That this single article would change your mind is fortunate, but I do not suspect that to hold true for the bulk of the conspiracy peddlers that remain.
Article publishes sound arguments, doesn't talk down to the audience, admits problems with appeals to authority... and converts a conspiracy believer!
...No way, there is no way that can possibly work, the others are way too dumb, and the convert is a bad person... basically anything to just go back to pretending appeals to authority work. Despite clear evidence to the contrary. Or lamenting that they don't. I'm drawing some parallels with miracle cures here ;)
edit: just one exhibit: https://news.ycombinator.com/threads?id=mewpmewp2
The way someone gets ivermectin is to walk a doctor through the evidence they've seen and then ask them to prescribe it.
Is the idea that doctors deserve deference because they are conditioned to submit to guidelines formulated by experts?
There is a lack of consensus on many long-standing, common medical questions, much less novel diseases. When I ask my GP about prostate screening, for example, he lays out the current state of research as best he can, but delegates the decision to me. Why is the COVID situation different, given that experts are still fighting through a figurative fog of war?
As to why the COVID situation is different, presumably because prostate cancer screening affects only you (and perhaps your family in the case of a true/false positive/negative diagnosis), and COVID represents a threat to everyone around you, and everyone around them, etc.
- There is no expert consensus (on treatments, etiology, etc.).
- Consensus exists, but the level of consensus is overstated.
- There is broad consensus, but with relatively low confidence.
A generalized public health threat like a pandemic doesn't change the epistemological calculus, nor the sociology of knowledge.
- there a consensus, it is broad and it has good experimental support and high confidence
1. Treat you according to guidelines/expert opinion, should you choose to.
2. Give you the opportunity to participate in a relevant study.
But _never ever_ will your GP formulate an experimental treatment plan based on his own research. Not GP's job, and big risk of liability. Your GP has at best a cursory view of the research happening in a certain field. COVID is different due to several good and bad reasons: hugely politicized, confusing messages from experts, and most of all novelty. 'Lack of medical consensus' usually means 'several treatments backed by experts are available', not 'do what you like'. COVID is too new for the dust around expert debates to have settled. That's what makes it different.
What you yourself _have_ to realize is that the expert researchers who are in a position to create and inform guidelines are themselves not some kind of 'super-experts' who know everything better than normal experts. They're just researchers in a political position in a bureaucracy.
I don't exaggerate when I say that an average HN reader could write better guidelines for patient outcomes in my subfield, with no prior training, simply by reading a few studies and observing a practice.
Now, does any of this apply to internal medicine, specifically covid? Probably not. But when the data is anything other than crystal clear, you should not assume the expert guidelines are anything more than some guesses by guys in a room. The consequence of knowing this is that all guidelines and consensus is suspect until you see the data yourself, like TFA outlines. In this case it seems true that Ivermectin doesn't cure covid. But with my experience, the exact opposite result could have been shown and I would not be surprised whatsoever; experts saying it doesn't work does not constitute in my eyes anything other than noise until the data is clear.
What I'm saying is only that:
- on average, experts do spectacularly better than Joe Schmoe. Including science degree holders thinking they understand medical studies while missing the whole political and social context of the field.
- it's not the job of field practitioners to prescribe experimental therapies, and those people cannot do better than follow expert opinion and guidelines.
But I actually agree with you on all points, especially regarding flawed research and understanding. Which makes people basing opinions solely on papers without any practical knowledge of the field wrong all the more often. Does it make it a good idea for people to go and try on their own the thing they read about in the last issue of 'covid today'? I don't think so.
I'm saying that, when the data is unclear and Joe is thorough, I don't even think that's true. Or at least it's not spectacularly better. My point is that for something like Ivermectin where the data was initially null and even now isn't super clear, the word of experts was basically meaningless. Trust them if you don't care enough to look into it, but if you're Joe I'd say just go ahead and believe whatever you understand to be correct until there's a better consensus.
So even if the data is unclear we can safely conclude that it isn't a miracle cure and never was. And Joe Schmoe here isn't talking about some condition that he's been walking around with for a while and has studied extensively, Joe Schmoe here is a guy who believes doing your own research is watching youtube videos by people who have done their own research reading a bunch of papers without understanding any of it.
The problem is that that gets in the way of achieving the goal: beating this pandemic, and that isn't going to happen with ivermectin. (Or HCQ for that matter).
The zero hypothesis is the long standing default, that a random thing will not cure this illness. The alternative hypothesis is that it does cure it and then we can analyze the results based on the results of a fair trial.
Edit: I meant this to go with debating techniques, not cures. There are people for whom no amount of saying "why can't you just listen to Dr. Fauci" is going to work. We can say they are bad people, but that doesn't work very well for getting them to agree either.
You are right to call out above that there were other anti-Ivermectin arguments before and roenxi might not have had the background to understand them. That's exactly the point: here we have an argument that he can understand, and it's effective. This is good science journalism. The kind that doesn't work (too much moralizing or too confusing for the general audience) is bad journalism.
"move fast and break stuff" is the wrong attitude for medicine and aerospace.
But a solution is better than no solution, and of all the countermeasures that we had available in March 2020 we only used a fraction.
See:
https://www.youtube.com/watch?v=AqRHH6e-y6I
note the date on that video.
As to your edit: no, here we have an argument that he thinks he understands, that's not the same thing. The argument as presented is at best a hypothesis, it isn't proof of anything, just one more theory that may or may not end up being the right one explaining the sometimes observed effect, assuming it really was observed in the first place.
This is precisely what makes this discussion so tiring: people will be swayed one way or the other based on arguments that they have no way of understanding unless they were trained in that particular field.
Unfortunately, there are plenty of politicians that fall into the same trap, leading to terrible examples of wishful thinking, outright quackery and conspiracy amplification. The harm that this is causing is substantial.
So even if this article swayed one person I'm pretty sure you'll be able to find people who get the opposite out of it, because hey 'x' has now joined the establishment, must have sold out.
They then seek others and continue to have conversations, and they find others lacking trust resonates and that opens the door for a lot of BS normally and easily seen.
Just an example of the difficulty we now face:
Hiding YouTube dislikes will, among other effects, serve to help big corporate media compete against new media.
Hiding the dislikes also breeds more mistrust. This is unavoidable no matter how reasoned the move is.
Public trust in corporate media is really low, and the younger a potential user of that media is the worse those metrics are.
Had that same media held more closely to journalism, rather than access journalism, which is essentially a sales job, the trust problems we struggle with today would not have grown into the chronic problem it all is today.
You identified politicians committing similar abuse of the public trust.
Look at Russiagate. Basically, it flat out did not happen the way many believed it did. Back when that started, many and myself included went to the original documents, saw speculation and in some cases saw it helpfully color coded, and turned on the news only to see all that elevated to fact.
That scared me frankly.
What can one conclude?
I do not see how judging others helps right now. Not saying anyone did here, but I am saying that is happening a lot and when it happens the door for good info to find it's way home gets closed. Advocates render their efforts far less potent.
Secondly, the lack of trust really can't be assigned to people. We have a lot of "they are stupid" type discussion, judgement and rationalization going on and very little of that is helpful.
ie: 70 million people voted for...
The people who had a far better position of authority and trust denigrated that themselves, and for dollars and ratings.
All that is a real mess!
How can authorities, who have abused public trust be counted on to fact check and improve on misinformation without amplifying the already chronic trust problems they created?
In a more basic sense, how can we improve on public trust at all?
I am not sure how that is done quickly.
Longer term, we need media that makes informing people a priority. And doing that likely means a move away from the current AD and access based media we have now.
Given how things are right now, the more important thing is to avoid judgement of others and encourage more and better information exchange. We will not know what reaches people, until it does.
Once it does, we need those people to continue seeking better information so we see more people making better choices more of the time.
Now the changes are coming so fast and are so drastic that we as society - including our legal system - have no way of keeping up with it. Technology routinely moves from one phase to the next before the legal framework has caught up with it. This translates into effectively operating without a legal framework for a very important chunk of society.
That's dangerous territory. I don't have any solutions and I'm sure that there are plenty of people that disagree with me but I've gone from a technophile to being very skeptical about the degree to which I allow tech into my life. Familiarity breeds contempt, or something to that effect.
However, and as a thought exercise, say we did not go down the Citizens United path after Reagan repealed the Fairness Doctrine, and Clinton Telecommunications Act of 1996.
Social media viewed through that lens, one where both the public interest is a thing we recognize must at least compete with profit, and the public trust is recognized and maintained as the high value part of our Democracy it is.
I do not disagree with you about tech and the law being behind. And right now we remain in a particularly difficult time due to so many legislators not understanding tech well enough to perform their role as well as it needs to be performed.
That said, our difficulty right now is greatly exacerbated by basic policy priority shifts that happened well in advance of tech.
Owning that is particularly difficult too. Money and markets are a higher priority than the public interest is, and that is true for government as well as big media.
The vacuum was there and significant, leaving tech, social media to rapidly expand into it.
Had that time been one of more robust public trust, social media would have to compete much harder, and regulation may well have both been more effective as well as earlier, more robust in its positive impact.
"Thinks they understand"
That will be true for very large numbers of people. Not their fault at all. It simply does not happen that a population all ends up able to sort these kinds of things out.
Implying they should is fine in the sense of self improvement, but as policy? Nope.
Perhaps it is time we, as concerned people, begin to take much harder look at our national priorities and demand the public interest be far better served than it is today.
Having done that, and sadly we are no where close to the basic consensus needed, we will find painful discussions like this one are a lot less frequent.
Know what I did not see in this exchange?
"Yes! You got there. How can we reach more people and help get past this?"
Feels a lot more like, "better late than never, and you need to do much better."
It's not bullying or "talking down to" to simply ignore bullshit, it's effective use of your time.
I was never an ivermectin proponent — although I thought the "horse dewormer" rhetoric was self-defeating, because it's obviously and well-known to be also a human dewormer (amongst other parasites), and the "horse" part just seemed to be played up to make ivermectin supporters look stupid — but this article is indeed the first one I've seen to make the parasite-COVID-comorbidity argument. It's not, in fact, the first time that argument has been made... But it seems like the first time that link was made was within the last month, as the blog post links to the following Twitter thread from a medical researcher: https://twitter.com/AviBittMD/status/1456376484180922368
It's not ridiculous to me that this blog post would be someone's first encounter with that argument, considering how recent the link is.
I have a little bit of experience with reading lots of research papers about COVID safety measures, and coming to the opposite conclusion of medical experts: in early 2020 I read lots of papers on masks, and tried to convince most of my family to mask up even when the CDC said that masks didn't work. I happened to be right, and to my parents, I now look like a smart and forward-thinking, science-driven person. But that's only because I was right! I could see someone doing the same with the ivermectin studies, and while it appears that they were wrong, I don't think it deserves dismissal or derision — especially when it comes from someone willing to change their mind and admit they were wrong when presented with compelling evidence to the contrary.
It's not a lot in absolute numbers, but it probably hides a sizable amount of cases not serious enough to get to poison control.
By way of comparison, every year, two out of every million people in the US die by falling out of bed.
Because the introduced question was regarding characterization of proponents, not the rate injury.
It’s very unfortunate that Covid started under trump because being anti-science was part of his marketing message to his base, many because of the risk to certain jobs with caring about climate change (aka the great “hoax”) and the association of science/medicine and abortion.
Unfortunately explaining the rationale in a way that people can comprehend and not tune out is very very difficult, and far more time consuming than whatever 2 syllables Trump could come up with as a retort.
These two perspectives are not equivalent opposites though.
"Believe in science" is not a religious statement.
It is a shorthand for "trust in the scientific institutions that have proven their track record via decades of public health progress, and not in anti-scientific rhetoric with a culture war agenda".
That concept wasn't even controversial on most of the political right until their recent nationalist turn.
The facts are out there, whether you believe it or not, and eventually the scientific method will catch up.
Of course if you're not a trained scientist, then it's hard to appreciate how the scientific method works, and that even when we're very sure of something, true scientists will always hedge their statements. This will be misinterpreted by those who are outside this world as there being more gray than actually exists, and those with an agenda will drive a truck right through it.