Comment by nradov | Hacker News Reader

Comment by nradov | Hacker News Reader

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There is a non-anonymous sort of meta-analysis in the form of a letter containing corrections to an earlier flawed meta-analysis. (I'm not endorsing this letter, just pointing out that it exists.)

https://journals.lww.com/americantherapeutics/fulltext/2021/...

I think though that most people aren't asking the right question about ivermectin. From a population health standpoint it's clearly not a viable alternative to vaccination (and I encourage everyone to get vaccinated if they can). But vaccination isn't 100% effective so there will continue to be many symptomatic breakthrough cases. So the real question is whether ivermectin should be added to the treatment protocol along with other drugs including monoclonal antibodies? Is it clinically justified on a risk / reward basis?

https://www.covid19treatmentguidelines.nih.gov/about-the-gui...

The NIH is currently sponsoring a large scale clinical trial of ivermectin and other drugs.

https://www.nih.gov/research-training/medical-research-initi...

While waiting for results from that study does it make sense to act based on lower quality research? There are at least some small studies which appear to show a significant clinical benefit with minimal risk.

https://www.mdpi.com/1999-4915/13/6/989

https://www.thelancet.com/journals/eclinm/article/PIIS2589-5...

https://journals.sagepub.com/doi/10.1177/03000605211013550

It's unfortunate that the issue has been so heavily politicized. Decisions on off-label drug use should generally be left up to individual physicians.

> From a population health standpoint it's clearly not a viable alternative to vaccination

But from a sociological standpoint there's a strong case for its inclusion.

The reason there even is a divide in politics is because people lean towards one style of thinking. To either stay cautious and follow historical precedence, or to believe change is needed and want to move on from it.

Vaccines are the new and most likely to be effective solution, but we don't know its long term side effects simply because it hasn't been around long enough. Ivermectin on the other hand has been around and has been used for many illnesses on many creatures, including people and horses, successfully and may potentially be effective against Covid for which the risks outweigh potential death.

Some people, due to how they think, will never be getting the vaccine short of being strapped in a chair and shot. And that's a good thing, the diversity of thinking patterns is what keeps our species alive. Disparaging them and labeling them as idiots for refusing it, then trying to force feed it to them is bordering on what we should expect of a dystopian government.

Again, its a good thing that some people are unwilling to try new things, it keeps things balanced, but what that also means is they will never be getting vaccinated until there is more evidence. Look further than the simple math of herd immunity, factor in the fact that we aren't cattle to be vaccinated by some statistician, that we all have individual rights and different modalities of making decisions, and suddenly the solution of using vaccination _along with_ alternative drug treatments should make way more sense than trying to replicate some statistical analysis. Vaccinate as many people as possible and for those more cautious with new things, provide treatments that show some promise for which long term effects are known.

But like you said, this whole thing is so politically motivated, I dont see either side giving up any ground.

Of course it makes sense to act on low quality evidence, it’s called a risk benefit discussion and it’s done everyday in doctors offices. Risk of ivermectin is low. Possible benefit is high. Calling something contrarian doesn’t make it any less true. It’s nuts how the basics of medicine have also been thrown out the window. Get the vaccine. And do your best to stay safe, including staying up to date on potential treatments.

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