That's a remarkable attitude. I'm curious why you have a passionate aversion to a one-time dose of mRNA but you're quite happy dosing yourself dozens, if not a hundred or more times, with another unnatural chemical. I can totally understand Vitamind D and zinc, as you eat those things all the time, but ivermectin isn't a normal part of the human (or any animal) diet. It's not a natural compound at all, it's synthesized by bacteria and its primary effect is to kill insects and worms by frying their nerves.
It could screw up your nerves, too, if you get too much of it, and it's not even implausible that it could cause some very minor nerve or brain damage at moderate doses taken long enough. A recent survey of potential side effects:
Nobody knows or sure what might happen with long-term moderate use, because the normal treatment for worms is a short dose, and anyway the chance of some very minor neurological side effects would be totally acceptable if your other option is river blindness, so nobody has looked for this. But it seems like an odd risk to willingly run the clinical trial on yourself if you're otherwise in perfect health.
Do you know the CDC recommended ivermectin for international travel?
A little bit of research about this reveals there are many travelers who have taken it for months at the recommended doses, with no long-term side effects. There is plenty of long term data for its safety at the doses in doctor-recommended protocols for COVID.
In the case of COVID, instead of taking it prophylactically we could even just focus on taking it for the rare cases you go home with symptoms. That would reduce the risk profile even more drastically to basically an unprecedented low-risk level.
On the question of safety, it doesn't matter what the goal was in taking ivermectin.
But this is all sort of red herring to me: the problem isn't people taking ivermectin, the problem is people believing Steve Kirsch when he says "covid vaccines have killed over 150,000 people in America alone!" or wanting to believe that guy who claims 90% of people who took the vaccine will be dead in a year or two.
Nothing to do with civil liberties. Everything to do with preventing death and misery. Oh, I have know three people who died from Covid-19 over the last two years. So, what!
Preventing death is a modern day euphemism for taking away civil liberties. Some people figure that life would be a more joyful place if we did not have the freedom and power to harm ourselves or others, and that they way to achieve this is by ceding more and more power to the government.
Nope, not a euphemism. Just a fact. It is called living in a society. Stop at red lights, do not smoke in no-smoking places, get a driver’s license, vaccinate(polio, etc.), and on and on and on.
On and on until the people are enslaved to the government. Then there is eventually a rebellion or some other sort of collapse of the society and the process starts all over again.
This. Although, for me it's not so much Scott (I see some of that, I used to be libertarian leaning, the pandemic sure as hell cured me of that) but I definitely downrated the commenters. The whining about the vaccine sure does not give a good picture.
If the pandemic really "cured" your liberty leaning thinking, a.1) you never had a solid philosophical conviction or a.2) you're lying, and b) You lack analytical skills to realize what's real and what's a lie.
> If people pushing Ivermectin wanted to be treated seriously
I think you are confusing "the medical establish destroyed its own credibility" with "ivermectin people demand respect."
The ivermectin people (who I think were wrong, but that's not relevant here) were not trying to convince other people to take ivermectin. It is the medical establishment that wanted them to take vaccines.
If you want me to do something, I necessarily have power in that dynamic. If you cannot stomach the idea of me having any power because of how bad I suck, well, then you really didn't care that much about getting me to do that thing.
Yeah! Like what, are we just going to accept quantum mechanics because there's a "consensus"? No, it's because Juan and I have read the studies personally and understood for ourselves that hidden variable theories are incorrect. And of course, as free thinkers, we did not allow blogs or news outlets or YouTube videos to influence our opinions, no sir. Reasoned from first principles, we did, that's the Elon Musk way.
Even if the vaccines work (I think we do) we should still be looking for effective drugs, because the vaccines don't always work and can't always be delivered.
Well, fair enough, but bear in mind Scott's willingness to engage with disparate viewpoints is why *he* will have influence and you will not. When you write off people who don't share your worldview as complete orcs and morons, you necessarily write off your ability to influence them. There's nothing wrong with that -- so long as you are comfortable with the big decisions being made by, or influenced by, the people who are more patient.
If Bret Weinstein is a fair sample of people pushing Ivermectin, his intent seemed to be to encourage doubt about the vaccine, with pushing Ivermectin as a side effect of doubting the vaccine.
It was more like "the vaccines aren't proven safe, *and* they're concealing the effectiveness of Ivermectin".
I don't know which way this counts. Weinstein thought vaccines were a good idea for older people while sowing fear, uncertainty, and doubt about vaccines for anyone who isn't old.
That's interesting, given how Weinstein praised his guest Steve Kirsch, who claims (albeit not in the Weinstein podcast I saw) that vaccines mostly kill the elderly. This follows naturally from the observation that the distribution of deaths by age in sources like VAERS is roughly proportional to the base rate of how many natural deaths by age you would expect in the general population. Indeed, the number of VAERS deaths is well below the base rate, which by itself demonstrates underreporting in VAERS. Of course, if we look at how Kirsch has accounted for the base rate...
I mean it's Scott, he's writing in the American Political context so the real take away is almost always going to be that liberals should altruistically give additional power to conservatives within liberal dominated institutions in hope that this will increase conservative trust in those institutions while ignoring the agency or interest of any conservative epistemological elites in undermining that trust.
I think there's a lot of meat to this analogy, but I do think it's a relevant real-world consideration that even the most ardent anti-vaxxers will generally concede the evidence that science has some particular power as a grand institution for generating truths or working mechanisms, given that they're having the discussion on the internet. And most of them are further prepared to concede that medical science in particular also generates working mechanisms. Rather than throwing out the whole edifice, they're looking for reasons to throw out elements piecemeal, without expertise relating to how participants in the edifice of science judge evidence.
In a symmetrical situation, you'd be challenging the orthodox church on its record on Covid, while acknowledging that orthodox miracle-powered airplanes and such are obviously real.
This might be the core of why anti-vaxxers behaviour is so hard to understand for me. There even seem to be a significant number of anti-vaxxers working in medical professions. It really puzzles me what makes people accept most of medicine/science, but not some specific other parts.
In the aliens analogy, the alien technology seems to demonstratedly work. So what about vaxination differs from other medicine so fundamentally?
What would be the thing you obviousls accept about the orthodox church? That thes have some superiour moral knowledge?
As a theoretical biophysicist (I have a Master of science in that, I dont work in the field though) who is heavily sceptical of mRNA Vaccines:
I distrust their "science", they have made too many mistakes, and emotionally speaking I really dislike getting heckled and shut down in my field of study by "journalists".
I also believe that the main problem with the m-RNA vaccine will be that Covid can escape quite quickly from an immune response only focused on a single viral protein, even if this protein is well chosen.
Furthermore, if Pfizer is unwilling to contribute to defeating the crisis by stopping to block the admission of Sinovac et. al, then I am equally unwilling to contribute by accepting escalating intrustions on my personal freedoms.
I would take Sinovac, or any other attenuated vaccine recogniced by the WHO, but to do this in the EU, I would have to:
1: first emigrate to Serbia,
2: succesfully apply for permanent residence there, then
3: get vaccinated with Sinovac (there is a EU-Serbia agreement that Vaccines used in serbia "count" as proof of vaccination, but only for serbian citizens or permanent residents) and well.
The rejection of non western vaccines in the west is just political stupidity motivated by greed, pride and stupidity on part of our ruling classes.
They need to clean up their act and be held accountable.
When you write you distrust the science behind the mRNA vaccines, do you mean that they don't work (and therefore the studies showing they do are fake), that they have short term side effects (therefore again faked studies) or that they have long term side effects?
Complying with vaccine mandates within Canada requires taking one of the more dangerous vaccines. I could enter the US if I took a less dangerous vaccine, but I could not travel or live freely within Canada.
Actually, strong side effects are the *hallmark* of an effective therapy. You don't expect chemotherapy to cure cancer without making you very, very, sick, do you? Powerful therapies have powerful effects, by definition, and since it is utterly impossible to precisely target the problem -- you get powerful side effects, and the stronger and more effective the therapy, the more of them you get.
Zero side effects are the hallmark of completely impotent therapies with do nothing at all. That's the main reason you can dismiss stuff like homeopathy and crystal healing. *Because* they have zero side effects, it's an excellent rebuttal presumption that they have zero effects at all, which means they can't possibly be doing any good.
Yeah, sorry, you're just wrong on the facts. The effectiveness of a therapy within a given class does indeed scale with its bad side effects. That's kind of like basic chemistry.
I was talking with my wife about homeopathy last night, and I realized I want someone to accuse a manufacturer of them of causing a heart attack or something. Just to see how they respond.
Well hell if homeopathic or herbal medicine or magic crystals *did* cause a heart attack or two, now and then, I'd take the proposition that they are effective a lot more seriously.
>Actually, strong side effects are the *hallmark* of an effective therapy
No they absolutely are not. Chemotherapy and radiation are extreme outliars in that they are known to be very toxic, but people generally consider cancer to be a worse option. If preventative chemotherapy were a thing, almost nobody would ever consider it. The vast majority of therapies cause absolutely no side effects in the vast majority of cases. Nobody pretends aspirin doesn't work because it didn't cause them to have uncontrollable bleeding for 8 months.
Yes and no. Traditional chemotherapy still mostly uses the same agents, e.g. 5FU or cisplatin and they still have the same evil side effects. They kind of have to, since the whole goal here is trashing DNA replication, so *anything* that's fast-dividing, like your hair cells or lining of the gut, gets trashed along with the cancer cells. Nobody has yet figured out how to screw with the DNA replication of *only* cancer cells, although there are some amazing potentialities out there perhaps with micro RNAs and CRISPR-Cas9 tech:
But there are also a burgeoning number of biologicals which are making their way into the clinic, e.g. the justly famous CAR-T treatment, and *these* are indeed often far more targeted and do far less collateral damage. When one of these works it's like a freaking miracle cure.
I believe most other new non-chemotherapy therapies are along the lines of inhibitors -- they slow down or stop cancer growth, but they do not actually kill cancer cells (although slowing them down might allow the immune system to catch up, I would guess, and is a very worthy goal in itself). You need chemo for that (or the biologicals, or radiation), I believe, although this field is sufficiently complex I speak under correciton if anyone knows better.
Not that this has much to do with the question of the vaccines, but menstrual problems in general get short shrift. "Oh, your periods are painful/irregular/you're bleeding when you shouldn't be? Just go home and take paracetamol". Even consultant gynaecologists, in my experience, tend to glaze over when you're trying to tell them no, this is NOT normal, this is NOT how my periods go.
So yeah, even in the best of times, you're going to get the brush-off as an hysterical female when it comes to 'women's troubles'.
I don't think it is a brush-off as a hysterical female, I think it is just a lack of anything productive to offer and an unwillingness to admit they don't really know much about what they are doing. It seems a bit far fetched to assume female gynecologists just dismiss women as being hysterical because they are women, yet they anecdotally seem more likely to do it and are more casual about it than males. "Why am I bleeding immediately following a "routine procedure" you did not warn me could cause bleeding?" "Its just your period." "No, my period just ended a week ago this is not normal." "Yeah it is you are just irregular quit worrying about nothing". At least men tend to act sympathetic before dismissing you.
I can't speak to your second point, but as to your first, I'll just say that my second dose was about equivalent to the worst day of my smallpox vaccine. If I can rate it as about the same as a vaccine we've been using for over a century without much issue, I think I can call it safe (if admittedly very unpleasant).
And yeah, you probably don't want to go partying on the day you're getting your second shot. Then again, you probably also don't want to go partying on the day you're donating blood, but I would also consider that pretty safe.
Vaccines can make you feel sick even though you're not sick, and it's well known why.
A little know fact is the fever and general sick feeling we get when infected come from the immune system response, not the infection itself.
Vaccines work by putting virus like particles in your body, tricking the immune system to think you've been infected. It then launches a fight against the intruder, which will leave behind antibodies etc for if you really get infected.
If this a big enough effort for the immune system you'll feel it as a fever. But that does NOT mean the vaccine is toxic or that you've been injured.
First of all, the mRNA vaccines *do* cause the synthesis of viral components, that's the whole point. Secondly, it's not clear the presence of *any* viral particles (or components) is necessary for an inflammatory reponse. The body does that all the time in response to a wide range of insult or injury, only some of which are viral infections, and sometimes for no reason at all (alas). We don't know how exactly inflammation gets started, but it's reasonable to assume cells have some way of noticing when abnormal things are going on and they send out cytokines annnouncing that fact -- which is what inflammation is. What are they noticing? How are they noticing it? This we don't really know in great detail. I mean, it would be great if we did, since inflammation in general contributes mightily to all kinds of poor outcomes.
No insight into the second part (menstrual symptoms) but to the first, I don’t get the impression at all that knowledge of those types of side effects (fatigue, fever) are being suppressed. Far from it - that you should be prepared for such symptoms, especially from the second shot, seems to be widely acknowledged (indeed signing off that you were aware of such potential side effects was part of getting the vaccine).
But 1) it doesn’t seem like “most” people are having significant immediate side effects (in my circles, “most” people had very mild effects, with maybe 1 in 10 having anything worse than arm soreness and mild fatigue).
And 2), these seem like common side effects for all vaccines, not unique to the COVID shot. I get the same side effects warnings for the flu shot. It makes sense - most of the side effects are due to your own immune response, and the whole point of vaccines is to provoke an immune repose.
There’s also a degree of confirmation bias - fatigue and muscle soreness aren’t exactly unheard of for the average adult, and are normally written off. But if you’re tired the day after a shot - well, must have been the shot right?
You mostly took the words out of my mouth, but you forgot the relatively recent high profile cases when the process "worked" (i.e. years of trials) and still the end result wasn't safe: Vioxx anyone? Or the more salient Dengvaxia controversy?
Medical science is HARD. Does doing something hard at Warp Speed make it more or less error prone?
Wow, those sound like some severe reactions indeed. I can share my anecdotes:
Of the 50 or so odd people I've had conversations with in person and know well in real life (through work, social clubs, sports, etc) I can report:
1. Those who received Moderna had strong reactions and were generally sick the day after. A few reported fever, a few nausea, etc. All recovered quickly and all really only reported the severe reaction to one of the shots not both.
2. Those who received any of the other shots generally reported little to no effect. My wife and I (30s) received Pfizer. She had no effect really and continues to menstruate healthily. I was groggy headed the next day and was fine after that.
So my anecdotal world is extremely different than yours. I'm from the US if it matters and the age range of folks I'm interacting with is 30 - 50.
Either way, VAERS offers an objective way to look into this information. I searched for all incidents of menstruation reported issues in the database resulting from COVID 19. There were 697 reported cases of menstruation issues in VAERS.
697 out of 201,922 women in the US 18-49 who have reported to VAERS after receiving the COVID-19 shot. 0.3% incidence.
The literature I can find reports 5% - 35% incidence of menstruation irregularity in this age range depending on a range of factors, including stress.
While I appreciate the anecdotes you shared, when I include them in with the 201,922 other anecdotes shared in VAERS it appears you just happened to have some very unlucky or stressed female friends and have not uncovered a hidden side effect plaguing the hundreds of millions of women who have received mRNA vaccines. Thankfully.
To each their own. To me VAERS is more trustworthy then anecdotes for various reasons (all the same reasons as review biases + to your own point the general hysteria around COVID on BOTH sides).
When I received my COVID vaccine I was handed a slip of paper that informed me about VAERs and how to participate. I signed up and since then I receive text messages every couple days in the beginning, then weekly, now only monthly.
One time I reported having an infection that for all intents and purposes I could see no reason why it would be related to my covid vaccine months ago. I received a phone call from VAERs within 2 days of submitting the report. They gathered more information about my infection and how I treated it, and then we moved on.
This is an audited, public database. I certainly agree that participation is fairly low (way more than 220k women 18-49 have been vaccinated, including my wife who did not participate in VAERs), but it is also certainly statistically significant.
Pardon me for being a smug bitch, but this is what I have been maintaining all along in the ivermectin discussions - it probably gives good results where people have, or are prone to, parasitic infections. In places where there is less to no risk of these, the results are not going to be as good.
Only in comments on here whenever we were discussing Covid, ivermectin, etc. So I haven't a record written down anywhere, unless anyone wants to go plough through the million words we're all thrashed out on this.
But yeah, I felt all along that "parts of the world showing good results = parts of the world with lots of poor, rural populations pretty likely to have worm infestations" was the major explanation for ivermectin success, if any.
I think people are seeing positive results (and that Cochrane meta-study has links to a lot of studies that are "no result/slight result" rather than "wowzers, this is a miracle cure!") is because (a) many of the studies, as listed above, are done in countries where I'd expect a lot of poor/rural communities with bad/poor health outcomes, including worm and other parasite infestations and (b) everyone is looking for the new silver bullet.
So you're a peasant farmer in Bangladesh and you picked up a worm infestation. You also picked up a dose of Covid. Treating you with an anti-parasitic drug in combination with other therapies is going to show a better result than leaving your system to fight off both at once."
I also dived into some of the Cochrane meta-study on the Ivermectin studies to see where all the countries were located:
"Deiseach Sep 7
Well, I could be totally wrong and ivermectin turns out to be an amazing anti-viral on top of everything else. But I'm going to stick to "it does what it says on the tin and if you're suffering from sarcoptic mange mites, go right ahead, but otherwise cool it unless a doctor prescribes the human version to you".
People are so anxious for "definite sure-cures!" that they'll swallow (ha!) any story about "this showed up in clinical trials as IT REALLY WORKS". I'm just surprised to see otherwise reasonable people jumping at "Doctors hate this ONE WEIRD TRICK" kind of story, but hey, we're all only human!"
Also got into some arguing with another commenter, but sure, that's me for ya!
"
Deiseach Sep 7
"One even needs zero studies when looking at the raw figures which came out of India where a ‘natural’ experiment happened with their big covid wave a few months ago. These are extremely positive results and we should be trying whatever we can in a pandemic as long as it is safe. There is even passive evidence from lower covid rates in some parts of Africa, quite possibly matching up well with existing use of ivermectin for its well known and longstanding use against parasites which can cause blindness."
Ivermectin is well-known and longstanding use *against parasites*, which you mention in your comment, but seem not to have understood. You are saying "this is a safe and effective drug!" and yes it is - *when used as intended*.
What you are extrapolating from "it's used to treat parasitic infections in humans" is "therefore it should be used for covid", with a side of "what can it hurt, it won't kill you" and unexamined anecdotes about "and they used it in India and they're getting fabulous results!"
I'm not so convinced about those fabulous results, I imagine that any benefits may come from the anti-parasitic treatment. If you have two patients, A and B, both in hospital undergoing treatment for Covid, and both have roundworm infestations as well, and A gets treated with Ivermectin which kills off the roundworms but B does not - I am going to guess that A will do better than B. But I don't think you can conclude from that "Ivermectin cures Covid!"
And the problem with this sunny assumption of "what harm can it do?" is that some people are refusing to get vaccinated, which is our best preventative at present, and along with others are all rushing off to buy veterinary products containing ivermectin, which are graduated for animals much larger than humans; believing this will save them; overdosing then because they're taking dosages calibrated for horses and cows; then ending up in the hospital with the side-effects of same."
Any credit is purely down to the agricultural ads on the national television and radio broadcaster of my nation and my youth; that so firmly fixed ivermectin in my brain as cattle drench and for sarcoptic mange mites, I had incredulity built up about "it'll cure Covid".
I remember you writing that. That was freaking brilliant, honestly. Your talents are wasted on whatever you're doing, unless it actually is teaching empirical skepticism to young people so they need not repeat endlessly the mistakes of their forefathers.
Oh gosh, my vanity is getting stroked here! 😁 Really, it came down to nothing better than years of "what the hell are sarcoptic mange mites?" listening to ads for cattle drench, then along comes the ivermectin recommendation and my sluggish rural roots bestir themselves with "who the hell is thinking dosing yourself with fluke cure is a good idea?"
It has nothing to do with superior ratiocination, I regret to say!
Same, I thoroughly enjoyed it. I feel even worse for not getting it because I think/talk about worms *really frequently* in relation to effective altruism causes, including the immunological impacts. One for the humility box!
I had the same reaction, but then I felt sort of manipulated — why go through the tedious exercise of winnowing the good studies from the bad ones, if even the good ones are trumped by the helminth observation?
Agreed. Scott analyzing lockdowns, cloth masks, surgical masks, voluntary social distancing (estimated from cell phone activity) etc would be a very interesting post.
The massive RCT from Bangladesh essentially found no impact on increased masking (no statistical significance for cloth masks, possibly maybe some statistical significance for surgical masks but for a bizarrely small infection rate)
I’d add vaccines to your list as well. It’s misleading to assert that vaccines are an effective treatment without performing a similar meta analysis on their studies. Without such an analysis, the author is no different than the “proponents of pseudoscientific medicine” mentioned in the article; he is just as guilty of blindly trusting papers because they sound good and come from an authoritative place.
No, it's not the same thing at all. Unlike the ivermectin studies the vaccines were developed in HUGE randomized controlled trials, and have been administered billions of times with careful monitoring of safety signals by teams across the world. This is not even in the same ballpark as the small ivermectin studies analyzed here. You could still do a meta analysis, but the results are not murky - we already know they work amazingly well. Your comment reeks of conspiratorial motivations.
"careful monitoring of safety signals" Imma need some evidence here, because we have real examples of missed safety signals. Also, there is still disagreement in safety. There are several European countries not using mRNA on large cohorts due to safety concerns.
Really? They work for 6 months and they don't stop infection or transmission. To call that "amazingly well" seems disingenuous. Compared with traditional vaccines that stop infection and transmission and last for decades or longer, I would have to say the COVID vaccines work very poorly.
"careful monitoring of safety signals by teams across the world"
Sounds good, the experts are looking out for us! Unfortunately the experts have failed us so many times that I now want to review their work, and I've yet to see them actually publish their work in this area. Hmm... are they actually doing the work?
Akoluthic - At one time, perhaps before you came of age on the internet, many arguments ended by one party resorting to acccusing the other of being Hitler. That phenomena became known as Godwin's Law. Fast forward to today, Hitler doesn't come up so often. Now, the adversary, especially if they hold views critical of the government, is a conspiracy theorist. As if conspiracy itself is a fantasy; Pharma cannot/does not have deep and wide influence on the government and media. Of course "conspiracies" exist and are pervasive in modern society. A person unwilling to contemplate the existence of conspiracies should ask them self a hard question: am I authoritarian; one who irrationally defers to authority?
Wrong. There are big RCT's that show efficacy and safety. A meta-analysis would be fine, but isn't necessary when you have well-done, large RCTs with sensible and meaningful endpoints.
Yes, I don't like that we're not allowed to question or debate vaccines. How can this help anyone? How can we improve the vaccines if we can't be open and honest about adverse reactions? I'm not comfortable with vaccines being used as a means to a medical end. I gotta say. It has an element of quackery to me vaccines. There. i said it. Reading up on Jenner and Pasteur and the vaccine roll outs for mumps, rubella, measles, diphtheria, pertussis opened my eyes. It's not conspiratorial or unreasonable this is a huge money maker from the beginning and they probably believed the harms were low enough to justify continuing profiting off it.
Why do you say that we are not allowed to question or debate vaccines Paul? There is a lot of that going on here and on forums elsewhere.
Do you acknowledge that laypersons are not equipped to evaluate the safety or efficacy of vaccines? You need to do massive population studies of people who have received the vaccine to tease out if there are a significant number of adverse reactions that can be associated with vaccine.
Vaccine are developed in an entirely different fashion today than they were in the days of Jenner and Pasteur. It is disingenuous to try to make a comparison.
Vaccines are not big money makers for anybody. This is why there are so few companies that make them. Covid vaccines are the exception because of the urgent need for them. One could make the argument that we should not rely on for profit institutions to develop and manufacture drugs, but that is the system we have chosen. It is a false argument to suggest that you should avoid getting a covid-19 vaccination because some pharma company will profit from it.
Agreed. Didn't RFK jr & Children's Health Defense win a landmark case asserting no vaccines could ever be mandated/forced due to the fact not one safety study could be produced for any of the ridiculous amount of "school/travel required" vaccines from time of inception to date? I trust my own biology, physics, chemistry & lab skills over any doctor, paper, government. We need to ho back to the days of using basic skills & analysis, with a foundation in natural scientific observation.
For the record, if this is the GiveWell study, I believe that they found a significant result for cloth masks in their infection-based endpoint while for their hospitalization-based endpoint only surgical masks showed a significant difference.
The effect size was low, but it's not like they were comparing 100% masked villages to 0% masked villages. Encouraging mask use in a village like their study did had a real effect on mask wearing but it was modest and dissipated over the period of the study. So it's hard to get much from the RCT except "some increase in surgical mask wearing caused some decrease in infection as measured by seropositivity". Hard to know what the effect size is.
Yeah, it sure seems like most of the evidence for normal (non-N95/KN95) masks being helpful is basically along the lines of "this seems like it probably helps some." For good masks, if you're getting a good seal (you can't smell smoke through the mask), then it sure seems like you ought to be getting good protection there, since 95%+ of virus-bearing droplets should not be making it into your nose/throat/lungs.
That Bangladesh study showed that a 30% increase in cloth masks led to a 5% decrease in infections, and a 30% increase in surgical masks led to a 10% decrease in infections. Both of these were statistically significant.
Restricting to seroprevalence-verified cases is a serious restriction that drastically cuts the power of the study, given the difficulty of getting these tests. It's not surprising that it gets some of the important results outside the significance level.
Worrying about confounds like distancing is more reasonable.
I still wouldn't think it's appropriate to summarize this as "essentially no effect".
No significant impact of cloth masks in a vaccinated population. Surgical masks in an unvaccinated one probably worked better, because more to affect, better tools to affect it. Which is why I was fervently pro mask until widespread rollout of vaccines, and now I find most of it total theater.
I think it failed by the experts' own standards, I think there were better options than "nothing" and "everything", but I've taken it out since it wasn't as strong an example.
I remember a few years ago reading about how Southeast Asian mask use was basically superstition. It's bizarre to me to see that turned completely on its head.
Do we have a good explanation for why Asian countries generally seemed to do so much better with covid? Is it likely to be widespread mask use? Prior exposure to similar coronaviruses? Something else?
I wrote on the prior OT that someone should be doing the RCTs on masks, at least for influenza. Even if expensive, they'll pay off with knowledge that billions of people can use in the short-term.
The UK's plan involved minimal attempts to prevent or slow transmission, and 210,000 - 315,000 deaths in a fifteen week period. It rested on the assumption that the population of the UK would allow the government to do almost nothing while 210,000 - 315,000 people died over a short period. Whether or not it was a good plan is irrelevant. The assumption was obviously insane, and the plan was worthless.
The document setting out the plan is an interesting example of a well-written, coherent and convincing 70 page strategy document being worse than useless. It's not perfect, but you can tell that a lot of intelligent, knowledgeable people have put a lot of work into it, and you can see why the UK got such good marks for pandemic preparedness from international assessors. Ignore the "Influenza Pandemic Strategy" title, the plan specifically states that it can be applied to a SARS virus, and Covid falls within its assumptions as to possible transmissibility and case fatality rate.
It's worse than useless because it hides the reality of the situation it's planning for. The first sentences of the introduction should have been "This plan is based on 200,000 to 300,000 people dying from the infection in a three month period. We aren't going to try to stop that happening." But over seventy pages, and no doubt hundreds of other documents stemming from those seventy pages, the ludicrous assumption at its heart is swathed in layer after layer of reassuring competence, and utter nonsense was transformed into a gold standard public policy strategy.
Public support for lockdowns in March 2020 in the UK was 93%, with 76% of those 'strongly' supporting it (YouGov). Politicians don't tend to survive ignoring their voters in such situations.
It's not impossible that the House of Commons could have triggered a snap election anyway, with a loss of confidence in the Govt, or the governing party could have replaced the PM who serves at the pleasure of his/her party only. 'First among equals'.
If 93% of people supported taking ivermectin instead of vaccines, should the government just roll over and say "well, I guess the people have spoken"? Not try and all to change people's minds?
As we've seen, people get sick of lockdowns, so they can only be done in limited amounts. The UK officials knew this and said this beforehand, directly to the people: "you think this is fun now, but you'll hate it in 8-12 weeks."
But, just like ivermectin, there was media hostile to following the recommended scientific plan, telling people that the government's plan was evil and stupid and going to kill them.
The UK govt. had successfully sold financial austerity with majority support for years prior to this. There's at least one reason for them to believe they could indeed convince the UK populace to accept the argument "210,00 - 315,000 people will die in the short term, so that >>315,000 lives can be saved from the long-term negative effects of lockdowns".
Videos are Inherently Annoying because, for example, they are not searchable and they almost never contain hyperlinks (because for some reason the person who produces the video thinks it's OK to offload that work onto thousands of non-expert viewers rather than doing it once while they have all the context).
Many youtube videos now do provide hyperlinks to both positions in the video as well as external content. I find that quickly checking the video description for these is a good indicator of quality.
I don't. I always seek the least possible noise in my communications channels, and video presents a giant amount of irrelevant sensory information relative to the critical info. For the record, I also hate scientific papers that start with an introduction in which they summarize the structure of the paper, and I despise talks that begin with 5 minutes of reminiscence and dad jokes.
"But I don’t really know how to do that, and any speculation would be too political even for a section titled “The Political Takeaway”. I would instantly kick in an extra month's subscription fee to read this.
fully agree. I think we have kind of a trust crisis. What you name are ingredients to build trust. But many people underestimate what a sensible plant trust is, how easily it is destroyed and how hard it is to build up. Especially all kind of elites should learn this if they want to stay were they are without fear.
As one of those people (presumably plural) that think there's too much politics on ACX as it is, I'll have to respectfully disagree.
In general, I'm worried about the comment section's potential degree of control over the topics and perspectives that get covered by Scott. It's partly inevitable, I guess, but I think at least we should make an effort to minimize this effect. I would hate to see ACX become more echo chamber-y. (this is also why Substack displaying the number of likes and comments under a post is a bad thing.)
So, 85-80% confidence of less than 30% mortality reduction does in fact represent a major crime against humanity in your estimation, I would think? Expected loss of lives is well into the hundreds of thousands.
I have a vague plan for another post which is something like "should we just give everyone any drug that might possibly work, because Pascal's Wager?", but I'm not entirely sure of the answer!
Ivermectin is pretty low side effect. I think HCQ might have been worse and could have done some real damage. But if it took ten drugs that didn't work to make sure people got fluvoxamine (which did work), maybe it would have been worth it even if HCQ could be bad? I'm genuinely not sure here.
Economic cost + value-of-information means it's far better to do large scale RCTs, rather than tell everyone to take things and never be able to figure out what is working.
I also think that the "trust in science" thing is valuable, and as I told Kelsey - https://twitter.com/davidmanheim/status/1458153900553510915 - in the wake of HCQ + Ivermectin, I've updated towards experts shouldn't tell people to take a drug based on moderately clear preliminary information, because it turns out that they won't listen later if you find out it doesn't work. In general, updating once you publicly commit to something being worthwhile is really, really hard. And then they refuse the vaccine.
2. You can't as easily do RCTs once a drug is being used widely, because you get selection bias issues for who is willing to participate.
3. You can allow widespread access + randomization fairly easily, if it's planned for. And in a medical system less messed up than the US, it's straightforward to do this, which is exactly how the UK's RECOVERY trial was set up in April 2020.
And no, this wouldn't have ruled out trying lockdowns, especially because 1) we had incredibly clear evidence of effectiveness, and 2) it's not a medical intervention, so the way RCTs are done is very different.
And honestly, we probably would have gotten masks used more quickly in the US if we had done trials immeidately, compared what actually happened - which was listening to the surgeon general and CDC which delayed until the evidence was incontrovertible anyways - and for some insane reason, still won't require HEPA filters, etc. (Compare this to the Japanese government experts, who got both of these right on day 1 based on actually looking at the initial outbreaks.)
The problem is that you aren't actually helping people. We only produce about as much of these drugs as we actually need to treat the actual medical conditions that those drugs are needed to treat.
Thus, if a ton of people suddenly start buying a lot of these drugs, you end up with massive shortages and people dying who actually need the drugs.
In real life, almost none of these drugs are actually helpful, and almost all drugs have side effects, and the idea that ivermectin was even going to be helpful in humans was dubious just looking at the in vitro studies because the most likely path of function was impairing cell function, which is probably going to kill people.
"experts shouldn't tell people to take a drug based on moderately clear preliminary information, because it turns out that they won't listen later if you find out it doesn't work."
I think this is a deadly attitude and a big part of why there's so much mistrust. You have to respect the minds of others.
That would be easier if so many of them weren't so keen to believe obvious bollox and clinicians still have a duty of care to those same people who will cheerfully drink fish tank cleaner.
For people who aren't in the RCTs, it seems better to give them an experimental drug cocktail of all the drugs which have promising initial results & are readily available & don't have significant side effects. (Where "give" means that this is the default recommendation from doctors or in medical kits.)
That seems better in terms of straightforward direct results (health & cost), ignoring what it does to the information environment.
And for navigating the information environment, there's an advantage to playing it straight (giving people the drugs that are +EV) and finding ways to have clear messaging about it (to avoid informational side effects). If you're withholding a drug that might work, that opens the door to stories about the authorities suppressing a miracle cure. If you're including the drug in the experimental drug cocktail, then you just need to find a find a way to convey "experimental drug cocktail". Here are some things that might help, studies are underway to figure out which of them really help, we can at least be pretty sure that they don't do much harm. We've improved the covid-fighting cocktail, HCQ is out and fluvoxamine is in.
There doesn't seem to be any fundamental reason we can't allow RCTs like this to be near-universal, and let anyone who wants to join be randomized, ideally with adaptive A/B assignments, so that later participants benefit from what we know - if a setup for doing this is put in place. Of course, clinical trials are broken, as is the US healthcare system, so this probably isn't happening in the US, at least this decade.
But for "navigating the information environment," there's a huge difference between telling people we have unclear preliminary indications and recommending or prescribing medicines. (But again, US healthcare is broken, the FDA is broken, etc. as Scott has discussed in the past, so this gets screwed up.) And as I said below, telling people "this probably works" has some massive downsides in practice, as we see from the fact that there are still people taking HCQ instead of getting vaccinated.
First off, almost all "safe" drugs are only safe in isolation. We don't generally test most drugs for drug combinations unless we expect them to be used in conjunction with each other. Many drugs are not safe to take with other drugs, but we don't know that because we don't typically mix them.
Secondly, combined drugs don't necessarily have linear effects with each other; sometimes they will counteract each other, sometimes they will multiply each others' effects. So you can't even be sure that the drugs will work at all.
Thirdly, taking more drugs greatly increases the probability of organ failure (mostly kidney and liver failure).
Fourth, almost all of these drugs are ineffective, meaning you are wasting vast amounts of resources when there are better things to do.
Fifth, most of these drugs are only produced in limited quantities and cannot be rapidly scaled up. So you will create shortages for things that they are actually important for.
Sixth, almost all drugs have side effects. The more drugs are taking, the more likely you are to experience side effects, and this actually is even worse with mixing drugs.
Seventh, most of the population is completely incapable of making educated decisions about their health like this, because they can't do the proper risk/benefit analysis.
While it might be "better" to do large scale rct, in practice it's either not being done at all or not being done fast enough, so that option doesn't exist
or they could communicate better. What if instead of recommending it you just label it as our recommended guess work at the time. Couldn’t they just improve by giving their opinion in language that people understand
The thing is, early on in any epidemic, the doctors are going to be throwing absolutely anything they think might work at the thing, trying to save their patients. ISTR that many hospitals were giving zinc, HQC, azithromycin, vitamin D, etc. Which makes sense, because they weren't trying to run studies, they were trying to figure out some way to keep a few of their patients from dying on them.
Once that's happening, people who want it are going to be able to see the discussion among experts. I've been trying to listen to the Covid Clinical Update on TWIV as often as possible, for example--that's available to anyone but it's mostly a top tier ID doctor who's been treating covid patients for the last 18 months talking about what treatments seem to work, how they're used, what the promising stuff coming down the pike is, what the research looks like, etc.
And that leaves the possibility that people are going to misunderstand it, or misinterpret it, or whatever. The only way to prevent that is to keep anyone but certified experts from being allowed to see any of that information, which fails the "let the medical student debunk the fraudulent study" test, as well as the "let the Turkish sociologist make much better recommendations than the national health authorities" test.
According to tests of adult reading ability, only about 1 in 6 adults is fully literate - that is to say, capable of understanding statistical analysis and scientific papers. They might not know specific terminology but they are capable of reading and successfully understanding top-level stuff.
They also are the only people capable of actually usefully comparing and contrasting points from multiple articles, like, say, two opinion columns or whatever, and looking at evidence, etc.
The problem is that those people make up 50%+ of the high-end professional community. So the idea of "Well, we can try something, and if it doesn't work, we can try something else" works fine for them.
It is absolutely horrible advice for almost the entire rest of the population because they aren't capable of really understanding this unless you explain it to them carefully, and they will have to lower their level of trust in "experts" because, as it turns out, explaining this stuff to them will make them CORRECTLY stop trusting the media and experts and whatnot nearly as much as they did.
Like, you can't explain the Gell-Mann Amnesia effect to someone and have them trust the press anymore. They *shouldn't* trust the press. And yet, if you completely don't trust the press, you'll tune out important information.
Right - they won't listen later. And halo effect means that once people are convinced that the positives slightly outweigh the negatives, their brains immediately jump to "there is no downside, and this is the best thing ever."
I honestly believe that if people were given the correct information, as known at the time, they would have been open to changing their minds (in general, obviously not all people are going to act responsibly).
If doctors told people that there was some positive early but speculative results from taking a common, cheap, and harmless drug, lots of people would want to take that drug. But if there were no concerted effort to shut down discussion of that drug, further results would have shown 1) side effects or other issues, 2) lack of efficacy, or 3) hey this thing really works! Option 1 gets communicated to patients by their doctor, and the doctor steers patients away, especially if 2 is proven or seems likely. Option 2 the doctors simply stop offering it as an option. Option 3 sounds like a best case scenario, not an apocalyptic harm.
If it really works, then I think people should be able to go ahead and skip the vaccine or whatever else you're worried about. If it doesn't work, but conversations are allowed to happen about it like normal, then the incentive to take it instead of the vaccine goes away.
Doesn't this apply to the vaccine as well, particularly how it doesn't stop spread? If 80% of people who have taken the vaccine see that as a reason to now return to life as normal and go to gyms, bars, etc as they did before, isn't their brain "there is no downside, this is the best thing ever" and they become spreaders (aka a mutating breeding ground for the virus until it becomes something like Delta)
I know more people who are unvaccinated who take less risk than vaccinated people. I'd love to see a study of who really spread the virus more and are a responsible party for the mutants.
But vaccines ACTUALLY work, we are 100% sure on this one.
Ivermectin MIGHT decrease severity for SOME patients (and cure worms.)
I've taken Ivermectin before and it's not the worst, but I've seen some people shit themselves inside out after taking it, so ??? on side effects also.
The TOGETHER platform trial is really interesting. A few comments:
* First I don't think that it is correct that they used non-contemporaneous controls for the ivermectin TOGETHER study. This is a well-known problem in adaptive trials where new arms can enter and leave the platform. The controls that they will have used are only those who could have been randomised to ivermectin. See for example their write up of fluvoxamine (https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00448-4/fulltext)
* Regarding fluvoxamine: interesting that your assessment is that it "works". From a Bayesian perspective, a priori it's highly unlikely to do anything (some random doc decided to test because why not; no known mechanism of action); and there is a real problem of post-randomisation bias. See this article for more detail https://www.the-scientist.com/news-opinion/a-closer-look-at-the-new-fluvoxamine-trial-data-69369
I guess, but from my perspective if a bunch of doctors are excited about a drug I want good studies done immediately. A-priori it seems unlikely that we got really good at saving people at the point of practically choking on their own fluids with existing meds (steroids, etc), but apparently there was nothing whatsoever that could be done preventitively to help. Not only that, but we were absolutely certain of this beyond any shadow of any conceivable doubt. We were certain that the physiological profile of covid-19 was PERFECTLY disjoint from the sum total of existing medical practice.
It's simply unforgivable that our elites ignored the attack on therapeutics.
The thrust of your claim that "this is one of the most carefully-pored-over scientific issues of our time" just doesn't hold water. It's been two years and you're still not sure if it might be moderately helpful (nvm Vit D. and all the others). In no universe can we call this a functioning medical science establishment.
The fact of the matter is a bunch of elites decided that their reputation was far more important to them than the off chance of saving many lives. Can't risk being associated with those crazies pushing their "remedies".
"The thrust of your claim that "this is one of the most carefully-pored-over scientific issues of our time" just doesn't hold water. It's been two years and you're still not sure if it might be moderately helpful (nvm Vit D. and all the others). In no universe can we call this a functioning medical science establishment."
The emerging claim I'm seeing now is that vitamins, generic medicine (IVM, HCQ etc) and anything homeopathic is pseudoscience and dangerous misinformation, and must be shut down.
The reality is that pretty much no pre-existing drug would be expected to work. Most things don't work against viruses in concentrations that won't kill the host, which is why viruses are a PITA to deal with.
The people who try and push anti-parasitic drugs as cure-alls can be safely dismissed out of hand because they try and push their favorite drug at everything. We don't have infinite bandwidth, it is best to focus on things that we have a good reason to believe might actually work.
Right, we have the bandwidth to shut the economy down and stop school but we can't run a few trials. Give me a break.
We have existing drugs that work very well against covid--steroids.
You better be really, really, really freaking sure that you're right. We'll be looking very carefully at patient outcome variability in the medical records over the next couple years, very carefully indeed.
I don't know the proper statistical terminology for this, but I feel like there's an issue where you have to ask "why are we asking this question in the first?" e.g why did invermectin become something that people were talking about and was it for a good reason. Because of you were to give people a bunch of random substances you might by chance get good results for some of them. Similar to with homeopathy trials, my prior against them working is sufficiently high that I would be unwilling to take an otherwise good study as evidence. If there's no particular reason to think something will work, then the burden of evidence should be high
I don't think this has a clear name, though it's related to curse of dimensionality, but I'll quote Yudkowsky discussing exactly the issue you're noting:
"On problems with large answer spaces, the greatest difficulty is not verifying the correct answer but simply locating it in answer space to begin with. If someone starts out by asking [is X true], they’re jumping to a 100-bit proposition, without a corresponding 98 bits of evidence to locate it in the answer space as a possibility worthy of explicit consideration. It would only take a handful more evidence after the first 98 bits to promote that possibility to near-certainty, which tells you something about where nearly all the work gets done."
"Privileging the hypothesis." IIRC the example given was the police saying "We have no idea who the murderer is, so have we considered the possibility that Mortimer Snodgrass did it?" Maybe he did and maybe he didn't, but what evidence led you to investigate that man to begin with?
There are people who believe that anti-parasitic drugs are cure-alls and try them against everything. Tonic water is a great example of this - the active ingredient is actually effective against Malaria, but people promote it as a health drink against everything, which it isn't.
That's why these anti-parasitic drugs got pushed in the first place.
It's really bad.
Also just throwing a lot of random drugs at the wall and seeing what sticks is often a bad strategy.
"no reason" you know of, but when there's a coordinated effort to suppress information, that is to be expected. As Mark Twain 'said', it's far easier to fool people than to convince them they've been fooled. You are right about finding things that work. It's very difficult and requires the free expression of ideas, and referees without a conflict of interest. Big Pharma, Big Government and Big Tech's response to the pandemic has been exactly the opposite, authoritarian, draconian, closed minded and illogical.
No, both ivermectin and HCQ got suggested as promising candidates for trials because people observed significant correlations between parts of the world where large portions of the population take those drugs routinely, and low COVID cases and severity. There was no "throwing a lot of random drugs at the wall" involved. It is not surprising that you don't know why ivermectin was suggested as a candidate, given that it is virtually impossible to find anything other than "evil trump nazi terrorist klansman are filling emergency rooms after poisoning themselves with horse medicine!" using google. Isn't it weird how hard it is to find any English copy or reference of Haruo Ozaki's press briefing about this?
My contention, and those of *all* of my friends who think deeply on this one, is basically "IVM is so incredibly safe why wouldn't I roll the dice on it being 10% effective? What's the drawback? There's no drawback. Why do we think there's a drawback?"
And I haven't yet heard a counter to this argument. If you can cook up a counter to this argument I'd love to read it.
HWFO Slack hangs on your word on topics like these, so I would be very interested to see if you could convince them otherwise.
Are you and your friends also vaccinated? If so, I have no problem with that.
The danger of the pro-ivermectin crowd isn't that they're putting themselves in danger (aside from perhaps the people who take massive doses of horse medicine and get sick), or that they're draining the world's supply of deworming pills, the danger is that people think it's a miracle cure so they don't need to get vaccinated.
Some are, some aren't. I'm double Pfizer personally but I'm not going to get a booster. Some of my peers don't consider Covid-19 to be a big deal for their age bracket and health, which is a legitimate perspective especially for those under 30 for whom Covid is less deadly than ordinary influenza. Covid-19 is extremely recoverable for a very large number of people, especially younger with no comorbidities.
Why is the danger of people taking massive doses of "horse medicine" (it is a human medicine, like many human medicines, it is also used in many other animals) constantly presented, despite no evidence that anyone has ever actually done this? Why aren't you attaching a completely unnecessary caveat like that to other things, like say the vaccines? Where is the (aside from perhaps people getting dozens of doses of vaccines) when you mention vaccines? People do not think ivermectin is the reason they don't need to get vaccinated, they think the incredibly low risk posed by COVID is the reason they don't need to get vaccinated. A healthy 25 year old has absolutely no reason to get vaccinated other than "the TV told me to".
Seems like a case of privileging the hypothesis. Homeopathy has no harms so i might as well take it. Painting myself blue has no harms and might work so might as well. You can make the same argument for an infinite number of things equally well.
Homeopathy also has no benefits, where ivermectin clearly does.
Painting yourself blue could actually have some harms. Maybe it reduces your visibility when crossing the street for example. At the very least, people wouldn't take you seriously and will have trouble getting a job.
If painting myself blue had a 90% chance of doing nothing against Covid-19 (and therefore a 10% chance of reducing my Covid-19 infection) I would see no harm in painting myself blue.
I will grant that these sorts of arguments are often used badly, such as "IF IT SAVES ONE CHILD'S LIFE ITS WORTH IT" etc. The appropriate way to respond to these sorts of bad faith applications of the argument are to dig out the trolley problem math. But in the case of IVM, it's so incredibly cheap and there's basically nobody dead on the other side of the trolley tracks no matter what, I can't see how the anti-IVM crowd can fully form the argument, other than crafting a "false hope" narrative. And I hate those because they must start with the presumption that humans are stupid cattle and their behavior must be manipulated for their own good. Banning IVM as behavioral manipulation will backfire, arguably already has backfired, due to Streisand Effect.
Seems very specious. Bullet one also applies to vaccines now that they're only 40% (?) effective vs Delta. Money diverted towards eating at McDonalds kills more people than non-vaccination does. 80% of Covid wards are obese.
* If there is a limited quantity of ivermectin because of a sudden surge in interest, and certain people definitely need it to stay alive, then you taking a dose denies it to someone who needs it to live.
I think this is a pretty reasonable perspective. I think it would result in you also taking HCQ, doxycycline, Vitamin D, and a few other things, but that's not necessarily a dealbreaker.
In my deep dive, the numbers on HCQ are largely conflated with the rest of the HCQ protocols which included Zinc and Vitamin D. I think you touched on that in earlier writings. I've been popping Zinc and D since the early HCQ days, writing most of the HCQ effect off to simply having better vitamins. I haven't bothered with IVM but whenever I do finally catch Covid (I think everyone is going to catch it sooner or later given the reinfection happening among the vaxxed) I plan on taking IVM unless there's better stuff out there by that point.
$700 a pop "Pfivermectin" might work. I'm on record saying I think the thing that got Joe Rogan through, outside of his probably very robust immune system in general, was probably monoclonal antibodies. If anything is a true scandal, it should be the general suppression of monoclonal antibodies as a treatment.
One thing you'll notice in the responses to my post (scan up) is a lot of folks saying the bad thing about IVM is that it disincentivizes vaccination. That's a super common theme among the IVM Culture War. The problem is that such a position should also suppress the distribution of other treatments that do work better than IVM. The pro vax crowd is so hung up on vaxxes that they'd suppress a perfectly safe and perfect Covid-19 treatment because it would suppress vax rates. This is more of a culture war issue than a medical issue, tied up with your "I can tolerate anyone except the outgroup," and similar writings on my wall.
If you mean what's the drawback on taking it personally, it would be the universal drawback that absence of evidence isn't the same as evidence of absence. People have studied ivermectin in the context of curing river blindness, a very nasty disease, so below a certain level they're not even looking for side effects. It's like (at a much lower level) if you've got a drug that can postpone death from Stage IV lung cancer by 6 months, you're not even going to bother asking whether people throw up more or less on it, or it gives them heart murmurs, or even causes leukemia 20 years later.
Does it happen that this ignorance is tragic? Maybe. Sometimes. In the 19th century, I believe physicians recommended smoking tobacco for various mild maladies on similar grounds: might help, couldn't hurt, seems totally safe, because nobody had died suddenly and abruptly from smoking. Now, it turns out smoking gives you lung cancer after a few decades, which is pretty horrible, and totally not worth whatever benefit it might have to losing weight or reducing anxiety -- but nobody knew about that, because nobody looked for it.
That's the problem. When you interfere randomly in your biochemical machinery, it's always the unknown unknowns that will nail you. So that's the important and unfortunately essentially impossible to quantify risk you need to weigh against the odds of a benefit. Doesn't mean you don't decide to go for it, but it does mean it's not the case that there is ever zero drawback.
There's an ugly flipside to this thinking as well. Tobacco (nicotine specifically) is one of the only confirmed drugs that ameliorates Parkinson's Disease, but the researchers who have identified this (the evidence is solid) aren't even allowed to give presentations on their findings at conferences because of the stigma against smoking.
And I think the "yes but unknown long term effects" thing is also pretty prominent among the IVM crowd who wants to avoid vaccination. One of the most important reasons to keep Covid vaccination from being mandatory is so there's a control group to compare long term outcomes against. It seems likely to me based on my reading that Covid-19 results in long term damage to the body because of these spike proteins. I'm not convinced that a smaller version (yet in some cases significant) of that damage is invoked by vaccination. I still got vaxxed, but I'm very uneasy about having a six month spike protein booster for this reason.
That seems obviously related to either Covid-19 or the Covid-19 vaccinations. Or both. I don't think an analysis like they did could differentiate between the two without a lot more research, but I'm alarmed that this research isn't even being done.
Nicotine actually is a useful drug for a few conditions, COVID even appears to be one of them. Smoking is probably not the ideal way to take it, but their advice wasn't that misguided. In the 19th century, smoking probably was actually harmless or very close to it. The health problems associated with smoking were not noticed until cheap, machine produced cigarettes were introduced. Many deadly substances are only deadly in large enough doses. Nobody smoked a pipe 20+ times a day. Modern studies don't appear to show any negative health effects for pipe smokers. It could very well be purely due to the dose, there's still no 2 pack a day equivalent pipe smokers.
If you get covid, I think there are better choices of medicines now (the newish antivirals and the monoclonal antibodies early, the steroids later), but obviously that's not something you want to be trying to do-it-yourself on while you're deathly ill--that's why we have doctors.
But AFAIK, there's not some huge reason *not* to take ivermectin or vitamin D or zinc or whatever, assuming there's not some reason they're going to interact badly with drugs you're on or something.
IVM isn't actually "incredibly safe" in the doses necessary to impair viral replication in vitro; it actually is fatal at that dosage.
That was always the problem; the suspected mechanism for disruption of viral replication in vitro was disruption of cellular processes, which is often fatal in people.
There's no reason to believe it is any better than injecting bleach, in other words. Bleach is definitely effective at killing SARS-CoV-2 - it just kills you, too.
There was never any reason to believe it was actually effective, but there are conmen who push anti-parasitic drugs as cure-alls.
In vitro concentrations aren't always directly translatable to clinical results. Ivermectin also has anti-inflammatory effects, and inflammation is a serious issue with COVID, therefore the direct anti-viral behaviour could have been merely a secondary effect to why IVM might have worked against COVID.
There is a difference between "there was never any reason to believe it was actually effective" and "I do not know of any reason to believe it was actually effective". There was a reason, tens of thousands of doctors didn't all randomly decide to try the same random drug for no reason. The COVID death rate in countries where people routinely take ivermectin is substantially lower than in other countries. This correlation is an obvious thing to investigate to see if it is causative or not.
I think you have to consider the ethical ramifications for future studies. Suppose you do a half-assed study and it suggests drug X kinda-sort works for condition Y *and then it becomes the standard of care*. How do you ethically go back and do the study right? What's your moral argument for the existence of the control arm? Informed consent is not going to cut it, not when the lawsuits flow.
I think this is part of the sotto voce rationalization for the FDA's reluctance to approve things that maybe kinda sorta work but where the evidence is thin -- and you cited this yourself when it came to the aducanumab approval, and perhaps it's worth noting that AD kills at a rate that isn't *that* far behind COVID. Once you sort of let the cat out of the bag, and a big constituency starts to exist for a therapy regimen, it becomes extremely difficult to go back and study it critically and precisely. Even when it's ethical to do the study per se, meaning you can talk yourself (and others) into the ethical propriety of the control arm, there are political and sociological barriers that may be difficult to surmount.
There aren't any easy peasy solutions to this, I'm just pointing out that when we consider the interests, costs and benefits, of things like drug approval, I think as an enlightened society we are obliged to consider the interests, costs and benefits, that will apply to future human beings because of what we do today. It's not *just* about making our lives better, we need to consider whether a cost to us today will produce a significant benefit to those who come later (cf. global warming, right?) and take that into account also. Information is not free: sometimes we have to pay for it in current lives, or misery, in order that the future has it and can trust it.
Or people could get the fucking vaccines (some of which aren't even mRNA or in any way experimental), which are absolutely without a doubt effective way beyond this nonsense. The options are not ivermectin or nothing, except that a bunch of dumbasses are out there spreading BS about the vaccines.
That someday is coming soon, Bill Gates is already warning that he is going to release smallpox and blame it on "bioterrorism". A new smallpox vaccine has just co-incidentally been approved, and now smallpox vials have magically been found at a merck facility, even though they have no way to have access to smallpox.
Nitpick: The prediction in Scott's post is that effect size as measured by Cohen's d is less than 0.3. This is not the same thing as a relative risk reduction.
Cohen's d is the difference in means between the group that received ivermectin and the group that did not, divided by the pooled standard deviation.
Scott, long-time lurker here. My antivax, anti-public health elite uncle is currently taking ivermectin for his long COVID, at the behest of his nutty physician's assistant (he fired his doctors, who wouldn't prescribe him things like ivermectin when he had an active infection back in December 2020). I asked him to explain how ivermectin could possibly treat both an active viral infection *and* the damage to his organs he's experiencing in the medium-term aftermath. He was flummoxed.
He later came back and said that the PA's theory is that parasites "acted up" while his body was fending off the virus, and that parasites are causing his respiratory and digestive issues. Mind you, he lives in a wealthy part of Southern California, not Bangladesh. Has anyone ever made the case that long COVID = parasites? I don't know whether to laugh or cry.
Reminds me of the classic rebuttal to medical woo, which is to ask as much detail as possible about what they think they're cleansing from your body with their juices and tonics-- species and subspecies if possible.
One of my parents bosses has been vaccinated for every previously vaccination she's been offered but doesn't like the covid vaccine because she says that RNA vaccines cause the virus to stay in your system. Of course if anything it's traditional vaccines that work that way, while RNA vaccines avoid it.
The more I read smart people strategizing how we might mollify the antivax, the more cynical I get. I'm not sure that these are people who will change their minds over anything, no matter how dumb dumb belief is. Of course I might be cherrypicking and we might as well try to reach more people.
If you "follow the science," you know that as a vaxxed person, other people being vaxxed doesn't affect you (maybe there are edge cases but the debate is not centered on those). So I can't understand why vaxxed people care if other people get the vaccine or not. (If I'm wrong on the science, please let me know.) *Especially* when, as it appears to me, the people trying to do the convincing often view the non-vaxxed as having "dumb" beliefs and hold them in contempt. If you think someone is stupid and you hold them in contempt, you are not likely to want them vaxxed because you want what's best for them.
So as far as I can tell, there are two plausible interpretations here: Charitably, the people who want to force or convince everyone to become vaxxed don't understand the science. Uncharitably, the people who want to force or convince everyone to become vaxxed (or to treat unvaxxed as second-class) solely want to exercise power.
- People that want everyone vaxxed worry about the healthcare system being blocked by a lot of unnecessary covid cases. This could hurt anyone including themselves if they need to go to hospital.
- They are sorry for the overworked healthcare workers that have stress because of unnecessary cases. More general it is a waste of resources.
So i see plausible reasons why someone can have a strong opinion that everybody should be vaxxed. But people being missionary or even want to force everyone to be vaxxed are stupid on an other level: If you exercise pressure on people, expecially at such intimate things regarding the own body, will always earn resistance. If you want to convince someone you have to can present all your arguments but than you have to respect their free will.
Third option: People want relief from all the stress and fear and disruption that this COVID/pandemic thing has caused on their lives, and they've been marketed to that this vaccination is the only way for that.
The only way to return to normal, is to vaccinate the population. Say the politicians and even some medical experts.
Anything otherwise, is an uncomfortable, cognitive dissonance driven, untruth.
I think you're probably right in general -- it's become a tribal/political issue, so for both sides the major motivation now is "stuff this bitter conclusion down the throat of my enemies so they totally choke on it ha ha."
But that said, there are indeed some legitimate reasons for vaccinated to want to impose vaccination on the un. The most obvious is, for the sake of those who cannot take, or are not as well protected by, vaccines, including the very old, the very young, immunocompromised people like cancer patients, transplant patients, or those being treated for autoimmune disorders. These people totally rely on "herd immunity" because they can't defend against the virus themselves, and can't use a vaccine to help them do so.
The second reason would be to reduce the social costs of the disease. If the cost of ICU stays and very expensive interventions to try to save the life of a COVID patient were *only* borne by that patient, we could be fairly indifferent to whether he had himself taken steps to reduce the probability of him getting (very) sick. But this is not the case, much of those costs are socialized, so that willy nilly means the preventative care decision necessarily gets socialized a bit, too. You can't really have it both ways, you can't ask to make all your own health-care decisions because privacy *but* ask other people to pay for (a big part of) your health-care costs because humanity.
Is there a good reason to believe that "herd immunity" can actually be achieved with vaccination? The latest data from UK shows that vaccinated have recently been more likely to be infected than unvaccinated (possibly because they take more risks).
"The social costs of the disease" argument might make sense if it was directed only to the elderly. But trying to enforce it on young people, let alone on those who already had the disease, suggests that a different real motive.
My main "third option" is that a virus's number of opportunities to evolve (to be more contagious) is proportional to the number of infections. More unvaccinated people means more variants arriving faster, which means higher probability that a variant will evade your immune defenses. (arguably this doesn't matter so much until there is enough vaccine production capacity for the whole world, though I heard that unclaimed doses tended to be thrown away instead of e.g. being sent to developing countries)
In addition, vaccines are what, 90% effective with delta or less, (I never got a firm number), and probably less effective still with omicron? So more unvaccinated people means more chances you (as a vaccinated person) will get sick.
And then there's people with weak/missing immune systems for whom the vaccine is ineffective. One can reasonably want to try to protect such people via "herd immunity" if possible (I'm now leaning toward "it's not possible" but most people, including me, have not seen enough evidence to be sure)
I believe that 90% effective is relative effectiveness, not absolute effectiveness. The COVID-19 vaccine's absolute effectiveness appears to be incredibly low, especially for newer variants. In fact, it is so ineffective (on an absolute scale) that there is no negative correlation (what one would expect for an effective vaccine) between vaccination rate in a region and all cause mortality (or any other metric, though most metrics people use are pretty terrible).
With the current vaccines at least, there is essentially no chance at reaching herd immunity, as seen by countries with a near 100% fully vaccinated population who continue to have "outbreaks".
You are correct. I've been interested in antimisinformation for years. People who are vocal about their belief will easily find excuses that enable them to ignore all evidence. You cannot change their mind. (I do think there are fence-sitters you might convince with a public conversation, but only if you are good at debate and ready to handle the contrarian's arguments.)
Writing this while about 1/3 of the way through reading...
A) Thank you so much for doing the yeoman's work to read through these carefully. This is what we pay you for (/s, lol)
B) Regarding Babaloba et al, I tentatively think I may have found the solution:
(This is the context)
"I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look."
We have four columns - 1 for treatment A, B and control each, plus an overall. This allows us to triangulate to see what has happened with the data.
Column A is the mystery - how do you get 50% of 21 people, and so forth? Easy, have K people who have missing data for this outcome. Happens all the time. (In my research, I deal with much larger samples, but there's always missing values for some trivial % of the data). Technically you can have different numbers of missing by variable, but the easiest solution to make (at least a few) of these numbers work is to allow 1 person with missing data in Column A.
Then we have 6/20 with fever, 10/20 = 50% with headache, and so forth. Columns B and C look fine. Ok, the question then is does my "fix" give the correct totals in the "overall" column? Turns out that (as far as I checked, it does)
Details:
Headache: 10/20 in col A, 12/21 in col B, 5/20 in col C. This would give 27/61 overall, which is 44.26%, which matches their 44.3% exactly.
Fever: 6/20 in col A, 9/21 in col B, 4/20 in col C. This would give 19/61 overall, which is 31.147%. They report 31.2%. This *doesn't quite match*. But if you round to 2 dp, you get 31.15%. And then if someone later rounds to 1 dp, you get (incorrectly) 31.2%. I bet errors like this happen all the time - you have your software print the result to 2 dp, and then as you write your table, you decide to do 1 dp and every time you have something end with "5" you don't go and check which way the raw data should round. (I bet I make this mistake in my research all the time when rounding coefficients and so forth manually in text, because who always remembers to stop and check?).
Haven't checked the other variables, but getting these sufficiently close matches for the first two I checked for the most simple "non-fraud" explanation of "1 data point missing" seems too much of a fluke otherwise.
The problem is then that the study does not report why they excluded and how many of the patients. This could be removing a patient that would skew the results in ways that they do not like, and so it is a problem still, not guaranteeing a fraud, but hinting at some data tampering.
Studies almost never report anything beyond "missing data are dropped" (which doesn't tell you anything that isn't completely obvious). It's not like you can choose whether to keep missing data or not - of course it automatically gets dropped!
Look, I'm not disproving data tampering but this is by no means the simplest or most likely explanation here. You'll find missing data being dropped for specific outcomes in 99% of studies.
The alien / vaccine hypothetical is compelling, but what's missing is that IRL all humans would have 7-12 different alien chips already in them and are objecting to getting another.*
*Yes yes mRNA is a new tech but you don't see anti-vaxx people being willing to get non-mRNA vaccines.
Oops, this is what I get for skimming Google results. In my defense, the mRNA tech developed a particular notoriety for being "brand-new" and "untested," but I guess that was not a defensible position based on how long each type of vaccine has been in use.
While J&J is unlike most other vaccines Americans would have received, and it does contain DNA, "DNA vaccine" refers to something else: https://en.wikipedia.org/wiki/DNA_vaccine
The only approved DNA vaccine is an Indian vaccine for covid, approved in August 2021.
J&J is a nonreplicating viral-vector vaccine; the first vaccines of that type approved for general use were for Ebola.
I do know several people who say they will take the Novovax vaccine if it's approved (we shall see, but come on FDA) but are refusing to take the adenovirus and mRNA based vaccines. They have (imho irrational) negative response to anything 'genetic' (e.g. super seriously avoid GMO foods etc.).
I said this upthread, but the one person I know (secondhand) who fits this description says she is worried that mRNA vaccines are less safe than other vaccines because they put part of the virus into you. Of course this is the opposite of what's really true-- there's a very small risk of modern vaccines causing infections, but if they did it would be from older vaccines that use live viruses, or vaccines that use dead or deactivated virus, whereas RNA and DNA vaccines basically carry an instruction manual to the virus rather than the real thing.
Any vaccine you make is somehow going to have to put something from the virus into you in a way that gets presented to your immune system. The mRNA and viral vector vaccines do that by making your cells make some spike protein. (I don't think anyone's done a DNA vaccine for covid, but that's how it would work, too.) Subunit vaccines just inject a chunk of protein that appears on the virus (Novavax is doing this), plus something to make your immune system pay attention. Inactivated virus vaccines inject a virus that's been "killed" by heat or formaldehyde or something. Attenuated live virus vaccines inject a form of the virus that has been adapted not to make you sick, so you get a mild asymptomatic infection and your immune system learns how to fight the real virus off.
The mRNA part of the mRNA vaccines only contains instructions for building the S protein part of the virus coat. There are no instructors for building the viral DNA itself, nor for the other parts of the viral coat. Furthermore, it's not the actual genuine S protein, but a modified version of it that is stable *without* being incorporated into a complete virus. In other words, it isn't even a part of the virus that could be assembled with other parts to make a complete virus.
Well unfortunately, even existing vaccines (like the flu shot) have now become politicized. I expect to see the lowest child vaccination rates in decades over the next few years.
The medical establishment, the media, the internet, government, and many churches, were taken over by an authoritarian political group of billionares years ago, What's hapening now is necessary to expose it so people will get off their asses and change it before the whole human race is in a grave. Imagine if Hitler or one of the other evil dictators of the past came to power today, took control of genetics, started manufacturing chimeras, releasing sterility viruses and deceiving people to take sterility vaccines.
What are the most prominent examples of the medical establishment taking political sides, as opposed to medical sides that happen to be supported by one party?
The medical establishment was taken over by a political side, authoritarian socialists, along with a majority of government departments and large corporations. When medical mistakes are the forth cause of death, you know something is wrong. The takeover began in earnest 70 years ago with a 93% tax on capitol growth by doctors and huge subsidies to large corporations to establish health care collectives. It's been all down hill ever since. Health care costs went from 5% of GNP to 20%, while quality went down. Constant hype about breakthroughs convinces people it's getting better but it's not.
The pathetic response to the pandemic made it very clear. The billions of dollars taken from workers and given to bureaucrats to prevent pandemics were wasted, and even worse diverted to labs creating pathogens like the one that caused the pandemic.
I think also missing is the behavior of conservative political and media elites, who are actually in a social class where they might have immunologist relatives but who kept up anti-blue tribe COVID skepticism. Trump is vaccinated, Fox News has an internal vaccine passport system, these are the people best positioned to persuade skeptics motivated by 'hostile aliens' and they refuse to do it because maximal ongoing culture war serves their interests.
Tribalism makes people stupid. There are plenty of utterly amoral people in media and politics who will happily play along with the stupidity to increase their money/power/audience. But also, there's a genuine danger of getting caught up in a feedback loop of your bubble + your confirmation bias. I'm pretty sure Bret Weinstein isn't dishonest about ivermectin, and he's certainly not dumb, but the whole ivermectin controversy / big pharma conspiracy theory thing seems to have broken his brain in a rather depressing way.
I think even very smart and sophisticated people are susceptible to getting high on their own supply.
Yes, I think Bret Weinstein is hooked on the idea that he's right when a lot of other people are wrong.
He could have just had (reasonable?) doubts about the mRNA vaccines, but no, he had to go on from that to the idea that there's an extremely effective drug that's being suppressed.
Trump has been shilling the vaccines since he was still president, he is shilling them now. The qboomers you want to pretend are representative of everyone who isn't hysterical about COVID can't be swayed by Trump, so Fox can do absolutely nothing to convince them either. They have less than no influence over the rest of us, who think fox is just as worthless as CNN. The CDC's statistics are why I am not taking a dangerous vaccine for a harmless cold. Not because only 99.8% of empty headed media puppets are devoting all their time to lying and fear mongering about COVID instead of 100% of them.
It would be great to see analysis of why a deworming medicine is thought by some medical professionals to be an effective treatment for a respiratory disease.
What could possibly motivate the folks at ivmmeta.com to spend so much effort in creating and maintaining such an impressive site? I see only two candidates - sincere belief in the effectiveness of Ivermectin or a profit motive. I don't believe trolls or nihilistic fraudsters would have that much motivation. Since the drug is already a generic drug, it would seem the profit motive is less likely than a sincere belief that it is an effective treatment for COVID19.
I don't understand the intensity of the establishment backlash against Ivermectin. I have not seen evidence that vaccination rates would be higher if people did not believe ivermectin worked. Nor do I think that it's intuitively clear that this would be the case. People who distrust the establishment don't trust them on vaccines or on whether or not ivermectin works. Even if they were somehow convinced that ivermectin didn't work, they wouldn't trust the vaccines unless the public health establishment suddenly became more trustworthy overall. Add to this the fact that if taken in human sized doses, ivermectin is safe and I don't really see the reason for the virulent mainstream backlash. In fact, the backlash probably cost some lives by causing people to take crazy dosages.
More generally, I don't understand the establishment messaging of vaccines (+masks) or you're the worst. There are plenty of other ways to reduce risk including doing things to maintain or improve overall health (exercise and sunlight). And these activities are not mutually exclusive with taking vaccines. The messaging should not have been anti vaccine alternative - that just spreads distrust. It should have been vaccines are good and here's a bunch of other positive steps you might take to reduce your COVID19 risk. And the evidence for ivermectin is mixed, but if your doctor wants to give you some, whatever its harmless. Again, I think the vaccine or bust messaging was really counterproductive.
How about pointing the anger at the FDA for forbidding the use of tests early on other than the one they had approved — and later discovering that that one didn't work? Also for delaying the unblinding of the vaccine data until election day.
I would go further, and blame those responsible for making it take nine or ten months from a vaccine being created to its being approved for use, in part by not permitting challenge trials.
While Zvi has criticized the FDA, he himself has been wrong about a number of things. So while the FDA screwup rate is not 0, his is not 0, either.
In particular, everyone who was eager to get the masks off was wrong. My personal opinion has been (and will continue to be) that everyone should continue to mask up until COVID is gone, and that maybe wearing masks on public transportation like planes and trains and buses should be *permanent* - that is to say, even *after* COVID is gone, we keep doing it.
Anti-COVID measures had an enormous effect on flu season last year - we had approximately 1% of the normal fatalities due to influenza. That's crazy.
It shows just how ridiculously infectious COVID is by comparison - measures inadequate to fully control COVID were sufficient to lower flu deaths by 99%.
>really beat it, in the way Japan, South Korea, and Australia beat covid
You mean, not "beat it" at all and have no statistically significant difference from any other developed country? Whatever country "we" is, managed that just fine.
>We blew it because people refused to come together as a society and work on the problem - refused to wear masks, refused to self-isolate, refused to social distance, refused to endorse policies we knew could reduce the spread of the disease.
But we know all of that is complete BS. The anger is floating around precisely because so many people live in the TV fabricated alternate reality where that nonsense is true. They somehow forget that at the beginning, when we had no concrete information to go on, republicans were the ones taking COVID seriously, and dems were insisting it is "just the flu" and organizing "hug a random asian person because the imaginary racism we just made up is the real disease" events. Dems were the ones insisting masks don't work and you are an evil panic spreading fear monger if you wear one. And then as we got real information from countries with slightly more trustworthy governments than China's, and we determined that it really is just the flu and there is no need to do anything, everything suddenly reversed and we had always been at war with Eastasia.
We knew from the time of the great reversal, once efforts to restrict travel to prevent spread had been successfully shut down by "racism" accusations, that it had become endemic and it was going to be a permanent disease like the flu. This was openly explained to all of you, when you were told that we needed temporary 2 week measures to "flatten the curve" and not overwhelm our health care systems with too many cases at once, since there was nothing we could do to change the number of cases that would happen overall. And yet, on week 89 of 2 weeks to flatten the curve, people are somehow able to delude themselves into blocking all of this out of their head, while simultaneously remaining completely convinced of their own superior, skeptical mind.
You have to look at all the variables, not just the one you like. The US has more deaths from everything all the time than Japan does. The US has far more people with serious health problems than Japan does. We know age and co-morbidities are the most important factors in COVID deaths by several orders of magnitude. And denying the lack of seriousness of COVID is just silly. Look up the average age of COVID death victims yourself. It is higher than the average life expectancy. Look at the survival rate for people below 80 without co-morbidities. COVID is killing people 3 weeks sooner than they would have died anyways from something else. Many COVID deaths are admittedly not even COVID deaths, they are deaths within a selected time window of having a positive PCR test for COVID.
To clarify, in case it seems like I'm being too glib, good and evil both exist and it isn't all that terribly hard to tell the difference. Certain morally valent policy recommendations are sufficiently morally incorrect as to constitute evil behavior. Censoring the net is evil. Convincing depressed teens and twentysomethings to pay hundreds of thousands of dollars to have their genitals mutilated and rendered permanently nonorgasmic, in an intervention that is sold as preventing suicide but is ineffective even at that, is evil. Advocating for the normalization of sexual relationships between mature adults and people too young to give informed consent, and the concomitant power imbalance, is evil. Advocating for the legalization of the murder of viable fetuses is evil. All of these are mainstream positions within the Democratic party and the broader academic left from which the Democratic party draws its social policy recommendations. When I claim the Democratic party is evil, I am not dunking on the outgroup. I have specific and grave moral concerns about their specific and openly held social policy recommendations.
Strongly agreed. Parts of the medical profession actively worked with social media and mainstream media to block any discussion of a potential treatment of a major pandemic. What about that wouldn't cause great concern and lead to groups of people trying to create an honest discussion of the merits of the treatment? For a normal response, most of us would never have heard of ivermectin and the medical profession would have worked through the studies and made recommendations to doctors. Individual people would have heard positives or negatives about the drug from their doctor, and made up their own mind. Nothing special, no big deal.
I don't want to be too uncharitable, but I get annoyed by the double standard sometimes here. If ivermectin boosters are acting unreasonable-- and most are getting out ahead of their skis even on a charitable interpretation-- then anything they get above mockery is gravy.
Yes, we should be trying to get through to people about vaccines, and yes, if you're a blue check physician health communicator type you shouldn't be making fun of random people on twitter. But still, if you're ignoring a working vaccine to take snake oil, you're being silly and I'm not going to feel bad that people make fun of you.
Of course you're right that we should be exercising more, eating better, etc., to prevent covid, but we should also be wearing surgical masks and ventilating indoor spaces. We don't need to choose between air bags and seat belts.
The vaccine might justify taking fewer cautions since it's simply way more effective than any NPI, but there's nothing else that compares. I might even trade in all our messaging on NPIs for messaging that boosts vaccinations, given that the marginal value of an additional vaccination is so much higher.
It's not representative, but there have been a few celebrities including Joe Rogan and other celebrities who apparently get their health advice from Joe Rogan taking ivermectin but not getting the vaccine. Rogan has maybe the largest platform on health matters in the world in terms of the listenership regularly tuning in for health content, so he's not a marginal player.
Rogan did not just take ivermectin, he also took monoclonal antibodies which have excellent evidential basis, and he was very transparent about everything he took. He also routinely, literally says not to listen to him for medical advice because he's a moron, and that you should talk to your doctor. All in all, very reasonable messaging.
You might want to stop and consider (charitably!) why people might want to listen to Joe Rogan on a matter that he emphatically says is not his expertise.
It's a mixture of experts/elites/establishment people actively lying to them about COVID treatments and preventions, including lying about both masks and the vaccines, and Joe Rogan laying out his thought process pretty clearly in a way that invites people to make up their own minds. That may lay out a better approach out medical establishment should take in the future.
Someone can correct me if I am wrong. But my understanding of what happened with Rogan was that he was not vaccinated because he felt that he was healthy and did not need it. Then he contracted COVID. Then he contacted a doctor that he had had on the show who supposedly had a bunch of treatments for folks who had COVID. He paid that doctor a lot of money to recommend/proscribe him a bunch of stuff of which Ivermectin was one thing along with monoclonal antibodies. Once he recovered he mentioned on his show the laundry list of stuff he took. Then the media jumped on the fact that he took Ivermectin and said he took horse dewormer.
I don't think Rogan was actively promoting Ivermectin as an alternate to vaccination before or after he got COVID
One of the cases of non-vaxxers I know at second hand is in this boat. As in, has specifically said, "I don't need to get the jab. It's not safe in the first place, and in the second place if I do get it I'll just take ivermectin."
There was also a nurse on this board who discussed doing this in a previous thread, though if memory serves they were in fact taking the ivermectin prophylactically.
I don't know if there's been a survey, but these people are, at least anecdotally, around.
What if you replace IVM in this case with monoclonal antibodies, or the Merck pill? Isn't that a reasonable stance, if that person decides to take the risk of getting Covid and then treating it if it gets bad?
There is a n% chance that you get Covid, an n% chance that it is symptomatic and an n% chance that it is serious. Depending on who you are, getting all the way to it getting bad is pretty slim. A vaccine helps you in the case that all of these are true, whereas if there is an effective therapy, which there is, then I think people should be able to take the risk of getting Covid and then treating it.
I can understand your frustration, and if making fun of silly people helps you, you can do this. But i don't see any other reason and the cause not to mock but to respect them is not mainly because you feel bad for them. People that don't don't feel a minimum respect from you, just won't listen to you, even if you have the arguments that would otherwise convince them.
Small-molecule drugs often change multiple things in both the highly complex systems of both the human body and disease-causing organisms; we don't really understand these systems in anything like the detail necessary to predict the effects in advance.
A fairly standard approach when screening an existing drug for potential use against a new disease is roughly "Well, one of the systems we know drug X affects is system Y, and system Y seems to be active in disease Z, so maybe it'll have a positive effect". So, ivermectin (which seems to have fizzed out) made sense as something to test for the same reason fluvoxamine (which seems to work) did; well-tolerated in-production drugs with effects on inflammation systems (since inflamation is a factor in COVID).
A whole bunch of other drugs that fit that general description have been tested, too, without making the news; that's because they failed (unlike fluvoxamine) without any faked studies declaring them a major success (unlike ivermectin).
As far as the psychology on the pro- side, it looks like the usual confirmation bias. People saw the studies where it had a major effect and were convinced, and have held to that regardless.
And on the anti- side, the invective is the usual tribalist animosity signaling. The vaccine hesitancy arguments are not the reason for the venom spewed at the Other, they're the excuse for the venom spewed at the Other.
>I don't understand the intensity of the establishment backlash against Ivermectin.
The US is extremely polarised right now and like a lot of ambiguous things COVID mitigation wound up getting pattern-matched to Blue Tribe vs. Red Tribe. A lot of scientists are fairly apolitical, but establishment messaging is very definitely Blue.
This put a lot of emotional loading into an ideally-quite-dry question, and so the tiniest shred of a "lives are at stake" suddenly becomes front¢re (let us be clear; in a country of hundreds of millions a lot of things have lives at stake) and the deplatformers start reaching for their toolbox.
I disagree with Darin; I think most of the establishment messaging is honest, if foolish.
There are lots people who are scared of both COVID and COVID vaccines and aren't sure which is more dangerous. Evidence:
- Old people are much more likely to get the vaccine than young people, which indicates people are making a cost benefit calculation but overestimating the "cost" of the vaccine.
- You have people like Nicki Manaj encourage mask wearing but will not get the vaccine.
- My hairdresser was scared of both, and says a lot her friends are too. She did ultimately decide she was more scared of COVID and got the vaccine.
Now if you are scared of COVID and vaccine, and Team Ivermectin tells you not to be worried about COVID because their pill will protect you, that should make you less likely to get the vaccine. I'm not a huge fan of "risk-compensation" arguments against imperfect interventions because it's rare people risk compensate more than the benefits of the imperfect intervention, but here the benefit is probably zero so any risk compensation is harmful.
These were shared by a lady at my workplace, a few days after work announced that the vaccines would be mandatory, and the day before she abruptly left. No idea if she was terminated or stormed out. They were sent to the dept mailing list, then followed by a sorry disregard email. I think they're illustrative of what a lot of us think of the anti-covid-vax / pro-invermectin crowd, and of what that crowd thinks of us. I don't know what there is to do, or where we go from here.
"In the US, the Supreme Court has ruled that vaccinated people worldwide are products, patented goods, according to US law, no longer human. Through a modified DNA or RNA vaccination, the mRNA vaccination, the person ceases to be human and becomes the OWNER of the holder of the modified GEN vaccination patent, because they have their own genome and are no longer "human" (without natural people), but "trans-human", so a category that does not exist in Human Rights. The quality of a natural person and all related rights are lost. This applies worldwide and patents are subject to US law. Since 2013, all people vaccinated with GM-modified mRNAs are legally trans-human and legally identified as trans-human and do not enjoy any human or other rights of a state, and this applies worldwide, because GEN-POINT technology patents are under US jurisdiction and law, where they were registered. SOURCE of the decision of the US SUPREME COURT PDF HERE (https://www.supremecourt.gov/opinions/12pdf/12-398_1b7d.pdf) To follow how / if it applies to others, outside the US."
And
"Reasons why the jab cannot be mandatory and why not to take it This is 100% ILLEGAL. 1) there was to be a full experiments done on testing animals FIRST. When ALL the animals DIED, they stopped the experiments ! ***They are REQUIRED to explore all options to see if there already is an approved therapy on the market BEFORE even making jabs... Ivermectin and HQC were two that were acceptable. But they demonized doctors who used those safer therapies and banned their use, thus many lives were lost in the process !!! Also, Fauci had a contract with Moderna back in 2015 I think. Mass amounts of PCR tests were also sent world wide between 2017 and 2019... Event 201was held in October 2019 simulating a corona virus pandemic... Boom - then we have one ! Not coincidental or suspicious at all ??!!! Fauci had also written a paper how the two therapies above were great in treating the SARS virus as a treatment and cure .... 2) This is NOT FDA approved. It is under the Emergency Authorization Act as an "Experimental GENE THERAPY Injection... It is NOT even a vaccine ! 3) By not going through ALL the protocols set by the Nuremberg Trials, they are breaking the Nuremberg Laws !!! 4) A drug CANNOT be mandated that has NOT been approved by the FDA. And that is not saying it is safe even then - look at all the commercials for lawsuits against FDA treatments all night long on your tv... 5) Why would anyone want to take a product where the manufacturers are NOT LIABLE for any deaths or injury ? If they are not willing to stand behind it, it is defective at best and nefarious at worst. 6) The clinical trials are not even done until 2023... We are the lab rats ! They won't even list all the bad stuff until the trials are finished !!! But we see all the deaths, injuries and diseases that these jabs are giving people, and they still line up for it AND make their CHILDREN get it !! Children have not been tested for this yet ! 7) If your employer makes this mandatory for you or anyone else, they too could be subject to breaking the Nuremberg Laws. One of the penalties is EXECUTION for breaking any one of these Laws. The employers also are 100% liable for any injury or death you may have ...not the manufacturers. Remind them of this when they want you to take the jab....especially the execution part. NOTE - If you or anyone knows of someone injured or died, contact PJI.Org On their site they have a PDF about your rights with this whole hot mess, and they can represent you for free. If you die or get injured, your insurance may refuse to pay ANY BENEFITS due to you knowingly got involved in what they term as Risky Behavior... Like some one jumping out of a plane without a parachute .. So say goodbye to all that money you paid into your burial and health insurance... 9) These jabs do NOT prevent you from getting the virus in fact, more people get the virus directly after the jab . They also then shed the virus onto non vaxxed people. Unvaxxed are exposed to vaxxed are experiencing miscarriages, changes in their menstrual cycles for the women, and other things are popping up. The vaxxed are dying from the Delta varient in more numbers than the unvaxxed... 10) During the Senate Committee Corona Virus hearings, they had various doctors that were highly educated speaking about how dangerous these are and that there has been more deaths and injuries from these jabs than with all the other approved vaccines in history COMBINED, that they should have been pulled with just the first couple of deaths and injuries... LINKS to the brave doctors testifying https://youtu.be/mIPb0AtEvAEhttps://youtu.be/MGboD4KAgbM 11) The CDC was recently caught removing a large amount of jab injuries and deaths on their VAERS website. It has been estimated that 150 THOUSAND people have died from the jabs. So I have given just some of the facts as to why people may not choose to get this. It isn't that they are anti-vaxxers, They are just Pro Life !!! KNOW YOUR RIGHTS ! I made that so people have a defense when getting attacked by people or employer This was created by Brenda Purvis https://www.newsbreakapp.com/n/0auna1tA?share_id=eyJ1c2VyaWQiOjQ5MTUyMDIxLCJkb2NfaWQiOiIwYXVuYTF0QSIsInRpbWVzdGFtcCI6MTYyNjI4MTE3MTIyN30=&s=a7&pd=03KEgXnK&hl=en_US&lp=v2"
There's a rational mode of thinking where you are weighing evidence and making tradeoffs. Living there is hard work, you're constantly having to read papers and try to remember how some weird ass statistical tool or clinical trial design is supposed to work, there aren't any easy answers, and even when you've done your best you know you might just turn out to be wrong. Most people are pretty bad at this, probably journalists and politicians are mostly very bad at this, and to be honest, almost nobody is really good at it.
There's also a moralistic/tribal mode of thinking, where you are following norms yourself, enforcing norms on others, denouncing shirkers and wreckers, etc. This is easy--our brains are evolved for this kind of game, it's fun, it's accessible to the dumbest and least educated people. Probably journalists and politicians are extra good at this game.
Almost from the beginning of covid, most mainstream people with prominent voices/platforms were playing the moralistic/tribal game. Racism is the real virus. Get a load of these weird aspie racist techbros wearing masks and using hand sanitizer. Sanitize surfaces and wash your hands! Masks are only for medical personnel. The lab leak hypothesis is racist and must be suppressed. Joe Rogan's taking horse dewormer.
A few people were playing the rational game, but they were mostly not the people with the biggest megaphones. And one reason they didn't have the biggest megaphones is that most people don't want to play that game, and to be honest most of them probably can't do it very well and couldn't even if anyone had ever bothered trying to teach them how.
They are "much less" likely to spread COVID according to Fauci. The exact opposite of what you claimed.
Why are you spreading misinformation?
Every single study has found that it reduces transmisssion.
We are boosting because immunity wanes over time and because antivaxxers continue to spread the disease. To actually reach herd immunity we'd need to vaccinate about 95% of the population due to the infectiousness of the virus.
Sadly antivaxxers lie about this because they don't want to come to grips with the fact that they're killing people.
A simple google search is a fictional reality which does not match actual reality. I find it hard to believe that you are not aware of google's "helpful" suppression of inconvenient facts. Citing "Fauci says" is just absurd, he has lied over and over again, even under oath in front of congress. He has even openly admitted to some of the lies. Cite studies, not celebrities.
I'm pretty sure I know which group is involved with ivmmeta, though I don't know which members run it.
I think the motivation is that the authors' self-image involves them "solving covid". They need to have found & promoted a cure by the end of the pandemic. They've made a bunch of websites for different potential drugs and hyped the most promising ones. They believe that ivermectin works, but it's not something they are unbiased about.
This group has also decided that covid vaccines are net bad for most of the population, and are hyping ivm as an alternative to vaccines, along with accusations against establishments re: why they promote vaccines but not ivm. I'm betting if the messaging was "establishments are too slow" and "vaccines and ivm together" there would be far less backlash.
This is the single best article written on ivermectin throughout the whole pandemic. Thank you.
I've been looking at ivermectin since the early months of the pandemic. I had heard of the I-MASK+ protocol when people were still using ventilators on COVID patients (with an 85% death rate in NYC), and it sounded really promising to me. So I've been really open-minded as to whether or not it actually worked.
But over the next several months, and now 18+ months later, it never really succeeded in having a home run in terms of proving that it worked. I don't think we need medication that decreases viral load 3 days faster, we need medication that keeps people out of the hospital and from dying. It was pretty clear anecdotally that ivermectin wasn't doing that.
I think basically it comes down to the fact that when you have a disease where 85% of people suffering no or only mild symptoms and 0.5% death, it's going to be a very hard disease to determine if a treatment worked or not.
I think the science we have been doing over the course of the pandemic has been largely garbage because we haven't learned anything to help us whatsoever since March 2020. If I remember correctly, the mRNA vaccine was designed within days of the virus being sequenced in January. The rest of the time on the vaccine was spent making sure it was safe, but you can argue that nothing new was learned after the vaccine was created. Since then, we haven't really learned anything about the virus, about the transmission, how to fight it, etc. Our best bet is to wear masks and stay outdoors, which we already knew.
What we as a species really need is a global mobilization of scientists, where a single global committee designs a thousands of different experiments that would help us narrow down how the virus works and how to fight it, and divvy up the work globally. We could have worked in parallel doing thousands of experiments to help us figure out what exactly we need to do to beat COVID, but instead the millions of scientists around the world were trying to determine if SARS-CoV-2 was found in vaginal fluid or semen.
The parallel rapid response trials idea been proposed before COVID-19, and is thankfully being more actively pursued now. It's is a big part of both the UK 100-day proposal for response and the White House's $65bn proposal, championed by Eric Lander and OSTP, which unfortunately wasn't a high-enough priority for congress in the just-passed infrastructure bill, so it was mostly eliminated.
I was a bit hyperbolic in terms of my choice of words, and I couldn't edit my words after posting. But practically we haven't found anything real. Yes, in the last couple of weeks there have been pills that came out that cut the risk by 85% which is finally what we need. But aside from finding those drugs, we don't know why it causes severe symptoms in some people, and almost no symptoms in most people. Is it genetic? We have no idea, but it's been 2 years and we don't know. We don't know why many people lose their sense of smell. We don't fully understand the mechanism of transmission. The only definitive thing we know is that as the age of the person increases, the chance of severe symptoms and death rises exponentially, but we don't know why. We don't know why kids are largely immune to COVID. We don't know why some people are dying of blood clots, although there was a recent study saying that the spike protein may interfere with some parts of the clotting process.
There's so much we don't know. The medications like fluvoxamine give a percentage improvement but it's not a home run like the Pfizer drug. I would classify that as a statistical modifier rather than a real medical treatment. We need something akin to penicillin that effective solves bacterial infection, we don't need things that only provide statistical significance to moderately improving symptoms over a large number of people.
Read the whole Vox article, it's not just about "the last couple of weeks", but also says, for example that "In the nearly two years since this coronavirus started spreading, we’ve learned a lot about how to care for patients who are sick enough to require hospital care. Cheap, widely available drugs such as dexamethasone have substantially reduced the hospital mortality rate for severe Covid-19." And there have been tons of other research findings about the virus, transmission, etc. since March 2020.
"What we as a species really need is a global mobilization of scientists, where a single global committee designs a thousands of different experiments that would help us narrow down how the virus works and how to fight it, and divvy up the work globally."
And if that committee ends up committed to a mistake, as committees not uncommonly do, there is nobody outside it to point out the error. Centralization is dangerous.
Great read, Scott. You moved me from the “IVM probably works a little” basket to the “IVM probably doesn’t work” basket.
I do think there’s a few points you could add to your analogy that seem fairly important to the more educated and knowledgeable vaccine hesitant people I know:
- Previous brain implants have gone through long trial periods to ensure they don’t cause adverse effects. However, the aliens believe the quantum memetic plague constitutes an emergency and there isn’t time for such a process. Plus they say the early trial results look great.
- The first implants start getting inserted and some rare side effects are noticed. In the worst cases, some of the implanted die as a result. The aliens insist there’s nothing to worry about, as it’s a very rare occurrence. But you can’t help wondering if they’re investigating the problem in good faith.
- A few months into the program the implants stop working as well as promised. The memetic plague has mutated, and found new ways around the implants. The aliens acknowledge this but maintain it changes nothing of practical importance. Herd immunity to the memes may no longer be possible.
- Anyone promoting vaccines in public is censored. On some platforms, even non-promotional discussion of vaccine efficacy is targeted.
- A few more months pass and the aliens decide that implants will be mandatory, and refusal will mean you cannot use any alien technology! Alien tech has already permeated all of earth life. They’re also implanting children, who were supposed to be almost unaffected by the memetic plague. The brief explanations are difficult to parse, and seem somewhat circular to the human mind.
I'd love to know the answer to these questions too, because they primarily go ignored and unanswered by anyone knowledgable I know who's in the camp "I've taken the vaccine and it's safe, and you should too".
Probably some mix of cognitive dissonance and not wanting to think any longer about a problem they think they solved with the solution that these questions bring into doubt.
Yes, it's important to address the reasonable concerns people have, but also to be clear about the facts, and these analogies break down.
To be clear, the COVID vaccines went through the same trials other vaccines did, just in parallel and with much less delay, and regardless of the reasonableness of early hesitancy, we do have really good data on levels of side effects now that over half of earth is vaccinated - and they are far lower than what we see from COVID-19. And there is strong evidence that the vaccines work very well for active immune response, but that only kicks in after a couple days, so people get mild COVID once the neutralizing antibodies are no longer circulating.
(And the "memetic plague" analogy breaks down once we can see people dying from the plague en masse.)
> To be clear, the COVID vaccines went through the same trials other vaccines did
Thats false. Scott makes a big story about aliens but it's completely unecessary. I just don't trust you (you speaking for the establishment here) because you keep lying to me. You don't even feel bad and when I point ot out you'll just slander me.
The establishment would've been much better off with "Trump got that idiot FDA out of the way, so these vaccines could be tested at better than the snail's pace those silly safety officers wanted to do it at."
But that would've involved saying something nice about Trump.
why did vaccines have higher all cause mortality than placebo in pfizer's six month follow up? 21 vs 17? with much of the mortality coming from cardiac issue? I believe moderna had similar all cause mortality iirc?
Which study do you mean? I only know DOI: 10.1056/NEJMoa2110345 being referenced as "pfizer's six month follow up", there the mortalities are 15 vs. 14.
I maintain that the real conspiracy is the FDA keeping a helpful vaccine out of our hands for so long, which makes the metaphor even more fun. Imagine that a group of human bureaucrats had studied the alien biochips, approved some after a long process and refused to approve others, but all the material evidence was that the biochips worked better than expected. The only bumps in the administrative processes are when the bureaucrats blame one biochip for an unrelated problem and make it illegal to use for a brief period. We get evidence even months later than breaking the chips in half confers the same level of protection, even though the bureaucratic process made that difficult to study. Have I totally killed this metaphor yet?
Also the part where the bad orange alien said the brain implant would be ready soon, and a bunch of human leaders said not to trust the bad orange alien's brain implants. And the alien brain implant manufacturers probably delayed releasing the brain implants because they didn't like the bad orange alien. Then a couple of months later all the people who said not to trust the bad orange alien's brain implants, after getting the brain implants themselves, said you absolutely must get the brain implants.
There is one quote to this effect, and you’re leaving out the literally very next thing that person said. “If Dr. Fauci, the doctors, tell us that we should take it, I'll be the first in line to take it."
In other words, she sensibly discounted what someone trying to win and election said — someone who also was claiming 20 million doses would be distributed by the end of October 2020 even as the pharma companies were saying that was impossible. No one ever mentions that context.
It was still a stupid comment, because the vaccine wasn’t being cooked up at Trump campaign headquarters. The “doctors” were already hard at work overseeing the development process of a vaccine based on a new but well-studied technology following an abbreviated but extensive testing program. All of this was well known and well publicized - the vaccine rolling out on Trump’s word without the doctors signing off was never an option on the table.
There are multiple statements to that effect. How does Trump lying about how many doses would be ready by what date make any of the statements made by Harris, Biden or Cuomo acceptable? There is no context that makes these statements responsible or honest unless their current position is irresponsible and dishonest. The same vaccines made and approved by the same people through the same processes do not become dangerous or safe based on political whims. Either we should be wary and skeptical of the rushed vaccines then and now, or we should "trust the science", shutup and take them then and now.
Interviewer: "Let's just say there's a vaccine that is approved and even distributed before the election, would you get it?"
Harris: "Well, I think that's going to be an issue for all of us. I will say that I would not trust Donald Trump."
Biden: "If and when a vaccine comes, its not likely to go through all the tests that needs to be and the trials that are needed to be done."
Biden: "Who's going to take the shot? Are you going to be the first one to say sign me up?"
Cuomo: "You’re going to say to the American people now, ‘Here’s a vaccine, it was new, it was done quickly, but trust this federal administration and their health administration that it’s safe? And we’re not 100 percent sure of the consequences.’ I think it’s going to be a very skeptical American public about taking the vaccine, and they should be.”
Cuomo: “Frankly, I’m not going to trust the federal government’s opinion, and I wouldn’t recommend [it] to New Yorkers, based on the federal government’s opinion.”
All three of them knowingly and deliberately made it seem like there was something wrong with the vaccines before they knew anything about them and that people should avoid them simply because Trump exists. And looking at old twitter posts from before the election, it certainly worked. Thousands of dems tweeted about how they would never take the unsafe, rushed, "so-called" vaccine that Trump was dangerously and irresponsibly pushing.
Honestly, the most important difference is that previous mind implants weren’t being pushed hard by aliens.
People who took other vaccines but refuse THIS one, are doing so because they think (not without reason) that the people telling them “take it or else” are untrustworthy assholes who hate them. Everything else is post hoc rationalization by people who aren’t quite ready to admit that their real reason is basically “you can’t make me, nah nah nah”.
It’s unfortunate that the vaccine didn’t hit about 3 months earlier, to become well-established prior to Biden taking over and “get the vaccine” being therefore slotted as a Blue coded behavior.
What's weird is that I think we already require tons of vaccinations to work, travel, and get educated, so why is this mandate suddenly more coercive?
The woman I'm talking about also made a big deal about how even though everyone else was wearing a mask she could get away with not wearing it in stores, elevators, etc. because no one is going to stop her. There's a certain type of vice signalling that I really don't think I'll ever understand.
See, all of my priors tend to point the other way. It seems obvious to me that the worst and most coercive government practices are things probably passed bureaucratically with the support of both parties and which have existed for decades already. I mean, I get that people move on headlines, but there's something frustrating about the "only the government coercion that existed before last Sunday" libertarian types.
For some jobs you do have to present certain vaccination records, particularly if you work in health care. (And they mean it: when I couldn't find some of mine, I had to get re-vaccinated to keep my job! This was back in 1980!) And in some jurisdictions you have to annually prove you got a flu shot to work in health care.
As for travel--you haven't lived through a raging respiratory pandemic before, so no, nobody ever asked for proof of immunizations for routine travel. That said, when my daughter went to school in France before the pandemic broke out, she had to present immunization records in order to get a student visa. And foreign students who come to the US for college also must present proof of several immunizations--a practice that substantially predates this pandemic.
>I think we already require tons of vaccinations to work, travel, and get educated
No. We require a few vaccinations dangerous childhood diseases if we want to put our children in a public school. You do not need to attend a public school to get educated, and there is a strong argument that doing so will in fact seriously hinder you from getting educated. You do not need to be vaccinated for typical work or travel. Since COVID is not a dangerous disease, and the people trying to mandate vaccination against it openly say that they hate me and want me dead, and are also trying to mandate all sorts of idiotic things that are clearly not for health reasons, it is pretty rational to be skeptical of such vaccine mandates.
How sure are you that if vaccination had gotten underway three months earlier it wouldn't have gotten slotted as Red coded behavior? That could have been even worse, given that the Blues have much bigger megaphones. Imagine a skepticism campaign in the NYT quoting Harvard professors on why the dangers of the vaccine were being hidden to make Trump look good.
I don’t think that was ever likely, because the Blues were never that wedded to anti-vaccine, and were always pro-intervention in COVID. The anti-Trump vaccine handwringing was just cheap partisan refusal to give Trump credit for anything positive.
The Blues of Europe were clamoring for a vaccine too, so I don’t think the democrats could have maintained that dissonance post-Trump.
You have a selective memory. Dems were initially 100% hostile to doing ANYTHING about COVID. It was "just a flu" and you were anti-science if you suggested otherwise. Wearing masks made you an immoral fear monger, and the most basic common sense action of "restrict travel from the country experiencing the outbreak of some unknown new contagious disease" made you an evil racist. It was only once it was too late to do anything and the virus was securely endemic in North America and Europe that they were willing to flip the script and start the "two weeks to flatten the curve" psyop. Boy, it has been a long two weeks...
- Many people get the memetic plague, and recover. Presumably this confers some manner of immunity, yet the aliens keep insisting that these people need the brain chip and indeed act as though having the plague and recovering confers zero protection against future plague infection. No discussion of the value of brain chips addresses this; the benefits are always in terms of never infected/recovered humans with or without chips.
I will try and write up some more on this issue on my own blog this evening... traveling for work keeping me busy all day.
Jordan Peterson has entered the chat. He loves the way that linguistic alignments reveal previously unseen connections. Frequently correct in that analysis.
Great read... you must have a nuclear reactor mod for your brain, I can't imagine having the energy, time and focus to write these pieces, but I'm grateful that you do. You're probably the only person I trust at this point to do a fair analysis.
I suspect a lot of this is that it is one of the 10 required beliefs of Red Tribe membership, and you can't pick and choose, or God forbid, take some from the 10 required beliefs of Blue Tribe membership. I seem to remember an old SSC about this
"For more evidence that the number of true young-earthers is fairly small, consider another question from the survey run by the National Science Board since the early ’80s. In that survey, about 80% consistently agree “The continents on which we live have been moving their locations for millions of years and will continue to move in the future.” Ten percent say they don’t know, leaving only about 10% rejecting continental drift over millions of years. Though young-earth creationists often latch onto continental drift as a sudden process during Noah’s flood (as a way to explain how animals could get from the Ark to separate continents), they certainly don’t think the continents moved over millions of years. This question puts a cap of about 10% on the number of committed young-earth creationists, lower even than what Bishop found. More people in the NSB science literacy survey didn’t know that the father’s genes determine the sex of a baby, thought all radioactivity came from human activities, or disagreed that the earth goes around the sun.
In short, then, the hard core of young-earth creationists represents at most one in ten Americans—maybe about 31 million people—with another quarter favoring creationism but not necessarily committed to a young earth. One or two in ten seem firmly committed to evolution, and another third leans heavily toward evolution. About a third of the public in the middle are open to evolution, but feel strongly that a god or gods must have been involved somehow, and wind up in different camps depending how a given poll is worded."
I think all of these surveys and analyses ignore cognitive dissonance and framing.
I know plenty of religious people who will agree with both "God created the earth and humans less than 6,000 years ago" *and* "The earth is billions of years old, and humans evolved over millions of years" - many would say they agree with both on the same survey, and even more would agree to either of them if asked separately.
Are these people young earth creationists? Depends on what you mean.
Also, almost all Christians say that the bible is true, and might say the account of creation is "true," but only biblical literalism says that it's "*literally* true", and even then, what literally means in this context is a bit fuzzy. And despite all of that, I strongly suspect that even most people who would say that the bible is literally true would also say that the earth is billions of years old if asked the question on a survey that was clearly not about religion, because framing.
Were I taking a survey that asked "was the forbidden fruit in the Garden of Eden an apple?" and it was a plain "yes/no" answer with no room for development https://en.wikipedia.org/wiki/Forbidden_fruit, and furthermore my impression of the entire survey was "ha ha let's laugh at the knuckle-draggers who believe in gods", then I'd be "Eff you, I'm one of those knuckle-draggers and not alone was it an apple, we know for a fact it was a Cox's Orange Pippin".
Numbers have falling a little recently. However, when you include people who accept that the age of the earth is older, but also (wrongly) believe that because evolutionary theory does account for some aspect of biodiversity, design is a reasonable inference - creationism in other words - the number balloons up to 60-80% of Americans being creationists depending on how you ask the question.
I wonder if this is the type of thing that you might cover in an epistemology/philosophy of statistics class. Every time I see something like this I just end up more and more confused about what kinds of reasoning is legitimate, and when does statistical evidence actually point to the conclusions that it naively says it does.
Great article, thank you! But I really wish you got the worm hypothesis advanced enough, in your view, to feel more than 50% confident that worms are a significant confounder.
Before your months late entrance into this, I recall looking up who maintained this site. Since I did that, I have associated it with the FLCCC Alliance.
Tonight, when I went to icann whois, the first auto text suggestion was for ivmmeta.com. I recall finding that it either shared a server or owner with FLCCC.
Caution, my memory may not be serving correctly:
I may have looked up information about FLCCC the same night, but I am quite sure my inquiries were at different times.
I may have connected them, because the "meta" and "C19" sites link to FLCCC.
I don't remember enough detail to give to say definitively what it was I saw that made me sure of a connection.
With the caveats out of the way, I will say I have high confidence that this site is indeed related to the Alliance.
But most alarming in my view is that there are identical sites for HCQ and Vitamin D. And the analyses appear to show similar levels of effectiveness as IVM.
I've been called both a BigPharma apologist/corporate shill and a pinko by anti-vaxers since the pandemic started. I'm certainly much closer to the latter, but it illustrates how generic heuristics can override judgement by otherwise rational people.
I have some speculations here, but a friend quite correctly pointed out it was hypocritical for me to get upset about NYT doxing me and also add useful information to the debate about who runs ivmmeta, so I'm not going to.
Fair enough. I wouldn't expect you to opine on it, nor criticize you for refraining.
I didn't want to wildly speculate, so I added the cautionary notes. I just wish I would have taken a screenshot. At the very least, I could (dis)confirm my memory with one. Then again, it's interesting trying to figure out ways I may have formed a mistaken impression.
Buried under all that is my real issue with those sites--the mirrors, the identical formats, shared servers, and anonymity all purporting to show three different treatments with similar effectiveness as an alternative to vaccines.
It screams ulterior motive or motivated reasoning to me.
Err, it's not doxxing to say that sites X and Y are run by the same person(s)? But I'm not sure how you or Kurtz would know: WHOIS does not reveal the owner of IVMMETA.COM and its About page gives no names.
This whole thing was really excellent, but it does give me an opportunity to ride one of my hobby horses:
Steinbeck's "temporarily embarrassed millionaires" quote was not an explanation for why the poor did not join the communist movement, but rather a sorta self-deprecating description of those who did. In other words, he was complaining about the champagne socialists who were in the movement, rather than aspirational workers who were not. https://en.wikiquote.org/wiki/John_Steinbeck#Disputed
Read up on "luxury beliefs" — fashionable beliefs that confer social status upon the elites who hold them, but lead to damaging consequences to those in the lower economic strata.
Scott, I really appreciate this careful review of the data on ivermectin. While it mostly matches what I already thought about the subject, it presents it much more clearly and carefully than anywhere else I have seen.
Which is why I'm so baffled that you are so confident that the covid vaccines are safe and effective that you don't even feel the need to present an analysis of the studies on the subject, and instead went with this analogy about aliens. Even though the Pfizer study to get FDA approval was just shown to be partially based on falsified data, and the all cause mortality was higher in the vaccine arm than the placebo arm. Even though the trial for children 5-11 did not show any clinical benefit at all (because no one had any serious outcomes in either arm). Even though no one has demonstrated any population level association between vaccination rate in a state or country and covid rate.
I really, truly wish I was as convinced as you seem to be that the vaccines are safe and effective. But it doesn't match my personal experience, and what I'm seeing in the world around me. I know that one shouldn't base one's epistemology on personal anecdotes, but I haven't found the studies on this subject nearly as reassuring as I would have hoped. I see everyone dismissing the sudden spike in VAERS reports because causation can't be proven--but why would the rate of reports suddenly increase so much compared to previous vaccines? All the papers I've seen about VAERS prior to covid suggest that it almost certainly underreports the true rate of adverse events from vaccines rather than overreporting them.
I know it's a huge, probably impossible ask, but if you could find the time to try to dig into this subject, I would be truly, deeply grateful. I want to be convinced, and I believe that I can be convinced that the vaccines are safe and effective (I actually am vaccinated, but based on the research I have done since then, I regret it and don't want to get the booster). I see vaccine denialists making obvious errors and exaggerations, but I also see them pointing out what seem to me to be serious flaws and shortcomings in the studies supporting vaccination. I'm not saying I think the vaccines are definitely unsafe/ineffective, but especially for young healthy people who are at low risk for covid, I'm not seeing the convincing case that getting vaccinated is statically a good idea that I would like to see, especially considering the many places that are now mandating them.
This is the ask I am also looking for, and hundreds (if not thousands) of Scott's readers and those influenced by him would also benefit from.
I have yet to find anyone willing to do this type of analysis once they've taken the shot. In my experience, it is the level of cognitive dissonance, being excluded from society, and the strong affect that being labeled "conspiracist" or "anti-vax" has that stops them from doing this work. I hope Scott would not be susceptible to that and willing to dig deeper.
I don't think I've ever seen anyone claim that we should vaccinate children to protect them; I'd presume we'd vaccinate children to protect their parents and grandparents. So the only relevant criterion would seem to be infectiousness.
How about polio vaccines? Children are still routinely immunized against polio, and last year there were about 150 cases of polio worldwide, all of them in Afghanistan and Pakistan. I would say the odds that a random American kid will get polio are far lower than the odds that he'll get a serious (life-threatening) case of COVID.
Children are not routinely immunized against polio because of speculative benefit for others, they are routinely immunized against polio because of a known benefit to the children themselves. Children can die from polio, and the vaccine does lower the chances of that happening. Known and proven benefit, to the child being vaccinated. The fact that the odds of that benefit proving useful are very small does not mean it is speculative, or that it is intended to benefit someone else.
I've heard lots of people claim the risk of COVID being "unknown" is a lot worse and scary than the risk of the vaccine, so the children's health was better off with this Uber-safe vaccine (which we supposedly have oodles of safety data for children on).
This reminds me of Scott's posts about masking. If we didn't have any data on this question, which risk is more plausibly concerning? It seems like we have almost no cases of modern vaccines endangering a child who is not immunocompromised, whereas you can probably find case studies for most infectious diseases in which they created serious comorbidities when striking young children.
Sure that’s a reasonable prior if you or your child is deciding whether to a get a new and insufficiently tested vaccine that might or might not help you avoid getting covid. It’s not a reasonable foundation from which you should try to force literally every person in the world to get the vaccine. I agreed with your prior. I got vaccinated. Since then pretty much all the data that has come out has caused me to update away from the vaccines being safe and effective. I don’t think the VAERS reports can or should be handwaved away. And even if the adverse reactions aren’t as bad as I think, the complete lack of evidence that the vaccines reduce transmission on a population level would be enough to make me think mass vaccination is not a good idea.
I’m not wedded to these beliefs. There is some evidence that vaccination is helpful, such as reduced rates of death from covid in the vaccinated. But the results on all cause mortality, which is what we really care about, are much more mixed. And more importantly, I haven’t seen anyone on the pro-vaccine side engage in good faith with what seem to me like pretty important criticisms of the vaccines. That’s why I would so much like to see a post on this by Scott, because I know that whatever his conclusion, it would be an honest effort to synthesize all the evidence, something I can’t find literally anywhere else.
I like this example, however I think it breaks down in the analogy of comparing this COVID-19 vaccine(s) to a modern vaccine. This vaccine does not have a comparable profile nor the decades of safety data of modern vaccines. I see this analogy made quite often, as thought its common belief ("comeone everyone knows vaccines are the safest thing in the world don't you know!") but where did this belief come from? What makes this vaccine comparable to modern vaccines besides the label that people use (call it a vaccine) and that you inject it into your arm?
This also why we vaccinate for chickenpox. Mostly harmless in children but much riskier for adults. We’ve never had more than 600 deaths from chickenpox in a year, but nonetheless it’s required in all 50 states. Measles, too, has never killed more than 1,000 per year in the states.
I never got chicken pox as a kid, now each year I ask myself: "do I get the vaccine this year, or do I hold out another year for a dead-virus version."
"In 1912, measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year." (https://www.cdc.gov/measles/about/history.html)
This would be a much more compelling argument if there was any evidence that mass vaccination reduced covid transmission. While it seems like intuitively it must do something, studies have mostly shown no correlation between a location’s vaccination rate and covid cases, and some have even shown a slight positive association.
There’s tons of evidence that vaccination dramatically lowers risk of ending up in the hospital. I live in an area with low vaccination rates and our ICUs were overwhelmed with Delta, so much that they had to hire hundreds of temporary health workers from out of state. Those same hospitals were actually loaning people to New York and NEw Jersey when the first wave hit.
How does that relate to vaccinating children, who overwhelmingly do not suffer significant consequences of COVID and almost never end up in the hospital, vaccinated or not?
It lowers risk of hospitalization...for adults. It doesn't lower it for children because they were already not at risk of hospitalization for covid. And it doesn't prevent children from transmitting covid to adults because it doesn't prevent transmission.
I would claim that. I vaccinate my kids against the flu, and that's a much less effective vaccine and a much less dangerous disease. What's the case for getting your kids a flu shot not a covid shot?
Besides, covid is both not particularly dangerous to kids and the number ten cause of child mortality, because nothing that we allow in our society is particularly dangerous to kids. This lets me remove (or at least dramatically mitigate) one risk from my kids lives. A remote risk, to be sure, but nonetheless one I'm glad to take off the board. I'd be happier to take the leaders off the board, but I can't get rid of cars or guns or cancer. Some of the other leaders I've worked pretty hard on. Drowning by making sure they can swim, and drugs and suicide by trying to raise them well and making as sure as I can that lines of communication are open between us and them. We do what we can do. This is something we can do, and it's a clear win in terms of their welfare.
I think any conscientious parent would get their kids vaccinated for their own sakes, quite aside from societal benefits. I'm not actually clear on the case against.
The case against is that there is some evidence that the vaccine increases your kids’ risk of dying from a heart attack or stroke more than it decreases their risk of dying of covid. The risk is still not high, but as you point out, it doesn’t need to be to exceed the risk from covid. Because we’re talking about such a small signal, the government would need to do very careful monitoring to detect it, monitoring that they’re not doing. The (highly imperfect) data we have suggests the covid vaccine is much more dangerous than the flu shot (and contrary to what you said, the flu is known to be much more dangerous to children than covid). Instead of trying to gather better data on the matter, health authorities have just said “Well, the data we have is imperfect, so we’ll just ignore it and keep saying it’s probably safe.”
Flu is probably more serious than COVID in younger children. But among the 5-11 age group neither is vary dangerous. That said it's unlikely the vaccine carries much of any risk either.
Also note the difference between a mandate, and an option. I don't know anyone who is against parents having the option to vaccinate their kids against COVID.
No, the flu is a much MORE dangerous disease for children than COVID is. The fact that media bullshit has become so prevalent that the majority of people think COVID is dangerous to children is both amazing and soul crushing. We are doomed.
>I'm not actually clear on the case against.
The known risk of serious side effects or death from the vaccines are higher than the risk of serious illness or death from COVID in children. This is pretty much the most basic and obvious simple probability decision one could be faced with.
You are wrong. More children have died from COVID this year than from flu. And long term negative side effects are way worse from covid. Including almost x10 chance of myocarditis compared to vaccine.
And their teachers, and school bus drivers, and neighbors, and non-parental caregivers... Now, it also seems to be the case that even when infected, children do not transmit the disease as readily as adults or (especially) adolescents, so you can still question the rationale and ethics of vaccinating little kids to protect others if the effect is small. But small children actually have pretty extensive networks of contacts, and they often include high-risk people.
Well, that's not even Medical Ethics 101. If that were true, we would never do organ transplants.
But apart from that, let me be clear that I am not a libertarian, not at all. I do not want to live in a world where people have no obligation to protect their communities unless it is in their personal interest to do so. I'm not persuaded, though my mind is open to revised information, that the community benefit from vaccinating little kids is large enough to warrant making it obligatory. But for adolescents and adults, I think it is a moral obligation to get vaccinated against Covid-19 unless you have a medical contraindication even though for the youngest among them, the personal benefit is very small.
How about treating pregnant women who test positive for Group B strep with antibiotics during delivery? This is done solely for the benefit of the baby, since it's endemic (and harmless) in the adult.
First off, a lot of children ARE dying of COVID - more and more over time. The deadliness of the disease in children is probably higher now than it was with the original strain.
Secondly, COVID causes significant long-term side effects in an appreciable number of people.
1) That's 605 confirmed cases. The actual count is larger.
2) Far less than half of under 18s have had COVID - probably less than 20%. It's amazing how you scream at me about "lack of data" but then make up a fraudulent number as a basis for your argument.
Post-COVID syndrome is well established at this point, and seems to affect somewhere in the realm of 5-10% of people. It's quite common.
People just are in denial about it because it means that they were wrong about everything and were downplaying a very serious disease. They aren't stable geniuses after all.
Without numbers this is just spreading fear which itself can contribute to ill health. How many otherwise healthy children, ie children that would not be in mortal danger from any other infection, have died from COVID in total? How many would have died from the flu in the same time frame?
People just go into denial about it because they don't want to admit that they were wrong.
And somewhere around 5-10% of people who get COVID suffer long-term problems from post-COVID syndrome. It seems to be modestly lower in children, but it still shows up in them fairly frequently.
How many 85 year olds do we need to "save" from death by COVID so they can instead die 3 weeks later from pneumonia or influenza or heart failure, in order to justify killing one 6 year old?
That is a red herring. Answer the question. If you want to justify forcing a dangerous vaccine onto children, knowing it will kill some number of them, in order to slightly prolong the life already dying elderly people, then you need to quantify the value of those lives. Unvaccinated healthy children have a zero risk. None have died. Zero. Morbid obesity is a co-morbidity. Morbidly obese children are not healthy. Those teachers and parents are welcome to vaccinate themselves if they are worried. You do not force innocent children to take dangerous vaccines because you are worried about yourself, YOU take the dangerous vaccine. It is highly effective at preventing death, remember? So why do you keep dishonestly acting like everyone else needs to get vaccinated as if your vaccine won't work to protect you? If you taking the vaccine doesn't protect you, then why would anyone else get it to protect you? That is absurd.
Isn't VAERS self reported? If people have a lot more concern about this vaccine, AND all of that concern is unfounded, wouldn't you still expect to see a spike in self reports which misattribute random issues to vaccines? It would also be true in that case that VAERS might go from underreporting to overreporting problems.
Any future investigations into VAERS might deploy an RCT design where half of participants are given a placebo and allowed to self report their side effects regardless... mostly joking.
I'll also bring out the big gun here: even if I was convinced that the most plausible accounts of coronavax side effects were true, they seem mostly minor. For the vast majority of people, and for society at large, there's no question that the vaccines are net life and QoL preserving, even if we accepted the marginal claim about side effects. This is of course hypothetical because there doesn't seem to be either good mechanisms or solid evidence behind any side effects claims.
VAERS is doctor reportet and the CDC itself says that the main problem with it is underreporting. Dimissing the huge VAERS spike in deaths as antivaxxers trolling is steping into the realm of hermetically sealed circular reasoning. It's also literally a conspiracy theory about a global conspiracy to fake high numbers of adverse events into various reporting systems like yellow card, UK and PEI, Germany.
I didn't say it was antivaxxers trolling. The most likely cause is genuine concern and worry. It isn't hard to imagine that people could wrongly attribute health problems that would've emerged regardless to a vaccine that they have mixed feelings on. The vaccine is being rolled out at scale in an unprecedented way with a very particular media environment around it so I don't think you can take the change in reporting as anything but a several confounded measure.
Look at ivermectin or any of the other drugs we've failed to prove help covid. They get studied because a doctor gives them to patients, the patients feel better, and the doctor notices. Without blinding, randomization, and large sample sizes we can't tell if "some doctors/patients say they have a good/bad feeling about this" is signal or pure noise.
At the very least, you ought to concede that it's plausible that the change in reporting could happen without changes in the rate of actual negative vaccine reactions. I'm not saying that's definitively true, but if you can't dismiss the possibility of a null result then your evidence isn't very solid.
Yes, I concede that it's plausible that VAERS could be overreported due to the unusual attention given to the covid vaccine and covid in general. I would also like you to concede that it's plausible that VAERS could be even more underreported than usual due to the unprecedented push by public health authorities to get everyone vaccinated, including suppressing too much discussion of adverse events and calling anyone who questions the safety of the vaccines a peddler of misinformation. I don't concede that your hypothesis is the default hypothesis and mine is something that would be extremely surprising (I think the default hypothesis is that VAERS has the same amount of underreporting as usual). I would very much like to see some serious investigation of the matted to find out what is actually the case instead of apparently just ignoring the whole thing.
"VAERS accepts reports of adverse events and reactions that occur following vaccination. Healthcare providers, vaccine manufacturers, and the public can submit reports to the system. "
Would you therefore agree that any sub-population that does not have a net life and QoL gain would be reasonable to conclude that the vaccine is optional and not a big deal?
Would you also agree that if there were some concern of side effects, and the net QoL gain from the vaccine were small enough, that it may actually make sense to avoid the vaccine? Children have such a small rate of serious complications from COVID that even a very small rate of side effects would mean that taking the vaccine reduces QoL.
For sure. I don't think kids are that important of a subgroup to worry about in terms of controlling the coronavirus, especially since we've moved away from a zero covid approach. I think both of your arguments are reasonable in form and would be true if they had true premises. But there aren't good reasons to think there are meaningful side effects, so these arguments don't apply.
My understanding of the side effects are that they are very real, but quite rare. [Some argue less rare than we think, but it sounds quite speculative to me. I haven't seen any claims at all that there are zero side effects.] There are some who don't recommend giving the vaccine to young men, particularly teenagers, because the cardiac complications show up primarily in that group and they gain far less from being vaccinated than older individuals. The case for children getting vaccinated is worse in that regard, because the hospitalization/fatality rate among children is so low than even a nearly non-existent side effect can still be the same or higher than the actual effects of COVID.
For context, the way VAERS is *supposed* to work is that **every** adverse event that occurs within `n` days (14 IIRC) of being vaccinated must be reported (there is allegedly a legal obligation to report). This means if you get a vaccine and then die from a gunshot wound to the head 6 days later you **must** report that to VAERS.
The system, as designed, is intentionally meant to avoid individual physicians trying to determine causality. Every event "must" be reported regardless of how obviously not-vaccine-related it is, and then statisticians presumably will analyze the data in aggregate afterwards and compare it against background expected death rates or population comparable death rates and look for signals of unexpectedly elevated levels of specific events.
As an example of why physicians determining causality is a bad idea, one can imagine vaccines causing mental instability that leads to suicide. Individual physicians would almost certainly assert that "the vaccine didn't cause suicide, so I shouldn't report it", but when looking at population level statistics one might notice a sharp rise in suicides among vaccine recipients and that would signal that we (society) should investigate the issue further to determine if there is a causal link or not.
It was easy enough to find the CDC statement "FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS," but I couldn't find the timeframe so I'm curious where you saw 14 days.
Yeah, I tried to find a reference after writing this post and was unable to find the 14 days either. I have a similar comment to this elsewhere in this mega-tree discussion where I believe I corrected my claim. I didn't reply here because this particular branch looked like it was a dead end while the other had more engagement.
I'm unvaccinated ( But am keeping an open mind ), and agree with all of the points you raised. These are issues that are hard to ignore, or at least difficult to explain away. Would be interested in hearing the other side of the argument though.
Just throwing my vote out there to see a similar dual steel man and analysis of the "vaccines are safe and effective" argument.
After reading this article (the entire thing) I walked away thoroughly convinced that the author is someone who understands nuance, the scientific method, the concept of spectrums and grey, trade-offs, and how to identify low quality science and confounding variables. However, this leaves me confused how such a person could look at the totality of evidence related to the vaccines and walk away with what sounds like near total conviction that the vaccines are "safe and effective". When I look at the totality of evidence I walk away about as confused and uncertain as I think I could possibly be on the matter, and this is after a lot of digging and with some understanding of the biology behind vaccines (including delivery methods).
I think my personal confidence in the safety and efficacy of the vaccines comes from living in the UK, where we have very good data on all cause mortality and morbidity on a population level. We have given 50m first doses, 46m second doses and 13m booster shots.
We know from data released weekly that Yellow Card (our version of VAERS) reporting is between 3-6 reports per 1000 cases, and that most of these are mild symptoms like a temperature or sore arm following a dose. These would be expected at a rate of 1 in 10 anyway given the vaccine trial data.
Anaphylaxis in very, very rare situations following the vaccine itself was quickly identified as a problem from this data. It's enormously rare (256 cases/109m doses) but precautions were quickly taken to ensure that any severe issues were mitigated – this by introducing a waiting period.
Bells Palsy was identified as a possible side-effect, but it's not actually occurring within the population at a higher rate than would be expected normally.
The big one was clotting with the Astrazeneca vaccine, which occurred at a rate of about 1.9 cases per million doses. The population was of course at more risk of clotting by catching coronavirus itself which everyone would have done without a vaccine. This was mitigated by only giving at risk groups other brands of vaccine. Still incredibly rare, but did lead to a small number of deaths.
About 1,000 cases of myocarditis and pericarditis have been reported to the MHRA, causing 5 deaths. For some reason Moderna has 7x as much risk of this as Pfizer and Moderna.
Basically it comes down to the fact that you have about a 26 in a million chance of dying in a car crash in any given year in the UK. The risk of dying as a result of taking the vaccine are in the region of 1 in a million. So a 26th of the chance of driving in a car, which people do all the time without thinking twice about it.
I think most people would describe a Honda Accord as safe and effective at getting you from A to B, if a little uninspiring. Pretty much any Covid vaccine is 25x safer, especially given the death rates pre-vaccine from catching a disease that essentially everyone would have got.
20-49 yo's had a death rate of 1 in 300, (remember, vs 1 in a million for vaccine complications), 1 in 72 people aged 50-59 died, 1 in 27 aged 60-69, 1 in 12 for 70-79, and 1 in 7 over 80s.
Vaccines *are* "safe and effective", as long as you give them the right context, which is the emergence of a pandemic which would have a much, much, much higher chance of killing me.
As far as I can tell, having an allergic reaction to the vaccine is the big danger with it--that can kill you. It's very rare, but you don't want to be far from medical help (or at least an epi-pen) if it happens!
Otherwise, it seems like all the vaccine side effects reported are less bad than the effects of getting covid.
That's true, but the alternative to vaccination isn't getting Covid, it's a risk of getting it — although, as things are looking, it may be a high risk. And vaccination doesn't eliminate the risk, it only reduces it.
Your Honda comparison isn't quite right, because those are per year death rates, not per trip death rates. One vaccination is (much) safer than three hundred trips (or however many the average UK resident makes in a year).
Honestly, I feel like a lot of the VAERS spike comes down to two things. 1) A lot more people are being vaccinated for this than for other things, and 2) People are actually being told about VAERS and to report any adverse effects.
Addressing the second point first, my second Pfizer shot hit me about as hard as the worst night of my smallpox vaccine. For the Covid vaccine, I had a handy-dandy piece of paper giving me a website I could have reported the fever and chills etc.; for my smallpox vaccine, I didn't even know VAERS existed. I was certainly never told about it when getting yearly flu shots. I would be willing to bet hundreds of dollars that at least part of the increase is being driven by increased awareness of VAERS.
As for the increased number of vaccines, let's again compare smallpox and Covid. VAERS reports 36 cases of "Body Temperature Increased" for smallpox adverse reactions. Since 1990 when they started collecting data. I can give you arbitrarily high confidence that more than 36 such cases have occurred in the last 31 years. That's a rate of basically one fever per year, which is unrealistically low. For Covid, they have 6,685 such cases in what, just over a year? NPR says that 195,000,000 Americans have been fully vaccinated, so if we think that VAERS is being remotely accurate we would conclude that something like. .003% of fully vaccinated Americans got a fever? But I'm pretty sure it's higher than that.
So I'm not saying that people are over-reporting to VAERS. I'm saying that more people are being vaccinated and they are *under-reporting less* than they have for other vaccines. If you combine those two things that I feel are fairly obvious, it goes a long way to explaining the influx of VAERS reports.
All of these claims have been made numerous times, and been relatively soundly argued against or integrated into the "vaccine may not be safe" arguments. This is why I want to see an in depth analysis like what was done here for ivermectin, that first tries to deeply understand the specific claims being made and then argue against them clearly. There is a lot of debate happening in comment sections (like here), but I think the world would get far more value from a deep analysis with strong steel man positions being setup and then torn down rather than people arguing against straw men.
To go against what I just said, I'll give you a bit of a debate here in the comments since I don't want to come off as entirely dismissive.
The TL;DR is that either VAERS is not a useful tool for detecting adverse events in the wild because we cannot know the underreporting factor (due to many confounding variables as you have suggested here), in which case we cannot know whether the vaccine is safe because we have no good data, or the VAERS data can be used by applying an underreporting factor using reasonable and (ideally) previously agreed upon heuristics (which do exist), in which case there is a strong danger signal coming out of VAERS that should cause everyone to pause until it is investigated much more deeply.
I am willing to accept either of those positions as reasonable, but I haven't seen any strong arguments for "the vaccine is safe", and this is what I want to see.
The CDC (or maybe it was the FDA) seems to assert an underreporting factor of 1 (meaning 100% reporting compliance), but provides no evidence for why one should believe that and we have some pretty strong evidence that it is definitely not 1. Of course, someone can come up with an underreporting factor that is greater than 1 and still shows the vaccines as safe, and then they can derive a plausible way to get that underreporting factor (using the line of thinking you have above), but that feels very much like p-hacking or adjusting the endpoint of a study or deciding on grouping/analysis methods after you have the results (which as stated numerous times in this article is bad).
If you use the "official"/previously agreed on methodology for calculating the URF, then you get a strong signal for "COVID-19 vaccines are dangerous". This doesn't mean they *are* dangerous, but it does mean the alarm bell is going off loudly in our signaling system and we are saying "eh, we can't really trust the signaling system so let's just pretend like the alarm isn't going off and say that vaccines are safe".
I guess we should start by defining our terms. What are we counting as safe versus dangerous? I think my cutoff for safety would be something like "If properly administered, unlikely to cause life-threatening conditions or chronic adverse responses." I'd be willing to take input on a better definition (as well as a good % cutoff for "unlikely").
I think that is a reasonable definition of "safe".
To make a blanket statement about safety I would want the % to be on the order of 0.0001% or lower I think, beyond that I think it becomes "safety is relative to its benefit" so things become significantly more complicated. Eating salad is blanketly safe. Drinking water is blanketly safe. Traveling by car is not blanketly safe, but it is safe relative to its benefits in many (most?) contexts.
Coming back to this comment after actually browsing the VAERS data for a while. I'm curious what you think the VAERS data shows in regards to Covid vaccine safety (or lack thereof). Specifically, do you think the signal is the mere volume of reported adverse effects, or some specific subset of them?
The signal is the significant increase in severe adverse events after accounting for the underreporting factor (URF) when using the standard mechanism for calculating the URF.
Again, I want to reiterate (so it doesn't get lost in discussion) that I accept "we have no functional monitoring system for vaccine safety" as a very reasonable position to hold. The *only* position I am opposed to (at the moment) is that we have good statistical evidence of vaccine safety.
There is a lot of debate around whether the standard mechanism for calculating URF is reasonable or not and the arguments that it is not reasonable are sound IMO. What is fairly unacceptable to me is to construct an alternative method for calculating URF post-hoc, since in my experience those new measures always seem to magically come out in favor of whatever position the author holds prior to constructing the new analysis method (this is true for both camps).
You are vastly less likely to be hospitalized and die *from covid*. I don’t dispute this. But for those whose risk of serious outcomes from covid was already very low to begin with, even a fairly low risk of adverse events from the vaccine could lead to more total deaths among those who got the vaccine than those who didn’t. There is no good data on this, but there are some concerning signals from the clinical trials and VAERS that are not being properly addressed.
Why this is true is unclear, though my personal guess is that people who get vaccinated are probably more intelligent and more conscientious in general.
Your personal guess suggests you may be a midwit. Both high and low IQ, and high and low educational attainment are strongly correlated with "COVID vaccine hesitancy". It is precisely those who are smart enough to know they aren't dumb, but not smart enough to actually understand the issues they are faced with who are most likely to conform to the arbitrary and baseless demands of authority figures they perceive as being on "their team".
"but why would the rate of reports suddenly increase so much compared to previous vaccines?"
It's a passive reporting system. More people are aware it exists, and more people are aware that we need to figure out any rare side effects, so more people report adverse events.
I realized there was some confusion and people thought I originated this hypothesis (or was stealing it from you), so I've tried to credit you more conspicuously in the piece. Thanks for everything you do!
No my issue is not that you didn't give me credit. My issue is that you're using my outdated analysis (really a back of the envelope analysis) which is susceptible to some critiques. I am offering you a formal analysis which is not susceptible to the critiques raised by others in the comments here.
"Putting aside the question of accuracy and grading only on presentation and scale, this is the most impressive act of science communication I have ever seen." -- surely something that can make you confident that you have learned something true when in fact you have learned something false is *bad* science communication even if the information is accurate, right? One takeaway from this post seems to be that this kind of chart isn't a good way to communicate science even when the underlying claim is true, because it provides a false sense of confidence and promotes a common misunderstanding of how progress in science actually works ("just take all the effect sizes from the papers and put them together without stopping to understand all the underlying science / which papers you can trust / what sorts of evidence experts are used to seeing for claims that turned out to be false /etc.)
"Can something have a p-value less than 0.001 and still be a fluke?"
Yes of course!! P-values only measure the probability of flukes under the null hypothesis assuming everything went exactly according to plan. But there are lots of boring flukes (a table got mixed up somewhere in the data entry process, the randomization got screwed up in a way the balance tests missed, a doctor felt bad that these patients were on a deworming drug for a virus and slipped them antivirals, etc.) that are unlikely but not "literally one in a thousand" unlikely.
I can't remember which it was, but when looking at all the trials about this, one at least of them had a correction that was along the lines of "ooops, yeah, one of our control groups wasn't because they got given the same combination of medication until we found out".
Scott, and anyone else, what makes you so confident in the COVID-19 vaccines? Have any of you looked at the data for them after the past year?
Under the "Political Takeaway" section, you write this:
"But the basic issue - that the vaccine works really well and is incredibly safe for adults - seems beyond question. Yet people keep questioning it."
I'd love to stop questioning it, really, but I can't see the raw data. And neither can you. As a fellow human, the aliens have all this sophisticated and powerful technology, and a year+ of data of the new tech being used "successfully", however they won't share it. They've locked it all up in vaults that only their peers can access, and whenever I ask for where I can go to view the data, they refer me to VAERS (an unreliable, under-reported and discredited database). They then go on to discredit it themselves and assert their belief of how only they can ever really know what the data means.
Case and death rates in countries/stayes with different vaccination rates are pretty easy to find, if you don't trust the studies that have been published around the vaccines.
Looking at those, the obvious conclusion is that vaccination is effective against death but not against infection — the patterns look similar to those before vaccination.
It may even be true, since vaccinated people have less reason to take precautions.
Be careful. A major confounder is that the vaccines were built against alpha, but it's delta that's dominant in the latest surge, and delta is inherently way more infectious. Comparing novax/alpha rates to vax/delta rates is a bit apples and oranges, alas.
But comparing low vax rate countries to high vate rate countries at the same time and seeing no statistically significant difference in cases, only in deaths, is apples to apples. And confirms what we've known all along, but many people have tried to pretend we haven't, that the vaccines are leaky, and have never been intended to, claimed to, or tested for, preventing transmission. People do not want to admit this, because then it would also be obvious how irresponsible and immoral pushing it in the middle of an outbreak was. That is precisely WHY there is a delta variant. If you keep transmission, but reduce symptoms, you are removing the natural evolutionary pressure towards lower lethality, so instead you get mareks.
You have gone pretty hard against cluster randomised trials!
"This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc)."
The same argument could be made against individual based randomisation, eg "there could be differences between these individuals (eg one might have chronic diabetes and do poorly, one might be in excellent health and do well)".
Cluster randomisation and individual randomisation are basically the same except that the denominator in a cluster randomised trial is not the number of individuals but the number of clusters (the unit of randomisation).
There are situations where doing cluster randomisation *is* the best thing to do, for example when you think there could be interactions between individuals in the clusters (the example I have in mind in mass drug administration for an infectious disease, give it to a whole village - the cluster - and you can wipe it out, whereas if you give it to individuals at random they can then re-infect each other).
In Scott's defence, he wrote, rRCTs are never a _great_ idea. I think he implied that a cRCT is not a good idea if individual randomization is possible. Which seems to be the case here.
Related to this: I immediately updated my lecture slides on cRCT to include "If you’re going to do cRCT (...), you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics". Hence, hospital discharge, as it has been used in the study under consideration, is not a good endpoint for a cRCT.
I think the issue is that cluster randomization will multiply the effects by the number of patients in each cluster. E.g., if 100 patients are in a crappy hospital where everyone gets sick, and that hospital is randomly assigned to the control group, then you'll see 100 control patients get really sick, which is a big number that could swamp any smaller effect you're measuring.
If you're using the # of clusters as the denominator then it should still even out (it'll just be a really small sample size), but unless I'm misunderstanding, the meta-analysis added up the number of patients in each study, not the number of clusters.
If you have 10 clusters of 100 people and do a cRCT, you have 10 data points instead of 1000 data points. It is hard to get statistical significance with 10 data points.
So correcting the analysis might not solve the problem.
Somewhat related story: for a class I was messing around with data from the COVID-19 School Data Hub and found out that their preliminary write-up on Virginia (https://www.covidschooldatahub.com/preliminary_research) had a pretty big flaw. Emailed the researchers and they said I was probably right!
Essentially it's Occam's Razor (paraphrased): stupid mistakes are much more common than conspiracies or manipulation
I thought it was a really good article! As a lay person, getting to go inside of the mind of someone with a more trained eye for evaluating scientific papers was helpful.
I will say that your comment "half of Americans are young-earth creationists" (I assume you are talking about Christians in general?), while possibly true but also feels like a straw man, may also breed the same mistrust to certain readers as in your analogy of the humans to the hostile aliens. It kind of cheapens what was one of the main points of your article (or as I read it): Don't talk down to people.
I honestly distrust such results about Christians and creationism because I have no idea how the surveys phrase such a question, and what they think they mean by it, and what the respondents think they mean by it, and what the survey takers think the respondents mean.
E.g. "Survey wants to find out how many Young Earth Creationists are out there"
Sample 1: Do you believe humans were created by God?
Sample 2: Do you believe the Earth was created 6,000 years ago and humans were created in their current form then?
Sample 3: Do you believe God created the Universe?
Question 2 is the one that will get you the Young Earth Creationists (most probably). But if you, the survey-taker, think that questions 1 and 3 are *also* measuring Young Earth Creationists, you're wrong.
But if the survey-takers aren't careful as to what they mean/think they mean/think the respondents mean, I get lumped in with Young Earth Creationists. Because everyone who believes in (Christian) God is a Biblical literalist, right?
Certain polling firms like PPP will ask ridiculous questions that have some political or ideological tilt to them and get above 30% of people in support. I swear if you asked people whether Joe Biden was Muslim you'd see at least 30% of people say yes. Survey respondents are usually answering based on what answer they think fits the "team" that they're on.
Also, how many people asked a question about some weird thing they never think about that's strongly associated with their tribe are trying to give you an answer based on their careful thinking through of the question?
They did publish which question they used in the poll though. In this case, it was "Which of the following statements comes closest to your views on the origin and development of human beings? 1) Human beings developed over millions of years, but God guided this process; 2) Human beings developed over millions of years, but God had no part in this process; 3) God created man in present form", of which 38% replied 3. It seems your answer might be 1, in which case you wouldn't be lumped with them.
You can still attack it of course by pointing out that option 3 doesn't strictly include the young earth part, or by saying that there could be sampling bias (eg it was conducted with telephone interviews). Or by bringing up that people behave wildly inconsistently on polls.
The funny thing is, in 2009 there was a [poll](https://ncse.ngo/americans-scientific-knowledge-and-beliefs-about-human-evolution-year-darwin) with a bunch of true/false questions. For "God created the universe, the earth, the sun, moon, stars, plants, animals, and the first two people within the past 10 000 years", 39% said true. For "The earth is less than 10 000 years old", 18% did. (And 60% for "All people are descendants of one man and one woman — Adam and Eve"!) So uh, yay polls!
Option 3 doesn't just fail to strictly include the young earth part, it doesn't even imply or suggest it. If someone believes God created the earth billions or years ago, and man in present form a million years ago, this would label them a "young earth creationist", which they clearly are not. For a claim that is so specific and easily defined, posing "which is closest to your belief" questions can only be deliberately trying to skew the results. If they wanted an accurate result, they would simply ask "do you believe God created the earth 6000 years ago?".
You can also ask a question that doesn't target religion but does test belief, for example "have continents been moving around for millions of years?" I gather that gets a "yes" from most people, inconsistent with the YEC results. Which suggests the YEC question is being interpreted as "are you loyal to your tribe" not "what do you actually believe"
I think it's worth mentioning that helminths are a bigger problem in the US, particularly the South, than is commonly known. Enough so that it could be a relevant factor in studies here, IMO.
Great post! every time I see work like yours, my faith in humanity increases. Taking such a deep dive in such a divisive and already not-so-relevant topic (given availability of actually working therapeutics like dexamethasone and fluxovamine, not to mention new Pfizer and Merck drugs) just for the sake of getting things straight - that's admirable!
What we see with Covid is that people who refuse to get the cybernetic brain implant are still going to the hospitals run by aliens once they experience symptoms of the quantum memetic plague. If you trust aliens/doctors enough to treat you when you're sick, you should trust them enough to get the vaccine.
This argument reads as being in very poor faith to me, because vaccines are in the category of "long-established methods." Of course, this hinges on how relevant you consider the "Untested mRNA Technology" argument, versus how much you're willing to think of the current options as stock-standard vaccines. I think it's pretty reasonable to conclude that DNA-in-vector and mRNA-in-vector vaccines have been safe and overdue for use since ~2005, but it sounds like this might be a crux between us.
It's not an entirely different mechanism of action. It uses the same pathway and same mechanism as a weakened virus vaccine, the principal differences being (1) it uses a lipid nanoparticle instead of a protein coat to get into the cell, and (2) it uses stabilized mRNA instead of DNA or RNA. Also, it's assembled artificially instead of by some other organism. To be sure, those are not necessarily trivial differences, but the *mechanism* -- the route by which it gets into the cell, the route by which it provokes in immune response -- is very similar to what natural viruses do. Which is of course why it was a no-brainer to try it.
Considering how virtually every mention of mrna vaccine technology prior to 2019 are things like "persistent safety problems" and "seemingly insurmountable issues with safety" and "will likely never meet regulatory approval" I think it is pretty reasonable to conclude that they have not been safe or overdue since 2005. Remember what moderna is? A company founded and absurdly overvalued based on bullshit promises to deliver mrna based treatments for everything, which ended up (exactly as expected and predicated by scientists rather than suits) never being safe enough in animal trials to even attempt human trials with? So they had to resort to trying to make some "much less lucrative" vaccines instead?
The doctors and nurses in the hospitals aren't the aliens. They are humans who may be a bit too eager to trust the aliens and take orders from them and collaborate with them, but they're still mostly on our side. They're *probably* not going to secretly put the cybernetic brain implant into you while you sleep.
My doctor told me there is no reason for me to get the vaccine. So did my uncle, who is a doctor, but not my doctor. I trust them both. Your assumption that all doctors are pushing an experimental, unapproved vaccine on people who have no reason to take it is not a good one.
> although rationalists did no better here during the early phase of “looks promising so far” than anyone else
You sure? I have the sense that people in the LW orbit were much more likely to say "we don't know" than the placebo group of smart-sounding people on Twitter. Don't know how I'd go about quantifying that, though.
Compared to a random sample from Twitter, we're probably better, but compared to the baseline of "ignore the small studies and wait for the FDA/CDC to weigh in" we didn't really cover ourselves in glory.
Back when hydroxychloroquine was in a similar "looks promising so far" situation, I remember a lot of people here and in adjacent spaces patting themselves on the back for finding out about a new treatment so quickly, and wondering when the medical establishment would finally catch up. Oops.
For the worm hypothesis, you could find some interesting evidence for it by looking at the IVM prophlyaxis studies. If the IVM only lowers severity by avoiding hyper worm growth, it should have basically no effect on preventing getting a COVID case. Triangulating the evidence would probably strengthen your case, would you try that out or read an analysis of that? OTOH it would be puzzling otherwise. The prophylaxis results are at the bottom of this table https://ivmmeta.com/#fig_fp .
Perhaps reconsider including Mayer et al. Or rather, given the potential for that choice to swing your analysis, you might take more time to consider your logic on excluding it. Yes it is not an RCT. But the point of RCT is to even out factors among both groups to not favor either the control or the threatment. It's highly improbable for obese, diabetic, many other co-morbidities IVM group to outperform, given even one of those conditions increases hospitalization / mortality risk around 1.5 to 2x (from my fallible memory). P(results | ivermectin is working in high parasite places AND Argentina is a low parasite place) should be quite low yet the results are more improbable than the unadjusted p value p<.03 stated in the post. Is an adjusted analysis where they regress to mostly remove those differences, more informative for that probability i.e. "risk of death, 55.1% lower, RR 0.45, p < 0.001, treatment 3,266, control 17,966, adjusted per study, odds ratio converted to relative risk, multiple logistic regression, Figure 3." ?https://c19ivermectin.com/mayer.html
If helminths are suppressing immune response in a way that makes it harder to fight off covid, you might end up being less likely to develop symptomatic covid (or serious symptoms) once you've treated your worms--you still catch it but your immune system is able to ramp up fast enough to clear it out before it does much to you.
I'm not sure how you would test that. But if you're likely to have some sort of parasitic infection, it seems like treating it is a good idea. (Though ISTR there are some parasitic infections that will make you sick when you treat them.)
This is true, at the same time the effectiveness seen in the 60-80% range implies you'd need at least 60-80% parasite prevalence (since you need parasites in this theory to have an effect). This paper on prevalence (which is for one parasite) is 10-15% in e.g. India for example https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/
If parasites have such a huge impact on disease mortality for COVID I would think we should see increased mortality in Africa and these regions, which also have less healthcare capacity, so that is puzzling also. I would expect to see discussion of such a major issue (parasite infections causing worse viral disease or other infectious disease outcomes) and commonly discussed in public health, I have not seen that in reporting but maybe no one has studied that or noticed, or perhaps I am just ignorant.
There are many mechanisms of action for IVM against viral infections from binding to viral proteins or receptors, and IL modulation. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8203399/ I was surprised to not see Scott bring those up, it's not like there are no mechanisms (it's moreso that without any mechanism we should be much more skeptical, not that mechanisms necessarily increase probability it will work).
There is also a dose-response IVM effect seen in the Mayer paper, which some commenters say is evidence for causality, but I am unfamiliar with methods work on how to evaluate that.
The other thing IVM proponents harp on for study quality is not dosing IVM with fatty food, which effectively decreases the dose by 40-60% by my rough memory.
Of course comparing mortality between countries is very fraught, age pyramid, etc, but I'd think the effect would be known / discussed in public health about the region. Instead I see particular campaigns against parasites with terrible symptoms like river blindness from tsetse fly.
This argument "This is true, at the same time the effectiveness seen in the 60-80% range implies you'd need at least 60-80% parasite prevalence (since you need parasites in this theory to have an effect). This paper on prevalence (which is for one parasite) is 10-15% in e.g. India for example https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/" Was wrong because parasite prevalence is actually in order of magnitude of the absolute risk of death in the studies (ie the number of people that died all could be explained by parasites). At the same time largely iatrogenic parasite deaths from steroids replacing all actual covid deaths is a bit odd.
I can't see that others have pointed this out yet. The analysis linked in Avi Bitterman's tweet, which looks at the effect of ivermectin in regions (of high, medium and low prevalence of Strongyloides) doesn't actually find a significant difference in risk between those subgroups (p=0.27). That is, there isn't evidence that there's an interaction; that it's effective in places with high prevalence but not effective in places with low prevalence. The effect in the high prevalence regions individually is also barely significant (p=0.02). This is an example of the idea which Andrew Gelman popularised, that 'the difference between “significant” and “not significant” is not itself statistically significant'.
Good point. Also, as I mentioned in other comment, the prevalence of Strongyloides stercoralis infection is estimated at ~10-15% in high-prevalence areas. It's an interesting idea and it could be true, or it could be a little too clever. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/
Unfortunately the author of this article is using my old analysis, which was really just a back of the envelope calculation. My current (and more rigorous) analysis contains the true model which is the meta regression which is significant. And the dichotomization does reveal a significant difference between subgroups. And the effect of high prevalence regions was significant at P=0.008
This was a much better and more important post than the title led me to expect. The last few sections are Toxoplasma-of-Rage-level good. (Parasitic infections bring out the best in Scott, apparently.)
The argument about filter bubbles and aliens goes further than it needs to, though. Scott seems to be trying to steelman Ivermectin support as a dry epistemic determination when it's clearly motivated reasoning. Ivermectin enthusiasts want it to be a good treatment because they don't want to take the vaccine. They don't want to take the vaccine because it's a Boo Red Tribe button. It's a Boo Red Tribe button because it got politicized. Also, the aliens in that Red Tribe view aren't immunologists, but the political and cultural elites whom they (somewhat correctly) model as being willing and able to control the narrative of What Immunology Says.
I have been vaccinated. I suffered no ill effects, but from what I'm seeing in recent data I'm not at all sure that I actually got a real benefit from being vaccinated. At least not a long lasting one. I'm thinking that the best strategy would have been to get deliberately infected with a recent wuflu strain (delta?) a month or two after vaccination because it looks like vaccination does limit immune system overreaction for a few months.
I also completely do not understand why the vaccine enthusiasts want to vaccinate people who have recovered from the disease. This makes no logical sense to me since if you have had the disease you almost certainly have a decent (likely very very good) immune system response anyway and the vaccine isn't going to help. If you were infected and for whatever reason you don't have a good immune system response why is a vaccine that works by triggering your immune system going to do any better?
The CDC claims vaccination is more protective than previous infection. The Israeli study, with a much larger sample size, claims previous infection is more protective. On the other hand it also finds vaccination plus previous infection still better.
Wow. Now that you lay it out so clearly, I wonder how this hasn't been part of the standard story about Ivermectin since day one? "It doesn't do much against Covid on its own, but it *is* a good dewormer; getting Covid while having a worm infection can make the Covid more dangerous, so people who get Covid while they may have worms can benefit from taking Ivermectin". It seems so obvious when you put it like that.
Surely the people who did those studies in areas of the world where worms are endemic, would have been aware that probably a lot of the patients in their study groups had worms, and that therefore Ivermectin being a dewormer probably had something to do with its effectiveness? Wouldn't they check for that?
In the summary, Scott writes "Parasitic worms are a confounder in ivermectin studies." Wouldn't another valid conclusion be "Ivermectin *actually does work* to reduce Covid symptoms, in the subset of patients who happen to have a parasitic worm infection? Which may be a nontrivial percentage of patients, depending on which area of the world we're talking about.
Thanks for making this comment. This article also confused me insofar as, once it had assembled the evidence, I thought the conclusion was going to be "ivermectin kills all the helminths you might be hosting, without any side effects, and as a massive bonus, that will make you more likely to survive covid in the case where you happened to be harbouring helminths, basically for free, so yay ivermectin, let's give it to everyone"; but instead it went back to "ivermectin is for gullible rubes". Huh?
Like, am I really the only one here who read this and my take-away was, whoa I should probably do some ivermectin just to be safe? I live in a temperate place but I have travelled in wormy areas, and Scott just convinced me that I should get some ivermectin! What's the downside?
The downside is, if you're not taking ivermectin in the formulation for humans, and if you're amateur dosing yourself, and you don't have worms in the first place, you may do yourself more harm than good.
It's a lot more reasonable to go to your doctor, tell them you've travelled in places where you could have picked up a worm infestation, and ask them to test and see if you need an anti-helminthic, than to buy something off a veterinary website and go "Here's hoping!"
IMO that's not the only problem: even if you're taking the right version with the right dosage, you're still taking a non-effective drug. At an individual level, this is not so bad, but when large swaths of people start doing __and dropping other precautions__ because of that, we have a problem.
It does not matter at all what formulation you take, and you would have to be functionally retarded to be able to accidentally overdose by a large enough amount to do anything harmful. An entire tube of ivermectin intended for horses will have absolutely no negative effect on a person, and that is a very large overdose, which requires a very dumb person to accidentally manage to do. If someone can't figure out that they weigh less than a horse, they also couldn't follow anything written in the post. The rate and severity of side effects from ivermectin are less than tylenol. Don't swallow the laziest and most dishonest media schlock so unquestioningly. This is the same kind of stupid nonsense vets have been spouting for years to con people into paying $60 for heart worm prevention ivermectin for their dog, when they could get several years worth for $8 from the farm store. "You are too stupid to do grade school arithmetic, you couldn't possibly figure out the dose!".
It's not so much "ivermectin is for gullible rubes", it's that "if you're living in a First World country in an area of said country and in a socio-economic class that does not routinely (or ever) suffer worm and parasite infestations, then believing Internet hype and relying on dosing yourself with cattle drench instead of taking other precautions IS NOT GOING TO WORK".
Parasites are much more common than people want to believe in developed countries, and are increasing rather than decreasing, including in higher socio-economic classes. You might want to consider the possibility that certain behaviours that are now promoted but were considered disgusting and abhorrent for all of human history have a very high propensity to spread parasites.
Yeah, it's not really a "confounder". It's that the result doesn't generalize to other countries. Mahmud et al. really does show that Ivermectin is effective in reducing the average number of days required for clinical recovery (in Bangladesh, or really just in Dhaka. Also at the time the study was done). This is the same issue people have with studies on WEIRD populations being used to make broad sweeping claims.
The prevalence or lack of worms seems like a good explanation for the failure of results to generalize. It's consistent with the data, although as another comment points out, that difference is not statistically significant (p=.27). It's also makes sense, Ivermectin is helpful in areas where the condition Ivermectin treats is more prevalent. As a bayesian, the combination of these gives me a pretty good confidence (85%?) that this is the explanation.
And it was obscured by a lot of bad/fraudulent studies as well.
The author is using my old analysis, which was a back on the envelope one. My formal analysis does have the subgroups being statistically significant P=0.02, and the meta-regression (which is the true model) is also significant.
Of course, one crucial question here is: how is the alien-brain-implant skeptic going to react when the aliens go "Okay, to hell with you rubes, we're going to mandate the brain implant as a condition for going to work (or going to a bar or a sports game etc.)"?
Revelation 13:16-17 not looking so dumb now, eh? 😁
"16 Also it causes all, both small and great, both rich and poor, both free and slave, to be marked on the right hand or the forehead, 17 so that no one can buy or sell unless he has the mark, that is, the name of the beast or the number of its name. "
The thing is that most vaccine hesitant people are not principled objectors but more often people who are unmotivated to get the vaccine or will be won over with a small push.
It's also ridiculous that the groups fighting hardest against these mandates are unions for teachers, cops, and nurses-- how are we supposed to trust any of these people if they can't be responsible in a pandemic?
Just because we're steelmanning the antivax position doesn't mean we can ignore that vaccines are the best solution to the pandemic. Understanding why someone is against teaching evolution in schools isn't supposed to lead to you opposing teaching evolution as well.
It is a typical problem of elites to think that it is OK to push ordinary people for their best. I don't want to judge it, I'm sure it is meant for the best and sometimes it may even be necessary. But at an other level it doesn't show respect at all, in the opposite it expresses: 'You are too stupid to take decisions and responsibility for your own life.'
If you want the people to listen to your arguments you have to show respect to them. With pressure perhaps they give in and get vaccinated, but they don't feel respected and don't trust you anymore. Others get ideological and just want to proof that they are independent and dont let you push them around. Than they hear you say that [...] is bullshit and doesn't help at all. Why should they trust you? Why isn't this just the next of your tricks to get your will after pressure didn't help?
Perhaps it is especially the teachers, cops and nurses that know this, because they work with many different people every day and know how they think and react. And especially unions are used to focus on self determination and questioning power.
I think on the long term it always is much better to respect peoples hesitations and choices, because than they are open to new data and evidence when it shows up and they can change they mind without loosing their face.
Imagine yourself being hesitant to something that is affecting your most private place, your body, how would you like 'a small push'? I think this would cause resistance as in most people.
I know this first hand from my brother who worked many years as a paramedic, his girlfriend is a nurse. He literally said to me this summer: "Perhaps this vaccinations work as well as most other vaccinations, and I really think it does good to many people. But at the moment I don't really see the benefit for me to get vaxinated as I'm a young healthy man working outside as in a small team not meeting many people. But the more all the society, the media and politics pushes everyone to get vaccinated and they act as if this is the only solution. The more they push the more resistance builds up in me, not for medical arguments, just to prove my independence and not to be pushed around.
That particular example of insistence on not being told what to do didn't work out so well, with a quarter million dead and a far more imperious Federal government than ever before jammed down the throats of the survivors. Perhaps there's a time for the majority respecting the individual, whether or not he seems to be making sense, and a time for the individual to respect the majority, whether or not it seems to be making sense.
Or to add some additional lyrics, from Kenny Rogers:
"You've got to know when to hold 'em
Know when to fold 'em
Know when to walk away
Known when to run."
I'm not being facetious, either. I think there is a sad parallel with the Civil War here. I *agree* with the Southern antebellum views on quite a lot of things, about the importance of state's rights, for example, and I think they had the better view of the Constitution. But they hung all this most excellent thought on the most appalling and disgusting aim, a defense of the right of one man to own another -- and so everything worthwhile about that point of view went up in smoke, because it was used to defend an abomination.
Similarly, I'm horrified that so much of the right has chosen to hang its most excellent arguments on individual rights, the proper limits of government power, et cetera -- on defending the right of individuals to do something which looks by all reasonable historical precedent to be in practice dumb, or at best neutral, and can plausibly be argued (whether or not it is in fact true) to put the health of millions at some kind of unknown risk.
Philosophically, there's much to be said about their reasoning, and in fact I agree with almost all of it -- but using it to defend an antivax point of view is the height of practical folly, a ludicrous failure to pick your battles wisely, the kind of thing that can very easily take down the entire point of view with it. It's an excellent example to my mind of picking the wrong issue to go to the mat over principle on, like choosing to defend free speech in a child pornography case instead of a deplatforming/Twitter assassination case in which some minority view on global warming is suppressed.
You do understand that your reference is an ignorant and smug outsider inventing an incorrect and obviously stupid motive for people he looks down on because he didn't want to make any effort to understand them, right? It is very fitting if you realize that, but very ironic if you don't.
"Just because we're steelmanning the antivax position doesn't mean we can ignore that vaccines are the best solution to the pandemic."
Vaccines are the least costly way of greatly reducing my chance of dying of Covid. It isn't clear that they solve the pandemic, given that behavioral changes may cancel the protection against infection, which is much less than against death.
I agree that most people who haven't been vaccinated are willing to get vaccinated, but I still have reservations about the implementation of vaccine mandates in this case.
In a July 2021 survey by Statistics Canada [1], over 94% of respondents had already been vaccinated or said that they were "likely" or "very likely" to choose to be vaccinated in the future. Despite this, nationally, only 80% of Canadians have received a dose of COVID-19 vaccine according to Our World In Data (though plenty of regions have rates above 90%). This implies that most people who haven't yet been vaccinated responded in July that they were "likely" or "very likely" to choose to do so. So I agree with your analysis, at least in Canada, that most people, at least at one point, were willing to get vaccinated but just hadn't, for whatever reason.
I recall seeing articles (which I can find if you want) that said that Toronto Public Health was having success with door-to-door vaccination, though it's not been deployed broadly across Canada to my knowledge (I know specifically that it's not happ
ened at all where I live). This suggests that simply spending the money to knock on doors would get a lot of people vaccinated.
I think there's a general consensus that vaccine mandates will raise vaccination rates (though I couldn't find any direct evidence in a quick search, I think this is probably true, though perhaps less so than people think). But this leads to the uncomfortable conclusion that governments in Canada are, in fact, using vaccine mandates as a cost-saving measure rather than spe
nd the money on door-to-door vaccination drives. I think this is clearly immoral. First, given that we already do door-to-door drives for the census, it's clearly not cost-prohibitive. A vaccine mandate is an infringement on freedom - I don't think anyone would deny that. I think it's justified if it's necessary to make sure people who want to be safe from COVID can in fact go to place like restaurants without having to worry. But I don't think it's justified if the same effect could be achieved without a mandate. (You could argue that people intended to do both - door-to-door campaigns and vaccine mandates - but in practice that hasn't happened, so it's kind of irrelevant.)
To approach this a bit differently, I don't think it's acceptable to use vaccine mandates with the goal of increasing vaccination rates; rather, I think the only acceptable goal of a vaccine mandate is to allow things like indoor dining that otherwise wouldn't be safe to take place. I think that many advocates of vaccine mandates see increasing vaccination rates as a primary benefit of them.
This is really frustrating, because I support vaccine mandates in general. I just hate that we've somehow managed to make what's clearly a good policy into something that's at best morally ambiguous.
I also wonder what it says about the way people view unvaccinated people. I worry that people don't really view them as human, or as deserving of compassion. I think that would be really sad.
After reading Erwin's reply (which I agree with 100%), I want to add an alternate framing that leads to this conclusion: vaccine mandates run the risk of making people resistant to getting vaccinated simply because they (understandably) don't like being told what to do; whereas less coercive policies like door-to-door vaccination drives (or paying people to get vaccinated, or giving people paid time off to get vaccinated, anything like that) could potentially lead to higher vaccination rates because people they would potentially lead to less resistance, because people (understandably) don't like being coerced. I think it's always important to remember the human when making policy, and acknowledge that humans have feelings, not just incentives. One thing I heard a lot from teachers is that people won't remember what you teach them, but they will remember how you made them feel. I think that's an important idea.
(I know I'm saying a lot of "potentially" and "could". I could probably find support for my claims but I've done enough research for today already.)
>how are we supposed to trust any of these people if they can't be responsible in a pandemic?
Because they are being responsible. Forcing people to take an unnecessary, novel and potentially harmful therapy is immoral. People demanding that everyone be forced to make the same mistake they did so they feel less dumb for having made the mistake can not be trusted.
I reached the same conclusion without doing any analysis of the data. But it’s reassuring to see the the experts agree with me. Paradoxical parasites explain the significance of tropical effect. Tiny.one/clotstop
I appreciate the depth, but it doesn't engage with a few arguments that proponents make and groups studies together in a haphazard way. Possible defenses include that IVM works much better when given early or as a prophylactic, and that many negative studies enrolled the patients pretty late.
Also that epidemiological evidence in India and a few Latin American countries suggest a strong effect for IVM.
Not sure either way, but so far I have not read ONE article, either by proponents or sceptics, that differentiates studies by time of administration and endpoints. Personally, I think it's likelier than not that it doesn't work, but given the safety profile I would still take it.
Seems like a rather hard to falsify claim, since you'd need a huge randomly selected population taking invermectin and wait for some of them to get sick to test it. I'd also wager thdt many of these people making that claim had previously claimed it was more generally effective then were forced to retreat on that
Really not a fan of the alien analogy, I find it insulting by implying that those who are skeptical of the prevailing narrative around the Covid vaccines are only doing so out of reflexive distrust of "science" and big pharma. If I genuinely thought that the vaccines were as safe and effective as they were purported to be I wouldn't disbelieve them out of some tribal reason. I was rooting for the vaccines, ideally they really would have "got us out of the pandemic".
About the vaccines - i have no idea how you can reach the conclusion that they are "very safe and effective" - here are a few things that poke holes in that conclusion.
1. High vaccination rates having no correlation with low case rates. Many countries or cities with high vaccination rates are seeing explosions in cases
2. Several studies that show waning vaccine efficacy over time, both for prevention of disease and reducing symptoms
3. Excess mortality being higher this year in many countries where vaccines were rolled out compared to last year.
4. Consistently much higher rates of adverse events recorded in monitoring databases such as VAERS ( And is the case over many different countries )
Not that this is a black and white picture, I do think that the vaccines seem to reduce mortality for Covid, but the question is how long for and if there's anything else that we could do to help those who catch the disease in addition to vaccination.
I am more sympathetic to the authorities in the case of the vaccine backlash because way back at the start everyone was demanding fast action on vaccines - no messing around waiting months for trials while the pandemic was upon us, get them out fast and trust the drug companies' results! Nip it in the bud by herd immunity and mass vaccination!
*Now* when there has been time, and mass vaccination, we see the downsides, the bad results, the side-effects and so on.
But you can't both have it be "skip the usual heel-dragging over-cautious FDA approval process" and "they should have known the vaccines were dangerous/ineffective".
These are the sort of arguments that I would love to see fleshed out more. In the vaccine debate online, you have the anti-vaccine-mandate crowd who does a bunch of research and presents data (which may be wrong/confounded/bad!) and you have the pro-vaccine-mandate crowd that just says "safe and effective" and the only data they point to is data that has incredibly questionable provenance, integrity issues, etc. (all of the things this article laments about).
It seems to me that the market for debunkers just isn't very big. (I volunteered for Denial101x and SkepticalScience. People don't know these are operated by unpaid volunteers.) So if you really want to earn a living, explain with high confidence and great exaggeration how very awful and deadly Covid vaccines are. Or work for a mainstream news outlet and mostly ignore the antivaxxers except to make lazy comments about how wrong they are. Or work for a university and ignore the antivaxxers because there's no grant money in talking to the public.
Scott doesn't do debunking so much, but maybe it's all for the best; to debunk is to put the "bunker" in the driver's seat, to react to whatever they say. Scott's approach is mostly just to take a deep dive into something and ignore what the bunkers are saying. I'd love to see him deep dive into the same data FDA and other regulators looked at for approval purposes. BUT... it would be wise of him to be aware of what claims are out there lest he be caught flat-footed...
I agree, fear and extremism sell *way* better than a boring centrist viewpoint. This is unfortunately true on both sides, which I suspect is why we have Fauci on the one hand saying "human civilization will end if you don't all get vaccinated and cover your face and lock yourself inside" and on the other hand you have Kirsch saying "vaccines will kill everyone who gets it".
The reason I tend to fall on the "anti-vax" side is because the anti-vax side is only asking for a *choice* while the pro-vax side is demanding compliance and using violence (police) to enforce that demand. Anytime things are uncertain (such as with this entire pandemic) I strongly prefer choice over compulsion.
I do not hold a strong view that vaccines are dangerous, but I haven't seen any evidence to suggest they are safe & effective (at the same time) either. If we had good quality evidence that vaccines are in fact safe & effective and we had strong evidence that COVID-19 is as deadly as Fauci implies then I may be a little more lenient on the pro-vax crowd. However, given the reality of the situation (everything is very fuzzy/clouded) and the epidemiological evidence that the vaccines *may* be causing more harm then good (again, can't make any solid claims here because data is bad across the board), I cannot get on board with decreasing civil liberties because some people say we should.
You should be less sympathetic to the authorities, not more. Biden and Harris were both personally part of the "the vaccines are being rushed and that's terrible and unsafe and you shouldn't trust them" campaign before the election, and now that we know that they really are unsafe and ineffective, they are both personally part of the "force everyone to take a shot every 6 months forever at gunpoint" campaign, while also campaigning to have social media companies "do more" to censor facts and data that show the ineffectiveness of the vaccines. You should only be sympathetic to them if their positions were the exact opposite.
Being tribal doesn't often feel like you are tribal. It can feel that you are genuinely sure to the best of your ability that this is the right course of action for all sorts of sound reasons. Similarly how having a belief doesn't feel that you have a belief, just that reality is this way. I'm saying it with empathy and respect, as someone who is often victim to this problem myself.
Regarding your concerns, I'm not a medical expert but my naive intuition tells me that 1 and 3 are explained by the shift from lockdown to normallity which became possible due to the access to vaccines. 4 is probably the result of covid itself. And maybe 2 is due to the same reasons we have seasonal flu vaccines.
Maybe my opposition to the covid vaccine is tribal (I got the vaccine by the way, but changed my mind about whether it was safe and effective afterwards after doing more research). But don’t you think you’re doing the same thing? You refute every point with “Maybe it’s due to this other thing.” Well, maybe? But maybe not? I haven’t seen anyone try to do a serious analysis of the seeming flaws that have shown up with the vaccines. (Well actually I have, but they all concluded that the vaccine wasn’t safe and effective). It’s just a circular analysis of “We know the vaccines are safe and effective, therefore any apparent flaws with them must be the result of confounding.” That’s not science.
You're being very disingenuous by ignoring the effects of people's behavior. I will speak only of my community, the state of MA in the USA.
Today people are mingling in groups unmasked indoors. Indoor dining with no restrictions. Going clubbing. Concerts. Sporting events. Offices. Kids are in school.
Last summer none of that was true unless you were a "deviant". And by definition since most people were "deviants" you and your group of "deviants" were fairly small and therefore community spread would be far less likely.
This is good. This is much better than before. And again, this is completely ignoring the massive changes in social behavior over time. Those huge spikes on this graph?
They occurred when there was no indoor dining. No events. No gatherings. When, by my unscientific estimation, 95%+ of Bostonians *wore masks religiously OUTSIDE*.
How can you truly say the vaccine is having no impact?
How can you be so sure that the NPIs were so effective that they happened to nearly exactly cancel out the effects of the super-effective vaccine? That seems a little suspicious to me...
I know I am tribal, but I have not been coerced or pressured into adopting a surrogate tribe. My tribe is my real actual biological tribe, not democrats or republicans or liberals or conservatives or sportsball_team_x fans. I genuinely have no allegiance to political or social nonsense, only to my actual tribe. This is confusing to both liberals and conservative, who can not think beyond the surrogate tribes they have adopted, and so liberals call us "far right" and conservatives call us "socialists". I really can say there is no tribal reason for me to be for or against these vaccines.
There is simply no compelling evidence that would suggest a healthy young person should get vaccinated with an experimental, unsafe vaccine for a virtually risk free disease. I recommended that my elderly grandmother get vaccinated, because the risk of COVID for her is higher than the likely risk from the vaccines, and although we can not be certain of long term risks, she probably doesn't have much of a long term to be concerned about in the first place.
But I am not elderly, I have no health problems, I do not consume polyunsaturated fats, and I have adequate vitamin D levels naturally from sun exposure. My risk of being hospitalized from COVID is nonexistent. I may well have already had it and not even known, because it is only a serious illness in people who are not healthy. The average age of COVID deaths is higher than the average lifespan. I am more likely to struck by lightning on my way to get vaccinated than I am to be killed by COVID. The bizarre insistence on ignoring this obvious reality and pretending everyone should be afraid of COVID is much more likely to be tribal than the "get it if you are at risk, don't bother if you are not" mentality that most of us so-called "anti-vaxxers" have.
Okay, well, my antivax father is 74 and I haven't seen any of the major antivaxxers (like Kirsch, Cahill, Zelenko, Mercola) encourage vaccination for the elderly or anyone else, but thank you for being exceptional by carving out an exception for those who are "at risk".
Part of the issue is that it really seems like a lot of anti-COVID vaxxers will make very reasonable sounding objections like your 4, but essentially never apply the same level of scrutiny to other medical interventions. So it’s not bad reasoning necessarily, but it is motivated.
Not to mention that all 4 of your points are distillations of very complex data into arguments anti-vaxxers generally come to by way of summaries from other motivated reasoners, making it hard to trust without doing the same sort of analysis Scott does here.
I replied to one of Leaf's comments elsewhere with my take on #4, but to summarize I would say that it's because many more people are getting vaccinated and are being told that VAERS even exists. It should be no surprise that there is a higher rate of reports.
I've been thinking a lot about what to replace "trust the science" with. We have this compulsion to over-fetishize scientific form (p-values are a weird, barely useful social construct in a world as nebulous and interconnected as ours) precisely to defend against an outside view problem where low-effort conspiracy theories look exactly the same as correct contrarians without doing a lot of work to sift it out. But when you think about fraud from a institutional lens a la Davies's Lying for Money, you can see that "what matters is where it came from!" as a position is tailor-made to let people cash in on the form as a free credibility signal. The cranks are great at throwing in stats words now, and have been for a while.
To think about the way forward, it's worth making the ethnomethological flip (https://metarationality.com/ethnomethodological-flip). That is - how do the people who *are* right actually *do it?*? I'm a temporarily-embarrassed immunologist too, and I was the one who warned all my friends about COVID-19 in Feb '20. I wasn't reading studies and I wasn't calculating p-values. How did I know anyway? Well, because I followed Zeynep Tufekci and a lot of Hong Kongers and had an easy time putting the pieces together. But conspiracy theorists are also great at writing little stories to explain anecdotal evidence. You can say in principle that relying on anecdote here doesn't work because there are also anecdotes about FEMA death camps. But do the flip; I DID believe the good anecdotes, and I didn't believe the bad anecdotes, so it's clearly possible somehow and that somehow doesn't involve math or probability.
This has been my research area for a few months and I suspect that a lot of the secret sauce is ontological. Ontologies can't be *right or wrong* but they can be *better or worse*, and we're not really used to talking about them in that way. So I think people end up talking at cross-purposes a lot because some people are Just More Likely To Be Right because they're using a more sensible ontology, but we don't have the language to make that claim. So we can try to assume that "using a better ontology" and "following proscribed scientific norms" are the same thing - and they probably match above random chance - but there's plenty of cases where it's not true which gives cranks all the ammunition they need.
The slogan ought to be something like "trust the most sensible ontology", but we have scads of really urgent work to do on helping people determine sensible ontologies. And this work historically has been done through mentorship which is why things feel so distinctly odd nowadays.
I ended up just hitting post when I got sick of writing this because I realized it was starting to get full post levels and I didn't want to put in the work, but here is one example of what I mean. This is an article from Cris Moore about how R0 is really unhelpful as a measure for diseases with heavy tails:
Let's say we're in the future now. There's a few flareups of a new disease and we're trying to figure out if it will be a pandemic. Someone writes a paper estimating R0 as .8 and says that we don't have to worry. I wake up from my coma and only read their paper. I worry a lot, because R0 is a bad estimator to use in isolation, and equating R0 with risk is an enormous red flag. I didn't do ANY research, I haven't made ANY probabilistic guess, I just said "It clearly exists (because you had to write a paper about it), and R0 isn't really a measure you can use to call things safe. If it was actually safe, you'd have a real reason to say why. If the best point you can think of is invoking R0, we're boned."
This made up person did a lot of research work, and I didn't do a god damn thing, and I haven't said anything about the methods or data analysis they employed. But I have a smarter **way of representing the relevant factors**. So I think this is a pretty sizeable hint that representations are critically important, and probably a big part of how we actually go about the work of sifting the wheat from the chaff enough to keep the lights on.
I'm biased because I lean towards a philosophical pragmatism on political issues like this, but I feel like the obvious answer is the easy one: people should trust the vaccine because it works, and if it didn't work they shouldn't trust it even if every scientist in the world was convinced otherwise.
To flesh it out a but more, why did so many of us start following Zeynep's Covid coverage? Because she kept being right when other people were wrong. She's a journalist with no special expertise, and there's nothing that would've stopped her from turning out like Alex Berenson, the infamous "pandemics wrongest man." But her predictions kept coming true and her policy reccomendations made sense, neither of which is true for Berenson. I feel like we keep wanting a form or structure to validate epistemic authority for us, but ultimately the only authority is whether what someone says comforts with the data.
I feel crazy sometimes as someone who has realized that the WHO, CDC, FDA, etc. embarrassed themselves by getting major issues wrong but not thinking that Fauci is the devil or something. These orgs are run by basically competent bureaucrats and I trust them on a lot of banal issues. Maybe I'm just reinventing Bayesianism here, but we can trust orgs like this as far as they've been accurate without making it a binary switch.
I'd like to hear more of your point about ontology, but I'm not quite sure how you're using it. If you're using it in a standard way to refer to platonic forms, nomination, metaphysics or naturalism, etc., I'm skeptical. Ramanujan thought he was being given math insights by a patron goddess writing in phantom blood but that didnt seem to hamper his math acumen.
So I agree with the *attitude* of this post - I think a sort of rough and ready pragmatism is exactly the ticket here. The point I want to make is just that "she kept being right" is a phrase that, in a rationalist community, can sometimes imply a lot of excess baggage: are we saying that Zeynep gave probabilistic predictions that were above random chance? Did Zeynep predict the outcomes of studies? No, she dealt with anecdote. What does it mean for an anecdote to be right, when you can always do any degree of special pleading to explain any outcome?
Correctness here was coarse-graining in the correct way. She "kept being right" because she made the sort of claims where a given observation we could all make would count as right with respect to those claims. All her prediction boiled down to was "The reasons why novel infectious diseases often don't take off don't apply here; this rhymes with SARS enough PLUS differs on the key metric of asymptomatic infectivity that it will be bad." If Zeynep had been forced to give a number of exactly how bad it would get, it would have been a total potshot and likely would have been objectively wrong. If Zeynep had been forced to write her thoughts as a study, or as a rebut to a study, they would have been way too slow.
So a major part of being right here is making the *kind of claim that can be right*. That's what I mean by factoring in ontology. Nothing about naturalism or platonic forms. More that focusing overmuch on studies and evidence can blind us to how effective people actually do decision making in highly uncertain and quickly changing environments, which has a lot to do with reducing things to the right factors instead of finding the right coefficients for the factors you have. The people who were thinking in terms of "takeoff or no? What factors stop most takeoffs and are they relevant here?" were correct; the people who were trying to predict the R0 of COVID-19 in February '20 were wrong, **regardless of what R0 they ended up calculating**, because they were thinking about it **in the wrong way**. Does that make sense?
>To flesh it out a but more, why did so many of us start following Zeynep's Covid coverage?
We're talking about the woman who wrote outright bullshit articles about the efficacy of masking right? Where she misrepresented the evidence to support it, and pretended all the overwhelming evidence showing it does nothing didn't exist?
>there's nothing that would've stopped her from turning out like Alex Berenson, the infamous "pandemics wrongest man."
Did he actually say anything factually wrong, or did he merely get called "the wrongest" by a tabloid? I've never heard of him, but the wikipedia summary makes it seem like he's been stating obvious facts that the media doesn't want people to hear, like that COVID is very low risk for children, and so had to be silenced.
How do things like the silencing, discrediting and lying about people who are inconvenient not leap out to you as a huge red flag? Why do you not apply any skepticism to the mainstream narrative? Take Dr. Malone for another example. Read his wikipedia page. Google his name. And consider, he is objectively a real doctor, an actual virologist, and the man who discovered that it was possible to transfer mRNA protected by a liposome into cultured cells to signal the information needed for the production of proteins. These are not subjective claims, and they should not be (and were not) controversial. This is a man who, until the politicization of COVID was a well respected scientist and in no way controversial at all. Now all you can find about him is that he is a fraud who claims to have discovered the basis for mrna technology, but that he is really an evil far right nazi terrorist conspiracy klansman who is killing millions of babies with his evil facebook COVID memes! His wikipedia article can't even make enough of a pretense of objectivity to call him "Dr. Malone". How can someone look at this level of insane 1984 manipulation of public opinion, for someone who has very objectively done absolutely nothing wrong, and think "there's definitely nothing suspicious here, I have no reason to doubt any aspect of the media/government complex's ever shifting narrative at all!". Shouldn't the need for them to constantly edit history ring huge alarm bells?
Berenson's predictions are sometimes correct and sometimes not, but the most pathetic thing about him is how incredibly bitter he is at being banned from twitter. Only losers are that invested in social media.
One idea that came to my mind is that instead of "trusting science" people can "trust scientists". Specifically, we can poll all scientists to learn what the scientific consensus is. This will presumably avoid the issue of "trusting experts" where only a select few most loud personalities get a say.
Imagine a Wikipedia-type site where you could find the surveys of the world scientific community on lots of issues, what do they agree on and what do they disagree on, classified by specialty and country of origin, and tracking the change of sentiment over time. If you're interested, I wrote more about this idea on my blog: https://www.see-elegance.com/post/making-consensus-legible
Problem with that is getting a large enough number of scientists informed about the study, and determining what kind of scientists count (eg theoretical physicists probably shouldn't do immunology). In theory the peer review process is meant to do something like this, but it seems like it's failing in large amounts if these studies got through
Is there a reason to think that scientists have historically had more accurate or meaningfully quasi-objectively better political views than anyone else? I don't see why you'd need an scientist to weigh in outside their field.
I'm not talking about politics here, I'm specifically talking about consensus on interesting questions inside a field, or to compare the views of two fields. For example, to check how many nutrition researchers are for or against certain diets, how many neurobiologists vs. quantum physicists believe in orchestrated objective reduction and so on.
On anything important, the "polling" will end up being done by someone with an axe to grind and a big enough megaphone to be heard. My poster child for that is Cook et. al. 2013, the source for the 97% factoid on climate. For details, see:
wikipedia entries that are even remotely controversial are just the view of whatever power editor is most active on the given topic. let's not replicate that shitty system.
My scepticism about it being a miracle cure for Covid is partly based on the following - warnings when dosing cattle either by pour-on or injection that it is not to be used in animals producing milk for human consumption:
"Animec Pour-on for Cattle is used for the treatment and control of gastro-intestinal nemotades, lungworms, warbles, chotioptic and sarcoptic mange mites and sucking and biting lice of beef and non-lactating dairy cattle.
Active Ingredient:Ivermectin
Target Species: Cattle
Treats and Controls: Gastro-intestinal roundworms, lungworms, eyeworms, mites and lice
Administration Method: Pour-on
Withdrawal Time: 28 days for animals intended for meat and offal, Not permitted for use on animals producing milk for human consumption.
Signs and effects of infected livestock
Infection:Gut Worm
Symptoms: Diarrhoea, decreased appetite, loss of weight
Effects: Gutworm can cause severe damage to the stomach and small intestine which will cause parasitic gastroenteritis, this will not only negatively affect the health of the animal but will affect the profitability for the farmer.
Infection: Lungworm
Symptoms: Short, sharp cough that becomes worse with exercise, in severe cases the animal will have obvious difficulty breathing.
Effects: Lungworm infections cause a high susceptibility to respiratory viruses and bacteria. Infected cattle are prone to contracting severe bronchial pneumonia which if left untreated can lead to death."
And partly because I do not see how something that is mainly a wormer cattle drench is going to be a great anti-viral. Maybe it is! In vitro - which is a hell of a lot different than in vivo.
My position has always been that the good results came from trials in places where, as Scott points out, people are prone to worm and parasite infestations. My totally untutored guess was that the ivermectin treated parasites, which took strain off the immune system, which gave back capacity to fight Covid, and so yes treated patients did better than untreated.
But if you really want to inject or swallow or pour on ivermectin on yourself, I still think your best option is to be a cow in a field.
The same warnings against consumption are included in all livestock medications, including the ones (like ivermectin) that are human medications. Are you afraid of taking erythromycin? Because if you go by the "cover our ass" disclaimer that comes with it when prescribed for chickens, you can never eat an egg from a chicken who was given erythromycin ever again. Does it make sense that I can take erythromycin just fine, but the unlikely and untested possibility that a vastly smaller quantity of erythromycin could be in an egg makes the egg unsafe? It is just a disclaimer because they have not (and have no financial incentive to) tested if any gets into the egg, and then done a safety trial on people eating those eggs. Ivermectin is a human medication. It has been taken billions of times by millions of people. It won the nobel prize for its use in humans. It also happens to be used in virtually all other animals because there is nothing species specific about its mechanism or safety profile. Calling it "mainly a wormer cattle drench" can only be deliberate dishonesty.
One sociological question this triggers for me is why are there so many of these terrible studies from strange people testing invermectin? Is it just thet if something is in the news a lot then people will do stuff related to it to try and make a name for themselves?
Which then leads to the secondary question of why people started asking about invermectin in the first place. My level of charitability to the studies would vary a lot based on whether it was a) because some sensible doctors had a plausible method of action by which it would fight viruses b) someone chose it randomly from a hat c) people who sell invermectin, or in some other way make money off it, started promoting it.
But there were tons of studies of nearly everything that got started by mid-2020, and it was the ones that were getting news coverage (HCQ, Ivermectin) that people rushed to publish. 1 year from study launch to publication is insanely fast, and many were far faster than that. Clearly, selecting on speed + positive results preferentially selects for fraud, sloppiness, and mistakes - and so many of the other studies are file-drawer bound, or are only getting submitted now.
Biochemistry, particularly involving immunology and multiple species, is so freaking complicated that you can probably find a plausible mechanism for almost anything. So it's a good rule of thumb to assume that a plausible mechanism and $5 will get you a good cup of coffee, no more.
My understanding-- someone more authoritative than me found this upthread-- is that our candidate drugs are ones that affect systems of the body also affected by covid. IVM is anti-inflammatory I beleive and HCQ interacts with the immune system (so does remdesivir I think? I think they're also both sort of like steroids). So we just go through widely available cheap generics that will probably do something and hope that one of the drugs we have works.
And of course the follow-up question. Is there anything special about invermectin, or are we drowning in terrible people doing terrible studies on everything?
I want to plug my heuristic for deciding not to use Ivermectin -
1. The government DOES NOT WANT YOU TO DIE. They are not lying to you!
Even if you suspect the political class of lying, people underestimate the competency of the many bureacratic organizations full of scientists and doctors in a time of crisis. My mental model is they are nerds just like engineers - they are interested in truth, not politics.
They were called upon in a crisis. I am absolutely sure they did their best as a whole, and I am absolutely sure the best of them will forget more about medicine and statistics than I'll ever know. Deep competence acquired over years is real, and no even dedicated amateur science by smart people is not a substitute.
Personally it was clear to me that e.g the urging not to use masks was driven by fear of shortages. That was a lie, but not enough of a lie to make me distrust the entirely of institutional medicine like wow calm down.
I don't believe that masks were discouraged due to shortages. Maybe some politicians thought like that but they got suggestions to discourage masks from people who really thought that they are not effective (based on studies et al.). Even now we are not sure how helpful the masks are. I estimate a weak effect, mostly good in crowded placed with poor ventilation. It might be the case that improving ventilation gives much higher protection that makes masks practically useless in such conditions. But because we rely on masks too much, there is not enough attention to ventilation issues that the total effect might be even slightly negative compared to a hypothetical world where we don't use masks but have learned aerosol spread much earlier.
I have no doubts that many people in these organizations are competent and have good intentions. But due to bureaucratic nature and also because this science is really hard, they couldn't provide effective recommendations.
People don't like to admit mistakes, so they will chose a version that makes them look less bad.
I was just re-reading articles from the last year because now everybody is trying to pretend that zero covid was not the strategy that countries (except for Sweden) were trying to achieve, especially countries that were spared during the first wave.
This is almost certainly not the truth either. There are two points here:
1) they said it doesn't work and they mentioned reasons. If the reasons they gave were wrong why were they never challenged / fact checked? Why were health authorities all over the world giving the same advice and giving similar reasons? Why do the reasons given line up so well with the prior science as well as the WHO (flu) pandemic advice?
2) Why was PPE so scarce if it's such a game changer? Really think about this question and remember all the morality tales around the masks "You are killing people if you don't wear one", "Czech Republic beat Corona with wearing masks" and so on. IF masking was so effective why weren't doctors stocked up? Why weren't health authorities stocked up? Remember that your thesis is that they thought masks worked but wanted to save them for medical personnel. So why did they have so little?
The truth is that the evidence for masks was always very weak. Studies couldn't even find a protective effect for surgeons wearing them while operating. It's been a puzzle for science because according to logic they should work much better than they seem to.
I would normally agree that the government doesn't have any reason to want people to die, but the FDA response to covid demonstrates otherwise. We had signs in early trials that these vaccines were safe and effective, and even ones like AZT that got more skepticism from the FDA would've been better than nothing. Instead of rushing an effective solution to the pandemic the FDA delayed the release of the vaccine and let tons of people die.
Many of the commenters here show exactly the problem with that - large swaths of the population don’t trust the vaccines because they were done quickly. If they had been done even more quickly, there would have been even more pushback and it is at least plausible that *more people would have died*. It’s impossible to know for certain, but it is at least a very reasonable position to hold.
I tend to think that complaints about "how fast" the vaccines were made available is so much retconning rationalization. How fast is *normal* for vaccine development? I doubt 1 in 100 people have the faintest idea.
Yes, and if you ask someone with this view how long they need to wait before they think it's safe, they never seem to have a number in mind, and only rarely do they rarely decide to get vaccinated after some months.
If they had come out three months earlier, there would have been three months of large-scale evidence that they worked and didn't kill people by the time they became available in our timeline. More convincing than eleven months instead of eight of small-scale testing.
I mean this is the same problem of just thinking you know so much more than the experts.
Early trials were done on a small number of people. What if the vaccine had a rare side effect that caused death or disease in even 0.01% of cases? What if those effects were not obvious after a short period of time? It would be absolutely devastating to have a bad vaccine - it could have done as much or much more damage than COVID itself.. The vaccine had to be extremely, extremely safe, over the entire worlds population with all of the genetic diversity, pre existing diseases, diets, environmental factors, age and on. There is absolutely no magical way to design a study that will effectively capture a small effect in a population that varied - the only realistic response is a lot of caution and a slow rollout. Like its so easy to sit here on a comment thread talking shit about the FDA 2 years later when we know the vaccines are safe, but we did not know that then. T
People actually think about this. They're not clueless idiots. Safety studies are designed with sufficient statistical power (= number of people enrolled, basically) so that any missing bad side effects are by definition less common than the equally negative outcomes of what you're trying to treat. So in this case, they enrolled enough people in the COVID vaccine studies so that any deadly side effects they missed because of the limited size of the study would be rarer than dying of COVID itself. That's actually why those studies had to be so big and took so long. When you are studying a therapy for a much deadlier disease, you can use smaller studies, because it's more OK to miss a deadly side effect that occurs with a higher rate of incidence.
>When you are studying a therapy for a much deadlier disease, you can use smaller studies, because it's more OK to miss a deadly side effect that occurs with a higher rate of incidence.
But since we're talking about a therapy for a cold with virtually no risk, the rare deadly side effect problem is much more important.
Isn't it partly bureaucratic difficulties which are making COVID tests expensive in the US? And cheap COVID tests would help a lot?
The government presumably wants its citizens to not die (except for failing to define ageing as a disease), but that doesn't mean it always gets things right.
Members of the government openly and plainly state that they do want me to die. So the claim that they both do not want me to die, and are not lying is impossible. There is no competency needed or perceived for malevolence to be involved here. Almost all of the "government experts" dictating how we get jerked around are very clearly in WAY over their heads. Dr. Tam is malevolent, he knows what he is doing. All the bureaucrats and appointed "chief doctor" bobble heads constantly contradicting themselves and giving moronic and factually wrong statements are not malevolent, they are incompetent. As one would expect for appointed political positions. I am sure Trudeau is a tool as he is obviously too dumb to understand much of the script he mindlessly repeats. But that does not make the malevolence of those manipulating the tool any less real.
The PRINCIPLE trial is a large scale RCT in the UK is investigating ivermectin. Given that it is in the UK, it shouldn't suffer from parasite-related confounders.
I'll bet you 150$ to $100 that it shows a weak but positive result for ivermectin. I don't mean in the sense of "statistically significant", but in the sense that "average days to recovery ivermectin" < "average days to recovery non-ivermectin", if they don't measure average days to recovery we can pick another indicator. If ivermectin had no effect the probabilities should be 50-50 (under reasonable assumptions on the noise) so this bet would be positive expected value for you.
It's articles like these that... well... greatly reduced my confidence in "studies say" and "SCIENCE"!!!
I did a bachelor of science and thoroughly enjoyed it, but I got to spend a lot of times with scientists and it shattered my childhood illusions of noble men in white coats with a rock solid commitment to follow the truth wherever it led.
The original pro-inver compilation looked fantastic until a veritable firehose of fisking was turned upon it ... but the only reason the firehose got turned on was an epic load of political motivation. I generally trust Scott because he writes like a standup guy, so I'm happy to accept his fisking, but I bet if there was another standup guy out there who started fisking his fisking I'd end up scratching my head again.
I'm not anti-vax or pro-inver so I say great - fisk on Scott! But what other steam piles lurk out there that haven't attracted the firehose yet that I'm smugly confident in?
As the years roll by, I'm becoming increasingly aware that there is about 3 men and a dog who are interested in what is true and damn the torpedos, full speed ahead.
If creationism or race science turned out to be true, who here would actually legitimately want to know if there was a chance their social circle would find out they knew it?
I'm not ready to toss science because I can see a bunch of great stuff it's delivered... but boy are my days of making authoritative scientific pronouncements in the lunchroom are behind me.
Well, maybe the takeaway is that you shouldn't be smugly confident in things that don't have at least an unobjectionable decades-long track record for which you don't have to take somebody's word for? Science, like many our best practices, is both terrible and better than everything else that has been tried, with the buildup of positive effects being apparent only over the long term.
Oh come on. We have a vaccine that works against COVID, after only a year! Where would we be if the vaccine was going to take 10 years? Just basically waiting for it to burn itself out, right? Mortality averaged over a long time was running about ~1% so if 85% of the US had to get it to reach herd immunity, and 1% of those died, that would be about 2.8 million deaths. We're currently sitting at about 790,000 deaths, which is to say so far science has saved 2 million lives.[1] If that's not dramatic and massive proof of the positive effect of having brilliant science available[2], what the heck would be?
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[1] The deaths will undoubtably rise, because of variants, so bad there, but on the other hand we can make vaccines against variants even faster (and for all we know variants would vitiate naturally-acquired her immunity), so I kind of doubt our deaths will ever come near those we would've had to endure in the absence of a vaccine.
[2] Those vaccines didn't come out of nowhere, they came out of decades of basic resaerch that just happened to have reached a point of applicability in the nick of time. Yet another argument for a continuous investment in basic research: where would we have been if people had said to heck with paying for this basic research?
It seems that you're mostly agreeing with me. Indeed, those vaccines didn't suddenly materialize out of thin air, the technology that enabled their deployment is exactly the result of intelligible decades-long scientific advancement that I had in mind. And yet, this shouldn't be enough to make you smugly confident that every single one of them is safe and effective just because "science say so", because, for one, honest scientists don't actually claim that, it's mainly the "pro-science" propaganda that does it. In the end, you still have to make the best choice with the information that's available, and when your options are approved vaccines vs. ivermectin vs. nothing, it's not that hard of a problem.
Sure I am, I'm just encouraging a sense of wonder and appreciation for how freaking fast this problem got solved. I really don't get why there isn't more amazement and wonder at this. I remember when AIDS came calling, and people were desperate for treatment, prevention, anything. It took *years* before there was anything even half-assed. I think the first genuinely effective protease inhibitor was maybe 15 years after we recognised the disease? That's a long, long time to wait. It *could* have been the case this time, but it wasn't. We were very, very lucky (and maybe a little smart, to have been supporting the basic research all along).
Huh. Sounds like you're about 2/3 of the way to being a scientist yourself. On account of everything you've written is exactly how empirical science is supposed to work. Trust nobody, check everything for yourself, doubt the hypotheses promulgated by enthusiastic majorities most of all.
"If we want to make people more willing to get vaccines, or less willing to take ivermectin, we have to make the scientific establishment feel less like an enclave of hostile aliens to half the population. Do that, and people will mostly take COVID-related advice, for the same reason they mostly take advice around avoiding asbestos or using sunscreen - both things we’ve successfully convinced people to do even without having a perfect encapsulation of the scientific method or the ideal balance between evidence and authority."
Purely hypothetically, do you honestly doubt that if certain IDW influencers randomly decided to gin up sunscreen or asbestos-removal opposition as a culture war issue, then we wouldn't subsequently see widespread opposition to sunscreen and asbestos removal among their followers? People might even start mocking the weirdos who randomly decided sunscreen is anti-American, at which point this vicious condescension would be all the proof anti-screeners need that elites look down on them and their values, further entrenching sunscreen opposition as an essential pillar of their identity. These grievances and suspicions aren't fixed essential flashpoints that can be traced back to significant divisions in the tribes and their values. They can be turned on and off like a light switch, especially thanks to a relatively new insatiable economy of culture war influencers chasing clicks. (As others have pointed out, many holdouts were fine with mandated alien implants until less a year ago, others have argued that mRNA vaccines are actually *new* and that's what makes them alien and suspicious but that doesn't change the fact that very similar implant *mandates* were just an assumed normal part of life explicitly defended by conservatives like Ben Shapiro and the Federalist and now overnight mandates became unconscionable tyranny.)
The entirely alien analogy suffers from a flaw that emerges in a lot Scott's writing where he seems to just assume the Blue Tribe and its aligned elites are the prime movers of these dynamics and on some level nearly all polarization and animus emerges from what they do or don't do (and subsequently how the Red Tribe has to helplessly respond in kind), completely ignoring the fact that the Red Tribe actually does have an agency all its own to play offense in the culture wars. It's like seeing a Hatfield attack a McCoy, then witnessing a McCoy attack a Hatfield in retaliation, then writing 10,000 words about how the Hatfields started this whole thing and they really need to learn to be more charitable to the McCoys and take their grievances seriously. The Hatfields might well have started it but that's a hell of an intractable, difficult question that can't just be assumed because that's the first attack you saw or you feel some collective guilt as a Hatfield yourself.
Is there anything in the alien analogy where anti-alien famous people confidently, loudly pronounce that quantum plague memetic deaths will remain at zero or hold steady at like 15 cases, then at one point 3000 people start dying of the quantum memetic plague every single day? Or how about anti-alienists compulsively repeat debunked canards about how actually the quantum plague is no worse than a common tachyonic sinus infection with a 99 percent survival rate while ignoring the inherent risk of unknown memetic plagues having unknown long-term consequences while *simultaneously* arguing the the memetic plague is actually a fiendishly designed bioweapon that the aliens are deliberately deploying to wipe us out? What if anti-alien media outlets start encouraging anti-alienists to harass and intimidate aliens and the people allied with them by calling the cops on people they see wearing memetic plague blocking space helmets. What if in addition to trumpeting the (human created) vaccine, anti-aliens had also aggressively promoted ginko, ginseng, forsythia, and oleandrin as cures for the memetic plague *before* they ever settled on the ambiguously effective human vaccines as their go to miracle cure? (I mean these as all as honest questions as my adhd forced me to kind of skim the last section and I may have missed something) Would you still say they were basically being reasonable if using flawed reasoning? If all these things had happened as a human I might still have my suspicions of the implants but( if my identity weren't completely emotionally wrapped around anti-alienism) I'd have to admit that my fellow human alien skeptics had behaved far worse and gotten more wrong than even the smug imperious aliens. It's one thing to interrogate the myriad failings of scientific elites, its something else entirely to do so while seemingly ignoring the record of even worse miserable failure and arguably unprovoked culture war aggression that emanates from the opposition to medical/scientific elites. It's something that looks a lot more like rationalization rather than rationalism.
I think I understand at least some of the inchoate anxieties that drive people to vaccine opposition or Ivermectin boosterism. I've struggled with crippling anxiety, sometimes about unknown chemicals, my entire life. I also live in a fairly conservative area and I've had two people I respect and care about approach me and vent their vaccine fears and subtly ask me for advice, which vaccine I'd gotten etc. Imo just on that small sample size there are some relatively organic fears (as opposed to the ginned up ones) that are far stranger, somewhat a-partisan, and in weird way deeper rooted than just these particular noisy culture war flare ups between medical elites and IDW influencers. I get that all Ivermectin boosters and vaccine skeptics aren't necessarily the worst Joe Rogan types but I think we very nearly approached a limit where the persuadable Fauci-skeptics have already bitten the bullet and gotten vaccinated and what's left just isn't very amenable to reason.
This reminds me of the concept of "Conflict Entrepreneurs". There are people with a vested interest in polarization and conflict, because they can profit off it, whether by getting clicks on articles or indirectly by selling things. So they will seek to make any issue in the public sphere into an ideological conflict independent of its prior status
Sorry to nitpick a small object-level issue here, but I don't think sunscreen is actually ubiquitous and uncontroversial. If you look at beauty/skincare subreddits and communities with a lot of newbies, you'll see many people treat the idea of daily sunscreen use as a revelation, rather than a kind of obvious anti-aging measure (and may save you from cancer to boot.) Meanwhile, I've heard a lot of middle-aged or old relatives/friends say they believe sunscreen is unnatural and bad for you and they need the Vitamin D (not that they're supplementing vitamin D or drinking fortified milk in winter, of course.)
I suspect sunscreen is in fact unnatural and bad for you. I think metal oxides are probably okay, and bad sunburns are probably carcinogenic, so I'll smear some on above 8000 ft or so where I tend to burn anyway, but below that I don't wear sunscreen, don't make much effort to cover my skin, and don't burn. I also supplement vitamin D, but I suspect the benefits of sun exposure accrue via other pathways as well.
The wrinkles thing is probably true, but I don't really care.
There's at least one good effect from sunlight which isn't from vitamin D-- sunlight activates nitric oxide precursors under the sun, and they regulate blood pressure.
Yep, I think that might be the best-studied non-Vitamin-D pathway. I also remember a Greg Cochran post suggesting that sun exposure helped to keep low-grade fungal infections in check, with corresponding health benefits.
Count me in with @psmith .... I think the idea of applying sunscreen daily is insane. I believe depending on your skin type and exposure it is a useful tool like bug spray.
It is unnatural but may not be bad for you (depending ingredients).
Something I forgot. The most famous human in the world, and a relentless, aggressive critic of the aliens actually presided over the alien labs that developed the implants. (This guy even went so far as to call the aliens space rapists one point) He and his followers spent months taking credit for the implants and insisted they couldn't have happened without amazing human ingenuity. To this day you can still sometimes see anti-alienists pop up in message threads bitterly telling you you ought to thank them for developing the implants in the first place. And while the most famous human in the world at the time still affirms that he hates the aliens with all his heart *he still tells his fellow earth-first humans that they really ought to get the implants.*
Does anti-implant sentiment still seem basically reasonable?
It's hard to respond coherently to the alien example theater, so let's drop that pretense.
I think what is MOST interesting about all of this is the interplay between Trump and his followers. Trump bet the farm on vaccines - to the point where he felt no other intervention was necessary. Operation Warp Speed was his big initiative. He was all about it. And... it was successful.
His base didn't buy it. They should be screaming from the rooftops that Trump delivered us from the pandemic and Biden is riding in his coattails. But they're not. Why? Because the Red Tribe has lost control of their base.
Majoree Taylor Green and her ilk are NOT the Right Tribe's elite or their thought leaders. She is a symptom of the cancer in the Red Tribe. The House of Reps is a clown show, and always has been (read Alexis de Tocqueville nothing changes!).
So yes, I think the criticism that the Blue Tribe deserves some blame here is valid. I don't think they're alone in the criticism, and I don't think Scott is claiming that either.
"So yes, I think the criticism that the Blue Tribe deserves some blame here is valid. I don't think they're alone in the criticism, and I don't think Scott is claiming that either."
But his analogy was a one-sided laundry list of failed predictions and allegedly uncharitable things said by the Blue Tribe, which was intended to prove that the Red Tribe's suspicions were on some level rational or understandable. That completely falls apart if you were to take the extra step of adding all the failed predictions and wildly uncharitable things said by the Red Tribe *at the same time* (cases down to zero in March 2020, "Covid is their new Hoax", "as bad as the flu", "hydrochloroquine is the cure, "Oleandrin is the cure"). Like describing a fist fight and only mentioning all the times Jim hit Tom without bothering to mention Tom was hitting Jim at the same time.
- "Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”" -> "Babalola et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakaloko”" (two misspelled names)
- "mispelled as “Profesional Medical Journal” in its URL" -> "misspelled", though possibly intentional
- "which will lead to them having making good health decisions" -> "which will lead to them making good health decisions"
"Trust Science" is definitely not the right approach. It will devolve in in-group vs out-group. However, simple explanations of underlying truths are much more effectively convincing. In this very article, a simple paragraph, explaining that worm prevalence confounds positive results for ivermectin, did more convincing that all those individual and meta-analyses discussed previously.
Explain the Science! People require a "why" they can understand. Ivermectin works against COVID. Ok. Why? What does it do the virus or the body? Without a clear answer to that, statistics and data are hopelessly getting in the middle of the perpetual cultural warfare.
Honestly, I would be disappointed to learn that "how and why does this drug work" is not the first thing, before even reading a single paper, that doctors consider before deciding on whether to administer a new drug.
It is because sometimes we don't really know how drugs work. Sometimes explanations have been proven wrong and it actually works by a different mechanism than previously thought. As for ivermectin, I think there are some explanations which sound scientific and are proven to work in cell cultures. But it doesn't convince anyone because there are too many potential drugs that work in cell cultures but not in the living body for reasons we don't always fully understand.
I say this as an IVM hopeful: this is how you do it. My anxiety about this topic went way down reading this even though I was specifically called out. But I was also given my due. I was not just called named and dismissed (invariably by some person arguing without good faith). Just like with lab leak, the minute I see this discussed rationaly, I can rest easy because I can have faith the truth will prevail in the end. I can live with IVM not being a COVID cure, but I couldn't bear a cure being denied through censorship, supression and the rank propaganda like "horse dewormer".
I don't like the Alien metaphor. Like you said, some of these people aren't stupid, some even have PhDs or Medical degrees. They know what a vaccine does, and that it can't be used to control people, unlike a microchip which literally has logical circuits built into it.
To me, there are two layers of fear here: one is people who dont like needles. This is a lot more than you think, because admitting you're too afraid of needles makes you essentially a child. The other is that they're afraid of side-effects. But instead of voicing these fears, they've managed to turn them into bravery, claiming they're against the establishment or that they are too tough to worry about covid.
We basically have a society so ruined by individualism that no one can be vulnerable.
Your second outcomes table (the one resulting in p = 0.04) should probably say "Hospitalization" instead of "Death" in the row for Together. (Also, for others who have been wondering where to find these hospitalization numbers in the given link without watching videos, they are on page 21 of https://dcricollab.dcri.duke.edu/sites/NIHKR/KR/GR-Slides-08-06-21.pdf , inconspicuously linked under "Slides" there.)
Came across this article Neglected Parasitic Infections and Poverty in the United States, Peter J. Hotez. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154650/ which is interesting in the context of the parasite prevalence conclusion. As it would imply there is more parasite issues in the US than expected, so possibly explain some of the anecdotal reports of invermectin effectiveness? Though would have thought tests would turn up the parasites as well.
Not buying this. You need to factor in regional prevalence. Trials are run in more sophisticated cities, where prevalence of worms would be far less than the outskirts. I live in Chennai, India, and prevalence of worms would be orders of magnitude away from a randomly picked village in India.
Trials are also run in pretty well funded hospitals, which again naturally have a self-selection for wealthier people who again will be far less likely to have worms.
Hi sathish, accounting for regional prevalence is exactly what I did when possible in my analysis. I didn't just use country average prevalences. Wherever possible, I used prevalences as granular to the area where the trial was conducted.
Worm factor: If everyone is getting IVM to treat the worms, there are no more worms to kill that could factor into the covid19 infection outcomes. General availability in the bodies of those people taking it could be the real reason there's much less infections and bad outcomes generally. See Nigeria (average age 20, less co-morbidities in general, ...).
Just sharing one piece of evidence that made me decide ivmmeta.com is untrustworthy. After Gideon Meyerowitz-Katz pointed out problems with many of the studies, ivmmeta.com published a response to him (sidebar "Respones", ctrl-F "GMK"). I don't have the time and energy to address the object-level issues in the studies. However, I did a quick search for "We note that this personality [GMK] has an extensive history of incorrect advice, including for example..." and found out that all the examples given were manipulative or outright false (read: pure slander). That was it for me. If they lie or manipulate with something easily checkable (whether X ever said Y), why should I believe them in subtle statistical issues?
Do you truly dismiss all subtle statistical analyses made by any organization that has ever purposefully misled the public on easily checkable issues? Doesn't the CDC qualify as such an organization? I'm not in your brain so I can't be sure, but this kind of smells like a high barrier that you only put on the evidence you dislike...?
I'm not from the US, so I don't really care much (nor am very knowledgeable) about CDC. But, yes, obviously given their track record so far, I'd double or triple check any claim made by them.
I read the social process and got to the opposite conclusion at the time. At one point Gid seemed to be tactically holding back information to discredit specific papers rather than seeking the truth. In contrast, ivmmeta.com at least appeared to be forthcoming with all of the relevant information they had.
We perhaps got to different results here because I was watching Gid's behavior on Twitter and you were looking at ivmmeta.com. Our observations were at different times.
Fortunately our host does seem to be making a good case and does not seem to be holding back information, so Gid's evasiveness doesn't feel so relevant anymore.
One of the best things I have read. But you leave out risk and reward. The risk for almost all people to take ivermectin is basically zero, the reward for some people (maybe with worms that decrease their immune response) is positive with a high likelyhood.
This is a strawman argument though. There are thousands (tens of thousands? hundreds of thousands?) of substances with the low risk profile of ivermectin. Just because something is low risk doesn't mean we should have doctors medically prescribing it to the millions of COVID patients. There are numerous reasons why (how many "basically zero risk" substances are you going to ask them to take? How do you pick some from the thousands that have no mechanism of action? Etc.
At the end of the day it is important to have sound theory and credible results behind a medical prescription.
Well, while I'm patting myself on the back, let me repost a comment of mine from the September post "Too Good To Check: A Play In Three Acts" where I was trawling through the Cochrane meta-study:
Deiseach Sep 7
(6) India (different study):
DISCUSSION: In this study we did not observe any benefit of adding ivermectin to the hydroxychloroquine in the management of patients of SARS-CoV-2 resistant to standard care treatment. Our finding are based on small cohort of asymptomatic or patients with mild symptoms of COVID-19.Such patients were recruited when they did not responded to the standard treatment. Ivermectin was tested as an adjuvant drug to the standard treatment with hydroxychloroquine. On comparisons of patients receiving hydroxychloroquine plus ivermectin with the patients receiving hydroxychloroquine alone, no significant difference was observed in the cure rates. There were no significant adverse effects were observed in patients receiving ivermectin. The use of ivermectin 12 mg single dose as an adjuvant to standard treatment was based on the widespread uncontrolled studies that suggested that the ivermectin has antiviral activity against a broad range of viruses. .Based on these studies it was concluded that ivermectin's nuclear transport inhibitory activity may be effective against SARS-CoV-2.
(This is one of those "throw it against the wall and see what sticks" studies; ivermectin didn't do much but that's not what they were studying. Result here neutral again, I think).
(7) Argentina:
Findings: The trial run between May 18 and September 29, 2020 with 45 randomized patients (30 in the IVM group and 15 controls). There was no difference in viral load reduction between groups but a significant difference in reduction was found in patients with higher median plasma IVM levels (72% IQR 59 – 77) versus untreated controls (42% IQR 31 – 73) (p=0·004). The mean ivermectin plasma concentration levels also showed a positive correlation with viral decay rate (r:0·47, p=0·02). Adverse events were reported in 5 (33%) patients in the controls and 13 (43%) in the IVM treated group, without a relationship between IVM plasma levels and adverse events.
Interpretation: A concentration dependent antiviral activity of oral high dose IVM was identified in this pilot trial at a dosing regimen that was well tolerated. Large trials with clinical endpoints are necessary to determine the clinical utility of IVM in COVID-19.
(This one contradicts the Bangladesh and Spain studies about reductions in viral load, but it does show 'something something need high doses').
(8) Colombia:
Findings: In this randomized clinical trial that included 476 patients, the duration of symptoms was not significantly different for patients who received a 5-day course of ivermectin compared with placebo (median time to resolution of symptoms, 10 vs 12 days; hazard ratio for resolution of symptoms, 1.07).
Meaning: The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand effects on other clinically relevant outcomes.
(And this one contradicts the Indian 5-day trial. They don't seem to have seen a positive effect re: mortality, and they did manage to screw up the 'which group gets what' dosing. Read the whole thing: https://jamanetwork.com/journals/jama/fullarticle/2777389)
(9) India (different study):
In our study subjects, Ivermectin did not improve the time to symptom recovery, clinical status at day 14, or hospital-free days at day 28 after drug administration. Similar results were observed in the only other randomized-trial of Ivermectin (12 µg/kg) in predominantly mild COVID-19 patients (n=62) in Bangladesh, wherein Podder et al(19) found that Ivermectin failed to hasten the resolution of symptoms compared to usual care. The same investigators repeated RT-PCR only once on day 10 and found that most patients had attained a negative result(19). In contrast, we performed RT-PCR at days 3, 5 and 7 to serially evaluate decline in viral load with Ivermectin. Our rationale was that faster viral load decline may enable the non-severe COVID-19 patient to become non-infectious sooner, thereby limiting the contagion. Indeed, it has been shown that at a lower viral load (CT > 24), infectivity declines with lower viral culture positivity(20). Hence the trend towards increased viral negativity at day 5 with ivermectin 24 mg in our trial, particularly among mildly ill patients, encourages further exploration in this regard.
In a retrospective study of hospitalized patients in Florida(21), patients who received Ivermectin were found to have a significantly lower mortality that those who did not (15% versus 25%). The mortality benefit remained significant after propensity-matched analysis and adjusting for confounders. However, they included patients with greater illness severity than our study population, illustrated by lack of mortality in our trial. Furthermore, the greater use of concurrent therapies and retrospective design preclude drawing definitive conclusions from their data. Nonetheless, we did find a 56.2-61.5% RT-PCR negativity among moderately ill patients who received Ivermectin at day 5 of enrolment. The immunomodulatory rather than antiviral effect of Ivermectin may be hypothetically more important in moderate and severe COVID-19
(Interesting results that you get more bang for your buck, as it were, if you take your ivermectin after a meal and with booze. Again, some contradictory findings).
I'm not going to go through the whole list, but going by this, if you want ivermectin to work, then you should be in India (parts thereof), Bangladesh, or Florida.
Scott: "It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!"
You turning out to be right made it funnier.
I'm hoping but not expecting that the human genome will turn out to be the result of alien meddling. This would make the evolutionists *and* the creationists both wrong.
The social takeaway is an alluring story, but it's a little pat.
I, too, am a temporarily-embarrassed expert of all kinds. Also, about half the people I know are creationists, but a surprising number of them are conversant with science and expertise - both the immunologist kind where experts wear white lab coats, and the plumber kind where experts keep the immunologists from sloshing through poop on the walk to the metro.
My personal feeling, and that of all the thoughtful vaccine-hesitant and ivermectin-curious people I've talked to about it (n~=10) is that I'm very angry at the authority-experts, I feel manipulated and spoken down to and frankly betrayed. If anyone is treating anyone like a horse, it's the elites who want to herd me into the corral. I couldn't care less if it's for my own good, or even if they're right about it - I resent being treated like cattle. The risk I perceive from a little vaccine hesitancy (I got the shot when it became convenient, but no sooner, and I don't even remember which one) and a little ivermectin curiosity (I've never even seen ivermectin but I wouldn't turn it down if someone passed me some at a party) is very low, and it trolls the Confident Ones so it seems like a pretty safe way to vent my anger and resentment at them.
Reasonable question! Part of the answer is that I'm just angry, it's not a decision or anything, and venting makes me feel better. But it's also true that I do encourage that anger a little, and it's because I don't want to just get used to it. Every time I make a choice about my future, I want to take into account that there are big powerful forces trying to herd me. Maybe it's my own weakness, but it's easy to forget that when the proof isn't right in front of you and right now you just have to make a choice and it would be so convenient to go with the herd without even noticing it.
But that's not why I post comments like this - i.e. "troll" the authority-elites, though "troll" is probably too harsh a term. I have the impression that my blind spots are different than the norm in places like this (e.g., I hang out with creationists, I have long talks over beer with blue collar types, etc.) I'm a committed rationalist (for example I first read the Sequences long ago and I read them yearly for a while) so I think my perspective is not only different, but also compatible. (Symmetrically, I do the same thing with my less rationalist friends. There are plenty of Confident Ones on all sides.) If I had more time, I'd write more, but as it is I contribute occasional comments when I see a hole, like in Scott's social takeaway.
"I know that even if somebody wanted to control you by sneaking a microchip into a vaccine, that’s impossible with current technology. I know enough about politics and economics to know it’s really unlikely that some cabal of elites has developed super-futuristic technology in secret."
Well, and there's shady shit like this to make people go "See? SEE??? You can't trust the bastards!"
"On May 2, 2011, President Barack Obama announced that the US Central Intelligence Agency (CIA) had located and killed Osama Bin Laden. The agency organised a fake hepatitis vaccination campaign in Abottabad, Pakistan, in a bid to obtain DNA from the children of Bin Laden, to confirm the presence of the family in a compound and sanction the rollout of a risky and extensive operation. Release of this information has had a disastrous effect on worldwide eradication of infectious diseases, especially polio.
On May 16, 2014, the White House announced that the CIA will no longer use vaccination programmes as a cover for espionage. The news comes in the wake of a series of militant attacks on polio vaccination workers in Pakistan, with legitimate health-care workers targeted as being US spies. The attacks have forced organisations such as the UN to suspend polio vaccination efforts in Pakistan, and have severely hampered anti-polio efforts, with parents refusing to have their children vaccinated. News of the vaccination programme led to a banning of vaccination in areas controlled by the Pakistan Taliban, and added to existing scepticism surrounding the sincerity of public health efforts by the international health community.
Consequently, WHO declared that polio has re-emerged as a public health emergency in Pakistan—one of only three countries, including Afghanistan and Nigeria, where the disease remains endemic. According to the Global Polio Eradication Initiative, 61 of 77 cases of polio reported this year have been in Pakistan, and cases of paralytic polio have spiked, with 66 cases reported up to now, compared with only 14 last year.
The lesson learned from the experience in Pakistan is that public health programmes should be politically neutral. Although the announcement from the White House might go some way to building bridges towards that neutrality, health officials and local leaders now have the challenge of convincing communities that vaccination is not merely beneficial, but vital for children."
Deeply regrettable, but alas all too typical. The Obama Administration was much to ready to cut corners in pursuit of what they saw to be noble aims. I don't attribute that to ideology or malice, but to the fact that they were unusually young (in years, I mean). Zealous kids.
That is a bit more charitable than I would be. I'd chalk it up more to callus indifference to the results of their actions. The outcome was hardly unforeseeable for someone vaguely intelligent and paying attention to consequences.
Callous indifference to the results of one's actions sounds pretty human to me, though perhaps its more common among young people. I'd need evidence for that.
Older people might know more about the likely effects of their actions, which isn't the same thing as caring.
I think your framing of the central issue as one of outreach/messaging is mistaken.
Until and unless the central institutions become worthy of trust, many proles will continue to defy them and believe weird stuff instead.
The strategy is not for the Establishment to become better at PR campaigns. It's for it to stop acting like hostile aliens, who (inadvertently, hubristically) created this virus in a lab and then used it as a pretext for a global social engineering effort aimed directly at the lives of normal people.
> I want a world where “I did a study, but I can’t show you the data” should be taken as seriously as “I determined P = NP, but I can’t show you the proof.”
I am not a theoretical computer scientist, but I guess that you could possibly convince me that you had a polynomial algorithm to solve NP-hard problems just by solving challenges of a suitable size -- much like solving sample cubic equations was meant to convince others you had a formula to solve them back in the time of Tartaglia. (This of course will not help if you have an existence proof only or can solve SAT in O(n^200).)
Also, it seems like most people faking data (that we know about) are much less science literate than the people checking them. Carlisle-Stouffer-Fisher and GRIM detection could both be avoided when the fakers would go to the trouble of actually simulating a study instead of just making up percentages on the spot, I guess?
Of course, if you have to publish your raw data, this becomes a lot harder, as people could sanity check any correlations in your sample, e.g. between obesity and smoking. The best way to fake data then might be to take past real patient data, randomly assign them to intervention and control group and discard 30% of death in the intervention group.
To detect this, you would basically have to deanonymize patient data so that people could check the actual outcomes, I guess? Which basically would mean employing a trusted intermediary somehow?
"I’m not an immunologist. I don’t have the specific expertise it would take to evaluate whether vaccines work."
...
"Again, ivermectin optimism isn’t exactly like vaccine denialism - it’s a less open-and-shut question, you can still make a plausible argument for it."
So, how can you lack expertise to evaluate, yet be sure enough about it to use langauge like "open-and-shut" and no "plausible" argument?
Lopez-Medina et al is cited often because it shows that ivermectin is only moderately useful. They did it by shortening the observation period to 21 days so they haven't had to observe too many deaths. Even then they had one death in the placebo group and none in the treatment group, but they ignored that completely in their conclusions.
I would like to see a discussion on possible microbiological ways Ivermectin could work. It's protease inhibitor. The new drug currently being developed by Pfizer with allegedly 90% efficiency is also a protease inhibitor. I am not a microbiologist, but how different could these two be?
Besides that, we should be free to choose what medicine we take, given side effects are clearly explained, no matter how flimsy the evidence for effectiveness is.
I think that might better be put as "simulations suggest it might be" rather than "it is." Computer simulations of big biomolecules are frequently wrong. Which I guess is lucky for the careers of the med chem people who have to do it the hard way (make the molecule, do the measurement).
In Vitro and in Silico assays have shown reasonable evidence that it can bind to one of Covids Proteases subunits, and also somewhat worse to both the Covid Spike Protein as well as to the receptor for that spike protein.
Mechanically, the Pfizer curative and Ivermectin look and most likely act very differently.
If one accepts in silico evidence, the one thing they have in common is intereference with the Covid CLA3 protease.
Pfizer curative trolls the Protease into using it as a building block for one of its subunits, and then becoming ineffective, while my guess is that Ivermectin probably binds to neccessary for functioning parts of the Protease thus temporarily or permanently reducing its functions.
Thanks for the explanation. Sounds a little bit like you are not quite sure how exactly Ivermectin works In Vitro though. In any case, both seem to act as protease inhibitors if I understand correctly
Thanks for talking about this. I came here to see if it had been mentioned. I appreciate Scott's approach where the drug is considered almost as a "black box" and we're only looking at the study data, however it seems that it dwindles down into a fractal rebuttal of rebuttal "ad modem" (attack of the methods) argument as these things often will. Ivermectin has been studied and there's a proposed method of action, which, to my knowledge is the same as the new Pfizer drug. This video by John Campbell goes into this in detail and, in my uneducated opinion, makes a great argument with quality sources showing "proof" for each point (Pfizer claims their drug works through protease inhibition on 3CL, Ivermectin has been shown to do the same, etc.). https://www.youtube.com/watch?v=ufy2AweXRkc With this in mind, it seems foolish to look only at a somewhat flawed, erratic, and politicized set of studies. If Campbell's argument checks out based on what is in those papers, we'd expect to be able to run a trial with Ivermectin using as similar as possible effective dosages and schedules (pre, post infection, etc.) and achieve similar results. This might not happen in practice of course, as one might be longe lasting or have who-knows-what difference, but at least it seems to be a logical hypothesis. Am I missing something obvious? I do see A.I.S's comment below and I'll try to learn more about the implications or if this has been addressed elsewhere.
1rst step: Have in silico studies where you match the structure of the protein to the structure of the proposed drug, see if they latch. This happens on a computer. Ivermectin, as far as I am concerned, passed this test. Anyone with a computer can do in silico studies, computational power has gotten pretty cheap.
2nd step: Have in vitro studies, where you basically mount the protein on a bullseye, and throw the proposed drug at it. This happens in a lab, you can do this in a basic university lab actually, provided you can order covid CLA 3 Protease.
Ivermectin passed this as well.
3rd step: You go into actual living systems. Typically mice. If you know that a drug is harmless, you can in some cases jump to humans. The drug now either works, does not works, or has a statisitically non significant result. Ivermectins passing of this step is debatable.
Mechanically, there are 2 main reasons to explain why in vitro binding =! in vivo being a cure. One is that detected in vivo binding does not neccessarily mean that this actually inhibits to protein from doing its function.
If I for example go for a sparring match, and blindfold myself, my boxing function would be very much inhibitied. If I however just use a headband, there would be no inhibition, even thought the blindfold and the headband are very similar, and bind to the same part of my body (the head).
The second part is that the body is a rather large place, from the perspective of a virus and even more so from the perspective of an Ivermectin protein. Actually finding a CLA Protease is not trivial, Ivermectin binds to a lot of things, and Covid does not express CLA Protease on the outward facing part of its hull (unlike its spike protein).
I would have been very very happy if Ivermectin would work, because it is safe, cheap, and its manufactoring capacities can be boosted by making use of manufactoring capacities currently used for horse ivermectin (retooling a factory is easer then building a new one), I am yet unconvinced that it does.
Thanks for the rundown of each step and metaphor for that last one. It's a lot clearer now why it might not be as simple as is shown in the video. I hope that last question on whether or not there is similar inhibition gets more attention.
This article really stands out. Thank you very much!
As to the political part: I wonder if the strong US divide between "blue tribe" and "red tribe" doesn't lead to oversimplification, and veiling a diversity of motivations. Lots of anti-vaxxers in western European countries with a strong vaccine-critical movement (at least France and Germany, perhaps Italy too but I'm far less knowledgeable about it) would imho definitely be "blue tribe" if transposed into the American context, and I don't think the medical establishment feels like aliens to them.
Honestly, I really wanna know what's become of the left-wing antivaxxer in 2021. Have they flipped to getting a vaccine? Flipped to conservative or QAnon? Still in the same camp? What's up?
We spent the last decade defenestrating them. This (left wing anti-vax) went from being "that family is a little weird but they're crunchy" to "that family hates science and we shouldn't let their kids anywhere near ours". This had the effect the most of the loose hippy-dippy lefty ones just quietly left the movement once there were social costs, leaving only the hard core crazies. No idea what's become of them, I haven't seen one in the wild in years.
Now that you mention it, the whole hippy Birkenstock live off the land, grow your own food (and dope), get those damn government fingers out of my life demographic seems to have dried up (at least in the US). It's strange. The most viisible modern left has become corporatized, establishment, and pro-government in a way that would make Ward and June Cleaver's head spin. They drive $50,000 cars (albeit Teslas instead of Beemers), network via iPhones, and pull down $250k a year as employees for Fortune 500 firms. Weird how things change, but don't, if you know what I mean.
For what it's worth, my guess at the end of part 1 was "if all the small studies show a weak positive effect," and all the large studies show no effect, there's probably a confounder in the small studies that we haven't thought of." Maybe big trials have more people watching and do a better job of randomizing in some subtle way. Maybe Big Dewormer isn't very wealthy and can only fund the small studies. Maybe the small studies are from smaller countries and there's some subtle bias introduced by that.
> People are going to fight hard against this, partly because it’s annoying and partly because of (imho exaggerated) patient privacy related concerns.
I think there are more selfish motives. Keeping the data private means they could potentially slice the data another way to get another publication out of it. Making the data public means someone else could easily scoop them. Requiring pre-registration maybe eliminates this incentive.
Good review overall. I had seen enough to be convinced there was *something* going on with ivermectin, but didn't dig deep enough to ferret out exactly what was going on. Combined with how so much of the criticism seemed ridiculously far fetched and partisan raised my suspicion as well, as you described.
Scientized debates also tend to be biased in terms of who bears the burden of proof. Many large businesses’ lobbies have demanded that any regulation affecting their products should be rooted in “sound science.” On its surface, that demand seems reasonable. Why would anyone not want regulations to be based on the best available scientific knowledge? However, the implication of “sound-science” policy is that no restrictive regulation of an industry can be developed until proof of harm is conclusively demonstrated.
Scientists are often not able to provide firm answers, especially for complex physiological and environmental phenomena — and typically not in the time scales appropriate to policymaking. As a result, calls for “sound science” end up being a delaying tactic that provides an advantage to the industrial firms producing risky products at the potential expense of humans and nonhuman species — who may be needlessly exposed to potentially toxic substances during the decades spent “proving” harm.
Political scientism starkly divides societies into friends and enemies, the enlightened and the ignorant.
Absolutely fantastic post. There aren't many people out there writing with such a sincere commitment to unbiasedness, charity towards hostile viewpoints, and the courage to tackle controversial topics. Well done.
The treatment regimen the American group is recommending includes Vitamin D, Vitamin C, Zinc and a Zinc ionophore (drug that facilitates cellular absorption of Zinc). The ionophore can be Ivermectin, Hydroxychloroquine or Quercetin.
I have been baffled up until now why studies are not looking specifically at the combined treatment, just the ionophore, with no regard to whether it was being taken with Zinc or the other drugs. The fact that even Scott seems to have overlooked this is very concerning.
It's the Zinc that inhibits coronavirus replication. That's the whole theory.
Terrific post. There is a flip side to the vax deniers/ivermectin promoters. The popular coverage of the ivermectin issue in the MSM was also pretty hysterical. A question: given the apparent low downside risks of taking ivermectin, would it not have been rational to use the drug? In other words, in the absence of evidence that it was harmful to use, given its long track record of non harmful use why not use? Of course, once we have decent reasons to think it does not good then why use it. But as you note, getting to this point was quite a journey.
The mainstream coverage was hysterical because ivermectin was being pushed as a miracle cure by anti-vaxxers, and an alarming number of people seemed to believe them. Anyone who thought "I don't want the vaccine, I'll just use ivermectin" was 100% making the wrong decision. Even if ivermectin *had* turned out to be slightly effective against Covid, preventing the disease is better than treating it.
"Ivermectin may help in some countries" is an interesting fact worth sharing, but it's the sort of fact that belongs in the science section on page 3. The fact that should go in 48-point bold on the front page is still "THERE IS NO PILL AS EFFECTIVE AS A VACCINE." So I really can't fault how this got covered in the mainstream.
If everyone got vaccinated and we were just haggling over the marginal case of "what is the optimal treatment protocol for breakthrough infections?", the discourse would look a lot different.
I think you are right that the issue was fear that Ivermectin would support vax hesitancy. But it was more than this, as the heat of the denunciations indicated. The best read is yours, that the heat was a kind of nobel lie to prevent the worst interpretations from happening come down as hard as possible. The problem is that this didnt work very well. Moreover, I suspect that there was also a desire to embarras. Follow the science! I think that if you want people to follow the science then it is best to model scientific discussion. And in the case of Ivermectin the science at the time was not clear it does any good, but seems pretty anodyne. Just dont use it in place of vax. That would have been honest, and might have worked better. As it was, it just became another battle in the culture wars.
I wouldn't usually interject into these kinds of conversations... but I have been *so* frustrated by people telling me to trust the science, and yet prevent science for happening. And I need to damn well vent.
Science gets people killed - trials require placebo groups who don't get potentially life-saving treatment, and gives people potentially dangerous drugs. Science requires debate and conversation - the same people who are intent on banning and suppressing "disinformation" are preventing legitimate discussion since censorship is a hammer and smashes ALL, both the legitimate discussing along with the illegitimate. Science takes time, and gets things wrong more often than right. Science requires we not get emotionally invested in what WE believe is the truth, because it may not be. Science requires dissent and people doing things differently - so please no vaccine mandates. After all, if there ARE long-term health effects from the mRNA covid vaccines, perhaps we should WANT a control group who hasn't had it, to compare outcomes with? Science requires providing data and letting others check your work - rather than hiding it and simply telling people that it's perfectly safe.
I also hope to never hear the term "expert" again, or have the 'benevolent' government forcing things upon me for my own good. This whole pandemic response has destroyed my trust in virtually all institutions, and all I really want now is to be left alone, and allowed to make my own medical decisions... which for the first time in my life, I'm fearful will be stripped from me. I can weigh my own damn risks *according to my own set of values*, thank you get very much. I can make my own choices. I'm an adult, and I accept the consequences of my actions. But at least for the time being, they are still MY actions to make.
> For example, if a paper reports analyzing 10 patients and finding that 27% of them recovered, something has gone wrong.
Great, there's no problem here, but you've used this type of analysis to slam the Nigerian study, and to make snide rhetorical asides about the Nigerian study while discussing other things, and I think it's worth pointing out that the reported data you've highlighted in Babalola et al. is not an example of this problem. It is impossible for 27% of 10 patients to recover. But it's not at all impossible for 50% of 21 patients to recover. That's just a question of how many significant digits you think you should use to report your results.
And as a matter of first principles, as opposed to cultural norms, I don't see a big problem with reporting results that were drawn from 21 people to just one significant digit. There isn't enough data to justify a second digit!
(Am I saying that Babalola et al. were entirely on the level and just nobly setting a higher standard for reporting precision? No. But I'm uncomfortable seeing their study slammed for exhibiting what is ultimately *better practice* than the cultural norm. Call them out for that, and you end up drawing bad lessons.)
> But it's not at all impossible for 50% of 21 patients to recover. That's just a question of how many significant digits you think you should use to report your results.
No. It's a question of why they decided to report 0 significant digits for those results, but were happy to report the additional digit for the 13 or so other results in the same table.
No, that's a completely separate criticism. "Why does this column look so different from every other column?" is a question you can ask without reference to what you think the values in the cells can potentially be. Scott has pounded heavily on the idea that you can't measure 50% of 21 people. That idea is incorrect. Accepting it will lead to bad conclusions. The low-precision numbers are what that paper is doing *right*. The high-precision columns are wrong.
The discrepancy between columns can inform your opinion of "DID they get these numbers, or are they making them up?". But that is not the same question as "COULD they get these numbers?". That second question is easy, and the answer is yes.
I think you're right that the theory that ivermectin was effective but people in the medical establishment were downplaying, ignoring, or lying about this for financial reason was indeed "extremely plausible," and helps explain why people like Bret Weinstein, who seems like generally a good guy, went so all in on it. With that in mind, I think the political takeaway here needs a couple more points added to it:
1. I don't know how many conferences at five star resorts on Tralfamadore or Coruscant the aliens have attended on the brain implant manufacturer's dime.
2. I don't know the extent of industry capture in the aliens' medical device regulatory agencies.
3. I don't know how much stock these aliens own in the company that manufactures the implant or what kind of swag the company's sales people (sales aliens?) might offer.
4. I don't know to what extent alien medical grant funding decisions are consolidated in a small number of people or agencies, which might be used to create a false image of consensus among the aliens.
5. In short, it's hard for me to develop an accurate picture of what incentives the aliens face, and how those incentives might affect what they say publicly about the desirability of universal brain implants.
Well, just to be clear, I personally have a Johnson & Johnson made brain implant, so that's a 'no' in my case, but from what I gather from those who have eschewed to follow the prescribed disease prevention plan in our current pandemic, I think their belief is that the studies were rushed and thus the downside risks related to complications from the vaccine like myocarditis were not captured in the trials or were ignored or what have you.
Again, I think the incentives played a role in how people came to view both: the federal government has spent umpteen billion dollars funding vaccine research over the past 18 months or so. Once there were a couple different versions, there was, I'm sure, plenty of political pressure to start showing a positive ROI on all that money sooner rather than later, especially after people's hopes were raised in the interim by news of their development. "We spent $10 billion on developing a novel vaccine, but we can't roll it out because it failed our safety review. You'll just have to wait longer, people" is not a message politicians or the bureaucracy wants to have to deliver. On the flipside, nobody really has an incentive to favor ivermectin as a treatment option because it's off patent.
Again, I'm not saying this is an accurate or complete picture, I'm not saying it's a compelling picture, but I do think it's a plausible one and some people out there found it compelling.
This is sort of off the cuff, but maybe the takeaway should be "Trust decentralized decision making processes, instead of centralized bureaucracies or guilds."
Also, on this point:
"But you also don’t want people to make bad health decisions."
I agree with this on a moral level, but if you don't know which health decisions are bad and which health decisions are good, then don't you sort of need some people to make bad decisions some of the time?
"So what do you do?" Give people as honest and complete a picture as possible and let them choose for themselves what to do with that information. Don't limit people's options unless there are significant externalities.
Did you read the post?!? The decentralized approach of ivermeta website seems to be completely wrong. And “giving people all the data” lead to millions of people believing that ivermectin is a miracle cure.
I think the takeaway is unfortunately that big name journals and organizations like WHO and FDA and NIH seem to be more trustworthy than an anonymous website and a coalition of loud doctors.
I don’t find this conclusion satisfying, but I don’t have a good synthesis from all our covid experiences to conclude a simple prescription on who to trust. Just who NOT to trust.
I did read the post, but I guess I had a different takeaway. The medical establishment seems to have been right about ivermectin, but not for the right reasons. I don't give them a ton of credit for that.
And while I agree that the decentralized-process ivmmeta.com guy(s) and the authors of the studies they relied upon also got it wrong, I group "ASC and a bunch of academics doing meta analyses and thinking really hard about confounders" as also being part of the decentralized-process that ultimately seems to have arrived at the right answer.
In other words, I accept that error is part of trial-and-error, but I'm a lot less forgiving of error when it's part of argument-from-authority.
I don’t think the medical establishment was right for the wrong reasons. All along, docs and scientists have been saying that the data supporting ivermectin is flimsy and they’re waiting for good, large RCTs before starting to prescribe to patients. The sleuths finding fraud only bolster the official position of orgs like NIH and WHO.
That’s because docs and scientists see flimsy data all the time, and they know that there are an infinite number of shitty journals that will publish anything. They’ve learned to be skeptical of poorly done science, because they know how easy it is to trick oneself with biased and confounded data.
I don’t trust scientists and scientific orgs because they are authorities, but because they (try to) apply the same skepticism to things that they believe as they do to things that they don’t believe.
Argument of authority is on itself a logical fallacy, and highly suspect. "Authorities" and "experts" are NOT some kind of saintly angels with no self interest or incorruptible. In fact they are VERY corruptible. Decentralized decision making crates a robust, stable, outcome mesh. Centralized systems are very unstable, any mistake can extinguish human life. Just imagine the pfizer vax had the undesirable effect of making your sperm inert (we still don't know the full long term effects), and every man on earth took it. For another example of the fragility of centralized systems, look how the Incas (an extremely centralized civilization) were conquered by 20 spaniards when they kidnapped the Inca (emperor). But they couldn't beat the decentralized mapuche of southern Chile and Argentina in 300 years of war. The economy has also nice examples.
This article is a great example of how *hard* it is to perform a good medical review. Most people have not had the training to do so.
Our medical community *is* decentralized today. There are a lot of different experts reviewing and commenting and driving forward science. Yes, eventually the FDA or the CDC need to take a position based on the outcome of that work, so in that sense there is centralization, but all of the other voices are still there and available.
I do not believe a 10,000 couch doctors without any experience reviewing medical studies can perform an appropriate medical meta analysis.
I consider myself very bright, a natural skeptic, and aware of my own potential biases. I would have missed a good number of the items that Scott raised in this article, let alone the countless more specific details that he either only eluded to or didn't even mention. I just don't have the skills.
Skills matter. When it comes to golf I will bet on Tiger Woods over 100,000 randomly selected individuals any day. I want a trained surgeon giving me a heart transplant, not 100,000 internet commentators who have "done the research". Before I sit down and go 80 mph on a highway in a metal death box I am reassured the experienced people with skills and training built my car, not 100,000 twitterati who watched youtube and read repair manuals.
I'm not so happy with the "everyone was wrong" conclusion. Everyone wasn't equally wrong. There were people following studies and drawing reasonable conclusions (as you pointed out) and others demonized a harmless medicine that by all appearances seemed to be saving lives. And it actually did so in many places. They might happen to be vindicated (not of their own accord) if we pretend mainstream media only affects the west. Even if you're right, I wonder how many lives were lost in the 3rd world due to the demonization of ivermectin? Is "being wrong" the right expression for this?
Yeah, this is def not an “everyone was wrong.” Most docs and scientists said that ivermectin might be helpful, but the studies so far were low quality. Folks like Dr. Daniel Griffin mentioned the worm/steroids thing a year ago.
Twitter and NYT mocking “horse dewormer” was a very small sliver of the mainstream experts who voiced concern about ivermectin. They were just the loudest.
I don't understand why Scott rejects the Ghauri study from Pakistan for non-random allocation of subjects. Wouldn't sicker subjects be given ivermectin, anyway? It seems that the non-random nature of allocation would bias the study towards *not* finding a significant effect for ivermectin, and the study still finds it, supporting the hypothesis that ivermectin has a large positive effect on Covid patients.
Is that true? If I were sicker, I’d want the proven therapy. And very sick patients can’t discuss and consent and just end up in the control. It’s a mess, either way.
But Scott rejects another study by saying that sicker patients would opt out of studies just so that they could take ivermectin, and not be subject to randomization.
Can you quote him? Anyway, my point is not that it confounds only in one direction, but *that we don’t know* how it confounds, so we can’t easily correct for it.
I think one element of the political takeaway that was understated is the idea of something like normalization of control, and how that plays into commands that are mentally bucketed with other commands.
The idea that the left (in the part of the government sense) loves to have as much control as possible and to overall put in as many restrictions as possible so it's more "in control" isn't a new one; a lot of people on the right hold it. And the idea that the left (in the voter bloc sense) likes being restricted in this way to the point where they will sometimes make obeying restrictions into a performative social signaling type of thing isn't new to them, either.
A lot of these people have accurately noticed that when the government gets "I can tell you to do this" normalized on any particular subject, not only do you never get that particular freedom back but it also makes it easier for the next command to be considered normal. They aren't going to see "take vaccines" as a needle-thin targeted command, because to them it's part of a super-obvious wave of "no, we eventually want to have much greater control over what you can be compelled to do or not do in a lot of parts of your life; do this one so the next one is easier for us, please".
The reason this is distinct is because it deemphasizes the "do vaccines work and do they have microchips" part of things; you can think the vaccines are part of a greater scheme to control you without thinking they have nano-tech control devices, particularly. Imagine the scenario you proposed with the aliens to include "and if they get everyone to have microchips, they've established a precedent where they get greater control over all human healthcare forever" and you are close.
The Last Psychiatrist once did an article on Dove Soap creating arguments on beauty, where the practical upshot of creating the argument for Dove is that they were then viewed as an authority on beauty at least important enough to be in the argument. More simply, they normalized the idea of "If Dove gets something wrong on beauty, that matters" which naturally leads into "Dove matters". Similarly here, the right is correct to notice that if the left can force vaccines on them, then "We are an authority on this vaccine and making you take it" naturally translates into "We are an authority on your health, and can make you do a bunch of stuff".
I actually think part of why "these have microchips to control you" theories got a foothold as easily as they did is because of this; if the political left views this not just as a "get good health outcomes" thing, but also as a "how dare they disobey us; crush the other!" thing as well, then the average person might pick up those "this is also about making sure people know who is boss" vibes and go looking for a plausible way the left gets the control it's clearly seeking from a simple shot. Some people look in the wrong place for the mechanism of control (the tech) but that doesn't mean the actual mechanism of control (establishing an ever widening sphere of places in which one has command) doesn't exist.
Nice comment. I agree there was a bit of medical libertarianism in play with some people who are "vaccine hesitant" or whatever the term of art is these days.
I think the hostility dynamic is waaay more important than the alien dynamic in explaining why some people don't just ignore the medical establishment, but seem to actively go against it. In fact, I think it explains a lot more than people's varying reactions to COVID. Something like 25% of Americans hate something like another 25% of Americans and think latter is out to destroy the former's way of life (and the feeling is mutual). So, yeah, trust is going to be hard to build. And even when the objective evidence is pretty strongly on one side, sometimes people do potentially harmful things just to spite their enemies. In the case of COVID this is even easier to do because the risk is in this weird gray area somewhere between background-level that everyone sort of ignores and existential that scares everyone into the same boat.
I WONDER what would happen if you applied the same level of rigorousness to the effectiveness studies (and other data, like adverse effect prevalence) available for the emergency authorized vaccines. Not holding my breath tho.
"So “believe experts”? That would have been better advice in this case. But the experts have beclowned themselves again and again throughout this pandemic"
This whole article could have been summarized in these two sentences, and it's really all you need to know. The establishment has visibly produced a string of completely absurd measures and policies against Covid. Every time you get something like Biden ignoring mask laws, that's a hit to the credibility of vaccines and scientists. It's like OJ Simpson, who got found not guilty because he was guilty, but the police tried to frame him anyway.
I think Scott managed to get this right, but he's softening it by far too much. "People feel like the establishment is hostile aliens" is one thing. "The establishment acts in ways that resemble hostile aliens" is very different. And Scott is putting too much emphasis on the former, and not enough on the latter, and when he does mention the latter, it's things that they're doing at the start of the pandemic, not things they're doing now. Biden ignored the mask laws just a month ago, and eviction bans where Covid is used as an excuse for blatantly political sticking it to the landlords are quite recent. Scott didn't even mention the double standard over BLM riots during a pandemic.
I have some sympathy for this attitude, but at the same time, I think there's an important sense in which it really only makes sense if you gold the left wing of our political establishment specifically responsible for being the adults in the room.
Should Biden have ignored mask laws? Clearly no. Did Democrats exercise a double standard over BLM protests? Absolutely, and I called people in my own social circles on this at the time. Do liberals favor eviction bans because they stick it to landlords? It probably increases support, although caring for poor and potentially homeless people is already left-aligned policy without bringing landlords into the picture at all.
But at the same time, when right wing establishment figures have acted to politicize questions like "is Covid-19 dangerous and worth taking seriously at all?" Or "is it a good idea to get vaccinated?" Which are much simpler and easier to answer than the ones we're looking at here, then expecting left wing figures to do a better job than they're doing to set a better example means holding them responsible for being much smarter than figures across the aisle from them.
Left wing figures could have done a much better job than they have, but if they had met these standards, it would have meant our populace was divided along political lines into "the dumb side that needs to be carefully shepherded" and "the smart side which is responsible for taking care of them." I don't think we can expect things to shake out like that in reality.
I was talking about the establishment discrediting themselves because on one hand, they say that vaccines are good, but on the other hand their very obvious allies are doing other things which lead to a loss of trust. The right-wing "establishment" are trying to discredit the other side. They're not discrediting <i>themselves</i>. It's a very different kind of thing.
And even counting them as the establishment is questionable, because they don't have enough influence; they're not in the political system, and they don't control the media (let alone social media).
Trump, as president, made public statements that the virus was nothing to worry about, that the pandemic would go away on its own, while recordings of internal discussions indicate that he believed it to be a deadly serious threat. I don't see how that fails to meet the standards of "establishment " or "self-discrediting." Rather, I think it's a serious problem that many conservatives only recognize "media" or "establishment" as such when they're liberal.
That counts as a single example of a non-leftist establishment figure saying something stupid and self-discrediting, but Trump was an anomaly. The media and political estblishment are leftist by a huge margin, and the overwheming majority of such things comes from the left simply because the left has so much control, even if not literally every single one does.
I was convinced of the conclusion from Deiseach's comment earlier, so no surprises for me personally. (Another +1 to Deiseach from me.)
However, the comprehensive treatment made me notice something else:
The places with a preponderance of parasites tend to be the places where medical trials aren't great. The places without much parasites tend to be the places where medical trials are comparatively excellent. This association is not coincidental.
That is, a high standard of quality for evidence may bias you towards interventions that work in developed countries, and bias you away from interventions that work in developing countries, insofar as there is a difference in outcome between them.
And I think this is a lot more of a generalized phenomenon than that statement may imply, and that a high standard of quality for evidence is itself not an accident; we calibrate to the environment we experience.
(Also, the hostile alien thing is quite general, and I've slowly come to a position I'd describe as rational anti-rationality, away from a position I used to occupy in which I believed it was best to believe whatever the best arguments and evidence suggested was true. Increasingly I believe the relevant currency is not evidence, but trust.)
1. Ivermectin clearly isn't as effective as a vaccine.
2. Several of the top studies claiming it was super-effective were obviously fraudulent (and now have been proved fraudulent).
3. Ivermectin is almost certainly more effective than a placebo.
4. Even if Ivermectin is basically only as effective as a placebo, it still is probably effective enough to use as a treatment of last resort.
4A. I originally would have had a joke that some of the patients might have worms; it did not occur to me that patients actually having worms might have been a significant factor in some studies.
5. Many of the studies saying that ivermectin doesn't work aren't actually proving that, they're only proving that it isn't 90%+ effective or that they are bad at determining study size.
6. The Scientific Establishment has failed miserably here. There should be at least one "gold standard" Western trial with at least 2500 people.
6A. Also the political establishment has failed miserably here; why didn't Ron DeSantis and the Florida Legislature order the state medical establishment to conduct a study?
7. Publishers such as Elsevier regularly publish crap; they publish both pro-IVM and anti-IVM crap so it is presumably incompetence.
A counterpoint to the worm hypothesis: in all the hospitals I have worked, it is standard of care to give ivermectin to any patients before starting high-dose corticosteroids (to prevent disseminated strongyloidiasis), long before COVID. My experience is only in tertiary hospitals of a single city in Brazil, so maybe it's not a widespread practice and ivermectin might improve outcomes in other places, but at least here, but at least here, the main effect of ivermectin has been gastrointestinal symptoms in patients talking it
Issue #1 is the standard of practice is excluded in the trials, because ivermectin was not given to the control group despite some trials giving steroids to every single member of the control group. Issue #2 is that you don't need steroids to have disseminated strongyloidiasis, as COVID-19 itself is associated with eosinopenia even without steroids.
Well, you don't need to deworm patients for just any dose of steroids, just for very high doses. Eosinopenia is also a feature of any serious disease, it happens in sepsis and disseminated strongyloidiasis is not a problem in those cases
First point is demonstrably false. Disseminated strongyloidiasis has been found after starting wide ranges of doses, not just very high doses. Regarding the second point, there is evidence that Eosinopenia can occur fairly early on in COVID-19 infection, at the point of admission, not just at the point of decompensation. Also, we don't actually know that disseminated strongyloidiasis isn't a problem in sepsis cases with underlying strongyloides. It absolutely has been associated with sepsis cases and various infections. It just is underdetermined because those cases usually have other things involved that could cause disseminated strongyloidiasis.
There have been reports of it happening after a wide range of doses, sure, but the risk has to be extremely low or else emergency rooms would be full of cases, given how relatively common corticosteroid is. Similarly, eosinopenia and sepsis are routinely seen, and if disseminated strongyloidiasis was common, we would probably see some manifestation of it
After i read scott's post I was wondering why they don't give deworming tablets to everyone in the hospital waiting room in countries where this is a problem.
Of course it would be better to give antihelminitics to everybody but the EAs are already working on that.
I'm unaware of any studies showing a positive outcome of deworming everyone in the waiting room, but I'll admit I haven't looked into it. I doubt it's a cause of high morbidity in asymptomatic adults with appropriate food intake
I did a very quick search and there are a few studies out there that suggest that parasitic intestinal worms actually reduce the severity of Covid19disease outcomes. For example https://www.medrxiv.org/content/10.1101/2021.02.02.21250995v1 Perhaps someone with more research experience than me would look into this here since it seems relevant to this hypothesis put forward by Scott?
The hypothesis is they reduce the severity of COVID-19 because they are Th2 loaded, not Th1 loaded. So they clear COVID-19 *slower* but have better clinical outcomes. However, if COVID-19 causes eosinopenia, as it can sometimes cause, or if steroids are given, then all bets are off - since that's a recipe for disseminated strongyloidiasis.
We have a mystery. The US has 30 times the population of Haiti. The US is the richest nation in the world with the preeminent medical establishment. Haiti is one of the poorest nations where medical care depends to a significant degree on the organizational efforts of one man: Dr. Paul Farmer.
Covid-19 deaths per day (7 day average) in the US peaked around 3400 deaths per day. Covid deaths per day in Haiti peaked at 6.
3400 divided by 6 is 567. The ratio should be 30. In fact it should be lower than 30 considering the glaring difference in resources.
There have been 751,815 deaths from Covid in the US but only 658 deaths in Haiti.
How do we explain this? We need a list of hypotheses and widespread use of prophylactic ivermectin in Haiti is as good as any other hypothesis I have heard.
A prophylactic treatment is different from a cure. Daily aspirin in small doses has been recommended to reduce thekk likelihood of heart disease. This does not mean that aspirin will cure heart disease.
Ivermectin may not cure Covid and yet be a prophylactic which reduces the chance of getting Covid.
A COVID-19 prophylaxis? Lower incidence associated with prophylactic administration of ivermectin
Using the drug ivermectin for prophylactic or preventive purposes among healthcare workers with high exposure to patients with the virus reduces the risk of presenting symptomatic Covid-19 by 74% compared to their peers working under the same conditions.
Other reasonable answers are that the population of Haiti is much younger (a median age of 24, compared to the USA at 38!!), Haiti has much fewer intentional connections so it spread slower and later, and that Haiti will underreport deaths from COVID (if someone dies in a small village, it doesn’t get reported to anyone).
Between those, I don’t see any reason to favor ivermectin as the cause of the reported disparity. The age difference especially is a strong explanation because almost all of the deaths in the US are among the elderly.
There 93 times as many persons 65+ in the US. If we make the simplifying assumption that all Covid deaths occur in this age bracket, than we would expect 93 times more Covid deaths in the US than in Haiti. This also assumes that Covid fatality rates are the same in the two countries.
This is our null hypothesis.
There have been 788,127 deaths from Covid in the US but only 711 deaths in Haiti.
US sample mean: 788,127 ÷ 329,500,000
0.00239
Haiti sample mean: 711 ÷ 589,000
0.00121
As of Jan 8, 2021: 237 Covid deaths in Haiti.
As of Nov 15, 2021: 708 Covid deaths in Haiti
As of Jan 1, 2021: 370,601 Covid deaths in US
As of Nov 15, 2021: 785,131 Covid deaths in US
I took the latest totals. The mean difference would be greater at the end of 2020.
I assumed a standard deviation of .001 for both populations.
We agree that after adjusting for the age, it’s approximately a factor of 10 different.
For the difference in time, you have to look at the case fatality rate over time, not just the number of deaths - the fatality rate has dropped significantly over the course of the pandemic, so if the vast majority of Haitian cases have been later in the pandemic, they would have significantly fewer deaths. I would expect this to take off another factor of two or so
I’m not sure whether COVID is endemic in Haiti, but I would be unsurprised if it hasn’t fully reached all of Haiti yet, especially the isolated communities that are poorly connected. I would expect this to be about another factor of two. Remember that some countries (for example, Australia) have had essentially no COVID deaths) because they’ve been good at isolating populations and lockdowns.
The under reporting could easily represent another factor of ten on top of those, so this would bring Haiti to a higher number of deaths per cases than the US, as expected by their worse healthcare.
Frankly, the US and Haiti are extremely different countries because of economic and age situations, and you don’t need to bring in anything mysterious to explain it.
Hmm, if the over-65 demographic is much smaller, relative to the whole population, that might argue a few confounding factors: (1) the over-65s are more spread out, so transmission between them is lower. Do Haitians stick their old folks in nursing homes? That was certainly a factor in a lot of early US deaths. And (2) maybe the over-65s are generally tougher in Haiti on account of greater winnowing at younger ages. (I mention this because one of the weird facts of US life expectancy is that past the age of 80 the longest living demographic is black women. Not at all what you'd expect, but if you experience a more callous regime when you're younger, those who survive it will necessarily be tougher.)
Not that I think either would explain your results. I would guess Haiti is going to end up with Africa as one of the very strange aspects of COVID that will take decades to unravel. Why are African blacks less susceptible to COVID (as far as we can tell) but American blacks are more? That is seriously weird.
"because one of the weird facts of US life expectancy is that past the age of 80 the longest living demographic is black women. Not at all what you'd expect, but if you experience a more callous regime when you're younger, those who survive it will necessarily be tougher."
It's possible, but not necessary. Those who survive the longest might be the toughest, but also the most damaged.
Indigenous people might have it about as bad as back as black people. Do they show this pattern? Is there anything like this pattern in other countries?
Any time a poor country is involved (let alone Haiti) you should immediately wonder if they have a well-functioning bureaucracy that is able to record all deaths in a timely manner with a determined cause. And similarly for cases, do they have sufficient testing capacity, deployment and bureaucratic function to detect and centrally record a large fraction of cases?
Yes, my default assumption is that a poor country will undercount or, even if they don't undercount, underattribute (leave deaths as unexplained due to a lack of resources). They will also undertest for Covid. This explains why most poor countries are "spared" from the pandemic in official figures: https://twitter.com/DPiepgrass/status/1467572944150794241
The Strongyloides stercoralis hypothesis is interesting but it seems pretty speculative. The prevalence of infection in these areas that are supposedly "teeming with worms" is in the range of ~10-15%, and most of those infections are going to be light. It's possible that those who are infected are at greater risk of death when hospitalized with covid, and also have that risk attenuated when treated with ivermectin due to the deworming effect, but again that's speculative. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/
Thanks, I am "pro Ivermectin" because I found in silico studies showing attachments to several viral proteins to be fairly compelling, and I greatly appreciate your work of having actually read all of them.
I intrinsically tend to give pro-Ivermectin studies the benefit of doubt because nobody financially benefits from a positive finding. This is of course an implicit bias and also just my opinion.
The sidebar on worms is actually highly intriguing.
My "vaccine distrust" comes from several sources:
--A Vaccine centric theory of beating Covid has a fairly hard time accounting for the fact that Africa is not on fire. Younger population, warmer climate or genetical immunities could contribute, but the counter examples of somewhat similar in these metrics Brazil or India would in part disprove this. As such, the existence of a possible Africa specific Coronavirus-like, or Covid being effectivly treated with "non standard treatments" would seem plausible, and Ivermectin would solve the "Africa riddle" while also having a mechanism of function according to multiple in Silico studies. If one believes in a possible "Covid-Vaccinia equivalent" to "Covid-Variola", then we should certainly send some crack scientists there to figure that out yes?
--There is of course an emotional and psychological factor. I have a major in Theoretical Biophysics. Journalists and "experts" who are cleary not demonstrating "subject mastery" tell me what to do and what is science and restrict my freedoms.
--While I am pro Vaccine, I am skeptical of m-RNA vaccines if a safe conventional vaccine like Sinovac is available and has been used 3 billion times in humans. The issue with m-RNA vaccines is that Covid can at least evade the immune system more easily, on account of m-RNA vaccines only presenting a single protein. Delta is basically 3 point mutations on the spike protein.
Sinovac would be more of a generalist, and perhaps less strong against any individual covid strain but reasonable against all of them.
--A reasonable case can be made for Ivermectin in that it does no harm, and a very reasonable case if you simply see it as a mostly harmless (we know the side effects reasonably well) placebo. Giving it, under controlled conditions, safely to people who want it is imho fine.
Declaring reverse jihad on "Horse dewormer guzzling rednecks" is completely out of line.
Nothing stops you from being vaccinated and taking ivermectin. One is prevention, the other is cure. The vitriol against it is so out of line that my admittdely conspiracy spidey senses are tingling.
--Concerning myocarditis from vaccinations, I am of the opinion that this is due to accidental intravenous rather then intramuscular injection (a phenomenon also known from smallpox vaccine). There are pragmatic ways to reduce the odds of this, and probably save hundreds of lives. That this is not done seriously galls me.
> nobody financially benefits from a positive finding
Whoever authors the paper definitely financially benefits from a positive finding. Because of publication bias and the general bias towards positive results, publishing a pro-ivermectin paper gets you a fancy new job at a prestigious hospital while an anti-ivermectin paper probably won’t even be published (and if it is published, it will be seen as boring and won’t get cited).
> Sinovac is available and has been used 3 billion times in humans. The issue with m-RNA vaccines is that Covid can at least evade the immune system more easily
Last time I checked Sinovac was inferior in effectiveness to m-RNA vaccines.
TLDR, but the most obvious comment, far as I saw he didn't mention the fact that two of the four negative studies were massive overdoses, and no discussion of zinc. it was obvious in spring 2020 that the cabal tried to get out front of early treatments by offering fraudulent studies of both HCQ and Ivermectin, including studies set up to fail by massive overdose of IVM, and studies on patients already on vents or nearly.
Odd how that both with ivermectin and HCQ, the proponents are always moving the goalposts . . . if a study shows that it "works," then they broadcast the study far and wide even if totally fraudulent or incompetent. If a study shows that it "doesn't work," then they start quibbling over the dosage and timing -- as if there was any solid evidence for dosage or timing being relevant.
It's not odd, it's 100% human nature. We are all natural scholastics, and empiricism come hard to us. If there's a conflict between theory and experiment, empiricism says believe the experiment and revise your theory, while our natural scholasticism says find out how the experiment was flawed.
Can you point to a study that overdosed on IVM? I have pointers to ones that overdosed on HCQ, and studies that allegedly got null results because the IVM dose was too low. IVM is not very toxic so overdosing on IVM is hard to accomplish.
>They would feel like immunologists are some sort of dark and terrible figures from a shadow dimension they could never reach. They would seem like aliens.
I like the rest of it but... this doesn't feel like it fits. Too many people I know in research and medicine and immunology still have close family who are anti-vaxers.
Like, sure, don't believe the sinister Other.
But this is people who have close family who can say "Mom, I literally worked in the team that did that research, there's no microchips, the vaccines aren't for targeting jewish space lasers" and yet Mom or Uncle Harry still believe the daily mail and facebook memes over their close family.
It's more like the creepy hostile aliens managed to slip those brain control chips into a chunk of the population and then they all short-circuited leaving them believing a laundry list of things that don't make even a little sense and their friends and family can't get through to them.
Genuine question. How confident should we be that mRNA technology has no negative long-term effects? For context, I ran out and got three shots of mRNA vaccine as soon as possible.
As I understand it, the mRNA technique is getting a lot more directly involved in the body's chemical pathways than previous vaccines. Is there strong evidence and theory that this can't affect these or other pathways in unintended ways? Do we have strong evidence and theory that the reprogramming of these pathways won't have longer term effects on the immune system's reaction to the body's own markers (e.g. either making it more permissive and allowing cancer or less permissive and creating auto-immune responses) or affect gene expression (even if it doesn't affect DNA) etc.
If you google these questions, you get lots of comforting CDC/FDA pages or very dense immunology papers that seem several steps removed from these questions. But of course, public health communication has consistently been focused on convincing the public to take particular actions, so there's always that nagging question.
Is this a situation where:
1) we just have no idea
2) these problems are ruled out essentially entirely by theory and evidence
3) we think that these problems would have shown up if they were going to, but we can't rule out some edge cases
strongly ruled out by theory outside of a few edge cases like cells getting infected by *exactly* the right kind of retrovirus virus at *just* the same time and then the immune system not just killing off the affected cells... but that case would also apply to getting infected by any normal virus so someone should probably be more worried about that happening with every random cold they get.
Since they're sort of doing what viruses already do but with a known "package"... just about every hypothetical way it could cause long term problems undetected in any clinical trials so far seem like they would apply more strongly to any mundane viral infection.
I would say (2) and (3). mRNA just backs up the place where you interfere in the biochemistry a little bit: instead of injecting a foreign protein, you inject the instructors for building a foreign protein (which is what a virus does). So the body builds the foreign protein and that gets you your immune response. How do you know it doesn't *continue* to build the foreign protein? Because the pseudo-infection doesn't continue. Also because, since you are mimicking, to a substantial extent, what a virus does naturally, there are many and powerful methods the body has for discovering and snuffing out illegal alien instructions for making protein.
mRNA vaccine are *in principle* very simple technology, and the reason they are only coming into existence now should give you additional reason to be more confident in them: the problem has always been that the body is *too* good at discovering and smashing alien nucleic acids. The difficulty in getting an mRNA vaccine to work was preserving it *against* the body's detection and kill machinery long enough for it to do its work. Tricks had be played to make it unnaturally harder to identify and destroy. But even so, it's wiped out quickly, within minutes. Future work may very well center on how to make it even longer-lived, how to get the body to reverse transcribe it back into the genome, et cetera, to engineer longer-lasting effects, immunological and otherwise.
It's very reasonable to be extra concerned at introducing some alien thing into the body that acts at a "higher" level of the command-and-control machinery. The reassuring info is that *the body itself* "feels" the same way, and so our internal search-and-destroy apparatus is more powerfully attuned and faster-acting when it comes to those kinds of alien artifacts. Doesn't mean we can't screw that up. But we'd have to work harder, or be more (un)lucky.
"So the body builds the foreign protein and that gets you your immune response. How do you know it doesn't *continue* to build the foreign protein? Because the pseudo-infection doesn't continue. "
Correct - but also note it's because mRNA is very fragile. So what you get in the injection doesn't have a long "shelf life inside the body", so to speak.
Thanks this is a really useful explanation. My one followup would be that we know that some real infections are cleared quickly by the body but come with long postviral syndromes (e.g. EBV) that seem to have something to do with the immune response. Is there any concern that mRNA vaccines could have similar effects? Again, is this something that is a real concern but would have been observed already, ruled out by theory or still a longshot possibility?
Well, I don't *know* because the only way to know would be to collect the observational data long enough. The body can do weird and surprising things and the more you know about immunology the humbler you get, in my experience.
But it would be surprising, to me. The vaccine components are eliminated pretty quickly, the mRNA within minutes to hours, and the components of the lipid nanoparticles over a week or two. The longest-lived components are a few somewhat unnatural polymers that have to be laboriously converted in the liver to something more oxidizable, this seems to take a week or two according to rat studies. So it's hard to think of a mechanism for long-term effects. Why would that happen?
With the virus itself, one would assume (in the case of COVID) that long-term effects are a result of the damage that is done before the virus is cleared. Some tissues in the body repair themselves quickly, some very slowly, and some never repair themselves at all (which is part of why heart attacks and strokes are so deadly of course). So it is possible the COVID infection sometimes damages tissues that heal very slowly or not at all, and this is responsible for any long-term effects.
That said, there are viral infections that "hide out" and can persist for decades. The herpes family is famous for this, they become quiescent chunks of DNA/RNA living in cells peaceably, reproducing slowly and being passed on from cell to cell without causing the massive disruption and death (and aggressive immune response) of a more active infection, and so they can be there for a long time, sometimes flaring up into an aggressive infection years to decades later. I don't think anyone suggests COVID is like this, if only because it tends to infect fast-growing cells, like the epithelial cells that line the lungs and blood vessels, rather than long-lived nerve or immune cells. But who knows? There is still much to learn about this disease.
That's interesting that you're saying post-viral effects are mostly the result of damage from past viral infections or from ongoing latent infections.
My working mental model had been that certain infections led the immune system to generate pathological tools to combat infections that had persistent negative effects afterwards (i.e. by ongoing auto-immune disease). Are you saying that post-viral syndromes aren't really best characterized as auto-immune diseases? Or alternatively that the auto-immune diseases that result from infections (I've seen this claimed for type-1 diabetes for instance) are actually either ongoing responses to latent/active infections or the result of organ damage that the acute response to those infections caused?
I'm actually realizing that I don't know the answer to the basic question of: if you somehow got a type-1 diabetic's own beta cells and reimplanted them, would their immune system immediately kill them again or is that threat now gone? Given that type-1 diabetes takes years to kill off all the islet cells, should we be extracting and freezing diabetics' own islet cells for later retransplantation?
>Future work may very well center on how to make it even longer-lived, how to get the body to reverse transcribe it back into the genome, et cetera, to engineer longer-lasting effects, immunological and otherwise.
mRNA is unstable and is broken down fairly rapidly. Indeed, one of the reasons why these vaccines have such annoying handling requirements is that mRNA just isn't very stable to begin with.
As such, these things just can't linger in your body for a long time because it literally isn't something that is stable for long periods of time.
Any side effects from the vaccine would show up very rapidly.
My current thinking is that any time you get a cold you'll have uncontrolled growth of a virus using mRNA to making copies of itself, and also there have been many "live" vaccines based on attenuated viruses before (https://www.hhs.gov/immunization/basics/types/index.html).
In both cases, I expect you'll have real virus particles abusing your cell's RNA/mRNA machinery. I have yet to hear anyone try to explain why this abuse is "safe" when live viruses or attenuated-virus vaccines do it but "dangerous" when mRNA-in-a-nanoparticle does it. I watched a 3-hour video of Kirsch et al talking about how we "know spike protein is dangerous", I looked at his blog post, but AFAICT he just said it's dangerous over and over, never actually presenting any evidence. Kirsch did say that "Biodistribution of lipid nanoparticles which carry the mRNA show that the ovaries get the highest concentration" but this is clearly false: https://www.lesswrong.com/posts/7NoRcK6j2cfxjwFcr/covid-vaccine-safety-how-correct-are-these-allegations?commentId=f97bJXwj2M5toGDvt
But also, if the spike protein is dangerous in a vaccine, why wouldn't it be more dangerous in an actual Covid infection?
I have seen a peer-reviewed study showing that spike proteins are cytotoxic - in concentrations 100,000 times higher than you get from a vaccine - as study co-author Uri Manor explained on Twitter while expressing dismay at how their work had been misused. https://twitter.com/manorlaboratory/status/1395564601907896322
I mean, 100,000 times greater than a vaccine would be 50 liters. Injecting 50 liters of anything into your bloodstream is going to kill you; at that point, spike protein is the least of your worries.
Indeed, though the 100,000x is a statement about bloodstream concentration, and only a tiny amount of vaccine is seen to leave the injection site so it'd be far below 50 L. And one must distinguish between LNPs and spike protein, but I'll shut up now.
Great post. As someone who is 100% convinced Covid vaccines are a Bad Idea, I'd love you to give them the same treatment; my mind is open.
Your alien brain implant metaphor describes my thinking perfectly (yes, it IS a reasonable way to think) — except for two things. I don't distrust science/tists, I distrust the academic establishment, the medical establishment, the political establishment, and the establishment media. It's a question not of malice, but of incentives. I'm sure I don't need to elaborate. Second, the trojan horse Covid vaccines are introducing is not technological or medical (e.g. nanobots, DNA rewriting), it's social. Hardcore imposition of vaccines are a way to suppress independence and redefine "freedom" into a synonym for "security". This is very bad for society, regardless of the science — I just don't see any scientific reason to take the Covid vaccine either (you can mostly thank Alex Berenson for that).
I think that ship may have sailed long before your birth.
if anything governments have kept the kid gloves on re: covid.
Go back a century and "vaccination raids" were a thing, think people kicking in doors and vaccinating people. And that was in the days before the high safety/purity standards of modern vaccines.
it's the "less nice" side of how smallpox was wiped out.
If anything governments have avoided most of the really heavy handed stuff they used to use to force vaccines on people in the past. It's kind of proof of them moving in the exact opposite direction, more freedom and less jackboots and force.
Well I think he's arguing that public health has *historically* been the one area of government where people have tolerated a surprising (by modern standards) level of enforcement rigor, and a surprisingly low (by moderns standards) -- like zero -- level of dissidence.
And I think that is quite true. Remnants of it persist even today: if you refuse to take your TB meds, almost all states IIRC have provisions in public statute for having you locked up until you do. No trial needed, no charge, no civil liberties defense -- if the local public health authority says you've got TB and aren't cooperating in treatment, you go off to jail indefinitely. I think most modern people would find that a little shocking, but it's a leftover from an earlier time period when people were just a lot less tolerant of dissent when it came to infectious disease.
There are similar provisions for STDs, in many cases a treating physician is compelleted to report them, and public health authorities are entitled to do tracing, none of it with the patient's consent. Imagine proposing *that* as a new law in today's world.
In some ways I feel like the Overton window on public health just slowly shifted over the past few decades, without people much noticing, because infectious disease just went out of the life experience of most younger people.
One reason I say this is because in my experience a lot of older people are just kind of baffled over some of the heat on vaccines. When I was a kid, it was absolutely routine, for example, for countries to require vaccination proof for entry. I used to have a little yellow International Vaccine Record that my mother had to take with her when we traveled, and show to border officers. In some cases we had to get extra shots to visit some country or other. Totally routine, unremarkable.
Same with school vaccines. It was routine to require these things, and nobody in my experience much thought twice about it. We didn't even *ask* whether they were super duper effective or just kind of, or whether there might be some reason rooted in civil liberties or religion or whatever to carve out some exceptions. It's just what people routinely did, and getting passionate about it seems like getting passionate about the requirement that you have a driver's license before you drive on public roads. Sure, if you think about it, I can readily see the case for why this might be an infringement of civil liberties in some sense or other, but it feels strange to even get worked up about it because we're so used to it.
That seems to have changed, and it's a little mystifying to me. My tentative hypothesis is that 50 years ago we (as a people) were *much* more used to infectious disease causing serious death and destruction. People remembered polio, and smallpox. VD was harder to treat. So there was a sense that this shit is verious serious and hard to deal with, so yeah we're not going to be too careful about the rights of minorities and civil disobedience when we draw these lines.
That doesn't mean it was necessarily *wrong* for times to change, of course. Maybe we *can* afford to be more sensitive to individual liberties now, because we *have* almost entirely removed the threat of infectious disease in modern First World life. That would probably be a good thing.
I commented above that vaccines for travel sound like the most normal thing in the world, to the point that a country not verifying vaccine status for polio for anyone who's been in a country that still has it is a failed state.
And you have no general right to enter a foreign country, so you submit to their demands. Keeping out people with disease is absolutely the host country's right!
I was vaguely approving of Trump doing border controls [1] to keep out people coming from abroad unless they could prove they didn't have covid, and he was getting heat from the left for doing it, because The Science says border controls don't work[2].
I expect the polarity on border controls for disease have flipped completely. Because people are nuts.
[1] but his implementation sucked and may have been worse than doing nothing
That is certainly one factor. Perhaps another factor is that we have less civil liberties than we had 50 years ago (along with a much larger and more questionable government), and so people are more cautious about giving more of them away. And another factor is that we have a superior source of information in the internet, and the time and resources to do our own analyses. Another factor is that citizens have become more individualistic/greedy and less community-oriented/cultured. And so on and so on. Lots has changed in 50 years and some of it is for the better, some of it for the worse, but it is what it is and there's no going back!
I mostly agree with your prescription, but probably not for reasons you'd find nice. I view vaccines, like I view airbags, helmets when skiing, or the decision to smoke, as opportunities for natural selection. They are ways in which the future can have a higher fraction of more prudent and thoughtful human beings. I'm reluctant to have government impose good ideas on people against their will, because I would rather people who have bad ideas experience the full consequences of those. They will either learn something useful in the School o' Hard Knocks, or as I said reduce the burden of their genotype on the future.
That said, I also believe people have a right of free association, so if for example a company wants to say "sorry, no vaccine no job" that should be respected also, as an extension of the right of the individual to say "sorry, I'm not convinced by your fancy-dancy vaccination bullshit, not doing it." That is, I don't like government telling individuals they have to be vaccinated, and I also don't like government telling individuals, or voluntary groups of individuals, that they can't insist on vaccination for membership or private association.
It's gets a little tricky when we get down to the weeds, of what we do with children in required public school setting. So there would need to be some negotiation and compromise there, unfortunately, as the simple solution isn't viable.
Given that most people have pretty limited freedom to change jobs without dramatic effects to their livelihood, I'm not convinced this follows as a principled extension of the right to free association, at least in a way which wouldn't also permit the government to do the same.
Yeah I'm never persuaded by that line of argument. I draw a bright and shining line between "hard, annoying, don't want to" and "impossible by force of law."
Additionally, if *you* don't hold your own principles of self-determination in high enough regard that you're willing to take the hit to your annual salary to exercise them, I can very reasonably conclude that *I* shouldn't hold them very high either, and so I can dismiss any appeal to principle that you make as disingenuous.
I mean, as far as I can tell, even the most hardline vaccine mandate policies don't *force* anyone to get vaccines, they just make it impossible to hold a lot of jobs or access a lot of public services without doing so, which seems to me like more a difference of degree than kind from "you may not work here without getting a vaccine."
For a lot of people, having their employer mandate vaccination is not a matter of "get the vaccine or take a hit to your annual salary," but "get the vaccine or become homeless as you do not have the resources to remain solvent without the job for as long as it would take to find a new one. A large proportion of Americans live paycheck to paycheck. For those people, giving up their job on short notice, without another one lined up, is a sacrifice of greater scope than most people are willing to make for any political principles.
Do you have a similar complaint about requiring vaccines to send kids to public school? Or is it just *this* vaccine that is going to redefine freedom as we know it?
I really haven't thought through that, since the cost/benefit ratio of those required vaccines are much clearer than for the Covid vaccine from where I sit. But I think public school should work the same way as employment, i.e., the organization imposes requirements, and the participant gets to choose whether to follow them. Freedom of association. Public school being a tax-funded thing, parents should be reimbursed in the form of education vouchers.
Can you point me to a description of trust iteration that you like? I am aware of some of the Prisoner's Delimma work, and I recently found and intend to read: "An iterative algorithm for trust and reputation management" https://ieeexplore.ieee.org/document/5205441
Ah, sorry. I didn't mean iterated trust. I meant "in a space where the truth is discoverable, you can trust that many iterations of honest parties seeking the truth will eventually produce consensus truth that outlasts motivated falsehoods".
That is, give the (good) scientists and (skilled) statisticians and (sincere) experts ten or fifteen years on a topic like this, and they'll produce an answer that outlasts the answers given by weaker and less well meaning players.
What I (and many) do not get is why there is not a proper US or EU or whatever PC country/region funded large scale study that actually does a proper job at evaluating Ivermectin. It sounds much cheaper to me than designing a new drug. And this is one of the few aspects that just does not add up.
Another is why it is banned in a lot of countries. If this ban makes sense to you: https://www.youtube.com/watch?v=_gndsUjgPYo then surely your brain works differently (probably much better) than mine.
I think ivermectin believers say that it has to be taken at a very early stage, or before the infection happens for it to be effective. If a PC country wanted to do a study they would need to include this in their parameters.
I do not know whether Ivermectin is useful against COVID but because its side effects are known I would definitely be happy to have some in my medicine cabinet. I have taken a non-PC jab (non mrna, I'd stay away from those), but still if I feel like symptoms are coming I'd definitely try Ivermectin, because what can I lose. Because it is banned, I have no chance to do that.
Whoever used the "my body my choice" slogan to support any political agenda before, if that person is not angry now about the COVID situation (and motorcycle helmets), then that person is two-faced, to say the least.
> is why there is not a proper US or EU or whatever PC country/region funded large scale study that actually does a proper job at evaluating Ivermectin
That's making the decision to test *that* drug, and not another one. Only so many people are willing to sign up and pass the requirements to be in a trial, and maybe they're all busy with HCQ.
Meaning even though doing a study on ivermectin is cheaper than doing a new vaccine, society will invest into making the vaccine, because the study is expensive and there is no hope for proper return on investment. I hope this is a correct rephrasing of what we are saying. I.e. it is not medicine, not common sense that made this decision, but economics. So let us see the economics.
> why doesn't the majority allocate $150 million of its own money (via taxes or whatever) to do a study which only a minority finds important
I am sure Pfizer alone has made a profit that is magnitudes higher than $150 million. I am also sure that if in the beginning people had been asked: do you want to spend $150 million, less than 50 cents per capita in the US, if you add the EU it becomes like 20 cents for a pill that has been in use for decades, or do you want to have a competition among private companies that will pocket profit which is magnitudes higher (for each successful company), well I doubt that the majority would have decided to go with the version that is majority opinion today.
I'd like to add that the opinion of the majority did not become such because of luck or facts or anything cheap. There is a lot of marketing work, i.e. time, effort and money invested done by politicians and businesses that in the end made the vaccine the choice of the majority. Significant part of this effort and time and money was invested before the vaccine was available. Just that effort was IMO magnitudes higher than doing the study.
On top of this practically all western countries banned ivermectin. This is a step further, much further. This way the profit becomes guaranteed, the investment risk for the private companies becomes negligible. Even if the outcome of this article was that ivermectin is superior to the vaccines, nothing would change, because the whole thing is decided based on economics, not medicine.
And again another angle, $150 million is nothing compared to the big political plans that Biden is proposing ATM.
> Hopefully as soon as you frame the question properly the answer jumps out at you.
Yes it does. From the beginning this was an economical decision, or if the decision involved something else as well, it was surely not medicine. There was doubt in the effectiveness of the vaccine, and there was doubt at the effectiveness of ivermectin. Investigating ivermectin is cheap, but it promises no proper profit, no proper GDP increase. All bet went to the vaccines so, funnily because economically that costs more money, i.e. businesses were happier to invest and work on vaccines than anything else. The people involved, politicians and science, still make all effort that the vaccine economy keeps working. I hope we agree on this, this does not contradict your answer, or if it does please let me know how.
> Meaning even though doing a study on ivermectin is cheaper than doing a new vaccine,
Maybe you responded in the wrong place, but you were asking why no one did a "large-scale test," and I was saying the limiting reagent is the number of people willing to be a participant (and further meeting the requirements to participate).
A small group that believed its own press releases could fund a Phase I study to raise interest for a Phase II study.
But "just try this existing drug" runs into the problem that there are lots of existing drugs.
You are right, I was trying to answer Carl Pham. I made a mistake, sorry about that.
I do not work in medicine science so I have no practical knowledge about how these things go. What you are saying about the number of people willing to be participants seems reasonable. Carl Pham thinks $150 million could achieve this large scale study, I have no idea if that money would solve the participation problem. For sure taking medicine that existed on the market for decades and that had been consumed by millions of people, I personally could be convinced to try it. For a new medicine I'd probably say no.
> But "just try this existing drug" runs into the problem that there are lots of existing drugs.
That is also true. For some reason, for COVID it is always ivermectin that is mentioned. But you are right, if we wanted to try all drugs that would be impossible.
Of course it's an economic decision. Freaking everything is an economic decision, unless you're Jeff Bezos and you have essentially infinite money and can do whatever the hell you want for the purest of ethical/aesthetic/philosophical motives.
What difference does it make that Pfizer has $150 million they could spend on this? Why should they? It almost sounds like you're saying the money should come from whoever has it, and not from whoever wants the information. By me that's immoral. If you want it, pay for it. I don't steal gasoline from my neighbor's car because he earns twice what I do and won't notice the hit that much, I go out and buy it myself, because I'm the guy who wants it, and it's right that I pay for what I want. Wanting other people pay for what you want is the philosophy of the criminal.
Sure, the proposition could have been put to the American people in April of 2020: do you want to spend umpty $billions of your tax money on accelerating vaccine development (and giving Moderna, for example, the most incredible $$$ windfall ever in the history of pharma), or do you want to spend it on studying about a hundred random existing cheap pharmaceuticals to see if by random chance one of them works as well as a vaccine?
And who knows what they would have said? But the proposition wasn't made, the Trump Administration just decided they knew what was the best plan, and they went with Option A. May not have been exactly what *I* would have done, but it was squarely within their ambit and mandate. That's what we elect Presidents to do, make tough choices in tricky situations. If you ended up not liking the choice, well then presumably you voted to boot Trump from office in November and prefer the Biden Administration approach, whatever it is. Democracy in action!
Large scale studies cost money, lots of it. If you personally have $150 million lying around, I'm 100% sure the required experts would take it gladly and do the work. But if not...what you are asking is: why doesn't the majority allocate $150 million of its own money (via taxes or whatever) to do a study which only a minority finds important, and for which the minority is *not* willing to pony up the cash? Hopefully as soon as you frame the question properly the answer jumps out at you.
1. Given who you are, I'm surprised by the absence of a Bayesian analysis, and more than almost any other factor than tribalism (vide infra), this seems relevant to how people made up their minds in this case:
1a) How often do studies from Argentina or Bangladesh end up violently overturning medical consensus opinion in the US or Europe, meaning amazing things are discovered in Sao Paolo that were totally overlooked in London or Seattle?
1b) How often do vaccines succeed in almost entirely preventing a viral disease (or its evil consequences)? How often do they have strange awful side-effects not detected in the initial approval studies?
1c) How often do repurposed antibiotics, or indeed any small molecule drug, end up being powerful cures for viral disease?
1d) How often are public health policy people dead wrong?
1e) Notwithstanding (1d), how often are public health policy people *initially* wrong (when a problem first appears), and how often are they unrealistically overzealous all the time?
1f) How often in a person's personal experience have they been told something confidently by a soi-disant smart/educated/credentialed person that turned out to be wrong? How likely is it that people in general overestimate (if not outright misrepresent) their own competence in areas not exactly within their training and experience?
1g) How often do politicians in search of votes and pundits in search of page clicks oversimplify or overdramatize if not caricature the stakes in a debate, the importance of the favored outcome, or the villainy/ignorance of the supporters of the disfavored outcome?
2. When you discuss the tribal aspects of this, you seem to assume that members of each tribe arrive at their conclusions completely independently, and ask "What common experience could lead all these people to *independently* arrive at Conclusion X?" But this overlooks the very nature of tribalism (or indeed of social movements, fads, bubbles, et cetera) in that for a large number of members of a tribe, the reason to have Conclusion X is merely because it's a dogma of the tribe.
Consider the thought experiment: if nuclear power plants had been invented by a bunch of bearded hippies funded by Greenpeace in the 2010s as a solution to global warming, instead of by a bunch of pocket-protector-wearing narrow-necktie poindexters in the 1940s funded by the military to build awesome weapons of destruction, would you not see a neck-snappingly abrupt reversal of positions pro- and anti- among a very substantial number of people?
Human beings are perfectly capable of believing, or at least subscribing to belief in, propositions that go strongly *against* their own inclinations, or available evidence, if it promotes their social belonging in the right way. I'm a little sorry you didn't tackle this issue. It's certainly discouraging, in one sense, because it says *no* amount of improved access to information, education, less screwups by the expert class, et cetera -- *no* difference in what is available to the individual thinking it over -- will reduce tribalistic splits on issues, because these do not arise in the first place from distinctions in individual awareness. They arise from the requirement of any faith group to have a dogma, and to insist on faith in the dogma as a condition of membership.
3. Along these lines: your final prescription ("How can we get more people to trust (but verify) the experts I trust (but verify)?") reads a little tribalistic itself. Have you considered the possibility that nothing is actually going wrong here? Science and expert opinion is being severely challenged -- is that a *bad* thing, generally speaking? Maybe not! It's not like your (and my) preferred worldview here ("vaccines work well, you should all take one, you can take/not take ivermectin if you get sick, according to your personal beliefs, but you should be reluctant to become a zealot about that and try to persuade others to do so") isn't dominant. It is. Most people get vaccinated. Most people don't become ivermectin crusaders. A few people fall into the other categories in both cases, and it causes strife and dissension, and the majority is compelled to accommodate this to some extent or other: compromises have to be made in legislation and regulation and decree, room must be made for disagreement that the majority finds futile or stupid.
Is that a *bad* thing? Maybe that's actually how a republic should work. Maybe the fact that a minority that feels strongly about something that the majority finds ridiculous *should* be allowed to carve out a certain amount of space for its beliefs, and should be able to disrupt the ability of the majority to get its way, a bit. Even if it costs lives? Yeah maybe. It's probably more important in the long run that the everyone remains mutually committed to the republic and solving problems by voting and argument (rather than weapons and death) than that every life that can be saved is.
>1a) How often do studies from Argentina or Bangladesh end up violently overturning medical consensus opinion in the US or Europe, meaning amazing things are discovered in Sao Paolo that were totally overlooked in London or Seattle?
I don't know the answer to this, and it's not amenable to quick and easy investigation, but I strongly suspect the answer is "not very." I know a few people who're involved in biomedical research in South American and Middle Eastern countries, and all of them have expressed pretty grim views of the state of research in their countries, and would prefer to move to Europe or America where they feel it would be more practical to conduct research which would be less subject to corruption, poor research practices and environments, etc. One online acquaintance in Pakistan told me that many of her peers deliberately hold off on their higher-impact research plans pending the opportunity to move.
Regarding "People [researchers] are going to fight hard against [releasing their raw data], partly because it’s annoying and partly because of (imho exaggerated) patient privacy related concerns."
If your belief is that compromising patient privacy doesn't actually harm them as much as one might infer from U.S. cultural/legal norms about this then hey -- you are the psychiatrist, and plus you have lots of personal experience with the harms of loss of privacy, so I won't argue with you about that!
But if your belief is that patient reidentification from a data set is a difficult thing to do, or would be unlikely to happen in the real world, then I am sad to inform you that this is just false.
Difficulty:
As I am sure you will have heard, it takes only 33 bits of entropy to uniquely identify a living human somewhere on this planet. If you know the person is in the USA, you are down to 28 bits. If you know their gender, there goes another one. If you know there state, there goes a couple more. Approximate age, a few more still.
Once information is released, it can never be un-released, but it can be combined with other information.
It can be surprising what has been shown to uniquely identify people. A few links from a social relationship graph -- not the actual names, but just the shape of the graph in your immediate neighborhood[1], your home and work location[2], of course your browser's device fingerprint[3], or your writing or coding style[4].
Likeliness to happen:
As just one example, internet advertisers in the sketchier/less-ethical parts of the adtech universe have large monetary incentives to reidentify users, using whatever data they can get their hands on, and though they are unlikely to make public statements about their efforts, their capability has been repeatedly demonstrated.[5]
Whether privacy harms are outweighed by society's interest in learning true and important facts about the world using the scientific method:
I disagree with the sociological takeaway, and probably a few other takeaways as well. You seem to be suggesting that we should have had an answer for whether ivermectin was effective before we had an answer. Why? Because this had become a red/blue tribe issue? Because you couldn't talk about it on social media so we should circle the wagons and say those people were eventually justified? Because we should have a way to decide based on incomplete data, or based on an incomplete understanding of confounding factors? I don't see it that way at all.
The problem, as I see it, was that there was credible evidence that something was going on here, but also serious reason for doubts. Some smart people were saying exactly that, and not challenging individual decision-making based on the available data. They said, "Sure, there may be something there, but it's not clear yet whether it's a good treatment, for whom, or under what treatment circumstances" (early/late, treatment/prophylaxis, genetic profiles, other proposed subgroups). That was a reasonable set of conclusions to come away with from the data available.
Scott's discussion of "how should we have been treating this all along" misses the point. Crafting heuristics that lend more certainty than the data support is just plain bad practice.
More generally, there was the community touting ivermectin as a great replacement for vaccination, and the reactionary community that condemned ivermectin as an evil distraction. Okay, but that's just people whose heuristics led them to greater certainty than the data supported. If there's anything to learn from them, it's that we should be aware how others' bad heuristics - and fighting over bad heuristics - can lead us toward greater certainty than we should have.
The real takeaway should have been something like, "Let's not settle for a simple yes/no answer to this question. Instead, let's call this an open question and look into it more seriously."
This is what we do in less politically charged areas. We keep looking until some intrepid researcher does an interesting subgroup analysis that generates a hypothesis. That hypothesis is tested and (unlike the dozens of other hypotheses we end up rejecting) we discover some confounding factor we hadn't considered before.
In this case, I think you've buried the lead on ivermectin. The lead should be, "Ivermectin may be a lifesaving treatment for COVID-19 sufferers with parasitic worm infections." It looks like that's a promising subgroup explanation of whom this drug works for. This feels like an excellent opportunity to promote de-worming efforts around the globe and save lives. Too bad it got politicized as a binary "cure/hoax" before we could figure out the real answer to the question.
> Some smart people were saying exactly that, and not challenging individual decision-making based on the available data. They said, "Sure, there may be something there, but it's not clear yet whether it's a good treatment, for whom, or under what treatment circumstances" (early/late, treatment/prophylaxis, genetic profiles, other proposed subgroups)
Right, there were scientists being properly scientific, and skeptical of broad claims.
But then the media was saying that The Science had spoken, and accusing them of taking horse-dewormers, and ha ha you idiots. And then wondering why they don't take our good advice.
And it's not like the media was some uncontrollable beast here. Fauci could've been calling up people like Don Lemon and said "please stop with that."
> am I secretly suggesting that we make rationality higher status?
I'm all for it, but asking society to become rational enough to make a dent in the problem seems infeasible. Between "believe X" and "become significantly more rational", there must be some message/framing that would improve this whole situation.
And I think Scott identified likely the best take:
> we have to make the scientific establishment feel less like an enclave of hostile aliens to half the population... But I don’t really know how to do that, and any speculation would be too political even for a section titled “The Political Takeaway”.
But I'm happy to speculate!
1) We just have to engage with people. The overall conclusion of Lee McIntyre analysis in "How to Talk to a Science Denier" felt viscerally right to me: science deniers can be convinced if they can just talk openly, candidly, *safely* with more rational people. "Safe spaces" are a wonderful idea Our schools, universities and institutions purport to have safe spaces, but they aren't safe for the people that likely need them most: the half of our population that is not liberally aligned.
2) In absence of those healthy, personal relationships, people will turn to whatever authority is most prominent in their lives. And we have horrible, evil, awful people in positions of authority. I don't actually know how, but the required outcome is obvious: get money out of politics, and invest in public media.
Why is rationality not privileged? Why is a prophet ever without honor in his own country?
Because for most people most of the time, the fastest and surest way to wind up dead or seriously disadvantaged has been at the hands of our fellow humans. At the same time, "our group", whether by faith, family, tribe, regiment, frat, whatever, are the people we can surely trust to have our back when we need support, when we are sick or threatened.
Therefore, whatever else happens, whatever we have to do, believe absurdities, participate in degrading rituals, risk our lives, blindly follow barking insane leaders, parrot obvious lies to our detriment, do or suffer terrible things, but please whatever you do, please don't kick us out of the group!
As a result, when people are presented with evidence, strong evidence, irrefutable evidence, evidence verging on philosophical proof, that their deeply held beliefs, the beliefs that people use to define themselves and tribe, are wrong, that the tribal leaders are crazy, stupid or malevolent, that we are headed to catastrophe - rather than change beliefs, change leaders, change tribe or change course, most people, most of the time will instead double down. Witness the behavior of cultists. Solzhenitsyn has documented true believer Communists heartfully confessing their guilt at a show trial because the Party demanded it.
The process is called "cognitive dissonance" and it is abundantly documented. As alluded to earlier, there are entire religions organized around the principle.
Cognitive dissonance is not limited to stupid people. In fact, the intelligent are at least as prone, perhaps because they are better at rationalizing. In fact, much so-called "knowledge work" is basically manipulating symbols in order to justify whatever the paymaster wants to see justified.
Hi Scott. Really thorough review of the IVM studies that helped confirm what I've been thinking - there's just little data proving effectiveness. The roundworm incidence was an eye-opener, though.
When you mention myocarditis, though, it seems you pooh-pooh it just a little bit. The thing is though is that the incidence in young males has really surprised the CDC and caught it a bit off-guard. The whole of the vaccine safety meetings are available published at
And in particular CDC showed how far actual cases of myocarditis exceeded their prior estimates in the slide in the YT video linked below. Their estimates were for single-digit numbers but instead they found real-world incidences in the hundreds.
Yeah, I wanted to balance "I'm not claiming this is a reason to avoid the vaccines" with "I think this one might be a real serious objection". My personal experience is that one of my younger patients and one of a friend's younger patients got (mild, quickly-resolving) myocarditis around the time they got vaccinated. I can't prove it was related but that's a heck of a coincidence and suggests it's pretty common.
Thanks Scott. I just wanted to show you that CDC slide. Subsequent safety meetings show similarly high rates vs. expectations - not that they're "high" in a global sense, just high compared to the rainbow estimates they'd put out earlier.
The good news is that this does seem mainly transient in nature. The bulk (some 80%) end up hospitalized, but it's short duration and so far, the CDC tracking indicates that by 3 months, over 70% are fully Sx-free and cleared for all activities by their cardiologists. (3 months is all the tracking data they have so far as of last month's meeting)
Just a heads-up on this issue, you'll see people citing the 5-year mortality rate for **chronic** myocarditis as if it applies to these more transient cases, when pretty clearly it should not be relevant.
For your alien analogy to work, wouldn’t most humans have to already have chips implanted in our brains, provided by the same aliens who want us to get this new chip?
And the already-installed chips would be for mimetic plagues we’ve never actually seen break out in earth, much less Jill someone we actually know. Whereas this new mimetic plague is one where we can observe the effects within our own communities.
Not only is ivermectin boosterism strongly correlated with anti-vaxxism, it also strongly correlates with Trumpyness, FWIW.
Also FWIW, I am neutral on ivermectin; it may be of some benefit and I am willing to see. That said, both pro and anti camps are so polarized, that no amount of research, logic, facts or evidence will convince most partisans of either side. Strongly in favor of vaccines as a general principle. Detest Team R and Team D about equally, most days.
Lord knows that I despise Trump, but a lot of people attribute positions to the man that he doesn't appear to actually hold.
The cognitive dissonance of certain Trumpy antivaxxers is a pure delight. "The COVID isn't real, but China invented it, and Trump defeated it, all using a vaccine that doesn't work and contains microchips'n'stuff." How many internal contradictions can you pack in a single sentence?
I think this is well known in our circles. It's one of the things that comes up repeatedly when people in my bubble talk about the anti-covid-vax people. Something like, "And what's weird is this is Trump's thing, you know? Like, remember when covid first hit and all the talk was at least a year and most likely 18 months to vaccination. And Trump and Warp Speed got us there in like 8 or 9. Don't get me wrong, I think he's a bad guy and all, but this is a real thing he really did, and his own people won't use it. It's *so* weird."
Well, it's certainly in passing in my circles, typically while on the way to bag on the red tribe for whatever bad thing we think they're doing this week. But Trump gave us quicker vaccines and sentencing reform and both of those are goods. Even an evil orange clock is right twice a day.
When I read Scott was going over 30+ studies of Ivermectin - I thought about switching to TikTok. Stayed - and will soon need a new carpet. ROFL. - Funniest piece ever. And more depressing than Moloch. WTF went wrong with "science"?
score one more for the Maps sans New Zealand : (. I've been thinking a lot about #trustthescience from an epistemology point of view lately, there is definitely something in that. The scientific method was never really designed to generate trust among non-experts, it was designed to generate truth when operating over the smartest and best resourced experts. There is probably a need to develop a new epistemological system from the ground up to try and grow a deep and reasonable trust, a hashtag is not really going to cut it. (Requiring data to be published would be a damn good start though...)
Probably the best attempt at making a case for vaccines from a "not an alien" point of view that I have seen is this one by conservative Christian apologist Neil Shenvi. He tries to argue in a way that "requires minimal confidence in the government, public health officials, doctors, and scientists." https://shenviapologetics.com/a-minimal-case-for-covid-vaccination/
For a good comparison, look at vitamins. I take OTC pills for A C D K Fishoil Magnesium Calcium and a few others, just bought off Amazon.
Do I need them? Probably not
Did a doctor recommend them? No
Do doctors recommend them as a treatment for anything? No, or else they'd be locked behind a prescription and cost $40/pill instead of ~$0.30 for my daily regimen.
Does anybody think they are directly harmful to me? Not that I'm aware of.
Should I be taking these? Why not? The cost is absolutely negligible and I think there is a reasonable chance I am deriving some health benefit
My self-medication with these is the exact same sort of not "trusting the science" as people taking OTC Ivermectin prophylactically. I think all of the above answers would be the same for an Ivermectin taker. I don't think my position on taking vitamins is in any way unreasonable and would be unlikely to stop unless somebody made a strong argument that they were actually harmful.
With that in mind it feels like the wrath and ridicule towards Ivermectin must come from the (admittedly often accurate) conflation between Ivermectin and Antivaxxing, and the vitriol used to attack my above position is just ludicrous and takes away any credibility the speaker could have.
There is some evidence that supplementation of calcium as opposed to receiving calcium from food can lead to a spike in blood calcium levels leading to potential heart problems. Google for more info. Perhaps low supplementation is ok.
What form of calcium can be assimilated, and how is it provided in the supplements? Because if any calcium carbonate can be metabolized, my daily dose of tab water is enough
Interesting, thank you. My tap water is fairly hard and unfiltered and I drink quite a bit of it every day. I'm taking 620mg of Calcium supplement daily but I think I'll tone it down to just the 120mg that's part of a multivit.
So this talk of a "quantum" "memetic" plague...just silliness, right? OR is there something more there?
Cause I don't know if it's occurred to anybody else but there is clearly a Copenhagen Interpretation issue going on with this pandemic stuff. Talking like an individual person is clearly either sick or not sick. When you got these mathematical models and whatnot, though, a person can have a relatively greater or lesser probability of getting sick or not getting sick based on some or other variables.
You and me, we're walking around, according to the modelling on which the public policy is being based we are all in a superposition of sick and not sick, on a probability distribution, right? But obviously a person is still either sick or they are not sick. The probability distribution is collapsed into one or the other state.
Where do people fall on this issue? It's a complicated one, and not distinct from ethics; I recommend reading the play by Michael Frayne.
Hi Scott, please get in touch with my via twitter. You're using my old analysis here, which was a back of the envelope calculation. My formal analysis is more rigorous and not susceptible to the critiques some are raising here.
Really good, but I think one thing is worth mentioning: if you don't want to be seen as hostile, don't force people to do things they don't want to do. The extra benefit from compulsory lockdowns, mask mandates, and mandated vaccination and boosters is small compared to the loss of trust.
Vaccine hesitance among the old and obese is driven partly by viewing public health as hostile. Mask mandates and lockdowns caused this, and achieved little or nothing that could not have been achieved voluntarily. Forcing old or disabled people to vaccinate is very difficult - the mandates mainly affect those who benefit far less.
To the author: Did you submit your criticisms to the site? If so what was their response. What was your opinion of ivermectin before anaylizing the studies? Did reading them change your mind about anything? Do you have any conflicts of of interest? Are you at all concerned about the EUA creating a multi billion dollar incentive to suppress alternate treatments like ivermectin? Have you carefully examined what reputable critics of the 'vaccine' are saying? Do you think the risk of ADE has been proven to be minimal? Do you think the growing number of incidents reported on VARES are being properly evaluated? Are acceptable and should play no role in people's decision making? Do you think mandates are a good idea?
The quantum memetic plague sure is funny, and probably catch some of the deep reasons around vaccine fear....But not the "those aliens are part of a circle I can not even imagine me or any of my friends would ever be part of", this is at most a fringe reason. Many technically-minded people have reticence, some (crackpotish, or among the small scientific red-tribe - it's becoming difficult to distinguish between those) health-related scientist are even among the not-so-warm to vaccine crowd.
I think people could trust a utterly alien circle, provided this circle has no past hostility (and preferably some past helpful behavior) to show, so the political aspect (the advice-givers are actually hostile, at least on other subjects) is more than enough for explanation. Add the fact that Covid is not Ebola (if it was, there would be far less space for discussion and far more for riots around pharmacies holding the rationed vaccine), and that's more than enough.
The political aspect in particular is huge: In an increasingly polarized political climate, 95% of biological professors are democrat! I guess it would be enough even if covid was worse. Maybe not Ebola-like, but significantly worse.
This 95% is completely crazy, and I can guess something about the remaining 5%: They follow Greg Cochran. They have stumbled by accident or interest on parts of biology that is taboo to the blue tribe, and, because of polarization, now tends to reject other parts they would never have rejected 50 years ago.
Most parts of my life are linked to techno-science (work, practical hobbies, learning interests), since as long as I remember. But the evolution of science, at least those last ten years, in its public message form, makes me sad. Not to the point of wholly rejecting it, it's still my main interest in life....But now I zap out mainstream media except for mindless entertainment, and get anything I consider seriously from other sources, like this blog.
About the alien analogy: there must be something more to it, right? Anti-vax sentiments seem to be a primarily Western, First-World phenomenon, though there are many rural, low-education populations in the rest of the world that probably do not identify with scientists.
Well, I don't think so, it's not western. In Europe, it's quite prevalent in recent immigrant communities, and I assure you (because I have a lot of first hand experience) that it's prevalent in Africa, not only the African diaspora in Europe, but among locals too. Maybe its slightly different in the sense it's not scientists (or Bluetribe scientists) that are the alien, non-understable powerful and malevolent group who are believed behind the vaccine push, it's the whites in general. Post-colonialism effect there for sure.
I *love, love, love* the worm interpretation of the data. Also, Scott, a million thanks for finally doing a deep dive on ivermectin.
If there's one thing to be huffish over, it's the tirade against the vaccine hesitant at the end. I swear that my following negative comments will last no more than 4 sentences, and will then return to adulatory effusiveness, but: Ahem - O Thou Who Art Vaxxed - dost thou know what it is to be threatened with termination from thy job because thou dost not wish to take an experimental drug that hath only been around 1 year? I mean, seriously - some of us are being persecuted because we want to wait 2-3 more years to see what the data is on long-term side effects. This sort of hesitancy about drugs is pretty common and is prima facia reasonable. It's not even political, or not obviously so, since (if I can cite findings from a few studies that may or may not be RCTs and may or may not be fraudulent and may or may not be significant and may or may not have confounders, because really we need Scott to figure that out) the vaccine hesitant tend to be people with PhDs and middle-aged women who vote liberal.
That having been said, it helps to have the ivermectin side of things cleared up. And this is the most brilliant thing I've read since the analysis of trapped priors, or of race and police shootings, or the other cool things that Scott comes out with so often that I can't keep track. It really deworms the horse. I mean, it hits the worm on the head. It cuts the Gordian Worm. And now I have to go re-evaluate my supply of ivermectin.
The vaccine hesitancy among PhDs turned out to be false. It was based on a Facebook survey. A very small percentage of the population holds PhDs, and a small percent of people also lie on these surveys, and it turned out that the people lying were enough to completely distort the stats on vaccine hesitancy in PhDs.
Did it? I'd like to read the follow-up report but I can't find it (it's probably buried beneath all the headlines about "PhDs Most Reluctant to Get Vaccine").
Do you know if the follow-up study also found a comparable amount of lying in the other demographic groups (masters/undergrad degrees)? I don't trust Facebook, but it's not obvious to me that people would lie more about having PhDs than MAs, and it would take a lot of work to check a significant sample size of the 5 million responders to determine who lied about their education level. But maybe someone found a way to do that.
"To be included in the analysis sample, participants had to complete the questions on vaccine uptake and intent, and report a gender other than “prefer to self-describe.” This exclusion was made after discovering that the majority of fill-in responses for self-described gender were political/discriminatory statements or otherwise questionable answers (e.g. Apache Helicopter or Unicorn), and that as a group, those who selected self-described gender (<1% of the sample) had a high frequency of uncommon responses (e.g., Hispanic ethnicity [41.4%], the oldest age group [23.2% ≥75 years] and highest education level [28.1% Doctorate]), suggesting the survey was not completed in good faith."
In other words, if you exclude the people who identify as an attack helicopter from the dataset, the surprising result disappears.
Thanks beleester! You just saved me from clicking through a gazillion duckduckgo pages.
Hm, but does the effect "disappear"? It looks like PhDs just drop to being the 2nd-most-hesitant group, still following the original U-curve. I mean, the updated article doesn't actually give the raw numbers or a nice chart like the first version had, but here's what it says:
"The association between hesitancy and education level followed a U-shaped curve with the lowest hesitancy among those with a master’s degree, followed by those with a 4 year college degree, then a professional degree, and a doctorate. The highest hesitancy was among those with ≤high school education or some college."
So basically, the <1% change in responses, after the helicopters were weeded out, resulted in the PhD side of the U-curve dropping slightly lower than the high-school-only side.
In the meantime: apache helicopters! I have a PhD and I'm totally using that to self-describe my gender on my next anonymous survey.
Aren't we interested in a very small tail, the 0.03% of people who do not survive COVID? In ML, we have specific model building techniques, usually called Fraud Detection, to build models that will pull out the signal from this hugely lopsided categorical data. Plus you need A LOT of data.
Furthermore, I think it's plausible to put Ivermectin, or any other drug that works "non-intuitively" into a category that only works for a segment of the total population (e.g. let's say the 20% of people who are strongly deficient in vitamin D at time of infection). In statistical terms, an "interaction effect" which can be tough to capture and easy to confound. Overall this is going to be very difficult to tease out from the noise of SES, geographic happenstance and strain potency.
If we had a medical tricorder from the future, is it possible that would identify 1% of the population as strongly benefiting from administering ivermectin on infection / taking it continuously as prophylactic, where P(survive) could be increased by an order of magnitude?
I think we might currently be around .3%, but that's post vaccine and post several months of sorting through leads to find treatments that actually help. .03 is an order of magnitude off.
Could you comment on Jimmy Dore/Dr Campbell whereby Dr Campbell reviews papers that same Ivermectin is a 3 PC pro tease inhibitor- much like Pfizer new pill which will be combined with a AIDS drug.
docking papers are a dime a dozen, but most of thwm are crap. I perform research in that exact area and (to a first aproximation) EVERYTHING can do docked into EVERY protein and for that reason every high ranking docking candidate must be compared (eg through molecular dynamics) to well-known binders and non-binders or decoy molecules to ensure one is indeed looking at a relevant interaction instead of run-of-the-mill "stickiness". I am not saying the reference you showed is crap, but that it may not be as strong evidence as you may think
I remember very clearly when this jamoke started their page for hydroxychloroquine (c19study.com) early in the hype cycle, before diversifying into every brand of snake oil under the sun, there were only two decently sized RCTs. They disallowed one early-treatment RCT because took place in a hospital and was therefore not "early" (obviously like half of the crappy convenience samples included in their "early treatment" list were also hospitals) and the prophylactic RCT (Boulware) got a full page treatment of "reanalysis" and mutually contradictory nitpicking (compliance was low! but also the placebo might have been active!) which was not afforded any of the insanely sloppy papers that French guy was churning out. I note that the current iteration of the page does not have Boulware anymore but does have multiple "reanalyses" of their data. Rigor is worthless if its reserved only for studies you don't like.
What gets me about all this is that we already DID the whole "analyze all these cheap off-patent drugs for efficacy against coronavirus" and got a hit: dexamethasone! Studies were done, they looked promising, and it was uncontroversially accepted. It's weird, and I've found it best to think of everyone who hung on to HCQ throughout all of 2020 and to IVM all of 2021 as a very unfortunate flavor of hipster. Sure, we found a cheap drug that helped, but it wasn't THEIR cheap drug, it's the ESTABLISHMENT'S cheap drug, so piss on it.
It's worse than you think - some of the people involved in early promotion of dexamethasone later moved onto ivermectin. Dexamethasone was their drug of choice, but they abandoned it once the establishment adopted it and its impacts became quantifiable.
First off, the article comes off to me that, the evidence looks exactly like the right would have predicted, going against what the left would have predicted, but the left makes up some after the fact left field excuse to ignore the data, as they always do.
Second, safety is never mentioned. Right wing solutions are completely safe and risk free, and reasonably could work, but the leftists just demonize us and demand that we ignore all the cheap and safe solutions and tunnel vision in on dangerous expensive solutions.
I don't have a high degree of confidence that ivermectin solves covid. I do have very high confidence, that if we held the top hundred promising treatments with completely solid safety records to the exact same standards as pfizer gets when considering their new drug, covid would be over by now.
Finally, as a young person who already caught covid and has natural immunity, I see the left in extremely uncharitable light when they try to force the vaccine on me. Wouldn't the world be much saner if we actually studied ivermectin, and kept the vaccines (and the lockdowns, and the masks, and the etc.) to the people actually at risk?
The US certainly has its share of intestinal worms. Pinworm in particular (Enterobius vermicularis) is quite common in children, and tends to spread to other members of the household. It's pretty innocuous on the whole and tends to be asymptomatic except for a mysteriously itchy butt, and may even have helpful immune modulating effects, but maybe also harmful ones. (And yes, ivermectin would kill it.)
Wikipedia says that Strongyloides infection is detectable by immunoassay. Assuming that that test is reliable, it should be feasible to divide the experimental population of an ivermectin trial into worm-positive and worm-negative groups and separately evaluate the impact of the drug on both populations as compared to the control. Does that seem like a legitimate experiment?
Can you get that past an ethics board? "We're going to confirm that you have an intestinal parasite with a known treatment, but then we're not going to give you that treatment." I'm honestly not sure where I stand on it, either.
Speaking as a member of a religious, vax hesitant community, where I have been the one arguing for more openness to the vaccine, let me first say your model is not bad (though see some of the suggested improvements from other commenters below). The Orthodox priest example below is a little better, though it misses the hostility. (Also, I once again have to commend you Scott on your consistent attempts to try and strongman opposing views that you find stupid - the world would be so much better if more people could do that).
some other data points:
- There are medical/scientific folks in my community, and while they have a more nuanced view, even they are skeptical/untrusting. Probably doesn't help that they've being closeted for years in a field listening to open conversations about how stupid/awful/deplorable they are.
- Being seriously religious already means you've shown willingness to abandon the expert consensus (at least if you live in any metro area). So my community probably has a higher-than-normal representation of the kind of people who are willing to take unconventional positions.
So, it's kind of a situation of trapped priors as you've discussed elsewhere. Which is actually a decent model, because I can get people to update a little, though rarely enough. The traction I make with people when arguing for the vaccines is not with expert sources but generally with updates based on data we all see - who in the community has serious COVID vs vax side effects, whether vax or not are transmitting, and what some of our community who work in the ER see. FWIW, from ONLY this data, the model is that vax side effects are worse and under-reported (because most docs blow off reports and say the effects are just coincidence, even when serious), but I can get folks to agree that they are not THAT much worse. Maybe 50% underreported for serious effects beyond the expected out for 1-2 days. With this view of the data, folks generally agree that vax makes you 2-3x less likely to die or be hospitalized, and so they generally view it's ok for older folks or those w co-morbidities. However, the community would also say that vax is not much better with infection prevention. This is possibly biased by louder reports of breakthroughs within the community, but then again, community is only probably 25% vaxxed, and we hear about a LOT of breakthroughs. So this updated model, even with the trapped priors, isn't THAT far off of scientific consensus in microchip-land, though definitely still less confident than expert consensus.
The other thing that I think would allow updates out of the trapped prior is seeing approved/official sources expose more questions and data counter to the political narrative, even if they're eventually proven false. We can all see that it has been something that only deplorable people question for a while, so of course very few scientists want that risk. I've seen a a few small instances of contrary opinions making their way out, and so have updated the priors in my argument a small amount, but I would still like to get to the point where it feels like a scientist isn't risking their career to publish any counter-narrative studies before folks in our community will remove the penalty.
Obviously, the best approach is your recommendation for the expert class to abandon the conflict theory model to anyone below them and get out of the bubble. But since an alien invasion feels more likely, a slight update in messaging might help. For perspective, the meme that worked the best with me was one Zvi was using pre-mandate re vax hesitant, ie. "go ahead and die - what do I care?". I found this most persuasive because 1) it fits my model that everyone hates our community, 2) it fits my model of you all being mostly libertarian leaning, and 3) it fits the medical data better - ie vax are far better at preventing death than transmission. (I also originally found the "in service of the common good" meme persuasive in my community as well as it fits the religion, until it became clear the vaccine was non-sterlizing.) The mandate and its messaging was far more confusing ('you need to vaccinate to protect the vaccinated"), not to mention a naked exercise in political scapegoating.
So, do we have at least a somewhat happy ending, where I've been able to slowly pull a few people over each month to the idea of vaccinating? LOL, no - thanks Joe Biden. And I can't emphasize enough how harmful the mandates have been here, when I had been making progress. It's not just the psychological reactance that should have been wholly expected by so-called experts. For me, it's one thing for me to be a 'diplomat' of sorts with the aliens, and represent their point of view to the skeptical, while the aliens are peacefully contained in Australia. It's wholly different when the aliens attack - arguing their point of view on my part becomes a lack of solidarity, akin to treason. Thanks, JB! Really doesn't seem like the right policy if you're interested in public health. Though that was probably never the point - I suspect it was viewed as a political win-win. Scapegoat the unvaxxed if COVID resurges this winter, or if not, declare victory through strong leadership. Not like anything ever goes wrong when a political leader scapegoats a community! ;-)
P.S.: I also think a blind spot in the ACT/LW/rationalist community comes from your relative willingness to self-medicate, i.e, via nootropics. This makes you particularly willing to medicate even when you're healthy (ie. vaccinate). A lot of folks (not just my community) don't like to medicate unless absolutely necessary, which is why I think you see IVM and the new Merck/Pfizer pills getting more traction vs vaccines.
Great post. I'm in Europe, atheist (which is probably a very different thing here than in the US) so should be in a very different circle. Still I find your analysis spot on. Maybe this show this whole thing should not be analyzed from a scientific point of view, but on who would welcome a more homogeneous society with strong central control, or one with individual (or small group) liberties maximized. It's a little bit blue tribe/red tribe, but not exactly so...People who prefer the second choice, are reluctant with the official policies mainly because they feel the COVID policies are used to push the first goal....
Every person on earth no matter the I.Q knows intuitively that life is full of nuance and a message presented this way breeds distrust.
Black and white messaging is tolerable when it comes to things like abortion, that don't affect ppl everyday and one can support without much impact on their life... but when a persons individual health is on the line they're going to start questioning these messages.
Then combine that with the rediculous way most science papers are worded which makes half of them unintelligable to people IN SCIENCE.
I think Science Establishment thinks it's doing everyone a favor with simple messaging and everyone else thinks science is patronizing them and giving an untrustworthy message.
They need analysis like this blog tacked on to every message and analysis of the studies in a human friendly format that average people who want to look deeper into the data can read.
I just subscribed today. I did it to add my thoughts to this comment thread: this is one of the very very best articles that Scott has penned. Thank you.
Does anyone know how or why an antipsychotic would be an effective treatment of an amoebic infection? From the link:
"Unfortunately, the mechanism of chlorpromazine action is still unclear. However, we suggest that the activity of chlorpromazine may change amoeba calcium regulatory protein or may be due to the lipophilic action of the drugs on the amoeba plasma membrane. The accumulation of chlorpromazine in the central nervous system makes it a potentially useful chemotherapeutic agent for the treatment of PAME in humans that is caused by N. fowleri."
Thanks for this and it definitely put forward an idea which none of the proponents of either position are saying in terms of worms and other parasitic issues in developing nations leading to immune system suppression.
My conclusions from your conclusions:
1. We should immediately give out ivermectin very widely in all places which have parasite issues which appears to be the vast majority of humanity. Their immune systems are suppressed by parasites and we have a great tool to fix that and boost their immunity which helps them in multiple ways including with covid.
This is a great solution, viable, easy, and cheap for poor countries who can't beat rich nations in the bidding war between 1st vaccine in poor countries vs booster shots in rich ones.
2. We should be very very concerned about why our institutions are giving out horribly bad and wrong advice over and over and over again and lying on so many fronts that they cannot be reasonably trusted. For different reasons than the average pro-ivermectin person, Scott too is calling out the NIH and CDC and WHO for being dead wrong in what they are saying.
Meanwhile the elites are fixated on expanding their power, giving away profits for publicly funded vaccines to mint more billionaires, and being vaxterical about all alternatives to vaccines as though the devil were coming. Thanks German and US and UK massive research funding, promises to buy the vaccine even if it didn't work, legal immunity, and all the exclusive IP control which led to record profits! You did all the work public money and public research bodies....but in terms of hoarding profit.....we'll take it from here.
Also, at Big Pharma are clearly motivated by science, Truth with a big T, and caring about you! Ummm...I'm not sure why the 1st dose of vaccines across Africa wont arrive for most people until 2023 and the vaccines only work for 6 months...we'll umm...look into that, just keep the money flowing for us, thanks!
3. This concern about widespread multiyear repeated Institutional failure about a mild disease triggering an insane reaction should be more of a concern than some pseudoscience folks who listened to the science a little too closely and found a good safe drug that does work to make covid less bad for 80% of Earth's population, but for the 'wrong' reasons.
4. Our entire public health approach seems to be severely flawed where we have a disease problem and a tactic which removes a hurdle or adds support to the immune system is viscously attacked. Do we want to help people, control a disease, etc. or do we want to only deploy the most highly scientifically researched ideas?
Or insteadMight we throw everything at it and just use anything that works for any reason as long as it is safe? Why is one approach the ONLY way and all other ideas wrong...even if every single thing from 'the one true way' has resulted in wrong choices to date?
5. The corruption of science, government, and institutions with oodles of bribe money seems to have narrowed our entire scope of understanding down to things that fit into centralisation, profits, and power expansion to the exclusions and active ridicule of any idea which doesn't promote more elite power, profit, and authority. Somehow this is left out and is central to distrust growing.
The longer winded version with more detail of the above points:
I really think Scott might be trapped in a bubble of 'trying really hard to find ways to make the professional/expert/leadership class who are like me' sound more reasonable than they are.
Largely through omission and a quick acceptance of the fact that they have repeatedly lied, cheated, stolen, engaged in horrifically amoral profit seeking, and killed people by releasing drugs which have been recalled and some which are still on the market despite the fact that they should probably be recalled or have their guidelines changed to be proscribed far less often.
This is like excusing Pinochet with 2 sentences as 'a bad guy' and 'we know that, yea' and then fixating on a person who killed 2 people while drunk driving while using shoddy statistics. The focus just seems a bit....off. As though a few tweaks to some 'bad science' would somehow fix the atrociously and terribly wrong choices made by every single person in a position of power.
I'm not so concerned that random doctors and the public found that Ivermectin worked, but think it works for the wrong reason....than I am about why all our institutions and experts missed this! And are stillllll missing it!
The end goal is clear that 'we need to find a way to trust the RIGHT experts'..as in the ones who are correct. Which does indeeds sound reasonable and very difficult and also....why in the world had we not already been doing all of this already? Why is there a sea of low standard such that the highest quality journals are still quasi wrong and below good standards most of the time? Isn't that a bigger problem than folk remedies which work for the wrong reason?
And yet, as you said the goal isn't to get negative PCR test, but instead to help people and for people to avoid the disease or become heathy if they do get sick.
So what should our goal be here? In terms of deciding what to do. I saw in another comment Scott talked about Pascal's Wager and yet....besides the adjacent Pascal's Mugging concept...this isn't a hypothetical trolley problem or an argument, it is a reality for hundreds of millions of people who've had COVID and what choices we make as a species in terms of how to deal with it.
Maybe giving out a harmless and in fact beneficial drug which won a Nobel prize is the right thing and the hysterical and objectively insane overreaction to ban it, ban it for all time to irrational promote a VACCINES ONLY policy from all the governments, media, and medical institutions is an obviously wrong approach.
One which we have never seen for any other disease and is linked to enormous power and profits....every single red flag should be raised right now to the shoddy and insane logic and approach which we've never seen before where the CDC and NIH and WHO are MORE concerned about stopping people from taking safe drugs which may not work than they are in finding therapeutics.
I've even seen ads and media talking about not taking vitamin d, not losing weight, and not taking monoclonal antibodies or other treatments. They are actively advocating against ALL ideas which are not the vaccine. This has never happened before and is noteworthy. It is vaxteria where news anchors start spitting blood and gnashing their teeth at the thought of anyone doing anything other than get as many vaccines as possible. This shit isn't normal!
To me part of this comes down to the incredible set of Western medicine style blinders of 'I need a drug to treat this specific disease directly'. The Truth with a capital T is all about this somehow....instead of the more holistic Eastern medicine concepts of looking at the overall health of the patient. In the West if a drug works for the 'wrong' reason, then we should ban it?
That's the lesson I'm hearing from all our leadership in all the important sounding places. It is important to understand mechanisms of action sure...but is that MORE important than throwing everything at the wall and going with anything that helps, even slightly and with limited side effects, during a pandemic? What should be our guiding star when we have a research system which takes years to come to semi-reliable conclusions while we face an immediate problem of a pandemic which is not going to wait for us?
For vaccines the answer was to rush the out as best we could...but that approach was used no where else where even basic treatment of patients such as corticosteroids was banned for many months at the start of the pandemic. Why the different logic, approach, policy in public health? One side of that equation had billions of profits which minted at least 9 new big pharma investors into the ranks of billionaires and the other options didn't.
Somehow......at the end of the day......we see more profits, more corruption, more centralisation, and more power held by fewer and fewer people to do more things.
How could someone not think the goal here is to boost profits when the ONLY idea which is acceptable is to have as many vaccines and booster shots as possible which were all publicly funded, guaranteed, given legal immunity for the lowest risk drug release in history, and then 100% of the options were locked up under IP and private profiteering.
The ultra strong conclusion I can see from Scott's worms are the problem trollish outcome is that 'this is the best time in history' to expand deworming programs in countries where this is a problem. It is low cost and DOES help people in those countries who get covid to not get as sick, not go to hospital, and to not die from covid.
Also! there are also many benefits of NOT having parasites which would help them in lots of other ways. Unless there is some strange pro-parasite movement (aside from the 'it fights celiac disease' somehow) I don't know about.
Somehow we're fixated nitty gritty of the dog bites man story here and ignoring the man bites dog story!
Just clicked on the link from Twitter suggestions. Thanks for your research, number crunching and insight. I'm very much surrounded by ivermectin proponents and vaccine/mask skeptics.
My personal perspective has been rooted in the Critical Rationalism of Karl Popper and deontological ethics. Overall, COVID has been dominated by consequentialism and Scientific Instrumentalism. Hopefully, people have learned that we should NEVER trust experts for being experts, only consider their arguments and more importantly their explanations. Also, that science is not an instrument for pushing a political agenda, but a process to seek out the best explanations for why the natural world is the way it is. Hume taught us a long time ago that you cannot get an ought from an is, but that is exactly the dominant message during COVID. This, along with people being bombarded with ad hominems and other logical fallacies from "authorities" I fear the next pandemic will be more catastrophic as both sides double down. All-in-all this has been an epic failure of hubris on the part of "experts".
Sorry, ended up posting way more than the simple "Thanks!" I intended.
When you say "50% confident", does that mean probability 0.5 (which is complete uncertainty for a boolean assertion), or "half way between complete uncertainty and complete certainty"?
One thing the political section leaves out is that the left-wing diversity pushers are trying to solve a similar problem. Black people have been harmed by scientists in the past, and there are few black scientists now, so they need to increase black confidence in science (black people are more likely to be unvaccinated) by forcing everyone to promote minority scientists even if they aren't the most qualified. Now try to deliberately add conservative scientists through non-meritocratic methods, and there won't be any space left for real talent. In such a polarized society, you can't please everyone. What needs to happen, is judgment by results and getting people to downplay the actual demographics of scientists.
Now this is a general problem with communication of science. The scientifically proven ways of convincing people are very different from the scientific method. Therefore, the scientific method can't defend itself well, because if it use the scientific process, people won't listen, and if it uses arguments that work, those won't be the real reasons.
"Worms can't explain the viral positivity outcomes (ie PCR)"
I don't understand this statement. I thought worms were influencing recovery time from Covid, and hence they would definitely affect PCR results on any given day.
Apparently there's some evidence that ivermectin docks to the spike, thus possibly hindering the spike-ACE2 interaction: https://pubmed.ncbi.nlm.nih.gov/32871846
Which sounds quite helpful during the first 2-3 days of infection, and not important at later stages. So after the active phase of the spike-ACE2 binding ends, ivermectin becomes more or less a placebo with some anti-inflammatory properties.
Could timing of the treatment explain why some people claim it to be the (anecdotally) ultimate cure, while others experience no effect at all?
I was with you until "Ivermectin supporters were really wrong". Surely, what (non-strawman) "ivermectin supporters" supported was not blind acceptance of the barely-tested drug's effectiveness, but a reasonable and proportionate investment into further research from trustworthy institutions. Within the year, we had new vaccines and 30k person trials, but not so much as an acknowledgement of similar scale treatment studies in the US
The health care system's response to the pandemic or scamdemic as 'conspiracy theorists' call it, laid bare corruption that's been festering for years, and revealed that authoritarians are now in control of all major institutions in society. And like all people who seek power for power's sake, they've convinced themselves they know what they do not! It's been known for years that correct levels of vitamine D are essential for a healthy immune system and the majority of people who had a problem with Covid-19 were deficient, especially children, more than 90%, yet I've never seen one public service notice informing people they should have their level checked, among the thousands telling people to issolate, wear masks, and take an experimental vaccine that doesn't stop people from getting infected, it reduces the symptoms, which makes it more likely they'll spread the disease, while causing the virus to adapt to a more contagious form. The establishment's failure to study and explain the huge spike in adverse reactions reported on VAERS, and the imposition of mandates, has created a perfect storm, undermining people's faith in government and private institutions, making it appear they're colluding for some nefarious purpose. Knowing there's an information channel between the CDC and Big Tech censoring people, makes me very suspicious,
If you comprehended the post, you'd know the point was: The contradictary and illogical responce of goverment agencies given billions to determing the best course of action, and the outright censorship of critics, is undermining peoples faith those agencies, feeding conspiracy theories, and spreading distrust in all vaccines.
I think the claim that they're reasonable people who just want bigger RCTs would be easier to swallow if the very first reply to your comment wasn't an anti-vaxxer calling it a "scamdemic" and arguing that all you need is Vitamin D. You can call that a weakman, but I'm just saying there are enough weakmen out there that I didn't even have to leave the comments here to find a couple.
As for larger trials, if you didn't find an effect with 600 people (the largest trials in the meta-analysis), it's unlikely to be worth trying it with 30,000.
For the record, I responded to beleester before reading your response and did not mean to draw a conclusion that your specific response was unreasonable
No, I said 'conspiracy theorists' called it a scamdemic, and that misinformation about and mishandling by the establishment was giving ammunition to anti-VAXers. For children, evidence shows that the experimental vaccines are more dangerous than COVID-19, that's why countries who's health departments aren't controlled by Big Pharma stopped giving them to people under 30. The virus that causes COVID-19 is a very dangerous bio-weapon, and when when treatment options are suppressed by the WHO and CDC to maintain the EUA necessary for Big Pharma to make thousands of dollars a second, with zero liability, even more dangerous. The pandemic needs a multi dimensional response, The one size fits all approach the CDC advocated couldn’t work, but those who understood were censured and censored. The use of multiple boosters wasn’t even studied, but they’re going ahead with them, why not, they have zero liability and doing so will make then even more big bucks.
So what you're saying is that all it takes for you to be convinced to not advocate for the right thing (bigger RCTs) is for a group of people on the internet to go around posting unreasonable things? (I'm sure if anyone were trying to push an agenda, they would be happy to know that as well.)
You've changed the subject from "evaluating ivermectin supporters as a whole" to "evaluating the subset who argued for bigger RCTs." Scott's statement that "ivermectin supporters were really wrong" is broadly correct, and your claim that *surely* they weren't promoting anything besides bigger RCTs is proven wrong by John Hart and a dozen others in these comments.
If you're trying to advocate for the right thing while a lot of people in your circle are advocating for the wrong thing, then you need to work hard to distance yourselves from those people. That may not feel fair to you, but nobody can single-handedly control the conversation on anything, you just have to play it where it lies.
(I am also unconvinced that bigger RCTs are "the right thing" - as I said in my second paragraph, they *did* do two bigger RCTs and didn't find anything.)
In 'The Web that Has No Weaver', a seminal (in my view) book on Chinese medicine, Ted Kaptchuk starts with a story about a poor cleaner from the country who works in a western-style hospital in China.
The cleaner steals a store-room full of antibiotics when he leaves his job and returns to his home village. He then dishes out these pills whenever one of his neighbours get sick. He gains a reputation as a great healer because a significant proportion of his patients are miraculously cured. Kaptchuk likens this to the Western approach to Chinese medicine where we 'do acupuncture' and 'use herbs', but we don't have a deep understanding of why it works.
I was reminded of this parable when reading Scott's description of the effect of Invermectin with helminths.
If you give Ivermectin to everyone with COVID, maybe a proportion of them will get miraculously better. But without a deep understanding of how it works, we can't say why ...
> Somebody’s going to try make some kind of gated thing where you have to prove you have a PhD and a “legitimate cause” before you can access the data, and that person should be fought tooth and nail
This is already happening with some genetic datasets. You have to sign a legal clause that you aren't going to use the data for badthink. https://thessgac.com/register/
As a skeptical vaccine-denier who did not have strong feelings about ivermectin but doubted the ivmmeta presentation and wanted to read some other opinions on it, I enjoyed your neutral analysis. Your conclusions regarding ivermectin seem very reasonable.
Towards the end, you unfortunately abandoned your neutral position and vilified vaccine-deniers by calling us crazy. That is not true. We can be perfectly reasonable people who simply do not see a compelling reward vs. risk in favor of vaccines in the calculus of our lives. In my assessment, the safety of vaccines is an oft-repeated mantra but is not actually backed up with scientific evidence. There are many hypotheses about potential vaccine harm, informed based on real world signals, that have generally gone untested due to political forces. At the same time, the risk of my children dying from chicken pox, measles, polio, COVID, etc, appears to be exceedingly low.
It is great and magnanimous to be neutral in our assessments, to focus on facts and evidence, to approach others with respect and accept that we might be able to learn something from them.
You are free riding. The risk of *your* children dying or being paralyzed from polio is exceedingly low because other people, much more numerous than skeptical vaccine-deniers like you, do vaccinate *their* children. As for comparative risk, know why FDR was mostly confined to his wheelchair all his adult life? You can get some 100-year old books and newspaper articles written in American English long before polio vaccines were invented and learn what it was like. I won't recommend 200- and 300-year old books (also written in English) because standards of hygiene and public health improved bigly in late XIX century, but you must be aware what childhood mortality figures were before that.
It is true that the majority of parents vaccinate their children and that I benefit from that. That is simply the environment that I am operating in. My goal is to do the best for my children in said environment, as should be the goal of all parents. If the landscape were different, I might make a different choice.
Even polio only causes paralysis in a small percentage of cases (0.1-0.5% of children), and cases themselves are exceedingly rare in the modern Western world. Raising an anecdote of a famous historical case is not very interesting.
With regards to COVID, the case for the vaccine is even weaker since safety is much less understood, herd immunity is no longer a thing, and the virus appears to be extremely mild for children.
In my view, the modern world is thoroughly corrupted. Just look at vaccine safety for example: pharma companies don't really study it (granted immunity from liability and have no incentive to), governments don't study it (inept, corrupt, whatever), and independent researches who do study it seem to get character assassinated. There's no good answer here for parents. We are making the best we can of a hostile environment.
If I wish to win hearts and minds, it's not by appealing to some naive sense of collective good that will be found in trusting the government. I'd rather talk honestly about the serious issues facing us.
Are you aware that your approach can change this? And with measles in USA antivaxxers had first "successes" and caused outbreaks. Not sure if they managed to kill or main someone already.
For me it is in the same category as stealing railway tracks for scrap "after all, even if train will derail, noone from my family will be there - if the landscape were different, I might make a different choice".
Comparing stealing someone else's private property to neglecting to inject a pharmaceutical product into my body is a fairly ridiculous analogy.
Measles is part of life. It's fairly harmless in the West, especially if you have a healthy lifestyle. But if you're scared of it, you're welcome to lock yourself inside and hide in fear. You will not force me to inject pharmaceuticals into my body to comfort you.
I specifically avoided mentioning corona because I mostly agree with your estimate of it. In particular "long covid" appears to be the modern incarnation of neurasthenia and other vague predominantly affluent female problems.
As for the rest, I won't call your position selfish because you act, as you say, for the best of your children, but I submit that it is completely analogous to refusing to pay taxes because the money would be better invested in your children's college funds, while public goods won't suffer because skeptical tax-deniers like you being a small minority others will pay enough taxes to keep things running.
Does the Pre-infective therapeutics that were calling a vaccine decrease the risk of transmission?
Spoiler even the CDC says it does not.
If we call the thing by its right name then all of the fog surrounding the idea of heard immunity goes away.
But if we are going to embrace endless treatment with uncertain safety as a treatment strategy to protect the healthcare infrastructure shouldn’t we at least equally emphasize weight loss and similarly restrict those who failed to comply?
"COVID-19 vaccines currently approved or authorized in the United States have been shown to provide considerable protection against severe disease and death caused by COVID-19. These findings, along with the early evidence for reduced levels of viral mRNA and culturable virus in vaccinated people who acquire SARS-CoV-2 infection, suggest that any associated transmission risk is substantially reduced in vaccinated people: even for Delta, evidence suggests fully vaccinated people who become infected are infectious for shorter periods of time than unvaccinated people infected with Delta."
"Evidence suggests the U.S. COVID-19 vaccination program has substantially reduced the burden of disease in the United States by preventing serious illness in fully vaccinated people and interrupting chains of transmission. Vaccinated people can still become infected and have the potential to spread the virus to others, although at much lower rates than unvaccinated people."
The techniques you suggest for detecting fraud sound really basic. Like something anyone who had taken statistics 201 could tell was kind of stupid. Are we assuming competent fraud doesn't happen? I would think the existence of large amounts of incompetent fraud would imply the existence of competent fraud too.
Generally speaking running a scan for incompetent fraud and then pivoting on the co-authors etc. of the fraud will show you people that are worth doing more investigation on to see if they are doing more competent frauds.
This is a very impressive post, and it's boggling that you just threw it out there in your spare time. The amount of work that's gone into it is comparable to papers that people work full-time on for months.
Also, it's a really depressing snapshot of how much fraud and error there probably is in published science generally - and because most topics aren't as politically charged as ivermectin, they don't have adversarial reviewers going over them with a fine tooth comb, and they just get accepted as truth, used for policy decisions, and taught to students.
I agree researchers should be expected to publish their data.
And if closed-access journals are going to exist, they should earn their extortionate fees by providing a rigorous error-checking service.
So regarding your "must publish the raw data" bit. As someone who has been a keen observer of the global warming debate over the years, this was depressingly familiar.
You may or may not be aware but climate scientists have generally been really really bad at publishing their raw data and source code. There have also been any number of cases where analysis of their actual raw data and source code after a fight to get it has shown up statistical errors and other flaws (including coding bugs). It has to be said that the general attitude of the global warming scientists to requests for their data and critiques of their results has not helped me trust that they know what they are doing.
I am a strong believer in simply discarding any study that omits provision of raw data and tools used to process it.
Something to note about the parasite interpretation: To account for such a major effect in the high-prevalence countries, it implies that giving corticosteroids to an infected person is around 10% lethal. It is highly unlikely such a major effect has gone unnoticed until now (very few doctors know of this risk of steroids).
One way to get around it is to claim some complex interaction with Covid, so steroids are lethal only for Covid patients with parasites. Could be, but would be more believable if someone could provide a full mechanistic explanation.
Oh, this feels so pedantic, but... the Steinbeck quote is not entirely accurate. It's a worthy rabbit hole, so go do your own research. But now I don't trust any of the rest of this article. (Kidding, this was brilliant and thank you. Will be sharing with many who won't read it. Sigh.)
THANK YOU, finally a decent analysis of the issue that does not engage in dehumanizing vitriol but recognizes the rationale underneath many people's decision to use ivermectin. you did leave out one thing (I think or else i missed it): ask your doctor. it seems that it depends on whether the doctor agrees with the elite position or not, at least with this issue. because many doctors did in fact use it with their patients. thanks again.
There is a sinister type of literate simpleton thinking. It's on display here.
Now I don't like to start off with what appears like an attack, but a little pain can lead to gain.
Evidence. The observational evidence for IVM is strong. The clinical RCT evidence is weaker, but its there. The mechanistic evidence is strong. But perhaps most importantly, the real world anecdotal of US-based physicians like the Dr. Varon ("The Covid Hunter") or Dr. Barody ("Heliobacter Triple Therapy") and many others - it's very very very notable. So we're left to explain the literate simpleton.
It's not a character flaw, it is a failure to understand reality outside of academia where you try to isolate.
If you go to a court of law, RCT+observational evidence+real world anecodotal+mechanistic evidence = cause = conviction = proven. That's the real world. That's how we convict criminals
like Monsanto, and hopefully one day Pfizer.
Ivermectin works in combination therapies. You can prove that out just looking at Japan - not a big parasite country.
As for your current understanding of "tracking" - I think it is safe to say you don't know Lenz Law, which is 2nd year physics, without which you can't understand a lot of biotechnology that already exists. So when you say "impossible with current technology" you sound like a fool. I'm not arguing for "microchipping" in the sense you think, in fact I know that's not the case.
There is no space to expound on how advanced electromagnetic tech is suffice to say
that in Sweden they already scan their wrist at checkout, and that is old
technology. I'm not arguing for any conspiracy so you can stick me with a simpleton
hot poker, like "vaccine denialism" suggest you are apt to do.
As for the vaccines which is the most important matter at hand, the danger is the spike protein - it's a toxin, it causes clotting, it causes hyperinflamation, it is a prion, it enters the nucleus and can impact DNA. It's in the vaccine and in Sars-Cov-2.
Now reassess everything you thought was good about the vaccines. You don't need to understand immunology for that.
Finally, if you are a parent (anyone) and want to help your kids we'll soon have a course up on the science and a learning community, signup for The Discovery Force for free: mercy.school
I am not concerned about microentanglements on blogs, but about saving our youngest from a lot of pain.
The scientific method is much more valuable as a way of collecting evidence than anecdotes or the opinions of your favorite doctors. You are way off the mark.
There are places on internet where the debate already ends when you start calling everyone who disagrees with you a "simpleton". This is one of those places.
(inb4 "Ah, a tone argument. The ultimate version of simpleton." Whatever.)
Setting definitions that RCT = scientific method and all the other evidence is not scientific method is the type of illogic we expect from a 3rd grader. Arguing with 3rd graders on the internet, who may be paid pharma shills is not worth our time or yours.
There's a reason that's the traditional cry of the quack.
no, you don't have any special "real world" understanding that academics lack and courts are notorious for being kind of shit at distinguishing fact from fiction.
Do you think professional researchers don't need to figure things out?
A large fraction of medical researchers are practising clinicians.
Most of the time they're at the very pinnacle in their speciality such that if you have even a vaguely unusual disorder getting referred to a research group can be extremely good for you because they're vastly more likely to be able to help you than you local GP.
Because your local GP or your local ER doc is mostly "figuring out" the local elderly population with the top few dozen most common health disorders more than 90% of their time.
Most practicing clinicians don't have the millions of $ in resources to do multi-center RCTs on repurposed drugs. But yes, one of the largest groups of clinicians in world history took to Ivermectin as did elite academics in India. It is only in farma fields of the west that we are in this situation.
> in Sweden they already scan their wrist at checkout
even if true, how it is supposed to be related to vaccines? Are you actually seriously claiming that "5G microchip implants in vaccines" crowd is not utterly detached from reality?
It is exactly thing done by mercy.school with various attempts to make vaccines scary in the same way that could be applied to water. "chemicals" - water is also a chemical.
No, it is not, that's the point. Pointing out that a specific chemical (glyphosate) is harmful is not in any way the same as claiming or implying that all chemicals are harmful. This is why it is smug reddit midwit trash. You are ignoring what is being said in order to regurgitate a tired old worn out joke you clearly don't understand just because your mental keyword search found the word "chemical".
Get a real job. Baiting people with these emotional hooks works on the school yard, but here you'll be dismantled like a paidbot by intelligent beings.
Excuse me if this has been covered, but I thought one of Bret Weinstein's most interesting claims was that tropical countries where ivermectin was used routinely for parasites did much better (deaths? hospital admissions?) than nearby countries which didn't use ivermectin.
There could be any number of confounding factors, but it's at least worth a check.
Most of the first-world Covid-19 deaths, as I understand it, were in the medically vulnerable crowd; people who I think probably have already died of something else in countries with high parasite loads, since that is correlated with a number of other things, such as the absence of good sanitation systems.
It wouldn't surprise me at all if poor countries had lower death rates from Covid-19 than rich countries, just because of who Covid-19 was killing.
Then, if a lot of the deaths these countries do experience is from suppressing the immune systems of people with parasites in the course of treating Covid-19, we could arrive both at the absurd effectiveness that some of these studies have seen, and a situation in which countries which use Ivermectin widely do better than countries that don't.
Thegnskald, you need to read the article. In it it is explained that the Ivermecin used to treat covid was also treating parasitic infections at the same time. Any control group would include people with untreated parasitic infections AND covid infections. This would explain why it appears that Ivermenctin is effective.
> If you tell these people to “believe Science”, you will just worsen the problem where they trust dozens of scientific studies done by scientists using the scientific method over the pronouncements of the CDC or whoever.
Something that has been driving me UP THE WALL in the past two years is this social meme of "believe science". Don't _believe_ science, _understand_ it. If you _understood_ science, you would know that telling people to believe it is the most anti-science thing you can do
Science isn't an authority handing down diktats from on high. Science is a process. ANYBODY can do that process, +/- expensive equipment. In fact, we rely on that; we hope that multiple people try to do the same science independently and then we compare their results!
I was accused of "not believing in science" last year because I rejected most of the mainstream public narratives about covid. But the reason I rejected them was because they were false. I know, because for six months I spent almost three hours a night reading medical research preprints linked on r/covid19 and trying to draw conclusions.
What I was doing was more "science" than anyone who "believes" in it has ever done. I wish society was not trying so aggressively to dissuade people from doing this, in favour of mindless deference to people who, while under oath, have admitted to knowingly lying to the American people for policy-convenience reasons (the whole mask thing, eg)
> What heuristic tells us “Medical students should be allowed to publicly challenge heads of Health Institutes” but not “Distinguished critical care doctors should be allowed to publicly challenge the CDC”?
The heuristic of "educate yourself on basic relevant background information, then read the studies and judge for yourself". Exactly like Scott did here!
Part of the problem here is that science popularizers and politicians who "follow the science" are imputing WAY WAY WAY too much certainty to their comments (or, if not, they are implying it, possibly accidentally, in a bad way). When I ask myself, hey does ivermectin work, and I see all of these studies, I say "probably; who knows, we might have a proper answer in ten years. In the mean time, it's cheap and relatively safe so don't be an idiot but you might as well take it". When these public "scientists" (very rarely actual scientists) look at the same studies, they don't say "eeh these results are inconclusive, it probably doesn't work". They say "IT DOESN'T WORK, ITS OBVIOUS IT DOESN'T WORK, ANYONE WHO THINKS IT WORKS IS EITHER STUPID OR LYING".
Basically nothing in science deserves that level of confidence. Hell, even when science "officially" "blesses" a result with p <0.05, that just says (handwaving; I'm not a scientist sorry if I get this wrong) there's a less than 5% chance that this happened randomly. <5% is 1 in 20. Every single thing that science says is true can be false 1 in 20 times and science still says its true, because that's the best we can do. A 5% error rate is way, way too high to justify the level of certainty that our science communicators have
Since Mannan plans to read the comments I'll respond to him: I have been following the group of scientists and science students who did the grunt work of pointing out flaws in ivermectin studies. There are two times when they get shouty:
-People publish studies that are highly flawed or even made up, claiming extreme effectiveness for ivm
-People who should know better include these highly flawed or made up studies in their results, claiming extreme effectiveness for ivm
Their opinions differ on whether ivm has a good chance of being 8% effective at preventing deaths. They do not get shouty about this. The shouts happen when extreme claims of 90% effectiveness are made & used. Note that extreme claims are less likely to be true.
The studies with extreme claims are covered in red flags, and near-universal scientific training tells you how to look for those flags; accredited researchers generally know whether to treat a given study as being actually 95% or not. They get shouty at researchers who ignore red flags that they think should be obvious, because if the researchers know better than to ignore them then they're probably not being objective.
Note that this is a small group. There will be other experts whose experience with IVM advocacy is not known, some of whom have different policies on when to shout. And there is also the media and social media which is full of non-experts. They make most of the noise and have the least knowledge. If you allow these categories to mix you're gonna blame the debunkers for other people's actions.
Side note, the standard way to count a result as proven is p<.05, frequentist-style. Different fields may have harsher p-values or may have moved further into Bayes-land. But in general scientists wouldn't consider something Theory based on one p<.05 result; making Theory requires multiple experiments from multiple angles & multiple parties, followed by a period of waiting to see if a grouchy old professor will publish an angry letter that points out how it's all flawed.
> But the basic issue - that the vaccine works really well and is incredibly safe for adults - seems beyond question. Yet people keep questioning it.
The vaccine comes with an unacceptably high risk of fascism, and if you ignore this you will be extremely confused as to why a ton of normal, regular, not-stupid-at-all people are making the rational decision to not get vaccinated.
I believe that the vaccines probably work more than zero. I believe the _health_ benefits probably outweigh the risks (however, not for me; I already had covid so either I'm immune and it doesn't matter, or I'm ok with how sick I got if I get that sick again, so it doesn't matter). I'm still not getting it. The split second our governing institutions decided it was reasonable to say "get vaccinated or we will destroy your life and end society", my mind was made up. Even if that means fifty million Americans die (I don't believe that, but even if), well, on the order of fifty million people died the last time we stopped fascism and if you so much as question that cost-benefit analysis you get accused of being a Nazi.
In fact, if I wanted to be really cheeky I might say that the fact that the vaccine probably works _increases_ my hesitancy. If it was a bs vaccine that did nothing, the choice of whether to take it or not take it is meaningless. If the vaccine actually works, then refusing to take it is a costly, credible signal of "no, we're serious, these lockdowns are unacceptable".
For anyone who wants to try and change my mind, these are my requirements:
Someone has to give me an explanation for why I need to get immunized despite already having had covid. The explanation cannot involve either a) any reason that reduces to "there's no medical reason but it's easier for the government to track vax status than immunity status" (because the government enacting unacceptable measures for their own convenience is my entire problem!); or b) "immunity is temporary so get vaccinated" (because that immediately implies that I will have to get booster shots every year _forever_, which means that accepting the mandate means accepting a _permanent_ mandate, and that's unacceptable)
Someone has to give me a credible demonstration of remorse on the part of the government. At this point, the demonstration has to be something along the lines of "Dr. Fauci is executed in public, where I can see it so I know it's not a deep fake", or something equally costly. Not because I think he needs to be executed (though wouldn't shed a tear if he was), but rather because I have so little trust in anything the government says, it would take a signal that costly to convince me they're being honest
Someone has to give me a credible commitment to both the current restrictions being eliminated entirely, returning our society to the way it was in 2019, and also a credible commitment that this will NEVER. HAPPEN. AGAIN. No matter how bad the next pandemic is. I cannot think of a way in which the government could demonstrate enough credibility to convince me of this. (remember how they said they would totally never mandate vaccines and then three months later they made it law?)
Someone has to convince me that my getting vaccinated will nearly-immediately and permanently exempt me from _all_ covid restrictions. Given that almost every polity on the planet has already said this _and then backpedaled it_, I don't think its possible to convince me of this anymore.
Someone has to get me a formal apology from a high profile public figure for systematically emphasizing the worst and most socially costly measures possible (ie "we will throw you in jail if you try to go to work") while ignoring obvious low hanging fruit ("we will throw you in jail if you don't go to the gym and lose 20 lbs", etc).
I estimate the probability of achieving _any_ of the above items as 0+ε%, nevermind all of them.
Oh yeah. Also, the government must financially compensate me for what they've done. As a noncitizen with a white collar job, I did not see one penny of pandemic bucks, but I've had two years of my life stolen from me same as anyone else. One QALY is like $100k. Two years times 2 QALY per year (because these are my prime years; a multiplier of 2 is conservative) = basically half a million dollars. So that sets the floor of what I require
> I’ve been trying to figure out a model where ivermectin support and vaccine denialism both make visceral sense to me, and here’s what I’ve got:
Here's your model:
The people who said ivermectin doesn't work are openly hostile to IVM believers, and have been repeatedly caught in malicious lies in the past year
The people who said the vaccine is important are openly hostile to IVM believers, and have been repeatedly caught in malicious lies last year.
If the same person repeatedly lies to you, you should start assuming they're always lying.
If "IVM doesn't work" is a lie, that implies IVM works
If "The vaccine is safe and effective" is a lie, that implies vaccine denialism
If both of the groups saying that are lying, then the reactionary response will be coordinated without any underlying relationship between IVM and vaccines
(I am writing these comments as I read so apologies if the next paragraph has Scott outlining exactly what I just said)
Also worth calling out, although this is probably getting too close to partisan shit-flinging:
In late 2020, every single member of the current Democrat administration went on TV and told everyone to not get vaccinated, because it's Trump's vaccine so it's probably poison. Then they all flipped on a dime on January 20th. More importantly, they flipped on a dime without explaining why they flipped, and without even acknowledging that they flipped.
It's all fine and good to write off vax deniers as ignorant rednecks (I am NOT saying scott did this). However, curiously, the only people I heard who disavowed Harris and Biden saying "don't take a Trump Vaccine" are Trumpy people.
The currently elected united states federal government directly and intentionally created the anti-vax backlash against the _current_ vaccine, in order to win an election. Any discussion of anti-vaxxers that doesn't prominently raise this happening is missing an important detail
You are mischaracterising the Dem narrative in late 2020. They were concerned about Trump interfering with the CDC and FDA as he had been shown to do, and, they were concerned that perhaps he would force approval of the vaccine prematurely. He had voiced his desire to get the vaccines approved before the election. They did not flip on a dime. They waited for FDA approval , which happened after the election. Perhaps there was some politics involved. I think most observers would take that into account.
If you are concerned about how US politics informed vaccine approval, try looking at how other countries handled the process. Nobody approved the western vaccines before Nov 5.
I don't know what to say to someone who is so stupid that he still thinks the news is honest. I hope you aren't too shocked when they put you in cuffs too
If you're calling for the public execution of your political opponents.... for most of the population if you got your wish from some hypothetical party that came to power that would be a far far far stronger signal of the government falling to fascism.
"behave like textbook fascists or I'll believe you're a fascist" isn't the best rallying cry I've ever seen.
lockdowns etc are not new, used to be they'd just brick up the doors of the building you were in if they thought there was someone infected with you and leave you to die. Governments have historically been (reasonably) given far broader leeway for existential wars and epidemics. Simply because the body count for both can get so high. The latter having killed far more than the former throughout history. Plagues bring down empires.
Covid is both fortunate and unfortunate in that it's at the lower end of the scale of what can trigger governments into action. Many of the plans enacted were built for sars cov 1. The two viruses are relatives from the same area after all ... and if we had that rampaging instead of covid 19.... well a 10% kill rate would decimate our civilisation.
Covid 19 led to excess mortality on a par with WW2 in the UK but fortunately mostly the old. But that's a drop in the bucket next to the potential of epidemics.
I suspect much of the current policy was written based on history of previous epidemics like the spanish flu where a later variant turned out to be far far far worse than the initial version.
You know the old saying of safety rules being written in blood? pandemic rules are written with oceans of blood that dwarf even genocides.
Governments haven't handled it well and it's become political, on a pure QALY basis it would be very very hard to justify things like lockdown now that vaccines are rolled out and the death rates have dropped through the floor.
But they're slow juggernauts that are hard to turn.
You're not going to get an apology any more than if you get evacuated from a hurricane that turns out to be lower magnitude than expected or get moved away from a burning nuclear power plant but it turns out they managed to maintain containment.
Insisting that the government throw away all future pandemic plans that involve lockdowns? that's probably the worst possible response, because there are far worse things than covid19 out there and those plans were written in blood.
Further research will show us how to use Ivermectin to maximise its effect against SarsCov.
After that, a well designed "Study" will show the research to the public. Until then, clinicians will treat COVID patients, in consent, with the medications that they find appropriate - as it always was and as it should be.
> Again, ivermectin optimism isn’t exactly like vaccine denialism - it’s a less open-and-shut question, you can still make a plausible argument for it.
Using this as a jumping off point for one of my pet peeves.
Vaccine denialism is ABSOLUTELY NOT an open and shut case. Its an open-and-shut _medical_ case. But there are more things in heaven and earth, ACX, than are dreamt of in your medicine.
This is a thing that happens _a lot_ in politics/policy discussions, and rationalists tend to be especially bad at it (probably an artifact of them being disproportionately likely to be policy wonks). Alice decides to do a cost/benefit analysis to justify doing a thing. Bob doesn't want them to do a thing, and has some reasons. Alice wants to do the thing and is looking to justify it. Alice runs her cost/benefit analysis and comes up with some costs and some benefits. Then she looks at the costs column and crosses out 2/3rds of them because "that doesn't matter"
Except it matters to Bob. But Alice, trying to control the frame, simply doesn't acknowledge the concern and tries to get everyone to ignore those costs.
Sure, there's 'no reasonable cause to oppose covid vaccines' if you restrict your thinking to only medical (Note: I do not concede this; I think there is something real and significant going on wrt the severe reactions and deaths. I have no idea how big/significant it is, but I know that that when basically the entire world will try to get you fired simply for asking that question, you cannot trust their answers, ever. My current estimate is "it's real, its significantly higher than the risk of other vaccines, it is probably safer than actually getting covid +/- specific demographic and risk factors (ie covid might be safer than vaccine for teenagers on the ground that only about 600 people under age 18 have died of covid in the US, ever, which is basically a rounding error away from zero in a nation of half a billion (https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/). I've also seen some things suggesting cause for concern in vaccinating people who have already recovered from covid, but I haven't dived into that enough to know if it's just noise or not)
However, if someone's response to my very reasonable social and political concerns is "lol those don't count. 'Muh rights', lol moron, can't you see people are dying??!?!?!", then of course they're going to think they are obviously right and I am ridiculously denying an obvious good out of nothing but stubbornness.
(For a bit-flipped example, consider if it would be reasonable to accept significant curtailments of African-Americans' rights, on the ground that the 2020 BLM riots killed more people than the n word ever did, and if they didn't have rights, they couldn't riot. Even the most racist far right extremists I know would think that that's ridiculous, and yet this is the same principle of reasoning people are using for lockdowns. "Fuck your rights, people died, nothing else matters until they stop". If you have a right to free assembly, you might spread covid. If you don't have a right to free assembly, you can't spread covid)
Basically literally every time you have a social policy that does not have >95% consensus in the general public, you should start with the assumption that it's very much NOT an open-and-shut question. If it was, a ton of people would not disagree with you! And in case you think this is an unreasonable standard: I will pay out $5000 USD to anyone who can convince me that >5% of Americans sincerely believe that (eg) murder should not be illegal. there is overwhelming consensus that murder is bad, and so murder is illegal and nobody disputes this. (Even the people who believe that some _killings_ should be legal, do not concede that those killings are murder, and still agree that murder is bad). "Is murder good or bad?" is actually an open-and-shut case. "Are vaccines good?" is not, if for no other reason than that like a third of the country says 'no'.
What has ground my gears about this whole thing even more is that the corporate press, the blogosphere, social media, everything, has been telling us for over a year how we're surrounded by 30% of the country who are crazy and don't believe science. You know what I have NEVER seen ANY of them (including present company) do? Actually ask an anti-vaxxer why they're anti-vax. On the very rare occasion when something like this happens, they get the most ridiculous moron on and paint the whole group like that, instead of asking one of the literally millions of regular normal Americans why they have decided this
And I promise you, if you did this, you would find that a large majority of vaccine-hesitancy is driven by politics, and you would find that most of those political positions are not unreasonable.
Speaking personally, I am still at a loss how to have these discussions sometime because what has happened in the past two years is actually, seriously, sincerely, no-joke, Hitler/Stalin level evil. To bring one example at random: my home province shut down everything, no exception for churches. A handful of very religious communities who belong to my tiny ethnic minority group said that Jesus is more important, come make us stop. The government dispatched police to their rural communities to physically prevent them from worshipping
THEN, the state started running ad campaigns, spinning press releases, etc., to push the narrative of "those evil, selfish minorities, who think going to church is more important than saving lives, are why we have an outbreak now" and started stoking overt racial hatred against us. Which, in addition to being almost mustache-twirlingly, cartoonishly evil, is also ridiculous; a bunch of rural conservative farmers who live three hours' drive from the nearest city CANNOT have any meaningful impact on a disease that requires close contact to spread.
Even with how crazy society has been going lately, if you had asked me in 2019 "will the government, in your lifetime, make church illegal and send people to jail for worshipping Jesus, for any reason", I would have laughed you out of the room. _**That literally happened last year**_. Maybe it was necessary for the greater good (I do not concede this). But that is sufficiently extreme that, if nothing else, it should have come along with extremely vigourous public debate. Instead it came along with half a million Canadians uncritically accepting that my ethnic group is intentionally spreading covid because fuck everyone else. (Remember when all of society agreed that blaming the Chinese for spreading Covid was horrible evil racism? Why the disparate treatment?)
They made going to work illegal and disrupted communities and social bonds. They got churches to voluntarily shut down (and did it by force in some places). They took away everything that made life worth living. They justified tons of political and electoral incompetence and corruption on the grounds of "it's covid". They let crime and violence run rampant and even had the gall to publicize op-eds claiming that rioters don't spread covid, only you and I do. They printed trillions of dollars and caused inflation worse than anything we've seen in my _or my parents'_ generation. They broke the supply chain causing massive shortages of input intermediary goods that we still haven't seen the full consequences of. They eroded high trust society, getting everyone to snitch on each other and enforce arbitrary and capricious rules.
Again, even if you think all of this was necessary (it wasn't), that doesn't account for why so many people went along with this _gleefully_, instead of taking the tone of "this is horrible but it's what we have to do". But this is a horrible, egregious harm to millions of people. (Hell, hate to be so blunt about it, but I currently know of 6 people who killed themselves over lockdowns and 1 person who died of covid, if anyone really wants to do a deep cost/benefit analysis). Just because the damage is abstracted and spread throughout society, instead of highly legible and visible like eg a war, doesn't mean the damage is any less real.
I have no meaningful ability to change this. I can't take up arms and overthrow the government, for obvious reasons. I can't even vote here, I'm not a citizen. What I can do is engage in costly protest. The people who locked us down last year, are now telling me to get vaccinated. They have not compensated for last year or apologized to me. So now, I don't get the vaccine. Purely because I want those people to be mad that they can't achieve their vaccine policy goal. Because that is the only protest available to me.
This is a reasonable basis on which to make medical decisions, and casually writing it off as "it's an open-and-shut case and no reasonable person could possibly be against these vaccines" is intellectually dishonest
tl;dr: if you lived in 1944 Germany, and there was a plague going around, and the Nazi government made the plague vaccine mandatory, would it be reasonable for you to refuse the vaccine purely on the grounds that literal Nazis want you to take it? I assert yes, that is reasonable
This is a beautiful protest, and I, and likely hundreds of others, will take on a similar stance. It's said because all I and you really want is empathy, but that's so hard to get from anyone with a pro-vax stance.
At some level, all I want is a hug and an apology, but the people who run our world are so cartoonishly evil that they won't even do that. Those are only for the ingroup; what I get is thrown in prison because there are more neurotic voters than there are copies of me.
Having read all of your comments in this thread, I can say that while I disagree with almost every single statement of fact or judgment you have made here I nonetheless sense you are a conscientious person, and I genuinely wish you well.
I am reminded of Scott's closing thoughts on the difficulty of communication between hostile tribes. He didn't know how to manage it and neither do I, but maybe it starts with a hug and an apology.
You have had 6 friends commit suicide over Covid lockdowns? Wow. Given that suicide rates have been stable in Canada during the pandemic, I would guess that you and your friends are disaffected. If that is the case then I would also guess that you were disaffected before the pandemic and that it only got worse.
The difference between public health measures and actual tyranny is that the former IS temporary and is designed to save lives, and the latter is intended to be permanent and is designed to enrich the oppressor.
We have a ton of societal problems that make having a standard of living similar to that which recent generations have enjoyed next to impossible for young people today. Try not to blame pandemic restrictions for broader societal failings.
I guess these studies were done prior to the vaccine, but it seems like a few invermctin vrs vaccine studies might be convincing to doubters. Basically something comparing the outcomes of 1000 fully vaccinated people vrs 1000 unvacinnated people who took invermectin, either as a prophylactic or as treatment. We all know what the results of that kind of study would be overwhelmingly favor the vaccine, but they might be convincing to people who "do research."
(1) I DO know lots of young-earth creationists, and people suspicious of vaccines, and this article spots part of the problem: these people have seen the Establishment lie to them repeatedly, often citing "Science" even when caught in lies, and most of them (not all!) don't have good science training so they can't judge for themselves very well. They're in a tough spot.
(2) What disappoints me about this article is lack of cost-benefit analysis, loosely speaking. It's all about effectiveness, the benefit, which is dubious outside of wormy countries, high in wormy countries. What about cost? My impression is that the side-effects are minimal, tho it's unclear whether there are mild-but-bothersome side effects at the doses claimed to be effective for covid (side effects like those of vaccines, headaches and a half-day of work lost). The dollar cost is very low for sheep-and-horse ivermectin, closer to $100 for Indiana human pills. Is this correct? If so, it makes sense to go get some sheep dewormer if you feel sick.
Common side effects of Ivermectin are: headache, muscle aches, dizziness, nausea, diarrhea, mild skin rash. None of these are show stoppers if you are treating ringworm, but given that the consensus is that it does next to nothing for covid, I am thinking that a bout of diarrhea is worse than not taking it at all.
Common? I think you’re exaggerating the occurrence of these effects.
Maybe if you were taking a heroic horse dose.
I, would stick with doctor prescribed doses.
The consensus being it exactly DOES do something for COVId if you have ring worms, then that is a risk I would be willing to take given no one has discussed or talked about the possibility I or others have a ring worm related infection without visible symptoms or could be directly affected and helped by the other anti viral properties of IVM. The cost seems low to me.
As I’ve said; cost benefit analysis or you’re just sticking to a personal dogma you believe in.
Well, I don't know where you live, but where I live I (SW British Columbia) there is no ringworm and I generally don't go around in my bare feet and risk picking up an infection. It is not about dogma. When I first heard of Ivermectin a a possible therapy it sounded great. But as I dug deeper, I noticed the FDA, CDC and Health Canada had all issued statements saying that there is no evidence that Ivermectin helps with Covid infections. I also found other articles talking about how it appeared to be promising and it ended up not. So it is time to move on.
That's a remarkable attitude. I'm curious why you have a passionate aversion to a one-time dose of mRNA but you're quite happy dosing yourself dozens, if not a hundred or more times, with another unnatural chemical. I can totally understand Vitamind D and zinc, as you eat those things all the time, but ivermectin isn't a normal part of the human (or any animal) diet. It's not a natural compound at all, it's synthesized by bacteria and its primary effect is to kill insects and worms by frying their nerves.
It could screw up your nerves, too, if you get too much of it, and it's not even implausible that it could cause some very minor nerve or brain damage at moderate doses taken long enough. A recent survey of potential side effects:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8087035/
Nobody knows or sure what might happen with long-term moderate use, because the normal treatment for worms is a short dose, and anyway the chance of some very minor neurological side effects would be totally acceptable if your other option is river blindness, so nobody has looked for this. But it seems like an odd risk to willingly run the clinical trial on yourself if you're otherwise in perfect health.
Do you know the CDC recommended ivermectin for international travel?
A little bit of research about this reveals there are many travelers who have taken it for months at the recommended doses, with no long-term side effects. There is plenty of long term data for its safety at the doses in doctor-recommended protocols for COVID.
In the case of COVID, instead of taking it prophylactically we could even just focus on taking it for the rare cases you go home with symptoms. That would reduce the risk profile even more drastically to basically an unprecedented low-risk level.
They did so against parasitic worms; not COVID.
On the question of safety, it doesn't matter what the goal was in taking ivermectin.
But this is all sort of red herring to me: the problem isn't people taking ivermectin, the problem is people believing Steve Kirsch when he says "covid vaccines have killed over 150,000 people in America alone!" or wanting to believe that guy who claims 90% of people who took the vaccine will be dead in a year or two.
I would only take ivermectin from organically raised bacteria. Same botulism toxin.
Nothing to do with civil liberties. Everything to do with preventing death and misery. Oh, I have know three people who died from Covid-19 over the last two years. So, what!
Oops. You weren't supposed to say that. You were supposed to get defensive and insecure about how you don't know anyone who died from COVID.
Preventing death is a modern day euphemism for taking away civil liberties. Some people figure that life would be a more joyful place if we did not have the freedom and power to harm ourselves or others, and that they way to achieve this is by ceding more and more power to the government.
Nope, not a euphemism. Just a fact. It is called living in a society. Stop at red lights, do not smoke in no-smoking places, get a driver’s license, vaccinate(polio, etc.), and on and on and on.
On and on until the people are enslaved to the government. Then there is eventually a rebellion or some other sort of collapse of the society and the process starts all over again.
It has nothing to do with Civil Liberties, but we will take away your Civil Liberties in the meantime.
Oh, and while I slap you in the face literally, I am not slapping your face literally.
Your doctor probably hasn’t gone through all these studies either.
🤣🤣🤣
This. Although, for me it's not so much Scott (I see some of that, I used to be libertarian leaning, the pandemic sure as hell cured me of that) but I definitely downrated the commenters. The whining about the vaccine sure does not give a good picture.
If the pandemic really "cured" your liberty leaning thinking, a.1) you never had a solid philosophical conviction or a.2) you're lying, and b) You lack analytical skills to realize what's real and what's a lie.
> If people pushing Ivermectin wanted to be treated seriously
I think you are confusing "the medical establish destroyed its own credibility" with "ivermectin people demand respect."
The ivermectin people (who I think were wrong, but that's not relevant here) were not trying to convince other people to take ivermectin. It is the medical establishment that wanted them to take vaccines.
If you want me to do something, I necessarily have power in that dynamic. If you cannot stomach the idea of me having any power because of how bad I suck, well, then you really didn't care that much about getting me to do that thing.
wow
Yeah right ask Gibraltar and Israel, 100% vaxed. The very word "consensus" should make anyone with a particle of science oriented brain CRINGE.
Yeah! Like what, are we just going to accept quantum mechanics because there's a "consensus"? No, it's because Juan and I have read the studies personally and understood for ourselves that hidden variable theories are incorrect. And of course, as free thinkers, we did not allow blogs or news outlets or YouTube videos to influence our opinions, no sir. Reasoned from first principles, we did, that's the Elon Musk way.
Although, I did see that Israel has a vaccination rate similar to the US and well below Canada, while 121% of the people of Gibraltar are vaccinated (https://ourworldindata.org/explorers/coronavirus-data-explorer?zoomToSelection=true&time=2020-03-01..latest&facet=none&pickerSort=asc&pickerMetric=location&Metric=People+vaccinated&Interval=Cumulative&Relative+to+Population=true&Align+outbreaks=false&country=USA~GBR~CAN~DEU~ITA~IND~GIB~ISR).
Strange that Juan and I have such different statistics. We shall have to get to the bottom of this discrepancy with all due scientific haste.
Even if the vaccines work (I think we do) we should still be looking for effective drugs, because the vaccines don't always work and can't always be delivered.
If you refuse to do something that helps both you and others just because you feel the need to assert your power, then you do, in fact, suck.
If you want someone else to do something, you often have to give something up to accomplish it.
If you want to feel proud and smug and laugh at your outgroup, you don't hafta give up shit!
Well, fair enough, but bear in mind Scott's willingness to engage with disparate viewpoints is why *he* will have influence and you will not. When you write off people who don't share your worldview as complete orcs and morons, you necessarily write off your ability to influence them. There's nothing wrong with that -- so long as you are comfortable with the big decisions being made by, or influenced by, the people who are more patient.
Okey doke. Seems kind of defeatist, but whatever.
If Bret Weinstein is a fair sample of people pushing Ivermectin, his intent seemed to be to encourage doubt about the vaccine, with pushing Ivermectin as a side effect of doubting the vaccine.
It was more like "the vaccines aren't proven safe, *and* they're concealing the effectiveness of Ivermectin".
If you see a popular ivermectin proponent who is not slamming vaccines harder than a drunk driver into a family of four, let me know.
I don't know which way this counts. Weinstein thought vaccines were a good idea for older people while sowing fear, uncertainty, and doubt about vaccines for anyone who isn't old.
That's interesting, given how Weinstein praised his guest Steve Kirsch, who claims (albeit not in the Weinstein podcast I saw) that vaccines mostly kill the elderly. This follows naturally from the observation that the distribution of deaths by age in sources like VAERS is roughly proportional to the base rate of how many natural deaths by age you would expect in the general population. Indeed, the number of VAERS deaths is well below the base rate, which by itself demonstrates underreporting in VAERS. Of course, if we look at how Kirsch has accounted for the base rate...
> Google [site:stevekirsch.substack.com "base rate" ]
>
> No results found for site:stevekirsch.substack.com "base rate".
I really like this analogy!
I mean it's Scott, he's writing in the American Political context so the real take away is almost always going to be that liberals should altruistically give additional power to conservatives within liberal dominated institutions in hope that this will increase conservative trust in those institutions while ignoring the agency or interest of any conservative epistemological elites in undermining that trust.
I think there's a lot of meat to this analogy, but I do think it's a relevant real-world consideration that even the most ardent anti-vaxxers will generally concede the evidence that science has some particular power as a grand institution for generating truths or working mechanisms, given that they're having the discussion on the internet. And most of them are further prepared to concede that medical science in particular also generates working mechanisms. Rather than throwing out the whole edifice, they're looking for reasons to throw out elements piecemeal, without expertise relating to how participants in the edifice of science judge evidence.
In a symmetrical situation, you'd be challenging the orthodox church on its record on Covid, while acknowledging that orthodox miracle-powered airplanes and such are obviously real.
This might be the core of why anti-vaxxers behaviour is so hard to understand for me. There even seem to be a significant number of anti-vaxxers working in medical professions. It really puzzles me what makes people accept most of medicine/science, but not some specific other parts.
In the aliens analogy, the alien technology seems to demonstratedly work. So what about vaxination differs from other medicine so fundamentally?
What would be the thing you obviousls accept about the orthodox church? That thes have some superiour moral knowledge?
As a theoretical biophysicist (I have a Master of science in that, I dont work in the field though) who is heavily sceptical of mRNA Vaccines:
I distrust their "science", they have made too many mistakes, and emotionally speaking I really dislike getting heckled and shut down in my field of study by "journalists".
I also believe that the main problem with the m-RNA vaccine will be that Covid can escape quite quickly from an immune response only focused on a single viral protein, even if this protein is well chosen.
Furthermore, if Pfizer is unwilling to contribute to defeating the crisis by stopping to block the admission of Sinovac et. al, then I am equally unwilling to contribute by accepting escalating intrustions on my personal freedoms.
I would take Sinovac, or any other attenuated vaccine recogniced by the WHO, but to do this in the EU, I would have to:
1: first emigrate to Serbia,
2: succesfully apply for permanent residence there, then
3: get vaccinated with Sinovac (there is a EU-Serbia agreement that Vaccines used in serbia "count" as proof of vaccination, but only for serbian citizens or permanent residents) and well.
The rejection of non western vaccines in the west is just political stupidity motivated by greed, pride and stupidity on part of our ruling classes.
They need to clean up their act and be held accountable.
When you write you distrust the science behind the mRNA vaccines, do you mean that they don't work (and therefore the studies showing they do are fake), that they have short term side effects (therefore again faked studies) or that they have long term side effects?
Complying with vaccine mandates within Canada requires taking one of the more dangerous vaccines. I could enter the US if I took a less dangerous vaccine, but I could not travel or live freely within Canada.
Actually, strong side effects are the *hallmark* of an effective therapy. You don't expect chemotherapy to cure cancer without making you very, very, sick, do you? Powerful therapies have powerful effects, by definition, and since it is utterly impossible to precisely target the problem -- you get powerful side effects, and the stronger and more effective the therapy, the more of them you get.
Zero side effects are the hallmark of completely impotent therapies with do nothing at all. That's the main reason you can dismiss stuff like homeopathy and crystal healing. *Because* they have zero side effects, it's an excellent rebuttal presumption that they have zero effects at all, which means they can't possibly be doing any good.
Yeah, sorry, you're just wrong on the facts. The effectiveness of a therapy within a given class does indeed scale with its bad side effects. That's kind of like basic chemistry.
I was talking with my wife about homeopathy last night, and I realized I want someone to accuse a manufacturer of them of causing a heart attack or something. Just to see how they respond.
Well hell if homeopathic or herbal medicine or magic crystals *did* cause a heart attack or two, now and then, I'd take the proposition that they are effective a lot more seriously.
>Actually, strong side effects are the *hallmark* of an effective therapy
No they absolutely are not. Chemotherapy and radiation are extreme outliars in that they are known to be very toxic, but people generally consider cancer to be a worse option. If preventative chemotherapy were a thing, almost nobody would ever consider it. The vast majority of therapies cause absolutely no side effects in the vast majority of cases. Nobody pretends aspirin doesn't work because it didn't cause them to have uncontrollable bleeding for 8 months.
As I understand it (vague impression) cancer therapies are better targeted than they used to be and have less severe side effects. Yes? No?
Yes and no. Traditional chemotherapy still mostly uses the same agents, e.g. 5FU or cisplatin and they still have the same evil side effects. They kind of have to, since the whole goal here is trashing DNA replication, so *anything* that's fast-dividing, like your hair cells or lining of the gut, gets trashed along with the cancer cells. Nobody has yet figured out how to screw with the DNA replication of *only* cancer cells, although there are some amazing potentialities out there perhaps with micro RNAs and CRISPR-Cas9 tech:
https://www.cancer.gov/news-events/cancer-currents-blog/2020/crispr-cancer-research-treatment
But there are also a burgeoning number of biologicals which are making their way into the clinic, e.g. the justly famous CAR-T treatment, and *these* are indeed often far more targeted and do far less collateral damage. When one of these works it's like a freaking miracle cure.
I believe most other new non-chemotherapy therapies are along the lines of inhibitors -- they slow down or stop cancer growth, but they do not actually kill cancer cells (although slowing them down might allow the immune system to catch up, I would guess, and is a very worthy goal in itself). You need chemo for that (or the biologicals, or radiation), I believe, although this field is sufficiently complex I speak under correciton if anyone knows better.
Not that this has much to do with the question of the vaccines, but menstrual problems in general get short shrift. "Oh, your periods are painful/irregular/you're bleeding when you shouldn't be? Just go home and take paracetamol". Even consultant gynaecologists, in my experience, tend to glaze over when you're trying to tell them no, this is NOT normal, this is NOT how my periods go.
So yeah, even in the best of times, you're going to get the brush-off as an hysterical female when it comes to 'women's troubles'.
I don't think it is a brush-off as a hysterical female, I think it is just a lack of anything productive to offer and an unwillingness to admit they don't really know much about what they are doing. It seems a bit far fetched to assume female gynecologists just dismiss women as being hysterical because they are women, yet they anecdotally seem more likely to do it and are more casual about it than males. "Why am I bleeding immediately following a "routine procedure" you did not warn me could cause bleeding?" "Its just your period." "No, my period just ended a week ago this is not normal." "Yeah it is you are just irregular quit worrying about nothing". At least men tend to act sympathetic before dismissing you.
I can't speak to your second point, but as to your first, I'll just say that my second dose was about equivalent to the worst day of my smallpox vaccine. If I can rate it as about the same as a vaccine we've been using for over a century without much issue, I think I can call it safe (if admittedly very unpleasant).
And yeah, you probably don't want to go partying on the day you're getting your second shot. Then again, you probably also don't want to go partying on the day you're donating blood, but I would also consider that pretty safe.
Vaccines can make you feel sick even though you're not sick, and it's well known why.
A little know fact is the fever and general sick feeling we get when infected come from the immune system response, not the infection itself.
Vaccines work by putting virus like particles in your body, tricking the immune system to think you've been infected. It then launches a fight against the intruder, which will leave behind antibodies etc for if you really get infected.
If this a big enough effort for the immune system you'll feel it as a fever. But that does NOT mean the vaccine is toxic or that you've been injured.
The mRNA vaccines do put virus like particles in your body. They do so with an extra step, but that is the end result, and why they work.
First of all, the mRNA vaccines *do* cause the synthesis of viral components, that's the whole point. Secondly, it's not clear the presence of *any* viral particles (or components) is necessary for an inflammatory reponse. The body does that all the time in response to a wide range of insult or injury, only some of which are viral infections, and sometimes for no reason at all (alas). We don't know how exactly inflammation gets started, but it's reasonable to assume cells have some way of noticing when abnormal things are going on and they send out cytokines annnouncing that fact -- which is what inflammation is. What are they noticing? How are they noticing it? This we don't really know in great detail. I mean, it would be great if we did, since inflammation in general contributes mightily to all kinds of poor outcomes.
No insight into the second part (menstrual symptoms) but to the first, I don’t get the impression at all that knowledge of those types of side effects (fatigue, fever) are being suppressed. Far from it - that you should be prepared for such symptoms, especially from the second shot, seems to be widely acknowledged (indeed signing off that you were aware of such potential side effects was part of getting the vaccine).
But 1) it doesn’t seem like “most” people are having significant immediate side effects (in my circles, “most” people had very mild effects, with maybe 1 in 10 having anything worse than arm soreness and mild fatigue).
And 2), these seem like common side effects for all vaccines, not unique to the COVID shot. I get the same side effects warnings for the flu shot. It makes sense - most of the side effects are due to your own immune response, and the whole point of vaccines is to provoke an immune repose.
There’s also a degree of confirmation bias - fatigue and muscle soreness aren’t exactly unheard of for the average adult, and are normally written off. But if you’re tired the day after a shot - well, must have been the shot right?
You mostly took the words out of my mouth, but you forgot the relatively recent high profile cases when the process "worked" (i.e. years of trials) and still the end result wasn't safe: Vioxx anyone? Or the more salient Dengvaxia controversy?
Medical science is HARD. Does doing something hard at Warp Speed make it more or less error prone?
Wow, those sound like some severe reactions indeed. I can share my anecdotes:
Of the 50 or so odd people I've had conversations with in person and know well in real life (through work, social clubs, sports, etc) I can report:
1. Those who received Moderna had strong reactions and were generally sick the day after. A few reported fever, a few nausea, etc. All recovered quickly and all really only reported the severe reaction to one of the shots not both.
2. Those who received any of the other shots generally reported little to no effect. My wife and I (30s) received Pfizer. She had no effect really and continues to menstruate healthily. I was groggy headed the next day and was fine after that.
So my anecdotal world is extremely different than yours. I'm from the US if it matters and the age range of folks I'm interacting with is 30 - 50.
Either way, VAERS offers an objective way to look into this information. I searched for all incidents of menstruation reported issues in the database resulting from COVID 19. There were 697 reported cases of menstruation issues in VAERS.
697 out of 201,922 women in the US 18-49 who have reported to VAERS after receiving the COVID-19 shot. 0.3% incidence.
The literature I can find reports 5% - 35% incidence of menstruation irregularity in this age range depending on a range of factors, including stress.
While I appreciate the anecdotes you shared, when I include them in with the 201,922 other anecdotes shared in VAERS it appears you just happened to have some very unlucky or stressed female friends and have not uncovered a hidden side effect plaguing the hundreds of millions of women who have received mRNA vaccines. Thankfully.
To each their own. To me VAERS is more trustworthy then anecdotes for various reasons (all the same reasons as review biases + to your own point the general hysteria around COVID on BOTH sides).
When I received my COVID vaccine I was handed a slip of paper that informed me about VAERs and how to participate. I signed up and since then I receive text messages every couple days in the beginning, then weekly, now only monthly.
One time I reported having an infection that for all intents and purposes I could see no reason why it would be related to my covid vaccine months ago. I received a phone call from VAERs within 2 days of submitting the report. They gathered more information about my infection and how I treated it, and then we moved on.
This is an audited, public database. I certainly agree that participation is fairly low (way more than 220k women 18-49 have been vaccinated, including my wife who did not participate in VAERs), but it is also certainly statistically significant.
I guess you refer to the "confounding" role of worm infections? Yeah, same for me. One of these moments I felt like an absolute beginner again.
Pardon me for being a smug bitch, but this is what I have been maintaining all along in the ivermectin discussions - it probably gives good results where people have, or are prone to, parasitic infections. In places where there is less to no risk of these, the results are not going to be as good.
Did you say this *publicly* anywhere you can reference?
(I will admit that I put down my phone and said "Oh My God" when I got to the reveal, but in retrospect feel dumb for not seeing it.)
Only in comments on here whenever we were discussing Covid, ivermectin, etc. So I haven't a record written down anywhere, unless anyone wants to go plough through the million words we're all thrashed out on this.
But yeah, I felt all along that "parts of the world showing good results = parts of the world with lots of poor, rural populations pretty likely to have worm infestations" was the major explanation for ivermectin success, if any.
You definitely get credit for figuring it out in advance. https://astralcodexten.substack.com/p/too-good-to-check-a-play-in-three/comment/2799553 (Google is better at reading through millions of words to find things than I am.)
Okay, found it! Way back in September, under the post "Too Good To Check: A Play In Three Acts":
https://astralcodexten.substack.com/p/too-good-to-check-a-play-in-three
"Deiseach Sep 6
I think people are seeing positive results (and that Cochrane meta-study has links to a lot of studies that are "no result/slight result" rather than "wowzers, this is a miracle cure!") is because (a) many of the studies, as listed above, are done in countries where I'd expect a lot of poor/rural communities with bad/poor health outcomes, including worm and other parasite infestations and (b) everyone is looking for the new silver bullet.
So you're a peasant farmer in Bangladesh and you picked up a worm infestation. You also picked up a dose of Covid. Treating you with an anti-parasitic drug in combination with other therapies is going to show a better result than leaving your system to fight off both at once."
I also dived into some of the Cochrane meta-study on the Ivermectin studies to see where all the countries were located:
"Deiseach Sep 7
Well, I could be totally wrong and ivermectin turns out to be an amazing anti-viral on top of everything else. But I'm going to stick to "it does what it says on the tin and if you're suffering from sarcoptic mange mites, go right ahead, but otherwise cool it unless a doctor prescribes the human version to you".
People are so anxious for "definite sure-cures!" that they'll swallow (ha!) any story about "this showed up in clinical trials as IT REALLY WORKS". I'm just surprised to see otherwise reasonable people jumping at "Doctors hate this ONE WEIRD TRICK" kind of story, but hey, we're all only human!"
Also got into some arguing with another commenter, but sure, that's me for ya!
"
Deiseach Sep 7
"One even needs zero studies when looking at the raw figures which came out of India where a ‘natural’ experiment happened with their big covid wave a few months ago. These are extremely positive results and we should be trying whatever we can in a pandemic as long as it is safe. There is even passive evidence from lower covid rates in some parts of Africa, quite possibly matching up well with existing use of ivermectin for its well known and longstanding use against parasites which can cause blindness."
Ivermectin is well-known and longstanding use *against parasites*, which you mention in your comment, but seem not to have understood. You are saying "this is a safe and effective drug!" and yes it is - *when used as intended*.
What you are extrapolating from "it's used to treat parasitic infections in humans" is "therefore it should be used for covid", with a side of "what can it hurt, it won't kill you" and unexamined anecdotes about "and they used it in India and they're getting fabulous results!"
I'm not so convinced about those fabulous results, I imagine that any benefits may come from the anti-parasitic treatment. If you have two patients, A and B, both in hospital undergoing treatment for Covid, and both have roundworm infestations as well, and A gets treated with Ivermectin which kills off the roundworms but B does not - I am going to guess that A will do better than B. But I don't think you can conclude from that "Ivermectin cures Covid!"
And the problem with this sunny assumption of "what harm can it do?" is that some people are refusing to get vaccinated, which is our best preventative at present, and along with others are all rushing off to buy veterinary products containing ivermectin, which are graduated for animals much larger than humans; believing this will save them; overdosing then because they're taking dosages calibrated for horses and cows; then ending up in the hospital with the side-effects of same."
Any credit is purely down to the agricultural ads on the national television and radio broadcaster of my nation and my youth; that so firmly fixed ivermectin in my brain as cattle drench and for sarcoptic mange mites, I had incredulity built up about "it'll cure Covid".
Congratulations!
Well done Deiseach yaas queen 👸 you deserve all the smug you can muster 😅
That is impressive.
I remember you writing that. That was freaking brilliant, honestly. Your talents are wasted on whatever you're doing, unless it actually is teaching empirical skepticism to young people so they need not repeat endlessly the mistakes of their forefathers.
Oh gosh, my vanity is getting stroked here! 😁 Really, it came down to nothing better than years of "what the hell are sarcoptic mange mites?" listening to ads for cattle drench, then along comes the ivermectin recommendation and my sluggish rural roots bestir themselves with "who the hell is thinking dosing yourself with fluke cure is a good idea?"
It has nothing to do with superior ratiocination, I regret to say!
Same, I thoroughly enjoyed it. I feel even worse for not getting it because I think/talk about worms *really frequently* in relation to effective altruism causes, including the immunological impacts. One for the humility box!
I bet you didn't see a list of locations where the ivermectin studies were done tho?
I had the same reaction, but then I felt sort of manipulated — why go through the tedious exercise of winnowing the good studies from the bad ones, if even the good ones are trumped by the helminth observation?
Sure, the narrative structure was compelling, but it rang a little false after he had dumped on so many studies for inadequate preregistration.
Still, I did enjoy the read and it did shift my priors.
Agreed. Scott analyzing lockdowns, cloth masks, surgical masks, voluntary social distancing (estimated from cell phone activity) etc would be a very interesting post.
The massive RCT from Bangladesh essentially found no impact on increased masking (no statistical significance for cloth masks, possibly maybe some statistical significance for surgical masks but for a bizarrely small infection rate)
and masks
He did masks on March 23, 2020, when there was no COVID-specific data yet.
There is a recent overview of cloth mask studies from Cato at https://www.cato.org/sites/cato.org/files/2021-11/working-paper-64.pdf
Alas, like most of us, they are not Scott.
I’d add vaccines to your list as well. It’s misleading to assert that vaccines are an effective treatment without performing a similar meta analysis on their studies. Without such an analysis, the author is no different than the “proponents of pseudoscientific medicine” mentioned in the article; he is just as guilty of blindly trusting papers because they sound good and come from an authoritative place.
Note that the reports of fraud focused on an area involved with only around 1,000 (2.5%) of the around 40,000 total participants of that phase.
No, it's not the same thing at all. Unlike the ivermectin studies the vaccines were developed in HUGE randomized controlled trials, and have been administered billions of times with careful monitoring of safety signals by teams across the world. This is not even in the same ballpark as the small ivermectin studies analyzed here. You could still do a meta analysis, but the results are not murky - we already know they work amazingly well. Your comment reeks of conspiratorial motivations.
"careful monitoring of safety signals" Imma need some evidence here, because we have real examples of missed safety signals. Also, there is still disagreement in safety. There are several European countries not using mRNA on large cohorts due to safety concerns.
"we already know they work amazingly well"
Really? They work for 6 months and they don't stop infection or transmission. To call that "amazingly well" seems disingenuous. Compared with traditional vaccines that stop infection and transmission and last for decades or longer, I would have to say the COVID vaccines work very poorly.
"careful monitoring of safety signals by teams across the world"
Sounds good, the experts are looking out for us! Unfortunately the experts have failed us so many times that I now want to review their work, and I've yet to see them actually publish their work in this area. Hmm... are they actually doing the work?
Careful monitoring?
Can you give documentation Without an appeal to authority?
You’ll have to go to Pfizer for their vaccine and they only want to release their information Over 55 years.
Akoluthic - At one time, perhaps before you came of age on the internet, many arguments ended by one party resorting to acccusing the other of being Hitler. That phenomena became known as Godwin's Law. Fast forward to today, Hitler doesn't come up so often. Now, the adversary, especially if they hold views critical of the government, is a conspiracy theorist. As if conspiracy itself is a fantasy; Pharma cannot/does not have deep and wide influence on the government and media. Of course "conspiracies" exist and are pervasive in modern society. A person unwilling to contemplate the existence of conspiracies should ask them self a hard question: am I authoritarian; one who irrationally defers to authority?
Wrong. There are big RCT's that show efficacy and safety. A meta-analysis would be fine, but isn't necessary when you have well-done, large RCTs with sensible and meaningful endpoints.
I have done such an analysis on my substack; I hope you'll consider it: https://maximumtruth.substack.com/p/deep-dive-should-naturally-immune
Here's one: https://idpjournal.biomedcentral.com/articles/10.1186/s40249-021-00915-3
1 vaccine-related death per 100,000 on this one (within 7 days)?
Yes, I don't like that we're not allowed to question or debate vaccines. How can this help anyone? How can we improve the vaccines if we can't be open and honest about adverse reactions? I'm not comfortable with vaccines being used as a means to a medical end. I gotta say. It has an element of quackery to me vaccines. There. i said it. Reading up on Jenner and Pasteur and the vaccine roll outs for mumps, rubella, measles, diphtheria, pertussis opened my eyes. It's not conspiratorial or unreasonable this is a huge money maker from the beginning and they probably believed the harms were low enough to justify continuing profiting off it.
Why do you say that we are not allowed to question or debate vaccines Paul? There is a lot of that going on here and on forums elsewhere.
Do you acknowledge that laypersons are not equipped to evaluate the safety or efficacy of vaccines? You need to do massive population studies of people who have received the vaccine to tease out if there are a significant number of adverse reactions that can be associated with vaccine.
Vaccine are developed in an entirely different fashion today than they were in the days of Jenner and Pasteur. It is disingenuous to try to make a comparison.
Vaccines are not big money makers for anybody. This is why there are so few companies that make them. Covid vaccines are the exception because of the urgent need for them. One could make the argument that we should not rely on for profit institutions to develop and manufacture drugs, but that is the system we have chosen. It is a false argument to suggest that you should avoid getting a covid-19 vaccination because some pharma company will profit from it.
Agreed. Didn't RFK jr & Children's Health Defense win a landmark case asserting no vaccines could ever be mandated/forced due to the fact not one safety study could be produced for any of the ridiculous amount of "school/travel required" vaccines from time of inception to date? I trust my own biology, physics, chemistry & lab skills over any doctor, paper, government. We need to ho back to the days of using basic skills & analysis, with a foundation in natural scientific observation.
For the record, if this is the GiveWell study, I believe that they found a significant result for cloth masks in their infection-based endpoint while for their hospitalization-based endpoint only surgical masks showed a significant difference.
The effect size was low, but it's not like they were comparing 100% masked villages to 0% masked villages. Encouraging mask use in a village like their study did had a real effect on mask wearing but it was modest and dissipated over the period of the study. So it's hard to get much from the RCT except "some increase in surgical mask wearing caused some decrease in infection as measured by seropositivity". Hard to know what the effect size is.
Yeah, it sure seems like most of the evidence for normal (non-N95/KN95) masks being helpful is basically along the lines of "this seems like it probably helps some." For good masks, if you're getting a good seal (you can't smell smoke through the mask), then it sure seems like you ought to be getting good protection there, since 95%+ of virus-bearing droplets should not be making it into your nose/throat/lungs.
That Bangladesh study showed that a 30% increase in cloth masks led to a 5% decrease in infections, and a 30% increase in surgical masks led to a 10% decrease in infections. Both of these were statistically significant.
Restricting to seroprevalence-verified cases is a serious restriction that drastically cuts the power of the study, given the difficulty of getting these tests. It's not surprising that it gets some of the important results outside the significance level.
Worrying about confounds like distancing is more reasonable.
I still wouldn't think it's appropriate to summarize this as "essentially no effect".
A simple cloth mask doesn't protect wearer, it protects others.
So basically CRT is useless is these people breathing infected air from mask defectors, who are not part of the trial.
No significant impact of cloth masks in a vaccinated population. Surgical masks in an unvaccinated one probably worked better, because more to affect, better tools to affect it. Which is why I was fervently pro mask until widespread rollout of vaccines, and now I find most of it total theater.
I think it failed by the experts' own standards, I think there were better options than "nothing" and "everything", but I've taken it out since it wasn't as strong an example.
I remember a few years ago reading about how Southeast Asian mask use was basically superstition. It's bizarre to me to see that turned completely on its head.
Do we have a good explanation for why Asian countries generally seemed to do so much better with covid? Is it likely to be widespread mask use? Prior exposure to similar coronaviruses? Something else?
It would have to be a sequel to the one he wrote in March 2020. https://slatestarcodex.com/2020/03/23/face-masks-much-more-than-you-wanted-to-know/
I'm sure there's more info now.
I wrote on the prior OT that someone should be doing the RCTs on masks, at least for influenza. Even if expensive, they'll pay off with knowledge that billions of people can use in the short-term.
The UK's plan involved minimal attempts to prevent or slow transmission, and 210,000 - 315,000 deaths in a fifteen week period. It rested on the assumption that the population of the UK would allow the government to do almost nothing while 210,000 - 315,000 people died over a short period. Whether or not it was a good plan is irrelevant. The assumption was obviously insane, and the plan was worthless.
The document setting out the plan is an interesting example of a well-written, coherent and convincing 70 page strategy document being worse than useless. It's not perfect, but you can tell that a lot of intelligent, knowledgeable people have put a lot of work into it, and you can see why the UK got such good marks for pandemic preparedness from international assessors. Ignore the "Influenza Pandemic Strategy" title, the plan specifically states that it can be applied to a SARS virus, and Covid falls within its assumptions as to possible transmissibility and case fatality rate.
It's worse than useless because it hides the reality of the situation it's planning for. The first sentences of the introduction should have been "This plan is based on 200,000 to 300,000 people dying from the infection in a three month period. We aren't going to try to stop that happening." But over seventy pages, and no doubt hundreds of other documents stemming from those seventy pages, the ludicrous assumption at its heart is swathed in layer after layer of reassuring competence, and utter nonsense was transformed into a gold standard public policy strategy.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/213717/dh_131040.pdf
What would "the population of the UK not allowing it" have consisted of? The next election is in 2024.
Public support for lockdowns in March 2020 in the UK was 93%, with 76% of those 'strongly' supporting it (YouGov). Politicians don't tend to survive ignoring their voters in such situations.
It's not impossible that the House of Commons could have triggered a snap election anyway, with a loss of confidence in the Govt, or the governing party could have replaced the PM who serves at the pleasure of his/her party only. 'First among equals'.
Things aren't as set in stone here as in the US.
If 93% of people supported taking ivermectin instead of vaccines, should the government just roll over and say "well, I guess the people have spoken"? Not try and all to change people's minds?
As we've seen, people get sick of lockdowns, so they can only be done in limited amounts. The UK officials knew this and said this beforehand, directly to the people: "you think this is fun now, but you'll hate it in 8-12 weeks."
But, just like ivermectin, there was media hostile to following the recommended scientific plan, telling people that the government's plan was evil and stupid and going to kill them.
The UK govt. had successfully sold financial austerity with majority support for years prior to this. There's at least one reason for them to believe they could indeed convince the UK populace to accept the argument "210,00 - 315,000 people will die in the short term, so that >>315,000 lives can be saved from the long-term negative effects of lockdowns".
"I know I’m two months late here. Everyone’s already made up their mind and moved on to other things."
Fastest click I ever clicked on one of these posts.
YES. The culture war needs more replication studies, or AARs, or etc. Scott - you're doing yeoman's work. Thanks.
Right off the bat I learned pored is spelled differently from poured, so strong start to this post.
"I'm not going to watch it, because it is a video..."
You don't watch videos?
Sorry Paula, we only consume text-based content here.
lmao
Come on Paula, send us an ascii picture of your nudity.
You can always tell the guys who grew up with 300 bps modems.....
(.)(.)
top banter
Excellent.
I sure don’t! Why would I deliberately subject myself to someone’s meandering slow rambling that I can’t do a textual search in?
I could just go read something someone who cared enough to write it down said.
Some browser addons that let you watch videos at any speed. Speeding up by x3 or x4 makes most videos of people talking tolerable.
Videos are Inherently Annoying because, for example, they are not searchable and they almost never contain hyperlinks (because for some reason the person who produces the video thinks it's OK to offload that work onto thousands of non-expert viewers rather than doing it once while they have all the context).
Many youtube videos now do provide hyperlinks to both positions in the video as well as external content. I find that quickly checking the video description for these is a good indicator of quality.
I wasn't actually aware that Scott is a follower of the Always Bet On Text philosophy - https://graydon2.dreamwidth.org/193447.html - but it doesn't surprise me at all.
No, videos are several times slower, unsearchable, ad blocking is worse there, much lower quality than text on average and I read better than hear.
Video is acceptable for video, not for spoken text.
I don't. I always seek the least possible noise in my communications channels, and video presents a giant amount of irrelevant sensory information relative to the critical info. For the record, I also hate scientific papers that start with an introduction in which they summarize the structure of the paper, and I despise talks that begin with 5 minutes of reminiscence and dad jokes.
"But I don’t really know how to do that, and any speculation would be too political even for a section titled “The Political Takeaway”. I would instantly kick in an extra month's subscription fee to read this.
Me too. I really want to hear about that.
You can have it for free from me: honesty, transparency, humility, good faith.
fully agree. I think we have kind of a trust crisis. What you name are ingredients to build trust. But many people underestimate what a sensible plant trust is, how easily it is destroyed and how hard it is to build up. Especially all kind of elites should learn this if they want to stay were they are without fear.
As one of those people (presumably plural) that think there's too much politics on ACX as it is, I'll have to respectfully disagree.
In general, I'm worried about the comment section's potential degree of control over the topics and perspectives that get covered by Scott. It's partly inevitable, I guess, but I think at least we should make an effort to minimize this effect. I would hate to see ACX become more echo chamber-y. (this is also why Substack displaying the number of likes and comments under a post is a bad thing.)
So, 85-80% confidence of less than 30% mortality reduction does in fact represent a major crime against humanity in your estimation, I would think? Expected loss of lives is well into the hundreds of thousands.
I have a vague plan for another post which is something like "should we just give everyone any drug that might possibly work, because Pascal's Wager?", but I'm not entirely sure of the answer!
Ivermectin is pretty low side effect. I think HCQ might have been worse and could have done some real damage. But if it took ten drugs that didn't work to make sure people got fluvoxamine (which did work), maybe it would have been worth it even if HCQ could be bad? I'm genuinely not sure here.
Economic cost + value-of-information means it's far better to do large scale RCTs, rather than tell everyone to take things and never be able to figure out what is working.
I also think that the "trust in science" thing is valuable, and as I told Kelsey - https://twitter.com/davidmanheim/status/1458153900553510915 - in the wake of HCQ + Ivermectin, I've updated towards experts shouldn't tell people to take a drug based on moderately clear preliminary information, because it turns out that they won't listen later if you find out it doesn't work. In general, updating once you publicly commit to something being worthwhile is really, really hard. And then they refuse the vaccine.
1. I didn't suggest banning anything.
2. You can't as easily do RCTs once a drug is being used widely, because you get selection bias issues for who is willing to participate.
3. You can allow widespread access + randomization fairly easily, if it's planned for. And in a medical system less messed up than the US, it's straightforward to do this, which is exactly how the UK's RECOVERY trial was set up in April 2020.
And no, this wouldn't have ruled out trying lockdowns, especially because 1) we had incredibly clear evidence of effectiveness, and 2) it's not a medical intervention, so the way RCTs are done is very different.
And honestly, we probably would have gotten masks used more quickly in the US if we had done trials immeidately, compared what actually happened - which was listening to the surgeon general and CDC which delayed until the evidence was incontrovertible anyways - and for some insane reason, still won't require HEPA filters, etc. (Compare this to the Japanese government experts, who got both of these right on day 1 based on actually looking at the initial outbreaks.)
The problem is that you aren't actually helping people. We only produce about as much of these drugs as we actually need to treat the actual medical conditions that those drugs are needed to treat.
Thus, if a ton of people suddenly start buying a lot of these drugs, you end up with massive shortages and people dying who actually need the drugs.
In real life, almost none of these drugs are actually helpful, and almost all drugs have side effects, and the idea that ivermectin was even going to be helpful in humans was dubious just looking at the in vitro studies because the most likely path of function was impairing cell function, which is probably going to kill people.
How do you know if the things that you're trying are working? How do you know if they're making things worse?
"experts shouldn't tell people to take a drug based on moderately clear preliminary information, because it turns out that they won't listen later if you find out it doesn't work."
I think this is a deadly attitude and a big part of why there's so much mistrust. You have to respect the minds of others.
That would be easier if so many of them weren't so keen to believe obvious bollox and clinicians still have a duty of care to those same people who will cheerfully drink fish tank cleaner.
Large-scale RCTs sound great.
For people who aren't in the RCTs, it seems better to give them an experimental drug cocktail of all the drugs which have promising initial results & are readily available & don't have significant side effects. (Where "give" means that this is the default recommendation from doctors or in medical kits.)
That seems better in terms of straightforward direct results (health & cost), ignoring what it does to the information environment.
And for navigating the information environment, there's an advantage to playing it straight (giving people the drugs that are +EV) and finding ways to have clear messaging about it (to avoid informational side effects). If you're withholding a drug that might work, that opens the door to stories about the authorities suppressing a miracle cure. If you're including the drug in the experimental drug cocktail, then you just need to find a find a way to convey "experimental drug cocktail". Here are some things that might help, studies are underway to figure out which of them really help, we can at least be pretty sure that they don't do much harm. We've improved the covid-fighting cocktail, HCQ is out and fluvoxamine is in.
There doesn't seem to be any fundamental reason we can't allow RCTs like this to be near-universal, and let anyone who wants to join be randomized, ideally with adaptive A/B assignments, so that later participants benefit from what we know - if a setup for doing this is put in place. Of course, clinical trials are broken, as is the US healthcare system, so this probably isn't happening in the US, at least this decade.
But for "navigating the information environment," there's a huge difference between telling people we have unclear preliminary indications and recommending or prescribing medicines. (But again, US healthcare is broken, the FDA is broken, etc. as Scott has discussed in the past, so this gets screwed up.) And as I said below, telling people "this probably works" has some massive downsides in practice, as we see from the fact that there are still people taking HCQ instead of getting vaccinated.
This is bad policy for several reasons.
First off, almost all "safe" drugs are only safe in isolation. We don't generally test most drugs for drug combinations unless we expect them to be used in conjunction with each other. Many drugs are not safe to take with other drugs, but we don't know that because we don't typically mix them.
Secondly, combined drugs don't necessarily have linear effects with each other; sometimes they will counteract each other, sometimes they will multiply each others' effects. So you can't even be sure that the drugs will work at all.
Thirdly, taking more drugs greatly increases the probability of organ failure (mostly kidney and liver failure).
Fourth, almost all of these drugs are ineffective, meaning you are wasting vast amounts of resources when there are better things to do.
Fifth, most of these drugs are only produced in limited quantities and cannot be rapidly scaled up. So you will create shortages for things that they are actually important for.
Sixth, almost all drugs have side effects. The more drugs are taking, the more likely you are to experience side effects, and this actually is even worse with mixing drugs.
Seventh, most of the population is completely incapable of making educated decisions about their health like this, because they can't do the proper risk/benefit analysis.
While it might be "better" to do large scale rct, in practice it's either not being done at all or not being done fast enough, so that option doesn't exist
or they could communicate better. What if instead of recommending it you just label it as our recommended guess work at the time. Couldn’t they just improve by giving their opinion in language that people understand
The thing is, early on in any epidemic, the doctors are going to be throwing absolutely anything they think might work at the thing, trying to save their patients. ISTR that many hospitals were giving zinc, HQC, azithromycin, vitamin D, etc. Which makes sense, because they weren't trying to run studies, they were trying to figure out some way to keep a few of their patients from dying on them.
Once that's happening, people who want it are going to be able to see the discussion among experts. I've been trying to listen to the Covid Clinical Update on TWIV as often as possible, for example--that's available to anyone but it's mostly a top tier ID doctor who's been treating covid patients for the last 18 months talking about what treatments seem to work, how they're used, what the promising stuff coming down the pike is, what the research looks like, etc.
And that leaves the possibility that people are going to misunderstand it, or misinterpret it, or whatever. The only way to prevent that is to keep anyone but certified experts from being allowed to see any of that information, which fails the "let the medical student debunk the fraudulent study" test, as well as the "let the Turkish sociologist make much better recommendations than the national health authorities" test.
According to tests of adult reading ability, only about 1 in 6 adults is fully literate - that is to say, capable of understanding statistical analysis and scientific papers. They might not know specific terminology but they are capable of reading and successfully understanding top-level stuff.
They also are the only people capable of actually usefully comparing and contrasting points from multiple articles, like, say, two opinion columns or whatever, and looking at evidence, etc.
The problem is that those people make up 50%+ of the high-end professional community. So the idea of "Well, we can try something, and if it doesn't work, we can try something else" works fine for them.
It is absolutely horrible advice for almost the entire rest of the population because they aren't capable of really understanding this unless you explain it to them carefully, and they will have to lower their level of trust in "experts" because, as it turns out, explaining this stuff to them will make them CORRECTLY stop trusting the media and experts and whatnot nearly as much as they did.
Like, you can't explain the Gell-Mann Amnesia effect to someone and have them trust the press anymore. They *shouldn't* trust the press. And yet, if you completely don't trust the press, you'll tune out important information.
I don't think it's about the side effects of IVM. It's about the consequences of the false confidence that you're immune if you take it.
Right - they won't listen later. And halo effect means that once people are convinced that the positives slightly outweigh the negatives, their brains immediately jump to "there is no downside, and this is the best thing ever."
I honestly believe that if people were given the correct information, as known at the time, they would have been open to changing their minds (in general, obviously not all people are going to act responsibly).
If doctors told people that there was some positive early but speculative results from taking a common, cheap, and harmless drug, lots of people would want to take that drug. But if there were no concerted effort to shut down discussion of that drug, further results would have shown 1) side effects or other issues, 2) lack of efficacy, or 3) hey this thing really works! Option 1 gets communicated to patients by their doctor, and the doctor steers patients away, especially if 2 is proven or seems likely. Option 2 the doctors simply stop offering it as an option. Option 3 sounds like a best case scenario, not an apocalyptic harm.
If it really works, then I think people should be able to go ahead and skip the vaccine or whatever else you're worried about. If it doesn't work, but conversations are allowed to happen about it like normal, then the incentive to take it instead of the vaccine goes away.
Doesn't this apply to the vaccine as well, particularly how it doesn't stop spread? If 80% of people who have taken the vaccine see that as a reason to now return to life as normal and go to gyms, bars, etc as they did before, isn't their brain "there is no downside, this is the best thing ever" and they become spreaders (aka a mutating breeding ground for the virus until it becomes something like Delta)
I know more people who are unvaccinated who take less risk than vaccinated people. I'd love to see a study of who really spread the virus more and are a responsible party for the mutants.
Doesn't the same logic apply to the 'vaccine'?
But vaccines ACTUALLY work, we are 100% sure on this one.
Ivermectin MIGHT decrease severity for SOME patients (and cure worms.)
I've taken Ivermectin before and it's not the worst, but I've seen some people shit themselves inside out after taking it, so ??? on side effects also.
The TOGETHER platform trial is really interesting. A few comments:
* First I don't think that it is correct that they used non-contemporaneous controls for the ivermectin TOGETHER study. This is a well-known problem in adaptive trials where new arms can enter and leave the platform. The controls that they will have used are only those who could have been randomised to ivermectin. See for example their write up of fluvoxamine (https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00448-4/fulltext)
* Regarding fluvoxamine: interesting that your assessment is that it "works". From a Bayesian perspective, a priori it's highly unlikely to do anything (some random doc decided to test because why not; no known mechanism of action); and there is a real problem of post-randomisation bias. See this article for more detail https://www.the-scientist.com/news-opinion/a-closer-look-at-the-new-fluvoxamine-trial-data-69369
I guess, but from my perspective if a bunch of doctors are excited about a drug I want good studies done immediately. A-priori it seems unlikely that we got really good at saving people at the point of practically choking on their own fluids with existing meds (steroids, etc), but apparently there was nothing whatsoever that could be done preventitively to help. Not only that, but we were absolutely certain of this beyond any shadow of any conceivable doubt. We were certain that the physiological profile of covid-19 was PERFECTLY disjoint from the sum total of existing medical practice.
It's simply unforgivable that our elites ignored the attack on therapeutics.
The thrust of your claim that "this is one of the most carefully-pored-over scientific issues of our time" just doesn't hold water. It's been two years and you're still not sure if it might be moderately helpful (nvm Vit D. and all the others). In no universe can we call this a functioning medical science establishment.
The fact of the matter is a bunch of elites decided that their reputation was far more important to them than the off chance of saving many lives. Can't risk being associated with those crazies pushing their "remedies".
"The thrust of your claim that "this is one of the most carefully-pored-over scientific issues of our time" just doesn't hold water. It's been two years and you're still not sure if it might be moderately helpful (nvm Vit D. and all the others). In no universe can we call this a functioning medical science establishment."
Yes. Agreed.
The emerging claim I'm seeing now is that vitamins, generic medicine (IVM, HCQ etc) and anything homeopathic is pseudoscience and dangerous misinformation, and must be shut down.
This is an elitist hostile environment.
Just to clarify, because it does affect how I contextualize your other comments, are you arguing for homeopathy NOT being pseudoscience?
The reality is that pretty much no pre-existing drug would be expected to work. Most things don't work against viruses in concentrations that won't kill the host, which is why viruses are a PITA to deal with.
The people who try and push anti-parasitic drugs as cure-alls can be safely dismissed out of hand because they try and push their favorite drug at everything. We don't have infinite bandwidth, it is best to focus on things that we have a good reason to believe might actually work.
Right, we have the bandwidth to shut the economy down and stop school but we can't run a few trials. Give me a break.
We have existing drugs that work very well against covid--steroids.
You better be really, really, really freaking sure that you're right. We'll be looking very carefully at patient outcome variability in the medical records over the next couple years, very carefully indeed.
I don't know the proper statistical terminology for this, but I feel like there's an issue where you have to ask "why are we asking this question in the first?" e.g why did invermectin become something that people were talking about and was it for a good reason. Because of you were to give people a bunch of random substances you might by chance get good results for some of them. Similar to with homeopathy trials, my prior against them working is sufficiently high that I would be unwilling to take an otherwise good study as evidence. If there's no particular reason to think something will work, then the burden of evidence should be high
I don't think this has a clear name, though it's related to curse of dimensionality, but I'll quote Yudkowsky discussing exactly the issue you're noting:
"On problems with large answer spaces, the greatest difficulty is not verifying the correct answer but simply locating it in answer space to begin with. If someone starts out by asking [is X true], they’re jumping to a 100-bit proposition, without a corresponding 98 bits of evidence to locate it in the answer space as a possibility worthy of explicit consideration. It would only take a handful more evidence after the first 98 bits to promote that possibility to near-certainty, which tells you something about where nearly all the work gets done."
"Privileging the hypothesis." IIRC the example given was the police saying "We have no idea who the murderer is, so have we considered the possibility that Mortimer Snodgrass did it?" Maybe he did and maybe he didn't, but what evidence led you to investigate that man to begin with?
In particle physics, a similar issue is called the "look-elsewhere effect".
It's was tried because it showed promise in vitro as a protease inhibitor and because it has long been studied as an anti-viral medication.
Well put!
There are people who believe that anti-parasitic drugs are cure-alls and try them against everything. Tonic water is a great example of this - the active ingredient is actually effective against Malaria, but people promote it as a health drink against everything, which it isn't.
That's why these anti-parasitic drugs got pushed in the first place.
It's really bad.
Also just throwing a lot of random drugs at the wall and seeing what sticks is often a bad strategy.
"no reason" you know of, but when there's a coordinated effort to suppress information, that is to be expected. As Mark Twain 'said', it's far easier to fool people than to convince them they've been fooled. You are right about finding things that work. It's very difficult and requires the free expression of ideas, and referees without a conflict of interest. Big Pharma, Big Government and Big Tech's response to the pandemic has been exactly the opposite, authoritarian, draconian, closed minded and illogical.
>Also just throwing a lot of random drugs at the wall and seeing what sticks is often a bad strategy.
I thought that was an accepted good strategy when we didn't have anything else. Isn't it how we found out that fluvoxamine and dexamethasone work?
No, both ivermectin and HCQ got suggested as promising candidates for trials because people observed significant correlations between parts of the world where large portions of the population take those drugs routinely, and low COVID cases and severity. There was no "throwing a lot of random drugs at the wall" involved. It is not surprising that you don't know why ivermectin was suggested as a candidate, given that it is virtually impossible to find anything other than "evil trump nazi terrorist klansman are filling emergency rooms after poisoning themselves with horse medicine!" using google. Isn't it weird how hard it is to find any English copy or reference of Haruo Ozaki's press briefing about this?
My contention, and those of *all* of my friends who think deeply on this one, is basically "IVM is so incredibly safe why wouldn't I roll the dice on it being 10% effective? What's the drawback? There's no drawback. Why do we think there's a drawback?"
And I haven't yet heard a counter to this argument. If you can cook up a counter to this argument I'd love to read it.
HWFO Slack hangs on your word on topics like these, so I would be very interested to see if you could convince them otherwise.
Are you and your friends also vaccinated? If so, I have no problem with that.
The danger of the pro-ivermectin crowd isn't that they're putting themselves in danger (aside from perhaps the people who take massive doses of horse medicine and get sick), or that they're draining the world's supply of deworming pills, the danger is that people think it's a miracle cure so they don't need to get vaccinated.
Some are, some aren't. I'm double Pfizer personally but I'm not going to get a booster. Some of my peers don't consider Covid-19 to be a big deal for their age bracket and health, which is a legitimate perspective especially for those under 30 for whom Covid is less deadly than ordinary influenza. Covid-19 is extremely recoverable for a very large number of people, especially younger with no comorbidities.
How does this argument hold in the scenario of:
1) Someone vaccinated, but going out living life as normal, taking no precaution, and potentially transmitting the virus.
vs
2) Someone unvaccinated, but getting tested regularly, masking, taking precaution, and potentially transmitting the virus.
Why is the danger of people taking massive doses of "horse medicine" (it is a human medicine, like many human medicines, it is also used in many other animals) constantly presented, despite no evidence that anyone has ever actually done this? Why aren't you attaching a completely unnecessary caveat like that to other things, like say the vaccines? Where is the (aside from perhaps people getting dozens of doses of vaccines) when you mention vaccines? People do not think ivermectin is the reason they don't need to get vaccinated, they think the incredibly low risk posed by COVID is the reason they don't need to get vaccinated. A healthy 25 year old has absolutely no reason to get vaccinated other than "the TV told me to".
Seems like a case of privileging the hypothesis. Homeopathy has no harms so i might as well take it. Painting myself blue has no harms and might work so might as well. You can make the same argument for an infinite number of things equally well.
Homeopathy also has no benefits, where ivermectin clearly does.
Painting yourself blue could actually have some harms. Maybe it reduces your visibility when crossing the street for example. At the very least, people wouldn't take you seriously and will have trouble getting a job.
If painting myself blue had a 90% chance of doing nothing against Covid-19 (and therefore a 10% chance of reducing my Covid-19 infection) I would see no harm in painting myself blue.
Here's a game theory matrix of the argument. I can't find anyone who can argue with Omura's Wager on this. I'd like to see Scott's take.
https://twitter.com/alexandrosM/status/1432247947601661952
I will grant that these sorts of arguments are often used badly, such as "IF IT SAVES ONE CHILD'S LIFE ITS WORTH IT" etc. The appropriate way to respond to these sorts of bad faith applications of the argument are to dig out the trolley problem math. But in the case of IVM, it's so incredibly cheap and there's basically nobody dead on the other side of the trolley tracks no matter what, I can't see how the anti-IVM crowd can fully form the argument, other than crafting a "false hope" narrative. And I hate those because they must start with the presumption that humans are stupid cattle and their behavior must be manipulated for their own good. Banning IVM as behavioral manipulation will backfire, arguably already has backfired, due to Streisand Effect.
> If you can cook up a counter to this argument I'd love to read it.
The ones people have given me are:
* if someone is taking ivm, they're more likely to think they're protected and so won't get the vaccine
* money diverted to ivm is money diverted away from vaccines
Seems very specious. Bullet one also applies to vaccines now that they're only 40% (?) effective vs Delta. Money diverted towards eating at McDonalds kills more people than non-vaccination does. 80% of Covid wards are obese.
* If there is a limited quantity of ivermectin because of a sudden surge in interest, and certain people definitely need it to stay alive, then you taking a dose denies it to someone who needs it to live.
I think this is a pretty reasonable perspective. I think it would result in you also taking HCQ, doxycycline, Vitamin D, and a few other things, but that's not necessarily a dealbreaker.
In my deep dive, the numbers on HCQ are largely conflated with the rest of the HCQ protocols which included Zinc and Vitamin D. I think you touched on that in earlier writings. I've been popping Zinc and D since the early HCQ days, writing most of the HCQ effect off to simply having better vitamins. I haven't bothered with IVM but whenever I do finally catch Covid (I think everyone is going to catch it sooner or later given the reinfection happening among the vaxxed) I plan on taking IVM unless there's better stuff out there by that point.
$700 a pop "Pfivermectin" might work. I'm on record saying I think the thing that got Joe Rogan through, outside of his probably very robust immune system in general, was probably monoclonal antibodies. If anything is a true scandal, it should be the general suppression of monoclonal antibodies as a treatment.
One thing you'll notice in the responses to my post (scan up) is a lot of folks saying the bad thing about IVM is that it disincentivizes vaccination. That's a super common theme among the IVM Culture War. The problem is that such a position should also suppress the distribution of other treatments that do work better than IVM. The pro vax crowd is so hung up on vaxxes that they'd suppress a perfectly safe and perfect Covid-19 treatment because it would suppress vax rates. This is more of a culture war issue than a medical issue, tied up with your "I can tolerate anyone except the outgroup," and similar writings on my wall.
If you mean what's the drawback on taking it personally, it would be the universal drawback that absence of evidence isn't the same as evidence of absence. People have studied ivermectin in the context of curing river blindness, a very nasty disease, so below a certain level they're not even looking for side effects. It's like (at a much lower level) if you've got a drug that can postpone death from Stage IV lung cancer by 6 months, you're not even going to bother asking whether people throw up more or less on it, or it gives them heart murmurs, or even causes leukemia 20 years later.
Does it happen that this ignorance is tragic? Maybe. Sometimes. In the 19th century, I believe physicians recommended smoking tobacco for various mild maladies on similar grounds: might help, couldn't hurt, seems totally safe, because nobody had died suddenly and abruptly from smoking. Now, it turns out smoking gives you lung cancer after a few decades, which is pretty horrible, and totally not worth whatever benefit it might have to losing weight or reducing anxiety -- but nobody knew about that, because nobody looked for it.
That's the problem. When you interfere randomly in your biochemical machinery, it's always the unknown unknowns that will nail you. So that's the important and unfortunately essentially impossible to quantify risk you need to weigh against the odds of a benefit. Doesn't mean you don't decide to go for it, but it does mean it's not the case that there is ever zero drawback.
There's an ugly flipside to this thinking as well. Tobacco (nicotine specifically) is one of the only confirmed drugs that ameliorates Parkinson's Disease, but the researchers who have identified this (the evidence is solid) aren't even allowed to give presentations on their findings at conferences because of the stigma against smoking.
And I think the "yes but unknown long term effects" thing is also pretty prominent among the IVM crowd who wants to avoid vaccination. One of the most important reasons to keep Covid vaccination from being mandatory is so there's a control group to compare long term outcomes against. It seems likely to me based on my reading that Covid-19 results in long term damage to the body because of these spike proteins. I'm not convinced that a smaller version (yet in some cases significant) of that damage is invoked by vaccination. I still got vaxxed, but I'm very uneasy about having a six month spike protein booster for this reason.
I find stuff like this to be alarming:
https://stephenc.substack.com/p/5-fold-increase-in-sudden-cardiac
That seems obviously related to either Covid-19 or the Covid-19 vaccinations. Or both. I don't think an analysis like they did could differentiate between the two without a lot more research, but I'm alarmed that this research isn't even being done.
Nicotine actually is a useful drug for a few conditions, COVID even appears to be one of them. Smoking is probably not the ideal way to take it, but their advice wasn't that misguided. In the 19th century, smoking probably was actually harmless or very close to it. The health problems associated with smoking were not noticed until cheap, machine produced cigarettes were introduced. Many deadly substances are only deadly in large enough doses. Nobody smoked a pipe 20+ times a day. Modern studies don't appear to show any negative health effects for pipe smokers. It could very well be purely due to the dose, there's still no 2 pack a day equivalent pipe smokers.
If you get covid, I think there are better choices of medicines now (the newish antivirals and the monoclonal antibodies early, the steroids later), but obviously that's not something you want to be trying to do-it-yourself on while you're deathly ill--that's why we have doctors.
But AFAIK, there's not some huge reason *not* to take ivermectin or vitamin D or zinc or whatever, assuming there's not some reason they're going to interact badly with drugs you're on or something.
IVM isn't actually "incredibly safe" in the doses necessary to impair viral replication in vitro; it actually is fatal at that dosage.
That was always the problem; the suspected mechanism for disruption of viral replication in vitro was disruption of cellular processes, which is often fatal in people.
There's no reason to believe it is any better than injecting bleach, in other words. Bleach is definitely effective at killing SARS-CoV-2 - it just kills you, too.
There was never any reason to believe it was actually effective, but there are conmen who push anti-parasitic drugs as cure-alls.
In vitro concentrations aren't always directly translatable to clinical results. Ivermectin also has anti-inflammatory effects, and inflammation is a serious issue with COVID, therefore the direct anti-viral behaviour could have been merely a secondary effect to why IVM might have worked against COVID.
There is a difference between "there was never any reason to believe it was actually effective" and "I do not know of any reason to believe it was actually effective". There was a reason, tens of thousands of doctors didn't all randomly decide to try the same random drug for no reason. The COVID death rate in countries where people routinely take ivermectin is substantially lower than in other countries. This correlation is an obvious thing to investigate to see if it is causative or not.
Here is a link to recommended prescription from the FLCC doctors website, 0.6mg/kg (40mg/daily for my 150lb weight);
https://covid19criticalcare.com/wp-content/uploads/2021/01/FLCCC-Alliance-MATHplus-Protocol-ENGLISH.pdf
I was unable to find the study for the amount used in vitro, however I'd be very unsurprised if that amount was 10x or more this.
The anti-vax video I saw said the point of IVM is not to impair viral replication but to reduce excessive inflammation that can cause death.
But now that I think about it, even if true, the same video touted it as a prophylactic which makes no sense if its purpose is anti-inflammatory. https://www.lesswrong.com/posts/7NoRcK6j2cfxjwFcr/covid-vaccine-safety-how-correct-are-these-allegations
> "should we just give everyone any drug that might possibly work, because Pascal's Wager?"
Just in case you needed any encouragement on that front: I'd be interested in reading your meditations on the question.
I think you have to consider the ethical ramifications for future studies. Suppose you do a half-assed study and it suggests drug X kinda-sort works for condition Y *and then it becomes the standard of care*. How do you ethically go back and do the study right? What's your moral argument for the existence of the control arm? Informed consent is not going to cut it, not when the lawsuits flow.
I think this is part of the sotto voce rationalization for the FDA's reluctance to approve things that maybe kinda sorta work but where the evidence is thin -- and you cited this yourself when it came to the aducanumab approval, and perhaps it's worth noting that AD kills at a rate that isn't *that* far behind COVID. Once you sort of let the cat out of the bag, and a big constituency starts to exist for a therapy regimen, it becomes extremely difficult to go back and study it critically and precisely. Even when it's ethical to do the study per se, meaning you can talk yourself (and others) into the ethical propriety of the control arm, there are political and sociological barriers that may be difficult to surmount.
There aren't any easy peasy solutions to this, I'm just pointing out that when we consider the interests, costs and benefits, of things like drug approval, I think as an enlightened society we are obliged to consider the interests, costs and benefits, that will apply to future human beings because of what we do today. It's not *just* about making our lives better, we need to consider whether a cost to us today will produce a significant benefit to those who come later (cf. global warming, right?) and take that into account also. Information is not free: sometimes we have to pay for it in current lives, or misery, in order that the future has it and can trust it.
Or people could get the fucking vaccines (some of which aren't even mRNA or in any way experimental), which are absolutely without a doubt effective way beyond this nonsense. The options are not ivermectin or nothing, except that a bunch of dumbasses are out there spreading BS about the vaccines.
That someday is coming soon, Bill Gates is already warning that he is going to release smallpox and blame it on "bioterrorism". A new smallpox vaccine has just co-incidentally been approved, and now smallpox vials have magically been found at a merck facility, even though they have no way to have access to smallpox.
IVM was ready to deploy safely at scale on day 1. Obviously the window of opportunity has largely passed.
3 out of the 4 COVID vaccines have been banned at some point in time in some country due to safety reasons.
I was hospitalized for high blood pressure (200/100) 2 weeks after taking my 2nd dose of Pfizer; first time I went to an emergency room in 8 years.
Suffice to say, I do *not* like people who mock others over concerns regarding these vaccines.
Nitpick: The prediction in Scott's post is that effect size as measured by Cohen's d is less than 0.3. This is not the same thing as a relative risk reduction.
Cohen's d is the difference in means between the group that received ivermectin and the group that did not, divided by the pooled standard deviation.
Good catch, thanks.
Scott, long-time lurker here. My antivax, anti-public health elite uncle is currently taking ivermectin for his long COVID, at the behest of his nutty physician's assistant (he fired his doctors, who wouldn't prescribe him things like ivermectin when he had an active infection back in December 2020). I asked him to explain how ivermectin could possibly treat both an active viral infection *and* the damage to his organs he's experiencing in the medium-term aftermath. He was flummoxed.
He later came back and said that the PA's theory is that parasites "acted up" while his body was fending off the virus, and that parasites are causing his respiratory and digestive issues. Mind you, he lives in a wealthy part of Southern California, not Bangladesh. Has anyone ever made the case that long COVID = parasites? I don't know whether to laugh or cry.
Reminds me of the classic rebuttal to medical woo, which is to ask as much detail as possible about what they think they're cleansing from your body with their juices and tonics-- species and subspecies if possible.
One of my parents bosses has been vaccinated for every previously vaccination she's been offered but doesn't like the covid vaccine because she says that RNA vaccines cause the virus to stay in your system. Of course if anything it's traditional vaccines that work that way, while RNA vaccines avoid it.
The more I read smart people strategizing how we might mollify the antivax, the more cynical I get. I'm not sure that these are people who will change their minds over anything, no matter how dumb dumb belief is. Of course I might be cherrypicking and we might as well try to reach more people.
If you "follow the science," you know that as a vaxxed person, other people being vaxxed doesn't affect you (maybe there are edge cases but the debate is not centered on those). So I can't understand why vaxxed people care if other people get the vaccine or not. (If I'm wrong on the science, please let me know.) *Especially* when, as it appears to me, the people trying to do the convincing often view the non-vaxxed as having "dumb" beliefs and hold them in contempt. If you think someone is stupid and you hold them in contempt, you are not likely to want them vaxxed because you want what's best for them.
So as far as I can tell, there are two plausible interpretations here: Charitably, the people who want to force or convince everyone to become vaxxed don't understand the science. Uncharitably, the people who want to force or convince everyone to become vaxxed (or to treat unvaxxed as second-class) solely want to exercise power.
Is there a third option?
Yes there is, even more than that:
- People that want everyone vaxxed worry about the healthcare system being blocked by a lot of unnecessary covid cases. This could hurt anyone including themselves if they need to go to hospital.
- They are sorry for the overworked healthcare workers that have stress because of unnecessary cases. More general it is a waste of resources.
So i see plausible reasons why someone can have a strong opinion that everybody should be vaxxed. But people being missionary or even want to force everyone to be vaxxed are stupid on an other level: If you exercise pressure on people, expecially at such intimate things regarding the own body, will always earn resistance. If you want to convince someone you have to can present all your arguments but than you have to respect their free will.
We used to mass vaccinate the population without such levels of resistance.
These people are the enemy of all of society.
Third option: People want relief from all the stress and fear and disruption that this COVID/pandemic thing has caused on their lives, and they've been marketed to that this vaccination is the only way for that.
The only way to return to normal, is to vaccinate the population. Say the politicians and even some medical experts.
Anything otherwise, is an uncomfortable, cognitive dissonance driven, untruth.
I think you're probably right in general -- it's become a tribal/political issue, so for both sides the major motivation now is "stuff this bitter conclusion down the throat of my enemies so they totally choke on it ha ha."
But that said, there are indeed some legitimate reasons for vaccinated to want to impose vaccination on the un. The most obvious is, for the sake of those who cannot take, or are not as well protected by, vaccines, including the very old, the very young, immunocompromised people like cancer patients, transplant patients, or those being treated for autoimmune disorders. These people totally rely on "herd immunity" because they can't defend against the virus themselves, and can't use a vaccine to help them do so.
The second reason would be to reduce the social costs of the disease. If the cost of ICU stays and very expensive interventions to try to save the life of a COVID patient were *only* borne by that patient, we could be fairly indifferent to whether he had himself taken steps to reduce the probability of him getting (very) sick. But this is not the case, much of those costs are socialized, so that willy nilly means the preventative care decision necessarily gets socialized a bit, too. You can't really have it both ways, you can't ask to make all your own health-care decisions because privacy *but* ask other people to pay for (a big part of) your health-care costs because humanity.
Is there a good reason to believe that "herd immunity" can actually be achieved with vaccination? The latest data from UK shows that vaccinated have recently been more likely to be infected than unvaccinated (possibly because they take more risks).
"The social costs of the disease" argument might make sense if it was directed only to the elderly. But trying to enforce it on young people, let alone on those who already had the disease, suggests that a different real motive.
My main "third option" is that a virus's number of opportunities to evolve (to be more contagious) is proportional to the number of infections. More unvaccinated people means more variants arriving faster, which means higher probability that a variant will evade your immune defenses. (arguably this doesn't matter so much until there is enough vaccine production capacity for the whole world, though I heard that unclaimed doses tended to be thrown away instead of e.g. being sent to developing countries)
In addition, vaccines are what, 90% effective with delta or less, (I never got a firm number), and probably less effective still with omicron? So more unvaccinated people means more chances you (as a vaccinated person) will get sick.
And then there's people with weak/missing immune systems for whom the vaccine is ineffective. One can reasonably want to try to protect such people via "herd immunity" if possible (I'm now leaning toward "it's not possible" but most people, including me, have not seen enough evidence to be sure)
I believe that 90% effective is relative effectiveness, not absolute effectiveness. The COVID-19 vaccine's absolute effectiveness appears to be incredibly low, especially for newer variants. In fact, it is so ineffective (on an absolute scale) that there is no negative correlation (what one would expect for an effective vaccine) between vaccination rate in a region and all cause mortality (or any other metric, though most metrics people use are pretty terrible).
With the current vaccines at least, there is essentially no chance at reaching herd immunity, as seen by countries with a near 100% fully vaccinated population who continue to have "outbreaks".
You are correct. I've been interested in antimisinformation for years. People who are vocal about their belief will easily find excuses that enable them to ignore all evidence. You cannot change their mind. (I do think there are fence-sitters you might convince with a public conversation, but only if you are good at debate and ready to handle the contrarian's arguments.)
How is your uncle's long covid doing?
Great read, thanks
I second this comment.
Writing this while about 1/3 of the way through reading...
A) Thank you so much for doing the yeoman's work to read through these carefully. This is what we pay you for (/s, lol)
B) Regarding Babaloba et al, I tentatively think I may have found the solution:
(This is the context)
"I think his point is that if you have 21 people, it’s impossible to have 50% of them have headache, because that would be 10.5. If 10 people have a headache, it would be 47.6%; if 11, 52%. So something is clearly wrong here. Seems like a relatively minor mistake, and Meyerowitz-Katz stops short of calling fraud, but it’s not a good look."
We have four columns - 1 for treatment A, B and control each, plus an overall. This allows us to triangulate to see what has happened with the data.
Column A is the mystery - how do you get 50% of 21 people, and so forth? Easy, have K people who have missing data for this outcome. Happens all the time. (In my research, I deal with much larger samples, but there's always missing values for some trivial % of the data). Technically you can have different numbers of missing by variable, but the easiest solution to make (at least a few) of these numbers work is to allow 1 person with missing data in Column A.
Then we have 6/20 with fever, 10/20 = 50% with headache, and so forth. Columns B and C look fine. Ok, the question then is does my "fix" give the correct totals in the "overall" column? Turns out that (as far as I checked, it does)
Details:
Headache: 10/20 in col A, 12/21 in col B, 5/20 in col C. This would give 27/61 overall, which is 44.26%, which matches their 44.3% exactly.
Fever: 6/20 in col A, 9/21 in col B, 4/20 in col C. This would give 19/61 overall, which is 31.147%. They report 31.2%. This *doesn't quite match*. But if you round to 2 dp, you get 31.15%. And then if someone later rounds to 1 dp, you get (incorrectly) 31.2%. I bet errors like this happen all the time - you have your software print the result to 2 dp, and then as you write your table, you decide to do 1 dp and every time you have something end with "5" you don't go and check which way the raw data should round. (I bet I make this mistake in my research all the time when rounding coefficients and so forth manually in text, because who always remembers to stop and check?).
Haven't checked the other variables, but getting these sufficiently close matches for the first two I checked for the most simple "non-fraud" explanation of "1 data point missing" seems too much of a fluke otherwise.
The problem is then that the study does not report why they excluded and how many of the patients. This could be removing a patient that would skew the results in ways that they do not like, and so it is a problem still, not guaranteeing a fraud, but hinting at some data tampering.
Studies almost never report anything beyond "missing data are dropped" (which doesn't tell you anything that isn't completely obvious). It's not like you can choose whether to keep missing data or not - of course it automatically gets dropped!
Look, I'm not disproving data tampering but this is by no means the simplest or most likely explanation here. You'll find missing data being dropped for specific outcomes in 99% of studies.
Or maybe the 21 was just a typo for 20 (unlikely on the top row of a QWERTY keyboard but maybe they were using a number keypad)
Possible. But then they need to make an error on the 62 vs 61 as well. I.e. every reference in the entire text about n=62 would be wrong.
They also break out the 21 as 15 men and 6 women.
Thank you for this. It was a missing piece in my analysis. One gift deserves another, so here's what Kyle Sheldrick has to say about Babalola: https://twitter.com/alexandrosM/status/1547037869549699072?s=20&t=vL8K26wQr-S24YFDhidP2g
The alien / vaccine hypothetical is compelling, but what's missing is that IRL all humans would have 7-12 different alien chips already in them and are objecting to getting another.*
*Yes yes mRNA is a new tech but you don't see anti-vaxx people being willing to get non-mRNA vaccines.
I interpreted that as "willing to get non-mRNA COVID vaccines," e.g. Johnson & Johnson.
Oops, this is what I get for skimming Google results. In my defense, the mRNA tech developed a particular notoriety for being "brand-new" and "untested," but I guess that was not a defensible position based on how long each type of vaccine has been in use.
While J&J is unlike most other vaccines Americans would have received, and it does contain DNA, "DNA vaccine" refers to something else: https://en.wikipedia.org/wiki/DNA_vaccine
The only approved DNA vaccine is an Indian vaccine for covid, approved in August 2021.
J&J is a nonreplicating viral-vector vaccine; the first vaccines of that type approved for general use were for Ebola.
I do know several people who say they will take the Novovax vaccine if it's approved (we shall see, but come on FDA) but are refusing to take the adenovirus and mRNA based vaccines. They have (imho irrational) negative response to anything 'genetic' (e.g. super seriously avoid GMO foods etc.).
If they avoid GMOs and mRNA/adenovirus vaccines, well, at least that's a coherent worldview.
I said this upthread, but the one person I know (secondhand) who fits this description says she is worried that mRNA vaccines are less safe than other vaccines because they put part of the virus into you. Of course this is the opposite of what's really true-- there's a very small risk of modern vaccines causing infections, but if they did it would be from older vaccines that use live viruses, or vaccines that use dead or deactivated virus, whereas RNA and DNA vaccines basically carry an instruction manual to the virus rather than the real thing.
Any vaccine you make is somehow going to have to put something from the virus into you in a way that gets presented to your immune system. The mRNA and viral vector vaccines do that by making your cells make some spike protein. (I don't think anyone's done a DNA vaccine for covid, but that's how it would work, too.) Subunit vaccines just inject a chunk of protein that appears on the virus (Novavax is doing this), plus something to make your immune system pay attention. Inactivated virus vaccines inject a virus that's been "killed" by heat or formaldehyde or something. Attenuated live virus vaccines inject a form of the virus that has been adapted not to make you sick, so you get a mild asymptomatic infection and your immune system learns how to fight the real virus off.
The mRNA part of the mRNA vaccines only contains instructions for building the S protein part of the virus coat. There are no instructors for building the viral DNA itself, nor for the other parts of the viral coat. Furthermore, it's not the actual genuine S protein, but a modified version of it that is stable *without* being incorporated into a complete virus. In other words, it isn't even a part of the virus that could be assembled with other parts to make a complete virus.
You may not see them, but I assure you they exist in genuinely large numbers.
Well unfortunately, even existing vaccines (like the flu shot) have now become politicized. I expect to see the lowest child vaccination rates in decades over the next few years.
The medical establishment, the media, the internet, government, and many churches, were taken over by an authoritarian political group of billionares years ago, What's hapening now is necessary to expose it so people will get off their asses and change it before the whole human race is in a grave. Imagine if Hitler or one of the other evil dictators of the past came to power today, took control of genetics, started manufacturing chimeras, releasing sterility viruses and deceiving people to take sterility vaccines.
What are the most prominent examples of the medical establishment taking political sides, as opposed to medical sides that happen to be supported by one party?
The medical establishment was taken over by a political side, authoritarian socialists, along with a majority of government departments and large corporations. When medical mistakes are the forth cause of death, you know something is wrong. The takeover began in earnest 70 years ago with a 93% tax on capitol growth by doctors and huge subsidies to large corporations to establish health care collectives. It's been all down hill ever since. Health care costs went from 5% of GNP to 20%, while quality went down. Constant hype about breakthroughs convinces people it's getting better but it's not.
The pathetic response to the pandemic made it very clear. The billions of dollars taken from workers and given to bureaucrats to prevent pandemics were wasted, and even worse diverted to labs creating pathogens like the one that caused the pandemic.
I think also missing is the behavior of conservative political and media elites, who are actually in a social class where they might have immunologist relatives but who kept up anti-blue tribe COVID skepticism. Trump is vaccinated, Fox News has an internal vaccine passport system, these are the people best positioned to persuade skeptics motivated by 'hostile aliens' and they refuse to do it because maximal ongoing culture war serves their interests.
Tribalism makes people stupid. There are plenty of utterly amoral people in media and politics who will happily play along with the stupidity to increase their money/power/audience. But also, there's a genuine danger of getting caught up in a feedback loop of your bubble + your confirmation bias. I'm pretty sure Bret Weinstein isn't dishonest about ivermectin, and he's certainly not dumb, but the whole ivermectin controversy / big pharma conspiracy theory thing seems to have broken his brain in a rather depressing way.
I think even very smart and sophisticated people are susceptible to getting high on their own supply.
Yes, I think Bret Weinstein is hooked on the idea that he's right when a lot of other people are wrong.
He could have just had (reasonable?) doubts about the mRNA vaccines, but no, he had to go on from that to the idea that there's an extremely effective drug that's being suppressed.
Trump has been shilling the vaccines since he was still president, he is shilling them now. The qboomers you want to pretend are representative of everyone who isn't hysterical about COVID can't be swayed by Trump, so Fox can do absolutely nothing to convince them either. They have less than no influence over the rest of us, who think fox is just as worthless as CNN. The CDC's statistics are why I am not taking a dangerous vaccine for a harmless cold. Not because only 99.8% of empty headed media puppets are devoting all their time to lying and fear mongering about COVID instead of 100% of them.
A few random thoughts:
It would be great to see analysis of why a deworming medicine is thought by some medical professionals to be an effective treatment for a respiratory disease.
What could possibly motivate the folks at ivmmeta.com to spend so much effort in creating and maintaining such an impressive site? I see only two candidates - sincere belief in the effectiveness of Ivermectin or a profit motive. I don't believe trolls or nihilistic fraudsters would have that much motivation. Since the drug is already a generic drug, it would seem the profit motive is less likely than a sincere belief that it is an effective treatment for COVID19.
I don't understand the intensity of the establishment backlash against Ivermectin. I have not seen evidence that vaccination rates would be higher if people did not believe ivermectin worked. Nor do I think that it's intuitively clear that this would be the case. People who distrust the establishment don't trust them on vaccines or on whether or not ivermectin works. Even if they were somehow convinced that ivermectin didn't work, they wouldn't trust the vaccines unless the public health establishment suddenly became more trustworthy overall. Add to this the fact that if taken in human sized doses, ivermectin is safe and I don't really see the reason for the virulent mainstream backlash. In fact, the backlash probably cost some lives by causing people to take crazy dosages.
More generally, I don't understand the establishment messaging of vaccines (+masks) or you're the worst. There are plenty of other ways to reduce risk including doing things to maintain or improve overall health (exercise and sunlight). And these activities are not mutually exclusive with taking vaccines. The messaging should not have been anti vaccine alternative - that just spreads distrust. It should have been vaccines are good and here's a bunch of other positive steps you might take to reduce your COVID19 risk. And the evidence for ivermectin is mixed, but if your doctor wants to give you some, whatever its harmless. Again, I think the vaccine or bust messaging was really counterproductive.
How about pointing the anger at the FDA for forbidding the use of tests early on other than the one they had approved — and later discovering that that one didn't work? Also for delaying the unblinding of the vaccine data until election day.
I would go further, and blame those responsible for making it take nine or ten months from a vaccine being created to its being approved for use, in part by not permitting challenge trials.
While Zvi has criticized the FDA, he himself has been wrong about a number of things. So while the FDA screwup rate is not 0, his is not 0, either.
In particular, everyone who was eager to get the masks off was wrong. My personal opinion has been (and will continue to be) that everyone should continue to mask up until COVID is gone, and that maybe wearing masks on public transportation like planes and trains and buses should be *permanent* - that is to say, even *after* COVID is gone, we keep doing it.
Anti-COVID measures had an enormous effect on flu season last year - we had approximately 1% of the normal fatalities due to influenza. That's crazy.
It shows just how ridiculously infectious COVID is by comparison - measures inadequate to fully control COVID were sufficient to lower flu deaths by 99%.
>really beat it, in the way Japan, South Korea, and Australia beat covid
You mean, not "beat it" at all and have no statistically significant difference from any other developed country? Whatever country "we" is, managed that just fine.
>We blew it because people refused to come together as a society and work on the problem - refused to wear masks, refused to self-isolate, refused to social distance, refused to endorse policies we knew could reduce the spread of the disease.
But we know all of that is complete BS. The anger is floating around precisely because so many people live in the TV fabricated alternate reality where that nonsense is true. They somehow forget that at the beginning, when we had no concrete information to go on, republicans were the ones taking COVID seriously, and dems were insisting it is "just the flu" and organizing "hug a random asian person because the imaginary racism we just made up is the real disease" events. Dems were the ones insisting masks don't work and you are an evil panic spreading fear monger if you wear one. And then as we got real information from countries with slightly more trustworthy governments than China's, and we determined that it really is just the flu and there is no need to do anything, everything suddenly reversed and we had always been at war with Eastasia.
We knew from the time of the great reversal, once efforts to restrict travel to prevent spread had been successfully shut down by "racism" accusations, that it had become endemic and it was going to be a permanent disease like the flu. This was openly explained to all of you, when you were told that we needed temporary 2 week measures to "flatten the curve" and not overwhelm our health care systems with too many cases at once, since there was nothing we could do to change the number of cases that would happen overall. And yet, on week 89 of 2 weeks to flatten the curve, people are somehow able to delude themselves into blocking all of this out of their head, while simultaneously remaining completely convinced of their own superior, skeptical mind.
You have to look at all the variables, not just the one you like. The US has more deaths from everything all the time than Japan does. The US has far more people with serious health problems than Japan does. We know age and co-morbidities are the most important factors in COVID deaths by several orders of magnitude. And denying the lack of seriousness of COVID is just silly. Look up the average age of COVID death victims yourself. It is higher than the average life expectancy. Look at the survival rate for people below 80 without co-morbidities. COVID is killing people 3 weeks sooner than they would have died anyways from something else. Many COVID deaths are admittedly not even COVID deaths, they are deaths within a selected time window of having a positive PCR test for COVID.
Nothing about the establishment messaging is understandable under mistake theory.
"My outgroup is evil, not wrong."
To clarify, in case it seems like I'm being too glib, good and evil both exist and it isn't all that terribly hard to tell the difference. Certain morally valent policy recommendations are sufficiently morally incorrect as to constitute evil behavior. Censoring the net is evil. Convincing depressed teens and twentysomethings to pay hundreds of thousands of dollars to have their genitals mutilated and rendered permanently nonorgasmic, in an intervention that is sold as preventing suicide but is ineffective even at that, is evil. Advocating for the normalization of sexual relationships between mature adults and people too young to give informed consent, and the concomitant power imbalance, is evil. Advocating for the legalization of the murder of viable fetuses is evil. All of these are mainstream positions within the Democratic party and the broader academic left from which the Democratic party draws its social policy recommendations. When I claim the Democratic party is evil, I am not dunking on the outgroup. I have specific and grave moral concerns about their specific and openly held social policy recommendations.
Choosing conflict is frequently a mistake.
Establishment's censorship of discussion of ivermectin seems like the most likely motivator for the creation of ivmmeta.com.
Strongly agreed. Parts of the medical profession actively worked with social media and mainstream media to block any discussion of a potential treatment of a major pandemic. What about that wouldn't cause great concern and lead to groups of people trying to create an honest discussion of the merits of the treatment? For a normal response, most of us would never have heard of ivermectin and the medical profession would have worked through the studies and made recommendations to doctors. Individual people would have heard positives or negatives about the drug from their doctor, and made up their own mind. Nothing special, no big deal.
I don't want to be too uncharitable, but I get annoyed by the double standard sometimes here. If ivermectin boosters are acting unreasonable-- and most are getting out ahead of their skis even on a charitable interpretation-- then anything they get above mockery is gravy.
Yes, we should be trying to get through to people about vaccines, and yes, if you're a blue check physician health communicator type you shouldn't be making fun of random people on twitter. But still, if you're ignoring a working vaccine to take snake oil, you're being silly and I'm not going to feel bad that people make fun of you.
Of course you're right that we should be exercising more, eating better, etc., to prevent covid, but we should also be wearing surgical masks and ventilating indoor spaces. We don't need to choose between air bags and seat belts.
The vaccine might justify taking fewer cautions since it's simply way more effective than any NPI, but there's nothing else that compares. I might even trade in all our messaging on NPIs for messaging that boosts vaccinations, given that the marginal value of an additional vaccination is so much higher.
My point is it's not obvious they're ignoring a vaccine to take ivermectin. This is an assumption.
It's not representative, but there have been a few celebrities including Joe Rogan and other celebrities who apparently get their health advice from Joe Rogan taking ivermectin but not getting the vaccine. Rogan has maybe the largest platform on health matters in the world in terms of the listenership regularly tuning in for health content, so he's not a marginal player.
Rogan did not just take ivermectin, he also took monoclonal antibodies which have excellent evidential basis, and he was very transparent about everything he took. He also routinely, literally says not to listen to him for medical advice because he's a moron, and that you should talk to your doctor. All in all, very reasonable messaging.
You might want to stop and consider (charitably!) why people might want to listen to Joe Rogan on a matter that he emphatically says is not his expertise.
It's a mixture of experts/elites/establishment people actively lying to them about COVID treatments and preventions, including lying about both masks and the vaccines, and Joe Rogan laying out his thought process pretty clearly in a way that invites people to make up their own minds. That may lay out a better approach out medical establishment should take in the future.
Someone can correct me if I am wrong. But my understanding of what happened with Rogan was that he was not vaccinated because he felt that he was healthy and did not need it. Then he contracted COVID. Then he contacted a doctor that he had had on the show who supposedly had a bunch of treatments for folks who had COVID. He paid that doctor a lot of money to recommend/proscribe him a bunch of stuff of which Ivermectin was one thing along with monoclonal antibodies. Once he recovered he mentioned on his show the laundry list of stuff he took. Then the media jumped on the fact that he took Ivermectin and said he took horse dewormer.
I don't think Rogan was actively promoting Ivermectin as an alternate to vaccination before or after he got COVID
One of the cases of non-vaxxers I know at second hand is in this boat. As in, has specifically said, "I don't need to get the jab. It's not safe in the first place, and in the second place if I do get it I'll just take ivermectin."
There was also a nurse on this board who discussed doing this in a previous thread, though if memory serves they were in fact taking the ivermectin prophylactically.
I don't know if there's been a survey, but these people are, at least anecdotally, around.
At the best case and my most charitable, it's just in-tribe signaling.
What if you replace IVM in this case with monoclonal antibodies, or the Merck pill? Isn't that a reasonable stance, if that person decides to take the risk of getting Covid and then treating it if it gets bad?
There is a n% chance that you get Covid, an n% chance that it is symptomatic and an n% chance that it is serious. Depending on who you are, getting all the way to it getting bad is pretty slim. A vaccine helps you in the case that all of these are true, whereas if there is an effective therapy, which there is, then I think people should be able to take the risk of getting Covid and then treating it.
I can understand your frustration, and if making fun of silly people helps you, you can do this. But i don't see any other reason and the cause not to mock but to respect them is not mainly because you feel bad for them. People that don't don't feel a minimum respect from you, just won't listen to you, even if you have the arguments that would otherwise convince them.
Small-molecule drugs often change multiple things in both the highly complex systems of both the human body and disease-causing organisms; we don't really understand these systems in anything like the detail necessary to predict the effects in advance.
A fairly standard approach when screening an existing drug for potential use against a new disease is roughly "Well, one of the systems we know drug X affects is system Y, and system Y seems to be active in disease Z, so maybe it'll have a positive effect". So, ivermectin (which seems to have fizzed out) made sense as something to test for the same reason fluvoxamine (which seems to work) did; well-tolerated in-production drugs with effects on inflammation systems (since inflamation is a factor in COVID).
A whole bunch of other drugs that fit that general description have been tested, too, without making the news; that's because they failed (unlike fluvoxamine) without any faked studies declaring them a major success (unlike ivermectin).
As far as the psychology on the pro- side, it looks like the usual confirmation bias. People saw the studies where it had a major effect and were convinced, and have held to that regardless.
And on the anti- side, the invective is the usual tribalist animosity signaling. The vaccine hesitancy arguments are not the reason for the venom spewed at the Other, they're the excuse for the venom spewed at the Other.
>I don't understand the intensity of the establishment backlash against Ivermectin.
The US is extremely polarised right now and like a lot of ambiguous things COVID mitigation wound up getting pattern-matched to Blue Tribe vs. Red Tribe. A lot of scientists are fairly apolitical, but establishment messaging is very definitely Blue.
This put a lot of emotional loading into an ideally-quite-dry question, and so the tiniest shred of a "lives are at stake" suddenly becomes front¢re (let us be clear; in a country of hundreds of millions a lot of things have lives at stake) and the deplatformers start reaching for their toolbox.
I disagree with Darin; I think most of the establishment messaging is honest, if foolish.
There are lots people who are scared of both COVID and COVID vaccines and aren't sure which is more dangerous. Evidence:
- Old people are much more likely to get the vaccine than young people, which indicates people are making a cost benefit calculation but overestimating the "cost" of the vaccine.
- You have people like Nicki Manaj encourage mask wearing but will not get the vaccine.
- My hairdresser was scared of both, and says a lot her friends are too. She did ultimately decide she was more scared of COVID and got the vaccine.
Now if you are scared of COVID and vaccine, and Team Ivermectin tells you not to be worried about COVID because their pill will protect you, that should make you less likely to get the vaccine. I'm not a huge fan of "risk-compensation" arguments against imperfect interventions because it's rare people risk compensate more than the benefits of the imperfect intervention, but here the benefit is probably zero so any risk compensation is harmful.
These were shared by a lady at my workplace, a few days after work announced that the vaccines would be mandatory, and the day before she abruptly left. No idea if she was terminated or stormed out. They were sent to the dept mailing list, then followed by a sorry disregard email. I think they're illustrative of what a lot of us think of the anti-covid-vax / pro-invermectin crowd, and of what that crowd thinks of us. I don't know what there is to do, or where we go from here.
"In the US, the Supreme Court has ruled that vaccinated people worldwide are products, patented goods, according to US law, no longer human. Through a modified DNA or RNA vaccination, the mRNA vaccination, the person ceases to be human and becomes the OWNER of the holder of the modified GEN vaccination patent, because they have their own genome and are no longer "human" (without natural people), but "trans-human", so a category that does not exist in Human Rights. The quality of a natural person and all related rights are lost. This applies worldwide and patents are subject to US law. Since 2013, all people vaccinated with GM-modified mRNAs are legally trans-human and legally identified as trans-human and do not enjoy any human or other rights of a state, and this applies worldwide, because GEN-POINT technology patents are under US jurisdiction and law, where they were registered. SOURCE of the decision of the US SUPREME COURT PDF HERE (https://www.supremecourt.gov/opinions/12pdf/12-398_1b7d.pdf) To follow how / if it applies to others, outside the US."
And
"Reasons why the jab cannot be mandatory and why not to take it This is 100% ILLEGAL. 1) there was to be a full experiments done on testing animals FIRST. When ALL the animals DIED, they stopped the experiments ! ***They are REQUIRED to explore all options to see if there already is an approved therapy on the market BEFORE even making jabs... Ivermectin and HQC were two that were acceptable. But they demonized doctors who used those safer therapies and banned their use, thus many lives were lost in the process !!! Also, Fauci had a contract with Moderna back in 2015 I think. Mass amounts of PCR tests were also sent world wide between 2017 and 2019... Event 201was held in October 2019 simulating a corona virus pandemic... Boom - then we have one ! Not coincidental or suspicious at all ??!!! Fauci had also written a paper how the two therapies above were great in treating the SARS virus as a treatment and cure .... 2) This is NOT FDA approved. It is under the Emergency Authorization Act as an "Experimental GENE THERAPY Injection... It is NOT even a vaccine ! 3) By not going through ALL the protocols set by the Nuremberg Trials, they are breaking the Nuremberg Laws !!! 4) A drug CANNOT be mandated that has NOT been approved by the FDA. And that is not saying it is safe even then - look at all the commercials for lawsuits against FDA treatments all night long on your tv... 5) Why would anyone want to take a product where the manufacturers are NOT LIABLE for any deaths or injury ? If they are not willing to stand behind it, it is defective at best and nefarious at worst. 6) The clinical trials are not even done until 2023... We are the lab rats ! They won't even list all the bad stuff until the trials are finished !!! But we see all the deaths, injuries and diseases that these jabs are giving people, and they still line up for it AND make their CHILDREN get it !! Children have not been tested for this yet ! 7) If your employer makes this mandatory for you or anyone else, they too could be subject to breaking the Nuremberg Laws. One of the penalties is EXECUTION for breaking any one of these Laws. The employers also are 100% liable for any injury or death you may have ...not the manufacturers. Remind them of this when they want you to take the jab....especially the execution part. NOTE - If you or anyone knows of someone injured or died, contact PJI.Org On their site they have a PDF about your rights with this whole hot mess, and they can represent you for free. If you die or get injured, your insurance may refuse to pay ANY BENEFITS due to you knowingly got involved in what they term as Risky Behavior... Like some one jumping out of a plane without a parachute .. So say goodbye to all that money you paid into your burial and health insurance... 9) These jabs do NOT prevent you from getting the virus in fact, more people get the virus directly after the jab . They also then shed the virus onto non vaxxed people. Unvaxxed are exposed to vaxxed are experiencing miscarriages, changes in their menstrual cycles for the women, and other things are popping up. The vaxxed are dying from the Delta varient in more numbers than the unvaxxed... 10) During the Senate Committee Corona Virus hearings, they had various doctors that were highly educated speaking about how dangerous these are and that there has been more deaths and injuries from these jabs than with all the other approved vaccines in history COMBINED, that they should have been pulled with just the first couple of deaths and injuries... LINKS to the brave doctors testifying https://youtu.be/mIPb0AtEvAE https://youtu.be/MGboD4KAgbM 11) The CDC was recently caught removing a large amount of jab injuries and deaths on their VAERS website. It has been estimated that 150 THOUSAND people have died from the jabs. So I have given just some of the facts as to why people may not choose to get this. It isn't that they are anti-vaxxers, They are just Pro Life !!! KNOW YOUR RIGHTS ! I made that so people have a defense when getting attacked by people or employer This was created by Brenda Purvis https://www.newsbreakapp.com/n/0auna1tA?share_id=eyJ1c2VyaWQiOjQ5MTUyMDIxLCJkb2NfaWQiOiIwYXVuYTF0QSIsInRpbWVzdGFtcCI6MTYyNjI4MTE3MTIyN30=&s=a7&pd=03KEgXnK&hl=en_US&lp=v2"
There's a rational mode of thinking where you are weighing evidence and making tradeoffs. Living there is hard work, you're constantly having to read papers and try to remember how some weird ass statistical tool or clinical trial design is supposed to work, there aren't any easy answers, and even when you've done your best you know you might just turn out to be wrong. Most people are pretty bad at this, probably journalists and politicians are mostly very bad at this, and to be honest, almost nobody is really good at it.
There's also a moralistic/tribal mode of thinking, where you are following norms yourself, enforcing norms on others, denouncing shirkers and wreckers, etc. This is easy--our brains are evolved for this kind of game, it's fun, it's accessible to the dumbest and least educated people. Probably journalists and politicians are extra good at this game.
Almost from the beginning of covid, most mainstream people with prominent voices/platforms were playing the moralistic/tribal game. Racism is the real virus. Get a load of these weird aspie racist techbros wearing masks and using hand sanitizer. Sanitize surfaces and wash your hands! Masks are only for medical personnel. The lab leak hypothesis is racist and must be suppressed. Joe Rogan's taking horse dewormer.
A few people were playing the rational game, but they were mostly not the people with the biggest megaphones. And one reason they didn't have the biggest megaphones is that most people don't want to play that game, and to be honest most of them probably can't do it very well and couldn't even if anyone had ever bothered trying to teach them how.
Vaccines are the only thing that will ultimately work. So yeah, it makes sense to promote them, as it is literally the only way to end the pandemic.
We give far too much deference to these people. We used to mass vaccinate the public. We'd still have smallpox if these people had their way.
The reality is that vaccines + masks are really the only solution and have to be standardized.
You have created a fictional reality which does not match actual reality, which is easily confirmed with a simple google search.
https://www.google.com/search?q=vaccines+reduce+COVID+transmission&rlz=1C1CHZL_enUS701US701&oq=vaccines+reduce+COVID+transmission&aqs=chrome..69i57.5889j0j7&sourceid=chrome&ie=UTF-8
COVID vaccines do indeed greatly reduce transmission. They don't eliminate it, but they do reduce it.
This is public information and has been confirmed by the CDC and Fauci.
https://www.businessinsider.com/fauci-vaccinated-people-less-likely-to-spread-covid-2021-7
They are "much less" likely to spread COVID according to Fauci. The exact opposite of what you claimed.
Why are you spreading misinformation?
Every single study has found that it reduces transmisssion.
We are boosting because immunity wanes over time and because antivaxxers continue to spread the disease. To actually reach herd immunity we'd need to vaccinate about 95% of the population due to the infectiousness of the virus.
Sadly antivaxxers lie about this because they don't want to come to grips with the fact that they're killing people.
A simple google search is a fictional reality which does not match actual reality. I find it hard to believe that you are not aware of google's "helpful" suppression of inconvenient facts. Citing "Fauci says" is just absurd, he has lied over and over again, even under oath in front of congress. He has even openly admitted to some of the lies. Cite studies, not celebrities.
I'm pretty sure I know which group is involved with ivmmeta, though I don't know which members run it.
I think the motivation is that the authors' self-image involves them "solving covid". They need to have found & promoted a cure by the end of the pandemic. They've made a bunch of websites for different potential drugs and hyped the most promising ones. They believe that ivermectin works, but it's not something they are unbiased about.
This group has also decided that covid vaccines are net bad for most of the population, and are hyping ivm as an alternative to vaccines, along with accusations against establishments re: why they promote vaccines but not ivm. I'm betting if the messaging was "establishments are too slow" and "vaccines and ivm together" there would be far less backlash.
This is the single best article written on ivermectin throughout the whole pandemic. Thank you.
I've been looking at ivermectin since the early months of the pandemic. I had heard of the I-MASK+ protocol when people were still using ventilators on COVID patients (with an 85% death rate in NYC), and it sounded really promising to me. So I've been really open-minded as to whether or not it actually worked.
But over the next several months, and now 18+ months later, it never really succeeded in having a home run in terms of proving that it worked. I don't think we need medication that decreases viral load 3 days faster, we need medication that keeps people out of the hospital and from dying. It was pretty clear anecdotally that ivermectin wasn't doing that.
I think basically it comes down to the fact that when you have a disease where 85% of people suffering no or only mild symptoms and 0.5% death, it's going to be a very hard disease to determine if a treatment worked or not.
I think the science we have been doing over the course of the pandemic has been largely garbage because we haven't learned anything to help us whatsoever since March 2020. If I remember correctly, the mRNA vaccine was designed within days of the virus being sequenced in January. The rest of the time on the vaccine was spent making sure it was safe, but you can argue that nothing new was learned after the vaccine was created. Since then, we haven't really learned anything about the virus, about the transmission, how to fight it, etc. Our best bet is to wear masks and stay outdoors, which we already knew.
What we as a species really need is a global mobilization of scientists, where a single global committee designs a thousands of different experiments that would help us narrow down how the virus works and how to fight it, and divvy up the work globally. We could have worked in parallel doing thousands of experiments to help us figure out what exactly we need to do to beat COVID, but instead the millions of scientists around the world were trying to determine if SARS-CoV-2 was found in vaginal fluid or semen.
The parallel rapid response trials idea been proposed before COVID-19, and is thankfully being more actively pursued now. It's is a big part of both the UK 100-day proposal for response and the White House's $65bn proposal, championed by Eric Lander and OSTP, which unfortunately wasn't a high-enough priority for congress in the just-passed infrastructure bill, so it was mostly eliminated.
"we haven't learned anything to help us whatsoever since March 2020" - who does "we" refer to in this sentence? Certainly not the medical community, see e.g. https://www.vox.com/future-perfect/22772612/early-treatment-for-covid-fluvoxamine-molnupiravir-paxlovid
I was a bit hyperbolic in terms of my choice of words, and I couldn't edit my words after posting. But practically we haven't found anything real. Yes, in the last couple of weeks there have been pills that came out that cut the risk by 85% which is finally what we need. But aside from finding those drugs, we don't know why it causes severe symptoms in some people, and almost no symptoms in most people. Is it genetic? We have no idea, but it's been 2 years and we don't know. We don't know why many people lose their sense of smell. We don't fully understand the mechanism of transmission. The only definitive thing we know is that as the age of the person increases, the chance of severe symptoms and death rises exponentially, but we don't know why. We don't know why kids are largely immune to COVID. We don't know why some people are dying of blood clots, although there was a recent study saying that the spike protein may interfere with some parts of the clotting process.
There's so much we don't know. The medications like fluvoxamine give a percentage improvement but it's not a home run like the Pfizer drug. I would classify that as a statistical modifier rather than a real medical treatment. We need something akin to penicillin that effective solves bacterial infection, we don't need things that only provide statistical significance to moderately improving symptoms over a large number of people.
Read the whole Vox article, it's not just about "the last couple of weeks", but also says, for example that "In the nearly two years since this coronavirus started spreading, we’ve learned a lot about how to care for patients who are sick enough to require hospital care. Cheap, widely available drugs such as dexamethasone have substantially reduced the hospital mortality rate for severe Covid-19." And there have been tons of other research findings about the virus, transmission, etc. since March 2020.
"What we as a species really need is a global mobilization of scientists, where a single global committee designs a thousands of different experiments that would help us narrow down how the virus works and how to fight it, and divvy up the work globally."
And if that committee ends up committed to a mistake, as committees not uncommonly do, there is nobody outside it to point out the error. Centralization is dangerous.
Great read, Scott. You moved me from the “IVM probably works a little” basket to the “IVM probably doesn’t work” basket.
I do think there’s a few points you could add to your analogy that seem fairly important to the more educated and knowledgeable vaccine hesitant people I know:
- Previous brain implants have gone through long trial periods to ensure they don’t cause adverse effects. However, the aliens believe the quantum memetic plague constitutes an emergency and there isn’t time for such a process. Plus they say the early trial results look great.
- The first implants start getting inserted and some rare side effects are noticed. In the worst cases, some of the implanted die as a result. The aliens insist there’s nothing to worry about, as it’s a very rare occurrence. But you can’t help wondering if they’re investigating the problem in good faith.
- A few months into the program the implants stop working as well as promised. The memetic plague has mutated, and found new ways around the implants. The aliens acknowledge this but maintain it changes nothing of practical importance. Herd immunity to the memes may no longer be possible.
- Anyone promoting vaccines in public is censored. On some platforms, even non-promotional discussion of vaccine efficacy is targeted.
- A few more months pass and the aliens decide that implants will be mandatory, and refusal will mean you cannot use any alien technology! Alien tech has already permeated all of earth life. They’re also implanting children, who were supposed to be almost unaffected by the memetic plague. The brief explanations are difficult to parse, and seem somewhat circular to the human mind.
I'd love to know the answer to these questions too, because they primarily go ignored and unanswered by anyone knowledgable I know who's in the camp "I've taken the vaccine and it's safe, and you should too".
Probably some mix of cognitive dissonance and not wanting to think any longer about a problem they think they solved with the solution that these questions bring into doubt.
Yes, it's important to address the reasonable concerns people have, but also to be clear about the facts, and these analogies break down.
To be clear, the COVID vaccines went through the same trials other vaccines did, just in parallel and with much less delay, and regardless of the reasonableness of early hesitancy, we do have really good data on levels of side effects now that over half of earth is vaccinated - and they are far lower than what we see from COVID-19. And there is strong evidence that the vaccines work very well for active immune response, but that only kicks in after a couple days, so people get mild COVID once the neutralizing antibodies are no longer circulating.
(And the "memetic plague" analogy breaks down once we can see people dying from the plague en masse.)
> To be clear, the COVID vaccines went through the same trials other vaccines did
Thats false. Scott makes a big story about aliens but it's completely unecessary. I just don't trust you (you speaking for the establishment here) because you keep lying to me. You don't even feel bad and when I point ot out you'll just slander me.
The establishment would've been much better off with "Trump got that idiot FDA out of the way, so these vaccines could be tested at better than the snail's pace those silly safety officers wanted to do it at."
But that would've involved saying something nice about Trump.
why did vaccines have higher all cause mortality than placebo in pfizer's six month follow up? 21 vs 17? with much of the mortality coming from cardiac issue? I believe moderna had similar all cause mortality iirc?
Which study do you mean? I only know DOI: 10.1056/NEJMoa2110345 being referenced as "pfizer's six month follow up", there the mortalities are 15 vs. 14.
The FDA approval document has updated mortality figures, different from the article published by Pfizer previously.
I maintain that the real conspiracy is the FDA keeping a helpful vaccine out of our hands for so long, which makes the metaphor even more fun. Imagine that a group of human bureaucrats had studied the alien biochips, approved some after a long process and refused to approve others, but all the material evidence was that the biochips worked better than expected. The only bumps in the administrative processes are when the bureaucrats blame one biochip for an unrelated problem and make it illegal to use for a brief period. We get evidence even months later than breaking the chips in half confers the same level of protection, even though the bureaucratic process made that difficult to study. Have I totally killed this metaphor yet?
Also the part where the bad orange alien said the brain implant would be ready soon, and a bunch of human leaders said not to trust the bad orange alien's brain implants. And the alien brain implant manufacturers probably delayed releasing the brain implants because they didn't like the bad orange alien. Then a couple of months later all the people who said not to trust the bad orange alien's brain implants, after getting the brain implants themselves, said you absolutely must get the brain implants.
There is one quote to this effect, and you’re leaving out the literally very next thing that person said. “If Dr. Fauci, the doctors, tell us that we should take it, I'll be the first in line to take it."
In other words, she sensibly discounted what someone trying to win and election said — someone who also was claiming 20 million doses would be distributed by the end of October 2020 even as the pharma companies were saying that was impossible. No one ever mentions that context.
It was still a stupid comment, because the vaccine wasn’t being cooked up at Trump campaign headquarters. The “doctors” were already hard at work overseeing the development process of a vaccine based on a new but well-studied technology following an abbreviated but extensive testing program. All of this was well known and well publicized - the vaccine rolling out on Trump’s word without the doctors signing off was never an option on the table.
There are multiple statements to that effect. How does Trump lying about how many doses would be ready by what date make any of the statements made by Harris, Biden or Cuomo acceptable? There is no context that makes these statements responsible or honest unless their current position is irresponsible and dishonest. The same vaccines made and approved by the same people through the same processes do not become dangerous or safe based on political whims. Either we should be wary and skeptical of the rushed vaccines then and now, or we should "trust the science", shutup and take them then and now.
Interviewer: "Let's just say there's a vaccine that is approved and even distributed before the election, would you get it?"
Harris: "Well, I think that's going to be an issue for all of us. I will say that I would not trust Donald Trump."
Biden: "If and when a vaccine comes, its not likely to go through all the tests that needs to be and the trials that are needed to be done."
Biden: "Who's going to take the shot? Are you going to be the first one to say sign me up?"
Cuomo: "You’re going to say to the American people now, ‘Here’s a vaccine, it was new, it was done quickly, but trust this federal administration and their health administration that it’s safe? And we’re not 100 percent sure of the consequences.’ I think it’s going to be a very skeptical American public about taking the vaccine, and they should be.”
Cuomo: “Frankly, I’m not going to trust the federal government’s opinion, and I wouldn’t recommend [it] to New Yorkers, based on the federal government’s opinion.”
All three of them knowingly and deliberately made it seem like there was something wrong with the vaccines before they knew anything about them and that people should avoid them simply because Trump exists. And looking at old twitter posts from before the election, it certainly worked. Thousands of dems tweeted about how they would never take the unsafe, rushed, "so-called" vaccine that Trump was dangerously and irresponsibly pushing.
Honestly, the most important difference is that previous mind implants weren’t being pushed hard by aliens.
People who took other vaccines but refuse THIS one, are doing so because they think (not without reason) that the people telling them “take it or else” are untrustworthy assholes who hate them. Everything else is post hoc rationalization by people who aren’t quite ready to admit that their real reason is basically “you can’t make me, nah nah nah”.
It’s unfortunate that the vaccine didn’t hit about 3 months earlier, to become well-established prior to Biden taking over and “get the vaccine” being therefore slotted as a Blue coded behavior.
What's weird is that I think we already require tons of vaccinations to work, travel, and get educated, so why is this mandate suddenly more coercive?
The woman I'm talking about also made a big deal about how even though everyone else was wearing a mask she could get away with not wearing it in stores, elevators, etc. because no one is going to stop her. There's a certain type of vice signalling that I really don't think I'll ever understand.
*gestures broadly at all of the last 20 months*
Previous mandates were not rammed through on a national level in the midst of a pandemic response that was already polarized.
It’s not how coercive it is, it’s who Ian doing the coercion, and suspicion about the motives of the same.
See, all of my priors tend to point the other way. It seems obvious to me that the worst and most coercive government practices are things probably passed bureaucratically with the support of both parties and which have existed for decades already. I mean, I get that people move on headlines, but there's something frustrating about the "only the government coercion that existed before last Sunday" libertarian types.
Educated yes, but I have never been asked to present my vaccination records for a job or for travel.
For some jobs you do have to present certain vaccination records, particularly if you work in health care. (And they mean it: when I couldn't find some of mine, I had to get re-vaccinated to keep my job! This was back in 1980!) And in some jurisdictions you have to annually prove you got a flu shot to work in health care.
As for travel--you haven't lived through a raging respiratory pandemic before, so no, nobody ever asked for proof of immunizations for routine travel. That said, when my daughter went to school in France before the pandemic broke out, she had to present immunization records in order to get a student visa. And foreign students who come to the US for college also must present proof of several immunizations--a practice that substantially predates this pandemic.
>I think we already require tons of vaccinations to work, travel, and get educated
No. We require a few vaccinations dangerous childhood diseases if we want to put our children in a public school. You do not need to attend a public school to get educated, and there is a strong argument that doing so will in fact seriously hinder you from getting educated. You do not need to be vaccinated for typical work or travel. Since COVID is not a dangerous disease, and the people trying to mandate vaccination against it openly say that they hate me and want me dead, and are also trying to mandate all sorts of idiotic things that are clearly not for health reasons, it is pretty rational to be skeptical of such vaccine mandates.
How sure are you that if vaccination had gotten underway three months earlier it wouldn't have gotten slotted as Red coded behavior? That could have been even worse, given that the Blues have much bigger megaphones. Imagine a skepticism campaign in the NYT quoting Harvard professors on why the dangers of the vaccine were being hidden to make Trump look good.
I don’t think that was ever likely, because the Blues were never that wedded to anti-vaccine, and were always pro-intervention in COVID. The anti-Trump vaccine handwringing was just cheap partisan refusal to give Trump credit for anything positive.
The Blues of Europe were clamoring for a vaccine too, so I don’t think the democrats could have maintained that dissonance post-Trump.
>and were always pro-intervention in COVID.
You have a selective memory. Dems were initially 100% hostile to doing ANYTHING about COVID. It was "just a flu" and you were anti-science if you suggested otherwise. Wearing masks made you an immoral fear monger, and the most basic common sense action of "restrict travel from the country experiencing the outbreak of some unknown new contagious disease" made you an evil racist. It was only once it was too late to do anything and the virus was securely endemic in North America and Europe that they were willing to flip the script and start the "two weeks to flatten the curve" psyop. Boy, it has been a long two weeks...
Pfizer: Trump vaccine
Moderna: Biden vaccine
I would add:
- Many people get the memetic plague, and recover. Presumably this confers some manner of immunity, yet the aliens keep insisting that these people need the brain chip and indeed act as though having the plague and recovering confers zero protection against future plague infection. No discussion of the value of brain chips addresses this; the benefits are always in terms of never infected/recovered humans with or without chips.
I will try and write up some more on this issue on my own blog this evening... traveling for work keeping me busy all day.
This is an incredibly valuable post. Thanks for doing the work that all the people whose job it was didn’t do!
The fluke/fluke "coincidence" is the clearest proof I have ever seen that God made the babelfish.
Jordan Peterson has entered the chat. He loves the way that linguistic alignments reveal previously unseen connections. Frequently correct in that analysis.
This is not a coincidence because nothing is ever a coincidence....
Note: the above random string of characters is coincidence.
Great read... you must have a nuclear reactor mod for your brain, I can't imagine having the energy, time and focus to write these pieces, but I'm grateful that you do. You're probably the only person I trust at this point to do a fair analysis.
This also brought to mind a well circulated Twitter thread which summarizes some of the same sentiments: https://threadreaderapp.com/thread/1422181544161128450.html
This is your best post in a long while!
Sorry…50% of Americans are young earth creationists? Can you provide some data on this?
Maybe more like 40% https://en.wikipedia.org/wiki/Young_Earth_creationism
I suspect a lot of this is that it is one of the 10 required beliefs of Red Tribe membership, and you can't pick and choose, or God forbid, take some from the 10 required beliefs of Blue Tribe membership. I seem to remember an old SSC about this
It may or may not be that high, see this article:
https://ncse.ngo/just-how-many-young-earth-creationists-are-there-us
"For more evidence that the number of true young-earthers is fairly small, consider another question from the survey run by the National Science Board since the early ’80s. In that survey, about 80% consistently agree “The continents on which we live have been moving their locations for millions of years and will continue to move in the future.” Ten percent say they don’t know, leaving only about 10% rejecting continental drift over millions of years. Though young-earth creationists often latch onto continental drift as a sudden process during Noah’s flood (as a way to explain how animals could get from the Ark to separate continents), they certainly don’t think the continents moved over millions of years. This question puts a cap of about 10% on the number of committed young-earth creationists, lower even than what Bishop found. More people in the NSB science literacy survey didn’t know that the father’s genes determine the sex of a baby, thought all radioactivity came from human activities, or disagreed that the earth goes around the sun.
In short, then, the hard core of young-earth creationists represents at most one in ten Americans—maybe about 31 million people—with another quarter favoring creationism but not necessarily committed to a young earth. One or two in ten seem firmly committed to evolution, and another third leans heavily toward evolution. About a third of the public in the middle are open to evolution, but feel strongly that a god or gods must have been involved somehow, and wind up in different camps depending how a given poll is worded."
I think all of these surveys and analyses ignore cognitive dissonance and framing.
I know plenty of religious people who will agree with both "God created the earth and humans less than 6,000 years ago" *and* "The earth is billions of years old, and humans evolved over millions of years" - many would say they agree with both on the same survey, and even more would agree to either of them if asked separately.
Are these people young earth creationists? Depends on what you mean.
Also, almost all Christians say that the bible is true, and might say the account of creation is "true," but only biblical literalism says that it's "*literally* true", and even then, what literally means in this context is a bit fuzzy. And despite all of that, I strongly suspect that even most people who would say that the bible is literally true would also say that the earth is billions of years old if asked the question on a survey that was clearly not about religion, because framing.
This is Stephen Jay Gould's non-overlapping magisteria theory, isn't it?
I agree that framing is very important.
Were I taking a survey that asked "was the forbidden fruit in the Garden of Eden an apple?" and it was a plain "yes/no" answer with no room for development https://en.wikipedia.org/wiki/Forbidden_fruit, and furthermore my impression of the entire survey was "ha ha let's laugh at the knuckle-draggers who believe in gods", then I'd be "Eff you, I'm one of those knuckle-draggers and not alone was it an apple, we know for a fact it was a Cox's Orange Pippin".
Numbers have falling a little recently. However, when you include people who accept that the age of the earth is older, but also (wrongly) believe that because evolutionary theory does account for some aspect of biodiversity, design is a reasonable inference - creationism in other words - the number balloons up to 60-80% of Americans being creationists depending on how you ask the question.
Much more than that, woke ideology requires implicit belief in creationism to square the circle of "diversity" and "equality".
I wonder if this is the type of thing that you might cover in an epistemology/philosophy of statistics class. Every time I see something like this I just end up more and more confused about what kinds of reasoning is legitimate, and when does statistical evidence actually point to the conclusions that it naively says it does.
Great article, thank you! But I really wish you got the worm hypothesis advanced enough, in your view, to feel more than 50% confident that worms are a significant confounder.
Before your months late entrance into this, I recall looking up who maintained this site. Since I did that, I have associated it with the FLCCC Alliance.
Tonight, when I went to icann whois, the first auto text suggestion was for ivmmeta.com. I recall finding that it either shared a server or owner with FLCCC.
Caution, my memory may not be serving correctly:
I may have looked up information about FLCCC the same night, but I am quite sure my inquiries were at different times.
I may have connected them, because the "meta" and "C19" sites link to FLCCC.
I don't remember enough detail to give to say definitively what it was I saw that made me sure of a connection.
With the caveats out of the way, I will say I have high confidence that this site is indeed related to the Alliance.
But most alarming in my view is that there are identical sites for HCQ and Vitamin D. And the analyses appear to show similar levels of effectiveness as IVM.
I've been called both a BigPharma apologist/corporate shill and a pinko by anti-vaxers since the pandemic started. I'm certainly much closer to the latter, but it illustrates how generic heuristics can override judgement by otherwise rational people.
Great job, and awesome work for digging into this.
I am not vaccinated and I don't consider you any of those mean things. Thank you.
I have some speculations here, but a friend quite correctly pointed out it was hypocritical for me to get upset about NYT doxing me and also add useful information to the debate about who runs ivmmeta, so I'm not going to.
Fair enough. I wouldn't expect you to opine on it, nor criticize you for refraining.
I didn't want to wildly speculate, so I added the cautionary notes. I just wish I would have taken a screenshot. At the very least, I could (dis)confirm my memory with one. Then again, it's interesting trying to figure out ways I may have formed a mistaken impression.
Buried under all that is my real issue with those sites--the mirrors, the identical formats, shared servers, and anonymity all purporting to show three different treatments with similar effectiveness as an alternative to vaccines.
It screams ulterior motive or motivated reasoning to me.
Err, it's not doxxing to say that sites X and Y are run by the same person(s)? But I'm not sure how you or Kurtz would know: WHOIS does not reveal the owner of IVMMETA.COM and its About page gives no names.
This whole thing was really excellent, but it does give me an opportunity to ride one of my hobby horses:
Steinbeck's "temporarily embarrassed millionaires" quote was not an explanation for why the poor did not join the communist movement, but rather a sorta self-deprecating description of those who did. In other words, he was complaining about the champagne socialists who were in the movement, rather than aspirational workers who were not. https://en.wikiquote.org/wiki/John_Steinbeck#Disputed
Read up on "luxury beliefs" — fashionable beliefs that confer social status upon the elites who hold them, but lead to damaging consequences to those in the lower economic strata.
Thanks to you and to your horse for my new fact for the day.
Scott, I really appreciate this careful review of the data on ivermectin. While it mostly matches what I already thought about the subject, it presents it much more clearly and carefully than anywhere else I have seen.
Which is why I'm so baffled that you are so confident that the covid vaccines are safe and effective that you don't even feel the need to present an analysis of the studies on the subject, and instead went with this analogy about aliens. Even though the Pfizer study to get FDA approval was just shown to be partially based on falsified data, and the all cause mortality was higher in the vaccine arm than the placebo arm. Even though the trial for children 5-11 did not show any clinical benefit at all (because no one had any serious outcomes in either arm). Even though no one has demonstrated any population level association between vaccination rate in a state or country and covid rate.
I really, truly wish I was as convinced as you seem to be that the vaccines are safe and effective. But it doesn't match my personal experience, and what I'm seeing in the world around me. I know that one shouldn't base one's epistemology on personal anecdotes, but I haven't found the studies on this subject nearly as reassuring as I would have hoped. I see everyone dismissing the sudden spike in VAERS reports because causation can't be proven--but why would the rate of reports suddenly increase so much compared to previous vaccines? All the papers I've seen about VAERS prior to covid suggest that it almost certainly underreports the true rate of adverse events from vaccines rather than overreporting them.
I know it's a huge, probably impossible ask, but if you could find the time to try to dig into this subject, I would be truly, deeply grateful. I want to be convinced, and I believe that I can be convinced that the vaccines are safe and effective (I actually am vaccinated, but based on the research I have done since then, I regret it and don't want to get the booster). I see vaccine denialists making obvious errors and exaggerations, but I also see them pointing out what seem to me to be serious flaws and shortcomings in the studies supporting vaccination. I'm not saying I think the vaccines are definitely unsafe/ineffective, but especially for young healthy people who are at low risk for covid, I'm not seeing the convincing case that getting vaccinated is statically a good idea that I would like to see, especially considering the many places that are now mandating them.
This is the ask I am also looking for, and hundreds (if not thousands) of Scott's readers and those influenced by him would also benefit from.
I have yet to find anyone willing to do this type of analysis once they've taken the shot. In my experience, it is the level of cognitive dissonance, being excluded from society, and the strong affect that being labeled "conspiracist" or "anti-vax" has that stops them from doing this work. I hope Scott would not be susceptible to that and willing to dig deeper.
I don't think I've ever seen anyone claim that we should vaccinate children to protect them; I'd presume we'd vaccinate children to protect their parents and grandparents. So the only relevant criterion would seem to be infectiousness.
How about polio vaccines? Children are still routinely immunized against polio, and last year there were about 150 cases of polio worldwide, all of them in Afghanistan and Pakistan. I would say the odds that a random American kid will get polio are far lower than the odds that he'll get a serious (life-threatening) case of COVID.
Children are not routinely immunized against polio because of speculative benefit for others, they are routinely immunized against polio because of a known benefit to the children themselves. Children can die from polio, and the vaccine does lower the chances of that happening. Known and proven benefit, to the child being vaccinated. The fact that the odds of that benefit proving useful are very small does not mean it is speculative, or that it is intended to benefit someone else.
I've heard lots of people claim the risk of COVID being "unknown" is a lot worse and scary than the risk of the vaccine, so the children's health was better off with this Uber-safe vaccine (which we supposedly have oodles of safety data for children on).
This reminds me of Scott's posts about masking. If we didn't have any data on this question, which risk is more plausibly concerning? It seems like we have almost no cases of modern vaccines endangering a child who is not immunocompromised, whereas you can probably find case studies for most infectious diseases in which they created serious comorbidities when striking young children.
Sure that’s a reasonable prior if you or your child is deciding whether to a get a new and insufficiently tested vaccine that might or might not help you avoid getting covid. It’s not a reasonable foundation from which you should try to force literally every person in the world to get the vaccine. I agreed with your prior. I got vaccinated. Since then pretty much all the data that has come out has caused me to update away from the vaccines being safe and effective. I don’t think the VAERS reports can or should be handwaved away. And even if the adverse reactions aren’t as bad as I think, the complete lack of evidence that the vaccines reduce transmission on a population level would be enough to make me think mass vaccination is not a good idea.
I’m not wedded to these beliefs. There is some evidence that vaccination is helpful, such as reduced rates of death from covid in the vaccinated. But the results on all cause mortality, which is what we really care about, are much more mixed. And more importantly, I haven’t seen anyone on the pro-vaccine side engage in good faith with what seem to me like pretty important criticisms of the vaccines. That’s why I would so much like to see a post on this by Scott, because I know that whatever his conclusion, it would be an honest effort to synthesize all the evidence, something I can’t find literally anywhere else.
I like this example, however I think it breaks down in the analogy of comparing this COVID-19 vaccine(s) to a modern vaccine. This vaccine does not have a comparable profile nor the decades of safety data of modern vaccines. I see this analogy made quite often, as thought its common belief ("comeone everyone knows vaccines are the safest thing in the world don't you know!") but where did this belief come from? What makes this vaccine comparable to modern vaccines besides the label that people use (call it a vaccine) and that you inject it into your arm?
This also why we vaccinate for chickenpox. Mostly harmless in children but much riskier for adults. We’ve never had more than 600 deaths from chickenpox in a year, but nonetheless it’s required in all 50 states. Measles, too, has never killed more than 1,000 per year in the states.
Tangentially, it's been speculated (with some evidence) that the chickenpox vaccine helps reduce the risk of shingles later in life
I never got chicken pox as a kid, now each year I ask myself: "do I get the vaccine this year, or do I hold out another year for a dead-virus version."
"In 1912, measles became a nationally notifiable disease in the United States, requiring U.S. healthcare providers and laboratories to report all diagnosed cases. In the first decade of reporting, an average of 6,000 measles-related deaths were reported each year." (https://www.cdc.gov/measles/about/history.html)
This would be a much more compelling argument if there was any evidence that mass vaccination reduced covid transmission. While it seems like intuitively it must do something, studies have mostly shown no correlation between a location’s vaccination rate and covid cases, and some have even shown a slight positive association.
There’s tons of evidence that vaccination dramatically lowers risk of ending up in the hospital. I live in an area with low vaccination rates and our ICUs were overwhelmed with Delta, so much that they had to hire hundreds of temporary health workers from out of state. Those same hospitals were actually loaning people to New York and NEw Jersey when the first wave hit.
How does that relate to vaccinating children, who overwhelmingly do not suffer significant consequences of COVID and almost never end up in the hospital, vaccinated or not?
It lowers risk of hospitalization...for adults. It doesn't lower it for children because they were already not at risk of hospitalization for covid. And it doesn't prevent children from transmitting covid to adults because it doesn't prevent transmission.
I would claim that. I vaccinate my kids against the flu, and that's a much less effective vaccine and a much less dangerous disease. What's the case for getting your kids a flu shot not a covid shot?
Besides, covid is both not particularly dangerous to kids and the number ten cause of child mortality, because nothing that we allow in our society is particularly dangerous to kids. This lets me remove (or at least dramatically mitigate) one risk from my kids lives. A remote risk, to be sure, but nonetheless one I'm glad to take off the board. I'd be happier to take the leaders off the board, but I can't get rid of cars or guns or cancer. Some of the other leaders I've worked pretty hard on. Drowning by making sure they can swim, and drugs and suicide by trying to raise them well and making as sure as I can that lines of communication are open between us and them. We do what we can do. This is something we can do, and it's a clear win in terms of their welfare.
I think any conscientious parent would get their kids vaccinated for their own sakes, quite aside from societal benefits. I'm not actually clear on the case against.
The case against is that there is some evidence that the vaccine increases your kids’ risk of dying from a heart attack or stroke more than it decreases their risk of dying of covid. The risk is still not high, but as you point out, it doesn’t need to be to exceed the risk from covid. Because we’re talking about such a small signal, the government would need to do very careful monitoring to detect it, monitoring that they’re not doing. The (highly imperfect) data we have suggests the covid vaccine is much more dangerous than the flu shot (and contrary to what you said, the flu is known to be much more dangerous to children than covid). Instead of trying to gather better data on the matter, health authorities have just said “Well, the data we have is imperfect, so we’ll just ignore it and keep saying it’s probably safe.”
Flu is probably more serious than COVID in younger children. But among the 5-11 age group neither is vary dangerous. That said it's unlikely the vaccine carries much of any risk either.
Also note the difference between a mandate, and an option. I don't know anyone who is against parents having the option to vaccinate their kids against COVID.
>and a much less dangerous disease
No, the flu is a much MORE dangerous disease for children than COVID is. The fact that media bullshit has become so prevalent that the majority of people think COVID is dangerous to children is both amazing and soul crushing. We are doomed.
>I'm not actually clear on the case against.
The known risk of serious side effects or death from the vaccines are higher than the risk of serious illness or death from COVID in children. This is pretty much the most basic and obvious simple probability decision one could be faced with.
You are wrong. More children have died from COVID this year than from flu. And long term negative side effects are way worse from covid. Including almost x10 chance of myocarditis compared to vaccine.
And their teachers, and school bus drivers, and neighbors, and non-parental caregivers... Now, it also seems to be the case that even when infected, children do not transmit the disease as readily as adults or (especially) adolescents, so you can still question the rationale and ethics of vaccinating little kids to protect others if the effect is small. But small children actually have pretty extensive networks of contacts, and they often include high-risk people.
Well, that's not even Medical Ethics 101. If that were true, we would never do organ transplants.
But apart from that, let me be clear that I am not a libertarian, not at all. I do not want to live in a world where people have no obligation to protect their communities unless it is in their personal interest to do so. I'm not persuaded, though my mind is open to revised information, that the community benefit from vaccinating little kids is large enough to warrant making it obligatory. But for adolescents and adults, I think it is a moral obligation to get vaccinated against Covid-19 unless you have a medical contraindication even though for the youngest among them, the personal benefit is very small.
How about treating pregnant women who test positive for Group B strep with antibiotics during delivery? This is done solely for the benefit of the baby, since it's endemic (and harmless) in the adult.
https://www.acog.org/womens-health/faqs/group-b-strep-and-pregnancy
Having dead parents is a significant medical detriment.
Though really, children die of COVID too, and more importantly, get disabled.
We are literally saying this, because it is true.
First off, a lot of children ARE dying of COVID - more and more over time. The deadliness of the disease in children is probably higher now than it was with the original strain.
Secondly, COVID causes significant long-term side effects in an appreciable number of people.
1) That's 605 confirmed cases. The actual count is larger.
2) Far less than half of under 18s have had COVID - probably less than 20%. It's amazing how you scream at me about "lack of data" but then make up a fraudulent number as a basis for your argument.
3) https://pubmed.ncbi.nlm.nih.gov/34719599/#:~:text=Among%20them%2C%20495%20(40.1%25),%2Donset%20of%20COVID%2D19. would be an obvious example and one of the first Google results.
Post-COVID syndrome is well established at this point, and seems to affect somewhere in the realm of 5-10% of people. It's quite common.
People just are in denial about it because it means that they were wrong about everything and were downplaying a very serious disease. They aren't stable geniuses after all.
Without numbers this is just spreading fear which itself can contribute to ill health. How many otherwise healthy children, ie children that would not be in mortal danger from any other infection, have died from COVID in total? How many would have died from the flu in the same time frame?
Hundreds of children without such factors have died. Here would be an example:
https://www.cnn.com/2021/10/04/us/va-child-death-covid-trnd/index.html
People just go into denial about it because they don't want to admit that they were wrong.
And somewhere around 5-10% of people who get COVID suffer long-term problems from post-COVID syndrome. It seems to be modestly lower in children, but it still shows up in them fairly frequently.
How many 85 year olds do we need to "save" from death by COVID so they can instead die 3 weeks later from pneumonia or influenza or heart failure, in order to justify killing one 6 year old?
Unvaccinated children are more likely to die, too. As are their teachers. And their parents.
That is a red herring. Answer the question. If you want to justify forcing a dangerous vaccine onto children, knowing it will kill some number of them, in order to slightly prolong the life already dying elderly people, then you need to quantify the value of those lives. Unvaccinated healthy children have a zero risk. None have died. Zero. Morbid obesity is a co-morbidity. Morbidly obese children are not healthy. Those teachers and parents are welcome to vaccinate themselves if they are worried. You do not force innocent children to take dangerous vaccines because you are worried about yourself, YOU take the dangerous vaccine. It is highly effective at preventing death, remember? So why do you keep dishonestly acting like everyone else needs to get vaccinated as if your vaccine won't work to protect you? If you taking the vaccine doesn't protect you, then why would anyone else get it to protect you? That is absurd.
Isn't VAERS self reported? If people have a lot more concern about this vaccine, AND all of that concern is unfounded, wouldn't you still expect to see a spike in self reports which misattribute random issues to vaccines? It would also be true in that case that VAERS might go from underreporting to overreporting problems.
Any future investigations into VAERS might deploy an RCT design where half of participants are given a placebo and allowed to self report their side effects regardless... mostly joking.
I'll also bring out the big gun here: even if I was convinced that the most plausible accounts of coronavax side effects were true, they seem mostly minor. For the vast majority of people, and for society at large, there's no question that the vaccines are net life and QoL preserving, even if we accepted the marginal claim about side effects. This is of course hypothetical because there doesn't seem to be either good mechanisms or solid evidence behind any side effects claims.
VAERS is doctor reportet and the CDC itself says that the main problem with it is underreporting. Dimissing the huge VAERS spike in deaths as antivaxxers trolling is steping into the realm of hermetically sealed circular reasoning. It's also literally a conspiracy theory about a global conspiracy to fake high numbers of adverse events into various reporting systems like yellow card, UK and PEI, Germany.
I didn't say it was antivaxxers trolling. The most likely cause is genuine concern and worry. It isn't hard to imagine that people could wrongly attribute health problems that would've emerged regardless to a vaccine that they have mixed feelings on. The vaccine is being rolled out at scale in an unprecedented way with a very particular media environment around it so I don't think you can take the change in reporting as anything but a several confounded measure.
Look at ivermectin or any of the other drugs we've failed to prove help covid. They get studied because a doctor gives them to patients, the patients feel better, and the doctor notices. Without blinding, randomization, and large sample sizes we can't tell if "some doctors/patients say they have a good/bad feeling about this" is signal or pure noise.
At the very least, you ought to concede that it's plausible that the change in reporting could happen without changes in the rate of actual negative vaccine reactions. I'm not saying that's definitively true, but if you can't dismiss the possibility of a null result then your evidence isn't very solid.
Yes, I concede that it's plausible that VAERS could be overreported due to the unusual attention given to the covid vaccine and covid in general. I would also like you to concede that it's plausible that VAERS could be even more underreported than usual due to the unprecedented push by public health authorities to get everyone vaccinated, including suppressing too much discussion of adverse events and calling anyone who questions the safety of the vaccines a peddler of misinformation. I don't concede that your hypothesis is the default hypothesis and mine is something that would be extremely surprising (I think the default hypothesis is that VAERS has the same amount of underreporting as usual). I would very much like to see some serious investigation of the matted to find out what is actually the case instead of apparently just ignoring the whole thing.
Note that the same issue applies to estimates of long-Covid.
"VAERS accepts reports of adverse events and reactions that occur following vaccination. Healthcare providers, vaccine manufacturers, and the public can submit reports to the system. "
It includes self reports.
Would you therefore agree that any sub-population that does not have a net life and QoL gain would be reasonable to conclude that the vaccine is optional and not a big deal?
Would you also agree that if there were some concern of side effects, and the net QoL gain from the vaccine were small enough, that it may actually make sense to avoid the vaccine? Children have such a small rate of serious complications from COVID that even a very small rate of side effects would mean that taking the vaccine reduces QoL.
For sure. I don't think kids are that important of a subgroup to worry about in terms of controlling the coronavirus, especially since we've moved away from a zero covid approach. I think both of your arguments are reasonable in form and would be true if they had true premises. But there aren't good reasons to think there are meaningful side effects, so these arguments don't apply.
Why have Sweden and other countries stopped giving Moderna to under-30s if there aren't good reasons to think there are meaningful side effects?
My understanding of the side effects are that they are very real, but quite rare. [Some argue less rare than we think, but it sounds quite speculative to me. I haven't seen any claims at all that there are zero side effects.] There are some who don't recommend giving the vaccine to young men, particularly teenagers, because the cardiac complications show up primarily in that group and they gain far less from being vaccinated than older individuals. The case for children getting vaccinated is worse in that regard, because the hospitalization/fatality rate among children is so low than even a nearly non-existent side effect can still be the same or higher than the actual effects of COVID.
For context, the way VAERS is *supposed* to work is that **every** adverse event that occurs within `n` days (14 IIRC) of being vaccinated must be reported (there is allegedly a legal obligation to report). This means if you get a vaccine and then die from a gunshot wound to the head 6 days later you **must** report that to VAERS.
The system, as designed, is intentionally meant to avoid individual physicians trying to determine causality. Every event "must" be reported regardless of how obviously not-vaccine-related it is, and then statisticians presumably will analyze the data in aggregate afterwards and compare it against background expected death rates or population comparable death rates and look for signals of unexpectedly elevated levels of specific events.
As an example of why physicians determining causality is a bad idea, one can imagine vaccines causing mental instability that leads to suicide. Individual physicians would almost certainly assert that "the vaccine didn't cause suicide, so I shouldn't report it", but when looking at population level statistics one might notice a sharp rise in suicides among vaccine recipients and that would signal that we (society) should investigate the issue further to determine if there is a causal link or not.
It was easy enough to find the CDC statement "FDA requires healthcare providers to report any death after COVID-19 vaccination to VAERS," but I couldn't find the timeframe so I'm curious where you saw 14 days.
Yeah, I tried to find a reference after writing this post and was unable to find the 14 days either. I have a similar comment to this elsewhere in this mega-tree discussion where I believe I corrected my claim. I didn't reply here because this particular branch looked like it was a dead end while the other had more engagement.
I'm unvaccinated ( But am keeping an open mind ), and agree with all of the points you raised. These are issues that are hard to ignore, or at least difficult to explain away. Would be interested in hearing the other side of the argument though.
Just throwing my vote out there to see a similar dual steel man and analysis of the "vaccines are safe and effective" argument.
After reading this article (the entire thing) I walked away thoroughly convinced that the author is someone who understands nuance, the scientific method, the concept of spectrums and grey, trade-offs, and how to identify low quality science and confounding variables. However, this leaves me confused how such a person could look at the totality of evidence related to the vaccines and walk away with what sounds like near total conviction that the vaccines are "safe and effective". When I look at the totality of evidence I walk away about as confused and uncertain as I think I could possibly be on the matter, and this is after a lot of digging and with some understanding of the biology behind vaccines (including delivery methods).
I think my personal confidence in the safety and efficacy of the vaccines comes from living in the UK, where we have very good data on all cause mortality and morbidity on a population level. We have given 50m first doses, 46m second doses and 13m booster shots.
We know from data released weekly that Yellow Card (our version of VAERS) reporting is between 3-6 reports per 1000 cases, and that most of these are mild symptoms like a temperature or sore arm following a dose. These would be expected at a rate of 1 in 10 anyway given the vaccine trial data.
Anaphylaxis in very, very rare situations following the vaccine itself was quickly identified as a problem from this data. It's enormously rare (256 cases/109m doses) but precautions were quickly taken to ensure that any severe issues were mitigated – this by introducing a waiting period.
Bells Palsy was identified as a possible side-effect, but it's not actually occurring within the population at a higher rate than would be expected normally.
The big one was clotting with the Astrazeneca vaccine, which occurred at a rate of about 1.9 cases per million doses. The population was of course at more risk of clotting by catching coronavirus itself which everyone would have done without a vaccine. This was mitigated by only giving at risk groups other brands of vaccine. Still incredibly rare, but did lead to a small number of deaths.
About 1,000 cases of myocarditis and pericarditis have been reported to the MHRA, causing 5 deaths. For some reason Moderna has 7x as much risk of this as Pfizer and Moderna.
Basically it comes down to the fact that you have about a 26 in a million chance of dying in a car crash in any given year in the UK. The risk of dying as a result of taking the vaccine are in the region of 1 in a million. So a 26th of the chance of driving in a car, which people do all the time without thinking twice about it.
I think most people would describe a Honda Accord as safe and effective at getting you from A to B, if a little uninspiring. Pretty much any Covid vaccine is 25x safer, especially given the death rates pre-vaccine from catching a disease that essentially everyone would have got.
20-49 yo's had a death rate of 1 in 300, (remember, vs 1 in a million for vaccine complications), 1 in 72 people aged 50-59 died, 1 in 27 aged 60-69, 1 in 12 for 70-79, and 1 in 7 over 80s.
Vaccines *are* "safe and effective", as long as you give them the right context, which is the emergence of a pandemic which would have a much, much, much higher chance of killing me.
As far as I can tell, having an allergic reaction to the vaccine is the big danger with it--that can kill you. It's very rare, but you don't want to be far from medical help (or at least an epi-pen) if it happens!
Otherwise, it seems like all the vaccine side effects reported are less bad than the effects of getting covid.
That's true, but the alternative to vaccination isn't getting Covid, it's a risk of getting it — although, as things are looking, it may be a high risk. And vaccination doesn't eliminate the risk, it only reduces it.
Your Honda comparison isn't quite right, because those are per year death rates, not per trip death rates. One vaccination is (much) safer than three hundred trips (or however many the average UK resident makes in a year).
Endorsed on all counts.
Honestly, I feel like a lot of the VAERS spike comes down to two things. 1) A lot more people are being vaccinated for this than for other things, and 2) People are actually being told about VAERS and to report any adverse effects.
Addressing the second point first, my second Pfizer shot hit me about as hard as the worst night of my smallpox vaccine. For the Covid vaccine, I had a handy-dandy piece of paper giving me a website I could have reported the fever and chills etc.; for my smallpox vaccine, I didn't even know VAERS existed. I was certainly never told about it when getting yearly flu shots. I would be willing to bet hundreds of dollars that at least part of the increase is being driven by increased awareness of VAERS.
As for the increased number of vaccines, let's again compare smallpox and Covid. VAERS reports 36 cases of "Body Temperature Increased" for smallpox adverse reactions. Since 1990 when they started collecting data. I can give you arbitrarily high confidence that more than 36 such cases have occurred in the last 31 years. That's a rate of basically one fever per year, which is unrealistically low. For Covid, they have 6,685 such cases in what, just over a year? NPR says that 195,000,000 Americans have been fully vaccinated, so if we think that VAERS is being remotely accurate we would conclude that something like. .003% of fully vaccinated Americans got a fever? But I'm pretty sure it's higher than that.
So I'm not saying that people are over-reporting to VAERS. I'm saying that more people are being vaccinated and they are *under-reporting less* than they have for other vaccines. If you combine those two things that I feel are fairly obvious, it goes a long way to explaining the influx of VAERS reports.
All of these claims have been made numerous times, and been relatively soundly argued against or integrated into the "vaccine may not be safe" arguments. This is why I want to see an in depth analysis like what was done here for ivermectin, that first tries to deeply understand the specific claims being made and then argue against them clearly. There is a lot of debate happening in comment sections (like here), but I think the world would get far more value from a deep analysis with strong steel man positions being setup and then torn down rather than people arguing against straw men.
To go against what I just said, I'll give you a bit of a debate here in the comments since I don't want to come off as entirely dismissive.
The TL;DR is that either VAERS is not a useful tool for detecting adverse events in the wild because we cannot know the underreporting factor (due to many confounding variables as you have suggested here), in which case we cannot know whether the vaccine is safe because we have no good data, or the VAERS data can be used by applying an underreporting factor using reasonable and (ideally) previously agreed upon heuristics (which do exist), in which case there is a strong danger signal coming out of VAERS that should cause everyone to pause until it is investigated much more deeply.
I am willing to accept either of those positions as reasonable, but I haven't seen any strong arguments for "the vaccine is safe", and this is what I want to see.
The CDC (or maybe it was the FDA) seems to assert an underreporting factor of 1 (meaning 100% reporting compliance), but provides no evidence for why one should believe that and we have some pretty strong evidence that it is definitely not 1. Of course, someone can come up with an underreporting factor that is greater than 1 and still shows the vaccines as safe, and then they can derive a plausible way to get that underreporting factor (using the line of thinking you have above), but that feels very much like p-hacking or adjusting the endpoint of a study or deciding on grouping/analysis methods after you have the results (which as stated numerous times in this article is bad).
If you use the "official"/previously agreed on methodology for calculating the URF, then you get a strong signal for "COVID-19 vaccines are dangerous". This doesn't mean they *are* dangerous, but it does mean the alarm bell is going off loudly in our signaling system and we are saying "eh, we can't really trust the signaling system so let's just pretend like the alarm isn't going off and say that vaccines are safe".
I guess we should start by defining our terms. What are we counting as safe versus dangerous? I think my cutoff for safety would be something like "If properly administered, unlikely to cause life-threatening conditions or chronic adverse responses." I'd be willing to take input on a better definition (as well as a good % cutoff for "unlikely").
I think that is a reasonable definition of "safe".
To make a blanket statement about safety I would want the % to be on the order of 0.0001% or lower I think, beyond that I think it becomes "safety is relative to its benefit" so things become significantly more complicated. Eating salad is blanketly safe. Drinking water is blanketly safe. Traveling by car is not blanketly safe, but it is safe relative to its benefits in many (most?) contexts.
Coming back to this comment after actually browsing the VAERS data for a while. I'm curious what you think the VAERS data shows in regards to Covid vaccine safety (or lack thereof). Specifically, do you think the signal is the mere volume of reported adverse effects, or some specific subset of them?
The signal is the significant increase in severe adverse events after accounting for the underreporting factor (URF) when using the standard mechanism for calculating the URF.
Again, I want to reiterate (so it doesn't get lost in discussion) that I accept "we have no functional monitoring system for vaccine safety" as a very reasonable position to hold. The *only* position I am opposed to (at the moment) is that we have good statistical evidence of vaccine safety.
There is a lot of debate around whether the standard mechanism for calculating URF is reasonable or not and the arguments that it is not reasonable are sound IMO. What is fairly unacceptable to me is to construct an alternative method for calculating URF post-hoc, since in my experience those new measures always seem to magically come out in favor of whatever position the author holds prior to constructing the new analysis method (this is true for both camps).
You can find this data quite easily on your own, without Scott.
Just looking at hospitalization data, vaccinated people are vastly less likely to be hospitalized and vastly less likely to die.
You are vastly less likely to be hospitalized and die *from covid*. I don’t dispute this. But for those whose risk of serious outcomes from covid was already very low to begin with, even a fairly low risk of adverse events from the vaccine could lead to more total deaths among those who got the vaccine than those who didn’t. There is no good data on this, but there are some concerning signals from the clinical trials and VAERS that are not being properly addressed.
You're actually less likely to die of all causes PERIOD.
People who get vaccinated are not only less likely to die of COVID, they're less likely to die of literally anything.
https://www.cdc.gov/mmwr/volumes/70/wr/mm7043e2.htm?s_cid=mm7043e2_w
Why this is true is unclear, though my personal guess is that people who get vaccinated are probably more intelligent and more conscientious in general.
Your personal guess suggests you may be a midwit. Both high and low IQ, and high and low educational attainment are strongly correlated with "COVID vaccine hesitancy". It is precisely those who are smart enough to know they aren't dumb, but not smart enough to actually understand the issues they are faced with who are most likely to conform to the arbitrary and baseless demands of authority figures they perceive as being on "their team".
https://www.medrxiv.org/content/10.1101/2021.07.20.21260795v1
People are less likely to be hospitalized or die of covid if you shoot them in the face too, that doesn't make it safe.
"but why would the rate of reports suddenly increase so much compared to previous vaccines?"
It's a passive reporting system. More people are aware it exists, and more people are aware that we need to figure out any rare side effects, so more people report adverse events.
https://twitter.com/AviBittMD/status/1460855430805180421
Thanks!
I realized there was some confusion and people thought I originated this hypothesis (or was stealing it from you), so I've tried to credit you more conspicuously in the piece. Thanks for everything you do!
No my issue is not that you didn't give me credit. My issue is that you're using my outdated analysis (really a back of the envelope analysis) which is susceptible to some critiques. I am offering you a formal analysis which is not susceptible to the critiques raised by others in the comments here.
This is the full list of trials after excluding Elgazzar and Niaee (with are likely either fraudulent if not randomization failure)
https://twitter.com/AviBittMD/status/1461076939192602628
And here is the sensitivity analysis excluding trials with improper randomization protocols:
https://twitter.com/AviBittMD/status/1460989019060379648
Use these Scott. Not the half-baked idea I had when I started testing this hypothesis. The above are much more robust analyses.
May I ask you to publish peer-review? I would feel more confortable if your very interesting analysis is checked by experts.
"Putting aside the question of accuracy and grading only on presentation and scale, this is the most impressive act of science communication I have ever seen." -- surely something that can make you confident that you have learned something true when in fact you have learned something false is *bad* science communication even if the information is accurate, right? One takeaway from this post seems to be that this kind of chart isn't a good way to communicate science even when the underlying claim is true, because it provides a false sense of confidence and promotes a common misunderstanding of how progress in science actually works ("just take all the effect sizes from the papers and put them together without stopping to understand all the underlying science / which papers you can trust / what sorts of evidence experts are used to seeing for claims that turned out to be false /etc.)
"Can something have a p-value less than 0.001 and still be a fluke?"
Yes of course!! P-values only measure the probability of flukes under the null hypothesis assuming everything went exactly according to plan. But there are lots of boring flukes (a table got mixed up somewhere in the data entry process, the randomization got screwed up in a way the balance tests missed, a doctor felt bad that these patients were on a deworming drug for a virus and slipped them antivirals, etc.) that are unlikely but not "literally one in a thousand" unlikely.
I think he means "effective" in the sense of "it seems convincing" rather than "gives accurate conclusions". In the same way an advert is effective
I imagine part of the reason real public health messaging is less effective is the requirement to include various caveats for accuracy
I can't remember which it was, but when looking at all the trials about this, one at least of them had a correction that was along the lines of "ooops, yeah, one of our control groups wasn't because they got given the same combination of medication until we found out".
So mistakes do happen.
Scott, and anyone else, what makes you so confident in the COVID-19 vaccines? Have any of you looked at the data for them after the past year?
Under the "Political Takeaway" section, you write this:
"But the basic issue - that the vaccine works really well and is incredibly safe for adults - seems beyond question. Yet people keep questioning it."
I'd love to stop questioning it, really, but I can't see the raw data. And neither can you. As a fellow human, the aliens have all this sophisticated and powerful technology, and a year+ of data of the new tech being used "successfully", however they won't share it. They've locked it all up in vaults that only their peers can access, and whenever I ask for where I can go to view the data, they refer me to VAERS (an unreliable, under-reported and discredited database). They then go on to discredit it themselves and assert their belief of how only they can ever really know what the data means.
Case and death rates in countries/stayes with different vaccination rates are pretty easy to find, if you don't trust the studies that have been published around the vaccines.
Looking at those, the obvious conclusion is that vaccination is effective against death but not against infection — the patterns look similar to those before vaccination.
It may even be true, since vaccinated people have less reason to take precautions.
Be careful. A major confounder is that the vaccines were built against alpha, but it's delta that's dominant in the latest surge, and delta is inherently way more infectious. Comparing novax/alpha rates to vax/delta rates is a bit apples and oranges, alas.
But comparing low vax rate countries to high vate rate countries at the same time and seeing no statistically significant difference in cases, only in deaths, is apples to apples. And confirms what we've known all along, but many people have tried to pretend we haven't, that the vaccines are leaky, and have never been intended to, claimed to, or tested for, preventing transmission. People do not want to admit this, because then it would also be obvious how irresponsible and immoral pushing it in the middle of an outbreak was. That is precisely WHY there is a delta variant. If you keep transmission, but reduce symptoms, you are removing the natural evolutionary pressure towards lower lethality, so instead you get mareks.
You have gone pretty hard against cluster randomised trials!
"This was “cluster randomized”, which means they randomize different health centers to either give the experimental drug or not. This is worse than regular randomization, because there could be differences between these health centers (eg one might have better doctors who otherwise give better treatment, one might be in the poor part of town and have sicker patients, etc)."
The same argument could be made against individual based randomisation, eg "there could be differences between these individuals (eg one might have chronic diabetes and do poorly, one might be in excellent health and do well)".
Cluster randomisation and individual randomisation are basically the same except that the denominator in a cluster randomised trial is not the number of individuals but the number of clusters (the unit of randomisation).
There are situations where doing cluster randomisation *is* the best thing to do, for example when you think there could be interactions between individuals in the clusters (the example I have in mind in mass drug administration for an infectious disease, give it to a whole village - the cluster - and you can wipe it out, whereas if you give it to individuals at random they can then re-infect each other).
In Scott's defence, he wrote, rRCTs are never a _great_ idea. I think he implied that a cRCT is not a good idea if individual randomization is possible. Which seems to be the case here.
Related to this: I immediately updated my lecture slides on cRCT to include "If you’re going to do cRCT (...), you should be using some extremely objective endpoint that doctors and clinic administrators can’t possibly affect, like viral load according to some third-party laboratory, using the same third-party laboratory for both clinics". Hence, hospital discharge, as it has been used in the study under consideration, is not a good endpoint for a cRCT.
I think the issue is that cluster randomization will multiply the effects by the number of patients in each cluster. E.g., if 100 patients are in a crappy hospital where everyone gets sick, and that hospital is randomly assigned to the control group, then you'll see 100 control patients get really sick, which is a big number that could swamp any smaller effect you're measuring.
If you're using the # of clusters as the denominator then it should still even out (it'll just be a really small sample size), but unless I'm misunderstanding, the meta-analysis added up the number of patients in each study, not the number of clusters.
yeah but that's just the wrong thing way to analyse the data - doesn't mean that the study design itself is bad!
If you have 10 clusters of 100 people and do a cRCT, you have 10 data points instead of 1000 data points. It is hard to get statistical significance with 10 data points.
So correcting the analysis might not solve the problem.
Couldn't agree more on summary point #3.
Somewhat related story: for a class I was messing around with data from the COVID-19 School Data Hub and found out that their preliminary write-up on Virginia (https://www.covidschooldatahub.com/preliminary_research) had a pretty big flaw. Emailed the researchers and they said I was probably right!
Essentially it's Occam's Razor (paraphrased): stupid mistakes are much more common than conspiracies or manipulation
Any one manipulation is, prima facie, quite implausible. Sometime around the 20th or 30th one you notice, your priors should have shifted somewhat: https://www.tabletmag.com/sections/news/articles/vaccines-konstantin-kisin
More specifically Hanlon's razor "never attribute to malice that which is adequately explained by stupidity". https://en.m.wikipedia.org/wiki/Hanlon%2527s_razor
That's it! Thank you
Big Parasitic Worm strikes again!
I thought it was a really good article! As a lay person, getting to go inside of the mind of someone with a more trained eye for evaluating scientific papers was helpful.
I will say that your comment "half of Americans are young-earth creationists" (I assume you are talking about Christians in general?), while possibly true but also feels like a straw man, may also breed the same mistrust to certain readers as in your analogy of the humans to the hostile aliens. It kind of cheapens what was one of the main points of your article (or as I read it): Don't talk down to people.
He's not talking about Christians in general, the number for that is around 70% for that. (https://www.pewforum.org/religious-landscape-study)
Creationists, at least in 2017, came in at 38% (https://news.gallup.com/poll/210956/belief-creationist-view-humans-new-low.aspx). While not quite half, he's using it to illustrate the point that him not knowing any is statistically unlikely to happen purely by chance.
I honestly distrust such results about Christians and creationism because I have no idea how the surveys phrase such a question, and what they think they mean by it, and what the respondents think they mean by it, and what the survey takers think the respondents mean.
E.g. "Survey wants to find out how many Young Earth Creationists are out there"
Sample 1: Do you believe humans were created by God?
Sample 2: Do you believe the Earth was created 6,000 years ago and humans were created in their current form then?
Sample 3: Do you believe God created the Universe?
Question 2 is the one that will get you the Young Earth Creationists (most probably). But if you, the survey-taker, think that questions 1 and 3 are *also* measuring Young Earth Creationists, you're wrong.
I would answer "Yes" to Question 3, "Yes but see the Catholic view on this https://en.wikipedia.org/wiki/Evolution_and_the_Catholic_Church" for Question 1, and "No" for Question 2.
But if the survey-takers aren't careful as to what they mean/think they mean/think the respondents mean, I get lumped in with Young Earth Creationists. Because everyone who believes in (Christian) God is a Biblical literalist, right?
Wrong.
Certain polling firms like PPP will ask ridiculous questions that have some political or ideological tilt to them and get above 30% of people in support. I swear if you asked people whether Joe Biden was Muslim you'd see at least 30% of people say yes. Survey respondents are usually answering based on what answer they think fits the "team" that they're on.
The whole point of the term "young-earth creationists" over "creationists" is that 6000 year part! Missing that is a big deal!
Also, how many people asked a question about some weird thing they never think about that's strongly associated with their tribe are trying to give you an answer based on their careful thinking through of the question?
They did publish which question they used in the poll though. In this case, it was "Which of the following statements comes closest to your views on the origin and development of human beings? 1) Human beings developed over millions of years, but God guided this process; 2) Human beings developed over millions of years, but God had no part in this process; 3) God created man in present form", of which 38% replied 3. It seems your answer might be 1, in which case you wouldn't be lumped with them.
You can still attack it of course by pointing out that option 3 doesn't strictly include the young earth part, or by saying that there could be sampling bias (eg it was conducted with telephone interviews). Or by bringing up that people behave wildly inconsistently on polls.
The funny thing is, in 2009 there was a [poll](https://ncse.ngo/americans-scientific-knowledge-and-beliefs-about-human-evolution-year-darwin) with a bunch of true/false questions. For "God created the universe, the earth, the sun, moon, stars, plants, animals, and the first two people within the past 10 000 years", 39% said true. For "The earth is less than 10 000 years old", 18% did. (And 60% for "All people are descendants of one man and one woman — Adam and Eve"!) So uh, yay polls!
Option 3 doesn't just fail to strictly include the young earth part, it doesn't even imply or suggest it. If someone believes God created the earth billions or years ago, and man in present form a million years ago, this would label them a "young earth creationist", which they clearly are not. For a claim that is so specific and easily defined, posing "which is closest to your belief" questions can only be deliberately trying to skew the results. If they wanted an accurate result, they would simply ask "do you believe God created the earth 6000 years ago?".
You can also ask a question that doesn't target religion but does test belief, for example "have continents been moving around for millions of years?" I gather that gets a "yes" from most people, inconsistent with the YEC results. Which suggests the YEC question is being interpreted as "are you loyal to your tribe" not "what do you actually believe"
I think it's worth mentioning that helminths are a bigger problem in the US, particularly the South, than is commonly known. Enough so that it could be a relevant factor in studies here, IMO.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847297/
Great post! every time I see work like yours, my faith in humanity increases. Taking such a deep dive in such a divisive and already not-so-relevant topic (given availability of actually working therapeutics like dexamethasone and fluxovamine, not to mention new Pfizer and Merck drugs) just for the sake of getting things straight - that's admirable!
What we see with Covid is that people who refuse to get the cybernetic brain implant are still going to the hospitals run by aliens once they experience symptoms of the quantum memetic plague. If you trust aliens/doctors enough to treat you when you're sick, you should trust them enough to get the vaccine.
This argument reads as being in very poor faith to me, because vaccines are in the category of "long-established methods." Of course, this hinges on how relevant you consider the "Untested mRNA Technology" argument, versus how much you're willing to think of the current options as stock-standard vaccines. I think it's pretty reasonable to conclude that DNA-in-vector and mRNA-in-vector vaccines have been safe and overdue for use since ~2005, but it sounds like this might be a crux between us.
It's not an entirely different mechanism of action. It uses the same pathway and same mechanism as a weakened virus vaccine, the principal differences being (1) it uses a lipid nanoparticle instead of a protein coat to get into the cell, and (2) it uses stabilized mRNA instead of DNA or RNA. Also, it's assembled artificially instead of by some other organism. To be sure, those are not necessarily trivial differences, but the *mechanism* -- the route by which it gets into the cell, the route by which it provokes in immune response -- is very similar to what natural viruses do. Which is of course why it was a no-brainer to try it.
Considering how virtually every mention of mrna vaccine technology prior to 2019 are things like "persistent safety problems" and "seemingly insurmountable issues with safety" and "will likely never meet regulatory approval" I think it is pretty reasonable to conclude that they have not been safe or overdue since 2005. Remember what moderna is? A company founded and absurdly overvalued based on bullshit promises to deliver mrna based treatments for everything, which ended up (exactly as expected and predicated by scientists rather than suits) never being safe enough in animal trials to even attempt human trials with? So they had to resort to trying to make some "much less lucrative" vaccines instead?
The doctors and nurses in the hospitals aren't the aliens. They are humans who may be a bit too eager to trust the aliens and take orders from them and collaborate with them, but they're still mostly on our side. They're *probably* not going to secretly put the cybernetic brain implant into you while you sleep.
My doctor told me there is no reason for me to get the vaccine. So did my uncle, who is a doctor, but not my doctor. I trust them both. Your assumption that all doctors are pushing an experimental, unapproved vaccine on people who have no reason to take it is not a good one.
> although rationalists did no better here during the early phase of “looks promising so far” than anyone else
You sure? I have the sense that people in the LW orbit were much more likely to say "we don't know" than the placebo group of smart-sounding people on Twitter. Don't know how I'd go about quantifying that, though.
Compared to a random sample from Twitter, we're probably better, but compared to the baseline of "ignore the small studies and wait for the FDA/CDC to weigh in" we didn't really cover ourselves in glory.
Back when hydroxychloroquine was in a similar "looks promising so far" situation, I remember a lot of people here and in adjacent spaces patting themselves on the back for finding out about a new treatment so quickly, and wondering when the medical establishment would finally catch up. Oops.
Overall a great article!
For the worm hypothesis, you could find some interesting evidence for it by looking at the IVM prophlyaxis studies. If the IVM only lowers severity by avoiding hyper worm growth, it should have basically no effect on preventing getting a COVID case. Triangulating the evidence would probably strengthen your case, would you try that out or read an analysis of that? OTOH it would be puzzling otherwise. The prophylaxis results are at the bottom of this table https://ivmmeta.com/#fig_fp .
Perhaps reconsider including Mayer et al. Or rather, given the potential for that choice to swing your analysis, you might take more time to consider your logic on excluding it. Yes it is not an RCT. But the point of RCT is to even out factors among both groups to not favor either the control or the threatment. It's highly improbable for obese, diabetic, many other co-morbidities IVM group to outperform, given even one of those conditions increases hospitalization / mortality risk around 1.5 to 2x (from my fallible memory). P(results | ivermectin is working in high parasite places AND Argentina is a low parasite place) should be quite low yet the results are more improbable than the unadjusted p value p<.03 stated in the post. Is an adjusted analysis where they regress to mostly remove those differences, more informative for that probability i.e. "risk of death, 55.1% lower, RR 0.45, p < 0.001, treatment 3,266, control 17,966, adjusted per study, odds ratio converted to relative risk, multiple logistic regression, Figure 3." ?https://c19ivermectin.com/mayer.html
If helminths are suppressing immune response in a way that makes it harder to fight off covid, you might end up being less likely to develop symptomatic covid (or serious symptoms) once you've treated your worms--you still catch it but your immune system is able to ramp up fast enough to clear it out before it does much to you.
I'm not sure how you would test that. But if you're likely to have some sort of parasitic infection, it seems like treating it is a good idea. (Though ISTR there are some parasitic infections that will make you sick when you treat them.)
This is true, at the same time the effectiveness seen in the 60-80% range implies you'd need at least 60-80% parasite prevalence (since you need parasites in this theory to have an effect). This paper on prevalence (which is for one parasite) is 10-15% in e.g. India for example https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/
If parasites have such a huge impact on disease mortality for COVID I would think we should see increased mortality in Africa and these regions, which also have less healthcare capacity, so that is puzzling also. I would expect to see discussion of such a major issue (parasite infections causing worse viral disease or other infectious disease outcomes) and commonly discussed in public health, I have not seen that in reporting but maybe no one has studied that or noticed, or perhaps I am just ignorant.
There are many mechanisms of action for IVM against viral infections from binding to viral proteins or receptors, and IL modulation. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8203399/ I was surprised to not see Scott bring those up, it's not like there are no mechanisms (it's moreso that without any mechanism we should be much more skeptical, not that mechanisms necessarily increase probability it will work).
There is also a dose-response IVM effect seen in the Mayer paper, which some commenters say is evidence for causality, but I am unfamiliar with methods work on how to evaluate that.
The other thing IVM proponents harp on for study quality is not dosing IVM with fatty food, which effectively decreases the dose by 40-60% by my rough memory.
Of course comparing mortality between countries is very fraught, age pyramid, etc, but I'd think the effect would be known / discussed in public health about the region. Instead I see particular campaigns against parasites with terrible symptoms like river blindness from tsetse fly.
This argument "This is true, at the same time the effectiveness seen in the 60-80% range implies you'd need at least 60-80% parasite prevalence (since you need parasites in this theory to have an effect). This paper on prevalence (which is for one parasite) is 10-15% in e.g. India for example https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/" Was wrong because parasite prevalence is actually in order of magnitude of the absolute risk of death in the studies (ie the number of people that died all could be explained by parasites). At the same time largely iatrogenic parasite deaths from steroids replacing all actual covid deaths is a bit odd.
Sorry, not on topic, but why have the default avatars suddenly changed such that so many people are getting the same few? It's confusing.
I can't see that others have pointed this out yet. The analysis linked in Avi Bitterman's tweet, which looks at the effect of ivermectin in regions (of high, medium and low prevalence of Strongyloides) doesn't actually find a significant difference in risk between those subgroups (p=0.27). That is, there isn't evidence that there's an interaction; that it's effective in places with high prevalence but not effective in places with low prevalence. The effect in the high prevalence regions individually is also barely significant (p=0.02). This is an example of the idea which Andrew Gelman popularised, that 'the difference between “significant” and “not significant” is not itself statistically significant'.
Good point. Also, as I mentioned in other comment, the prevalence of Strongyloides stercoralis infection is estimated at ~10-15% in high-prevalence areas. It's an interesting idea and it could be true, or it could be a little too clever. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/
Unfortunately the author of this article is using my old analysis, which was really just a back of the envelope calculation. My current (and more rigorous) analysis contains the true model which is the meta regression which is significant. And the dichotomization does reveal a significant difference between subgroups. And the effect of high prevalence regions was significant at P=0.008
This was a much better and more important post than the title led me to expect. The last few sections are Toxoplasma-of-Rage-level good. (Parasitic infections bring out the best in Scott, apparently.)
The argument about filter bubbles and aliens goes further than it needs to, though. Scott seems to be trying to steelman Ivermectin support as a dry epistemic determination when it's clearly motivated reasoning. Ivermectin enthusiasts want it to be a good treatment because they don't want to take the vaccine. They don't want to take the vaccine because it's a Boo Red Tribe button. It's a Boo Red Tribe button because it got politicized. Also, the aliens in that Red Tribe view aren't immunologists, but the political and cultural elites whom they (somewhat correctly) model as being willing and able to control the narrative of What Immunology Says.
I have been vaccinated. I suffered no ill effects, but from what I'm seeing in recent data I'm not at all sure that I actually got a real benefit from being vaccinated. At least not a long lasting one. I'm thinking that the best strategy would have been to get deliberately infected with a recent wuflu strain (delta?) a month or two after vaccination because it looks like vaccination does limit immune system overreaction for a few months.
I also completely do not understand why the vaccine enthusiasts want to vaccinate people who have recovered from the disease. This makes no logical sense to me since if you have had the disease you almost certainly have a decent (likely very very good) immune system response anyway and the vaccine isn't going to help. If you were infected and for whatever reason you don't have a good immune system response why is a vaccine that works by triggering your immune system going to do any better?
The CDC claims vaccination is more protective than previous infection. The Israeli study, with a much larger sample size, claims previous infection is more protective. On the other hand it also finds vaccination plus previous infection still better.
Another really brilliant post. I think your metaphor is excellent.
Wow. Now that you lay it out so clearly, I wonder how this hasn't been part of the standard story about Ivermectin since day one? "It doesn't do much against Covid on its own, but it *is* a good dewormer; getting Covid while having a worm infection can make the Covid more dangerous, so people who get Covid while they may have worms can benefit from taking Ivermectin". It seems so obvious when you put it like that.
Surely the people who did those studies in areas of the world where worms are endemic, would have been aware that probably a lot of the patients in their study groups had worms, and that therefore Ivermectin being a dewormer probably had something to do with its effectiveness? Wouldn't they check for that?
In the summary, Scott writes "Parasitic worms are a confounder in ivermectin studies." Wouldn't another valid conclusion be "Ivermectin *actually does work* to reduce Covid symptoms, in the subset of patients who happen to have a parasitic worm infection? Which may be a nontrivial percentage of patients, depending on which area of the world we're talking about.
Thanks for making this comment. This article also confused me insofar as, once it had assembled the evidence, I thought the conclusion was going to be "ivermectin kills all the helminths you might be hosting, without any side effects, and as a massive bonus, that will make you more likely to survive covid in the case where you happened to be harbouring helminths, basically for free, so yay ivermectin, let's give it to everyone"; but instead it went back to "ivermectin is for gullible rubes". Huh?
Like, am I really the only one here who read this and my take-away was, whoa I should probably do some ivermectin just to be safe? I live in a temperate place but I have travelled in wormy areas, and Scott just convinced me that I should get some ivermectin! What's the downside?
The downside is, if you're not taking ivermectin in the formulation for humans, and if you're amateur dosing yourself, and you don't have worms in the first place, you may do yourself more harm than good.
It's a lot more reasonable to go to your doctor, tell them you've travelled in places where you could have picked up a worm infestation, and ask them to test and see if you need an anti-helminthic, than to buy something off a veterinary website and go "Here's hoping!"
IMO that's not the only problem: even if you're taking the right version with the right dosage, you're still taking a non-effective drug. At an individual level, this is not so bad, but when large swaths of people start doing __and dropping other precautions__ because of that, we have a problem.
It does not matter at all what formulation you take, and you would have to be functionally retarded to be able to accidentally overdose by a large enough amount to do anything harmful. An entire tube of ivermectin intended for horses will have absolutely no negative effect on a person, and that is a very large overdose, which requires a very dumb person to accidentally manage to do. If someone can't figure out that they weigh less than a horse, they also couldn't follow anything written in the post. The rate and severity of side effects from ivermectin are less than tylenol. Don't swallow the laziest and most dishonest media schlock so unquestioningly. This is the same kind of stupid nonsense vets have been spouting for years to con people into paying $60 for heart worm prevention ivermectin for their dog, when they could get several years worth for $8 from the farm store. "You are too stupid to do grade school arithmetic, you couldn't possibly figure out the dose!".
It's not so much "ivermectin is for gullible rubes", it's that "if you're living in a First World country in an area of said country and in a socio-economic class that does not routinely (or ever) suffer worm and parasite infestations, then believing Internet hype and relying on dosing yourself with cattle drench instead of taking other precautions IS NOT GOING TO WORK".
Parasites are much more common than people want to believe in developed countries, and are increasing rather than decreasing, including in higher socio-economic classes. You might want to consider the possibility that certain behaviours that are now promoted but were considered disgusting and abhorrent for all of human history have a very high propensity to spread parasites.
Yeah, it's not really a "confounder". It's that the result doesn't generalize to other countries. Mahmud et al. really does show that Ivermectin is effective in reducing the average number of days required for clinical recovery (in Bangladesh, or really just in Dhaka. Also at the time the study was done). This is the same issue people have with studies on WEIRD populations being used to make broad sweeping claims.
The prevalence or lack of worms seems like a good explanation for the failure of results to generalize. It's consistent with the data, although as another comment points out, that difference is not statistically significant (p=.27). It's also makes sense, Ivermectin is helpful in areas where the condition Ivermectin treats is more prevalent. As a bayesian, the combination of these gives me a pretty good confidence (85%?) that this is the explanation.
And it was obscured by a lot of bad/fraudulent studies as well.
The author is using my old analysis, which was a back on the envelope one. My formal analysis does have the subgroups being statistically significant P=0.02, and the meta-regression (which is the true model) is also significant.
Of course, one crucial question here is: how is the alien-brain-implant skeptic going to react when the aliens go "Okay, to hell with you rubes, we're going to mandate the brain implant as a condition for going to work (or going to a bar or a sports game etc.)"?
Revelation 13:16-17 not looking so dumb now, eh? 😁
"16 Also it causes all, both small and great, both rich and poor, both free and slave, to be marked on the right hand or the forehead, 17 so that no one can buy or sell unless he has the mark, that is, the name of the beast or the number of its name. "
This worked better when people were using it on stuff like Trump hats, at least those were visible and on the forehead.
The thing is that most vaccine hesitant people are not principled objectors but more often people who are unmotivated to get the vaccine or will be won over with a small push.
It's also ridiculous that the groups fighting hardest against these mandates are unions for teachers, cops, and nurses-- how are we supposed to trust any of these people if they can't be responsible in a pandemic?
Just because we're steelmanning the antivax position doesn't mean we can ignore that vaccines are the best solution to the pandemic. Understanding why someone is against teaching evolution in schools isn't supposed to lead to you opposing teaching evolution as well.
Perhaps it's not so ridiculous.
It is a typical problem of elites to think that it is OK to push ordinary people for their best. I don't want to judge it, I'm sure it is meant for the best and sometimes it may even be necessary. But at an other level it doesn't show respect at all, in the opposite it expresses: 'You are too stupid to take decisions and responsibility for your own life.'
If you want the people to listen to your arguments you have to show respect to them. With pressure perhaps they give in and get vaccinated, but they don't feel respected and don't trust you anymore. Others get ideological and just want to proof that they are independent and dont let you push them around. Than they hear you say that [...] is bullshit and doesn't help at all. Why should they trust you? Why isn't this just the next of your tricks to get your will after pressure didn't help?
Perhaps it is especially the teachers, cops and nurses that know this, because they work with many different people every day and know how they think and react. And especially unions are used to focus on self determination and questioning power.
I think on the long term it always is much better to respect peoples hesitations and choices, because than they are open to new data and evidence when it shows up and they can change they mind without loosing their face.
Imagine yourself being hesitant to something that is affecting your most private place, your body, how would you like 'a small push'? I think this would cause resistance as in most people.
I know this first hand from my brother who worked many years as a paramedic, his girlfriend is a nurse. He literally said to me this summer: "Perhaps this vaccinations work as well as most other vaccinations, and I really think it does good to many people. But at the moment I don't really see the benefit for me to get vaxinated as I'm a young healthy man working outside as in a small team not meeting many people. But the more all the society, the media and politics pushes everyone to get vaccinated and they act as if this is the only solution. The more they push the more resistance builds up in me, not for medical arguments, just to prove my independence and not to be pushed around.
"Most of us never owned slaves and never expect to,
It takes money to buy a slave and we're most of us poor,
But we won't lie down and let the North walk over us
About slaves or anything else."
(_John Brown's Body_, a novel in verse by Stephen Vincent Benet)
That particular example of insistence on not being told what to do didn't work out so well, with a quarter million dead and a far more imperious Federal government than ever before jammed down the throats of the survivors. Perhaps there's a time for the majority respecting the individual, whether or not he seems to be making sense, and a time for the individual to respect the majority, whether or not it seems to be making sense.
Or to add some additional lyrics, from Kenny Rogers:
"You've got to know when to hold 'em
Know when to fold 'em
Know when to walk away
Known when to run."
I'm not being facetious, either. I think there is a sad parallel with the Civil War here. I *agree* with the Southern antebellum views on quite a lot of things, about the importance of state's rights, for example, and I think they had the better view of the Constitution. But they hung all this most excellent thought on the most appalling and disgusting aim, a defense of the right of one man to own another -- and so everything worthwhile about that point of view went up in smoke, because it was used to defend an abomination.
Similarly, I'm horrified that so much of the right has chosen to hang its most excellent arguments on individual rights, the proper limits of government power, et cetera -- on defending the right of individuals to do something which looks by all reasonable historical precedent to be in practice dumb, or at best neutral, and can plausibly be argued (whether or not it is in fact true) to put the health of millions at some kind of unknown risk.
Philosophically, there's much to be said about their reasoning, and in fact I agree with almost all of it -- but using it to defend an antivax point of view is the height of practical folly, a ludicrous failure to pick your battles wisely, the kind of thing that can very easily take down the entire point of view with it. It's an excellent example to my mind of picking the wrong issue to go to the mat over principle on, like choosing to defend free speech in a child pornography case instead of a deplatforming/Twitter assassination case in which some minority view on global warming is suppressed.
You do understand that your reference is an ignorant and smug outsider inventing an incorrect and obviously stupid motive for people he looks down on because he didn't want to make any effort to understand them, right? It is very fitting if you realize that, but very ironic if you don't.
"Just because we're steelmanning the antivax position doesn't mean we can ignore that vaccines are the best solution to the pandemic."
Vaccines are the least costly way of greatly reducing my chance of dying of Covid. It isn't clear that they solve the pandemic, given that behavioral changes may cancel the protection against infection, which is much less than against death.
I agree that most people who haven't been vaccinated are willing to get vaccinated, but I still have reservations about the implementation of vaccine mandates in this case.
In a July 2021 survey by Statistics Canada [1], over 94% of respondents had already been vaccinated or said that they were "likely" or "very likely" to choose to be vaccinated in the future. Despite this, nationally, only 80% of Canadians have received a dose of COVID-19 vaccine according to Our World In Data (though plenty of regions have rates above 90%). This implies that most people who haven't yet been vaccinated responded in July that they were "likely" or "very likely" to choose to do so. So I agree with your analysis, at least in Canada, that most people, at least at one point, were willing to get vaccinated but just hadn't, for whatever reason.
I recall seeing articles (which I can find if you want) that said that Toronto Public Health was having success with door-to-door vaccination, though it's not been deployed broadly across Canada to my knowledge (I know specifically that it's not happ
ened at all where I live). This suggests that simply spending the money to knock on doors would get a lot of people vaccinated.
I think there's a general consensus that vaccine mandates will raise vaccination rates (though I couldn't find any direct evidence in a quick search, I think this is probably true, though perhaps less so than people think). But this leads to the uncomfortable conclusion that governments in Canada are, in fact, using vaccine mandates as a cost-saving measure rather than spe
nd the money on door-to-door vaccination drives. I think this is clearly immoral. First, given that we already do door-to-door drives for the census, it's clearly not cost-prohibitive. A vaccine mandate is an infringement on freedom - I don't think anyone would deny that. I think it's justified if it's necessary to make sure people who want to be safe from COVID can in fact go to place like restaurants without having to worry. But I don't think it's justified if the same effect could be achieved without a mandate. (You could argue that people intended to do both - door-to-door campaigns and vaccine mandates - but in practice that hasn't happened, so it's kind of irrelevant.)
To approach this a bit differently, I don't think it's acceptable to use vaccine mandates with the goal of increasing vaccination rates; rather, I think the only acceptable goal of a vaccine mandate is to allow things like indoor dining that otherwise wouldn't be safe to take place. I think that many advocates of vaccine mandates see increasing vaccination rates as a primary benefit of them.
This is really frustrating, because I support vaccine mandates in general. I just hate that we've somehow managed to make what's clearly a good policy into something that's at best morally ambiguous.
I also wonder what it says about the way people view unvaccinated people. I worry that people don't really view them as human, or as deserving of compassion. I think that would be really sad.
[1] https://www150.statcan.gc.ca/n1/daily-quotidien/210709/dq210709b-eng.htm
After reading Erwin's reply (which I agree with 100%), I want to add an alternate framing that leads to this conclusion: vaccine mandates run the risk of making people resistant to getting vaccinated simply because they (understandably) don't like being told what to do; whereas less coercive policies like door-to-door vaccination drives (or paying people to get vaccinated, or giving people paid time off to get vaccinated, anything like that) could potentially lead to higher vaccination rates because people they would potentially lead to less resistance, because people (understandably) don't like being coerced. I think it's always important to remember the human when making policy, and acknowledge that humans have feelings, not just incentives. One thing I heard a lot from teachers is that people won't remember what you teach them, but they will remember how you made them feel. I think that's an important idea.
(I know I'm saying a lot of "potentially" and "could". I could probably find support for my claims but I've done enough research for today already.)
>how are we supposed to trust any of these people if they can't be responsible in a pandemic?
Because they are being responsible. Forcing people to take an unnecessary, novel and potentially harmful therapy is immoral. People demanding that everyone be forced to make the same mistake they did so they feel less dumb for having made the mistake can not be trusted.
I reached the same conclusion without doing any analysis of the data. But it’s reassuring to see the the experts agree with me. Paradoxical parasites explain the significance of tropical effect. Tiny.one/clotstop
sincerely
Fantastic post!
Minor point - ‘Do forest plots to find publication bias’ should be funnel plots.
I appreciate the depth, but it doesn't engage with a few arguments that proponents make and groups studies together in a haphazard way. Possible defenses include that IVM works much better when given early or as a prophylactic, and that many negative studies enrolled the patients pretty late.
Also that epidemiological evidence in India and a few Latin American countries suggest a strong effect for IVM.
Not sure either way, but so far I have not read ONE article, either by proponents or sceptics, that differentiates studies by time of administration and endpoints. Personally, I think it's likelier than not that it doesn't work, but given the safety profile I would still take it.
Seems like a rather hard to falsify claim, since you'd need a huge randomly selected population taking invermectin and wait for some of them to get sick to test it. I'd also wager thdt many of these people making that claim had previously claimed it was more generally effective then were forced to retreat on that
Really not a fan of the alien analogy, I find it insulting by implying that those who are skeptical of the prevailing narrative around the Covid vaccines are only doing so out of reflexive distrust of "science" and big pharma. If I genuinely thought that the vaccines were as safe and effective as they were purported to be I wouldn't disbelieve them out of some tribal reason. I was rooting for the vaccines, ideally they really would have "got us out of the pandemic".
About the vaccines - i have no idea how you can reach the conclusion that they are "very safe and effective" - here are a few things that poke holes in that conclusion.
1. High vaccination rates having no correlation with low case rates. Many countries or cities with high vaccination rates are seeing explosions in cases
2. Several studies that show waning vaccine efficacy over time, both for prevention of disease and reducing symptoms
3. Excess mortality being higher this year in many countries where vaccines were rolled out compared to last year.
4. Consistently much higher rates of adverse events recorded in monitoring databases such as VAERS ( And is the case over many different countries )
Not that this is a black and white picture, I do think that the vaccines seem to reduce mortality for Covid, but the question is how long for and if there's anything else that we could do to help those who catch the disease in addition to vaccination.
I am more sympathetic to the authorities in the case of the vaccine backlash because way back at the start everyone was demanding fast action on vaccines - no messing around waiting months for trials while the pandemic was upon us, get them out fast and trust the drug companies' results! Nip it in the bud by herd immunity and mass vaccination!
*Now* when there has been time, and mass vaccination, we see the downsides, the bad results, the side-effects and so on.
But you can't both have it be "skip the usual heel-dragging over-cautious FDA approval process" and "they should have known the vaccines were dangerous/ineffective".
These are the sort of arguments that I would love to see fleshed out more. In the vaccine debate online, you have the anti-vaccine-mandate crowd who does a bunch of research and presents data (which may be wrong/confounded/bad!) and you have the pro-vaccine-mandate crowd that just says "safe and effective" and the only data they point to is data that has incredibly questionable provenance, integrity issues, etc. (all of the things this article laments about).
I was just remarking about this sort of thing over at Gift of Fire. He has been countering some anti-vax claims and getting a few "claps" out of it, while the antivaxxer he countered is getting thousands of paying customers: https://dpiepgrass.medium.com/we-can-guess-that-money-is-not-steves-primary-motivation-indeed-kirsch-apparently-donated-8afbb98da9d
It seems to me that the market for debunkers just isn't very big. (I volunteered for Denial101x and SkepticalScience. People don't know these are operated by unpaid volunteers.) So if you really want to earn a living, explain with high confidence and great exaggeration how very awful and deadly Covid vaccines are. Or work for a mainstream news outlet and mostly ignore the antivaxxers except to make lazy comments about how wrong they are. Or work for a university and ignore the antivaxxers because there's no grant money in talking to the public.
Scott doesn't do debunking so much, but maybe it's all for the best; to debunk is to put the "bunker" in the driver's seat, to react to whatever they say. Scott's approach is mostly just to take a deep dive into something and ignore what the bunkers are saying. I'd love to see him deep dive into the same data FDA and other regulators looked at for approval purposes. BUT... it would be wise of him to be aware of what claims are out there lest he be caught flat-footed...
I agree, fear and extremism sell *way* better than a boring centrist viewpoint. This is unfortunately true on both sides, which I suspect is why we have Fauci on the one hand saying "human civilization will end if you don't all get vaccinated and cover your face and lock yourself inside" and on the other hand you have Kirsch saying "vaccines will kill everyone who gets it".
The reason I tend to fall on the "anti-vax" side is because the anti-vax side is only asking for a *choice* while the pro-vax side is demanding compliance and using violence (police) to enforce that demand. Anytime things are uncertain (such as with this entire pandemic) I strongly prefer choice over compulsion.
I do not hold a strong view that vaccines are dangerous, but I haven't seen any evidence to suggest they are safe & effective (at the same time) either. If we had good quality evidence that vaccines are in fact safe & effective and we had strong evidence that COVID-19 is as deadly as Fauci implies then I may be a little more lenient on the pro-vax crowd. However, given the reality of the situation (everything is very fuzzy/clouded) and the epidemiological evidence that the vaccines *may* be causing more harm then good (again, can't make any solid claims here because data is bad across the board), I cannot get on board with decreasing civil liberties because some people say we should.
You should be less sympathetic to the authorities, not more. Biden and Harris were both personally part of the "the vaccines are being rushed and that's terrible and unsafe and you shouldn't trust them" campaign before the election, and now that we know that they really are unsafe and ineffective, they are both personally part of the "force everyone to take a shot every 6 months forever at gunpoint" campaign, while also campaigning to have social media companies "do more" to censor facts and data that show the ineffectiveness of the vaccines. You should only be sympathetic to them if their positions were the exact opposite.
Being tribal doesn't often feel like you are tribal. It can feel that you are genuinely sure to the best of your ability that this is the right course of action for all sorts of sound reasons. Similarly how having a belief doesn't feel that you have a belief, just that reality is this way. I'm saying it with empathy and respect, as someone who is often victim to this problem myself.
Regarding your concerns, I'm not a medical expert but my naive intuition tells me that 1 and 3 are explained by the shift from lockdown to normallity which became possible due to the access to vaccines. 4 is probably the result of covid itself. And maybe 2 is due to the same reasons we have seasonal flu vaccines.
Maybe my opposition to the covid vaccine is tribal (I got the vaccine by the way, but changed my mind about whether it was safe and effective afterwards after doing more research). But don’t you think you’re doing the same thing? You refute every point with “Maybe it’s due to this other thing.” Well, maybe? But maybe not? I haven’t seen anyone try to do a serious analysis of the seeming flaws that have shown up with the vaccines. (Well actually I have, but they all concluded that the vaccine wasn’t safe and effective). It’s just a circular analysis of “We know the vaccines are safe and effective, therefore any apparent flaws with them must be the result of confounding.” That’s not science.
You're being very disingenuous by ignoring the effects of people's behavior. I will speak only of my community, the state of MA in the USA.
Today people are mingling in groups unmasked indoors. Indoor dining with no restrictions. Going clubbing. Concerts. Sporting events. Offices. Kids are in school.
Last summer none of that was true unless you were a "deviant". And by definition since most people were "deviants" you and your group of "deviants" were fairly small and therefore community spread would be far less likely.
https://datavisualization.dph.mass.gov/views/MADPHCOVID-19Dashboard/OverviewTrends?showVizHome=n&:embed=y&:device=desktop&display_static_image=n&embed=y&display_count=y&:display_count=n&:showVizHome=n&:origin=viz_share_link
This is good. This is much better than before. And again, this is completely ignoring the massive changes in social behavior over time. Those huge spikes on this graph?
They occurred when there was no indoor dining. No events. No gatherings. When, by my unscientific estimation, 95%+ of Bostonians *wore masks religiously OUTSIDE*.
How can you truly say the vaccine is having no impact?
How can you be so sure that the NPIs were so effective that they happened to nearly exactly cancel out the effects of the super-effective vaccine? That seems a little suspicious to me...
I know I am tribal, but I have not been coerced or pressured into adopting a surrogate tribe. My tribe is my real actual biological tribe, not democrats or republicans or liberals or conservatives or sportsball_team_x fans. I genuinely have no allegiance to political or social nonsense, only to my actual tribe. This is confusing to both liberals and conservative, who can not think beyond the surrogate tribes they have adopted, and so liberals call us "far right" and conservatives call us "socialists". I really can say there is no tribal reason for me to be for or against these vaccines.
There is simply no compelling evidence that would suggest a healthy young person should get vaccinated with an experimental, unsafe vaccine for a virtually risk free disease. I recommended that my elderly grandmother get vaccinated, because the risk of COVID for her is higher than the likely risk from the vaccines, and although we can not be certain of long term risks, she probably doesn't have much of a long term to be concerned about in the first place.
But I am not elderly, I have no health problems, I do not consume polyunsaturated fats, and I have adequate vitamin D levels naturally from sun exposure. My risk of being hospitalized from COVID is nonexistent. I may well have already had it and not even known, because it is only a serious illness in people who are not healthy. The average age of COVID deaths is higher than the average lifespan. I am more likely to struck by lightning on my way to get vaccinated than I am to be killed by COVID. The bizarre insistence on ignoring this obvious reality and pretending everyone should be afraid of COVID is much more likely to be tribal than the "get it if you are at risk, don't bother if you are not" mentality that most of us so-called "anti-vaxxers" have.
Okay, well, my antivax father is 74 and I haven't seen any of the major antivaxxers (like Kirsch, Cahill, Zelenko, Mercola) encourage vaccination for the elderly or anyone else, but thank you for being exceptional by carving out an exception for those who are "at risk".
Part of the issue is that it really seems like a lot of anti-COVID vaxxers will make very reasonable sounding objections like your 4, but essentially never apply the same level of scrutiny to other medical interventions. So it’s not bad reasoning necessarily, but it is motivated.
Not to mention that all 4 of your points are distillations of very complex data into arguments anti-vaxxers generally come to by way of summaries from other motivated reasoners, making it hard to trust without doing the same sort of analysis Scott does here.
I replied to one of Leaf's comments elsewhere with my take on #4, but to summarize I would say that it's because many more people are getting vaccinated and are being told that VAERS even exists. It should be no surprise that there is a higher rate of reports.
I've been thinking a lot about what to replace "trust the science" with. We have this compulsion to over-fetishize scientific form (p-values are a weird, barely useful social construct in a world as nebulous and interconnected as ours) precisely to defend against an outside view problem where low-effort conspiracy theories look exactly the same as correct contrarians without doing a lot of work to sift it out. But when you think about fraud from a institutional lens a la Davies's Lying for Money, you can see that "what matters is where it came from!" as a position is tailor-made to let people cash in on the form as a free credibility signal. The cranks are great at throwing in stats words now, and have been for a while.
To think about the way forward, it's worth making the ethnomethological flip (https://metarationality.com/ethnomethodological-flip). That is - how do the people who *are* right actually *do it?*? I'm a temporarily-embarrassed immunologist too, and I was the one who warned all my friends about COVID-19 in Feb '20. I wasn't reading studies and I wasn't calculating p-values. How did I know anyway? Well, because I followed Zeynep Tufekci and a lot of Hong Kongers and had an easy time putting the pieces together. But conspiracy theorists are also great at writing little stories to explain anecdotal evidence. You can say in principle that relying on anecdote here doesn't work because there are also anecdotes about FEMA death camps. But do the flip; I DID believe the good anecdotes, and I didn't believe the bad anecdotes, so it's clearly possible somehow and that somehow doesn't involve math or probability.
This has been my research area for a few months and I suspect that a lot of the secret sauce is ontological. Ontologies can't be *right or wrong* but they can be *better or worse*, and we're not really used to talking about them in that way. So I think people end up talking at cross-purposes a lot because some people are Just More Likely To Be Right because they're using a more sensible ontology, but we don't have the language to make that claim. So we can try to assume that "using a better ontology" and "following proscribed scientific norms" are the same thing - and they probably match above random chance - but there's plenty of cases where it's not true which gives cranks all the ammunition they need.
The slogan ought to be something like "trust the most sensible ontology", but we have scads of really urgent work to do on helping people determine sensible ontologies. And this work historically has been done through mentorship which is why things feel so distinctly odd nowadays.
I ended up just hitting post when I got sick of writing this because I realized it was starting to get full post levels and I didn't want to put in the work, but here is one example of what I mean. This is an article from Cris Moore about how R0 is really unhelpful as a measure for diseases with heavy tails:
https://sfi-edu.s3.amazonaws.com/sfi-edu/production/uploads/ckeditor/2020/04/27/t-024-moore.pdf
Let's say we're in the future now. There's a few flareups of a new disease and we're trying to figure out if it will be a pandemic. Someone writes a paper estimating R0 as .8 and says that we don't have to worry. I wake up from my coma and only read their paper. I worry a lot, because R0 is a bad estimator to use in isolation, and equating R0 with risk is an enormous red flag. I didn't do ANY research, I haven't made ANY probabilistic guess, I just said "It clearly exists (because you had to write a paper about it), and R0 isn't really a measure you can use to call things safe. If it was actually safe, you'd have a real reason to say why. If the best point you can think of is invoking R0, we're boned."
This made up person did a lot of research work, and I didn't do a god damn thing, and I haven't said anything about the methods or data analysis they employed. But I have a smarter **way of representing the relevant factors**. So I think this is a pretty sizeable hint that representations are critically important, and probably a big part of how we actually go about the work of sifting the wheat from the chaff enough to keep the lights on.
I'm biased because I lean towards a philosophical pragmatism on political issues like this, but I feel like the obvious answer is the easy one: people should trust the vaccine because it works, and if it didn't work they shouldn't trust it even if every scientist in the world was convinced otherwise.
To flesh it out a but more, why did so many of us start following Zeynep's Covid coverage? Because she kept being right when other people were wrong. She's a journalist with no special expertise, and there's nothing that would've stopped her from turning out like Alex Berenson, the infamous "pandemics wrongest man." But her predictions kept coming true and her policy reccomendations made sense, neither of which is true for Berenson. I feel like we keep wanting a form or structure to validate epistemic authority for us, but ultimately the only authority is whether what someone says comforts with the data.
I feel crazy sometimes as someone who has realized that the WHO, CDC, FDA, etc. embarrassed themselves by getting major issues wrong but not thinking that Fauci is the devil or something. These orgs are run by basically competent bureaucrats and I trust them on a lot of banal issues. Maybe I'm just reinventing Bayesianism here, but we can trust orgs like this as far as they've been accurate without making it a binary switch.
I'd like to hear more of your point about ontology, but I'm not quite sure how you're using it. If you're using it in a standard way to refer to platonic forms, nomination, metaphysics or naturalism, etc., I'm skeptical. Ramanujan thought he was being given math insights by a patron goddess writing in phantom blood but that didnt seem to hamper his math acumen.
So I agree with the *attitude* of this post - I think a sort of rough and ready pragmatism is exactly the ticket here. The point I want to make is just that "she kept being right" is a phrase that, in a rationalist community, can sometimes imply a lot of excess baggage: are we saying that Zeynep gave probabilistic predictions that were above random chance? Did Zeynep predict the outcomes of studies? No, she dealt with anecdote. What does it mean for an anecdote to be right, when you can always do any degree of special pleading to explain any outcome?
Correctness here was coarse-graining in the correct way. She "kept being right" because she made the sort of claims where a given observation we could all make would count as right with respect to those claims. All her prediction boiled down to was "The reasons why novel infectious diseases often don't take off don't apply here; this rhymes with SARS enough PLUS differs on the key metric of asymptomatic infectivity that it will be bad." If Zeynep had been forced to give a number of exactly how bad it would get, it would have been a total potshot and likely would have been objectively wrong. If Zeynep had been forced to write her thoughts as a study, or as a rebut to a study, they would have been way too slow.
So a major part of being right here is making the *kind of claim that can be right*. That's what I mean by factoring in ontology. Nothing about naturalism or platonic forms. More that focusing overmuch on studies and evidence can blind us to how effective people actually do decision making in highly uncertain and quickly changing environments, which has a lot to do with reducing things to the right factors instead of finding the right coefficients for the factors you have. The people who were thinking in terms of "takeoff or no? What factors stop most takeoffs and are they relevant here?" were correct; the people who were trying to predict the R0 of COVID-19 in February '20 were wrong, **regardless of what R0 they ended up calculating**, because they were thinking about it **in the wrong way**. Does that make sense?
>To flesh it out a but more, why did so many of us start following Zeynep's Covid coverage?
We're talking about the woman who wrote outright bullshit articles about the efficacy of masking right? Where she misrepresented the evidence to support it, and pretended all the overwhelming evidence showing it does nothing didn't exist?
>there's nothing that would've stopped her from turning out like Alex Berenson, the infamous "pandemics wrongest man."
Did he actually say anything factually wrong, or did he merely get called "the wrongest" by a tabloid? I've never heard of him, but the wikipedia summary makes it seem like he's been stating obvious facts that the media doesn't want people to hear, like that COVID is very low risk for children, and so had to be silenced.
How do things like the silencing, discrediting and lying about people who are inconvenient not leap out to you as a huge red flag? Why do you not apply any skepticism to the mainstream narrative? Take Dr. Malone for another example. Read his wikipedia page. Google his name. And consider, he is objectively a real doctor, an actual virologist, and the man who discovered that it was possible to transfer mRNA protected by a liposome into cultured cells to signal the information needed for the production of proteins. These are not subjective claims, and they should not be (and were not) controversial. This is a man who, until the politicization of COVID was a well respected scientist and in no way controversial at all. Now all you can find about him is that he is a fraud who claims to have discovered the basis for mrna technology, but that he is really an evil far right nazi terrorist conspiracy klansman who is killing millions of babies with his evil facebook COVID memes! His wikipedia article can't even make enough of a pretense of objectivity to call him "Dr. Malone". How can someone look at this level of insane 1984 manipulation of public opinion, for someone who has very objectively done absolutely nothing wrong, and think "there's definitely nothing suspicious here, I have no reason to doubt any aspect of the media/government complex's ever shifting narrative at all!". Shouldn't the need for them to constantly edit history ring huge alarm bells?
Berenson's predictions are sometimes correct and sometimes not, but the most pathetic thing about him is how incredibly bitter he is at being banned from twitter. Only losers are that invested in social media.
One idea that came to my mind is that instead of "trusting science" people can "trust scientists". Specifically, we can poll all scientists to learn what the scientific consensus is. This will presumably avoid the issue of "trusting experts" where only a select few most loud personalities get a say.
Imagine a Wikipedia-type site where you could find the surveys of the world scientific community on lots of issues, what do they agree on and what do they disagree on, classified by specialty and country of origin, and tracking the change of sentiment over time. If you're interested, I wrote more about this idea on my blog: https://www.see-elegance.com/post/making-consensus-legible
Problem with that is getting a large enough number of scientists informed about the study, and determining what kind of scientists count (eg theoretical physicists probably shouldn't do immunology). In theory the peer review process is meant to do something like this, but it seems like it's failing in large amounts if these studies got through
Is there a reason to think that scientists have historically had more accurate or meaningfully quasi-objectively better political views than anyone else? I don't see why you'd need an scientist to weigh in outside their field.
I'm not talking about politics here, I'm specifically talking about consensus on interesting questions inside a field, or to compare the views of two fields. For example, to check how many nutrition researchers are for or against certain diets, how many neurobiologists vs. quantum physicists believe in orchestrated objective reduction and so on.
Oh, neat! PhilPapers did a similar thing for philosophy a while back: https://philpapers.org/surveys/results.pl
It's been helpful to help me think about philosophy to realize e.g. that hard determinism is a minority position.
Exactly, this is where I got the idea from.
On anything important, the "polling" will end up being done by someone with an axe to grind and a big enough megaphone to be heard. My poster child for that is Cook et. al. 2013, the source for the 97% factoid on climate. For details, see:
http://daviddfriedman.blogspot.com/2014/02/a-climate-falsehood-you-can-check-for.html
Couldn't the consensus website just have a voting feature for verified researchers? ResearcherID, ORCID, Scopus already exist for verification.
wikipedia entries that are even remotely controversial are just the view of whatever power editor is most active on the given topic. let's not replicate that shitty system.
I don't know about anyone else here, but I grew up hearing about ivermectin from radio and TV ads like this one:
https://www.youtube.com/watch?v=QGbZKlbjNCo
My scepticism about it being a miracle cure for Covid is partly based on the following - warnings when dosing cattle either by pour-on or injection that it is not to be used in animals producing milk for human consumption:
"Animec Pour-on for Cattle is used for the treatment and control of gastro-intestinal nemotades, lungworms, warbles, chotioptic and sarcoptic mange mites and sucking and biting lice of beef and non-lactating dairy cattle.
Active Ingredient:Ivermectin
Target Species: Cattle
Treats and Controls: Gastro-intestinal roundworms, lungworms, eyeworms, mites and lice
Administration Method: Pour-on
Withdrawal Time: 28 days for animals intended for meat and offal, Not permitted for use on animals producing milk for human consumption.
Signs and effects of infected livestock
Infection:Gut Worm
Symptoms: Diarrhoea, decreased appetite, loss of weight
Effects: Gutworm can cause severe damage to the stomach and small intestine which will cause parasitic gastroenteritis, this will not only negatively affect the health of the animal but will affect the profitability for the farmer.
Infection: Lungworm
Symptoms: Short, sharp cough that becomes worse with exercise, in severe cases the animal will have obvious difficulty breathing.
Effects: Lungworm infections cause a high susceptibility to respiratory viruses and bacteria. Infected cattle are prone to contracting severe bronchial pneumonia which if left untreated can lead to death."
And partly because I do not see how something that is mainly a wormer cattle drench is going to be a great anti-viral. Maybe it is! In vitro - which is a hell of a lot different than in vivo.
My position has always been that the good results came from trials in places where, as Scott points out, people are prone to worm and parasite infestations. My totally untutored guess was that the ivermectin treated parasites, which took strain off the immune system, which gave back capacity to fight Covid, and so yes treated patients did better than untreated.
But if you really want to inject or swallow or pour on ivermectin on yourself, I still think your best option is to be a cow in a field.
The same warnings against consumption are included in all livestock medications, including the ones (like ivermectin) that are human medications. Are you afraid of taking erythromycin? Because if you go by the "cover our ass" disclaimer that comes with it when prescribed for chickens, you can never eat an egg from a chicken who was given erythromycin ever again. Does it make sense that I can take erythromycin just fine, but the unlikely and untested possibility that a vastly smaller quantity of erythromycin could be in an egg makes the egg unsafe? It is just a disclaimer because they have not (and have no financial incentive to) tested if any gets into the egg, and then done a safety trial on people eating those eggs. Ivermectin is a human medication. It has been taken billions of times by millions of people. It won the nobel prize for its use in humans. It also happens to be used in virtually all other animals because there is nothing species specific about its mechanism or safety profile. Calling it "mainly a wormer cattle drench" can only be deliberate dishonesty.
One sociological question this triggers for me is why are there so many of these terrible studies from strange people testing invermectin? Is it just thet if something is in the news a lot then people will do stuff related to it to try and make a name for themselves?
Which then leads to the secondary question of why people started asking about invermectin in the first place. My level of charitability to the studies would vary a lot based on whether it was a) because some sensible doctors had a plausible method of action by which it would fight viruses b) someone chose it randomly from a hat c) people who sell invermectin, or in some other way make money off it, started promoting it.
The answer to your last question is a, there is a plausible mechanism - see this, for example: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290143/
But there were tons of studies of nearly everything that got started by mid-2020, and it was the ones that were getting news coverage (HCQ, Ivermectin) that people rushed to publish. 1 year from study launch to publication is insanely fast, and many were far faster than that. Clearly, selecting on speed + positive results preferentially selects for fraud, sloppiness, and mistakes - and so many of the other studies are file-drawer bound, or are only getting submitted now.
Biochemistry, particularly involving immunology and multiple species, is so freaking complicated that you can probably find a plausible mechanism for almost anything. So it's a good rule of thumb to assume that a plausible mechanism and $5 will get you a good cup of coffee, no more.
My understanding-- someone more authoritative than me found this upthread-- is that our candidate drugs are ones that affect systems of the body also affected by covid. IVM is anti-inflammatory I beleive and HCQ interacts with the immune system (so does remdesivir I think? I think they're also both sort of like steroids). So we just go through widely available cheap generics that will probably do something and hope that one of the drugs we have works.
And of course the follow-up question. Is there anything special about invermectin, or are we drowning in terrible people doing terrible studies on everything?
I want to plug my heuristic for deciding not to use Ivermectin -
1. The government DOES NOT WANT YOU TO DIE. They are not lying to you!
Even if you suspect the political class of lying, people underestimate the competency of the many bureacratic organizations full of scientists and doctors in a time of crisis. My mental model is they are nerds just like engineers - they are interested in truth, not politics.
They were called upon in a crisis. I am absolutely sure they did their best as a whole, and I am absolutely sure the best of them will forget more about medicine and statistics than I'll ever know. Deep competence acquired over years is real, and no even dedicated amateur science by smart people is not a substitute.
Personally it was clear to me that e.g the urging not to use masks was driven by fear of shortages. That was a lie, but not enough of a lie to make me distrust the entirely of institutional medicine like wow calm down.
See Scott's post on conflict vs mistake theory.
>Deep competence acquired over years is real, and no even dedicated amateur science by smart people is not a substitute.
I have a phd, and this is bullshit. Some scientists are really good at what they do. Some scientists can absolutely be beaten by smart people.
I don't believe that masks were discouraged due to shortages. Maybe some politicians thought like that but they got suggestions to discourage masks from people who really thought that they are not effective (based on studies et al.). Even now we are not sure how helpful the masks are. I estimate a weak effect, mostly good in crowded placed with poor ventilation. It might be the case that improving ventilation gives much higher protection that makes masks practically useless in such conditions. But because we rely on masks too much, there is not enough attention to ventilation issues that the total effect might be even slightly negative compared to a hypothetical world where we don't use masks but have learned aerosol spread much earlier.
I have no doubts that many people in these organizations are competent and have good intentions. But due to bureaucratic nature and also because this science is really hard, they couldn't provide effective recommendations.
In July 2020, Fauci explained [https://reason.com/2021/06/04/anthony-fauci-may-not-have-lied-about-face-masks-but-he-was-not-exactly-honest-either/] that the reason he formerly discouraged mask wearing (e.g. https://youtu.be/PRa6t_e7dgI) was because, "Back then, the critical issue was to save the masks for the people who really needed them, because it was felt that there was a shortage of masks."
People don't like to admit mistakes, so they will chose a version that makes them look less bad.
I was just re-reading articles from the last year because now everybody is trying to pretend that zero covid was not the strategy that countries (except for Sweden) were trying to achieve, especially countries that were spared during the first wave.
+1 for this. I remember COVID One Year Ago wrote up a short post about how the belief was genuine and not a shortage issue.
This is almost certainly not the truth either. There are two points here:
1) they said it doesn't work and they mentioned reasons. If the reasons they gave were wrong why were they never challenged / fact checked? Why were health authorities all over the world giving the same advice and giving similar reasons? Why do the reasons given line up so well with the prior science as well as the WHO (flu) pandemic advice?
2) Why was PPE so scarce if it's such a game changer? Really think about this question and remember all the morality tales around the masks "You are killing people if you don't wear one", "Czech Republic beat Corona with wearing masks" and so on. IF masking was so effective why weren't doctors stocked up? Why weren't health authorities stocked up? Remember that your thesis is that they thought masks worked but wanted to save them for medical personnel. So why did they have so little?
The truth is that the evidence for masks was always very weak. Studies couldn't even find a protective effect for surgeons wearing them while operating. It's been a puzzle for science because according to logic they should work much better than they seem to.
I would normally agree that the government doesn't have any reason to want people to die, but the FDA response to covid demonstrates otherwise. We had signs in early trials that these vaccines were safe and effective, and even ones like AZT that got more skepticism from the FDA would've been better than nothing. Instead of rushing an effective solution to the pandemic the FDA delayed the release of the vaccine and let tons of people die.
Many of the commenters here show exactly the problem with that - large swaths of the population don’t trust the vaccines because they were done quickly. If they had been done even more quickly, there would have been even more pushback and it is at least plausible that *more people would have died*. It’s impossible to know for certain, but it is at least a very reasonable position to hold.
I tend to think that complaints about "how fast" the vaccines were made available is so much retconning rationalization. How fast is *normal* for vaccine development? I doubt 1 in 100 people have the faintest idea.
Yes, and if you ask someone with this view how long they need to wait before they think it's safe, they never seem to have a number in mind, and only rarely do they rarely decide to get vaccinated after some months.
If they had come out three months earlier, there would have been three months of large-scale evidence that they worked and didn't kill people by the time they became available in our timeline. More convincing than eleven months instead of eight of small-scale testing.
I mean this is the same problem of just thinking you know so much more than the experts.
Early trials were done on a small number of people. What if the vaccine had a rare side effect that caused death or disease in even 0.01% of cases? What if those effects were not obvious after a short period of time? It would be absolutely devastating to have a bad vaccine - it could have done as much or much more damage than COVID itself.. The vaccine had to be extremely, extremely safe, over the entire worlds population with all of the genetic diversity, pre existing diseases, diets, environmental factors, age and on. There is absolutely no magical way to design a study that will effectively capture a small effect in a population that varied - the only realistic response is a lot of caution and a slow rollout. Like its so easy to sit here on a comment thread talking shit about the FDA 2 years later when we know the vaccines are safe, but we did not know that then. T
People actually think about this. They're not clueless idiots. Safety studies are designed with sufficient statistical power (= number of people enrolled, basically) so that any missing bad side effects are by definition less common than the equally negative outcomes of what you're trying to treat. So in this case, they enrolled enough people in the COVID vaccine studies so that any deadly side effects they missed because of the limited size of the study would be rarer than dying of COVID itself. That's actually why those studies had to be so big and took so long. When you are studying a therapy for a much deadlier disease, you can use smaller studies, because it's more OK to miss a deadly side effect that occurs with a higher rate of incidence.
>When you are studying a therapy for a much deadlier disease, you can use smaller studies, because it's more OK to miss a deadly side effect that occurs with a higher rate of incidence.
But since we're talking about a therapy for a cold with virtually no risk, the rare deadly side effect problem is much more important.
Isn't it partly bureaucratic difficulties which are making COVID tests expensive in the US? And cheap COVID tests would help a lot?
The government presumably wants its citizens to not die (except for failing to define ageing as a disease), but that doesn't mean it always gets things right.
Members of the government openly and plainly state that they do want me to die. So the claim that they both do not want me to die, and are not lying is impossible. There is no competency needed or perceived for malevolence to be involved here. Almost all of the "government experts" dictating how we get jerked around are very clearly in WAY over their heads. Dr. Tam is malevolent, he knows what he is doing. All the bureaucrats and appointed "chief doctor" bobble heads constantly contradicting themselves and giving moronic and factually wrong statements are not malevolent, they are incompetent. As one would expect for appointed political positions. I am sure Trudeau is a tool as he is obviously too dumb to understand much of the script he mindlessly repeats. But that does not make the malevolence of those manipulating the tool any less real.
The PRINCIPLE trial is a large scale RCT in the UK is investigating ivermectin. Given that it is in the UK, it shouldn't suffer from parasite-related confounders.
I'll bet you 150$ to $100 that it shows a weak but positive result for ivermectin. I don't mean in the sense of "statistically significant", but in the sense that "average days to recovery ivermectin" < "average days to recovery non-ivermectin", if they don't measure average days to recovery we can pick another indicator. If ivermectin had no effect the probabilities should be 50-50 (under reasonable assumptions on the noise) so this bet would be positive expected value for you.
It's articles like these that... well... greatly reduced my confidence in "studies say" and "SCIENCE"!!!
I did a bachelor of science and thoroughly enjoyed it, but I got to spend a lot of times with scientists and it shattered my childhood illusions of noble men in white coats with a rock solid commitment to follow the truth wherever it led.
The original pro-inver compilation looked fantastic until a veritable firehose of fisking was turned upon it ... but the only reason the firehose got turned on was an epic load of political motivation. I generally trust Scott because he writes like a standup guy, so I'm happy to accept his fisking, but I bet if there was another standup guy out there who started fisking his fisking I'd end up scratching my head again.
I'm not anti-vax or pro-inver so I say great - fisk on Scott! But what other steam piles lurk out there that haven't attracted the firehose yet that I'm smugly confident in?
As the years roll by, I'm becoming increasingly aware that there is about 3 men and a dog who are interested in what is true and damn the torpedos, full speed ahead.
If creationism or race science turned out to be true, who here would actually legitimately want to know if there was a chance their social circle would find out they knew it?
I'm not ready to toss science because I can see a bunch of great stuff it's delivered... but boy are my days of making authoritative scientific pronouncements in the lunchroom are behind me.
Well, maybe the takeaway is that you shouldn't be smugly confident in things that don't have at least an unobjectionable decades-long track record for which you don't have to take somebody's word for? Science, like many our best practices, is both terrible and better than everything else that has been tried, with the buildup of positive effects being apparent only over the long term.
Oh come on. We have a vaccine that works against COVID, after only a year! Where would we be if the vaccine was going to take 10 years? Just basically waiting for it to burn itself out, right? Mortality averaged over a long time was running about ~1% so if 85% of the US had to get it to reach herd immunity, and 1% of those died, that would be about 2.8 million deaths. We're currently sitting at about 790,000 deaths, which is to say so far science has saved 2 million lives.[1] If that's not dramatic and massive proof of the positive effect of having brilliant science available[2], what the heck would be?
------------
[1] The deaths will undoubtably rise, because of variants, so bad there, but on the other hand we can make vaccines against variants even faster (and for all we know variants would vitiate naturally-acquired her immunity), so I kind of doubt our deaths will ever come near those we would've had to endure in the absence of a vaccine.
[2] Those vaccines didn't come out of nowhere, they came out of decades of basic resaerch that just happened to have reached a point of applicability in the nick of time. Yet another argument for a continuous investment in basic research: where would we have been if people had said to heck with paying for this basic research?
It seems that you're mostly agreeing with me. Indeed, those vaccines didn't suddenly materialize out of thin air, the technology that enabled their deployment is exactly the result of intelligible decades-long scientific advancement that I had in mind. And yet, this shouldn't be enough to make you smugly confident that every single one of them is safe and effective just because "science say so", because, for one, honest scientists don't actually claim that, it's mainly the "pro-science" propaganda that does it. In the end, you still have to make the best choice with the information that's available, and when your options are approved vaccines vs. ivermectin vs. nothing, it's not that hard of a problem.
Sure I am, I'm just encouraging a sense of wonder and appreciation for how freaking fast this problem got solved. I really don't get why there isn't more amazement and wonder at this. I remember when AIDS came calling, and people were desperate for treatment, prevention, anything. It took *years* before there was anything even half-assed. I think the first genuinely effective protease inhibitor was maybe 15 years after we recognised the disease? That's a long, long time to wait. It *could* have been the case this time, but it wasn't. We were very, very lucky (and maybe a little smart, to have been supporting the basic research all along).
Huh. Sounds like you're about 2/3 of the way to being a scientist yourself. On account of everything you've written is exactly how empirical science is supposed to work. Trust nobody, check everything for yourself, doubt the hypotheses promulgated by enthusiastic majorities most of all.
"If we want to make people more willing to get vaccines, or less willing to take ivermectin, we have to make the scientific establishment feel less like an enclave of hostile aliens to half the population. Do that, and people will mostly take COVID-related advice, for the same reason they mostly take advice around avoiding asbestos or using sunscreen - both things we’ve successfully convinced people to do even without having a perfect encapsulation of the scientific method or the ideal balance between evidence and authority."
Purely hypothetically, do you honestly doubt that if certain IDW influencers randomly decided to gin up sunscreen or asbestos-removal opposition as a culture war issue, then we wouldn't subsequently see widespread opposition to sunscreen and asbestos removal among their followers? People might even start mocking the weirdos who randomly decided sunscreen is anti-American, at which point this vicious condescension would be all the proof anti-screeners need that elites look down on them and their values, further entrenching sunscreen opposition as an essential pillar of their identity. These grievances and suspicions aren't fixed essential flashpoints that can be traced back to significant divisions in the tribes and their values. They can be turned on and off like a light switch, especially thanks to a relatively new insatiable economy of culture war influencers chasing clicks. (As others have pointed out, many holdouts were fine with mandated alien implants until less a year ago, others have argued that mRNA vaccines are actually *new* and that's what makes them alien and suspicious but that doesn't change the fact that very similar implant *mandates* were just an assumed normal part of life explicitly defended by conservatives like Ben Shapiro and the Federalist and now overnight mandates became unconscionable tyranny.)
The entirely alien analogy suffers from a flaw that emerges in a lot Scott's writing where he seems to just assume the Blue Tribe and its aligned elites are the prime movers of these dynamics and on some level nearly all polarization and animus emerges from what they do or don't do (and subsequently how the Red Tribe has to helplessly respond in kind), completely ignoring the fact that the Red Tribe actually does have an agency all its own to play offense in the culture wars. It's like seeing a Hatfield attack a McCoy, then witnessing a McCoy attack a Hatfield in retaliation, then writing 10,000 words about how the Hatfields started this whole thing and they really need to learn to be more charitable to the McCoys and take their grievances seriously. The Hatfields might well have started it but that's a hell of an intractable, difficult question that can't just be assumed because that's the first attack you saw or you feel some collective guilt as a Hatfield yourself.
Is there anything in the alien analogy where anti-alien famous people confidently, loudly pronounce that quantum plague memetic deaths will remain at zero or hold steady at like 15 cases, then at one point 3000 people start dying of the quantum memetic plague every single day? Or how about anti-alienists compulsively repeat debunked canards about how actually the quantum plague is no worse than a common tachyonic sinus infection with a 99 percent survival rate while ignoring the inherent risk of unknown memetic plagues having unknown long-term consequences while *simultaneously* arguing the the memetic plague is actually a fiendishly designed bioweapon that the aliens are deliberately deploying to wipe us out? What if anti-alien media outlets start encouraging anti-alienists to harass and intimidate aliens and the people allied with them by calling the cops on people they see wearing memetic plague blocking space helmets. What if in addition to trumpeting the (human created) vaccine, anti-aliens had also aggressively promoted ginko, ginseng, forsythia, and oleandrin as cures for the memetic plague *before* they ever settled on the ambiguously effective human vaccines as their go to miracle cure? (I mean these as all as honest questions as my adhd forced me to kind of skim the last section and I may have missed something) Would you still say they were basically being reasonable if using flawed reasoning? If all these things had happened as a human I might still have my suspicions of the implants but( if my identity weren't completely emotionally wrapped around anti-alienism) I'd have to admit that my fellow human alien skeptics had behaved far worse and gotten more wrong than even the smug imperious aliens. It's one thing to interrogate the myriad failings of scientific elites, its something else entirely to do so while seemingly ignoring the record of even worse miserable failure and arguably unprovoked culture war aggression that emanates from the opposition to medical/scientific elites. It's something that looks a lot more like rationalization rather than rationalism.
I think I understand at least some of the inchoate anxieties that drive people to vaccine opposition or Ivermectin boosterism. I've struggled with crippling anxiety, sometimes about unknown chemicals, my entire life. I also live in a fairly conservative area and I've had two people I respect and care about approach me and vent their vaccine fears and subtly ask me for advice, which vaccine I'd gotten etc. Imo just on that small sample size there are some relatively organic fears (as opposed to the ginned up ones) that are far stranger, somewhat a-partisan, and in weird way deeper rooted than just these particular noisy culture war flare ups between medical elites and IDW influencers. I get that all Ivermectin boosters and vaccine skeptics aren't necessarily the worst Joe Rogan types but I think we very nearly approached a limit where the persuadable Fauci-skeptics have already bitten the bullet and gotten vaccinated and what's left just isn't very amenable to reason.
This reminds me of the concept of "Conflict Entrepreneurs". There are people with a vested interest in polarization and conflict, because they can profit off it, whether by getting clicks on articles or indirectly by selling things. So they will seek to make any issue in the public sphere into an ideological conflict independent of its prior status
Sorry to nitpick a small object-level issue here, but I don't think sunscreen is actually ubiquitous and uncontroversial. If you look at beauty/skincare subreddits and communities with a lot of newbies, you'll see many people treat the idea of daily sunscreen use as a revelation, rather than a kind of obvious anti-aging measure (and may save you from cancer to boot.) Meanwhile, I've heard a lot of middle-aged or old relatives/friends say they believe sunscreen is unnatural and bad for you and they need the Vitamin D (not that they're supplementing vitamin D or drinking fortified milk in winter, of course.)
I suspect sunscreen is in fact unnatural and bad for you. I think metal oxides are probably okay, and bad sunburns are probably carcinogenic, so I'll smear some on above 8000 ft or so where I tend to burn anyway, but below that I don't wear sunscreen, don't make much effort to cover my skin, and don't burn. I also supplement vitamin D, but I suspect the benefits of sun exposure accrue via other pathways as well.
The wrinkles thing is probably true, but I don't really care.
/deerdiary
There's at least one good effect from sunlight which isn't from vitamin D-- sunlight activates nitric oxide precursors under the sun, and they regulate blood pressure.
Yep, I think that might be the best-studied non-Vitamin-D pathway. I also remember a Greg Cochran post suggesting that sun exposure helped to keep low-grade fungal infections in check, with corresponding health benefits.
Count me in with @psmith .... I think the idea of applying sunscreen daily is insane. I believe depending on your skin type and exposure it is a useful tool like bug spray.
It is unnatural but may not be bad for you (depending ingredients).
It is also a scientific fact that many Americans are chronically low on vitamin d https://pubmed.ncbi.nlm.nih.gov/21310306/ .
Something I forgot. The most famous human in the world, and a relentless, aggressive critic of the aliens actually presided over the alien labs that developed the implants. (This guy even went so far as to call the aliens space rapists one point) He and his followers spent months taking credit for the implants and insisted they couldn't have happened without amazing human ingenuity. To this day you can still sometimes see anti-alienists pop up in message threads bitterly telling you you ought to thank them for developing the implants in the first place. And while the most famous human in the world at the time still affirms that he hates the aliens with all his heart *he still tells his fellow earth-first humans that they really ought to get the implants.*
Does anti-implant sentiment still seem basically reasonable?
It's hard to respond coherently to the alien example theater, so let's drop that pretense.
I think what is MOST interesting about all of this is the interplay between Trump and his followers. Trump bet the farm on vaccines - to the point where he felt no other intervention was necessary. Operation Warp Speed was his big initiative. He was all about it. And... it was successful.
His base didn't buy it. They should be screaming from the rooftops that Trump delivered us from the pandemic and Biden is riding in his coattails. But they're not. Why? Because the Red Tribe has lost control of their base.
Majoree Taylor Green and her ilk are NOT the Right Tribe's elite or their thought leaders. She is a symptom of the cancer in the Red Tribe. The House of Reps is a clown show, and always has been (read Alexis de Tocqueville nothing changes!).
So yes, I think the criticism that the Blue Tribe deserves some blame here is valid. I don't think they're alone in the criticism, and I don't think Scott is claiming that either.
"So yes, I think the criticism that the Blue Tribe deserves some blame here is valid. I don't think they're alone in the criticism, and I don't think Scott is claiming that either."
But his analogy was a one-sided laundry list of failed predictions and allegedly uncharitable things said by the Blue Tribe, which was intended to prove that the Red Tribe's suspicions were on some level rational or understandable. That completely falls apart if you were to take the extra step of adding all the failed predictions and wildly uncharitable things said by the Red Tribe *at the same time* (cases down to zero in March 2020, "Covid is their new Hoax", "as bad as the flu", "hydrochloroquine is the cure, "Oleandrin is the cure"). Like describing a fist fight and only mentioning all the times Jim hit Tom without bothering to mention Tom was hitting Jim at the same time.
Typos:
- "Babaloba et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakoloko”" -> "Babalola et al: Be warned: if I have to refer to this one in real-life conversation, I will expand out the “et al” and call it “Babalola & Alakaloko”" (two misspelled names)
- "mispelled as “Profesional Medical Journal” in its URL" -> "misspelled", though possibly intentional
- "which will lead to them having making good health decisions" -> "which will lead to them making good health decisions"
Long time reader, first time called.... Whats the battery life of these alien implants like ?
Seriously though, that was an awesome deep dive and analysis!
The citation link for Gluchowska et al is missing. Presumably it's this paper? https://doi.org/10.3390/jcm10112533
"Trust Science" is definitely not the right approach. It will devolve in in-group vs out-group. However, simple explanations of underlying truths are much more effectively convincing. In this very article, a simple paragraph, explaining that worm prevalence confounds positive results for ivermectin, did more convincing that all those individual and meta-analyses discussed previously.
Explain the Science! People require a "why" they can understand. Ivermectin works against COVID. Ok. Why? What does it do the virus or the body? Without a clear answer to that, statistics and data are hopelessly getting in the middle of the perpetual cultural warfare.
Honestly, I would be disappointed to learn that "how and why does this drug work" is not the first thing, before even reading a single paper, that doctors consider before deciding on whether to administer a new drug.
It is because sometimes we don't really know how drugs work. Sometimes explanations have been proven wrong and it actually works by a different mechanism than previously thought. As for ivermectin, I think there are some explanations which sound scientific and are proven to work in cell cultures. But it doesn't convince anyone because there are too many potential drugs that work in cell cultures but not in the living body for reasons we don't always fully understand.
I say this as an IVM hopeful: this is how you do it. My anxiety about this topic went way down reading this even though I was specifically called out. But I was also given my due. I was not just called named and dismissed (invariably by some person arguing without good faith). Just like with lab leak, the minute I see this discussed rationaly, I can rest easy because I can have faith the truth will prevail in the end. I can live with IVM not being a COVID cure, but I couldn't bear a cure being denied through censorship, supression and the rank propaganda like "horse dewormer".
I think you misspelt Kyle’s name 😅 Kyle Sheldrick
I don't like the Alien metaphor. Like you said, some of these people aren't stupid, some even have PhDs or Medical degrees. They know what a vaccine does, and that it can't be used to control people, unlike a microchip which literally has logical circuits built into it.
To me, there are two layers of fear here: one is people who dont like needles. This is a lot more than you think, because admitting you're too afraid of needles makes you essentially a child. The other is that they're afraid of side-effects. But instead of voicing these fears, they've managed to turn them into bravery, claiming they're against the establishment or that they are too tough to worry about covid.
We basically have a society so ruined by individualism that no one can be vulnerable.
What do you mean by individualism?
I'd go for normalization of malice, but maybe there's a overlap.
Your second outcomes table (the one resulting in p = 0.04) should probably say "Hospitalization" instead of "Death" in the row for Together. (Also, for others who have been wondering where to find these hospitalization numbers in the given link without watching videos, they are on page 21 of https://dcricollab.dcri.duke.edu/sites/NIHKR/KR/GR-Slides-08-06-21.pdf , inconspicuously linked under "Slides" there.)
Came across this article Neglected Parasitic Infections and Poverty in the United States, Peter J. Hotez. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4154650/ which is interesting in the context of the parasite prevalence conclusion. As it would imply there is more parasite issues in the US than expected, so possibly explain some of the anecdotal reports of invermectin effectiveness? Though would have thought tests would turn up the parasites as well.
Not buying this. You need to factor in regional prevalence. Trials are run in more sophisticated cities, where prevalence of worms would be far less than the outskirts. I live in Chennai, India, and prevalence of worms would be orders of magnitude away from a randomly picked village in India.
Trials are also run in pretty well funded hospitals, which again naturally have a self-selection for wealthier people who again will be far less likely to have worms.
Hi sathish, accounting for regional prevalence is exactly what I did when possible in my analysis. I didn't just use country average prevalences. Wherever possible, I used prevalences as granular to the area where the trial was conducted.
I hadn’t known that - apologies and thank you.
Worm factor: If everyone is getting IVM to treat the worms, there are no more worms to kill that could factor into the covid19 infection outcomes. General availability in the bodies of those people taking it could be the real reason there's much less infections and bad outcomes generally. See Nigeria (average age 20, less co-morbidities in general, ...).
It's a red herring.
Congrats!
Just sharing one piece of evidence that made me decide ivmmeta.com is untrustworthy. After Gideon Meyerowitz-Katz pointed out problems with many of the studies, ivmmeta.com published a response to him (sidebar "Respones", ctrl-F "GMK"). I don't have the time and energy to address the object-level issues in the studies. However, I did a quick search for "We note that this personality [GMK] has an extensive history of incorrect advice, including for example..." and found out that all the examples given were manipulative or outright false (read: pure slander). That was it for me. If they lie or manipulate with something easily checkable (whether X ever said Y), why should I believe them in subtle statistical issues?
Do you truly dismiss all subtle statistical analyses made by any organization that has ever purposefully misled the public on easily checkable issues? Doesn't the CDC qualify as such an organization? I'm not in your brain so I can't be sure, but this kind of smells like a high barrier that you only put on the evidence you dislike...?
I'm not from the US, so I don't really care much (nor am very knowledgeable) about CDC. But, yes, obviously given their track record so far, I'd double or triple check any claim made by them.
> that has ever
I would reduce weight for something said long time ago, different department, before serious changes.
For example, I am not worried that protestants will execute me as a witch - because that is not happening since long time.
I read the social process and got to the opposite conclusion at the time. At one point Gid seemed to be tactically holding back information to discredit specific papers rather than seeking the truth. In contrast, ivmmeta.com at least appeared to be forthcoming with all of the relevant information they had.
We perhaps got to different results here because I was watching Gid's behavior on Twitter and you were looking at ivmmeta.com. Our observations were at different times.
Fortunately our host does seem to be making a good case and does not seem to be holding back information, so Gid's evasiveness doesn't feel so relevant anymore.
Here is where I was with Gid on 2021-10- 10: https://twitter.com/ovjocm/status/1447193034064470034?t=bUjlrX9F90VJ5BHZO6ktxQ&s=19
One of the best things I have read. But you leave out risk and reward. The risk for almost all people to take ivermectin is basically zero, the reward for some people (maybe with worms that decrease their immune response) is positive with a high likelyhood.
This is a strawman argument though. There are thousands (tens of thousands? hundreds of thousands?) of substances with the low risk profile of ivermectin. Just because something is low risk doesn't mean we should have doctors medically prescribing it to the millions of COVID patients. There are numerous reasons why (how many "basically zero risk" substances are you going to ask them to take? How do you pick some from the thousands that have no mechanism of action? Etc.
At the end of the day it is important to have sound theory and credible results behind a medical prescription.
If only there was an much scrutiny on the studies supporting mask mandates and vaccine efficacy.
Masks: talk about statistically insignificant results and very few large scale RCTs.
Vaccine efficacy: Regulatory capture and lack of oversight: https://www.bmj.com/content/375/bmj.n2635
I love how 34lbs of meth was seized, and 33.5lbs made it all the way to evidence lol
I guess they had to test some of it, smell it and so on ;)
Well, while I'm patting myself on the back, let me repost a comment of mine from the September post "Too Good To Check: A Play In Three Acts" where I was trawling through the Cochrane meta-study:
Deiseach Sep 7
(6) India (different study):
DISCUSSION: In this study we did not observe any benefit of adding ivermectin to the hydroxychloroquine in the management of patients of SARS-CoV-2 resistant to standard care treatment. Our finding are based on small cohort of asymptomatic or patients with mild symptoms of COVID-19.Such patients were recruited when they did not responded to the standard treatment. Ivermectin was tested as an adjuvant drug to the standard treatment with hydroxychloroquine. On comparisons of patients receiving hydroxychloroquine plus ivermectin with the patients receiving hydroxychloroquine alone, no significant difference was observed in the cure rates. There were no significant adverse effects were observed in patients receiving ivermectin. The use of ivermectin 12 mg single dose as an adjuvant to standard treatment was based on the widespread uncontrolled studies that suggested that the ivermectin has antiviral activity against a broad range of viruses. .Based on these studies it was concluded that ivermectin's nuclear transport inhibitory activity may be effective against SARS-CoV-2.
(This is one of those "throw it against the wall and see what sticks" studies; ivermectin didn't do much but that's not what they were studying. Result here neutral again, I think).
(7) Argentina:
Findings: The trial run between May 18 and September 29, 2020 with 45 randomized patients (30 in the IVM group and 15 controls). There was no difference in viral load reduction between groups but a significant difference in reduction was found in patients with higher median plasma IVM levels (72% IQR 59 – 77) versus untreated controls (42% IQR 31 – 73) (p=0·004). The mean ivermectin plasma concentration levels also showed a positive correlation with viral decay rate (r:0·47, p=0·02). Adverse events were reported in 5 (33%) patients in the controls and 13 (43%) in the IVM treated group, without a relationship between IVM plasma levels and adverse events.
Interpretation: A concentration dependent antiviral activity of oral high dose IVM was identified in this pilot trial at a dosing regimen that was well tolerated. Large trials with clinical endpoints are necessary to determine the clinical utility of IVM in COVID-19.
(This one contradicts the Bangladesh and Spain studies about reductions in viral load, but it does show 'something something need high doses').
(8) Colombia:
Findings: In this randomized clinical trial that included 476 patients, the duration of symptoms was not significantly different for patients who received a 5-day course of ivermectin compared with placebo (median time to resolution of symptoms, 10 vs 12 days; hazard ratio for resolution of symptoms, 1.07).
Meaning: The findings do not support the use of ivermectin for treatment of mild COVID-19, although larger trials may be needed to understand effects on other clinically relevant outcomes.
(And this one contradicts the Indian 5-day trial. They don't seem to have seen a positive effect re: mortality, and they did manage to screw up the 'which group gets what' dosing. Read the whole thing: https://jamanetwork.com/journals/jama/fullarticle/2777389)
(9) India (different study):
In our study subjects, Ivermectin did not improve the time to symptom recovery, clinical status at day 14, or hospital-free days at day 28 after drug administration. Similar results were observed in the only other randomized-trial of Ivermectin (12 µg/kg) in predominantly mild COVID-19 patients (n=62) in Bangladesh, wherein Podder et al(19) found that Ivermectin failed to hasten the resolution of symptoms compared to usual care. The same investigators repeated RT-PCR only once on day 10 and found that most patients had attained a negative result(19). In contrast, we performed RT-PCR at days 3, 5 and 7 to serially evaluate decline in viral load with Ivermectin. Our rationale was that faster viral load decline may enable the non-severe COVID-19 patient to become non-infectious sooner, thereby limiting the contagion. Indeed, it has been shown that at a lower viral load (CT > 24), infectivity declines with lower viral culture positivity(20). Hence the trend towards increased viral negativity at day 5 with ivermectin 24 mg in our trial, particularly among mildly ill patients, encourages further exploration in this regard.
In a retrospective study of hospitalized patients in Florida(21), patients who received Ivermectin were found to have a significantly lower mortality that those who did not (15% versus 25%). The mortality benefit remained significant after propensity-matched analysis and adjusting for confounders. However, they included patients with greater illness severity than our study population, illustrated by lack of mortality in our trial. Furthermore, the greater use of concurrent therapies and retrospective design preclude drawing definitive conclusions from their data. Nonetheless, we did find a 56.2-61.5% RT-PCR negativity among moderately ill patients who received Ivermectin at day 5 of enrolment. The immunomodulatory rather than antiviral effect of Ivermectin may be hypothetically more important in moderate and severe COVID-19
(Interesting results that you get more bang for your buck, as it were, if you take your ivermectin after a meal and with booze. Again, some contradictory findings).
I'm not going to go through the whole list, but going by this, if you want ivermectin to work, then you should be in India (parts thereof), Bangladesh, or Florida.
I was going to point out that you were right about infection with worms being an important factor, but you beat me to it. I join in the back-patting.
Thank you RTÉ and years of tea-time adverts for cattle drench, fertiliser, and "it's a quare name but great stuff!" https://www.glanbiaconnect.com/shop/product/Cheno-Unction/B9061391 🤣
To make up for this, I will be hideously wrong on my next prediction about something that is a sure-fire cure!
Scott: "It feels right to me because it’s the most troll-ish possible solution. Everybody was wrong!"
You turning out to be right made it funnier.
I'm hoping but not expecting that the human genome will turn out to be the result of alien meddling. This would make the evolutionists *and* the creationists both wrong.
Yep, just me and the trolls, chilling out here under this bridge 😁
Impressive indeed.
The social takeaway is an alluring story, but it's a little pat.
I, too, am a temporarily-embarrassed expert of all kinds. Also, about half the people I know are creationists, but a surprising number of them are conversant with science and expertise - both the immunologist kind where experts wear white lab coats, and the plumber kind where experts keep the immunologists from sloshing through poop on the walk to the metro.
My personal feeling, and that of all the thoughtful vaccine-hesitant and ivermectin-curious people I've talked to about it (n~=10) is that I'm very angry at the authority-experts, I feel manipulated and spoken down to and frankly betrayed. If anyone is treating anyone like a horse, it's the elites who want to herd me into the corral. I couldn't care less if it's for my own good, or even if they're right about it - I resent being treated like cattle. The risk I perceive from a little vaccine hesitancy (I got the shot when it became convenient, but no sooner, and I don't even remember which one) and a little ivermectin curiosity (I've never even seen ivermectin but I wouldn't turn it down if someone passed me some at a party) is very low, and it trolls the Confident Ones so it seems like a pretty safe way to vent my anger and resentment at them.
Reasonable question! Part of the answer is that I'm just angry, it's not a decision or anything, and venting makes me feel better. But it's also true that I do encourage that anger a little, and it's because I don't want to just get used to it. Every time I make a choice about my future, I want to take into account that there are big powerful forces trying to herd me. Maybe it's my own weakness, but it's easy to forget that when the proof isn't right in front of you and right now you just have to make a choice and it would be so convenient to go with the herd without even noticing it.
But that's not why I post comments like this - i.e. "troll" the authority-elites, though "troll" is probably too harsh a term. I have the impression that my blind spots are different than the norm in places like this (e.g., I hang out with creationists, I have long talks over beer with blue collar types, etc.) I'm a committed rationalist (for example I first read the Sequences long ago and I read them yearly for a while) so I think my perspective is not only different, but also compatible. (Symmetrically, I do the same thing with my less rationalist friends. There are plenty of Confident Ones on all sides.) If I had more time, I'd write more, but as it is I contribute occasional comments when I see a hole, like in Scott's social takeaway.
"I know that even if somebody wanted to control you by sneaking a microchip into a vaccine, that’s impossible with current technology. I know enough about politics and economics to know it’s really unlikely that some cabal of elites has developed super-futuristic technology in secret."
Well, and there's shady shit like this to make people go "See? SEE??? You can't trust the bastards!"
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60900-4/fulltext
"On May 2, 2011, President Barack Obama announced that the US Central Intelligence Agency (CIA) had located and killed Osama Bin Laden. The agency organised a fake hepatitis vaccination campaign in Abottabad, Pakistan, in a bid to obtain DNA from the children of Bin Laden, to confirm the presence of the family in a compound and sanction the rollout of a risky and extensive operation. Release of this information has had a disastrous effect on worldwide eradication of infectious diseases, especially polio.
On May 16, 2014, the White House announced that the CIA will no longer use vaccination programmes as a cover for espionage. The news comes in the wake of a series of militant attacks on polio vaccination workers in Pakistan, with legitimate health-care workers targeted as being US spies. The attacks have forced organisations such as the UN to suspend polio vaccination efforts in Pakistan, and have severely hampered anti-polio efforts, with parents refusing to have their children vaccinated. News of the vaccination programme led to a banning of vaccination in areas controlled by the Pakistan Taliban, and added to existing scepticism surrounding the sincerity of public health efforts by the international health community.
Consequently, WHO declared that polio has re-emerged as a public health emergency in Pakistan—one of only three countries, including Afghanistan and Nigeria, where the disease remains endemic. According to the Global Polio Eradication Initiative, 61 of 77 cases of polio reported this year have been in Pakistan, and cases of paralytic polio have spiked, with 66 cases reported up to now, compared with only 14 last year.
The lesson learned from the experience in Pakistan is that public health programmes should be politically neutral. Although the announcement from the White House might go some way to building bridges towards that neutrality, health officials and local leaders now have the challenge of convincing communities that vaccination is not merely beneficial, but vital for children."
Has someone tried to estimate death toll of that?
Deeply regrettable, but alas all too typical. The Obama Administration was much to ready to cut corners in pursuit of what they saw to be noble aims. I don't attribute that to ideology or malice, but to the fact that they were unusually young (in years, I mean). Zealous kids.
That is a bit more charitable than I would be. I'd chalk it up more to callus indifference to the results of their actions. The outcome was hardly unforeseeable for someone vaguely intelligent and paying attention to consequences.
Callous indifference to the results of one's actions sounds pretty human to me, though perhaps its more common among young people. I'd need evidence for that.
Older people might know more about the likely effects of their actions, which isn't the same thing as caring.
I am a little confused how to interpret your comment, sorry.
I think your framing of the central issue as one of outreach/messaging is mistaken.
Until and unless the central institutions become worthy of trust, many proles will continue to defy them and believe weird stuff instead.
The strategy is not for the Establishment to become better at PR campaigns. It's for it to stop acting like hostile aliens, who (inadvertently, hubristically) created this virus in a lab and then used it as a pretext for a global social engineering effort aimed directly at the lives of normal people.
Great post.
> I want a world where “I did a study, but I can’t show you the data” should be taken as seriously as “I determined P = NP, but I can’t show you the proof.”
I am not a theoretical computer scientist, but I guess that you could possibly convince me that you had a polynomial algorithm to solve NP-hard problems just by solving challenges of a suitable size -- much like solving sample cubic equations was meant to convince others you had a formula to solve them back in the time of Tartaglia. (This of course will not help if you have an existence proof only or can solve SAT in O(n^200).)
Also, it seems like most people faking data (that we know about) are much less science literate than the people checking them. Carlisle-Stouffer-Fisher and GRIM detection could both be avoided when the fakers would go to the trouble of actually simulating a study instead of just making up percentages on the spot, I guess?
Of course, if you have to publish your raw data, this becomes a lot harder, as people could sanity check any correlations in your sample, e.g. between obesity and smoking. The best way to fake data then might be to take past real patient data, randomly assign them to intervention and control group and discard 30% of death in the intervention group.
To detect this, you would basically have to deanonymize patient data so that people could check the actual outcomes, I guess? Which basically would mean employing a trusted intermediary somehow?
> just by solving challenges of a suitable size
that is also a proof
"I totally solved this challenge" would be lack of proof.
"I’m not an immunologist. I don’t have the specific expertise it would take to evaluate whether vaccines work."
...
"Again, ivermectin optimism isn’t exactly like vaccine denialism - it’s a less open-and-shut question, you can still make a plausible argument for it."
So, how can you lack expertise to evaluate, yet be sure enough about it to use langauge like "open-and-shut" and no "plausible" argument?
There is difference between administering vaccine trial and interpreting its results.
Lopez-Medina et al is cited often because it shows that ivermectin is only moderately useful. They did it by shortening the observation period to 21 days so they haven't had to observe too many deaths. Even then they had one death in the placebo group and none in the treatment group, but they ignored that completely in their conclusions.
I would like to see a discussion on possible microbiological ways Ivermectin could work. It's protease inhibitor. The new drug currently being developed by Pfizer with allegedly 90% efficiency is also a protease inhibitor. I am not a microbiologist, but how different could these two be?
Besides that, we should be free to choose what medicine we take, given side effects are clearly explained, no matter how flimsy the evidence for effectiveness is.
Ivermectin isn't a protease inhibitor. Its mechanism against parasites is holding chloride channels open, which causes cells to shut down.
Wiki: https://en.m.wikipedia.org/wiki/Ivermectin#Mechanism_of_action
Ivermectin is many things. It is also a protease inhibitor.
https://www.nature.com/articles/s42003-020-01577-x
As to whether this is a plausible mechanism for IVM helping with C19, I don't know.
I think that might better be put as "simulations suggest it might be" rather than "it is." Computer simulations of big biomolecules are frequently wrong. Which I guess is lucky for the careers of the med chem people who have to do it the hard way (make the molecule, do the measurement).
In Vitro and in Silico assays have shown reasonable evidence that it can bind to one of Covids Proteases subunits, and also somewhat worse to both the Covid Spike Protein as well as to the receptor for that spike protein.
Mechanically, the Pfizer curative and Ivermectin look and most likely act very differently.
If one accepts in silico evidence, the one thing they have in common is intereference with the Covid CLA3 protease.
Pfizer curative trolls the Protease into using it as a building block for one of its subunits, and then becoming ineffective, while my guess is that Ivermectin probably binds to neccessary for functioning parts of the Protease thus temporarily or permanently reducing its functions.
Thanks for the explanation. Sounds a little bit like you are not quite sure how exactly Ivermectin works In Vitro though. In any case, both seem to act as protease inhibitors if I understand correctly
Thanks for talking about this. I came here to see if it had been mentioned. I appreciate Scott's approach where the drug is considered almost as a "black box" and we're only looking at the study data, however it seems that it dwindles down into a fractal rebuttal of rebuttal "ad modem" (attack of the methods) argument as these things often will. Ivermectin has been studied and there's a proposed method of action, which, to my knowledge is the same as the new Pfizer drug. This video by John Campbell goes into this in detail and, in my uneducated opinion, makes a great argument with quality sources showing "proof" for each point (Pfizer claims their drug works through protease inhibition on 3CL, Ivermectin has been shown to do the same, etc.). https://www.youtube.com/watch?v=ufy2AweXRkc With this in mind, it seems foolish to look only at a somewhat flawed, erratic, and politicized set of studies. If Campbell's argument checks out based on what is in those papers, we'd expect to be able to run a trial with Ivermectin using as similar as possible effective dosages and schedules (pre, post infection, etc.) and achieve similar results. This might not happen in practice of course, as one might be longe lasting or have who-knows-what difference, but at least it seems to be a logical hypothesis. Am I missing something obvious? I do see A.I.S's comment below and I'll try to learn more about the implications or if this has been addressed elsewhere.
This is like, the short version:
Does X theoretically works vs Y, mechanically.
1rst step: Have in silico studies where you match the structure of the protein to the structure of the proposed drug, see if they latch. This happens on a computer. Ivermectin, as far as I am concerned, passed this test. Anyone with a computer can do in silico studies, computational power has gotten pretty cheap.
2nd step: Have in vitro studies, where you basically mount the protein on a bullseye, and throw the proposed drug at it. This happens in a lab, you can do this in a basic university lab actually, provided you can order covid CLA 3 Protease.
Ivermectin passed this as well.
3rd step: You go into actual living systems. Typically mice. If you know that a drug is harmless, you can in some cases jump to humans. The drug now either works, does not works, or has a statisitically non significant result. Ivermectins passing of this step is debatable.
Mechanically, there are 2 main reasons to explain why in vitro binding =! in vivo being a cure. One is that detected in vivo binding does not neccessarily mean that this actually inhibits to protein from doing its function.
If I for example go for a sparring match, and blindfold myself, my boxing function would be very much inhibitied. If I however just use a headband, there would be no inhibition, even thought the blindfold and the headband are very similar, and bind to the same part of my body (the head).
The second part is that the body is a rather large place, from the perspective of a virus and even more so from the perspective of an Ivermectin protein. Actually finding a CLA Protease is not trivial, Ivermectin binds to a lot of things, and Covid does not express CLA Protease on the outward facing part of its hull (unlike its spike protein).
I would have been very very happy if Ivermectin would work, because it is safe, cheap, and its manufactoring capacities can be boosted by making use of manufactoring capacities currently used for horse ivermectin (retooling a factory is easer then building a new one), I am yet unconvinced that it does.
Thanks for the rundown of each step and metaphor for that last one. It's a lot clearer now why it might not be as simple as is shown in the video. I hope that last question on whether or not there is similar inhibition gets more attention.
This article really stands out. Thank you very much!
As to the political part: I wonder if the strong US divide between "blue tribe" and "red tribe" doesn't lead to oversimplification, and veiling a diversity of motivations. Lots of anti-vaxxers in western European countries with a strong vaccine-critical movement (at least France and Germany, perhaps Italy too but I'm far less knowledgeable about it) would imho definitely be "blue tribe" if transposed into the American context, and I don't think the medical establishment feels like aliens to them.
I don't think the left-wing antivaxxer is absent from America.
Honestly, I really wanna know what's become of the left-wing antivaxxer in 2021. Have they flipped to getting a vaccine? Flipped to conservative or QAnon? Still in the same camp? What's up?
We spent the last decade defenestrating them. This (left wing anti-vax) went from being "that family is a little weird but they're crunchy" to "that family hates science and we shouldn't let their kids anywhere near ours". This had the effect the most of the loose hippy-dippy lefty ones just quietly left the movement once there were social costs, leaving only the hard core crazies. No idea what's become of them, I haven't seen one in the wild in years.
Now that you mention it, the whole hippy Birkenstock live off the land, grow your own food (and dope), get those damn government fingers out of my life demographic seems to have dried up (at least in the US). It's strange. The most viisible modern left has become corporatized, establishment, and pro-government in a way that would make Ward and June Cleaver's head spin. They drive $50,000 cars (albeit Teslas instead of Beemers), network via iPhones, and pull down $250k a year as employees for Fortune 500 firms. Weird how things change, but don't, if you know what I mean.
For what it's worth, my guess at the end of part 1 was "if all the small studies show a weak positive effect," and all the large studies show no effect, there's probably a confounder in the small studies that we haven't thought of." Maybe big trials have more people watching and do a better job of randomizing in some subtle way. Maybe Big Dewormer isn't very wealthy and can only fund the small studies. Maybe the small studies are from smaller countries and there's some subtle bias introduced by that.
But I didn't expect it to be worms.
> People are going to fight hard against this, partly because it’s annoying and partly because of (imho exaggerated) patient privacy related concerns.
I think there are more selfish motives. Keeping the data private means they could potentially slice the data another way to get another publication out of it. Making the data public means someone else could easily scoop them. Requiring pre-registration maybe eliminates this incentive.
Good review overall. I had seen enough to be convinced there was *something* going on with ivermectin, but didn't dig deep enough to ferret out exactly what was going on. Combined with how so much of the criticism seemed ridiculously far fetched and partisan raised my suspicion as well, as you described.
Trust is hard....
https://thereader.mitpress.mit.edu/why-science-cant-fix-politics/
"""
Scientized debates also tend to be biased in terms of who bears the burden of proof. Many large businesses’ lobbies have demanded that any regulation affecting their products should be rooted in “sound science.” On its surface, that demand seems reasonable. Why would anyone not want regulations to be based on the best available scientific knowledge? However, the implication of “sound-science” policy is that no restrictive regulation of an industry can be developed until proof of harm is conclusively demonstrated.
Scientists are often not able to provide firm answers, especially for complex physiological and environmental phenomena — and typically not in the time scales appropriate to policymaking. As a result, calls for “sound science” end up being a delaying tactic that provides an advantage to the industrial firms producing risky products at the potential expense of humans and nonhuman species — who may be needlessly exposed to potentially toxic substances during the decades spent “proving” harm.
Political scientism starkly divides societies into friends and enemies, the enlightened and the ignorant.
""""
Great comment. The burden of proof is constantly shifting.
Absolutely fantastic post. There aren't many people out there writing with such a sincere commitment to unbiasedness, charity towards hostile viewpoints, and the courage to tackle controversial topics. Well done.
The treatment regimen the American group is recommending includes Vitamin D, Vitamin C, Zinc and a Zinc ionophore (drug that facilitates cellular absorption of Zinc). The ionophore can be Ivermectin, Hydroxychloroquine or Quercetin.
I have been baffled up until now why studies are not looking specifically at the combined treatment, just the ionophore, with no regard to whether it was being taken with Zinc or the other drugs. The fact that even Scott seems to have overlooked this is very concerning.
It's the Zinc that inhibits coronavirus replication. That's the whole theory.
I agree. It's very strange given how early that was identified.
I think you're giving the study investigators far too much credit, and examining their role with too little skepticism.
https://roundingtheearth.substack.com/p/the-meta-analytical-fixers-part-ii
Terrific post. There is a flip side to the vax deniers/ivermectin promoters. The popular coverage of the ivermectin issue in the MSM was also pretty hysterical. A question: given the apparent low downside risks of taking ivermectin, would it not have been rational to use the drug? In other words, in the absence of evidence that it was harmful to use, given its long track record of non harmful use why not use? Of course, once we have decent reasons to think it does not good then why use it. But as you note, getting to this point was quite a journey.
We still need the "vax-denier" version of this thorough article. I'm waiting.
The mainstream coverage was hysterical because ivermectin was being pushed as a miracle cure by anti-vaxxers, and an alarming number of people seemed to believe them. Anyone who thought "I don't want the vaccine, I'll just use ivermectin" was 100% making the wrong decision. Even if ivermectin *had* turned out to be slightly effective against Covid, preventing the disease is better than treating it.
"Ivermectin may help in some countries" is an interesting fact worth sharing, but it's the sort of fact that belongs in the science section on page 3. The fact that should go in 48-point bold on the front page is still "THERE IS NO PILL AS EFFECTIVE AS A VACCINE." So I really can't fault how this got covered in the mainstream.
If everyone got vaccinated and we were just haggling over the marginal case of "what is the optimal treatment protocol for breakthrough infections?", the discourse would look a lot different.
I think you are right that the issue was fear that Ivermectin would support vax hesitancy. But it was more than this, as the heat of the denunciations indicated. The best read is yours, that the heat was a kind of nobel lie to prevent the worst interpretations from happening come down as hard as possible. The problem is that this didnt work very well. Moreover, I suspect that there was also a desire to embarras. Follow the science! I think that if you want people to follow the science then it is best to model scientific discussion. And in the case of Ivermectin the science at the time was not clear it does any good, but seems pretty anodyne. Just dont use it in place of vax. That would have been honest, and might have worked better. As it was, it just became another battle in the culture wars.
I wouldn't usually interject into these kinds of conversations... but I have been *so* frustrated by people telling me to trust the science, and yet prevent science for happening. And I need to damn well vent.
Science gets people killed - trials require placebo groups who don't get potentially life-saving treatment, and gives people potentially dangerous drugs. Science requires debate and conversation - the same people who are intent on banning and suppressing "disinformation" are preventing legitimate discussion since censorship is a hammer and smashes ALL, both the legitimate discussing along with the illegitimate. Science takes time, and gets things wrong more often than right. Science requires we not get emotionally invested in what WE believe is the truth, because it may not be. Science requires dissent and people doing things differently - so please no vaccine mandates. After all, if there ARE long-term health effects from the mRNA covid vaccines, perhaps we should WANT a control group who hasn't had it, to compare outcomes with? Science requires providing data and letting others check your work - rather than hiding it and simply telling people that it's perfectly safe.
I also hope to never hear the term "expert" again, or have the 'benevolent' government forcing things upon me for my own good. This whole pandemic response has destroyed my trust in virtually all institutions, and all I really want now is to be left alone, and allowed to make my own medical decisions... which for the first time in my life, I'm fearful will be stripped from me. I can weigh my own damn risks *according to my own set of values*, thank you get very much. I can make my own choices. I'm an adult, and I accept the consequences of my actions. But at least for the time being, they are still MY actions to make.
> For example, if a paper reports analyzing 10 patients and finding that 27% of them recovered, something has gone wrong.
Great, there's no problem here, but you've used this type of analysis to slam the Nigerian study, and to make snide rhetorical asides about the Nigerian study while discussing other things, and I think it's worth pointing out that the reported data you've highlighted in Babalola et al. is not an example of this problem. It is impossible for 27% of 10 patients to recover. But it's not at all impossible for 50% of 21 patients to recover. That's just a question of how many significant digits you think you should use to report your results.
And as a matter of first principles, as opposed to cultural norms, I don't see a big problem with reporting results that were drawn from 21 people to just one significant digit. There isn't enough data to justify a second digit!
(Am I saying that Babalola et al. were entirely on the level and just nobly setting a higher standard for reporting precision? No. But I'm uncomfortable seeing their study slammed for exhibiting what is ultimately *better practice* than the cultural norm. Call them out for that, and you end up drawing bad lessons.)
> But it's not at all impossible for 50% of 21 patients to recover. That's just a question of how many significant digits you think you should use to report your results.
No. It's a question of why they decided to report 0 significant digits for those results, but were happy to report the additional digit for the 13 or so other results in the same table.
No, that's a completely separate criticism. "Why does this column look so different from every other column?" is a question you can ask without reference to what you think the values in the cells can potentially be. Scott has pounded heavily on the idea that you can't measure 50% of 21 people. That idea is incorrect. Accepting it will lead to bad conclusions. The low-precision numbers are what that paper is doing *right*. The high-precision columns are wrong.
The discrepancy between columns can inform your opinion of "DID they get these numbers, or are they making them up?". But that is not the same question as "COULD they get these numbers?". That second question is easy, and the answer is yes.
I get why you used a picture of Dune sandworms, but a better choice would have been Flukeman from that second season episode of the X-Files.
I think you're right that the theory that ivermectin was effective but people in the medical establishment were downplaying, ignoring, or lying about this for financial reason was indeed "extremely plausible," and helps explain why people like Bret Weinstein, who seems like generally a good guy, went so all in on it. With that in mind, I think the political takeaway here needs a couple more points added to it:
1. I don't know how many conferences at five star resorts on Tralfamadore or Coruscant the aliens have attended on the brain implant manufacturer's dime.
2. I don't know the extent of industry capture in the aliens' medical device regulatory agencies.
3. I don't know how much stock these aliens own in the company that manufactures the implant or what kind of swag the company's sales people (sales aliens?) might offer.
4. I don't know to what extent alien medical grant funding decisions are consolidated in a small number of people or agencies, which might be used to create a false image of consensus among the aliens.
5. In short, it's hard for me to develop an accurate picture of what incentives the aliens face, and how those incentives might affect what they say publicly about the desirability of universal brain implants.
But do we distrust the aliens enough to think that they fabricated their trial data and that the FDA are in on it?
Well, just to be clear, I personally have a Johnson & Johnson made brain implant, so that's a 'no' in my case, but from what I gather from those who have eschewed to follow the prescribed disease prevention plan in our current pandemic, I think their belief is that the studies were rushed and thus the downside risks related to complications from the vaccine like myocarditis were not captured in the trials or were ignored or what have you.
True. But I guess I just don’t understand why we’d trust other aliens with different studies that turn out to be ever more rushed and flimsy. :)
Again, I think the incentives played a role in how people came to view both: the federal government has spent umpteen billion dollars funding vaccine research over the past 18 months or so. Once there were a couple different versions, there was, I'm sure, plenty of political pressure to start showing a positive ROI on all that money sooner rather than later, especially after people's hopes were raised in the interim by news of their development. "We spent $10 billion on developing a novel vaccine, but we can't roll it out because it failed our safety review. You'll just have to wait longer, people" is not a message politicians or the bureaucracy wants to have to deliver. On the flipside, nobody really has an incentive to favor ivermectin as a treatment option because it's off patent.
Again, I'm not saying this is an accurate or complete picture, I'm not saying it's a compelling picture, but I do think it's a plausible one and some people out there found it compelling.
"I personally have a Johnson & Johnson made brain implant, so that's a 'no' in my case" - that's what an alien-controlled human would say. LOL
Don't blame me, I voted for Kodos.
This is sort of off the cuff, but maybe the takeaway should be "Trust decentralized decision making processes, instead of centralized bureaucracies or guilds."
Also, on this point:
"But you also don’t want people to make bad health decisions."
I agree with this on a moral level, but if you don't know which health decisions are bad and which health decisions are good, then don't you sort of need some people to make bad decisions some of the time?
"So what do you do?" Give people as honest and complete a picture as possible and let them choose for themselves what to do with that information. Don't limit people's options unless there are significant externalities.
Did you read the post?!? The decentralized approach of ivermeta website seems to be completely wrong. And “giving people all the data” lead to millions of people believing that ivermectin is a miracle cure.
I think the takeaway is unfortunately that big name journals and organizations like WHO and FDA and NIH seem to be more trustworthy than an anonymous website and a coalition of loud doctors.
I don’t find this conclusion satisfying, but I don’t have a good synthesis from all our covid experiences to conclude a simple prescription on who to trust. Just who NOT to trust.
I did read the post, but I guess I had a different takeaway. The medical establishment seems to have been right about ivermectin, but not for the right reasons. I don't give them a ton of credit for that.
And while I agree that the decentralized-process ivmmeta.com guy(s) and the authors of the studies they relied upon also got it wrong, I group "ASC and a bunch of academics doing meta analyses and thinking really hard about confounders" as also being part of the decentralized-process that ultimately seems to have arrived at the right answer.
In other words, I accept that error is part of trial-and-error, but I'm a lot less forgiving of error when it's part of argument-from-authority.
Yeah, sorry for my rude first sentence.
I don’t think the medical establishment was right for the wrong reasons. All along, docs and scientists have been saying that the data supporting ivermectin is flimsy and they’re waiting for good, large RCTs before starting to prescribe to patients. The sleuths finding fraud only bolster the official position of orgs like NIH and WHO.
That’s because docs and scientists see flimsy data all the time, and they know that there are an infinite number of shitty journals that will publish anything. They’ve learned to be skeptical of poorly done science, because they know how easy it is to trick oneself with biased and confounded data.
I don’t trust scientists and scientific orgs because they are authorities, but because they (try to) apply the same skepticism to things that they believe as they do to things that they don’t believe.
No worries. And I'll admit that I might be too hard on "the establishment" because of my Hayekian bias in favor of bottom up systems.
Argument of authority is on itself a logical fallacy, and highly suspect. "Authorities" and "experts" are NOT some kind of saintly angels with no self interest or incorruptible. In fact they are VERY corruptible. Decentralized decision making crates a robust, stable, outcome mesh. Centralized systems are very unstable, any mistake can extinguish human life. Just imagine the pfizer vax had the undesirable effect of making your sperm inert (we still don't know the full long term effects), and every man on earth took it. For another example of the fragility of centralized systems, look how the Incas (an extremely centralized civilization) were conquered by 20 spaniards when they kidnapped the Inca (emperor). But they couldn't beat the decentralized mapuche of southern Chile and Argentina in 300 years of war. The economy has also nice examples.
Yes but there is still value in expertise.
This article is a great example of how *hard* it is to perform a good medical review. Most people have not had the training to do so.
Our medical community *is* decentralized today. There are a lot of different experts reviewing and commenting and driving forward science. Yes, eventually the FDA or the CDC need to take a position based on the outcome of that work, so in that sense there is centralization, but all of the other voices are still there and available.
I do not believe a 10,000 couch doctors without any experience reviewing medical studies can perform an appropriate medical meta analysis.
I consider myself very bright, a natural skeptic, and aware of my own potential biases. I would have missed a good number of the items that Scott raised in this article, let alone the countless more specific details that he either only eluded to or didn't even mention. I just don't have the skills.
Skills matter. When it comes to golf I will bet on Tiger Woods over 100,000 randomly selected individuals any day. I want a trained surgeon giving me a heart transplant, not 100,000 internet commentators who have "done the research". Before I sit down and go 80 mph on a highway in a metal death box I am reassured the experienced people with skills and training built my car, not 100,000 twitterati who watched youtube and read repair manuals.
I'm not so happy with the "everyone was wrong" conclusion. Everyone wasn't equally wrong. There were people following studies and drawing reasonable conclusions (as you pointed out) and others demonized a harmless medicine that by all appearances seemed to be saving lives. And it actually did so in many places. They might happen to be vindicated (not of their own accord) if we pretend mainstream media only affects the west. Even if you're right, I wonder how many lives were lost in the 3rd world due to the demonization of ivermectin? Is "being wrong" the right expression for this?
Yeah, this is def not an “everyone was wrong.” Most docs and scientists said that ivermectin might be helpful, but the studies so far were low quality. Folks like Dr. Daniel Griffin mentioned the worm/steroids thing a year ago.
Twitter and NYT mocking “horse dewormer” was a very small sliver of the mainstream experts who voiced concern about ivermectin. They were just the loudest.
I don't understand why Scott rejects the Ghauri study from Pakistan for non-random allocation of subjects. Wouldn't sicker subjects be given ivermectin, anyway? It seems that the non-random nature of allocation would bias the study towards *not* finding a significant effect for ivermectin, and the study still finds it, supporting the hypothesis that ivermectin has a large positive effect on Covid patients.
Is that true? If I were sicker, I’d want the proven therapy. And very sick patients can’t discuss and consent and just end up in the control. It’s a mess, either way.
But Scott rejects another study by saying that sicker patients would opt out of studies just so that they could take ivermectin, and not be subject to randomization.
Can you quote him? Anyway, my point is not that it confounds only in one direction, but *that we don’t know* how it confounds, so we can’t easily correct for it.
Wow what a great piece of writing (not sarcastic, i promise)
I think one element of the political takeaway that was understated is the idea of something like normalization of control, and how that plays into commands that are mentally bucketed with other commands.
The idea that the left (in the part of the government sense) loves to have as much control as possible and to overall put in as many restrictions as possible so it's more "in control" isn't a new one; a lot of people on the right hold it. And the idea that the left (in the voter bloc sense) likes being restricted in this way to the point where they will sometimes make obeying restrictions into a performative social signaling type of thing isn't new to them, either.
A lot of these people have accurately noticed that when the government gets "I can tell you to do this" normalized on any particular subject, not only do you never get that particular freedom back but it also makes it easier for the next command to be considered normal. They aren't going to see "take vaccines" as a needle-thin targeted command, because to them it's part of a super-obvious wave of "no, we eventually want to have much greater control over what you can be compelled to do or not do in a lot of parts of your life; do this one so the next one is easier for us, please".
The reason this is distinct is because it deemphasizes the "do vaccines work and do they have microchips" part of things; you can think the vaccines are part of a greater scheme to control you without thinking they have nano-tech control devices, particularly. Imagine the scenario you proposed with the aliens to include "and if they get everyone to have microchips, they've established a precedent where they get greater control over all human healthcare forever" and you are close.
The Last Psychiatrist once did an article on Dove Soap creating arguments on beauty, where the practical upshot of creating the argument for Dove is that they were then viewed as an authority on beauty at least important enough to be in the argument. More simply, they normalized the idea of "If Dove gets something wrong on beauty, that matters" which naturally leads into "Dove matters". Similarly here, the right is correct to notice that if the left can force vaccines on them, then "We are an authority on this vaccine and making you take it" naturally translates into "We are an authority on your health, and can make you do a bunch of stuff".
I actually think part of why "these have microchips to control you" theories got a foothold as easily as they did is because of this; if the political left views this not just as a "get good health outcomes" thing, but also as a "how dare they disobey us; crush the other!" thing as well, then the average person might pick up those "this is also about making sure people know who is boss" vibes and go looking for a plausible way the left gets the control it's clearly seeking from a simple shot. Some people look in the wrong place for the mechanism of control (the tech) but that doesn't mean the actual mechanism of control (establishing an ever widening sphere of places in which one has command) doesn't exist.
Nice comment. I agree there was a bit of medical libertarianism in play with some people who are "vaccine hesitant" or whatever the term of art is these days.
I think the hostility dynamic is waaay more important than the alien dynamic in explaining why some people don't just ignore the medical establishment, but seem to actively go against it. In fact, I think it explains a lot more than people's varying reactions to COVID. Something like 25% of Americans hate something like another 25% of Americans and think latter is out to destroy the former's way of life (and the feeling is mutual). So, yeah, trust is going to be hard to build. And even when the objective evidence is pretty strongly on one side, sometimes people do potentially harmful things just to spite their enemies. In the case of COVID this is even easier to do because the risk is in this weird gray area somewhere between background-level that everyone sort of ignores and existential that scares everyone into the same boat.
Thanks much for this. Very high value post, and (part of) why I'm glad I support this substack.
Excellent, really useful. Covers both the scientific and social/political aspects. Really appreciate the effort to pull this together.
I WONDER what would happen if you applied the same level of rigorousness to the effectiveness studies (and other data, like adverse effect prevalence) available for the emergency authorized vaccines. Not holding my breath tho.
"So “believe experts”? That would have been better advice in this case. But the experts have beclowned themselves again and again throughout this pandemic"
This whole article could have been summarized in these two sentences, and it's really all you need to know. The establishment has visibly produced a string of completely absurd measures and policies against Covid. Every time you get something like Biden ignoring mask laws, that's a hit to the credibility of vaccines and scientists. It's like OJ Simpson, who got found not guilty because he was guilty, but the police tried to frame him anyway.
I think Scott managed to get this right, but he's softening it by far too much. "People feel like the establishment is hostile aliens" is one thing. "The establishment acts in ways that resemble hostile aliens" is very different. And Scott is putting too much emphasis on the former, and not enough on the latter, and when he does mention the latter, it's things that they're doing at the start of the pandemic, not things they're doing now. Biden ignored the mask laws just a month ago, and eviction bans where Covid is used as an excuse for blatantly political sticking it to the landlords are quite recent. Scott didn't even mention the double standard over BLM riots during a pandemic.
I have some sympathy for this attitude, but at the same time, I think there's an important sense in which it really only makes sense if you gold the left wing of our political establishment specifically responsible for being the adults in the room.
Should Biden have ignored mask laws? Clearly no. Did Democrats exercise a double standard over BLM protests? Absolutely, and I called people in my own social circles on this at the time. Do liberals favor eviction bans because they stick it to landlords? It probably increases support, although caring for poor and potentially homeless people is already left-aligned policy without bringing landlords into the picture at all.
But at the same time, when right wing establishment figures have acted to politicize questions like "is Covid-19 dangerous and worth taking seriously at all?" Or "is it a good idea to get vaccinated?" Which are much simpler and easier to answer than the ones we're looking at here, then expecting left wing figures to do a better job than they're doing to set a better example means holding them responsible for being much smarter than figures across the aisle from them.
Left wing figures could have done a much better job than they have, but if they had met these standards, it would have meant our populace was divided along political lines into "the dumb side that needs to be carefully shepherded" and "the smart side which is responsible for taking care of them." I don't think we can expect things to shake out like that in reality.
I was talking about the establishment discrediting themselves because on one hand, they say that vaccines are good, but on the other hand their very obvious allies are doing other things which lead to a loss of trust. The right-wing "establishment" are trying to discredit the other side. They're not discrediting <i>themselves</i>. It's a very different kind of thing.
And even counting them as the establishment is questionable, because they don't have enough influence; they're not in the political system, and they don't control the media (let alone social media).
Trump, as president, made public statements that the virus was nothing to worry about, that the pandemic would go away on its own, while recordings of internal discussions indicate that he believed it to be a deadly serious threat. I don't see how that fails to meet the standards of "establishment " or "self-discrediting." Rather, I think it's a serious problem that many conservatives only recognize "media" or "establishment" as such when they're liberal.
That counts as a single example of a non-leftist establishment figure saying something stupid and self-discrediting, but Trump was an anomaly. The media and political estblishment are leftist by a huge margin, and the overwheming majority of such things comes from the left simply because the left has so much control, even if not literally every single one does.
Well you’ve done it. I think this is in the top 5 list of best things you’ve ever written.
Criminettlies! Get outside, live. If you have to do such studying, follow the money.
I was convinced of the conclusion from Deiseach's comment earlier, so no surprises for me personally. (Another +1 to Deiseach from me.)
However, the comprehensive treatment made me notice something else:
The places with a preponderance of parasites tend to be the places where medical trials aren't great. The places without much parasites tend to be the places where medical trials are comparatively excellent. This association is not coincidental.
That is, a high standard of quality for evidence may bias you towards interventions that work in developed countries, and bias you away from interventions that work in developing countries, insofar as there is a difference in outcome between them.
And I think this is a lot more of a generalized phenomenon than that statement may imply, and that a high standard of quality for evidence is itself not an accident; we calibrate to the environment we experience.
(Also, the hostile alien thing is quite general, and I've slowly come to a position I'd describe as rational anti-rationality, away from a position I used to occupy in which I believed it was best to believe whatever the best arguments and evidence suggested was true. Increasingly I believe the relevant currency is not evidence, but trust.)
I wrote about this in June-July: https://www.notion.so/yevaud/The-Treatment-for-COVID-19-e052c9d829d34bc49eb6a2e1d2ad8e63 - the short summary:
1. Ivermectin clearly isn't as effective as a vaccine.
2. Several of the top studies claiming it was super-effective were obviously fraudulent (and now have been proved fraudulent).
3. Ivermectin is almost certainly more effective than a placebo.
4. Even if Ivermectin is basically only as effective as a placebo, it still is probably effective enough to use as a treatment of last resort.
4A. I originally would have had a joke that some of the patients might have worms; it did not occur to me that patients actually having worms might have been a significant factor in some studies.
5. Many of the studies saying that ivermectin doesn't work aren't actually proving that, they're only proving that it isn't 90%+ effective or that they are bad at determining study size.
6. The Scientific Establishment has failed miserably here. There should be at least one "gold standard" Western trial with at least 2500 people.
6A. Also the political establishment has failed miserably here; why didn't Ron DeSantis and the Florida Legislature order the state medical establishment to conduct a study?
7. Publishers such as Elsevier regularly publish crap; they publish both pro-IVM and anti-IVM crap so it is presumably incompetence.
what about this one American Journal of Therapeutics 28, e573–e619 (2021) and refs therein?
Perhaps the worms are killing COVID in the same way COVID may be killing influenza.
https://eugyppius.substack.com/p/the-disappearance-of-influenza
Nice
*standing ovation
Indeed, this was much more than I wanted to know. Will try to get through it though
Read Alex Berenson on substack. Do you know what else showed no benefit in mortality? Pfizer's own studies of their own vaccine.
Wow, no wonder the FDA approved it.
I want to print this out and put it on my fridge.
A counterpoint to the worm hypothesis: in all the hospitals I have worked, it is standard of care to give ivermectin to any patients before starting high-dose corticosteroids (to prevent disseminated strongyloidiasis), long before COVID. My experience is only in tertiary hospitals of a single city in Brazil, so maybe it's not a widespread practice and ivermectin might improve outcomes in other places, but at least here, but at least here, the main effect of ivermectin has been gastrointestinal symptoms in patients talking it
Issue #1 is the standard of practice is excluded in the trials, because ivermectin was not given to the control group despite some trials giving steroids to every single member of the control group. Issue #2 is that you don't need steroids to have disseminated strongyloidiasis, as COVID-19 itself is associated with eosinopenia even without steroids.
Well, you don't need to deworm patients for just any dose of steroids, just for very high doses. Eosinopenia is also a feature of any serious disease, it happens in sepsis and disseminated strongyloidiasis is not a problem in those cases
First point is demonstrably false. Disseminated strongyloidiasis has been found after starting wide ranges of doses, not just very high doses. Regarding the second point, there is evidence that Eosinopenia can occur fairly early on in COVID-19 infection, at the point of admission, not just at the point of decompensation. Also, we don't actually know that disseminated strongyloidiasis isn't a problem in sepsis cases with underlying strongyloides. It absolutely has been associated with sepsis cases and various infections. It just is underdetermined because those cases usually have other things involved that could cause disseminated strongyloidiasis.
There have been reports of it happening after a wide range of doses, sure, but the risk has to be extremely low or else emergency rooms would be full of cases, given how relatively common corticosteroid is. Similarly, eosinopenia and sepsis are routinely seen, and if disseminated strongyloidiasis was common, we would probably see some manifestation of it
After i read scott's post I was wondering why they don't give deworming tablets to everyone in the hospital waiting room in countries where this is a problem.
Of course it would be better to give antihelminitics to everybody but the EAs are already working on that.
I'm unaware of any studies showing a positive outcome of deworming everyone in the waiting room, but I'll admit I haven't looked into it. I doubt it's a cause of high morbidity in asymptomatic adults with appropriate food intake
I did a very quick search and there are a few studies out there that suggest that parasitic intestinal worms actually reduce the severity of Covid19disease outcomes. For example https://www.medrxiv.org/content/10.1101/2021.02.02.21250995v1 Perhaps someone with more research experience than me would look into this here since it seems relevant to this hypothesis put forward by Scott?
The hypothesis is they reduce the severity of COVID-19 because they are Th2 loaded, not Th1 loaded. So they clear COVID-19 *slower* but have better clinical outcomes. However, if COVID-19 causes eosinopenia, as it can sometimes cause, or if steroids are given, then all bets are off - since that's a recipe for disseminated strongyloidiasis.
All this accomplished was increase my belief that Scott in the pocket of Big Pharma.
I wrote this a few months ago.
A Covid Mystery -- A Possible Prophylactic
We have a mystery. The US has 30 times the population of Haiti. The US is the richest nation in the world with the preeminent medical establishment. Haiti is one of the poorest nations where medical care depends to a significant degree on the organizational efforts of one man: Dr. Paul Farmer.
Covid-19 deaths per day (7 day average) in the US peaked around 3400 deaths per day. Covid deaths per day in Haiti peaked at 6.
3400 divided by 6 is 567. The ratio should be 30. In fact it should be lower than 30 considering the glaring difference in resources.
There have been 751,815 deaths from Covid in the US but only 658 deaths in Haiti.
https://www.worldometers.info/coronavirus/#countries
1142 times as many deaths in the US!
How do we explain this? We need a list of hypotheses and widespread use of prophylactic ivermectin in Haiti is as good as any other hypothesis I have heard.
A prophylactic treatment is different from a cure. Daily aspirin in small doses has been recommended to reduce thekk likelihood of heart disease. This does not mean that aspirin will cure heart disease.
Ivermectin may not cure Covid and yet be a prophylactic which reduces the chance of getting Covid.
A COVID-19 prophylaxis? Lower incidence associated with prophylactic administration of ivermectin
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698683/
Using the drug ivermectin for prophylactic or preventive purposes among healthcare workers with high exposure to patients with the virus reduces the risk of presenting symptomatic Covid-19 by 74% compared to their peers working under the same conditions.
https://dominicantoday.com/dr/covid-19/2021/09/13/use-of-ivermectin-reduces-risk-of-covid-disease/
Other reasonable answers are that the population of Haiti is much younger (a median age of 24, compared to the USA at 38!!), Haiti has much fewer intentional connections so it spread slower and later, and that Haiti will underreport deaths from COVID (if someone dies in a small village, it doesn’t get reported to anyone).
Between those, I don’t see any reason to favor ivermectin as the cause of the reported disparity. The age difference especially is a strong explanation because almost all of the deaths in the US are among the elderly.
US Population (2020) 329.5 million
US Population 65+ 16.63%
US Number 65+ 54.80 million
Haiti Population (2020) 11.4 million
Haiti Population 65+ 5.17%
Haiti Number 65+ .589 million
65+ population ratio 54.8÷.589 = 93.0
There 93 times as many persons 65+ in the US. If we make the simplifying assumption that all Covid deaths occur in this age bracket, than we would expect 93 times more Covid deaths in the US than in Haiti. This also assumes that Covid fatality rates are the same in the two countries.
This is our null hypothesis.
There have been 788,127 deaths from Covid in the US but only 711 deaths in Haiti.
US sample mean: 788,127 ÷ 329,500,000
0.00239
Haiti sample mean: 711 ÷ 589,000
0.00121
As of Jan 8, 2021: 237 Covid deaths in Haiti.
As of Nov 15, 2021: 708 Covid deaths in Haiti
As of Jan 1, 2021: 370,601 Covid deaths in US
As of Nov 15, 2021: 785,131 Covid deaths in US
I took the latest totals. The mean difference would be greater at the end of 2020.
I assumed a standard deviation of .001 for both populations.
https://select-statistics.co.uk/calculators/two-sample-t-test-calculator/
p-value is <0.001
The null hypothesis is rejected.
Please check my work.
It's been many decades.
We agree that after adjusting for the age, it’s approximately a factor of 10 different.
For the difference in time, you have to look at the case fatality rate over time, not just the number of deaths - the fatality rate has dropped significantly over the course of the pandemic, so if the vast majority of Haitian cases have been later in the pandemic, they would have significantly fewer deaths. I would expect this to take off another factor of two or so
I’m not sure whether COVID is endemic in Haiti, but I would be unsurprised if it hasn’t fully reached all of Haiti yet, especially the isolated communities that are poorly connected. I would expect this to be about another factor of two. Remember that some countries (for example, Australia) have had essentially no COVID deaths) because they’ve been good at isolating populations and lockdowns.
The under reporting could easily represent another factor of ten on top of those, so this would bring Haiti to a higher number of deaths per cases than the US, as expected by their worse healthcare.
Frankly, the US and Haiti are extremely different countries because of economic and age situations, and you don’t need to bring in anything mysterious to explain it.
Hmm, if the over-65 demographic is much smaller, relative to the whole population, that might argue a few confounding factors: (1) the over-65s are more spread out, so transmission between them is lower. Do Haitians stick their old folks in nursing homes? That was certainly a factor in a lot of early US deaths. And (2) maybe the over-65s are generally tougher in Haiti on account of greater winnowing at younger ages. (I mention this because one of the weird facts of US life expectancy is that past the age of 80 the longest living demographic is black women. Not at all what you'd expect, but if you experience a more callous regime when you're younger, those who survive it will necessarily be tougher.)
Not that I think either would explain your results. I would guess Haiti is going to end up with Africa as one of the very strange aspects of COVID that will take decades to unravel. Why are African blacks less susceptible to COVID (as far as we can tell) but American blacks are more? That is seriously weird.
"because one of the weird facts of US life expectancy is that past the age of 80 the longest living demographic is black women. Not at all what you'd expect, but if you experience a more callous regime when you're younger, those who survive it will necessarily be tougher."
It's possible, but not necessary. Those who survive the longest might be the toughest, but also the most damaged.
Indigenous people might have it about as bad as back as black people. Do they show this pattern? Is there anything like this pattern in other countries?
Before we further complicate the question, we should focus on the possibility that Ivermectin has prophylactic powers to prevent Covid.
Should be straightforward to make two lists of countries where Iv. has been widely distributed and counties where it has NOT been distributed.
Any time a poor country is involved (let alone Haiti) you should immediately wonder if they have a well-functioning bureaucracy that is able to record all deaths in a timely manner with a determined cause. And similarly for cases, do they have sufficient testing capacity, deployment and bureaucratic function to detect and centrally record a large fraction of cases?
Are you thinking that a poor country such as Haiti would miscount deaths or wrongly attribute the cause of death?
Yes, my default assumption is that a poor country will undercount or, even if they don't undercount, underattribute (leave deaths as unexplained due to a lack of resources). They will also undertest for Covid. This explains why most poor countries are "spared" from the pandemic in official figures: https://twitter.com/DPiepgrass/status/1467572944150794241
My default assumption is that poor countries have been recording when people died for more than 2000 years and they haven't forgotten how to do it.
If they are under attributing deaths to Covid, then the deaths will show up in some other column.
The Strongyloides stercoralis hypothesis is interesting but it seems pretty speculative. The prevalence of infection in these areas that are supposedly "teeming with worms" is in the range of ~10-15%, and most of those infections are going to be light. It's possible that those who are infected are at greater risk of death when hospitalized with covid, and also have that risk attenuated when treated with ivermectin due to the deworming effect, but again that's speculative. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7349647/
Here's a JAMA paper from July 2020 discussing the issue with steroids and worm infections being treated by ivermectin:
Stauffer et al.
https://jamanetwork.com/journals/jama/fullarticle/2769100
Thanks, I am "pro Ivermectin" because I found in silico studies showing attachments to several viral proteins to be fairly compelling, and I greatly appreciate your work of having actually read all of them.
I intrinsically tend to give pro-Ivermectin studies the benefit of doubt because nobody financially benefits from a positive finding. This is of course an implicit bias and also just my opinion.
The sidebar on worms is actually highly intriguing.
My "vaccine distrust" comes from several sources:
--A Vaccine centric theory of beating Covid has a fairly hard time accounting for the fact that Africa is not on fire. Younger population, warmer climate or genetical immunities could contribute, but the counter examples of somewhat similar in these metrics Brazil or India would in part disprove this. As such, the existence of a possible Africa specific Coronavirus-like, or Covid being effectivly treated with "non standard treatments" would seem plausible, and Ivermectin would solve the "Africa riddle" while also having a mechanism of function according to multiple in Silico studies. If one believes in a possible "Covid-Vaccinia equivalent" to "Covid-Variola", then we should certainly send some crack scientists there to figure that out yes?
--There is of course an emotional and psychological factor. I have a major in Theoretical Biophysics. Journalists and "experts" who are cleary not demonstrating "subject mastery" tell me what to do and what is science and restrict my freedoms.
--While I am pro Vaccine, I am skeptical of m-RNA vaccines if a safe conventional vaccine like Sinovac is available and has been used 3 billion times in humans. The issue with m-RNA vaccines is that Covid can at least evade the immune system more easily, on account of m-RNA vaccines only presenting a single protein. Delta is basically 3 point mutations on the spike protein.
Sinovac would be more of a generalist, and perhaps less strong against any individual covid strain but reasonable against all of them.
--A reasonable case can be made for Ivermectin in that it does no harm, and a very reasonable case if you simply see it as a mostly harmless (we know the side effects reasonably well) placebo. Giving it, under controlled conditions, safely to people who want it is imho fine.
Declaring reverse jihad on "Horse dewormer guzzling rednecks" is completely out of line.
Nothing stops you from being vaccinated and taking ivermectin. One is prevention, the other is cure. The vitriol against it is so out of line that my admittdely conspiracy spidey senses are tingling.
--Concerning myocarditis from vaccinations, I am of the opinion that this is due to accidental intravenous rather then intramuscular injection (a phenomenon also known from smallpox vaccine). There are pragmatic ways to reduce the odds of this, and probably save hundreds of lives. That this is not done seriously galls me.
> nobody financially benefits from a positive finding
Whoever authors the paper definitely financially benefits from a positive finding. Because of publication bias and the general bias towards positive results, publishing a pro-ivermectin paper gets you a fancy new job at a prestigious hospital while an anti-ivermectin paper probably won’t even be published (and if it is published, it will be seen as boring and won’t get cited).
Um, any examples of authors of pro-IVM papers getting a "fancy new job at prestigious hospitals"?
> Sinovac is available and has been used 3 billion times in humans. The issue with m-RNA vaccines is that Covid can at least evade the immune system more easily
Last time I checked Sinovac was inferior in effectiveness to m-RNA vaccines.
Too soon to say...
TLDR, but the most obvious comment, far as I saw he didn't mention the fact that two of the four negative studies were massive overdoses, and no discussion of zinc. it was obvious in spring 2020 that the cabal tried to get out front of early treatments by offering fraudulent studies of both HCQ and Ivermectin, including studies set up to fail by massive overdose of IVM, and studies on patients already on vents or nearly.
Odd how that both with ivermectin and HCQ, the proponents are always moving the goalposts . . . if a study shows that it "works," then they broadcast the study far and wide even if totally fraudulent or incompetent. If a study shows that it "doesn't work," then they start quibbling over the dosage and timing -- as if there was any solid evidence for dosage or timing being relevant.
It's not odd, it's 100% human nature. We are all natural scholastics, and empiricism come hard to us. If there's a conflict between theory and experiment, empiricism says believe the experiment and revise your theory, while our natural scholasticism says find out how the experiment was flawed.
Can you point to a study that overdosed on IVM? I have pointers to ones that overdosed on HCQ, and studies that allegedly got null results because the IVM dose was too low. IVM is not very toxic so overdosing on IVM is hard to accomplish.
Thank you for doing this.
>They would feel like immunologists are some sort of dark and terrible figures from a shadow dimension they could never reach. They would seem like aliens.
I like the rest of it but... this doesn't feel like it fits. Too many people I know in research and medicine and immunology still have close family who are anti-vaxers.
Like, sure, don't believe the sinister Other.
But this is people who have close family who can say "Mom, I literally worked in the team that did that research, there's no microchips, the vaccines aren't for targeting jewish space lasers" and yet Mom or Uncle Harry still believe the daily mail and facebook memes over their close family.
It's more like the creepy hostile aliens managed to slip those brain control chips into a chunk of the population and then they all short-circuited leaving them believing a laundry list of things that don't make even a little sense and their friends and family can't get through to them.
Genuine question. How confident should we be that mRNA technology has no negative long-term effects? For context, I ran out and got three shots of mRNA vaccine as soon as possible.
As I understand it, the mRNA technique is getting a lot more directly involved in the body's chemical pathways than previous vaccines. Is there strong evidence and theory that this can't affect these or other pathways in unintended ways? Do we have strong evidence and theory that the reprogramming of these pathways won't have longer term effects on the immune system's reaction to the body's own markers (e.g. either making it more permissive and allowing cancer or less permissive and creating auto-immune responses) or affect gene expression (even if it doesn't affect DNA) etc.
If you google these questions, you get lots of comforting CDC/FDA pages or very dense immunology papers that seem several steps removed from these questions. But of course, public health communication has consistently been focused on convincing the public to take particular actions, so there's always that nagging question.
Is this a situation where:
1) we just have no idea
2) these problems are ruled out essentially entirely by theory and evidence
3) we think that these problems would have shown up if they were going to, but we can't rule out some edge cases
I think it would fall largely under 2.
strongly ruled out by theory outside of a few edge cases like cells getting infected by *exactly* the right kind of retrovirus virus at *just* the same time and then the immune system not just killing off the affected cells... but that case would also apply to getting infected by any normal virus so someone should probably be more worried about that happening with every random cold they get.
Since they're sort of doing what viruses already do but with a known "package"... just about every hypothetical way it could cause long term problems undetected in any clinical trials so far seem like they would apply more strongly to any mundane viral infection.
I'm reminded of an old newspaper clipping:
https://www.snopes.com/tachyon/2013/06/pregnant.jpg
I would say (2) and (3). mRNA just backs up the place where you interfere in the biochemistry a little bit: instead of injecting a foreign protein, you inject the instructors for building a foreign protein (which is what a virus does). So the body builds the foreign protein and that gets you your immune response. How do you know it doesn't *continue* to build the foreign protein? Because the pseudo-infection doesn't continue. Also because, since you are mimicking, to a substantial extent, what a virus does naturally, there are many and powerful methods the body has for discovering and snuffing out illegal alien instructions for making protein.
mRNA vaccine are *in principle* very simple technology, and the reason they are only coming into existence now should give you additional reason to be more confident in them: the problem has always been that the body is *too* good at discovering and smashing alien nucleic acids. The difficulty in getting an mRNA vaccine to work was preserving it *against* the body's detection and kill machinery long enough for it to do its work. Tricks had be played to make it unnaturally harder to identify and destroy. But even so, it's wiped out quickly, within minutes. Future work may very well center on how to make it even longer-lived, how to get the body to reverse transcribe it back into the genome, et cetera, to engineer longer-lasting effects, immunological and otherwise.
It's very reasonable to be extra concerned at introducing some alien thing into the body that acts at a "higher" level of the command-and-control machinery. The reassuring info is that *the body itself* "feels" the same way, and so our internal search-and-destroy apparatus is more powerfully attuned and faster-acting when it comes to those kinds of alien artifacts. Doesn't mean we can't screw that up. But we'd have to work harder, or be more (un)lucky.
"So the body builds the foreign protein and that gets you your immune response. How do you know it doesn't *continue* to build the foreign protein? Because the pseudo-infection doesn't continue. "
Correct - but also note it's because mRNA is very fragile. So what you get in the injection doesn't have a long "shelf life inside the body", so to speak.
Right. That was in my 2nd paragraph, but thanks for drawing attention to it.
My error; thanks Carl.
I wish to subscribe to your substack. And I’m serious. Give it some thought.
Thanks this is a really useful explanation. My one followup would be that we know that some real infections are cleared quickly by the body but come with long postviral syndromes (e.g. EBV) that seem to have something to do with the immune response. Is there any concern that mRNA vaccines could have similar effects? Again, is this something that is a real concern but would have been observed already, ruled out by theory or still a longshot possibility?
Well, I don't *know* because the only way to know would be to collect the observational data long enough. The body can do weird and surprising things and the more you know about immunology the humbler you get, in my experience.
But it would be surprising, to me. The vaccine components are eliminated pretty quickly, the mRNA within minutes to hours, and the components of the lipid nanoparticles over a week or two. The longest-lived components are a few somewhat unnatural polymers that have to be laboriously converted in the liver to something more oxidizable, this seems to take a week or two according to rat studies. So it's hard to think of a mechanism for long-term effects. Why would that happen?
With the virus itself, one would assume (in the case of COVID) that long-term effects are a result of the damage that is done before the virus is cleared. Some tissues in the body repair themselves quickly, some very slowly, and some never repair themselves at all (which is part of why heart attacks and strokes are so deadly of course). So it is possible the COVID infection sometimes damages tissues that heal very slowly or not at all, and this is responsible for any long-term effects.
That said, there are viral infections that "hide out" and can persist for decades. The herpes family is famous for this, they become quiescent chunks of DNA/RNA living in cells peaceably, reproducing slowly and being passed on from cell to cell without causing the massive disruption and death (and aggressive immune response) of a more active infection, and so they can be there for a long time, sometimes flaring up into an aggressive infection years to decades later. I don't think anyone suggests COVID is like this, if only because it tends to infect fast-growing cells, like the epithelial cells that line the lungs and blood vessels, rather than long-lived nerve or immune cells. But who knows? There is still much to learn about this disease.
That's interesting that you're saying post-viral effects are mostly the result of damage from past viral infections or from ongoing latent infections.
My working mental model had been that certain infections led the immune system to generate pathological tools to combat infections that had persistent negative effects afterwards (i.e. by ongoing auto-immune disease). Are you saying that post-viral syndromes aren't really best characterized as auto-immune diseases? Or alternatively that the auto-immune diseases that result from infections (I've seen this claimed for type-1 diabetes for instance) are actually either ongoing responses to latent/active infections or the result of organ damage that the acute response to those infections caused?
I'm actually realizing that I don't know the answer to the basic question of: if you somehow got a type-1 diabetic's own beta cells and reimplanted them, would their immune system immediately kill them again or is that threat now gone? Given that type-1 diabetes takes years to kill off all the islet cells, should we be extracting and freezing diabetics' own islet cells for later retransplantation?
>Future work may very well center on how to make it even longer-lived, how to get the body to reverse transcribe it back into the genome, et cetera, to engineer longer-lasting effects, immunological and otherwise.
What are we, Streptococcus?
Well, streptococcus after 1 billion years of natural selection, maybe.
It's actually very simple.
mRNA is unstable and is broken down fairly rapidly. Indeed, one of the reasons why these vaccines have such annoying handling requirements is that mRNA just isn't very stable to begin with.
As such, these things just can't linger in your body for a long time because it literally isn't something that is stable for long periods of time.
Any side effects from the vaccine would show up very rapidly.
My current thinking is that any time you get a cold you'll have uncontrolled growth of a virus using mRNA to making copies of itself, and also there have been many "live" vaccines based on attenuated viruses before (https://www.hhs.gov/immunization/basics/types/index.html).
In both cases, I expect you'll have real virus particles abusing your cell's RNA/mRNA machinery. I have yet to hear anyone try to explain why this abuse is "safe" when live viruses or attenuated-virus vaccines do it but "dangerous" when mRNA-in-a-nanoparticle does it. I watched a 3-hour video of Kirsch et al talking about how we "know spike protein is dangerous", I looked at his blog post, but AFAICT he just said it's dangerous over and over, never actually presenting any evidence. Kirsch did say that "Biodistribution of lipid nanoparticles which carry the mRNA show that the ovaries get the highest concentration" but this is clearly false: https://www.lesswrong.com/posts/7NoRcK6j2cfxjwFcr/covid-vaccine-safety-how-correct-are-these-allegations?commentId=f97bJXwj2M5toGDvt
But also, if the spike protein is dangerous in a vaccine, why wouldn't it be more dangerous in an actual Covid infection?
I have seen a peer-reviewed study showing that spike proteins are cytotoxic - in concentrations 100,000 times higher than you get from a vaccine - as study co-author Uri Manor explained on Twitter while expressing dismay at how their work had been misused. https://twitter.com/manorlaboratory/status/1395564601907896322
I mean, 100,000 times greater than a vaccine would be 50 liters. Injecting 50 liters of anything into your bloodstream is going to kill you; at that point, spike protein is the least of your worries.
Indeed, though the 100,000x is a statement about bloodstream concentration, and only a tiny amount of vaccine is seen to leave the injection site so it'd be far below 50 L. And one must distinguish between LNPs and spike protein, but I'll shut up now.
Great post. As someone who is 100% convinced Covid vaccines are a Bad Idea, I'd love you to give them the same treatment; my mind is open.
Your alien brain implant metaphor describes my thinking perfectly (yes, it IS a reasonable way to think) — except for two things. I don't distrust science/tists, I distrust the academic establishment, the medical establishment, the political establishment, and the establishment media. It's a question not of malice, but of incentives. I'm sure I don't need to elaborate. Second, the trojan horse Covid vaccines are introducing is not technological or medical (e.g. nanobots, DNA rewriting), it's social. Hardcore imposition of vaccines are a way to suppress independence and redefine "freedom" into a synonym for "security". This is very bad for society, regardless of the science — I just don't see any scientific reason to take the Covid vaccine either (you can mostly thank Alex Berenson for that).
I think that ship may have sailed long before your birth.
if anything governments have kept the kid gloves on re: covid.
Go back a century and "vaccination raids" were a thing, think people kicking in doors and vaccinating people. And that was in the days before the high safety/purity standards of modern vaccines.
it's the "less nice" side of how smallpox was wiped out.
If anything governments have avoided most of the really heavy handed stuff they used to use to force vaccines on people in the past. It's kind of proof of them moving in the exact opposite direction, more freedom and less jackboots and force.
Fair enough, history is pretty wild. But the fact that it's happened before doesn't justify doing it again.
People were also sterilized at gunpoint (approved by SCOTUS, even) so I'm not sure how much you want to imply they are your spiritual forebears.
Well I think he's arguing that public health has *historically* been the one area of government where people have tolerated a surprising (by modern standards) level of enforcement rigor, and a surprisingly low (by moderns standards) -- like zero -- level of dissidence.
And I think that is quite true. Remnants of it persist even today: if you refuse to take your TB meds, almost all states IIRC have provisions in public statute for having you locked up until you do. No trial needed, no charge, no civil liberties defense -- if the local public health authority says you've got TB and aren't cooperating in treatment, you go off to jail indefinitely. I think most modern people would find that a little shocking, but it's a leftover from an earlier time period when people were just a lot less tolerant of dissent when it came to infectious disease.
There are similar provisions for STDs, in many cases a treating physician is compelleted to report them, and public health authorities are entitled to do tracing, none of it with the patient's consent. Imagine proposing *that* as a new law in today's world.
In some ways I feel like the Overton window on public health just slowly shifted over the past few decades, without people much noticing, because infectious disease just went out of the life experience of most younger people.
One reason I say this is because in my experience a lot of older people are just kind of baffled over some of the heat on vaccines. When I was a kid, it was absolutely routine, for example, for countries to require vaccination proof for entry. I used to have a little yellow International Vaccine Record that my mother had to take with her when we traveled, and show to border officers. In some cases we had to get extra shots to visit some country or other. Totally routine, unremarkable.
Same with school vaccines. It was routine to require these things, and nobody in my experience much thought twice about it. We didn't even *ask* whether they were super duper effective or just kind of, or whether there might be some reason rooted in civil liberties or religion or whatever to carve out some exceptions. It's just what people routinely did, and getting passionate about it seems like getting passionate about the requirement that you have a driver's license before you drive on public roads. Sure, if you think about it, I can readily see the case for why this might be an infringement of civil liberties in some sense or other, but it feels strange to even get worked up about it because we're so used to it.
That seems to have changed, and it's a little mystifying to me. My tentative hypothesis is that 50 years ago we (as a people) were *much* more used to infectious disease causing serious death and destruction. People remembered polio, and smallpox. VD was harder to treat. So there was a sense that this shit is verious serious and hard to deal with, so yeah we're not going to be too careful about the rights of minorities and civil disobedience when we draw these lines.
That doesn't mean it was necessarily *wrong* for times to change, of course. Maybe we *can* afford to be more sensitive to individual liberties now, because we *have* almost entirely removed the threat of infectious disease in modern First World life. That would probably be a good thing.
I commented above that vaccines for travel sound like the most normal thing in the world, to the point that a country not verifying vaccine status for polio for anyone who's been in a country that still has it is a failed state.
And you have no general right to enter a foreign country, so you submit to their demands. Keeping out people with disease is absolutely the host country's right!
I was vaguely approving of Trump doing border controls [1] to keep out people coming from abroad unless they could prove they didn't have covid, and he was getting heat from the left for doing it, because The Science says border controls don't work[2].
I expect the polarity on border controls for disease have flipped completely. Because people are nuts.
[1] but his implementation sucked and may have been worse than doing nothing
[2] they do
That is certainly one factor. Perhaps another factor is that we have less civil liberties than we had 50 years ago (along with a much larger and more questionable government), and so people are more cautious about giving more of them away. And another factor is that we have a superior source of information in the internet, and the time and resources to do our own analyses. Another factor is that citizens have become more individualistic/greedy and less community-oriented/cultured. And so on and so on. Lots has changed in 50 years and some of it is for the better, some of it for the worse, but it is what it is and there's no going back!
I mostly agree with your prescription, but probably not for reasons you'd find nice. I view vaccines, like I view airbags, helmets when skiing, or the decision to smoke, as opportunities for natural selection. They are ways in which the future can have a higher fraction of more prudent and thoughtful human beings. I'm reluctant to have government impose good ideas on people against their will, because I would rather people who have bad ideas experience the full consequences of those. They will either learn something useful in the School o' Hard Knocks, or as I said reduce the burden of their genotype on the future.
That said, I also believe people have a right of free association, so if for example a company wants to say "sorry, no vaccine no job" that should be respected also, as an extension of the right of the individual to say "sorry, I'm not convinced by your fancy-dancy vaccination bullshit, not doing it." That is, I don't like government telling individuals they have to be vaccinated, and I also don't like government telling individuals, or voluntary groups of individuals, that they can't insist on vaccination for membership or private association.
It's gets a little tricky when we get down to the weeds, of what we do with children in required public school setting. So there would need to be some negotiation and compromise there, unfortunately, as the simple solution isn't viable.
Given that most people have pretty limited freedom to change jobs without dramatic effects to their livelihood, I'm not convinced this follows as a principled extension of the right to free association, at least in a way which wouldn't also permit the government to do the same.
Yeah I'm never persuaded by that line of argument. I draw a bright and shining line between "hard, annoying, don't want to" and "impossible by force of law."
Additionally, if *you* don't hold your own principles of self-determination in high enough regard that you're willing to take the hit to your annual salary to exercise them, I can very reasonably conclude that *I* shouldn't hold them very high either, and so I can dismiss any appeal to principle that you make as disingenuous.
I mean, as far as I can tell, even the most hardline vaccine mandate policies don't *force* anyone to get vaccines, they just make it impossible to hold a lot of jobs or access a lot of public services without doing so, which seems to me like more a difference of degree than kind from "you may not work here without getting a vaccine."
For a lot of people, having their employer mandate vaccination is not a matter of "get the vaccine or take a hit to your annual salary," but "get the vaccine or become homeless as you do not have the resources to remain solvent without the job for as long as it would take to find a new one. A large proportion of Americans live paycheck to paycheck. For those people, giving up their job on short notice, without another one lined up, is a sacrifice of greater scope than most people are willing to make for any political principles.
Part of the me too movement was people not wanting their income to be dependent on supplying sex.
Do you want to play hardball on that one?
Do you have a similar complaint about requiring vaccines to send kids to public school? Or is it just *this* vaccine that is going to redefine freedom as we know it?
I really haven't thought through that, since the cost/benefit ratio of those required vaccines are much clearer than for the Covid vaccine from where I sit. But I think public school should work the same way as employment, i.e., the organization imposes requirements, and the participant gets to choose whether to follow them. Freedom of association. Public school being a tax-funded thing, parents should be reimbursed in the form of education vouchers.
How about "Trust Iteration"?
I realize this is frustrating for people who want some kind of safety guarantee immediately, or even in a year.
Can you point me to a description of trust iteration that you like? I am aware of some of the Prisoner's Delimma work, and I recently found and intend to read: "An iterative algorithm for trust and reputation management" https://ieeexplore.ieee.org/document/5205441
Ah, sorry. I didn't mean iterated trust. I meant "in a space where the truth is discoverable, you can trust that many iterations of honest parties seeking the truth will eventually produce consensus truth that outlasts motivated falsehoods".
That is, give the (good) scientists and (skilled) statisticians and (sincere) experts ten or fifteen years on a topic like this, and they'll produce an answer that outlasts the answers given by weaker and less well meaning players.
What I (and many) do not get is why there is not a proper US or EU or whatever PC country/region funded large scale study that actually does a proper job at evaluating Ivermectin. It sounds much cheaper to me than designing a new drug. And this is one of the few aspects that just does not add up.
Another is why it is banned in a lot of countries. If this ban makes sense to you: https://www.youtube.com/watch?v=_gndsUjgPYo then surely your brain works differently (probably much better) than mine.
I think ivermectin believers say that it has to be taken at a very early stage, or before the infection happens for it to be effective. If a PC country wanted to do a study they would need to include this in their parameters.
I do not know whether Ivermectin is useful against COVID but because its side effects are known I would definitely be happy to have some in my medicine cabinet. I have taken a non-PC jab (non mrna, I'd stay away from those), but still if I feel like symptoms are coming I'd definitely try Ivermectin, because what can I lose. Because it is banned, I have no chance to do that.
Whoever used the "my body my choice" slogan to support any political agenda before, if that person is not angry now about the COVID situation (and motorcycle helmets), then that person is two-faced, to say the least.
> is why there is not a proper US or EU or whatever PC country/region funded large scale study that actually does a proper job at evaluating Ivermectin
That's making the decision to test *that* drug, and not another one. Only so many people are willing to sign up and pass the requirements to be in a trial, and maybe they're all busy with HCQ.
Meaning even though doing a study on ivermectin is cheaper than doing a new vaccine, society will invest into making the vaccine, because the study is expensive and there is no hope for proper return on investment. I hope this is a correct rephrasing of what we are saying. I.e. it is not medicine, not common sense that made this decision, but economics. So let us see the economics.
> why doesn't the majority allocate $150 million of its own money (via taxes or whatever) to do a study which only a minority finds important
I am sure Pfizer alone has made a profit that is magnitudes higher than $150 million. I am also sure that if in the beginning people had been asked: do you want to spend $150 million, less than 50 cents per capita in the US, if you add the EU it becomes like 20 cents for a pill that has been in use for decades, or do you want to have a competition among private companies that will pocket profit which is magnitudes higher (for each successful company), well I doubt that the majority would have decided to go with the version that is majority opinion today.
I'd like to add that the opinion of the majority did not become such because of luck or facts or anything cheap. There is a lot of marketing work, i.e. time, effort and money invested done by politicians and businesses that in the end made the vaccine the choice of the majority. Significant part of this effort and time and money was invested before the vaccine was available. Just that effort was IMO magnitudes higher than doing the study.
On top of this practically all western countries banned ivermectin. This is a step further, much further. This way the profit becomes guaranteed, the investment risk for the private companies becomes negligible. Even if the outcome of this article was that ivermectin is superior to the vaccines, nothing would change, because the whole thing is decided based on economics, not medicine.
And again another angle, $150 million is nothing compared to the big political plans that Biden is proposing ATM.
> Hopefully as soon as you frame the question properly the answer jumps out at you.
Yes it does. From the beginning this was an economical decision, or if the decision involved something else as well, it was surely not medicine. There was doubt in the effectiveness of the vaccine, and there was doubt at the effectiveness of ivermectin. Investigating ivermectin is cheap, but it promises no proper profit, no proper GDP increase. All bet went to the vaccines so, funnily because economically that costs more money, i.e. businesses were happier to invest and work on vaccines than anything else. The people involved, politicians and science, still make all effort that the vaccine economy keeps working. I hope we agree on this, this does not contradict your answer, or if it does please let me know how.
> Meaning even though doing a study on ivermectin is cheaper than doing a new vaccine,
Maybe you responded in the wrong place, but you were asking why no one did a "large-scale test," and I was saying the limiting reagent is the number of people willing to be a participant (and further meeting the requirements to participate).
A small group that believed its own press releases could fund a Phase I study to raise interest for a Phase II study.
But "just try this existing drug" runs into the problem that there are lots of existing drugs.
> Maybe you responded in the wrong place,
You are right, I was trying to answer Carl Pham. I made a mistake, sorry about that.
I do not work in medicine science so I have no practical knowledge about how these things go. What you are saying about the number of people willing to be participants seems reasonable. Carl Pham thinks $150 million could achieve this large scale study, I have no idea if that money would solve the participation problem. For sure taking medicine that existed on the market for decades and that had been consumed by millions of people, I personally could be convinced to try it. For a new medicine I'd probably say no.
> But "just try this existing drug" runs into the problem that there are lots of existing drugs.
That is also true. For some reason, for COVID it is always ivermectin that is mentioned. But you are right, if we wanted to try all drugs that would be impossible.
Sorry again for my mistake.
Of course it's an economic decision. Freaking everything is an economic decision, unless you're Jeff Bezos and you have essentially infinite money and can do whatever the hell you want for the purest of ethical/aesthetic/philosophical motives.
What difference does it make that Pfizer has $150 million they could spend on this? Why should they? It almost sounds like you're saying the money should come from whoever has it, and not from whoever wants the information. By me that's immoral. If you want it, pay for it. I don't steal gasoline from my neighbor's car because he earns twice what I do and won't notice the hit that much, I go out and buy it myself, because I'm the guy who wants it, and it's right that I pay for what I want. Wanting other people pay for what you want is the philosophy of the criminal.
Sure, the proposition could have been put to the American people in April of 2020: do you want to spend umpty $billions of your tax money on accelerating vaccine development (and giving Moderna, for example, the most incredible $$$ windfall ever in the history of pharma), or do you want to spend it on studying about a hundred random existing cheap pharmaceuticals to see if by random chance one of them works as well as a vaccine?
And who knows what they would have said? But the proposition wasn't made, the Trump Administration just decided they knew what was the best plan, and they went with Option A. May not have been exactly what *I* would have done, but it was squarely within their ambit and mandate. That's what we elect Presidents to do, make tough choices in tricky situations. If you ended up not liking the choice, well then presumably you voted to boot Trump from office in November and prefer the Biden Administration approach, whatever it is. Democracy in action!
Large scale studies cost money, lots of it. If you personally have $150 million lying around, I'm 100% sure the required experts would take it gladly and do the work. But if not...what you are asking is: why doesn't the majority allocate $150 million of its own money (via taxes or whatever) to do a study which only a minority finds important, and for which the minority is *not* willing to pony up the cash? Hopefully as soon as you frame the question properly the answer jumps out at you.
> I have taken a non-PC jab (non mrna, I'd stay away from those)
You mean like, Johnson and Johnson? Or something else? What makes it non-PC?
@Scott, FYI you can preface a search term in google with "-" to exclude it. E.g., "ahmed bangladesh ivermectin -elgazzar"
Solid work. Very well done! Congratulations.
A few critiques for your consideration:
1. Given who you are, I'm surprised by the absence of a Bayesian analysis, and more than almost any other factor than tribalism (vide infra), this seems relevant to how people made up their minds in this case:
1a) How often do studies from Argentina or Bangladesh end up violently overturning medical consensus opinion in the US or Europe, meaning amazing things are discovered in Sao Paolo that were totally overlooked in London or Seattle?
1b) How often do vaccines succeed in almost entirely preventing a viral disease (or its evil consequences)? How often do they have strange awful side-effects not detected in the initial approval studies?
1c) How often do repurposed antibiotics, or indeed any small molecule drug, end up being powerful cures for viral disease?
1d) How often are public health policy people dead wrong?
1e) Notwithstanding (1d), how often are public health policy people *initially* wrong (when a problem first appears), and how often are they unrealistically overzealous all the time?
1f) How often in a person's personal experience have they been told something confidently by a soi-disant smart/educated/credentialed person that turned out to be wrong? How likely is it that people in general overestimate (if not outright misrepresent) their own competence in areas not exactly within their training and experience?
1g) How often do politicians in search of votes and pundits in search of page clicks oversimplify or overdramatize if not caricature the stakes in a debate, the importance of the favored outcome, or the villainy/ignorance of the supporters of the disfavored outcome?
2. When you discuss the tribal aspects of this, you seem to assume that members of each tribe arrive at their conclusions completely independently, and ask "What common experience could lead all these people to *independently* arrive at Conclusion X?" But this overlooks the very nature of tribalism (or indeed of social movements, fads, bubbles, et cetera) in that for a large number of members of a tribe, the reason to have Conclusion X is merely because it's a dogma of the tribe.
Consider the thought experiment: if nuclear power plants had been invented by a bunch of bearded hippies funded by Greenpeace in the 2010s as a solution to global warming, instead of by a bunch of pocket-protector-wearing narrow-necktie poindexters in the 1940s funded by the military to build awesome weapons of destruction, would you not see a neck-snappingly abrupt reversal of positions pro- and anti- among a very substantial number of people?
Human beings are perfectly capable of believing, or at least subscribing to belief in, propositions that go strongly *against* their own inclinations, or available evidence, if it promotes their social belonging in the right way. I'm a little sorry you didn't tackle this issue. It's certainly discouraging, in one sense, because it says *no* amount of improved access to information, education, less screwups by the expert class, et cetera -- *no* difference in what is available to the individual thinking it over -- will reduce tribalistic splits on issues, because these do not arise in the first place from distinctions in individual awareness. They arise from the requirement of any faith group to have a dogma, and to insist on faith in the dogma as a condition of membership.
3. Along these lines: your final prescription ("How can we get more people to trust (but verify) the experts I trust (but verify)?") reads a little tribalistic itself. Have you considered the possibility that nothing is actually going wrong here? Science and expert opinion is being severely challenged -- is that a *bad* thing, generally speaking? Maybe not! It's not like your (and my) preferred worldview here ("vaccines work well, you should all take one, you can take/not take ivermectin if you get sick, according to your personal beliefs, but you should be reluctant to become a zealot about that and try to persuade others to do so") isn't dominant. It is. Most people get vaccinated. Most people don't become ivermectin crusaders. A few people fall into the other categories in both cases, and it causes strife and dissension, and the majority is compelled to accommodate this to some extent or other: compromises have to be made in legislation and regulation and decree, room must be made for disagreement that the majority finds futile or stupid.
Is that a *bad* thing? Maybe that's actually how a republic should work. Maybe the fact that a minority that feels strongly about something that the majority finds ridiculous *should* be allowed to carve out a certain amount of space for its beliefs, and should be able to disrupt the ability of the majority to get its way, a bit. Even if it costs lives? Yeah maybe. It's probably more important in the long run that the everyone remains mutually committed to the republic and solving problems by voting and argument (rather than weapons and death) than that every life that can be saved is.
>1a) How often do studies from Argentina or Bangladesh end up violently overturning medical consensus opinion in the US or Europe, meaning amazing things are discovered in Sao Paolo that were totally overlooked in London or Seattle?
I don't know the answer to this, and it's not amenable to quick and easy investigation, but I strongly suspect the answer is "not very." I know a few people who're involved in biomedical research in South American and Middle Eastern countries, and all of them have expressed pretty grim views of the state of research in their countries, and would prefer to move to Europe or America where they feel it would be more practical to conduct research which would be less subject to corruption, poor research practices and environments, etc. One online acquaintance in Pakistan told me that many of her peers deliberately hold off on their higher-impact research plans pending the opportunity to move.
Regarding "People [researchers] are going to fight hard against [releasing their raw data], partly because it’s annoying and partly because of (imho exaggerated) patient privacy related concerns."
If your belief is that compromising patient privacy doesn't actually harm them as much as one might infer from U.S. cultural/legal norms about this then hey -- you are the psychiatrist, and plus you have lots of personal experience with the harms of loss of privacy, so I won't argue with you about that!
But if your belief is that patient reidentification from a data set is a difficult thing to do, or would be unlikely to happen in the real world, then I am sad to inform you that this is just false.
Difficulty:
As I am sure you will have heard, it takes only 33 bits of entropy to uniquely identify a living human somewhere on this planet. If you know the person is in the USA, you are down to 28 bits. If you know their gender, there goes another one. If you know there state, there goes a couple more. Approximate age, a few more still.
Once information is released, it can never be un-released, but it can be combined with other information.
It can be surprising what has been shown to uniquely identify people. A few links from a social relationship graph -- not the actual names, but just the shape of the graph in your immediate neighborhood[1], your home and work location[2], of course your browser's device fingerprint[3], or your writing or coding style[4].
Likeliness to happen:
As just one example, internet advertisers in the sketchier/less-ethical parts of the adtech universe have large monetary incentives to reidentify users, using whatever data they can get their hands on, and though they are unlikely to make public statements about their efforts, their capability has been repeatedly demonstrated.[5]
Whether privacy harms are outweighed by society's interest in learning true and important facts about the world using the scientific method:
Man, I have no idea. Sorry. :(
[1] https://33bits.wordpress.com/2008/12/15/the-fallacy-of-anonymous-institutions/
[2] https://33bits.wordpress.com/2009/05/13/your-morning-commute-is-unique-on-the-anonymity-of-homework-location-pairs/
[3] https://en.wikipedia.org/wiki/Device_fingerprint
[4] https://freedom-to-tinker.com/2015/01/21/anonymous-programmers-can-be-identified-by-analyzing-coding-style/
[5] https://dl.acm.org/doi/10.1145/3372224.3419205
I disagree with the sociological takeaway, and probably a few other takeaways as well. You seem to be suggesting that we should have had an answer for whether ivermectin was effective before we had an answer. Why? Because this had become a red/blue tribe issue? Because you couldn't talk about it on social media so we should circle the wagons and say those people were eventually justified? Because we should have a way to decide based on incomplete data, or based on an incomplete understanding of confounding factors? I don't see it that way at all.
The problem, as I see it, was that there was credible evidence that something was going on here, but also serious reason for doubts. Some smart people were saying exactly that, and not challenging individual decision-making based on the available data. They said, "Sure, there may be something there, but it's not clear yet whether it's a good treatment, for whom, or under what treatment circumstances" (early/late, treatment/prophylaxis, genetic profiles, other proposed subgroups). That was a reasonable set of conclusions to come away with from the data available.
Scott's discussion of "how should we have been treating this all along" misses the point. Crafting heuristics that lend more certainty than the data support is just plain bad practice.
More generally, there was the community touting ivermectin as a great replacement for vaccination, and the reactionary community that condemned ivermectin as an evil distraction. Okay, but that's just people whose heuristics led them to greater certainty than the data supported. If there's anything to learn from them, it's that we should be aware how others' bad heuristics - and fighting over bad heuristics - can lead us toward greater certainty than we should have.
The real takeaway should have been something like, "Let's not settle for a simple yes/no answer to this question. Instead, let's call this an open question and look into it more seriously."
This is what we do in less politically charged areas. We keep looking until some intrepid researcher does an interesting subgroup analysis that generates a hypothesis. That hypothesis is tested and (unlike the dozens of other hypotheses we end up rejecting) we discover some confounding factor we hadn't considered before.
In this case, I think you've buried the lead on ivermectin. The lead should be, "Ivermectin may be a lifesaving treatment for COVID-19 sufferers with parasitic worm infections." It looks like that's a promising subgroup explanation of whom this drug works for. This feels like an excellent opportunity to promote de-worming efforts around the globe and save lives. Too bad it got politicized as a binary "cure/hoax" before we could figure out the real answer to the question.
> Some smart people were saying exactly that, and not challenging individual decision-making based on the available data. They said, "Sure, there may be something there, but it's not clear yet whether it's a good treatment, for whom, or under what treatment circumstances" (early/late, treatment/prophylaxis, genetic profiles, other proposed subgroups)
Right, there were scientists being properly scientific, and skeptical of broad claims.
But then the media was saying that The Science had spoken, and accusing them of taking horse-dewormers, and ha ha you idiots. And then wondering why they don't take our good advice.
And it's not like the media was some uncontrollable beast here. Fauci could've been calling up people like Don Lemon and said "please stop with that."
> am I secretly suggesting that we make rationality higher status?
I'm all for it, but asking society to become rational enough to make a dent in the problem seems infeasible. Between "believe X" and "become significantly more rational", there must be some message/framing that would improve this whole situation.
And I think Scott identified likely the best take:
> we have to make the scientific establishment feel less like an enclave of hostile aliens to half the population... But I don’t really know how to do that, and any speculation would be too political even for a section titled “The Political Takeaway”.
But I'm happy to speculate!
1) We just have to engage with people. The overall conclusion of Lee McIntyre analysis in "How to Talk to a Science Denier" felt viscerally right to me: science deniers can be convinced if they can just talk openly, candidly, *safely* with more rational people. "Safe spaces" are a wonderful idea Our schools, universities and institutions purport to have safe spaces, but they aren't safe for the people that likely need them most: the half of our population that is not liberally aligned.
2) In absence of those healthy, personal relationships, people will turn to whatever authority is most prominent in their lives. And we have horrible, evil, awful people in positions of authority. I don't actually know how, but the required outcome is obvious: get money out of politics, and invest in public media.
Why is rationality not privileged? Why is a prophet ever without honor in his own country?
Because for most people most of the time, the fastest and surest way to wind up dead or seriously disadvantaged has been at the hands of our fellow humans. At the same time, "our group", whether by faith, family, tribe, regiment, frat, whatever, are the people we can surely trust to have our back when we need support, when we are sick or threatened.
Therefore, whatever else happens, whatever we have to do, believe absurdities, participate in degrading rituals, risk our lives, blindly follow barking insane leaders, parrot obvious lies to our detriment, do or suffer terrible things, but please whatever you do, please don't kick us out of the group!
As a result, when people are presented with evidence, strong evidence, irrefutable evidence, evidence verging on philosophical proof, that their deeply held beliefs, the beliefs that people use to define themselves and tribe, are wrong, that the tribal leaders are crazy, stupid or malevolent, that we are headed to catastrophe - rather than change beliefs, change leaders, change tribe or change course, most people, most of the time will instead double down. Witness the behavior of cultists. Solzhenitsyn has documented true believer Communists heartfully confessing their guilt at a show trial because the Party demanded it.
The process is called "cognitive dissonance" and it is abundantly documented. As alluded to earlier, there are entire religions organized around the principle.
Cognitive dissonance is not limited to stupid people. In fact, the intelligent are at least as prone, perhaps because they are better at rationalizing. In fact, much so-called "knowledge work" is basically manipulating symbols in order to justify whatever the paymaster wants to see justified.
> invest in public media
How you prevent capturing them by politicians or some "independent" control group?
> How you prevent capturing them by politicians or some "independent" control group?
🌎 👨🚀🔫🧑🏻🚀
I'm worried about trying to make rationality higher status. I think we'll end up with more "rationality".
Hi Scott. Really thorough review of the IVM studies that helped confirm what I've been thinking - there's just little data proving effectiveness. The roundworm incidence was an eye-opener, though.
When you mention myocarditis, though, it seems you pooh-pooh it just a little bit. The thing is though is that the incidence in young males has really surprised the CDC and caught it a bit off-guard. The whole of the vaccine safety meetings are available published at
https://www.cdc.gov/vaccines/acip/meetings/live-mtg-2021-08-30.html
And in particular CDC showed how far actual cases of myocarditis exceeded their prior estimates in the slide in the YT video linked below. Their estimates were for single-digit numbers but instead they found real-world incidences in the hundreds.
https://youtu.be/mfFeocgSKvU?t=204
Yeah, I wanted to balance "I'm not claiming this is a reason to avoid the vaccines" with "I think this one might be a real serious objection". My personal experience is that one of my younger patients and one of a friend's younger patients got (mild, quickly-resolving) myocarditis around the time they got vaccinated. I can't prove it was related but that's a heck of a coincidence and suggests it's pretty common.
Thanks Scott. I just wanted to show you that CDC slide. Subsequent safety meetings show similarly high rates vs. expectations - not that they're "high" in a global sense, just high compared to the rainbow estimates they'd put out earlier.
The good news is that this does seem mainly transient in nature. The bulk (some 80%) end up hospitalized, but it's short duration and so far, the CDC tracking indicates that by 3 months, over 70% are fully Sx-free and cleared for all activities by their cardiologists. (3 months is all the tracking data they have so far as of last month's meeting)
Just a heads-up on this issue, you'll see people citing the 5-year mortality rate for **chronic** myocarditis as if it applies to these more transient cases, when pretty clearly it should not be relevant.
For your alien analogy to work, wouldn’t most humans have to already have chips implanted in our brains, provided by the same aliens who want us to get this new chip?
And the already-installed chips would be for mimetic plagues we’ve never actually seen break out in earth, much less Jill someone we actually know. Whereas this new mimetic plague is one where we can observe the effects within our own communities.
Avi Bitterman - one doctor that was cited - has an updated regression. https://twitter.com/AviBittMD/status/1460855430805180421
He posted himself elsewhere in the thread! :)
Not only is ivermectin boosterism strongly correlated with anti-vaxxism, it also strongly correlates with Trumpyness, FWIW.
Also FWIW, I am neutral on ivermectin; it may be of some benefit and I am willing to see. That said, both pro and anti camps are so polarized, that no amount of research, logic, facts or evidence will convince most partisans of either side. Strongly in favor of vaccines as a general principle. Detest Team R and Team D about equally, most days.
Lord knows that I despise Trump, but a lot of people attribute positions to the man that he doesn't appear to actually hold.
The cognitive dissonance of certain Trumpy antivaxxers is a pure delight. "The COVID isn't real, but China invented it, and Trump defeated it, all using a vaccine that doesn't work and contains microchips'n'stuff." How many internal contradictions can you pack in a single sentence?
No lie, and cognitive dissonance isn't a phenomenon that is limited to Trumpers.
I think this is well known in our circles. It's one of the things that comes up repeatedly when people in my bubble talk about the anti-covid-vax people. Something like, "And what's weird is this is Trump's thing, you know? Like, remember when covid first hit and all the talk was at least a year and most likely 18 months to vaccination. And Trump and Warp Speed got us there in like 8 or 9. Don't get me wrong, I think he's a bad guy and all, but this is a real thing he really did, and his own people won't use it. It's *so* weird."
Well, it's certainly in passing in my circles, typically while on the way to bag on the red tribe for whatever bad thing we think they're doing this week. But Trump gave us quicker vaccines and sentencing reform and both of those are goods. Even an evil orange clock is right twice a day.
Really enjoyed this one.
When I read Scott was going over 30+ studies of Ivermectin - I thought about switching to TikTok. Stayed - and will soon need a new carpet. ROFL. - Funniest piece ever. And more depressing than Moloch. WTF went wrong with "science"?
It works because ivermectin is a protease inhibitor and keeps the virus from replicating and kills worms.
score one more for the Maps sans New Zealand : (. I've been thinking a lot about #trustthescience from an epistemology point of view lately, there is definitely something in that. The scientific method was never really designed to generate trust among non-experts, it was designed to generate truth when operating over the smartest and best resourced experts. There is probably a need to develop a new epistemological system from the ground up to try and grow a deep and reasonable trust, a hashtag is not really going to cut it. (Requiring data to be published would be a damn good start though...)
Probably the best attempt at making a case for vaccines from a "not an alien" point of view that I have seen is this one by conservative Christian apologist Neil Shenvi. He tries to argue in a way that "requires minimal confidence in the government, public health officials, doctors, and scientists." https://shenviapologetics.com/a-minimal-case-for-covid-vaccination/
For a good comparison, look at vitamins. I take OTC pills for A C D K Fishoil Magnesium Calcium and a few others, just bought off Amazon.
Do I need them? Probably not
Did a doctor recommend them? No
Do doctors recommend them as a treatment for anything? No, or else they'd be locked behind a prescription and cost $40/pill instead of ~$0.30 for my daily regimen.
Does anybody think they are directly harmful to me? Not that I'm aware of.
Should I be taking these? Why not? The cost is absolutely negligible and I think there is a reasonable chance I am deriving some health benefit
My self-medication with these is the exact same sort of not "trusting the science" as people taking OTC Ivermectin prophylactically. I think all of the above answers would be the same for an Ivermectin taker. I don't think my position on taking vitamins is in any way unreasonable and would be unlikely to stop unless somebody made a strong argument that they were actually harmful.
With that in mind it feels like the wrath and ridicule towards Ivermectin must come from the (admittedly often accurate) conflation between Ivermectin and Antivaxxing, and the vitriol used to attack my above position is just ludicrous and takes away any credibility the speaker could have.
Calcium for one as a supplement is NOT recommended
Why? I don't consume much if any dairy so I figured I might as well
There is some evidence that supplementation of calcium as opposed to receiving calcium from food can lead to a spike in blood calcium levels leading to potential heart problems. Google for more info. Perhaps low supplementation is ok.
What form of calcium can be assimilated, and how is it provided in the supplements? Because if any calcium carbonate can be metabolized, my daily dose of tab water is enough
https://en.wikipedia.org/wiki/Milk-alkali_syndrome
Interesting, thank you. My tap water is fairly hard and unfiltered and I drink quite a bit of it every day. I'm taking 620mg of Calcium supplement daily but I think I'll tone it down to just the 120mg that's part of a multivit.
Anything else secretly dangerous?
Well that would be a much better argument if low levels of ivermectin were part of the routine diet.
So this talk of a "quantum" "memetic" plague...just silliness, right? OR is there something more there?
Cause I don't know if it's occurred to anybody else but there is clearly a Copenhagen Interpretation issue going on with this pandemic stuff. Talking like an individual person is clearly either sick or not sick. When you got these mathematical models and whatnot, though, a person can have a relatively greater or lesser probability of getting sick or not getting sick based on some or other variables.
You and me, we're walking around, according to the modelling on which the public policy is being based we are all in a superposition of sick and not sick, on a probability distribution, right? But obviously a person is still either sick or they are not sick. The probability distribution is collapsed into one or the other state.
Where do people fall on this issue? It's a complicated one, and not distinct from ethics; I recommend reading the play by Michael Frayne.
Hi Scott, please get in touch with my via twitter. You're using my old analysis here, which was a back of the envelope calculation. My formal analysis is more rigorous and not susceptible to the critiques some are raising here.
Avi Bitterman
Really good, but I think one thing is worth mentioning: if you don't want to be seen as hostile, don't force people to do things they don't want to do. The extra benefit from compulsory lockdowns, mask mandates, and mandated vaccination and boosters is small compared to the loss of trust.
" The extra benefit from compulsory lockdowns, mask mandates, and mandated vaccination and boosters is small compared to the loss of trust."
How so? They led to many lives saved.
Vaccine hesitance among the old and obese is driven partly by viewing public health as hostile. Mask mandates and lockdowns caused this, and achieved little or nothing that could not have been achieved voluntarily. Forcing old or disabled people to vaccinate is very difficult - the mandates mainly affect those who benefit far less.
To the author: Did you submit your criticisms to the site? If so what was their response. What was your opinion of ivermectin before anaylizing the studies? Did reading them change your mind about anything? Do you have any conflicts of of interest? Are you at all concerned about the EUA creating a multi billion dollar incentive to suppress alternate treatments like ivermectin? Have you carefully examined what reputable critics of the 'vaccine' are saying? Do you think the risk of ADE has been proven to be minimal? Do you think the growing number of incidents reported on VARES are being properly evaluated? Are acceptable and should play no role in people's decision making? Do you think mandates are a good idea?
Welcome. Please take a look around and take a few minutes to get yourself acclimated.
The quantum memetic plague sure is funny, and probably catch some of the deep reasons around vaccine fear....But not the "those aliens are part of a circle I can not even imagine me or any of my friends would ever be part of", this is at most a fringe reason. Many technically-minded people have reticence, some (crackpotish, or among the small scientific red-tribe - it's becoming difficult to distinguish between those) health-related scientist are even among the not-so-warm to vaccine crowd.
I think people could trust a utterly alien circle, provided this circle has no past hostility (and preferably some past helpful behavior) to show, so the political aspect (the advice-givers are actually hostile, at least on other subjects) is more than enough for explanation. Add the fact that Covid is not Ebola (if it was, there would be far less space for discussion and far more for riots around pharmacies holding the rationed vaccine), and that's more than enough.
The political aspect in particular is huge: In an increasingly polarized political climate, 95% of biological professors are democrat! I guess it would be enough even if covid was worse. Maybe not Ebola-like, but significantly worse.
This 95% is completely crazy, and I can guess something about the remaining 5%: They follow Greg Cochran. They have stumbled by accident or interest on parts of biology that is taboo to the blue tribe, and, because of polarization, now tends to reject other parts they would never have rejected 50 years ago.
Most parts of my life are linked to techno-science (work, practical hobbies, learning interests), since as long as I remember. But the evolution of science, at least those last ten years, in its public message form, makes me sad. Not to the point of wholly rejecting it, it's still my main interest in life....But now I zap out mainstream media except for mindless entertainment, and get anything I consider seriously from other sources, like this blog.
About the alien analogy: there must be something more to it, right? Anti-vax sentiments seem to be a primarily Western, First-World phenomenon, though there are many rural, low-education populations in the rest of the world that probably do not identify with scientists.
Also, this article was a joy to read.
Well, I don't think so, it's not western. In Europe, it's quite prevalent in recent immigrant communities, and I assure you (because I have a lot of first hand experience) that it's prevalent in Africa, not only the African diaspora in Europe, but among locals too. Maybe its slightly different in the sense it's not scientists (or Bluetribe scientists) that are the alien, non-understable powerful and malevolent group who are believed behind the vaccine push, it's the whites in general. Post-colonialism effect there for sure.
That's really interesting! That's the kind of data point I was looking for.
I *love, love, love* the worm interpretation of the data. Also, Scott, a million thanks for finally doing a deep dive on ivermectin.
If there's one thing to be huffish over, it's the tirade against the vaccine hesitant at the end. I swear that my following negative comments will last no more than 4 sentences, and will then return to adulatory effusiveness, but: Ahem - O Thou Who Art Vaxxed - dost thou know what it is to be threatened with termination from thy job because thou dost not wish to take an experimental drug that hath only been around 1 year? I mean, seriously - some of us are being persecuted because we want to wait 2-3 more years to see what the data is on long-term side effects. This sort of hesitancy about drugs is pretty common and is prima facia reasonable. It's not even political, or not obviously so, since (if I can cite findings from a few studies that may or may not be RCTs and may or may not be fraudulent and may or may not be significant and may or may not have confounders, because really we need Scott to figure that out) the vaccine hesitant tend to be people with PhDs and middle-aged women who vote liberal.
That having been said, it helps to have the ivermectin side of things cleared up. And this is the most brilliant thing I've read since the analysis of trapped priors, or of race and police shootings, or the other cool things that Scott comes out with so often that I can't keep track. It really deworms the horse. I mean, it hits the worm on the head. It cuts the Gordian Worm. And now I have to go re-evaluate my supply of ivermectin.
The vaccine hesitancy among PhDs turned out to be false. It was based on a Facebook survey. A very small percentage of the population holds PhDs, and a small percent of people also lie on these surveys, and it turned out that the people lying were enough to completely distort the stats on vaccine hesitancy in PhDs.
Did it? I'd like to read the follow-up report but I can't find it (it's probably buried beneath all the headlines about "PhDs Most Reluctant to Get Vaccine").
The original study is here: https://www.medrxiv.org/content/10.1101/2021.07.20.21260795v1.full.pdf
Do you know if the follow-up study also found a comparable amount of lying in the other demographic groups (masters/undergrad degrees)? I don't trust Facebook, but it's not obvious to me that people would lie more about having PhDs than MAs, and it would take a lot of work to check a significant sample size of the 5 million responders to determine who lied about their education level. But maybe someone found a way to do that.
It was in a links post a while back, which links to here: https://coronavirus.quora.com/Is-it-true-that-PhDs-are-the-most-vaccine-resistant-group-https-www-nationalreview-com-corner-the-most-vaccine-hesita-1. Which in turn links to a revised version of the paper: https://www.medrxiv.org/content/10.1101/2021.07.20.21260795v2.full
"To be included in the analysis sample, participants had to complete the questions on vaccine uptake and intent, and report a gender other than “prefer to self-describe.” This exclusion was made after discovering that the majority of fill-in responses for self-described gender were political/discriminatory statements or otherwise questionable answers (e.g. Apache Helicopter or Unicorn), and that as a group, those who selected self-described gender (<1% of the sample) had a high frequency of uncommon responses (e.g., Hispanic ethnicity [41.4%], the oldest age group [23.2% ≥75 years] and highest education level [28.1% Doctorate]), suggesting the survey was not completed in good faith."
In other words, if you exclude the people who identify as an attack helicopter from the dataset, the surprising result disappears.
Thanks beleester! You just saved me from clicking through a gazillion duckduckgo pages.
Hm, but does the effect "disappear"? It looks like PhDs just drop to being the 2nd-most-hesitant group, still following the original U-curve. I mean, the updated article doesn't actually give the raw numbers or a nice chart like the first version had, but here's what it says:
"The association between hesitancy and education level followed a U-shaped curve with the lowest hesitancy among those with a master’s degree, followed by those with a 4 year college degree, then a professional degree, and a doctorate. The highest hesitancy was among those with ≤high school education or some college."
So basically, the <1% change in responses, after the helicopters were weeded out, resulted in the PhD side of the U-curve dropping slightly lower than the high-school-only side.
In the meantime: apache helicopters! I have a PhD and I'm totally using that to self-describe my gender on my next anonymous survey.
Hi I am like a fifth through this article but I’ve skipped down here to say the Cadegiani section is the funniest thing I’ve read in months
Aren't we interested in a very small tail, the 0.03% of people who do not survive COVID? In ML, we have specific model building techniques, usually called Fraud Detection, to build models that will pull out the signal from this hugely lopsided categorical data. Plus you need A LOT of data.
Furthermore, I think it's plausible to put Ivermectin, or any other drug that works "non-intuitively" into a category that only works for a segment of the total population (e.g. let's say the 20% of people who are strongly deficient in vitamin D at time of infection). In statistical terms, an "interaction effect" which can be tough to capture and easy to confound. Overall this is going to be very difficult to tease out from the noise of SES, geographic happenstance and strain potency.
If we had a medical tricorder from the future, is it possible that would identify 1% of the population as strongly benefiting from administering ivermectin on infection / taking it continuously as prophylactic, where P(survive) could be increased by an order of magnitude?
I think we might currently be around .3%, but that's post vaccine and post several months of sorting through leads to find treatments that actually help. .03 is an order of magnitude off.
Good point, I was thinking 99.97% survival is for 18-35 I believe.
Could you comment on Jimmy Dore/Dr Campbell whereby Dr Campbell reviews papers that same Ivermectin is a 3 PC pro tease inhibitor- much like Pfizer new pill which will be combined with a AIDS drug.
Here is the video with Dr Campbell explains the action WITH cited chemistry papers.
https://www.youtube.com/watch?v=xROICA8Hr7I
please watch- i would enjoy your analysis
One paper referred to......just to show it's 'real'
https://pubs.rsc.org/en/content/articlelanding/2021/cp/d1cp02967c
docking papers are a dime a dozen, but most of thwm are crap. I perform research in that exact area and (to a first aproximation) EVERYTHING can do docked into EVERY protein and for that reason every high ranking docking candidate must be compared (eg through molecular dynamics) to well-known binders and non-binders or decoy molecules to ensure one is indeed looking at a relevant interaction instead of run-of-the-mill "stickiness". I am not saying the reference you showed is crap, but that it may not be as strong evidence as you may think
I remember very clearly when this jamoke started their page for hydroxychloroquine (c19study.com) early in the hype cycle, before diversifying into every brand of snake oil under the sun, there were only two decently sized RCTs. They disallowed one early-treatment RCT because took place in a hospital and was therefore not "early" (obviously like half of the crappy convenience samples included in their "early treatment" list were also hospitals) and the prophylactic RCT (Boulware) got a full page treatment of "reanalysis" and mutually contradictory nitpicking (compliance was low! but also the placebo might have been active!) which was not afforded any of the insanely sloppy papers that French guy was churning out. I note that the current iteration of the page does not have Boulware anymore but does have multiple "reanalyses" of their data. Rigor is worthless if its reserved only for studies you don't like.
What gets me about all this is that we already DID the whole "analyze all these cheap off-patent drugs for efficacy against coronavirus" and got a hit: dexamethasone! Studies were done, they looked promising, and it was uncontroversially accepted. It's weird, and I've found it best to think of everyone who hung on to HCQ throughout all of 2020 and to IVM all of 2021 as a very unfortunate flavor of hipster. Sure, we found a cheap drug that helped, but it wasn't THEIR cheap drug, it's the ESTABLISHMENT'S cheap drug, so piss on it.
It's worse than you think - some of the people involved in early promotion of dexamethasone later moved onto ivermectin. Dexamethasone was their drug of choice, but they abandoned it once the establishment adopted it and its impacts became quantifiable.
First off, the article comes off to me that, the evidence looks exactly like the right would have predicted, going against what the left would have predicted, but the left makes up some after the fact left field excuse to ignore the data, as they always do.
Second, safety is never mentioned. Right wing solutions are completely safe and risk free, and reasonably could work, but the leftists just demonize us and demand that we ignore all the cheap and safe solutions and tunnel vision in on dangerous expensive solutions.
I don't have a high degree of confidence that ivermectin solves covid. I do have very high confidence, that if we held the top hundred promising treatments with completely solid safety records to the exact same standards as pfizer gets when considering their new drug, covid would be over by now.
Finally, as a young person who already caught covid and has natural immunity, I see the left in extremely uncharitable light when they try to force the vaccine on me. Wouldn't the world be much saner if we actually studied ivermectin, and kept the vaccines (and the lockdowns, and the masks, and the etc.) to the people actually at risk?
The US certainly has its share of intestinal worms. Pinworm in particular (Enterobius vermicularis) is quite common in children, and tends to spread to other members of the household. It's pretty innocuous on the whole and tends to be asymptomatic except for a mysteriously itchy butt, and may even have helpful immune modulating effects, but maybe also harmful ones. (And yes, ivermectin would kill it.)
Wikipedia says that Strongyloides infection is detectable by immunoassay. Assuming that that test is reliable, it should be feasible to divide the experimental population of an ivermectin trial into worm-positive and worm-negative groups and separately evaluate the impact of the drug on both populations as compared to the control. Does that seem like a legitimate experiment?
Can you get that past an ethics board? "We're going to confirm that you have an intestinal parasite with a known treatment, but then we're not going to give you that treatment." I'm honestly not sure where I stand on it, either.
I mean, everyone in the experimental population is getting ivermectin. Is it ethical if you don't test the control population for worms?
Best post of the ACX era.
Agreed
Speaking as a member of a religious, vax hesitant community, where I have been the one arguing for more openness to the vaccine, let me first say your model is not bad (though see some of the suggested improvements from other commenters below). The Orthodox priest example below is a little better, though it misses the hostility. (Also, I once again have to commend you Scott on your consistent attempts to try and strongman opposing views that you find stupid - the world would be so much better if more people could do that).
some other data points:
- There are medical/scientific folks in my community, and while they have a more nuanced view, even they are skeptical/untrusting. Probably doesn't help that they've being closeted for years in a field listening to open conversations about how stupid/awful/deplorable they are.
- Being seriously religious already means you've shown willingness to abandon the expert consensus (at least if you live in any metro area). So my community probably has a higher-than-normal representation of the kind of people who are willing to take unconventional positions.
So, it's kind of a situation of trapped priors as you've discussed elsewhere. Which is actually a decent model, because I can get people to update a little, though rarely enough. The traction I make with people when arguing for the vaccines is not with expert sources but generally with updates based on data we all see - who in the community has serious COVID vs vax side effects, whether vax or not are transmitting, and what some of our community who work in the ER see. FWIW, from ONLY this data, the model is that vax side effects are worse and under-reported (because most docs blow off reports and say the effects are just coincidence, even when serious), but I can get folks to agree that they are not THAT much worse. Maybe 50% underreported for serious effects beyond the expected out for 1-2 days. With this view of the data, folks generally agree that vax makes you 2-3x less likely to die or be hospitalized, and so they generally view it's ok for older folks or those w co-morbidities. However, the community would also say that vax is not much better with infection prevention. This is possibly biased by louder reports of breakthroughs within the community, but then again, community is only probably 25% vaxxed, and we hear about a LOT of breakthroughs. So this updated model, even with the trapped priors, isn't THAT far off of scientific consensus in microchip-land, though definitely still less confident than expert consensus.
The other thing that I think would allow updates out of the trapped prior is seeing approved/official sources expose more questions and data counter to the political narrative, even if they're eventually proven false. We can all see that it has been something that only deplorable people question for a while, so of course very few scientists want that risk. I've seen a a few small instances of contrary opinions making their way out, and so have updated the priors in my argument a small amount, but I would still like to get to the point where it feels like a scientist isn't risking their career to publish any counter-narrative studies before folks in our community will remove the penalty.
Obviously, the best approach is your recommendation for the expert class to abandon the conflict theory model to anyone below them and get out of the bubble. But since an alien invasion feels more likely, a slight update in messaging might help. For perspective, the meme that worked the best with me was one Zvi was using pre-mandate re vax hesitant, ie. "go ahead and die - what do I care?". I found this most persuasive because 1) it fits my model that everyone hates our community, 2) it fits my model of you all being mostly libertarian leaning, and 3) it fits the medical data better - ie vax are far better at preventing death than transmission. (I also originally found the "in service of the common good" meme persuasive in my community as well as it fits the religion, until it became clear the vaccine was non-sterlizing.) The mandate and its messaging was far more confusing ('you need to vaccinate to protect the vaccinated"), not to mention a naked exercise in political scapegoating.
So, do we have at least a somewhat happy ending, where I've been able to slowly pull a few people over each month to the idea of vaccinating? LOL, no - thanks Joe Biden. And I can't emphasize enough how harmful the mandates have been here, when I had been making progress. It's not just the psychological reactance that should have been wholly expected by so-called experts. For me, it's one thing for me to be a 'diplomat' of sorts with the aliens, and represent their point of view to the skeptical, while the aliens are peacefully contained in Australia. It's wholly different when the aliens attack - arguing their point of view on my part becomes a lack of solidarity, akin to treason. Thanks, JB! Really doesn't seem like the right policy if you're interested in public health. Though that was probably never the point - I suspect it was viewed as a political win-win. Scapegoat the unvaxxed if COVID resurges this winter, or if not, declare victory through strong leadership. Not like anything ever goes wrong when a political leader scapegoats a community! ;-)
P.S.: I also think a blind spot in the ACT/LW/rationalist community comes from your relative willingness to self-medicate, i.e, via nootropics. This makes you particularly willing to medicate even when you're healthy (ie. vaccinate). A lot of folks (not just my community) don't like to medicate unless absolutely necessary, which is why I think you see IVM and the new Merck/Pfizer pills getting more traction vs vaccines.
Great post. I'm in Europe, atheist (which is probably a very different thing here than in the US) so should be in a very different circle. Still I find your analysis spot on. Maybe this show this whole thing should not be analyzed from a scientific point of view, but on who would welcome a more homogeneous society with strong central control, or one with individual (or small group) liberties maximized. It's a little bit blue tribe/red tribe, but not exactly so...People who prefer the second choice, are reluctant with the official policies mainly because they feel the COVID policies are used to push the first goal....
Part of the problem is also that science gives black and white messages.
Mask good/No mask bad. Vaccine good/No vaccine bad. Ivermectin good/No Ivermectin bad.
Every person on earth no matter the I.Q knows intuitively that life is full of nuance and a message presented this way breeds distrust.
Black and white messaging is tolerable when it comes to things like abortion, that don't affect ppl everyday and one can support without much impact on their life... but when a persons individual health is on the line they're going to start questioning these messages.
Then combine that with the rediculous way most science papers are worded which makes half of them unintelligable to people IN SCIENCE.
I think Science Establishment thinks it's doing everyone a favor with simple messaging and everyone else thinks science is patronizing them and giving an untrustworthy message.
They need analysis like this blog tacked on to every message and analysis of the studies in a human friendly format that average people who want to look deeper into the data can read.
It's a communication failure overall.
Abortion doesn't affect your everyday life if you aren't a fertile woman.
Really? Child's life doesn't matter a bean to its father? That's pretty cynical.
Fair enough. Men are involved on both sides-- some want a child, some pressure towards abortion.
Woman's body woman's choice, unless of course she decides to keep the child then it's the fathers responsibility to financially support the child!
I just subscribed today. I did it to add my thoughts to this comment thread: this is one of the very very best articles that Scott has penned. Thank you.
Kvestion: I understand that chlorpromazine, aka "Thorazine(R)" remains the treatment of choice for brain eating amoebas.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2573150/
Does anyone know how or why an antipsychotic would be an effective treatment of an amoebic infection? From the link:
"Unfortunately, the mechanism of chlorpromazine action is still unclear. However, we suggest that the activity of chlorpromazine may change amoeba calcium regulatory protein or may be due to the lipophilic action of the drugs on the amoeba plasma membrane. The accumulation of chlorpromazine in the central nervous system makes it a potentially useful chemotherapeutic agent for the treatment of PAME in humans that is caused by N. fowleri."
Thanks for this and it definitely put forward an idea which none of the proponents of either position are saying in terms of worms and other parasitic issues in developing nations leading to immune system suppression.
My conclusions from your conclusions:
1. We should immediately give out ivermectin very widely in all places which have parasite issues which appears to be the vast majority of humanity. Their immune systems are suppressed by parasites and we have a great tool to fix that and boost their immunity which helps them in multiple ways including with covid.
This is a great solution, viable, easy, and cheap for poor countries who can't beat rich nations in the bidding war between 1st vaccine in poor countries vs booster shots in rich ones.
2. We should be very very concerned about why our institutions are giving out horribly bad and wrong advice over and over and over again and lying on so many fronts that they cannot be reasonably trusted. For different reasons than the average pro-ivermectin person, Scott too is calling out the NIH and CDC and WHO for being dead wrong in what they are saying.
Meanwhile the elites are fixated on expanding their power, giving away profits for publicly funded vaccines to mint more billionaires, and being vaxterical about all alternatives to vaccines as though the devil were coming. Thanks German and US and UK massive research funding, promises to buy the vaccine even if it didn't work, legal immunity, and all the exclusive IP control which led to record profits! You did all the work public money and public research bodies....but in terms of hoarding profit.....we'll take it from here.
Also, at Big Pharma are clearly motivated by science, Truth with a big T, and caring about you! Ummm...I'm not sure why the 1st dose of vaccines across Africa wont arrive for most people until 2023 and the vaccines only work for 6 months...we'll umm...look into that, just keep the money flowing for us, thanks!
3. This concern about widespread multiyear repeated Institutional failure about a mild disease triggering an insane reaction should be more of a concern than some pseudoscience folks who listened to the science a little too closely and found a good safe drug that does work to make covid less bad for 80% of Earth's population, but for the 'wrong' reasons.
4. Our entire public health approach seems to be severely flawed where we have a disease problem and a tactic which removes a hurdle or adds support to the immune system is viscously attacked. Do we want to help people, control a disease, etc. or do we want to only deploy the most highly scientifically researched ideas?
Or insteadMight we throw everything at it and just use anything that works for any reason as long as it is safe? Why is one approach the ONLY way and all other ideas wrong...even if every single thing from 'the one true way' has resulted in wrong choices to date?
5. The corruption of science, government, and institutions with oodles of bribe money seems to have narrowed our entire scope of understanding down to things that fit into centralisation, profits, and power expansion to the exclusions and active ridicule of any idea which doesn't promote more elite power, profit, and authority. Somehow this is left out and is central to distrust growing.
The longer winded version with more detail of the above points:
I really think Scott might be trapped in a bubble of 'trying really hard to find ways to make the professional/expert/leadership class who are like me' sound more reasonable than they are.
Largely through omission and a quick acceptance of the fact that they have repeatedly lied, cheated, stolen, engaged in horrifically amoral profit seeking, and killed people by releasing drugs which have been recalled and some which are still on the market despite the fact that they should probably be recalled or have their guidelines changed to be proscribed far less often.
This is like excusing Pinochet with 2 sentences as 'a bad guy' and 'we know that, yea' and then fixating on a person who killed 2 people while drunk driving while using shoddy statistics. The focus just seems a bit....off. As though a few tweaks to some 'bad science' would somehow fix the atrociously and terribly wrong choices made by every single person in a position of power.
I'm not so concerned that random doctors and the public found that Ivermectin worked, but think it works for the wrong reason....than I am about why all our institutions and experts missed this! And are stillllll missing it!
The end goal is clear that 'we need to find a way to trust the RIGHT experts'..as in the ones who are correct. Which does indeeds sound reasonable and very difficult and also....why in the world had we not already been doing all of this already? Why is there a sea of low standard such that the highest quality journals are still quasi wrong and below good standards most of the time? Isn't that a bigger problem than folk remedies which work for the wrong reason?
And yet, as you said the goal isn't to get negative PCR test, but instead to help people and for people to avoid the disease or become heathy if they do get sick.
So what should our goal be here? In terms of deciding what to do. I saw in another comment Scott talked about Pascal's Wager and yet....besides the adjacent Pascal's Mugging concept...this isn't a hypothetical trolley problem or an argument, it is a reality for hundreds of millions of people who've had COVID and what choices we make as a species in terms of how to deal with it.
Maybe giving out a harmless and in fact beneficial drug which won a Nobel prize is the right thing and the hysterical and objectively insane overreaction to ban it, ban it for all time to irrational promote a VACCINES ONLY policy from all the governments, media, and medical institutions is an obviously wrong approach.
One which we have never seen for any other disease and is linked to enormous power and profits....every single red flag should be raised right now to the shoddy and insane logic and approach which we've never seen before where the CDC and NIH and WHO are MORE concerned about stopping people from taking safe drugs which may not work than they are in finding therapeutics.
I've even seen ads and media talking about not taking vitamin d, not losing weight, and not taking monoclonal antibodies or other treatments. They are actively advocating against ALL ideas which are not the vaccine. This has never happened before and is noteworthy. It is vaxteria where news anchors start spitting blood and gnashing their teeth at the thought of anyone doing anything other than get as many vaccines as possible. This shit isn't normal!
To me part of this comes down to the incredible set of Western medicine style blinders of 'I need a drug to treat this specific disease directly'. The Truth with a capital T is all about this somehow....instead of the more holistic Eastern medicine concepts of looking at the overall health of the patient. In the West if a drug works for the 'wrong' reason, then we should ban it?
That's the lesson I'm hearing from all our leadership in all the important sounding places. It is important to understand mechanisms of action sure...but is that MORE important than throwing everything at the wall and going with anything that helps, even slightly and with limited side effects, during a pandemic? What should be our guiding star when we have a research system which takes years to come to semi-reliable conclusions while we face an immediate problem of a pandemic which is not going to wait for us?
For vaccines the answer was to rush the out as best we could...but that approach was used no where else where even basic treatment of patients such as corticosteroids was banned for many months at the start of the pandemic. Why the different logic, approach, policy in public health? One side of that equation had billions of profits which minted at least 9 new big pharma investors into the ranks of billionaires and the other options didn't.
Somehow......at the end of the day......we see more profits, more corruption, more centralisation, and more power held by fewer and fewer people to do more things.
How could someone not think the goal here is to boost profits when the ONLY idea which is acceptable is to have as many vaccines and booster shots as possible which were all publicly funded, guaranteed, given legal immunity for the lowest risk drug release in history, and then 100% of the options were locked up under IP and private profiteering.
The ultra strong conclusion I can see from Scott's worms are the problem trollish outcome is that 'this is the best time in history' to expand deworming programs in countries where this is a problem. It is low cost and DOES help people in those countries who get covid to not get as sick, not go to hospital, and to not die from covid.
Also! there are also many benefits of NOT having parasites which would help them in lots of other ways. Unless there is some strange pro-parasite movement (aside from the 'it fights celiac disease' somehow) I don't know about.
Somehow we're fixated nitty gritty of the dog bites man story here and ignoring the man bites dog story!
Scott, this was wonderful. Thanks!
Yes, but do you have a parasitic infection? If so, you should probably take ivermectin.
😂
Just clicked on the link from Twitter suggestions. Thanks for your research, number crunching and insight. I'm very much surrounded by ivermectin proponents and vaccine/mask skeptics.
My personal perspective has been rooted in the Critical Rationalism of Karl Popper and deontological ethics. Overall, COVID has been dominated by consequentialism and Scientific Instrumentalism. Hopefully, people have learned that we should NEVER trust experts for being experts, only consider their arguments and more importantly their explanations. Also, that science is not an instrument for pushing a political agenda, but a process to seek out the best explanations for why the natural world is the way it is. Hume taught us a long time ago that you cannot get an ought from an is, but that is exactly the dominant message during COVID. This, along with people being bombarded with ad hominems and other logical fallacies from "authorities" I fear the next pandemic will be more catastrophic as both sides double down. All-in-all this has been an epic failure of hubris on the part of "experts".
Sorry, ended up posting way more than the simple "Thanks!" I intended.
I'm just continually amazed with Scott's ability to write so much and so many interesting, well researched, well thought-out posts.
When you say "50% confident", does that mean probability 0.5 (which is complete uncertainty for a boolean assertion), or "half way between complete uncertainty and complete certainty"?
I interpret it as meaning that after incorporating all his priors and gathered info, he assigns probability 0.5 to it.
One thing the political section leaves out is that the left-wing diversity pushers are trying to solve a similar problem. Black people have been harmed by scientists in the past, and there are few black scientists now, so they need to increase black confidence in science (black people are more likely to be unvaccinated) by forcing everyone to promote minority scientists even if they aren't the most qualified. Now try to deliberately add conservative scientists through non-meritocratic methods, and there won't be any space left for real talent. In such a polarized society, you can't please everyone. What needs to happen, is judgment by results and getting people to downplay the actual demographics of scientists.
Now this is a general problem with communication of science. The scientifically proven ways of convincing people are very different from the scientific method. Therefore, the scientific method can't defend itself well, because if it use the scientific process, people won't listen, and if it uses arguments that work, those won't be the real reasons.
Such a great article! Some poor bastard had to put the work in. Appreciate you Scott. Would love to get your eyeballs on this one from Joe Norman https://appliedcomplexity.substack.com/p/we-need-adaptive-disconnectivity?r=rn946&utm_campaign=post&utm_medium=web&utm_source=
I applaud to you sir for all the hard work you've done uncovering the causation amidst the correlations and conspiracies!
What a terrible pain this must’ve been to research and write. Thanks for doing it, Scott.
I liked your approach. You made people read a huge text.
I would like to invite you to read this article. The comment box is open for your observations. It will be of great value.
https://filiperafaeli.substack.com/p/hydroxychloroquine-the-world-has
Is it distrust if scientists or distrust of people perceived to be pulling their strings or filtering their voice?
"Worms can't explain the viral positivity outcomes (ie PCR)"
I don't understand this statement. I thought worms were influencing recovery time from Covid, and hence they would definitely affect PCR results on any given day.
Apparently there's some evidence that ivermectin docks to the spike, thus possibly hindering the spike-ACE2 interaction: https://pubmed.ncbi.nlm.nih.gov/32871846
Which sounds quite helpful during the first 2-3 days of infection, and not important at later stages. So after the active phase of the spike-ACE2 binding ends, ivermectin becomes more or less a placebo with some anti-inflammatory properties.
Could timing of the treatment explain why some people claim it to be the (anecdotally) ultimate cure, while others experience no effect at all?
pfizermectin: 3cl protease inhibitor
ivermectin: 3cl protease inhibitor
🤷♂️
Would you be willing to go to a non-animated icon? I get distracted by the motion.
I was with you until "Ivermectin supporters were really wrong". Surely, what (non-strawman) "ivermectin supporters" supported was not blind acceptance of the barely-tested drug's effectiveness, but a reasonable and proportionate investment into further research from trustworthy institutions. Within the year, we had new vaccines and 30k person trials, but not so much as an acknowledgement of similar scale treatment studies in the US
The health care system's response to the pandemic or scamdemic as 'conspiracy theorists' call it, laid bare corruption that's been festering for years, and revealed that authoritarians are now in control of all major institutions in society. And like all people who seek power for power's sake, they've convinced themselves they know what they do not! It's been known for years that correct levels of vitamine D are essential for a healthy immune system and the majority of people who had a problem with Covid-19 were deficient, especially children, more than 90%, yet I've never seen one public service notice informing people they should have their level checked, among the thousands telling people to issolate, wear masks, and take an experimental vaccine that doesn't stop people from getting infected, it reduces the symptoms, which makes it more likely they'll spread the disease, while causing the virus to adapt to a more contagious form. The establishment's failure to study and explain the huge spike in adverse reactions reported on VAERS, and the imposition of mandates, has created a perfect storm, undermining people's faith in government and private institutions, making it appear they're colluding for some nefarious purpose. Knowing there's an information channel between the CDC and Big Tech censoring people, makes me very suspicious,
> scamdemic
Please, do not pretend to be some COVID-denialist. This is not helpful to make fun of other side in so silly way.
If you comprehended the post, you'd know the point was: The contradictary and illogical responce of goverment agencies given billions to determing the best course of action, and the outright censorship of critics, is undermining peoples faith those agencies, feeding conspiracy theories, and spreading distrust in all vaccines.
The point is right. The inflammatory language doesn't help.
I think the claim that they're reasonable people who just want bigger RCTs would be easier to swallow if the very first reply to your comment wasn't an anti-vaxxer calling it a "scamdemic" and arguing that all you need is Vitamin D. You can call that a weakman, but I'm just saying there are enough weakmen out there that I didn't even have to leave the comments here to find a couple.
As for larger trials, if you didn't find an effect with 600 people (the largest trials in the meta-analysis), it's unlikely to be worth trying it with 30,000.
Why do you feel the need to mischaracterize the post to respond?
For the record, I responded to beleester before reading your response and did not mean to draw a conclusion that your specific response was unreasonable
Why do you feel the need to mischaracterize the post to respond?
You did, in fact, call the pandemic a "scamdemic" and argue that the vaccine caused more harm than good. I stand by my characterization of your post.
No, I said 'conspiracy theorists' called it a scamdemic, and that misinformation about and mishandling by the establishment was giving ammunition to anti-VAXers. For children, evidence shows that the experimental vaccines are more dangerous than COVID-19, that's why countries who's health departments aren't controlled by Big Pharma stopped giving them to people under 30. The virus that causes COVID-19 is a very dangerous bio-weapon, and when when treatment options are suppressed by the WHO and CDC to maintain the EUA necessary for Big Pharma to make thousands of dollars a second, with zero liability, even more dangerous. The pandemic needs a multi dimensional response, The one size fits all approach the CDC advocated couldn’t work, but those who understood were censured and censored. The use of multiple boosters wasn’t even studied, but they’re going ahead with them, why not, they have zero liability and doing so will make then even more big bucks.
So what you're saying is that all it takes for you to be convinced to not advocate for the right thing (bigger RCTs) is for a group of people on the internet to go around posting unreasonable things? (I'm sure if anyone were trying to push an agenda, they would be happy to know that as well.)
You've changed the subject from "evaluating ivermectin supporters as a whole" to "evaluating the subset who argued for bigger RCTs." Scott's statement that "ivermectin supporters were really wrong" is broadly correct, and your claim that *surely* they weren't promoting anything besides bigger RCTs is proven wrong by John Hart and a dozen others in these comments.
If you're trying to advocate for the right thing while a lot of people in your circle are advocating for the wrong thing, then you need to work hard to distance yourselves from those people. That may not feel fair to you, but nobody can single-handedly control the conversation on anything, you just have to play it where it lies.
(I am also unconvinced that bigger RCTs are "the right thing" - as I said in my second paragraph, they *did* do two bigger RCTs and didn't find anything.)
In 'The Web that Has No Weaver', a seminal (in my view) book on Chinese medicine, Ted Kaptchuk starts with a story about a poor cleaner from the country who works in a western-style hospital in China.
The cleaner steals a store-room full of antibiotics when he leaves his job and returns to his home village. He then dishes out these pills whenever one of his neighbours get sick. He gains a reputation as a great healer because a significant proportion of his patients are miraculously cured. Kaptchuk likens this to the Western approach to Chinese medicine where we 'do acupuncture' and 'use herbs', but we don't have a deep understanding of why it works.
I was reminded of this parable when reading Scott's description of the effect of Invermectin with helminths.
If you give Ivermectin to everyone with COVID, maybe a proportion of them will get miraculously better. But without a deep understanding of how it works, we can't say why ...
> Somebody’s going to try make some kind of gated thing where you have to prove you have a PhD and a “legitimate cause” before you can access the data, and that person should be fought tooth and nail
This is already happening with some genetic datasets. You have to sign a legal clause that you aren't going to use the data for badthink. https://thessgac.com/register/
As a skeptical vaccine-denier who did not have strong feelings about ivermectin but doubted the ivmmeta presentation and wanted to read some other opinions on it, I enjoyed your neutral analysis. Your conclusions regarding ivermectin seem very reasonable.
Towards the end, you unfortunately abandoned your neutral position and vilified vaccine-deniers by calling us crazy. That is not true. We can be perfectly reasonable people who simply do not see a compelling reward vs. risk in favor of vaccines in the calculus of our lives. In my assessment, the safety of vaccines is an oft-repeated mantra but is not actually backed up with scientific evidence. There are many hypotheses about potential vaccine harm, informed based on real world signals, that have generally gone untested due to political forces. At the same time, the risk of my children dying from chicken pox, measles, polio, COVID, etc, appears to be exceedingly low.
It is great and magnanimous to be neutral in our assessments, to focus on facts and evidence, to approach others with respect and accept that we might be able to learn something from them.
You are free riding. The risk of *your* children dying or being paralyzed from polio is exceedingly low because other people, much more numerous than skeptical vaccine-deniers like you, do vaccinate *their* children. As for comparative risk, know why FDR was mostly confined to his wheelchair all his adult life? You can get some 100-year old books and newspaper articles written in American English long before polio vaccines were invented and learn what it was like. I won't recommend 200- and 300-year old books (also written in English) because standards of hygiene and public health improved bigly in late XIX century, but you must be aware what childhood mortality figures were before that.
It is true that the majority of parents vaccinate their children and that I benefit from that. That is simply the environment that I am operating in. My goal is to do the best for my children in said environment, as should be the goal of all parents. If the landscape were different, I might make a different choice.
Even polio only causes paralysis in a small percentage of cases (0.1-0.5% of children), and cases themselves are exceedingly rare in the modern Western world. Raising an anecdote of a famous historical case is not very interesting.
With regards to COVID, the case for the vaccine is even weaker since safety is much less understood, herd immunity is no longer a thing, and the virus appears to be extremely mild for children.
"exceedingly rare in the modern Western world."
I wonder why....
You probably won't win many hearts and minds with variations on
"Why wouldn't I graze my cattle on the common as much as physically possible! I need to do what maximises return for me and mine!"
"Why would I ever cooperate in a prisoners dilemma? just mash defect like all good parents should!"
In my view, the modern world is thoroughly corrupted. Just look at vaccine safety for example: pharma companies don't really study it (granted immunity from liability and have no incentive to), governments don't study it (inept, corrupt, whatever), and independent researches who do study it seem to get character assassinated. There's no good answer here for parents. We are making the best we can of a hostile environment.
If I wish to win hearts and minds, it's not by appealing to some naive sense of collective good that will be found in trusting the government. I'd rather talk honestly about the serious issues facing us.
"exceedingly rare in the modern Western world"
Are you aware that your approach can change this? And with measles in USA antivaxxers had first "successes" and caused outbreaks. Not sure if they managed to kill or main someone already.
For me it is in the same category as stealing railway tracks for scrap "after all, even if train will derail, noone from my family will be there - if the landscape were different, I might make a different choice".
Comparing stealing someone else's private property to neglecting to inject a pharmaceutical product into my body is a fairly ridiculous analogy.
Measles is part of life. It's fairly harmless in the West, especially if you have a healthy lifestyle. But if you're scared of it, you're welcome to lock yourself inside and hide in fear. You will not force me to inject pharmaceuticals into my body to comfort you.
I specifically avoided mentioning corona because I mostly agree with your estimate of it. In particular "long covid" appears to be the modern incarnation of neurasthenia and other vague predominantly affluent female problems.
As for the rest, I won't call your position selfish because you act, as you say, for the best of your children, but I submit that it is completely analogous to refusing to pay taxes because the money would be better invested in your children's college funds, while public goods won't suffer because skeptical tax-deniers like you being a small minority others will pay enough taxes to keep things running.
Does the Pre-infective therapeutics that were calling a vaccine decrease the risk of transmission?
Spoiler even the CDC says it does not.
If we call the thing by its right name then all of the fog surrounding the idea of heard immunity goes away.
But if we are going to embrace endless treatment with uncertain safety as a treatment strategy to protect the healthcare infrastructure shouldn’t we at least equally emphasize weight loss and similarly restrict those who failed to comply?
"Spoiler even the CDC says it does not."
Can you link to the CDC page in question? No, not an antivaxer site that twists a quote to try to make it say something different.
https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/fully-vaccinated-people.html
"COVID-19 vaccines currently approved or authorized in the United States have been shown to provide considerable protection against severe disease and death caused by COVID-19. These findings, along with the early evidence for reduced levels of viral mRNA and culturable virus in vaccinated people who acquire SARS-CoV-2 infection, suggest that any associated transmission risk is substantially reduced in vaccinated people: even for Delta, evidence suggests fully vaccinated people who become infected are infectious for shorter periods of time than unvaccinated people infected with Delta."
"Evidence suggests the U.S. COVID-19 vaccination program has substantially reduced the burden of disease in the United States by preventing serious illness in fully vaccinated people and interrupting chains of transmission. Vaccinated people can still become infected and have the potential to spread the virus to others, although at much lower rates than unvaccinated people."
The techniques you suggest for detecting fraud sound really basic. Like something anyone who had taken statistics 201 could tell was kind of stupid. Are we assuming competent fraud doesn't happen? I would think the existence of large amounts of incompetent fraud would imply the existence of competent fraud too.
Generally speaking running a scan for incompetent fraud and then pivoting on the co-authors etc. of the fraud will show you people that are worth doing more investigation on to see if they are doing more competent frauds.
This is a very impressive post, and it's boggling that you just threw it out there in your spare time. The amount of work that's gone into it is comparable to papers that people work full-time on for months.
Also, it's a really depressing snapshot of how much fraud and error there probably is in published science generally - and because most topics aren't as politically charged as ivermectin, they don't have adversarial reviewers going over them with a fine tooth comb, and they just get accepted as truth, used for policy decisions, and taught to students.
I agree researchers should be expected to publish their data.
And if closed-access journals are going to exist, they should earn their extortionate fees by providing a rigorous error-checking service.
So regarding your "must publish the raw data" bit. As someone who has been a keen observer of the global warming debate over the years, this was depressingly familiar.
You may or may not be aware but climate scientists have generally been really really bad at publishing their raw data and source code. There have also been any number of cases where analysis of their actual raw data and source code after a fight to get it has shown up statistical errors and other flaws (including coding bugs). It has to be said that the general attitude of the global warming scientists to requests for their data and critiques of their results has not helped me trust that they know what they are doing.
I am a strong believer in simply discarding any study that omits provision of raw data and tools used to process it.
Something to note about the parasite interpretation: To account for such a major effect in the high-prevalence countries, it implies that giving corticosteroids to an infected person is around 10% lethal. It is highly unlikely such a major effect has gone unnoticed until now (very few doctors know of this risk of steroids).
One way to get around it is to claim some complex interaction with Covid, so steroids are lethal only for Covid patients with parasites. Could be, but would be more believable if someone could provide a full mechanistic explanation.
Oh, this feels so pedantic, but... the Steinbeck quote is not entirely accurate. It's a worthy rabbit hole, so go do your own research. But now I don't trust any of the rest of this article. (Kidding, this was brilliant and thank you. Will be sharing with many who won't read it. Sigh.)
THANK YOU, finally a decent analysis of the issue that does not engage in dehumanizing vitriol but recognizes the rationale underneath many people's decision to use ivermectin. you did leave out one thing (I think or else i missed it): ask your doctor. it seems that it depends on whether the doctor agrees with the elite position or not, at least with this issue. because many doctors did in fact use it with their patients. thanks again.
Thank you for this breakdown of Ivermectin. It's become so politicized that I couldn't get answers.
There is a sinister type of literate simpleton thinking. It's on display here.
Now I don't like to start off with what appears like an attack, but a little pain can lead to gain.
Evidence. The observational evidence for IVM is strong. The clinical RCT evidence is weaker, but its there. The mechanistic evidence is strong. But perhaps most importantly, the real world anecdotal of US-based physicians like the Dr. Varon ("The Covid Hunter") or Dr. Barody ("Heliobacter Triple Therapy") and many others - it's very very very notable. So we're left to explain the literate simpleton.
It's not a character flaw, it is a failure to understand reality outside of academia where you try to isolate.
If you go to a court of law, RCT+observational evidence+real world anecodotal+mechanistic evidence = cause = conviction = proven. That's the real world. That's how we convict criminals
like Monsanto, and hopefully one day Pfizer.
Ivermectin works in combination therapies. You can prove that out just looking at Japan - not a big parasite country.
As for your current understanding of "tracking" - I think it is safe to say you don't know Lenz Law, which is 2nd year physics, without which you can't understand a lot of biotechnology that already exists. So when you say "impossible with current technology" you sound like a fool. I'm not arguing for "microchipping" in the sense you think, in fact I know that's not the case.
There is no space to expound on how advanced electromagnetic tech is suffice to say
that in Sweden they already scan their wrist at checkout, and that is old
technology. I'm not arguing for any conspiracy so you can stick me with a simpleton
hot poker, like "vaccine denialism" suggest you are apt to do.
As for the vaccines which is the most important matter at hand, the danger is the spike protein - it's a toxin, it causes clotting, it causes hyperinflamation, it is a prion, it enters the nucleus and can impact DNA. It's in the vaccine and in Sars-Cov-2.
Now reassess everything you thought was good about the vaccines. You don't need to understand immunology for that.
Finally, if you are a parent (anyone) and want to help your kids we'll soon have a course up on the science and a learning community, signup for The Discovery Force for free: mercy.school
I am not concerned about microentanglements on blogs, but about saving our youngest from a lot of pain.
The scientific method is much more valuable as a way of collecting evidence than anecdotes or the opinions of your favorite doctors. You are way off the mark.
Ah, the debate ends when you erect the God of Science Method and call those who don't agree with you as apostates. A simpler version of simpleton.
There are places on internet where the debate already ends when you start calling everyone who disagrees with you a "simpleton". This is one of those places.
(inb4 "Ah, a tone argument. The ultimate version of simpleton." Whatever.)
Setting definitions that RCT = scientific method and all the other evidence is not scientific method is the type of illogic we expect from a 3rd grader. Arguing with 3rd graders on the internet, who may be paid pharma shills is not worth our time or yours.
"understand reality outside of academia "
There's a reason that's the traditional cry of the quack.
no, you don't have any special "real world" understanding that academics lack and courts are notorious for being kind of shit at distinguishing fact from fiction.
People who have to deal with real patients and engineer real things need to figure stuff out.
Do you think professional researchers don't need to figure things out?
A large fraction of medical researchers are practising clinicians.
Most of the time they're at the very pinnacle in their speciality such that if you have even a vaguely unusual disorder getting referred to a research group can be extremely good for you because they're vastly more likely to be able to help you than you local GP.
Because your local GP or your local ER doc is mostly "figuring out" the local elderly population with the top few dozen most common health disorders more than 90% of their time.
Most practicing clinicians don't have the millions of $ in resources to do multi-center RCTs on repurposed drugs. But yes, one of the largest groups of clinicians in world history took to Ivermectin as did elite academics in India. It is only in farma fields of the west that we are in this situation.
> in Sweden they already scan their wrist at checkout
even if true, how it is supposed to be related to vaccines? Are you actually seriously claiming that "5G microchip implants in vaccines" crowd is not utterly detached from reality?
> it is a prion
[citation needed]
> mercy.school
page that has on blog "We are all buying chemicals and injecting them into our bodies." and implying that vaccines are as toxic as glyphosate?
I have bad news for them about dangerous chemical dihydrogen monoxide.
Be aware!
Dihydrogen monoxide:
is also known as hydroxyl acid, and is the major component of acid rain.
contributes to the "greenhouse effect".
may cause severe burns.
contributes to the erosion of our natural landscape.
accelerates corrosion and rusting of many metals.
may cause electrical failures and decreased effectiveness of automobile brakes.
has been found in excised tumors of terminal cancer patients.
>Dihydrogen monoxide
That sort of smug reddit midwit trash only appeals to people who are already in your camp. To anyone else, it just shows dishonesty.
It is exactly thing done by mercy.school with various attempts to make vaccines scary in the same way that could be applied to water. "chemicals" - water is also a chemical.
No, it is not, that's the point. Pointing out that a specific chemical (glyphosate) is harmful is not in any way the same as claiming or implying that all chemicals are harmful. This is why it is smug reddit midwit trash. You are ignoring what is being said in order to regurgitate a tired old worn out joke you clearly don't understand just because your mental keyword search found the word "chemical".
>"it is a prion"
Wow, I missed that somehow.
it's like they've just picked random words associated with biology and thrown them in. Like that "exosome" nonsese than had r/biology face-palming.
I noticed the domain/username match.
Are you author of misinformation on mercy.school site? Then at least disclose that you spam your vaccine denial site.
Though I admit, it is relatively well done as vaccine denial sites go.
Get a real job. Baiting people with these emotional hooks works on the school yard, but here you'll be dismantled like a paidbot by intelligent beings.
Excuse me if this has been covered, but I thought one of Bret Weinstein's most interesting claims was that tropical countries where ivermectin was used routinely for parasites did much better (deaths? hospital admissions?) than nearby countries which didn't use ivermectin.
There could be any number of confounding factors, but it's at least worth a check.
Most of the first-world Covid-19 deaths, as I understand it, were in the medically vulnerable crowd; people who I think probably have already died of something else in countries with high parasite loads, since that is correlated with a number of other things, such as the absence of good sanitation systems.
It wouldn't surprise me at all if poor countries had lower death rates from Covid-19 than rich countries, just because of who Covid-19 was killing.
Then, if a lot of the deaths these countries do experience is from suppressing the immune systems of people with parasites in the course of treating Covid-19, we could arrive both at the absurd effectiveness that some of these studies have seen, and a situation in which countries which use Ivermectin widely do better than countries that don't.
Thegnskald, you need to read the article. In it it is explained that the Ivermecin used to treat covid was also treating parasitic infections at the same time. Any control group would include people with untreated parasitic infections AND covid infections. This would explain why it appears that Ivermenctin is effective.
Bret's point was that there are tropical countries which are fairly similar but some of them routinely administer ivermectin and some don't.
Would love Scott's input on this analysis https://juanchamie.substack.com/p/ivermectin-in-uttar-pradesh
@the first graph
Is there a reason to expect that proportion of reported cases to real cases is the same in India and USA?
> If you tell these people to “believe Science”, you will just worsen the problem where they trust dozens of scientific studies done by scientists using the scientific method over the pronouncements of the CDC or whoever.
Something that has been driving me UP THE WALL in the past two years is this social meme of "believe science". Don't _believe_ science, _understand_ it. If you _understood_ science, you would know that telling people to believe it is the most anti-science thing you can do
Science isn't an authority handing down diktats from on high. Science is a process. ANYBODY can do that process, +/- expensive equipment. In fact, we rely on that; we hope that multiple people try to do the same science independently and then we compare their results!
I was accused of "not believing in science" last year because I rejected most of the mainstream public narratives about covid. But the reason I rejected them was because they were false. I know, because for six months I spent almost three hours a night reading medical research preprints linked on r/covid19 and trying to draw conclusions.
What I was doing was more "science" than anyone who "believes" in it has ever done. I wish society was not trying so aggressively to dissuade people from doing this, in favour of mindless deference to people who, while under oath, have admitted to knowingly lying to the American people for policy-convenience reasons (the whole mask thing, eg)
Relatedly
> What heuristic tells us “Medical students should be allowed to publicly challenge heads of Health Institutes” but not “Distinguished critical care doctors should be allowed to publicly challenge the CDC”?
The heuristic of "educate yourself on basic relevant background information, then read the studies and judge for yourself". Exactly like Scott did here!
Part of the problem here is that science popularizers and politicians who "follow the science" are imputing WAY WAY WAY too much certainty to their comments (or, if not, they are implying it, possibly accidentally, in a bad way). When I ask myself, hey does ivermectin work, and I see all of these studies, I say "probably; who knows, we might have a proper answer in ten years. In the mean time, it's cheap and relatively safe so don't be an idiot but you might as well take it". When these public "scientists" (very rarely actual scientists) look at the same studies, they don't say "eeh these results are inconclusive, it probably doesn't work". They say "IT DOESN'T WORK, ITS OBVIOUS IT DOESN'T WORK, ANYONE WHO THINKS IT WORKS IS EITHER STUPID OR LYING".
Basically nothing in science deserves that level of confidence. Hell, even when science "officially" "blesses" a result with p <0.05, that just says (handwaving; I'm not a scientist sorry if I get this wrong) there's a less than 5% chance that this happened randomly. <5% is 1 in 20. Every single thing that science says is true can be false 1 in 20 times and science still says its true, because that's the best we can do. A 5% error rate is way, way too high to justify the level of certainty that our science communicators have
I would really, really like a response from someone on your comments. I agree too much to play a good devil's advocate.
I don't generally read the comments here, but I can't sleep so tonight is an exception
I used to, but after the fifth round of a dozen people calling me stupid and evil, I gave up.
The point of this comment being that I don't care if nobody responds to it. If they did I probably wouldn't read it
Since Mannan plans to read the comments I'll respond to him: I have been following the group of scientists and science students who did the grunt work of pointing out flaws in ivermectin studies. There are two times when they get shouty:
-People publish studies that are highly flawed or even made up, claiming extreme effectiveness for ivm
-People who should know better include these highly flawed or made up studies in their results, claiming extreme effectiveness for ivm
Their opinions differ on whether ivm has a good chance of being 8% effective at preventing deaths. They do not get shouty about this. The shouts happen when extreme claims of 90% effectiveness are made & used. Note that extreme claims are less likely to be true.
The studies with extreme claims are covered in red flags, and near-universal scientific training tells you how to look for those flags; accredited researchers generally know whether to treat a given study as being actually 95% or not. They get shouty at researchers who ignore red flags that they think should be obvious, because if the researchers know better than to ignore them then they're probably not being objective.
Note that this is a small group. There will be other experts whose experience with IVM advocacy is not known, some of whom have different policies on when to shout. And there is also the media and social media which is full of non-experts. They make most of the noise and have the least knowledge. If you allow these categories to mix you're gonna blame the debunkers for other people's actions.
Side note, the standard way to count a result as proven is p<.05, frequentist-style. Different fields may have harsher p-values or may have moved further into Bayes-land. But in general scientists wouldn't consider something Theory based on one p<.05 result; making Theory requires multiple experiments from multiple angles & multiple parties, followed by a period of waiting to see if a grouchy old professor will publish an angry letter that points out how it's all flawed.
> But the basic issue - that the vaccine works really well and is incredibly safe for adults - seems beyond question. Yet people keep questioning it.
The vaccine comes with an unacceptably high risk of fascism, and if you ignore this you will be extremely confused as to why a ton of normal, regular, not-stupid-at-all people are making the rational decision to not get vaccinated.
I believe that the vaccines probably work more than zero. I believe the _health_ benefits probably outweigh the risks (however, not for me; I already had covid so either I'm immune and it doesn't matter, or I'm ok with how sick I got if I get that sick again, so it doesn't matter). I'm still not getting it. The split second our governing institutions decided it was reasonable to say "get vaccinated or we will destroy your life and end society", my mind was made up. Even if that means fifty million Americans die (I don't believe that, but even if), well, on the order of fifty million people died the last time we stopped fascism and if you so much as question that cost-benefit analysis you get accused of being a Nazi.
In fact, if I wanted to be really cheeky I might say that the fact that the vaccine probably works _increases_ my hesitancy. If it was a bs vaccine that did nothing, the choice of whether to take it or not take it is meaningless. If the vaccine actually works, then refusing to take it is a costly, credible signal of "no, we're serious, these lockdowns are unacceptable".
For anyone who wants to try and change my mind, these are my requirements:
Someone has to give me an explanation for why I need to get immunized despite already having had covid. The explanation cannot involve either a) any reason that reduces to "there's no medical reason but it's easier for the government to track vax status than immunity status" (because the government enacting unacceptable measures for their own convenience is my entire problem!); or b) "immunity is temporary so get vaccinated" (because that immediately implies that I will have to get booster shots every year _forever_, which means that accepting the mandate means accepting a _permanent_ mandate, and that's unacceptable)
Someone has to give me a credible demonstration of remorse on the part of the government. At this point, the demonstration has to be something along the lines of "Dr. Fauci is executed in public, where I can see it so I know it's not a deep fake", or something equally costly. Not because I think he needs to be executed (though wouldn't shed a tear if he was), but rather because I have so little trust in anything the government says, it would take a signal that costly to convince me they're being honest
Someone has to give me a credible commitment to both the current restrictions being eliminated entirely, returning our society to the way it was in 2019, and also a credible commitment that this will NEVER. HAPPEN. AGAIN. No matter how bad the next pandemic is. I cannot think of a way in which the government could demonstrate enough credibility to convince me of this. (remember how they said they would totally never mandate vaccines and then three months later they made it law?)
Someone has to convince me that my getting vaccinated will nearly-immediately and permanently exempt me from _all_ covid restrictions. Given that almost every polity on the planet has already said this _and then backpedaled it_, I don't think its possible to convince me of this anymore.
Someone has to get me a formal apology from a high profile public figure for systematically emphasizing the worst and most socially costly measures possible (ie "we will throw you in jail if you try to go to work") while ignoring obvious low hanging fruit ("we will throw you in jail if you don't go to the gym and lose 20 lbs", etc).
I estimate the probability of achieving _any_ of the above items as 0+ε%, nevermind all of them.
Oh yeah. Also, the government must financially compensate me for what they've done. As a noncitizen with a white collar job, I did not see one penny of pandemic bucks, but I've had two years of my life stolen from me same as anyone else. One QALY is like $100k. Two years times 2 QALY per year (because these are my prime years; a multiplier of 2 is conservative) = basically half a million dollars. So that sets the floor of what I require
And I will calculate this compensation net of taxes, so if I get a 100k but also my taxes go up by 30k, that only counts as 70k)
Also:
> I’ve been trying to figure out a model where ivermectin support and vaccine denialism both make visceral sense to me, and here’s what I’ve got:
Here's your model:
The people who said ivermectin doesn't work are openly hostile to IVM believers, and have been repeatedly caught in malicious lies in the past year
The people who said the vaccine is important are openly hostile to IVM believers, and have been repeatedly caught in malicious lies last year.
If the same person repeatedly lies to you, you should start assuming they're always lying.
If "IVM doesn't work" is a lie, that implies IVM works
If "The vaccine is safe and effective" is a lie, that implies vaccine denialism
If both of the groups saying that are lying, then the reactionary response will be coordinated without any underlying relationship between IVM and vaccines
(I am writing these comments as I read so apologies if the next paragraph has Scott outlining exactly what I just said)
> The aliens are hostile, so I don’t trust them no matter how smart they are
Lol you basically said what I said
Also worth calling out, although this is probably getting too close to partisan shit-flinging:
In late 2020, every single member of the current Democrat administration went on TV and told everyone to not get vaccinated, because it's Trump's vaccine so it's probably poison. Then they all flipped on a dime on January 20th. More importantly, they flipped on a dime without explaining why they flipped, and without even acknowledging that they flipped.
It's all fine and good to write off vax deniers as ignorant rednecks (I am NOT saying scott did this). However, curiously, the only people I heard who disavowed Harris and Biden saying "don't take a Trump Vaccine" are Trumpy people.
The currently elected united states federal government directly and intentionally created the anti-vax backlash against the _current_ vaccine, in order to win an election. Any discussion of anti-vaxxers that doesn't prominently raise this happening is missing an important detail
You are mischaracterising the Dem narrative in late 2020. They were concerned about Trump interfering with the CDC and FDA as he had been shown to do, and, they were concerned that perhaps he would force approval of the vaccine prematurely. He had voiced his desire to get the vaccines approved before the election. They did not flip on a dime. They waited for FDA approval , which happened after the election. Perhaps there was some politics involved. I think most observers would take that into account.
If you are concerned about how US politics informed vaccine approval, try looking at how other countries handled the process. Nobody approved the western vaccines before Nov 5.
I don't know what to say to someone who is so stupid that he still thinks the news is honest. I hope you aren't too shocked when they put you in cuffs too
"Dr. Fauci is executed in public"
If you're calling for the public execution of your political opponents.... for most of the population if you got your wish from some hypothetical party that came to power that would be a far far far stronger signal of the government falling to fascism.
"behave like textbook fascists or I'll believe you're a fascist" isn't the best rallying cry I've ever seen.
lockdowns etc are not new, used to be they'd just brick up the doors of the building you were in if they thought there was someone infected with you and leave you to die. Governments have historically been (reasonably) given far broader leeway for existential wars and epidemics. Simply because the body count for both can get so high. The latter having killed far more than the former throughout history. Plagues bring down empires.
Covid is both fortunate and unfortunate in that it's at the lower end of the scale of what can trigger governments into action. Many of the plans enacted were built for sars cov 1. The two viruses are relatives from the same area after all ... and if we had that rampaging instead of covid 19.... well a 10% kill rate would decimate our civilisation.
Covid 19 led to excess mortality on a par with WW2 in the UK but fortunately mostly the old. But that's a drop in the bucket next to the potential of epidemics.
I suspect much of the current policy was written based on history of previous epidemics like the spanish flu where a later variant turned out to be far far far worse than the initial version.
You know the old saying of safety rules being written in blood? pandemic rules are written with oceans of blood that dwarf even genocides.
Governments haven't handled it well and it's become political, on a pure QALY basis it would be very very hard to justify things like lockdown now that vaccines are rolled out and the death rates have dropped through the floor.
But they're slow juggernauts that are hard to turn.
You're not going to get an apology any more than if you get evacuated from a hurricane that turns out to be lower magnitude than expected or get moved away from a burning nuclear power plant but it turns out they managed to maintain containment.
Insisting that the government throw away all future pandemic plans that involve lockdowns? that's probably the worst possible response, because there are far worse things than covid19 out there and those plans were written in blood.
Why put a final verdict on Ivermectin when the race to identify the mechanisms by which Ivermectin acts, has just been started:
https://pubmed.ncbi.nlm.nih.gov/?term=ivermectin+3clpro&sort=date
https://pubmed.ncbi.nlm.nih.gov/?term=ivermectin+importin&sort=date
Further research will show us how to use Ivermectin to maximise its effect against SarsCov.
After that, a well designed "Study" will show the research to the public. Until then, clinicians will treat COVID patients, in consent, with the medications that they find appropriate - as it always was and as it should be.
> Again, ivermectin optimism isn’t exactly like vaccine denialism - it’s a less open-and-shut question, you can still make a plausible argument for it.
Using this as a jumping off point for one of my pet peeves.
Vaccine denialism is ABSOLUTELY NOT an open and shut case. Its an open-and-shut _medical_ case. But there are more things in heaven and earth, ACX, than are dreamt of in your medicine.
This is a thing that happens _a lot_ in politics/policy discussions, and rationalists tend to be especially bad at it (probably an artifact of them being disproportionately likely to be policy wonks). Alice decides to do a cost/benefit analysis to justify doing a thing. Bob doesn't want them to do a thing, and has some reasons. Alice wants to do the thing and is looking to justify it. Alice runs her cost/benefit analysis and comes up with some costs and some benefits. Then she looks at the costs column and crosses out 2/3rds of them because "that doesn't matter"
Except it matters to Bob. But Alice, trying to control the frame, simply doesn't acknowledge the concern and tries to get everyone to ignore those costs.
Sure, there's 'no reasonable cause to oppose covid vaccines' if you restrict your thinking to only medical (Note: I do not concede this; I think there is something real and significant going on wrt the severe reactions and deaths. I have no idea how big/significant it is, but I know that that when basically the entire world will try to get you fired simply for asking that question, you cannot trust their answers, ever. My current estimate is "it's real, its significantly higher than the risk of other vaccines, it is probably safer than actually getting covid +/- specific demographic and risk factors (ie covid might be safer than vaccine for teenagers on the ground that only about 600 people under age 18 have died of covid in the US, ever, which is basically a rounding error away from zero in a nation of half a billion (https://www.statista.com/statistics/1191568/reported-deaths-from-covid-by-age-us/). I've also seen some things suggesting cause for concern in vaccinating people who have already recovered from covid, but I haven't dived into that enough to know if it's just noise or not)
However, if someone's response to my very reasonable social and political concerns is "lol those don't count. 'Muh rights', lol moron, can't you see people are dying??!?!?!", then of course they're going to think they are obviously right and I am ridiculously denying an obvious good out of nothing but stubbornness.
(For a bit-flipped example, consider if it would be reasonable to accept significant curtailments of African-Americans' rights, on the ground that the 2020 BLM riots killed more people than the n word ever did, and if they didn't have rights, they couldn't riot. Even the most racist far right extremists I know would think that that's ridiculous, and yet this is the same principle of reasoning people are using for lockdowns. "Fuck your rights, people died, nothing else matters until they stop". If you have a right to free assembly, you might spread covid. If you don't have a right to free assembly, you can't spread covid)
Basically literally every time you have a social policy that does not have >95% consensus in the general public, you should start with the assumption that it's very much NOT an open-and-shut question. If it was, a ton of people would not disagree with you! And in case you think this is an unreasonable standard: I will pay out $5000 USD to anyone who can convince me that >5% of Americans sincerely believe that (eg) murder should not be illegal. there is overwhelming consensus that murder is bad, and so murder is illegal and nobody disputes this. (Even the people who believe that some _killings_ should be legal, do not concede that those killings are murder, and still agree that murder is bad). "Is murder good or bad?" is actually an open-and-shut case. "Are vaccines good?" is not, if for no other reason than that like a third of the country says 'no'.
What has ground my gears about this whole thing even more is that the corporate press, the blogosphere, social media, everything, has been telling us for over a year how we're surrounded by 30% of the country who are crazy and don't believe science. You know what I have NEVER seen ANY of them (including present company) do? Actually ask an anti-vaxxer why they're anti-vax. On the very rare occasion when something like this happens, they get the most ridiculous moron on and paint the whole group like that, instead of asking one of the literally millions of regular normal Americans why they have decided this
And I promise you, if you did this, you would find that a large majority of vaccine-hesitancy is driven by politics, and you would find that most of those political positions are not unreasonable.
Speaking personally, I am still at a loss how to have these discussions sometime because what has happened in the past two years is actually, seriously, sincerely, no-joke, Hitler/Stalin level evil. To bring one example at random: my home province shut down everything, no exception for churches. A handful of very religious communities who belong to my tiny ethnic minority group said that Jesus is more important, come make us stop. The government dispatched police to their rural communities to physically prevent them from worshipping
THEN, the state started running ad campaigns, spinning press releases, etc., to push the narrative of "those evil, selfish minorities, who think going to church is more important than saving lives, are why we have an outbreak now" and started stoking overt racial hatred against us. Which, in addition to being almost mustache-twirlingly, cartoonishly evil, is also ridiculous; a bunch of rural conservative farmers who live three hours' drive from the nearest city CANNOT have any meaningful impact on a disease that requires close contact to spread.
Even with how crazy society has been going lately, if you had asked me in 2019 "will the government, in your lifetime, make church illegal and send people to jail for worshipping Jesus, for any reason", I would have laughed you out of the room. _**That literally happened last year**_. Maybe it was necessary for the greater good (I do not concede this). But that is sufficiently extreme that, if nothing else, it should have come along with extremely vigourous public debate. Instead it came along with half a million Canadians uncritically accepting that my ethnic group is intentionally spreading covid because fuck everyone else. (Remember when all of society agreed that blaming the Chinese for spreading Covid was horrible evil racism? Why the disparate treatment?)
They made going to work illegal and disrupted communities and social bonds. They got churches to voluntarily shut down (and did it by force in some places). They took away everything that made life worth living. They justified tons of political and electoral incompetence and corruption on the grounds of "it's covid". They let crime and violence run rampant and even had the gall to publicize op-eds claiming that rioters don't spread covid, only you and I do. They printed trillions of dollars and caused inflation worse than anything we've seen in my _or my parents'_ generation. They broke the supply chain causing massive shortages of input intermediary goods that we still haven't seen the full consequences of. They eroded high trust society, getting everyone to snitch on each other and enforce arbitrary and capricious rules.
Again, even if you think all of this was necessary (it wasn't), that doesn't account for why so many people went along with this _gleefully_, instead of taking the tone of "this is horrible but it's what we have to do". But this is a horrible, egregious harm to millions of people. (Hell, hate to be so blunt about it, but I currently know of 6 people who killed themselves over lockdowns and 1 person who died of covid, if anyone really wants to do a deep cost/benefit analysis). Just because the damage is abstracted and spread throughout society, instead of highly legible and visible like eg a war, doesn't mean the damage is any less real.
I have no meaningful ability to change this. I can't take up arms and overthrow the government, for obvious reasons. I can't even vote here, I'm not a citizen. What I can do is engage in costly protest. The people who locked us down last year, are now telling me to get vaccinated. They have not compensated for last year or apologized to me. So now, I don't get the vaccine. Purely because I want those people to be mad that they can't achieve their vaccine policy goal. Because that is the only protest available to me.
This is a reasonable basis on which to make medical decisions, and casually writing it off as "it's an open-and-shut case and no reasonable person could possibly be against these vaccines" is intellectually dishonest
tl;dr: if you lived in 1944 Germany, and there was a plague going around, and the Nazi government made the plague vaccine mandatory, would it be reasonable for you to refuse the vaccine purely on the grounds that literal Nazis want you to take it? I assert yes, that is reasonable
This is a beautiful protest, and I, and likely hundreds of others, will take on a similar stance. It's said because all I and you really want is empathy, but that's so hard to get from anyone with a pro-vax stance.
At some level, all I want is a hug and an apology, but the people who run our world are so cartoonishly evil that they won't even do that. Those are only for the ingroup; what I get is thrown in prison because there are more neurotic voters than there are copies of me.
Having read all of your comments in this thread, I can say that while I disagree with almost every single statement of fact or judgment you have made here I nonetheless sense you are a conscientious person, and I genuinely wish you well.
I am reminded of Scott's closing thoughts on the difficulty of communication between hostile tribes. He didn't know how to manage it and neither do I, but maybe it starts with a hug and an apology.
I'm sorry for how you've been treated.
https://bit.ly/3HGHZkc
Do you disagree that last year men with guns told you that if you go to work you'll be thrown in jail?
Do you disagree that large swaths of society are going to make this permanent for anyone who doesn't comply with them?
Do you disagree that such things are unacceptably authoritarian?
Then all I can say is that this is why I have guns, and I hope that when the time comes you are acting with honour on your convictions
You have had 6 friends commit suicide over Covid lockdowns? Wow. Given that suicide rates have been stable in Canada during the pandemic, I would guess that you and your friends are disaffected. If that is the case then I would also guess that you were disaffected before the pandemic and that it only got worse.
The difference between public health measures and actual tyranny is that the former IS temporary and is designed to save lives, and the latter is intended to be permanent and is designed to enrich the oppressor.
We have a ton of societal problems that make having a standard of living similar to that which recent generations have enjoyed next to impossible for young people today. Try not to blame pandemic restrictions for broader societal failings.
I guess these studies were done prior to the vaccine, but it seems like a few invermctin vrs vaccine studies might be convincing to doubters. Basically something comparing the outcomes of 1000 fully vaccinated people vrs 1000 unvacinnated people who took invermectin, either as a prophylactic or as treatment. We all know what the results of that kind of study would be overwhelmingly favor the vaccine, but they might be convincing to people who "do research."
Would love to see similar study on immunity from prior infection compared to vaccines!
There are 30 or so such studies. Strangely, only the two done by CDC show natural immunity to be inferior.
TIL that a fluke is also a ringworm!
I think you meant "roundworm"... I do get the joke, but the delivery left something to be desired. :-)
Patients got better on a deworming drug because they had worms. Ockham's Razor!
Wonderful article.
(1) I DO know lots of young-earth creationists, and people suspicious of vaccines, and this article spots part of the problem: these people have seen the Establishment lie to them repeatedly, often citing "Science" even when caught in lies, and most of them (not all!) don't have good science training so they can't judge for themselves very well. They're in a tough spot.
(2) What disappoints me about this article is lack of cost-benefit analysis, loosely speaking. It's all about effectiveness, the benefit, which is dubious outside of wormy countries, high in wormy countries. What about cost? My impression is that the side-effects are minimal, tho it's unclear whether there are mild-but-bothersome side effects at the doses claimed to be effective for covid (side effects like those of vaccines, headaches and a half-day of work lost). The dollar cost is very low for sheep-and-horse ivermectin, closer to $100 for Indiana human pills. Is this correct? If so, it makes sense to go get some sheep dewormer if you feel sick.
I think a cost-benefit analysis would be in favor of IVM.
Common side effects of Ivermectin are: headache, muscle aches, dizziness, nausea, diarrhea, mild skin rash. None of these are show stoppers if you are treating ringworm, but given that the consensus is that it does next to nothing for covid, I am thinking that a bout of diarrhea is worse than not taking it at all.
Thanks.
Common? I think you’re exaggerating the occurrence of these effects.
Maybe if you were taking a heroic horse dose.
I, would stick with doctor prescribed doses.
The consensus being it exactly DOES do something for COVId if you have ring worms, then that is a risk I would be willing to take given no one has discussed or talked about the possibility I or others have a ring worm related infection without visible symptoms or could be directly affected and helped by the other anti viral properties of IVM. The cost seems low to me.
As I’ve said; cost benefit analysis or you’re just sticking to a personal dogma you believe in.
Well, I don't know where you live, but where I live I (SW British Columbia) there is no ringworm and I generally don't go around in my bare feet and risk picking up an infection. It is not about dogma. When I first heard of Ivermectin a a possible therapy it sounded great. But as I dug deeper, I noticed the FDA, CDC and Health Canada had all issued statements saying that there is no evidence that Ivermectin helps with Covid infections. I also found other articles talking about how it appeared to be promising and it ended up not. So it is time to move on.