trial estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04368728

Moderna: estimated end date 2022 https://clinicaltrials.gov/ct2/show/NCT04470427

Johnson & Johnson (it’s actually a Janssen Product which is a subsidiary of J&J): estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04505722

AstraZeneca: estimated end date 2023 https://clinicaltrials.gov/ct2/show/NCT04516746

That would depend on the efficacy of the existing possible treatment. Ivermectin is 70%, so it's not as effective as a vaccine. But it's a hell of lot better than nothing.

Doctors often combine multiple drugs/treatments. Not every single part of the combination needs to be as good as a vaccine.

You have reversed the logical sequence.

You can't know how efficient a vaccine is without a trial. You need an authorization first to do that. But you wouldn't get an authorization if something exists, even "only" 70% better, because that 70% would make Covid less lethal than the yearly flu.

Hence 70% is enough to block emergency vaccines trial authorization.

Dexamethasone is an approved drug recommended by the FDA for treatment of Covid and it didn’t stop the vaccine EUA. The vaccines are 95-100% effective in trials, no other drug comes close.

Please do not spread fake news. All current vaccines are less than 1% effective. https://www.thelancet.com/journals/lanmic/article/PIIS2666-5...

For anyone reading the above comment:

* The quoted 95% etc. numbers are in terms of Relative Risk (ie, the ratio of attack rates with and without a vaccine—which is expressed as 1–RR) * These numbers are essentially a reported efficacy and useless to compare between studies held under different conditions.

With this in mind, from the lancet article linked above:

> However, RRR should be seen against the background risk of being infected and becoming ill with COVID-19, which varies between populations and over time. Although the RRR considers only participants who could benefit from the vaccine, the absolute risk reduction (ARR), which is the difference between attack rates with and without a vaccine, considers the whole population.

>__ARRs tend to be ignored because they give a much less impressive effect size than RRRs: 1.3% for the AstraZeneca–Oxford, 1.2% for the Moderna–NIH, 1.2% for the J&J, 0.93% for the Gamaleya, and 0.84% for the Pfizer–BioNTech vaccines.__

“ ARRs tend to be ignored because they give a much less impressive effect size than RRR”

This is an odd statement. Why would that be the reason to ignore it? ARR is extremely specific to a time frame and location.

Without wide deployment of vaccines, almost everyone would eventually naturally catch the coronavirus at some point in the next several years. As vaccines are deployed, the risk reduces since vaccines reduce the R0 of the virus in that population. Any calculation of ARR would be highly speculative and have to include models about how widely the vaccine would be deployed, the transmissibility and mutation of the virus, and the RRR of the vaccine itself, as well as being stated only for a specific timeframe and location.

Given all this it’s obvious why RRR is the typically reported number and the one that makes sense to use in discussions.

As your article notes “ Vaccine efficacy is generally reported as a relative risk reduction (RRR).”

There is nothing fake about what I said. It’s simply the common sense way to think about the effectiveness of a vaccine.

According to your reasoning the polio and smallpox vaccines are 0% effective because those viruses have been eradicated in the USA currently.

"I heard about Ivermectin for the first time this week"

This is what is extremely disturbing. This result of the control of information occurring in our society.

What's more, it is not just the literal control, but the social conditioning. Within the group of those who have known for a long time, there is a reluctance to share that with anyone else as society will apply any number of taboo labels to such individuals to make them outcasts.

I heard the earth was flat only a few months ago too—it does not make either claim any more likely to be true.

And FWIW, I have seen many ivermectin articles on HN (check my past comments), and all seem to say roughly the same thing, so they get rather annoying in my feed at this point.

"I heard the earth was flat only a few months ago too—it does not make either claim any more likely to be true."

It is not about the validity, it is that you can not even evaluate that which you have not heard.

The level of censorship varies greatly by media and platform.

I would make the claim to be constantly evaluating the validity of statements I have not heard, and may never hear. This may sound like nonsense, but the flip-side of censorship is not excess of information but curation. If my news sources are trustworthy, then they are filtering useless information for me, while hopefully not belying my trust by censoring important information.

To the other poster, my argument was supposed to be obvious: it was intended to be a simplified example to elucidate concerns by comparison.

Nice "motte-and-bailey" argument. But a little transparent, no ?

> There seemed to be an overwhelming amount of evidence....

> ....there hadn't been a randomized trial the drug

You don't see the contradiction here?

Edit: because it must be made 100% obvious, clinical trial results are the definition of evidence in medical science.

That's not really contradictory. Lots of covid treatments have been discovered in hospital settings by doctors trying desperately to find something to help their patients.

And those were later validated by evidence from clinical trials. Until clinical trials involving significant numbers of patients are available, there is not evidence according to the standards of medical science. That's the contradiction.

> there is not evidence according to the standards of medical science.

What the hell are you trying to say? That doctors treating patients observations can be dismissed because they don't talk the academic language or their results don't follow academic guidelines?

There is more to medicine than just clinical trials.

Many different things can count as evidence, even if they are not up to your academic standard. Doctors observations, population-level improvements, and studies of different cohorts.

There are levels of evidence, there is strong evidence based on reports of observable ivermectin benefit to profylaxis and some benefit in treatmeant of early infections.

Please don't cross into flamewar, especially on divisive topics.

https://news.ycombinator.com/newsguidelines.html

OK I could have worded that better, but I certainly did not want to get into a flamewar. I think there is a well visible point there still.

It would be nice to make a list of things that appeared to work in hospitals and then failed randomized trials.

Hydroxychloroquine is a good example. Lots of doctors were trying it and thought it seemed to help. Due to the interest in the drug several RCTs of it were performed and it was shown to have no effect on patient recovery or prophylaxis of covid.

This is just partially true. The studies you mention are on late treatment (and often on very high dosages). The data points to good efficacy for early treatment though. It seems clear that the only use for HCQ is during the viral multiplication phase which is not what the large studies have been looking into (they never look into early treatment for some reason).

This isn't true. A recent study showed significant results in using HCQ: https://www.straitstimes.com/singapore/health/throat-spray-a...

Are there any specific “trench innovations” that come to mind?

The thing that most immediately comes to mind is Cameron Kyle-Sidell, who recognized that the standard treatment protocols were over-intubating people for hypoxemia, and that overly high pressures of ventilators were causing damage. He faced a great deal of resistance within his institution at the time, and was quite controversial in taking his case to Twitter and Youtube. Since then, he's been vindicated, and protocols have been changed.

I post this because I think it's the exception that proves the rule. Dr. Kyle-Sidell is a physician of great perception and insight. For every one of him, there are no doubt hundreds of "hydroxychloroquine doctors" who peddle bullshit without scientific basis to the harm of their patients. But the existence of doctors like him does boost the "maverick doctor bucking the institution" narrative.

[1]: https://www.medscape.com/viewarticle/928156

[2]: https://elemental.medium.com/how-one-covid-19-doctor-became-...

These days youtube would ban him.

How do you know that?

Have you read the headline ?

They banned an interview with the inventor of mRNA vaccine tech for saying it might be dangerous and needs more caution and study.

> "hydroxychloroquine doctors" who peddle bullshit without scientific basis

as of today, the mechanism that made HCQ work has been explained scientifically, right? What is your bias regarding this?

Now, that the mechanism is better understood, the doctor who recommended HCQ has now moved on to a better suggestion utilizating the same mechanism.

MitoQ

Couple of them are described here..

https://drmalcolmkendrick.org/2021/01/27/does-lockdown-work-...

Under the heading "The damage inflicted by medical ideas"

There are degrees of evidence, it's not binary

Is that sort of like how the normal process for vaccine approval is the _definition_ of "safe", and yet government officials and media keep insisting that vaccines approved on an emergency use basis are "safe"?

The scientific method is a process. Evidence is just one part of the bigger picture.

It's an approved drug. Fully licensed and considered to have a wide safety profile.

Doctors don't need permission for off-label use. It's just not a thing. We're in strange territory where doctors (professionals) have been demoted to nurses and they can't profess.

In my country, ivermectin it is an approve drug but not for COVID. Like a lot of other drugs which are approved as being safe but that does not mean they are good for COVID.

So I don't see how your argument contradicts the one you are replying which says there is no an overwhelming amount of evidence for ivermectin as a good treatment for COVID.

I am also not against being used by doctors who have the time for trying it and seeing if works. As we don't have a wide available treatment which we know for sure (with a high probability) that will cure COVID then maybe trying various scenarios could be a way to cure more people. But we have to take into consideration that giving one treatment means not giving other treatments so it is not an easy choice.

In the Netherlands doctors can be fined up to €150.000 if they prescribe Ivermectine or HCQ. Even though they can normally prescribe things off-label.

Large RCTs are considered the "gold standard" but you are outright misleading if you are saying that large RCTs are the SOLE definition of evidence in medical science.

Or you know nothing about medical science.

Observational trials, natural experiments, etc. all constitute evidence.

As well, there have been over 25 RCTs performed globally on Ivermectin to date.

Well, in Brazil, the president (Borsalino) is promoting ivermectin as covid treatment. I can tell you is not working at all.

I doesn't help at all. I have a coworker who as using ivermectin as prophylactic and went to ICU (he is recovering now).

At what dose and frequency? Was it real Ivermectin or perhaps counterfeit? What was his overall health to begin with?

I fucking love HN - downvoting valid questions for criteria.

How do you know he wouldn't be dead if they hadn't been taking it?

Because a prophylactic means taking it regularly in order to avoid catching it, with the implication of the poster’s statement being that ivermectin, which carries significant risks when taken by a human at various doses, was the cause of the person going to ICU

Exactly. Just because someone doesn't dose something correctly, doesn't mean there is necessarily anything wrong with it.

Shall we ban water? Sometimes people don't dose that correctly either, and drown.

What a dangerous substance!

The valuable part of your comment would have been more impactful if it weren't for the following 2 paragraphs about water.

Maybe, it depends on your opinion of the established safety profile of Ivermectin prior to its attempted maligning. It's a fair comparison to this commenter.

Your absurdist attempts aside, the important thing to consider with a prophylactic medication is the therapeutic index.

Let’s take vaccines. Covid itself has a risk of harm of around 1:100 for older age groups of requiring hospitalisation. Risk of harm for vaccines is established at around 1:200,000.

Ivermectin? There is no good data on the therapeutic index however it is a toxic substance with a low therapeutic index and a narrow therapeutic window.

The sensible thing given the available data is to encourage vaccination. Barring that, masks and social distancing. And of course there are places where both there is no vaccine supply, and social distancing is economically in feasible. Is this a use case for ivermectin? Most data says no because establishing TI and TW and ensuring adequate safety of dosing is logistically about as difficult as maintaining social distancing.

Good chat

Risk of serious harm from vaccines from a country where I trust the people a lot more than Americans is 1:3571 (based on 446,380 doses). Where are you getting the 1:200,000 from?

https://www.medsafe.govt.nz/COVID-19/vaccine-report-overview...

125 serious AEFI in 446,380 doses. 1:3571 indeed.

But here too the reporting is open to anyone, and is voluntary. So chances of large under reporting is present here as well. Which is a bit scary..

Let me add that these reports don't show cause, just correlation. Attempting to determine cause is very speculative and tenuous, and so all adverse events should be reported. So long as everyone understands the vaccines don't actually cause this many adverse events. To be fair, the same goes for COVID-19: deaths associated with COVID-19 are not necessarily caused by COVID-19.

That point being addressed, I would expect the elderly to have a lot more background adverse events, such as death. If we live 28835 days on average, 15 people in this vaccinated group are expected to die every day from non-vaccine causes, and heavily weighted towards the elderly. But I'm not even seeing death as a side-effect, and the number of adverse events among the elderly (who got the vaccine first and have had the lions share of vaccine administration) is actually less than among younger groups. This perplexes me and if anyone thinks they know the answer to this riddle, please share.

[Oh wait... there aren't as many elderly people. hits head]

Huh? Ivermectin has been in use for decades and administered in the billions of doses and had only a handful of associated deaths in that time. How to safely dose it is extremely well-known and established.

If you look at any vaccine adverse events reporting system, you do indeed find the 1:200,000 number - as that's indeed where it came from - for all ~70 previous vaccines on the schedule (and adjusted for under-reporting - the raw numbers in the systems are in the 1 in millions in most cases).

The COVID-19 vaccines however, unadjusted, are in the low 1 in 10,000's.

Check any reporting system independent of country/region, you'll find the same massive safety disparity between COVID-19 vaccines and all other vaccines being tracked.

So, basically everything you've said is wrong.

That a widely-disputed "leader" is "promoting" a treatment in a country as diverse and with as many systemic issues as Brazil, has no necessary bearing nor indication of that treatments actual use or resultant efficacy.

That you have a friend that took it and went to the ICU is similarly meaningless. What dosage did he take? What other predispositions did he have? How badly was he exposed? What other treatments were used? Did he keep taking it throughout, or not? You say he's recovering now, would he have died without it, then?

Borsalino?

> I doesn't help at all. I have a coworker who as using ivermectin as prophylactic and went to ICU (he is recovering now).

This is an anecdote, and it is dangerous to generalize from it. I have several family members who seemed to respond well to Ivermectin, and recovered better than their initial condition would have indicated.

ok, show me good science. I drank beer all this time, didn't got any covid yet.

MAYBE BEER IS THE MEDICIN. BIG PHARMA IS HIDING FROM US.

I am not saying it is definitely a great medicine for Covid and everyone should use it, but we must be careful to not mandate the opposite as well. Let individual patients make the decision to use it with help from their respective doctors. If there is a genuine beneficial effect, it will emerge naturally and more doctors will urge their patients to go for it. If there isn't, the opposite will happen.

Banning it from the top is not going to help most people.

There isn't really. There's as much evidence as we had for hydroxy chloroquine. So, some but unconvincing. And since it's been widely deployed by several desperate governments you'd think we'd know more by now.

Here's a breakdown of what we've learned: https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv...

Here's the latest bad news: https://www.nytimes.com/2021/03/04/science/coronavirus-iverm...

Both the articles you cite mainly complain about lack of data, but they both predate the study posted here. The NY Times is 3 months old. This study may or may not be good, but neither article address that question.

The social media bans were over people making completely unjustified pronouncements about it's value. Same as the guys claiming HCQ was extremely effective when the data was completely inconclusive. Anyone saying we should widely deploy Ivermectin is spreading dangerous disinformation. Actually relevant and accurate information is being shared and published freely.

As per the latest meta study of June 6, for over on whole year, 549 authors in 60 conclusive studies published on medRxiv, Nature, Wiley (basically the usual medical research forums) during the last year => free and shared, as you asked.

Malone, Weinstein, Kory and al. were banned for two videos made one and two weeks ago talking among other this of this meta study.

That's hardly spreading disinformation, or am I wrong somehow ?

Several point of comparison :

Improvements with Ivermetcin were 76% for early treatment, 46% for late treatments, 85% for Prophylaxis for a 70% average over almost 19K patients. Ivermetcin was forbiden for Covid use in several western countries, and it's distribution forbidden to retail pharmacists (Switzerland is one).

Budesonide and Remdesivir were authorized with respectively averages of 17% and 31% improvement only over 3.5K patients, and it's use promoted everywhere as the miracle drug.

Dr. Raoult's initial HCQ announcement in early February was for 22 cases - very anecdotal and ridiculously insufficient. Later on, by the end of 2020 the hospital he's directing covering the southern third of France had treated 40K+ cases, with broadly similar results. We still hear the same "HCQ was debunked", somehow, and HCQ is still forbiden for Covid use in several countries.

In the hundreds of HCQ studies out there, eyeballing it about 2/3 of them show some sort of positive result [0]. Early treatment with the dosage on the lower end of the tested spectrum has 100% positive results [1].

It was odd a week ago to see some of the media suddenly decide to report on one of these [2], like the "HCQ Bad!" blinders had finally been removed.

[0] https://c19hcq.com/

[1] https://hcqmeta.com/

[2] https://www.dailymail.co.uk/news/article-9671029/Hydroxychlo...

HCQ needs to be good enough to overcome the heart risk though.

Without randomized trials you cannot recommend a drug because you cannot exclude confounders. It seems wrong to me to even speak of "overwhelming evidence" without a randomized trial or other sound ways to control or identify for confounders (e.g. causal models).

Actually a meta analysis can offer better evidence then a single RCT.

https://ascopost.com/issues/june-10-2014/randomized-trials-v...

The best meta-analyses are those made out of RCTs at any rate.

Wait a minute... This post is a debate between two opposing viewpoints. So it also makes the exact opposite point:

The primary difference between a randomized controlled trial and meta-analysis is that the former “provide the highest level of evidence because they contain the least amount of bias. Randomized controlled trials reduce bias, while meta-analyses increase bias."

This Hacker News story is about a recent meta-analysis. But an actual randomized control trial of Ivermectin in March (on 476 patients) found the duration of symptoms on treated and untreated patients "was not significantly different."

https://jamanetwork.com/journals/jama/fullarticle/2777389

Important thing to know about that study is they are testing time to recovery for people with mild covid.

I'm not anywhere near an expert, but two things stood out to me reading this study. First, time to recover in the ivermectin group was 10 days versus 12 in the placebo. The paper calls this "not significant" but it's not clear to me whether that's statistically not significant, and if so, why wouldn't it be, or if knocking two days off recovery isn't that meaningful. The other thing I noticed reading it was that only one person out of 400 died and that person was in the placebo group.

I think the Brett Weinstein response would be something like -

A. Ivermectin's best benefit is as a prophylactic not a treatment.

B. Ivermectin should be administered as early after onset as possible to treat, whereas here there was some delay to get people organized, enrolled in trial, etc.

C. It's hard to measure effect when the disease is mild.

> why wouldn't it be

Because you only gave the average time of recovery but not the standard deviation.

I didn't see the standard deviation reported in the paper. Is it?

I did see the innerquartile range and it was the same for both the ivermectin group and the placebo. To me that suggests that variation in outcomes is probably similar between the two groups.

They provide it in the form of a hazard ratio:

"hazard ratio for resolution of symptoms, 1.07 [95% CI, 0.87 to 1.32]"

So statistically, those on ivermectin recovered 1.07 times as quickly as those on placebo, but the uncertainty bounds are from 0.87 times as fact to 1.32 times as fast.

> But an actual randomized control trial of Ivermectin in March

Please see this

https://news.ycombinator.com/item?id=27566123

While randomized trials are certainly the gold-standard for determining if you should give a new drug to treat an arbitrary disease, that process is far too conservative during a pandemic where a huge majority of the world cannot access proper medical care. Ivermectin is already massively produced, used throughout the world, and cheap to manufacture (compared to new anti-Covid drugs). Even months ago before the benefits were known, the risks of taking the drug were very small, especially when the treatment guidelines were to do practically nothing.

Still, the many pieces of non-randomized evidence can still clearly point towards this drugs efficacy. The sudden drop in Covid cases in India as the clearest indicator to me.

> The sudden drop in Covid cases in India as the clearest indicator to me.

What's the alleged connection here? Are you claiming that some non-trivial number of patients in India were treated with this? How many, and at what point after being infected? And just how did the treatment affect the case numbers? Generally you'd expect the vast majority of secondary infections to happen before the diagnosis, not after, so a treatment seems totally irrelevant to the case numbers.

>Are you claiming that some non-trivial number of patients in India were treated with this

Yes, example from two states.

https://indianexpress.com/article/cities/lucknow/uttar-prade...

https://www.news18.com/news/india/mortality-rate-much-lower-...

The testimony video in this page cites examples in many other countries https://covid19criticalcare.com/

I see no numbers on how many people were treated on either of the first two links, and certainly don't intend to comb through the dross on the third link. So do you actually have a number? It doesn't need to be exact, just a credible source on the order of magnitude will be enough. Are we talking a thousand, a million, or a billion here?

To reduce R by a factor of 2 by the use of a prophylactic drug, you'd need to have half of the population on a regime of the drug. It seems pretty obvious that did not happen if this kind of reporting is the most impactful there is. Just think of the logistics of trying to do that! India has a population of 1.4 billion.

On the other hand, if they only gave the snakeoil to e.g. a single digit number of millions of people the reduction in the number of infections would be imperceptible.

This is a great comment, and an example of why discussion of ivermectin should not be CENSORED but instead debated. These would be good questions to ask the creators of any videos on the topic and from what I can see, the most popular creators would probably be open to the discussion.

Its the governments of the two states that are making the claims in the news articles.

I think it is safe to suppose they or the associated medical authorities have observed a big enough benefit before making that claim.

But no, no concrete numbers, as I think there was not much of tracking the number of patients who were given the drug. May be it is because such numbers are not much of a value in terms of research data due to lack of controls.

Not a primary source, so FWIW. The article compares states in India using ivermectin against those which are not. Some digging in the sources listed might get what you are looking for.

https://www.thedesertreview.com/news/national/ivermectin-obl...

>The sudden drop in Covid cases in India as the clearest indicator to me.

Nah that's just confirmation bias and rumors. It wasn't effective at all, otherwise India wouldn't have taken it off the recommended drugs list.

>India wouldn't have taken it off the recommended drugs list.

Normally authorities are afraid to go against W.H.O recommendations, because if it didn't work out, it would be hard to justify it on the basis of local observations alone, at least on paper.

But the important thing is that some states still did it, which might indicate there was very observable benefit.

That's rather credulous.

So's the idea that ivermectin must be the explanation for India's COVID spike abating.

Spikes abated all over the world, more than once in most countries, without ivermectin.

Ivermectin has been trialed also and has been available on experimental basis even in Europe - and it was found ineffective and is not recommended anymore.

See: https://jamanetwork.com/journals/jama/fullarticle/2777389

Also similar non-randomized evidence was strongly suggesting that hydroxychloroquine was very effective (e.g. Raoult in France) - until proper randomized trials found it was not effective at all.

So you really can't rely on such evidence. That someone gets better after they got some drug doesn't automatically mean they got better because of the drug. In the absence of controls for other factors (other drugs, spontaneous recovery on their own, etc.) it only means that the drug didn't make their affliction worse.

Not everything has to be immediately a conspiracy of big pharma (or worse).

The López-Medina trial was one of the biggest RCTs for Ivermectin. Out of the 60 trials for Ivermectin, it was one of the few that didn't show statistical significance.

It was also seriously flawed - a large percentage of the placebo group was self-medicating using Ivermectin, they mixed up the treatment and placebo group, and they switched the primary outcome in the middle of the trial. That trial still showed improvement, but it didn't reach statistical significance.

"[López-Medina] has many issues. The primary outcome was changed mid-trial from clinical deterioration to complete resolution of symptoms including "not hospitalized and no limitation of activities" as a negative outcome. Critically, temporary side effects of a successful treatment may be considered as a negative outcome, which could result in falsely concluding that the treatment is not effective. Such an outcome is also not very meaningful in terms of assessing how treatment affects the incidence of serious outcomes. With the low risk patient population in this study, there is also little room for improvement - 58% recovered within the first 2 days to "not hospitalized and no limitation of activities" or better. There was only one death (in the control arm). This study also gave ivermectin to the control arm for 38 patients and it is unknown if the full extent of the error was identified, or if there were additional undiscovered errors. The side effect data reported in this trial raises major concerns, with more side effects reported in the placebo arm, suggesting that more placebo patients may have received treatment. Ivermectin was widely used in the population and available OTC at the time of the study. The study protocol allows other treatments but does not report on usage. The name of the study drug was concealed by refering to it as "D11AX22". The presentation of this study also appears to be significantly biased. While all outcomes show a benefit for ivermectin, the abstract fails to mention that much larger benefits are seen for serious outcomes, including the original primary outcome, and that the reason for not reaching statistical signficance is the low number of events in a low risk population where most recover quickly without treatment."

https://ivmmeta.com/#exc

This prompted an open letter from over 170 physicians concluding that the study is fatally flawed.

https://jamaletter.com/

This also highlights the risk of only relying on a small number of large RCTs, instead of looking at the totality of evidence.

just look at Brazil, where ivermectin and HCQ are used as mentos.

I does not help at all. (I wish it was a valid treatment).

I read the french research at the time, and it was immediately obvious that it was deeply flawed. Asking around in more expert circles, that did seem to be the uniformly echoed initial reaction even then, from day 1 (not that that means it couldn't have worked, just that the paper that sparked it all was not convincing, at all - but absence of evidence isn't strong evidence of absence in such cases). In retrospect it seems obvious people were looking for some kind of light at the end of the tunnel, and too willing to ignore the warning signs.

The case for ivermectin is not a slam dunk. But it's definitely surpassed the low bar that HCQ set. There is at least quite a lot of suggestive correlation without trivially obvious other explanations, and the data set isn't just "a few people non-randomly selected".

To my non expert opinion the ivermectin case seems at least plausible, whereas HCQ was clearly and obviously nonsense. Still, I'm skeptical, partly precisely because there still hasn't been a slam dunk study and because quite a few proponents seem to have a worryingly conspiratorial view of the world. Stuff like assuming it's not being pushed because it's off patent screams conspiratorial thinking to me, and you hear that quite a lot. And that's a warning sign, because there are quite a lot of interested parties here that really don't care about some pharmaceutical companies profit, and in any case - just because they don't fund it doesn't mean they'll go all Machiavellian and intentionally prolong the pandemic just to sell a future drug, and actually get away with it to boot. At best, the lack of exclusivity might explain why there isn't a specific corporate backer for this research, but it doesn't explain why all of the governments and universities and hospitals etc aren't finding convincing data. So when people see a conspiracy here, I wonder how rationally they're looking at the evidence for Ivermectin, too - and at the end of the day, I'm just a random worried person without the capacity to deeply understand every single relevant bit of data, so I need to be able to find trustworthy sources and research. People that see conspiracies everywhere (without data and without real reason) don't inspire great trust in their analyses.

Still, it's hard to resist the lure of the cheap and affordable silver bullet...

I had the same opinion until my friend convinced me otherwise. The scientific community is taking a long-term approach here. If they were to recommend a drug based without a scientific trial, they risk losing the trust of the world (either from people who want them to only follow the science, and the risk that it is incorrect).

The anti-science block is growing, and they are loud. If they continue to grow it could be an even greater threat to humanity than COVID-19. Science is attempting to fight against it by retreating to a science-only corner, for better or for worse.

It would be nice if we somehow found a way as society to get the message out that scientists often just don't know. Because too often stories like this are interpreted by quite a few people as "science says ivermectin doesn't work". And perhaps that conclusion will turn out to be right, but the point is the jury is still out - and often enough it turns out wrong, and when such a false statement turns out to be wrong, people lose faith in science regardless, even though a reasonable interpretation of the science actually said "don't know" not "doesn't work".

This is kind of a corollary to the issues with rejecting conspiracies - when we reject a supposed conspiracy, due to lack of evidence, that can easily come across as claiming the conspiratorial claim is outright false - but in a sea of such claims, some then turn out to have at least a kernel of truth, which then turns into a big gotcha moment: "see, they're repressing us, we were right all along!"

So while I understand the idea of maintaining trust by not backing anything uncertain, I'm not sure it's the right call. Maybe communicating that uncertainty is better, and even communicating hints and possibilities - instead of trying to control the narrative but thereby ceding the ground to nutjobs until certainty arrives, often granting them considerable prestige if they guess sort of correctly ahead of time.

If they were to recommend a drug based without a scientific trial, they risk losing the trust of the world

But that's already happened with vaccines. A bit late to worry about that now.

https://sebastianrushworth.com/2021/05/09/update-on-ivermect...

I’ve included every double-blind randomized placebo-controlled trial I could find of ivermectin as a treatment for covid. Using only double-blind placebo-controlled trials means that only the highest quality studies are included in this meta-analysis, which minimizes the risk of biases messing up the results as far as possible. In order to be included, a study also had to provide mortality data, since the goal of the meta-analysis is to see if there is any difference in mortality .... What we see is a 62% reduction in the relative risk of dying among covid patients treated with ivermectin. That would mean that ivermectin prevents roughly three out of five covid deaths. The reduction is statistically significant (p-value 0,004). In other words, the weight of evidence supporting ivermectin continues to pile up. It is now far stronger than the evidence that led to widespred use of remdesivir earlier in the pandemic, and the effect is much larger and more important (remdesivir was only ever shown to marginally decrease length of hospital stay, it was never shown to have any effect on risk of dying).

I understand why pharmaceutical companies don’t like ivermectin. It’s a cheap generic drug. Even Merck, the company that invented ivermectin, is doing it’s best to destroy the drug’s reputation at the moment. This can only be explained by the fact that Merck is currently developing two expensive new covid drugs, and doesn’t want an off-patent drug, which it can no longer make any profit from, competing with them.

Does that mean that the covid vaccines shouldn't be recommended as there's no randomized trials on their long-term effects? Just curious as I'm not well versed on this topic.

Covid vaccines have been tested with randomized trials (Phase 3 of the testing phase). Regarding "long-term", that obviously depends on how you define "long-term but there is no need to move the goalpost.

Generally speaking, in evidence-based medicine drugs and vaccines are not recommended based on incomplete statistics or hunches.

Related post from Matt Taibbi on his Substack, about Bret Weinstein with a short interview of him. With recent takedowns of his videos, many viewers are anticipating his channel will be banned outright by Google/YouTube: https://taibbi.substack.com/p/meet-the-censored-bret-weinste...

last year's reports about ivermectin were from 3rd world countries, and they were not rct. i guess that contributed to dismissing it.

OTOH there was a lot of hype around remdesivir, despite it being barely effective. Pharma is really a weird world

Hmmm... did YouTube ban discussion of Remdesivir and delete videos that included this guy?

https://www.nbcnews.com/health/health-news/coronavirus-drug-...

Whether it works or not, there's no money to be made from Ivermectin. It's a very cheap generic drug. Why else would they stamp out all possible investigations of it just to ascertain truth?

So is dexamethasone, and that's used world-wide for seriously ill Covid patients.

What's the explanation for why dexamethasone was allowed but ivermectin is being suppressed?

Basically it's been that there had been no studies to prove it works for covid. It's been used mostly in poorer countries that have had it on hand because it's relatively inexpensive. Doctors in those countries have been sharing info with each other and that's how it started being used a lot.

During that time gather data for this use was begun and it's taken this long to gather enough, over enough time, to prove its efficacy according to the standards required.

Studies have been done and show that it is effective: https://covid19criticalcare.com/

Maybe because you cannot use it as a prophylactic, so it doesn't threaten EUA for vaccines?

People down vote this - they gasp saying "no way could this be true" - yet they complain about big pharma right up until the "right" virus/disease/whatever science thing comes along and their tribe picks it up and runs with it - they're now the savior. The left/right don't realize they both have faith/religion of government. These politicians do not speak for you or me. Voting only leads to consequence without recourse.

Is the same not true for dexamethasone[1], which was the first successful finding from the RECOVERY trial[2]? That's how I've repeatedly seen it described[3] (FWIW, I was treated with dexamethasone for Covid-19 in October 2020).

[1] https://en.wikipedia.org/wiki/Dexamethasone

[2] https://en.wikipedia.org/wiki/RECOVERY_Trial

[3] "A cheap and widely available drug can help save the lives[...]" https://www.bbc.co.uk/news/health-53061281

One could argue there's money to be lost if it displaces vaccines as a method of treatment (assuming it's affects are as lasting)

Vaccines are not a method of treatment.

Okay, will prevention do? But I'm sure you (and everyone else) knew what I meant

Yes and the UK discovered its benefit. The US has done nothing to investigate whether generic drugs will treat COVID19. The research is being conducted in the UK and EU where the financial incentives are different.

The same is NOT true for dexamethasone, well not exactly, since there was no directly competing drug. Dexamethasone, which you can probably confirm, is useful in the later stages of COVID where there's an inflammatory response. Since no other proposed medications were seeking an EUA as a "late stage" therapeutic, there's no chance the already approved Dexamethasone would have blocked the issuance of an EUA.

That's at least my understanding based on the proposed systemic problem in FDAs.

Conversely, in this proposed problem, it's said that ivermectin (and others) are only effective when used in the early stage or even prophylactic. Being already fully licensed medications, that could put the issuance of an EUA for vaccines or Remdesivir in jeopardy.

> Being already fully licensed medications, that could put the issuance of an EUA for vaccines or Remdesivir in jeopardy.

Remdesevir is fully approved in the US.

> Why else would they stamp out all possible investigations of it just to ascertain truth?

Dozens of (mostly Phase 2 and 2/3 combined) ivermectin trials as a Covid therapeutic are ongoing, no one has stamped them out.

You're commenting on a metaanalysis that summarizes 15 published trials, aren't you? Maybe you should spend less time on YouTube inspired guessing. Social media isn't relevant here. YouTube is not the center of the Galaxy. Medical doctors don't make their decisions based on YouTube videos -- at least I hope so.

Edit: sorry for the wrong position in the thread. Should have gone to the parent post.

> You're commenting on a metaanalysis that summarizes 15 published trials, aren't you?

The worrying split here is on HN I get to read 15-study meta-analysis posted by Steph C, int13 Labs CEO.

On YouTube, a PHD holder in a medical field discussing the same 15 study meta-anlysis might expect to have their video pulled.

It is quite worrying that the powers-that-be at YouTube are taking this radically anti-speech approach. It isn't like studies posted on HN are automatically good and on YouTube automatically bad. The YouTubers are probably more qualified to bring attention to studies.

In a sea of bullshit videos, the minions who screen this stuff probably have difficulties to distinguish some phd (in what field?) choosing the wrong channel and bullshit.

Anyway, the original statement was that there are no trials - this in a comment on a meta-analysis.

> the minions who screen this stuff

That's quite an elitist statement. My belief is that a majority of the people that view videos of technical discussions have the capability to understand the context. The ones that do not grasp the subject are far more unlikely to watch the video.

no, it's not elitist. I assume a human does the last decision. this human doesn't care about the content of the video (like you do) but has to make a defendable decision in limited time based on limited information.

> It is quite worrying that the powers-that-be at YouTube are taking this radically anti-speech approach.

Where you see "radical anti-sperch approach" I see a vestigial amount of false positives within a constant stream of crackpot and outright insane, anti-infellectual fearmongering-fueled conspiracy theories.

And let's face it: since when do appeals to authority pass off as a reliable indicator that the author is not a crackpot conspiracy theorist? I mean, during the past year the world had to endure a good share of people abusing their medical licenses to peddle bullshit conspiracy theories.

I've moved your comment to the parent post now.

Many people pushing Ivermectin have a vested interest in proving the vaccines are unnecessary.

It may work, but that's why you get recommendations for "vaccine made me magnetic" and other garbage like that whenever you search for videos.

It's the same group that was pushing hydroxychloroquine as a miracle drug

It is and it is weird.

What do these people (the promoters) get out of it? Attention? A more dedicated following?

I think the most useful lens to understand the sociology of these kinds of questions is religious belief. And there is no shortage of people out there who want to convince others of their belief.

The narrative for "the Ivermectin story" is particularly compelling, as it involves brave maverick doctors working selflessly to get the word out, suppression and censorship by shadowy organizations (big pharma fearing competition, the big Internet companies just lusting after the power of thought-control), and the empowerment of people to take medical decisions into their own hands.

Incidentally, this was the exact same narrative as HCQ, and is being pushed by a lot of the same people. The end of the story may turn out differently, as the evidence on HCQ is overwhelming that it doesn't work, so you only see dead-enders pushing it, but there is a good chance that Ivermectin will turn out to be at least moderately effective, though the jury is still out.

Religious belief. Exactly. And what are your religious beliefs ? Are you sure you have none ? Is there something or someone you would never doubt ?

How about having a discussion? Not everything has to be so complicated lol

> Many people pushing Ivermectin have a vested interest in proving the vaccines are unnecessary.

What is their vested interest in a generic, cheap, decades old, off patent drug? Vested interests tend to be in new, patented treatments. That's where big pharma profit is. So let's try a rephrase: Many people pushing patented treatments have a vested interest in proving off patent alternatives are unnecessary.

For example, here's Merck warning against using Ivermectin for Covid-19:

https://www.merck.com/news/merck-statement-on-ivermectin-use...

Then a few months later, "Merck Announces Supply Agreement with U.S. Government for Molnupiravir, an Investigational Oral Antiviral Candidate for Treatment of Mild to Moderate COVID-19"

https://www.merck.com/news/merck-announces-supply-agreement-...

Being proven right. That’s the anti-vac crowd’s dearest interest.

That's the wrong side to look at this from. These are just people on the fringe with little influence and funding.

If ivermectin was authorized as a viable treatment the vaccines receiving emergency use authorisation wouldn't have been possible. There were and still are billions on the line.

I'm having difficulty understanding this line of reasoning. What does the authorization of ivermectin have to do with the vaccines? Xofluza, Relenza, and Tamiflu have been approved for treating influenza, and that has had no effect on the recommendation that people get their flu shots.

It's the way that emergency authorisation use works with FDA. They won't issue that if there are other safe viable treatments. These vaccines got that approval because these other options were suppressed.

>Xofluza, Relenza, and Tamiflu

None of them are as effective as Ivermectin (allegedly). It is only logical that efficacy is also important.

Someone else answered correctly saying an EUA can't be issued if an already licensed drug can help. I would further that point by saying to actually go dig up the true source of that policy on the FDA's website in your country (not someone's summary or interpretation). It's a great exercise that will leave you with some sort of ground truth in this mess.

Same as in coding, you eventually reach a point where you learn that when in doubt, you must read the source.

Ok, but let's not get confused. This is different than being an anti-vaxxer. You can speak up for something like Ivermectin AND be a pro-vaxxer. The most prominent voice on this is Bret Weinstein (biology PhD), who is more vaccinated than average. He and his wife and kids are vaccinated for the typical things plus typhoid, rabies, yellow fever... They are pro-vaccine and so am I. Vaccines are one of the best inventions ever.

You can, but you'd have to have some proof.

And so far we do not have any. So until then this story is pushed way further than it has any right to. Weinstein thrives on the censorship, but the fact of the matter is that there simply is no proven efficacy and until then this has no business being promoted to a mainstream audience who might get themselves into a lot of trouble, or who might forego getting vaccinated.

In my case that is far from the case. The implications of an effective treatment such as ivermectin are huge in that a) Covid passports go away b) Deaths and illnesses due to covid get reduced greatly c) It puts a spotlight on why these treatments have not had government sponsored clinical trials considering the ramifications. Incompetence in our governments in regards to these kinds of situations should not be tolerated. For example in Canada the province of BC allowed a trial to commence in may of this year and yet has not started. almost 2 years after the start of this thing? ivermectin has proven safe over the 40 years its been in use and if we try similar doses (which is the recommended for covid) there is all gain and no loss to test even as small trials. I would have certainly taken it since I had severe effects from covid. d) We don't have to have a phase 3 vaccine trial be a public trial where normally that is phase 4

We already have a drug that's 99% effective at keeping you out out hospital. And it's only a single/double dose. It's the COVID vaccine.

Any other treatment is basically unnecessary at this point because COVID deaths in vaccinated people are less than 1 in a million.

That's why anti-vaxxers are so vested in other treatments. It's the only way they can rationalize not getting vaccinated

Well the covid vaccine comes with some caveats to me most crippling to freedoms being the vaccine passports that seemingly all nations are already implementing. Having various viable treatments would obviously put an end to that. Since ivermectin has a long history of safety and already largely available its reasonable that interest is strong.

But not for this particular application, and not in the doses where apparently it has some effect on COVID. And that is the problem with promoting this, as long as you weren't aware of that you probably should not be part of the army of 'useful idiots' of the anti-vax crowd.

I don't think this comment really addresses my point. From what I've seen the dosages (at least for prophylaxis) are similar to what you would normally take. No I don't think it should be rammed down peoples throats without solid evidence but neither should the vaccine. The fact is vaccines take around 7 years to exit trials and so yes I'm hopeful for a proven alternative that's not on trial but the likelihood as far as I'm convinced is nil.

Create the problem, bring an unecessary solution nobody would have accepted otherwise. Step 3, profit !

Vaccines and covid are going to come back every year for sure.

for all the talk of "vaccine passports", not a single state has done it. Biden said he wasnt going to do it months ago. Not a single country has done it in all of the earth.

if I was so worried about such a thing i might start to think maybe I was being manipulated to fear something that didnt exist.

Nobody has implemented vaccine passports. And nobody will.

But the idea of a treatment even close to effective as a vaccine is attractive to those that believe that in such magical thinking

Ivermectin might be cheap but the vaccine is literally free if you're in the US. There's zero reason to not get it, and zero reason to hang onto hope that alternatives will work. We already have an extremely effective treatment, so effective it can wipe of the virus entirely, and its totally free.

Our government under Trump bought the vaccine en masse for a few dollars a dose. Those that refuse such a miracle treatment when the rest of the world dies of COVID are a stain on America's sheen

These are extreme arguments with little legroom for nuance. If you are so sure then so be it. There's more than enough news on this countering most of your re-assurances.

> for all the talk of "vaccine passports", not a single state has done it

New York's Excelsior Pass is a vaccine passport, and has been called such by New York Times and other sources.

https://www.nytimes.com/2021/06/09/nyregion/excelsior-pass-v...

https://www.msn.com/en-in/money/topstories/new-york-s-excels...

Nope, that is not the only way. You have side effects. And you have the fact that the vaccine is still in test phase. What are the long term side effects, we don't know. And unless they are obvious we will never know, because vaccine are like a religion too many. You don't question a religion.

You're indirectly admitting that I'm right. The anti vaccine crowd is desperate for a non vaccine cure, because the vaccine is so incredibly effective their beliefs fall apart otherwise

We can believe the vaccine works but that the risk is too great to take it because it's so new. And for the record, I think the alternatives are also too risky.

The vaccine is empirically way more dangerous than every other vaccine commonly given. I did the vaccines but I don't understand why we can't be honest about it.

Ok, I was confused by this line of reasoning, so did some digging. I believe it's one of the popular antivax disinfo conspiracy theories. Here's my reading.

The line of reasoning hinges on the vaccines being "experimental" and only being distributed under an Emergency Use Authorization, as opposed to a full approval. The FDA policies for EUA indicate they're only to be used when there is no adequate, approved, and available alternative. This makes a lot of sense - if (let's say) someone comes up with a new flu vaccine (an mRNA one, to continue this example, as that would be kinda exciting), you really want it to go through the full approval process instead of EUA, even if it is better. That's because we have plenty of good, approved flu vaccines.

So, the theory goes, if we had an approved treatment for Covid, then the EUA for the vaccines would be illegal. And so that creates incentives for the pharmaceutical companies to suppress a miracle cure like (they claim) ivermectin.

To anybody with the capacity for rational thought, this is obviously bullshit. We have fully approved treatments already, including remdesivir. The idea that a treatment for Covid, even a pretty good one, would make vaccines unnecessary makes no sense.

I am fairly confident in making the following prediction. Full FDA approval for the Pfizer/BioNTech and Moderna vaccines is likely by the end of the year[1], at which point the above line of reasoning will no longer be applicable. Antivaxxers will smoothly transition to another line of argument.

I do think this "theory" is one reason you see a significant overlap between pro-ivermectin and antivax, for example in the comments of Bret Weinstein videos.

[1]: https://www.cnbc.com/2021/05/18/covid-vaccines-what-full-fda...

Yes. Anybody trying to rationalize not getting one of the extremely effective vaccines will be grasping at straws for any other effective treatment. It's a natural outcome.

The vaccines are as effective as the one that eliminated smallpox. To be against it, you need some serious FUD

FUD like the fact that the vaccines have had no completed studies on their long-term effects? Or being part of a demographic that has a low risk from COVID?

Yes, that's FUD. You can't have a completed long term study when a vaccine has not been on the market for a long enough term. That's pretty obvious.

Right, so how is it FUD if you simply want to avoid being part of a clinical trial? Vaccines take at least 7 years (usually 10ish) to complete long-term trials.

For young people, the cost-benefit analysis isn't clear at all--much less risk of anything bad at all from covid itself, plus far more years of life to lose or suffer from vaccine injury, which is a totally unknown risk.

To boot, the vaccines contain at least three entirely new technologies never before adopted in vaccine treatment.

The several newly minted billionaire Pfizer execs are certainly happy Ivermectin is only just recently starting to get a decent look.

I think what has separated the policy around Covid, vs. say the flu, is the death rate. If the death rate were closer to the flu, or below some threshold that takes spread into account, the response would have been much different.

If a better treatment was available that would lower the death rate that much, it would change the equation.

> vaccines being "experimental"

Under the PREP act, pharma companies have total immunity from liability. Why would that be. Maybe because the vaccines are still only in stage 3 of clinical trials? Because the long term effects are unknown because it hasn't been long? With worrying reports about side-effects including at least 5000 deaths in the U.S. VAERS database, do you think those quotes are appropriate?

> The idea that a treatment for Covid, even a pretty good one, would make vaccines unnecessary makes no sense.

Actually, it makes perfect sense to many people.

You are shooting down the weak version of this argument. I think you are confounding necessity from the point of view of the state and institutions with necessity from the point of view of many people.

You are correct that the state and health institutions do want to get people vaccinated regardless of other cures, the evidence for that is overwhelming and existence and availability of some alternative strategy/cure isn't going to stop immediately that intent.

However, if there was, hypothetically, an accessible and efficient medication/treatment with profylactic or curing effects for COVID-19, this would make substantial portion of population skeptical about getting the vaccine, especially now that the number of serious cases is low and manageable.

IMO vaccine are pushed as miracle drug. There is probably fanatic peoples in both though. You might also want to check remdisivir, drug that is not efficient, but they pushed it far enough to get a contract of 1 billion, and effectively 0.2 billion have been spent on it.

The vaccines are a miracle drug. Less than one in a million people that have gotten both doses of mRNA vaccines have died of COVID.

It's one of the biggest infectious disease success stories since the invention of penicillin

Maybe, but do you know how many have died from the vaccine-induced side effects? How could we find this number?

Yes. Basically none. The vaccines have been given to almost a billion people. And side effects have been tracked. How can we find this number? We already have it.

If there was anything dangerous within even 3 orders of magnitude of those that have died because they didn't get the vaccine it would be front page news.

Get vaccinated

What about long-term effects of the vaccines?

I asked why Covid vaccines are absent from VAERS list of reportable AEFIs

https://vaers.hhs.gov/docs/VAERS_Table_of_Reportable_Events_...

And the person you are responding basically said that the new vaccines are so safe that it didn't have to be on that list.

https://news.ycombinator.com/item?id=27513984

I don't mean this as a personal attack on that user, but It is really concerning how blind and apologetic some people are to the various things that can go wrong with a Vaccine.

I agree. I just hope that such blindness doesn't affect us. I worry that it will.

> And side effects have been tracked. How can we find this number? We already have it.

Oh, that is great! Where can I find this tracker and the reports of side-effects? And this number we have, what is it? Can you write it here?

Should I rely for this information on my TV news?

My mom is on dialysis, has diabetes and hypertension. Recently for a surgery we had to do a covid test. Dad also took the test. Both were positive.

The nephrologist prescribed ivermectin for mom. She had mild fever for 3 days and recovered. Dad had no obvious symptoms and recovered(he was not prescribed ivermectin, hence did not take it). The govt doctors don't prescribe it just vitamin c, zinc and dolo. This is india btw.

Because ivermectin is conspiracy theory land.

If you don't have a proven, understood mechanism (which ivermectin doesn't for a virus like Covid) then you have to rely on trials, and those just don't stand up.

Quoting Derek Lowe on this:

https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv...

> If you haven’t had to mess with drug discovery for a living, it’s understandable that you hear that Some Person Somewhere was very sick, took New Therapy X, and suddenly got better, and then assume that there it is, the cure has been found. But that’s not how it works. Real results stand up when you run larger, better-controlled trials, but most early results don’t turn out to be all that real.

Cue the Green Jellybean XKCD: https://xkcd.com/882/

This may explain the lack of widespread use at first, but it definitely does not explain the widespread censorship.

There are plausible mechanisms of action of Ivermectin against the Covid virus being explored. See https://www.nature.com/articles/s41429-021-00430-5/figures/1

The creator of mRNA vaccines disagrees with you:

> What happens to confidence in public health and USG if ivermectin turns out to be safe and effective for COVID, and the genetic vaccines turn out to have signficant safety issues? This looks like a very plausible scenario from where I sit.

https://twitter.com/RWMaloneMD/status/1403836354098872322

Mr. Malone is a very eminent scientist who has one serious problem in this particular case: he really doesn't like big pharma earning billions over what he considers to be his invention.

uhm he doesn't have problems with the system or the concrete tech used by Moderna and AZ, only with the dubious testing of these vaccines

his research becomes more important if these sort of vaccines become a silver bullet for medicine and basically end the modern flu and entire families of coronavirus; he could be looking at a Nobel prize

> If you don't have a proven, understood mechanism (which ivermectin doesn't for a virus like Covid) then you have to rely on trials, and those just don't stand up.

Please, there are a ton of antiviral drugs without an understood mechanism. We don't even know how Acetaminophen (Tylenol) works!

“then you have to rely on trials, and those just don't stand up.”

The trials for all those antiviral drugs show they work. As do with Acetaminophen.

> > If you don't have a proven, understood mechanism (which ivermectin doesn't for a virus like Covid) then you have to rely on trials, and those just don't stand up.

> Please, there are a ton of antiviral drugs without an understood mechanism

Yes, but they have trials that stand up.

Right, but trials are all that matter - there's a huuuuuuge list of drugs where we "know the mechanism" and it turns out that they still don't actually work despite that.

Next we'll find that the cheap and well-understood hydroxychloroquine is actually relatively effective Covid-19 treatment!

It's disturbing how much the suppression of Covid "wrong-think" over the last year has resulted in useful results and information only very slowly coming out (and generally, in the process, giving a feeling of vindication to the conspiracy theorists).

I have always been, and continue to be, against the idea that "this is such a novel emergency we just need to ignore all the processes that we know and trust". If anything, in those times, when we don't know what is going on, those principles are exactly the type of things we should stick to. I strongly believe it would have done us better over the past year.

> against the idea that this is such a novel emergency we just need to ignore all the processes that we know and trust

There is a pretty well trodden path for new medicine to prove their effectiveness, which all Covid measures have gone through. If ivermectin, hydroxichloroquine or any other alternative drug goes through due course they would have no difficult being accepted.

The reason discussions have been censored is precisely because people have been rallying around a drug like a football club before they’ve had their effectiveness scientifically proven, and demanding to skip the traditional due diligence.

And for some context: this paper was submitted to a mainstream journal in March and rejected for lack of evidence. This publisher who picked it up is not exactly a reputable one (and will benefit immensely from citations of this study).

> rallying round a drug like a football club

That’s what gets to me too, and this is the major issue I had with Trump saying anything about anything. He was floundering to look like he had a plan and the moment he mentioned HCQ he turned the whole thing political. It was massively irresponsible.

It should be left to medical science, which is doing pretty damn well with vaccinations and treatments like dexamethasone.

If Ivermectin can be helpful that’s great, and if it’s not then never mind, let’s evaluate other things. But it seems like people need to latch onto something, and then their ego and tribal allegiances won’t let it go.

> mentioned HCQ he turned the whole thing political.

Trump first mentioned it as a possibility and investigation and that he was taking it after consulting with his doctor. That's it. The media made you think otherwise.

Telling the public what drugs he's on is fine.. shouldn't we know what drugs POTUS is taking?

And the people who politicized it were medical journals who published fake studies with no data or vetting. Otherwise the comments would have passed on like every other trivial statement made by politicians. I mean Trump's statements may have been unwise or not backed by a double blind studies that doesn't make them untrue, not does it make them inherently political.

The immediate condemnation that HCQ was not only ineffective but harmful was based on data that does not exist. It was fake.

The only ones politicizing are the ones telling lies.

If you have genuine disagreements with trump, one ought to make them by issuing truths not made up fake studies.

All the times Trump promoted hydroxychloroquine: https://www.forbes.com/sites/andrewsolender/2020/05/22/all-t...

Trump ongoingly and repeatedly pushed hydroxychloroquine, criticized published research showing it was ineffective, and most likely lied about taking hydroxychloroquine seeing as how no evidence or independent confirmation that he was on the drug ever surfaced.

It was not a one off thing, and it was not "mentioned as a possibility".

> likely lied about taking hydroxychloroquine seeing as how no evidence or independent confirmation that he was on the drug ever surfaced.

White house physician said he was on it.

Also studies are mixed on it's efficacy. The ones showing it was supposedly harmful were fake.

This comment above is fake.

tl;dr The White House physician seems to have carefully avoided saying in public that he actually prescribed it to Trump. (others noticed this too: https://www.justsecurity.org/70253/nine-questions-for-the-wh...)

The only evidence we have that Trump took it is Trump saying he was taking it, and the press secretary while not giving a white house briefing directly saying it was prescribed[1], and the White House physician saying that he didn't see any harm in Trump taking it...[3] but I cannot find a single authoritative report [2] where someone claims to have actually prescribed the drug to Trump - from either the physician, or from Trump himself (remembering it is a prescription drug). The White House press office also never used those words that I can see, instead deflecting that whatever Trump said should be believed (while on the podium at a briefing, where there would be an accountability issue).

So, short version: it was implied by the people who would've had to prescribe it to him that they saw no problem giving it to him if he wanted it...but it seems like everyone carefully avoided saying they actually did prescribe it.

Now, on some level this is irrelevant whether he took it. Because he used the presidential podium to contradict medical professionals and push an ineffective treatment, created a shortage for a drug which a lot of people actually depended on (I knew a colleague who suddenly ran into trouble with this), which as it turned out provided no useful effect in preventing the president from actually catching COVID-19 and has since then continuously proven to be completely ineffective.

[1] https://thehill.com/homenews/administration/498803-white-hou...

[2] https://www.theguardian.com/us-news/2020/may/19/trump-hydrox...

[3] https://www.theguardian.com/us-news/2020/may/19/sean-conley-...

He shouldn’t have mentioned it at all.

It was massively irresponsible for a political leader to bring up anything that wasn’t actually shown to work at that point, and the ensuing shitstorm was entirely predictable.

The responsible, statesmanlike thing to do would have been to tell the public all the stuff that he was doing behind the scenes to find solutions, not throw out something specific but unproven.

Trump was unstatesmanlike... Sure I can agree.

But his opposition outright lied and they knew it.

Don’t care.

You’re just proving my point that it became more about sticking to your side and cheering for your team rather than relying on the medical evidence. This sort of stuff should not have been brought into the political sphere in the first place.

What is the medical evidence for significant virus-related health benefits (to anyone) of general surgical-style mask wearing?

There is massive amounts of evidence for that. Even the standard flu nearly disappeared due to these hygiene measures. But what’s the point if you’re going to say those studies are fake?

Try me. I've already read all of the ones I can find - they all say the same thing - masks have a barely positive impact (non-zero, but barely positive) on the transmission of Covid. This is not surprising, as the holes in a mask are significantly bigger than the aerosols that they are supposed to slow.

Many different measures have been implemented, you can't possibly pick one of them and say that particular one has had a definite impact on a certain thing.

At least where I live, the way that Covid deaths were recorded over the winter left plenty of leeway for those dying "with Covid" to have just died of the flu (to be specific, if a patient had symptoms or evidence of a viral respiratory disease being the cause of death, then all that was needed was a "clinical picture of Covid" to make it a Covid death).

Telling the world that you’re taking an unapproved drug, and recommending it for everyone, while being a public figure is not a “trivial statement”. It becomes political the moment that statement is made, since now it’s his word vs the medical establishment. And that’s not gonna be a technical discussion.

> medical journals who published fake studies

There is someone else who thrives on calling things “fake” when they disagree with his opinions…

> There is someone else who thrives on calling things “fake” when they disagree with his opinions…

Is Donald Trump a scientific journal?

> other alternative drug goes through due course they would have no difficult being accepted.

That is quite naive, the "due course" here would mean very costly trials that usually big pharma pays for. I'm not holding my breath for them to pay for that.

Ivermectin is a cheap drug, Mercer (who produces ivermectin) is trying to produce their own covid19 drug.

Further, if there are viable alternative treatments we shouldn’t be using a vaccine still in phase 2/3 trials that haven’t even been tested on animals... the entire emergency use authorization is only allowed if there aren’t safe alternatives.

Ivermectin is generally safe to take, and a known drug with known risks. If it was shown to be effective the vaccine rollouts should be stopped. So, there’s a lot of political and financial reasons to not publicize it.

A treatment isn't an alternative to vaccination. Millions of people have been vaccinated so we know it's safe, while tons of people have died from covid so we know it's not safe.

This study appears to show that there is a treatment that’s ~90% effective at reducing deaths.

The vaccines are not shown to be (may be) safe outside of a brief few month window (for specific classes of people). These are a new class of vaccine and there appears to be significant risk based on the cdc data (VAERS).

https://austingwalters.com/covid19-vaccine-risks/

To be clear none of the vaccines really completed a standard phase 2 or 3 trial. It had an abridged or expedited version that skipped things like pregnant women, etc. the vaccine is also not 100% effective, which is important as it’s a “leaky” vaccine. Meaning, we’re going to see lots of variants that get around our protection from the vaccine. That’s why treatments are important.

It’s also possible we see genetic defects 2-3 years from now or an increase in cancer. We really have no idea.

> Millions of people have been vaccinated so we know it's safe

In those millions we are missing the number of people that get seriously harmed, and killed due to getting the vaccine. So we do not know it is 100% safe, we only know that it is mostly safe, which is not good enough to be cheery and happy about it.

You can't get EUA for the vaccines if there's a working treatment. The doctor who promoted Hydroxychloroquine and zinc treatment, Dr. Zelenko, is still banned from Twitter for spreading COVID disinformation.

There's both actual conspiracies in this world, and well poisoning to damage the conversations. When you look at the amount of money these companies stand to make from producing billions of vaccinations, you should not be surprised.

Source for the EUA stuff? Source that HCQ and zinc are viable treatments? The problem isn't that some of these things might be viable, the problem is we don't know which of the literally hundreds of treatments are actually going to be viable when going through the proper testing and approval process. You can't just scream conspiracy when there much better explanations

>Source for the EUA stuff?

https://www.fdanews.com/ext/resources/files/archives/e/Emerg...

(PDF warning)(section III, the first list, point #4)

>Source that HCQ and zinc are viable treatments?

Dozens? Hundreds? of doctors speaking out, including videos posted to youtube, that they saw great effectiveness in the trial. The people promoting it weren't a bunch of nobodys, despite what the nightly news told you. There were plenty of frontline workers with actual experience. But that likely won't satisfy your request for a source - which is fine. We all appeal to authority as we see fit. I saw many actual doctors saying "this is effective", and I saw many large corporations working together to shut that conversation down.

Do you have any evidence it's not effective?

>Do you have any evidence it's not effective?

Do you have any evidence snake oil isn't effective?

Burden of proof is on the people claiming a magic cure.

Anyway here are a couple of studies that show it's not effective.

https://onlinelibrary.wiley.com/doi/10.1002/jmv.27122

https://jamanetwork.com/journals/jama/fullarticle/2777389

Here's a good take by someone that does research on new medicines.

https://blogs.sciencemag.org/pipeline/archives/2021/06/07/iv...

And there are papers which show that it does. Rather than descend into a 'my list of papers denoting effectiveness is bigger than your's suggesting the opposite' contest, I suggest you go to http://www.freefullpdf.com/#gsc.tab=0 and do some objective searching yourself preferably without a prior agenda.

You are seriously proposing that if an effective treatment had been found in 2020, that the US government would have denied EUA for vaccines while the rest of the world got to work vaccinating their citizens?

A number with a question mark behind it is not evidence, and even if hundreds of doctors did speak up about it, hundreds of doctors thought Cholera was caused by miasma instead of bad drinking water. Hundreds of doctors thought bleeding was the universal cure all. Hundreds of doctors thought washing their hands was useless. Some random number of random doctors saying it may be effective is not evidence of it's effectiveness.

Your document also doesn't say what you think it does. If it did, we wouldn't be able to have multiple vaccines approved. Is there any evidence that the FDA would interpret a non vaccine as an alternative to a vaccine, when there's no issue with granting EUA to multiple vaccines? I doubt it, but would love to see what you have.

We have to do this again? Hydroxychloroquine was debunked months ago.

"Among patients hospitalized with mild-to-moderate Covid-19, the use of hydroxychloroquine, alone or with azithromycin, did not improve clinical status at 15 days as compared with standard care. (Funded by the Coalition Covid-19 Brazil and EMS Pharma; ClinicalTrials.gov number, NCT04322123. opens in new tab.)"

https://www.nejm.org/doi/full/10.1056/NEJMoa2019014

"After high-risk or moderate-risk exposure to Covid-19, hydroxychloroquine did not prevent illness compatible with Covid-19 or confirmed infection when used as postexposure prophylaxis within 4 days after exposure. (Funded by David Baszucki and Jan Ellison Baszucki and others; ClinicalTrials.gov number, NCT04308668. opens in new tab.)"

https://www.nejm.org/doi/full/10.1056/NEJMoa2016638

"Neither HCQ nor HCQ/AZ shortened the clinical course of outpatients with COVID-19, and HCQ, but not HCQ/AZ, had only a modest effect on SARS-CoV-2 viral shedding. HCQ and HCQ/AZ are not effective therapies for outpatient treatment of SARV-CoV-2 infection."

https://www.sciencedirect.com/science/article/pii/S258953702...

"Among patients hospitalized with Covid-19, those who received hydroxychloroquine did not have a lower incidence of death at 28 days than those who received usual care. (Funded by UK Research and Innovation and National Institute for Health Research and others; RECOVERY ISRCTN number, ISRCTN50189673. opens in new tab; ClinicalTrials.gov number, NCT04381936. opens in new tab.)"

https://www.nejm.org/doi/10.1056/NEJMoa2022926

Shall we discuss creationism?

Hey mate for what it's worth and you might say not much and may be right, the argument I ear goes as follow: the trials showing the ineffectiveness of HCQ use protocols that are inconsistent with the protocols the advocate of HCQ propose.

To my understanding, the proponents tend to say that HCQ is effective when administered as soon as first symptoms (day 0 to 3 I believe). There are also dosage issues and combinations with other drugs, and they say that HCQ is ineffective administered late.

In the first paper you propose, patients treated are already hospitalized (day 14 or fewer still probably not day 0 to 3). The fourth paper states (when following the link the to protocol) that hospitalisation is a condition for eligibility. That's not first symptoms.

The third papers talks about "initiated medication a median of 5.9 days after symptom onset". So not 0 to 3 days?

The second paper you propose talks about administering HCQ as post-exposure prophylaxis. It seems outside of the scope to me.

There are other issues on this debate, dosage, drug combinations, I can't talk about that, this website does:

https://hcqmeta.com/

This person resumes the argument this way:

https://roundingtheearth.substack.com/p/how-to-rig-research-...

(Note that the fourth paper on your list is the RECOVERY trial he's no a fan of)

What do you think about this? Also what about intelligent design?

This is from the FDA website.

"Under section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act), when the Secretary of HHS declares that an emergency use authorization is appropriate, FDA may authorize unapproved medical products or unapproved uses of approved medical products to be used in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions caused by CBRN threat agents when certain criteria are met, including there are no adequate, approved, and available alternatives."

You should probably drill into this if you are interested, but the phrasing most often referenced by people talking about effective therapeutics and the lack of approval by the FDA is, "there are adequate, approved, and available alternatives."

Can you point to anything that says the FDA would consider HCQ or any of these other drugs as alternatives to vaccines? They are not the same, and though they could both treat COVID, my reading is not that this would limit vaccine emergency authorization if there was a non vaccine treatment. This is especially true considering there are multiple vaccines approved under emergency use which would be direct competitors. So, nope, I don't buy it from just this wording. I need something saying specifically that alternative treatments would stop a vaccine being approved.

I believe it means vaccines should go typical testing and vetting process, not the emergency shortened, is what the op wanted to tell.

I understand that's what op is trying to say, but op isn't providing sufficient evidence for that. Non vaccines are not alternatives for vaccines. And we have EUAs for things that would be alternatives to each other, multiple vaccines. So there's not reason to think a viable treatment for COVID would prevent a vaccine from getting a EUA.

I get vaccinated for flu every year. And yet there is Tamiflu, an effective palliative.

The idea that ivermectin (even if it works, and gets approved for this usage, which'd likely take as long as the vaccines are taking to get to that point) is an adequate alternative to a vaccine, which provides ongoing, lasting protection, is silly.

It'd be like claiming the existence of the iron lung is sufficient to yank the polio vaccine out of production.

For example, Remdesivir is approved, without any sign of that fact jeopardizing the EUA on the vaccines. https://www.cdc.gov/coronavirus/2019-ncov/hcp/therapeutic-op...

> FDA has approved one drug, remdesivir (Veklury), for the treatment of COVID-19 in hospitalized patients aged 12 years and older who weigh at least 40 kg.

Dr. Zelenko held studies that 'showed' that HCQ had 100% cure rate by excluding people that moved to an ICU from the treatment group. The studies turned out to be complete bunk. He's a fraud.

https://sebastianrushworth.com/2021/03/04/hydroxychloroquine...

Two observational studies, both carried out in New York (Carlucci et al. and Derwan et al.), appear to show promising results in patients treated with a combination of hydroxychloroquine, zinc, and azithromycin. The first, involving 932 paitents, showed a 55% reduction in relative risk of death among those getting zinc in addition to hydroxychloroquine and azithromycin, as compared with those just getting hydroxychloroquine and azithromycin. The second, involving 518 patients, showed an 80% reduction in relative risk of death among those getting the full triple therapy, when compared with a reference sample that didn’t get any of the drugs.

That seems impressive. However, these are low quality observational studies that are seriously limited by the methodology used. The scope for confounding effects is huge. Therefore, these studies should be considered exploratory and hypothesis generating. They certainly should not be considered evidence of any cause and effect relationship.

>https://www.nytimes.com/2020/05/01/us/coronavirus-doctor-zel...

>In an interview on Friday, Dr. Zelenko said that he was guilty of nothing more than sloppy wording.

>“I’m a clinician, not a researcher,” he said. “I don’t understand fully the language of clinical research.”

Yet he went on TV and on large podcasts and talked like he was an expert on clinical research.

Well, Jack Dorsey kicks people off the internet as if he's a clinician and they're not.

Pfizer, a company that has contributed probably trillions of dollars to global GDP over the past 6 months, is massively underperforming the stock market when you compare pre-pandemic to now [1]. The stock price in theory should price in all the future cash flows from the vaccine. What is your basis that the pharma companies are making tons of money on these vaccines?

It isn't like the vaccines are pure profit. The pharma companies have to develop them, they have to produce them, they have to distribute them, and if they charge too much they get into massive political trouble. It seems like it is basically a giant marketing effort for pharma companies where everybody in the world is benefiting.

1: For example, from Feb 1st, 20 to today, Pfizer is up 10% and the Vanguard total stock index VTI is up 35%

"everybody in the world is benefiting"

Did the patent issues get resolved? Last I heard, the drug companies didn't want to share because of reasons.

The parent commenter might have wanted to say with that that the vaccines help end the pandemic. The world benefits from that because we are losing massive amounts of money per day while still being stuck in the pandemic.

Isn't Pfizer mostly handling manufacturing and distribution for biontech?

> You can't get EUA for the vaccines if there's a working treatment.

Veklury (remdesivir) was approved by the FDA for the treatment of Covid-19 in hospitalized individuals on October 22, 2020. This was a full approval, not an emergency use application: https://www.fda.gov/media/137574/download

We've continued using the vaccines under the existing EUAs even after a treatment was approved.

The FDA has granted additional EUAs for other treatments, even after that date: four more, not counting a sedative agent, per https://www.fda.gov/emergency-preparedness-and-response/mcm-... .

In fact, the FDA has even granted an EUA for a vaccine after approving Veklury: the Janssen/J&J vaccine received its first EUA on February 27, 2021. https://www.fda.gov/media/146303/download

Even if ivermectin was a perfect treatment for Covid, and even if an approved treatment would pull all the vaccines off the market -- despite that not happening after the FDA approved Veklury -- by the time ivermectin made its way through the approval pipeline to be labelled for this indication, the Pfizer and Moderna vaccines would very likely have received approval as well. So there's no "billions of vaccinations" at risk should another treatment be found to be effective and approved.

Not to mention it’s good to have treatment options in addition to a vaccine. Vaccines aren’t full-proof (treatment options are then good), some people legitimately can’t get vaccinated, and should there be a mutation the vaccines can’t handle then you still want treatment.

This is exactly why instead of censoring podcasts like Bret Weinstein when he brings on guests to discuss ivermectin, other experts should engage in debate with him.

When people who are credible scientists (like many of his guests) get censored it can reasonably look suspicious.

I'm not saying he's correct, I'm just saying the right answer is debate.

A person who is willing to have a calm, 3 hour discussion on a topic is not the kind of person who needs to be censored.

No, the other experts are at work, and don't have time to debate every person out there who has a following. This pandemic is not yet over and guys like Weinstein are all noise and no signal. Keep enough Weinsteins engaged and progress on this front (real progress, not imaginary progress) will grind to a halt.

That’s a valid perspective, but aren’t there thousands of professors and scientists, maybe tens of thousands who could potentially respond?

And isn’t it valuable to have someone respond? Isn’t there value in educating the public so conspiracy theories don’t spread? (And preventing the theories from being discussed just makes them more firmly held, whereas debate doesn’t have that effect.)

Other experts are at work... so let the youtube with no science credentials or credibility judge and censor vocal scientists instead? How is that a desirable process?

It's hilarious how parent comment's opening sentence is a (easily debunked, as you've shown) conspiracy theory, and in the next breath they're trying to sound reasonable and Definitely Not a conspiracy theorist

Please don't post in the flamewar style to HN. It's hugely destructive of the threads, especially when the topic is divisive, and your comment adds no information, just poison. Please don't do that; instead, respond to bad information with accurate information, and weak arguments with stronger ones, without crossing into snark or personal attack. If you can't or don't want to do that, that's fine, but then please don't post.

https://news.ycombinator.com/newsguidelines.html

Remdisivir is a scam.

> You can't get EUA for the vaccines if there's a working treatment.

Per the FDA: ""Under section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act), when the Secretary of HHS declares that an emergency use authorization is appropriate, FDA may authorize unapproved medical products or unapproved uses of approved medical products to be used in an emergency to diagnose, treat, or prevent serious or life-threatening diseases or conditions caused by CBRN threat agents when certain criteria are met, including there are no adequate, approved, and available alternatives.""

And that falls apart under some scrutiny... it says "adequate, approved, and available alternatives." "adequate" being efficacious which is debatable without testing. "approved" which that drug is absolutely not approved for covid use. "available" being enough supply which is debatable if it turns out to be effective and widely used. I see no reason why the EUA for the vaccines would be threatened by this drug also being used in an EUA fashion. if they are going for actual approval for that drug it would take as long as the vaccine to get.

> When you look at the amount of money these companies stand to make from producing billions of vaccinations, you should not be surprised.

I think that when you look at everything through the conspiratorial lens... all you see are conspiracies.

Also, I simply wouldn't assume the FDA considers a treatment (this drug) an alternative to something that prevents the disease (vaccines).

They both are used for the same disease but in different ways. They are only alternatives in a very broad sense.

yeah agreed. literally the only people I've seen push this kind of nonsense are antivaxxers and conspiracy theorists. I don't understand why they need it to be true so badly; doesn't pass any of the sniff tests under even a little scrutiny.

Even if it fit all those criteria for being an alternative it's not like it's some kind of thing that couldn't be amended if they really needed/wanted to. saddens me how reactionary everyone is.

Edit: also I forgot to make the point in my replay above... it's not like having three vaccines under is preventing another vaccine from getting EUA so even under this logic framework it is nonsense. are they hinging it on the fact that it's an approved drug for some other disease?

"literally the only people I've seen push this kind of nonsense are antivaxxers and conspiracy theorists."

Literally? Everyone? LOL this is why there are so many normal people in this thread saying "at least let's have a discussion!"

Your sentiment is the reason (imo) that these discussions are so hard to have, no offense.

yes in fact literally everyone that pushes the "they are stopping the <insert treatment option> because big pharma wants to make all the money on vaccines" is an antivaxxer or a conspiracy theorist that I have seen in the wild... including my brother so this is a topic I am not taking lightly.

nowhere did I say that this treatment couldn't be effective and no where did I say that they shouldn't look into it as an alternative because I think all tools should be on the table. I am simply saying the part about the EUA thing being pushed by antivaxxers and other conspiracy theorists.

Lots of others have debunked this here. Yet with all this conspiracy stuff there’s a big elephant in the room that no one seems to ever talk about: Covid is a global virus. The FDA can block and approve whatever treatments in the US, but it has no authority in Brazil or Thailand. If all these conspiracy drugs worked well yet the FDA blocked it for some malicious intent, the rest of the world would approve and use it. Particularly since these conspiracy drugs have all been around forever, are generics, and exist globally. Yet we aren’t seeing this emerging despite massive world wide deaths.

Well, all the data we have is from outside the U.S. so I guess U.S. doctors in-the-know are trying to discuss it but getting shut down on U.S.-based social media.

Wrong - there are countries it’s being widely used in. For example, India and many Easter European countries (and some S. American???).

We need effective vaccines and therapeutics. I don’t understand this push to discredit any therapeutic before reasonable research has even been conducted.

> I don’t understand this push to discredit any therapeutic before reasonable research has even been conducted.

It’s simple. Money. Companies like it and want more of it.

> I don’t understand this push to discredit any therapeutic before reasonable research has even been conducted.

No such thing exists. There are literally dozens of therapeutics in trials , and a few actually approved and in non-trial general use (dexamethasone, remdesevir, and favilavir, in various jurisdictions) — for both, see [0] — the ones that tend to get strongly negative treatment are hydroxychloroquine (not actually in trials) and ivermectin (in Phase 2/3 trials), both on the basis of unsupported scams around both earlier in the pandemic, not any general aversion to therapeutics.

[0] https://www.raps.org/news-and-articles/news-articles/2020/3/...

Most regions that use ivermectin have significantly less deaths. Example: https://twitter.com/jjchamie/status/1334228581870931968

That chart shows that state being the lowest death toll both before and after ivermectin treatment, which would seem to point to some serious confounding factors in this analysis.

Not to mention dramatic changes else where as well, and that’s assuming this data is accurate. It’s also from very early in the pandemic, when we didn’t know as much generally. Plus correlation =! causation. Could be far better making behaviors there, or all kinds of other factors. That’s why you need randomized double blind clinical trials, done by experts. This arm chair “analysis” is just bad science.

To me, this kind of regional comparison, contrasting before and after Ivermectin was deployed as a treatment, has been the most convincing evidence that Ivermectin is an effective treatment.

This paper by Pierre Kory has graphs that clearly show the evolution of Covid cases and deaths across different states in Peru.

https://covid19criticalcare.com/wp-content/uploads/2020/11/F...

Convincing would be a large double blind controlled study.

In Brazil many people have used Ivermectin and our country is getting a record of 500.000 deaths of covid today. Also, here in Brazil we had many reports of people needing a liver transplant because they caught drug-induced hepatitis. So, in summary, 1. Ivermectin doesn't work and 2. it can cause severe health issues if used wrongly.

I've been monitoring this for a long time now. I have ivermectin on hand for deworming my two mini burros.

Of course, you're not supposed to use it on humans but they say that about fish mox too. But as time went on it was pretty clear to me that it was working to prevent covid from becoming severe in the countries that were using it for that because they had nothing much else to use. I saw many reports of it working.

I also read about vitamin D, melatonin, famotidine, and aspirin helping to reduce severity of infections. So, when my wife and I got our 1st and 2nd jab of the Pfizer vaccine we took all of those and had no reaction to it at all. Our daughter took it before her first jab and had no reaction but didn't for her 2nd and she did get sick. As soon as she told us she wasn't feeling good we dosed her with those and just an hour or so later she was feeling good again.

I haven't been infected and now I've reached full immunity so none of that proves anything at all but it's still been worth knowing.

How do you know that that dosing did not interfere with you developing proper immunity?

In fact, CDC recommends taking fever reducing medicine only once you develop fever after a vaccine and not before vaccination for just this reason.

How do you know eating a cheese sandwich doesn't interfere?

How do you know what I did doesn't improve immunity since all those things I mentioned do seem to lessen the severity of covid?

One thing I do know, is that no doctor anywhere has claimed what I did lessens the effectiveness of those vaccines.

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