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Comment by walterbell | Hacker News Reader

There are early treatments which may help some infected people, vaccinated or otherwise, to clear the infection more quickly. They do not work for everyone, but they have been used in some countries, including India, origin of the Delta variant. Summary and links to hundreds of studies, organized by therapeutic: https://c19early.com

> Who is @CovidAnalysis? We are PhD researchers, scientists, people who hope to make a contribution, even if it is only very minor. You can find our research in journals like Science and Nature.

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That website is fake:

- It is impossible to contact the owners of the website - The website has gotten direct critique of spreading misinformation in two papers - They draw their own conclusions from the paper.

But let's ignore all these red flags and focus on this. They claim that each of the following individual medicines works, Fluvoxamine, Proxalutamide, Iota-carrageenan, Molnupiravir, Quercetin, Povidone-Iodine, Curcumin, Casirivimab, Sotrovimab, Bamlanivimab, Nitazoxanide, Budesonide, Zinc, Bromhexine, Colchicine, Vitamin D, Aspirin, Favipiravir, Hydroxychloroquine, Remdesivir, and Vitamin C. I find it unlikely that ALL those claims are true which in turn makes me question their scientific approach.

> The website has gotten direct critique of spreading misinformation in two papers - They draw their own conclusions from the paper.

Good to know, is that critique public?

> They claim that each of the following individual medicines works

The site text says:

> Analysis of the efficacy of early treatments for COVID-19. Treatments do not replace vaccines and other measures. All practical, effective, and safe means should be used. Elimination of COVID-19 is a race against viral evolution. No treatment, vaccine, or intervention is 100% available and effective for all current and future variants. Denying the efficacy of any method increases the risk of COVID-19 becoming endemic; and increases mortality, morbidity, and collateral damage ... We focus on the most effective/promising early treatments. There are many treatments that are helpful for late stage patients, however we do not have the resources to cover everything and currently focus on early treatment.

That text doesn't say that each of the listed therapeutics "works", it says they are presenting an analysis/summary of the efficacy of each treatment, with data from referenced studies. If there's a critique of a referenced study, or an error in the summary which is derived from references, that would be good to identify publicly.

This type of summary of public data and research papers should be on github or other public source repo (the site says the content is CC0 licensed), where issues/PRs could be used to correct errors. Maybe the site can be forked, errors removed and additional studies added. Early treatment is an important and neglected topic, which can supplement vaccines in breakthrough cases.

This HN comment [0] links to a Twitter comment by an epidemiologist criticizing a related site for cherry-picking data, among other concerns.

It seems like there are several sites that all have similar layout/content and very distinctive plot styling. I think they are related, but I’m on a phone and haven’t made time for dig queries and such. Seems dodgy though.

Anyway, there’s been a feeding frenzy of questionable research since the pandemic started (well especially so anyway) so it’s more important than ever to practice informed skepticism.

[0]: https://news.ycombinator.com/item?id=28177264

Thanks, this is helpful, will review.

In theory, those opposed to early treatments could publish a competing analysis of studies on early treatments. Maybe that has already been done?

On some contested topics, there's almost a need for rules of evidence, so there's an agreed upon list of papers/data for discussion. Then different stakeholders/teams can debate on their (likely biased) interpretations of a pool of evidence that is clearly bounded at any point in time, but expanding as new data/studies become available.

Here is Derek Lowe on the matter back in June, with an update after the big Egyptian study was retracted: [0]. Not specifically on this website you linked, but on the body of evidence for ivermectin as a COVID therapeutic.

I was curious so I ran Whois queries on three sites: c19early.com which you linked, and ivmmeta.com and c19ivermectin.com. They all seem to be hosted through google sites, and use the same DNS privacy service. I don’t know if google sites by default uses this service or something, but just looking at the similarity of the sites I am wary.

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

Any idea why India is reporting success in the real world that isn't predicted by available studies? E.g. could someone design a study in Uttar Pradesh, with their huge population, to dig deeper into conflicts between the studies available for Lowe's analysis, and the claimed success in UP? There are states in India not using Ivermectin, which could be compared with the effects of UP's official state policy of making Ivermectin widely available to their population.

When experiments don't match our predictions, there is often either an error in the experiment, or an opportunity to improve the models behind the prediction. In this case, one of the experiments (UP with 200 million people) apparently has an unexpectedly good, positive, cheap outcome with minimal supply chain dependencies or safety risks.

If the observations are incorrect, that should be easy to establish.

If we are unable to explain this observed, positive, practical outcome via existing theory, that would be scientifically exciting!

India is lying and systematically undercounting their cases, hospitalizations and deaths by as much as 10 times. India does not have a robust public health system or effective record keeping. They can't even record every birth let alone keep track of deaths in a pandemic.

India isn't reporting success in the real world, what evidence do you have except some shady video? Covid went down in a similar fashion in other states in India too at the same time.

Cui prodest? Who may have an interest? Ideological only, or economical?

This week, the FDA added their voice to social media memes making fun of Ivermectin.

This week, there was a short video briefing for Malaysian doctors about the Indian success story in the state of Uttar Pradesh (UP), population ~200M. In India, each state can set their own health policy. Even though the central government was against Ivermectin, UP continued to use it. On June 29, the UP government released an official kit for children, containing: Paracetamol, multivitamins and Ivermectin. The briefing claims that Doxycycline, Ivermectin and Zinc were instrumental in treatment, prevention and reducing transmission of Covid.

This video was removed from YT within 24 hrs, interpret that as you will, but this is a field report from a medical professional describing a successful, real-world health outcome in a region with more humans than many countries, https://www.bitchute.com/video/ysnsHWrcqimp/

Meanwhile a study in the neighboring state of Bihar didn't show much benefit, if any.

https://pubmed.ncbi.nlm.nih.gov/34265236/

It was removed from YT because it's nothing but pure propaganda and misinformation.

It still confuses me as to what are they trying to push with this agenda.

Thanks for commenting. Since it's such a short video, would you mind quoting one sentence from the video which is incorrect, e.g. did the doctor from India describe a particular event which did not take place?

In the USA, the New York Supreme Court ruled that an elderly patient was allowed to take Ivermectin, against the wishes of the hospital where she was being treated. After winning her court case, Ivermectin was administered and she made a rapid recovery, https://www.mountainhomemag.com/2021/05/01/356270/the-drug-t....

Let's assume that her case is an outlier, can we agree that it is a remarkably positive, happy, outlier? Are such cases worthy of scientific study, to understand the therapeutic mechanisms involved, if only to inform the design of new therapeutics? Merck, holder of the Ivermectin patent that expired in 1996, is now developing a new, patented drug for early treatment of Covid.

>Ivermectin was administered and she made a rapid recovery,

Here's a counter anecdote, Phil Valentine, a popular right wing talk radio host took Ivermectin, still got hospitalized and died.

https://www.cbsnews.com/news/phil-valentine-dies-covid-conse...

The plural anecdote is not data. At the end of the day it comes down to statistics and reproducibility. A lot of things can happen for a lot a reasons. It’s why things like homeopathy still exist.

The site posted at the top of this thread has 800 scientific studies of various therapeutics, https://c19early.com/faq.html

> Whether it be treatments or interventions, the plethora of seemingly similar quality research supporting contradictory positions, and the use of digital echo chambers, facilitates widespread confirmation bias - evidence supporting any initial position can be easily found. Self-serving bias and cognitive dissonance further make it challenging to alter positions, especially for those taking very public and strong positions with serious implications. We felt that attempts to organize and make the research and data easier to navigate, highlighting areas of applicability, and analyzing limitations, could potentially be beneficial.

> What is the search strategy for papers? All significant original contributions related to the use of the treatments we cover, including searches of the typical sources augmented by contributions from the community. Covering all research is important because it is easy to choose a search strategy that results in a subset of papers reporting a desired conclusion. This is especially so if one takes the conclusions reported in papers at face value without examining the actual data, methods, or regions of applicability

That website is fake:

- It is impossible to contact the owners of the website

- The website has gotten direct critique of spreading misinformation in two papers

- They draw their own conclusions from the paper.

- A lot of the papers in its meta-analysis doesn’t have control groups or randomized trials. Some studies only compare ivermectin+X vs ivermectin+Y

- The total sample size of all studies are only 2000 people.

> A lot of the papers in its meta-analysis doesn’t have control groups or randomized trials. Some studies only compare ivermectin+X vs ivermectin+Y

If you have the time to share an illustrative example paper, that would be helpful.

> I find it unlikely that ALL those claims are true which in turn makes me question their scientific approach.

Response posted here: https://news.ycombinator.com/edit?id=28335175

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