Hacker News Reader

Comment by dfdz | Hacker News Reader

I think everyone (who is reasonable) agrees the vaccine is the most effective tool we have against covid based on current scientific studies

However this article about Ivermectin is not well reasoned:

> As infection rates soared, some people were taking excessively high doses of the medicine every day, hoping to stave off COVID-19, but in a few rare cases that move prompted liver failure.

>Other patients were unknowingly given the "kit" drugs by doctors in private hospitals instead of more standard treatments — and some of them died.

These quotes from the article don’t support … anything. People had Covid, they took a treatment, but some died? Really? Could they at least pretend to use some statistics or even an antidotal control group?

View on HN

Clinics distributed a box of pills with no proven efficacy for the SARS CoV-2 virus, but with significant downsides, and with no tracking. This was not a controlled experiment, this was negligent homicide, recklessly endangering a population by abusing their misplaced faith in careless medical and pseudo-medical "professionals".

“Negligent homicide” is hyperbole. The medication itself is safe, safer than paracetamol / acetaminophen. If you are saying it gave too many people false hope and they died from Covid, isn’t that the problem everywhere else without false hope? Are deaths in Australia “better” than deaths in Brazil because Ozzies didn’t attempt the same treatment?

Does ivermectin not function extremely well as a protease inhibitor? It probably doesn’t work anything for Covid, but it scientifically can prevent some viral binding despite that not being it’s primary function.

So making an educated guess wrong is one thing, having people abuse pills is another, and killing people unintentionally through criminal actions is another still.

Be rationale and reasonable. Because going overboard on accusations isn’t helping anyone nor adding to any scientific discussion.

To be clear- many of the cases of serious injury or death were people taking wildly high doses of ivermectin, beyond any reasonable dosage. Ivermectin does have some safe use cases for human prescription: there is no acceptable evidence that it is effective in the least for treating or preventing Covid.

https://www.researchsquare.com/article/rs-100956/v4

Much of the buzz was generated by the above preprint study, now retracted for some serious concerns that large portions were plagiarized and cherry-picked, and in some instances fabricated completely.

https://www.medpagetoday.com/special-reports/exclusives/9365...

One of the problems with ivermectin is that it is widely available and cheap. This is great if you are trying to treat river blindness or prevent your horse from contracting worms, but terrible when a deeply flawed (yet widely cited) purports it to be a miracle cure.

> The medication itself is safe

Upon what dosage do you base that on? And particularly is it safe for covid patients, or does it increase mortality?

Many doctors are in the US pushing Ivermectin and HCQ as "safe and effective" even though the #1 call to many poison control centers in the US concern Ivermectin poisoning.

> Because going overboard on accusations isn’t helping anyone nor adding to any scientific discussion.

Giving false hope (or false cures) is by far worse -- and that appears to be the case as to what happened in Brazil. Politicians were pushing Ivermectin as a way to reopen the economy. It's snake oil at it's worst form, and reduces trust between patients and doctors.

> Upon what dosage do you base that on?

The recommended human dosage. The one that hasn’t been a problem, ever, not in the millions and millions of people on it. Unlike the extremely common liver damage people get from Tylenol every year.

> or does it increase mortality?

I have never seen anyone claim that. Do you have a link that makes that claim? If you bring up a possibility without evidence. I guess that will make for spirited comments soon.

> Many doctors are in the US pushing Ivermectin and HCQ as "safe and effective" even though the #1 call to many poison control centers in the US concern Ivermectin poisoning.

Number one call would not mean number one poisoning. It has unbelievably high media attention, and discussion is being censored. People seem to be calling to ask because “officials” why wouldn’t they? If you have a citation that shows mass poisonings please post it. I could only find two confirmed poisonings in the USA. Whole tubes of horse paste like idiots.

> It's snake oil at it's worst form, and reduces trust between patients and doctors.

Good thing this has been the only example of that! I agree though, if there were questionable truths, policy decisions on 1/2 baked theories, changing and shifting narratives, that would be harmful for trust. That to me would be epic failures of policy work and would probably cause a backlash in a lot of areas.

>> or does it increase mortality?

>I have never seen anyone claim that.

It's part of being "safe and effective." -- which I believe is your stance here. It's also your burden of proof.

> The recommended human dosage.

Which is what exactly? I mean, if you want to be an expert, than be an expert. Nothing is stopping you.

The same happened with Remdesivir, a drug that is much more expensive and has more severe side-effects than Ivermectin. This isn't "pseudo-medicine", it's just how medicine works. If there's an emergency and some small trial suggests that there's an effect for minimal risk, you roll it out and see what happens.

No, because that goes against the narrative of demonizing ivermectin as some sort of dangerous drug. There's a reason all these outlets have been pushing the idea that it's a "horse dewormer."

What's the angle, though. Cui bono?

It's cheap? No US-based pharma corps are reaping big profits from it?

Btw., I live in Brazil, and I went with one of my daughters to see a GP a few days ago because she had symptoms of respiratory illness and was worried it might be Covid (she had had recent contact with peers who afterward tested positive). The physician told her to get a test, and if it were positive (it wasn't) she should take Vitamin C, N-acytilcholine, Ivermectin, and Hydroxychloroquine. I'm not saying that I think this makes sense, just reporting what a Brazilian physician said 5 days ago.

I also want to add that I'm fairly convinced that Ivermectin is probably useless for Covid, but I raise livestock and am a big fan of Ivermectin as a medication of first resort for my animals, and in some cases for ourselves as well... long before Covid I've taken Ivermectin for diverse parasitic infections with good results and no adverse effects.

Vaccines are cheap.

Once everyone starts taking it preemptively for covid, would it still be cheap?

> I think everyone (who is reasonable) agrees the vaccine is the most effective tool we have against covid based on current scientific studies.

Vaccination is perhaps the best solution in the short term, but to me it seems that preventive public health measures might be more effective over the long term.

We know that the severe cases mostly happen to people who are already medically vulnerable (overweight, diabetic, cardiovascular disease etc). Governments could have used the last two years to execute on policies to reduce these chronic diseases: better food, better air quality, better water quality, a less stressful lifestyle.

High blood pressure, high blood sugar, air pollution and obesity (not to mention smoking) are responsible for far more deaths than Covid-19 [1]. In addition, being exposed to any of those conditions is a risk factor for Covid-19. Logically, if we reduce the risk factors we can reduce both Covid-19 deaths and non-Covid-19 deaths!

[1] https://ourworldindata.org/air-pollution#air-pollution-is-re...

>air quality

And that’s the reason why covid is still “not airborne”, despite the fact that, semantics aside, it’s anything but. The whole issue has become over politicized and academia has let itself take center stage of public policy.

So now we have this fixation on pharmaceutical intervention, as it could have been some miracle panacea. The more time passes, the less reasonable it is sounding and the more the same academia turned public policy maker is doubling down on them.

> Governments could have used the last two years to execute on policies to reduce these chronic diseases: better food, better air quality, better water quality, a less stressful lifestyle.

Governments have been working on these problems for decades already. Food/obesity is only getting worse in rich countries, air quality and water quality have seen marked improvements over the last half-century from lead reduction, decommissioning coal plants, emissions regulations for cars etc.

However expecting government to dramatically reduce the number of overweight people suffering from diabetes in just 2 years without extreme authoritarian measures (e.g. concentration camp where they monitor your food intake) is pretty much just fantasy. Many different methods have been tried all over the world like education, food labeling, soda taxes, etc. and people continue to be fat when they can access and freely buy modern foods.

The nice thing about a vaccine is that it’s far easier and cheaper to use and deploy than any of these other improvements. A vaccine costs $1 to $100 per person, while transitioning the entire economy to solar, wind, and nuclear power within a few years to improve air quality would cost what, $10,000s per person? If even possible at all.

Reply on news.ycombinator.com