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Comment by TimTheTinker | Hacker News Reader

> Imagine doing research on vaccines and hearing the soon to be secretary of health speak on that topic.

I hope I'm not entering a minefield here... but from what I've heard, it sounds like he's not against vaccines in principle, just ones that haven't undergone clinical trials equivalent to what the FDA requires for pharmaceuticals.

(A sound byte I heard sums it up, where he said something like "no one called me anti-fish for working to get mercury removed from the fish sold in supermarkets, so I don't see why I should be labeled 'anti-vaccine' either.")

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No, he’s pretty much against them and makes a new excuse each time. He would claim that no vaccine ever has gone through enough testing.

He also denied HIV causes AIDS, days it’s Poppers or lifestyle.

He also pushed ivermectin which studies show has no statistically significant effect on COVID.

He also pushed raw milk when prior to pasteurization, milk was the cause of 25% of all communicable diseases (it’s a great medium for bacteria, it has avian flu viruses, parasites, etc). We invented pasteurization for a reason.

The guy latches on to whatever statistical outlier study he can find like an ambulance chasing lawyer and is a threat to public health that has been massively improved over the last century.

All of his attacks on dyes and seed oils won’t move the needle when the real reason for US health decline is too much sugars/carbs, too little exercise, and addiction to opioids and nicotine.

> He also pushed raw milk when prior to pasteurization, milk was the cause of 25% of all communicable diseases (it’s a great medium for bacteria, it has avian flu viruses, parasites, etc). We invented pasteurization for a reason.

Raw milk is legal to sell in most of Europe and they still have overall better health outcomes, so at the very least it’s a triviality.

Europe also has higher standards for animal husbandry and food products.

In most of Europe you can sell unrefrigerated chicken eggs. Why? Because chickens in the EU are vaccinated against salmonella, so the eggs don't need to be washed (and consequently it's also safer to eat poultry in the EU).

I'd be happy to sell raw milk on the market if there's a requirement that raw milk be tested for common pathogens to milk (Like listeria, for example).

I'll also say that this is not unique to him, it's how conspiracy minded people operate.

You'll see exactly this playbook playout with flat earthers. "We can't know the earth is round because it's not been tested." or "It's actually industry captured" or "The US government prevents people from doing real tests to see if the earth is flat".

You see, if you asked them "what would it take for you to abandon this theory" their honest answer is "nothing" because any counter evidence to the theory will just get wrapped up in more conspiracy.

What would it take for me to abandon my belief in evolution? Evidence that explains why things appear to evolve and shows what actually happens instead.

What will make me abandon my support of vaccination? Evidence that shows vaccines are more dangerous than the diseases they protect against.

I have avoided so many pointless arguments (or "debates") by leading with this question! I ask, "is there something I could say that would make you change your mind?" If the answer is no—if they can't tell me what will move them off their position—then I can say, "well let's not waste our time here, yeah?" and change the subject.

It's not perfect. But with otherwise-reasonable people, it's a nifty trick.

> He also pushed ivermectin which studies show has no statistically significant effect on COVID.

Studies showed that it had a statistically significant effect on COVID. The problem is that with hindsight it is obvious any sufficiently powerful study will show it has a statistically significant effect so the existence of that effect isn't particularly interesting evidence.

There will be people who have both COVID and parasites. If you give them Ivermectin around the time they catch COVID, they will get better outcomes. Statistics will pick that up, it is a real effect. AND it has real world policy implications, there are a lot of people in the world who should immediately be given Ivermectin if they catch COVID (or, indeed, any disease). The more important political issue was when people noticed that (very real) effect without understanding the cause they were attacked rather than someone explaining what was happening.

It is a good case study of evidence being misleading, but the statistical significance of that evidence is indisputable. Any study that doesn't find that effect is just underpowered - it is there. In fact as a baseline it turns out we would expect any effective drug will have a statistically significant positive effect on COVID outcomes.

> Studies showed that it had a statistically significant effect on COVID. The problem is that with hindsight it is obvious any sufficiently powerful study will show it has a statistically significant effect so the existence of that effect isn't particularly interesting evidence.

Preliminary studies with small n showed a statistically significant effect. Follow up studies with larger n showed no such effect. Meta studies also concluded no effect.

> Any study that doesn't find that effect is just underpowered

I'm sorry, but no, in fact the opposite is true. The underpowered studies are the only ones showing an effect. [1].

What has happened with Ivermectin is the "anchoring effect". [2] Early studies showed promise which has caused people to think there is promise there. After that, grifters and conspiracy peddlers started out publishing the actual research on the benefits.

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC9308124/

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

If you believe that, it implies you believe someone infested with parasites expects the same COVID outcomes as someone who is mostly healthy. That is a pretty extreme claim, to the point where 1 study (or review, in this case) isn't really an argument. It is much more likely that that they just aren't picking up the statistical signal that is obviously going to be there somewhere.

There isn't a shortage of studies showing an ivermectin-COVID relationship. https://c19ivm.org/meta.html makes for interesting reading, although it is quite misleading because it is probably measuring parasite prevalence rather than anything new.

> If you believe that, it implies you believe someone infested with parasites expects the same COVID outcomes as someone who is mostly healthy.

No, it doesn't.

The crux of your argument is that there is an invisible parasitic pandemic which is, frankly, absurd. Parasites by their nature are far less transmissible than an airborn virus is. They are primarily regionally locked and locked out of most developed countries. The US, for example, does not have a major internal parasite problem because public waters are treated against most parasites and filtered before general consumption.

As for the site, it's got a lot of pretty numbers that are like "Yeah look, 100% this ivermectin is great!" which is pretty fishy. You would not expect to see something like that. But, scroll to the bottom and all the sudden you see why that is, they purposefully find reasons to omit all studies that counter that claim.

Like, I'm sorry, I'm just not going to trust a website that is pushing for vitamin D supplements to treat covid. It's not a serious website and it has a very clear agenda.

Yourself (cogman10) and roenxi might both be in furious agreement from my PoV.

There are no good studies showing a useful relationship between ivermectin and COVID outcomes in low parasite G20 countries ( UK, AU, US, etc ).

The early studies most quoted had high N, good procedures, and showed ivermectin having a very positive effect across the board wrt many diseases ( flu, COVID, etc. ). These studies were in countries and regions with high parasite prevelance and demonstrated pretty conclusively that people with no worms were healthier, had better functioning immune systems, and both resisted and recovered from infections noticably better than untreated populations with parasites.

The supplement pushing website is being disingenous and obfuscating the context of the studies quoted in order to flog crap to rubes.

Best thing I've read that's summarized this well is the Scott Alexander piece incase anyone wants to do further reading from a somewhat reputable source: https://www.astralcodexten.com/p/ivermectin-much-more-than-y...

Fun read; I knew of the "good studies" that Scott ended up with, I'd never bothered to look much at the site in question as it screamed (to myself at least) of marketing driven bias .. and lo and behold many of the quoted papers are low N, sketchy, or outright fraudulent.

I suspect the best most concise summary is simply "If you have or even suspect you have worms, take ivermectin. Your general health and well being will most probably improve".

> No, it doesn't.

Alright, lets go through this slowly. Run me through the point which you think is unreasonable:

1. We do a study. Some % of the participants have parasites, in line with the base rate for the area.

2. Split the group into experiment and control. The experiment group gets Ivermectin.

3. Wait until everyone gets COVID. The people with parasites in the control group get terrible outcomes because their immune system is way overloaded, but the people who used to have parasites in the Ivermectin group do a bit better because they just took an anti-parasitic.

4. A sufficiently powerful statistical analysis correctly detects that the two groups got different COVID outcomes.

What part of that do you think won't happen in the real world?

> the real reason for US health decline is too much sugars/carbs, too little exercise, and addiction to opioids and nicotine.

I think a more fundamental root cause is that US regulation has failed to adequately keep up with the playbooks of large companies that stand to profit from various products that result in compromised health.

Take a look at what's being heavily advertised/marketed. If it contains ingredients people haven't been consuming for thousands of years, I think it's suspect and should be subject to intense scrutiny. (Same goes for widely used B2B products that affect what people consume.)

Unfortunately, there's too much "we only test in prod" going on, so it's hard to isolate widespread problems to a single source. That's why (in my opinion) the FDA should require clinical trials and use an allowlist-based approach to food additives. Currently it's a denylist, which amounts to testing in prod.

> If it contains ingredients people haven't been consuming for thousands of years, I think it's suspect and should be subject to intense scrutiny.

There are plenty of carcinogenic ingredients that have been consumed for thousands of years. There are plenty of additives that are effectively just refined versions of chemicals commonly/naturally consumed.

A prime example of a commonly consumed cancerous ingredient is alcohol.

My point being that prod is already littered with bugs and the most responsible thing to do is continuing research on what is being consumed to figure out if it is or is not problematic.

I mean within reason. Of course the FDA can't and shouldn't ban alcohol.

I mean things like BHT, FD&C colors, and anything else artificial that hasn't passed clinical trials.

> I mean within reason. Of course the FDA can't and shouldn't ban alcohol.

Certainly, but we are now at a sticky point where "reason" can be different things to different people.

Both BHT and FD&C are far less toxic than alcohol is. BHT and FD&C have both been integrated into the food supply for decades. The question would be, what would we learn from a clinical trial that we wouldn't learn from the ongoing population study?

I'm certainly not advocating for deregulation or looser standards for food safety. I certainly support the FDA being fully funded and actively investigating ingredients to ensure public health isn't being torpedoed because it turns out too much salt actually causes cancer (I don't believe it does, this is just an example). But also, I'd say that ingredients that have already been in the food supply for a generation are probably not the danger their detractors claim. At this point, we need evidence to say these additives are dangerous as the current weight of evidence (a generation eating this junk) points to them not being a primary contributor to negative health outcomes.

All that said, I certainly support the idea of applying a very high level of scrutiny to new ingredients. How the current set of GRAS ingredients made it onto the market was reckless.

I'm advocating for a much harder-line stance than that.

Europeans are generally far healthier than folks in the US -- let's start from there.

Also, autism rates are dramatically increasing decade-over-decade.

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