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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.

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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.

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They did so against parasitic worms; not COVID.

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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.

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They both have very good reasons for saying that, and are most likely correct. Since either conclusion is a total disaster and the probability of them being correct is high, you have to assume they are correct because of expected value. Also, many other people have come to the same conclusions using different means.

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Nope. The problem is people believing that Steve Kirsch must be wrong and vaccines couldn't possibly have killed anyone.

That's the problem.

Right or wrong thinking.

Black or white.

This or that.

And ad hominem. Personal hatreds, animosities taking the place of the real discussion.

I don't know how many people vaccines have killed but I'm more than ready to believe they've killed some. So why risk them?

Risk matching is the point. Isn't it?

But vaxers believe there's literally no risk with vaxes.

Vaxers generally believe a vax is something. Some 'thing'. You take 'a vax' and you've got some 'thing' that will now protect you against a virus.

Despite the evidence and clear statements everywhere that it won't.

And in apparent total ignorance of the fact that a vaccine only ever manipulates the immune system in one other way in the hopes of bringing forth a better performance from it.

They seem to be totally, totally ignorant of this.

To where they think : no vax = no protection. Vax = 100% protection.

Where the truth is, of course: no vax: 99.x% protection. Vax ( in best case scenario) 99.(x + 0.1) % protection. Plus risks.

And so on.

The whole narrative is about Vaccines.

And I maintain that is simply perpetuating a mass ignorance.

The question is all about the fire and the fire brigade which will put it out.

The fire is the virus.

The fire brigade is the immune system.

The vax is merely the fire alarm bell is the best analogy I can think of.

That corrupt narrative obscures the facts, all the facts.

That prior good health and attention to certain 'levels' of minerals and vitamins, etc can be equally or more effective at improving the performance of your immune system come the testing.

That's the problem. Ignorance and those who seek to perpetuate it, do nothing to diminish it.

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Not only all that, but the so-called vaccines do not meet the medical or legal definition of vaccines. They are called vaccines to trick people into thinking they are vaccines. Nor are they genetic therapies. They're an experimental genetic manipulation. Who knows what they really do, or what they're meant to do, or what their long-term effects are. They sure don't protect against the virus - so what do they really do? And they are being mandated with a vaccine pass?

I see no benefit at all, except the $33 billion to Pfizer last year and $36 billion this year.

The vaccines are gates we're forced to line up for that state, "Vaccines will set your free." Don't believe them. And don't believe the sign with the arrow that says, "Showers," either.

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It is odd that you do not believe Kirsch and 150,000 deaths. Have you seen the death data from openvaers.com? That data is CDC and FDA data. It is vastly underreported.

Are you not aware of the 2015 Harvard-Pilgrim VAERS study that found "only 1% of vaccine adverse events are reported"? That's an Under Reporting Factor of 100. Steve Kirsch used 6 independent methods to come up with his 41 URF. Have you seen them? Dr. Jess Rose, a biostatistician, applied mathematician, immunologist, biochemist, computational biologist, and 2019 woman's surfing champion, who programs in R, the VAERs language, calculated 31. 150,000 is a reasonable number. (For perspective the US has 55,000 deaths per week from all causes)

Are you aware (google: "S1 hypercoagulability" for the study) that the vaccines create micro-blood clots? Did you know that a BC physician, Dr. Charles Hoffe, found 62% of his vaxxed patients (900) had elevated D-dimer tests, which test for blood clots (https://tinyurl.com/wnrbc3hu). He lost his practice after writing a letter of concern to the Provincial Health Officer. Micro blood-clots block the capillaries that deliver O2 and nutrients to every cell and organ - think that could be causing those thousands of vaccine deaths reported in VAERS - and many more in a few years? Haven't you seen the UK study that found those Vaxxed lost their immunity after a few months where it went drastically negative and stayed there. Do you think that might kill you when need immunity? Guessin' you've not seen pathologist Dr. Ryan Cole's presentation: https://www.bitchute.com/video/Sjl0KqNIdNO2/

He's found that cancers are up by 20 times due to the immunity degradation from the Vax. Note the slides of clumped-up blood cells.

Seems like your approach is arguing from ignorance, like the fool MD who once told me, "If it were important, I'd have heard about it."

You have no data or studies - just wishful thinking. Your head is stuck in the sand. Get some data and studies if you want to present a credible comment.

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Good man. Stick it to them. :)

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Jan 24, 2022·edited Jan 24, 2022

I follow the principle "extraordinary claims require extraordinary evidence".

I wouldn't be surprised if Kirsch claimed to have "used 6 independent methods" to come up with his under-reporting factor, but looking at his article on the subject[1], I don't see 6 methods, I see only one. Even so. point taken: Kirsch is a master Gish Galloper, so he claims to have not one, not two, not six, but 12 methods in addition to his main VAERS-based method that "found an excess death rate of 150,000 or more".

Wow! 13 methods! Now, are any of those methods even the slightest bit reasonable? I'm sure you're nodding vigorously and indignantly without really thinking much about it. So, tell you what, why don't you deeply study method #5 entitled "Poll #1" and let me know what you find. Because as far as I can tell, Kirsch doesn't say what "Poll #1" even means.

But you know what extraordinary claims require, other than extraordinary evidence? A story that fits together. So. The minimum 150,000 deaths is supposed to be in just the U.S. alone, implying that there have been over a million (maybe 2 million?) deaths worldwide. That's a hell of a lot! So why is it that excess deaths line up with Covid deaths just about everywhere, but don't tend to line up with vaccination rates anywhere?[2]

Obviously, you're not going to be the slightest bit convinced by this counter-evidence. But the interesting question is why? What anchor belief[3] makes you insist on the 150,000 figure, reject the fact that excess deaths line up with Covid rather than vaccinations, and reject the principle of "extraordinary claims require extraordinary evidence"?

> You have no data or studies - just wishful thinking.

I have studied this issue about as well as a guy with a full-time job can be expected to do on weekends for free, I think.[4] It doesn't take that much research to notice that he is a liar.[5]

By the way, this thing Kirsch said bothers me:

> The URF of 41 is a minimum URF; the URF for “less obvious” events (including death) is always larger than this value. So for example, if you had menstrual problems, peripheral neuropathy, or your cancer got worse after the jab, the URF for that event might be 100 or more.

Kirsch is claiming that 41 is the ordinary under-reporting factor, but that the under-reporting factor actually *increases*, not decreases, as the side-effect gets more serious. Really? He is apparently saying that, if you felt ill and had to take a day off work after getting vaccinated, there is a 2.44% chance you'd file a VAERS report for that. If, on the other hand, you *DROPPED DEAD* there would be less than a 1% chance that ANYONE would bother filing a report? Does that make sense to you?

Tell me, does Kirsch ever explain to his throng that filing a VAERS report is legally required after serious adverse events including (obviously) death? Here's an FDA FAQ[6]:

> The reporting requirements for COVID-19 vaccines are the same for those authorized under emergency use or fully approved. Healthcare providers who administer COVID-19 vaccines are required by law to report to VAERS the following after vaccination:

> ....

> Serious AEs regardless of causality. Serious AEs per FDA are defined as:

> Death

> A life-threatening AE

> Inpatient hospitalization or prolongation of existing hospitalization

> (the list goes on for awhile)

Does Kirsch ever present evidence that doctors, family members and everyone else ignores these legal requirements?

And I've got two more words for you: base rate. Have you seen Steve Kirsch ever address the all-important issue of base rates? I haven't. Base rates are the key to understanding why there are so many VAERS reports, though I think it would also help to explore the reasons why 44% of VAERS death reports since June did not bother to mention the age of the person who died. They often have descriptions like this:

#1995488 "This spontaneous report received from a consumer via a company representative concerned a patient of unspecified age, sex, race and ethnic origin. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. ... ... On an unspecified date, the patient died from unknown cause of death. .... This event(s) is considered unassessable."

So, you know, I have this theory that there is a lot of double-counting in VAERS because, in addition to the Physician's report, there will often be a witness or family member who causes an extra report to be filed that contains almost no information. Of course, you will disagree with my theory. But how, exactly, do you know I'm wrong? And again, base rates are even more important than this. How do you know that the base rates don't matter for analysis of VAERS reports?

Well, you might say "well David YOU aren't verifying your suspicions either". That's true, but I have a day job. I work morning to evening 5 days a week. I don't have time to do a detailed investigation.

But you know who DOES have time to do a detailed investigation and chooses not to? Steve Kirsch has "thousands" of paying subscribers on his Substack alone paying $5/mo or $50/year (not counting his other earnings from TrialSiteNews). He's also a multi-millionaire. So yeah, where's his detailed investigation of base rates, and his detailed investigation that proves that virtually all doctors ignore the FDA requirement to report deaths in VAERS?

I think his behavior makes sense, because what do you think his thousands of paying customers want from him? Would they be happy if he said "hi there my dear thousands of customers, I've been investigating this and discovered that my earlier conclusions were quite wrong"? No, I think the next words out of Kirsch's mouth had better be "it's actually WORSE than I've been saying all along!" Because if he said he was GENUINELY wrong, his customers would cancel their subscriptions in droves, because (1) they're angry that he misled them or (2) they think someone "got" to him and is speaking in his place or forcing him to change his tune or (3) they very much like his style, they're paying for that style, and for Kirsch to say he was wrong in a big way would not be Kirsch's style at all.

[1] https://stevekirsch.substack.com/p/how-to-verify-for-yourself-that-over

[2] https://medium.com/microbial-instincts/debunking-steve-kirschs-latest-claims-97e1c40f5d74

[3] https://www.clearerthinking.org/post/human-behavior-makes-more-sense-when-you-understand-anchor-beliefs

[4] https://www.lesswrong.com/posts/7NoRcK6j2cfxjwFcr/covid-vaccine-safety-how-correct-are-these-allegations

[5] https://www.lesswrong.com/posts/7NoRcK6j2cfxjwFcr/covid-vaccine-safety-how-correct-are-these-allegations?commentId=f97bJXwj2M5toGDvt

[6] https://vaers.hhs.gov/faq.html

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I would only take ivermectin from organically raised bacteria. Same botulism toxin.

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Paula, you've been at this for months, I'm not sure you're a beginner any more. Don't sell yourself short!

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🤣🤣🤣

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Am I understanding you correctly?

The scientific and medical establishment endorsed BLM protests and riots, urging them to go out and hold mass demonstrations during a pandemic?

If so, I think you misunderstand the events of last summer.

I didn’t hear the the scientific and medical establishment saying such things and I was paying pretty close attention after the death of George Floyd.

If you are saying something else help me understand what it is.

Maybe the pronoun ‘they’ in the sentence after the ‘:’ refers to someone else

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You’ve made the case for some health care workers supporting the protest. You get careless with language when you say the scientific and medical establishment endorsed protests and *riots*.

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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)

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and masks

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a/s/l

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He did masks on March 23, 2020, when there was no COVID-specific data yet.

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Do you think the case has changed since then? My impression is that the analysis then still holds. Masks probably work, but only a little.

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I don't know, that's why I'd like to see an analysis based on empirical evidence for COVID.

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I can't seem to find a Gore Vidal GIF to put under here.

We could have a "How dare you call me a crypto Nazi" exchange here just for a bit of historical fun

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Masks actually work very well according to the data. The issue is more that a lot of people just don't wear masks consistently/properly. When you look at people who *actually* wore masks correctly, and did so consistently, their infection rates are very significantly lower (though not zero, either).

So it's actually good advice to encourage people to mask up, even if all the incompetent people will get only mild benefits, because the competent people will get large benefits, and we actually care more about the competent people anyway because they end up contributing more per capita to society.

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That's my interpretation of looking at the body of evidence going back to 1920 in both community and hospital settings. Of course, those studies were for influenza, but seeing that a coronavirus is smaller in size, it's logical to conclude the masks (ie breathing barriers - or dare I say amulets) are ineffective against it too. it's interesting to note actual PPE experts and industrial hygienists, at least the ones I've come across, don't think mass mask wearing do a thing. Not sure we should be conditioning people via mandates to wear them based on the evidence.

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They work in the same manner that coughing into your sleeve works. Perhaps they provide a little personal protection but nowhere near enough to make an observable impact on the progression of the pandemic.

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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.

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Scott = I'm always right. RIGHT?

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Dude, what are you even doing here? Obviously people are going to think highly of the guy in the comments section of his blog. RIGHT?

Come on.

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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.

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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.

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Furthermore, after billions of people vaccinated (with a broad set of different vaccines) and effects seen in the field, the phase 3 studies have long been amended by much better data. We know things the phase 3 studies haven't even asked (like “does it prevent transmission, and if, to what extent” or “how about variants of concern?” and ”is the immunity fading, and if, at what pace, and when do we need a third shot?”).

I'm not an immunologist. But the really important basics of immunology like antibodies are middle school biology stuff, at least here in Germany, just like evolution. I have no idea why the German speaking world has such a large minority believing the same bullshit as in the USA, where anti-scientific sentiments for lack of education are much more widespread. This must be the quantum memetic plague mentioned above, a disinfodemics spreading memes through entangled brain cells.

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Do not underestimate the political identity aspect. Academia and the Press are, to a large extent, at least as hostile towards the 10-15% percent citizens who consider themselves conservative but do not support centrist parties as it is in the US. And their voting pattern and CoVid denialism in all its forms show some significant geographic overlap.

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The idea that the US has worse science education than Germany is actually false. It actually has *better* science education than Germany does.

This is obscured by poor statistical methodology. The US has far more disadvantaged minorities than Germany does (roughly a third of our population is disadvantaged minorities).

If you just compare white Americans to Europeans, white Americans outscore every country in Europe on standardized science tests. (The same applies to Asian Americans)

The US's "poor education" is a statistical artifact. If you look at comparable demographics, the US actually has one of the best educational systems in the world.

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Ah, so this is the "galaxy rotation curves can be explained by MOND!" of vaccine objections then.

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Ii would hazard a guess that Russia has a lot to do with German vaccine hesitancy. The GRU has been actively spreading anti vax propaganda throughout the western world as a part of a campaign to destabilise their rival nations. Add to that the legacy of East Germany where the politics lean right and (I imagine) that the educators are not as sharp as their colleagues that were educated in the western side, and you have a recipe for ignorance and division.

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"The fraud was small" is a strange argument. It suggests one of two possibilities:

1) The small fraud was nevertheless meaningful to the overall outcome of the study, or they wouldn't have bothered.

OR

2) If they perpetrated a small fraud with little effect on the overall results, it suggests their SOP is simply to commit fraud wherever and whenever it's convenient, and in that case how could one reasonably assume this one 'insignificant' fraud that we happened to discover is the extent of the total fraud?

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I mean, is this one team doing fraud only in one area, or are there separate teams per area? I agree with your 2) take, but the consequences for the study probably differ between the two cases.

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The issue is the most obvious motivation behind the fraud there was not to change the conclusions of the entire trial. It was a subcontractor trying to cover up sloppy data gathering practices and cutting corners about meeting followup deadlines. Backdating results doesn't do much to change the analysis but it does do a lot to save your ass from awkward questions about why you didn't follow the plan you were given. In that case the fraud can be both inconsequential to the overall conclusion and rationally motivated.

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That is what we know of. There are probably more mistakes that were covered and hidden from the public. I can understand that they were rushing to get the vaccine approved and people being people and companies being companies with their tendency to cut corners and cover mistakes. I don't think it changes the outcomes substantially but it might be that the vaccine effectiveness is actually slightly less than originally thought.

My issue is that when Astra Zeneca found some irregularities with their studies due to very bizarre circumstances with product testing and they were completely open and forthcoming, they were completely vilified by the media and politicians. It doesn't provide any incentives for companies to be open at all. Pfizer's incident shows that it is better to deny or cover up everything and when they are finally exposed then say that it is not a big deal.

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Not to mention the cutting short of the long term study by way of vaxxing the control group. Oh but sCiUncee!

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Yes

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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.

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"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.

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The studies were not powered to detect the safety signals that have emerged in real world tests - they were powered to detect relatively common (1% - 0.01%) side effects that occurred in the general population within the time frame of the trial.

The safety signals that have emerged in real world tests (VITT with adenoviral vaccines in young-to-middle age women, myocarditis with mRNA vaccines in young men) have a frequency more on the order of magnitude of 0.001% in the specific subpopulation. And they can easily be circumvented by just using a different vaccine technology in those subpopulations: mRNA for young-to-middle aged women, single shot mRNA + 1 dose J&J with young men (or 2 dose J&J if you prefer).

A trial powered to detect those kinds of effects would have had to enroll hundreds of thousands of people, and would have delayed roll out of the vaccine by months, costing thousands - if not tens of thousands - of lives.

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How do the Myocarditis concerns apply to booster shots? I am a man in my 20s vaxxed with Pfizer, but I've been avoiding booster shots because from what I've seen it I think the risk of vaccine complications from a booster outweighs the risk of getting covid once already vaccinated with the original dosing. But in the case that I am forced to get a booster, should I be seeking out J&J?

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I'm not even confident that myocarditis is caused by the COVID-19 vaccine. Myocarditis is a known side effect of COVID itself. It's basically impossible to control for myocarditis rates at this point because there's a disease going around that increases risk of myocarditis by about 20x. Myocarditis is rare, but you only need a few infections that lead to it to screw up your numbers precisely because the numbers are so small.

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"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?

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They worked better than initially expected and REDUCE infection, transmission, severe illness and death a great deal.

I have read of a vax under development that will be administered as a nasal spray and promises to provide the "sterilising immunity" that is more in line with your unreasonably high expectations.

Most vaccines do not work perfectly - they work by reducing community transmission to the point where the virus runs out of hosts and goes extinct.

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Are you a shill? This is absolutely not an accurate recounting of events. The COVID vaccines were initially expected to confer immunity and to allow us to build herd immunity. It is now known that they do neither. We have literally broadened the idea of what a vaccine is because the COVID vaccine was unable to achieve what used to be expected of vaccines.

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So goes the theory.

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I've read they're effective for anywhere between 2 - 8 months. It's especially does lower hospitalizations and deaths inside three months. But they do wane - hence the boosters. The interesting thing is the vaccinated have become asymptomatic silent spreaders and the vaccines - or experimental gene therapy - don't halt transmission nor protect people. They were designed to lower symptoms. Basically it's a flu vaccine in drag. Whatever, it certainly doesn't justify mandates or passports on any grounds as it will not lead to herd. Have we ever really reached herd with influenza? We rely on natural immunity to get by. These are not diseases we can possibly control and 'defeat' with vaccines. I don't see how.

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The vaccines were designed to give human immune systems a chance to prepare to fight a covid infection. They are only as good as the immune system that they are assisting. While effectiveness does wane disappointingly fast, that does not mean that the vaccines are not beneficial. What is apparently beneficial is a longer period between doses. This will make the 3rd dose that much more effective. Your argument that the Covid vaccines are not as effective as purported is counter to your overall point that they are not justified. Rather, It suggests that higher vaccination rates are needed to control the virus.

Ultimately it is always about the hospitalizations.

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Not to mention situations like Marek's disease in chickens, where vaccination results in strains adapting to be resistant to the vaccine and the very specific immunization provided by it. In the case of Marek's this resulted in a disease so deadly and virulent ONLY vaccinated chickens have a chance. Alternatively, a resistant strain could be more dangerous to the vaccinated than those who have a more varied and complete immune adaptation from natural immunity alone, as opposed to a high alert but highly specialized immunity driven by a vaccine.

Ultimately the biggest problem is not the vaccine itself though, anyone should be able to get one if they want it. The problem is the bribery and ultimately coercion being enacted to try to force it on people.

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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.

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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?

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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.

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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

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1 vaccine-related death per 100,000 on this one (within 7 days)?

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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".

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In general there's always an effect (positive or negative) and you want a powerful enough study to detect the effect so that you can understand its magnitude, to know whether it matters or not (and whether it's positive or negative). Even if the individual data points are noisier, having a lot more of them can be helpful in confirming trends that are only suggestive with a small number of data points.

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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.

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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.

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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.

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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.

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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?

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Like, all of the above?

They'd had prior experience, which gave them literal T-cells as well as society-wide immunity because they knew how to react and take it seriously.

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I'd say it's this. We saw SARS in the name of the virus and anyone reasonable immediately started prepping like this will be a second SARS epidemic.

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Lower rates of obesity

May have played a role.

https://amp.cnn.com/cnn/2021/03/04/health/obesity-covid-death-rate-intl/index.html

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That can't explain low *infection* numbers.

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Good question. Apart from lower rates of obesity and a generally healthier diet and lifestyle, in Asian countries there tends to be a near universal compliance with social distancing, contact tracing and mask-wearing mandates.

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John Campbell just mentioned in a video that a lot of Asians produce an enzyme which protects against covid. If you search his channel on youtube for a video called 'the japanese miracle' you'll find it.

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Interesting. Here’s the link

https://youtu.be/E1GF0H9V_1g

And also a link to an article about the research from Japan Times for anyone in a hurry:

https://www.japantimes.co.jp/news/2021/11/18/national/delta-variant-self-destruction-theory/

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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.

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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.

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How would you carry out an RCT on masks for influenza?

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Put a bunch of people in a dorm. Everyone wears masks, but you can't easily tell how good the mask is -- some don't keep out anything, some are N95 or better, and lots in-between.

Deliberately infect several people with the flu (like we do for challenge testing) and then test everyone daily.

The very very first tests might just have 2 people in a hotel suite for a week (repeated a few dozen times).

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You don't even have to deliberately infect people - presumably in any study like this you want some number of known positives and some number of known negatives going into the study, so you want to recruit a lot of people and testing them all. But if you recruit enough people, and the disease is spreading quickly, you'll surely find a reasonable number of positives without having to infect anyone. It's only the negatives being used to test the masks that run the risk of getting infected by the study.

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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

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What would "the population of the UK not allowing it" have consisted of? The next election is in 2024.

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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.

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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.

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I'm not sure I agree that lockdowns are as limited as you claim.

The population of the UK has by and large been pretty happy about government measures to protect them from the pandemic. They have supported essentially every lockdown, even in Jan-March 2021, almost a year on from the start of the pandemic restrictions. Yes there's absolutely a vocal minority who don't support them, but the majority consistently did as we know from all polling data.

The first lockdown was almost inarguably a good idea, and that's the one we're referring to, as it allowed breathing space to create a massive expansion of govt and medical capacity, as well as the space to do large-scale trials that revealed dexamethasone by June 2020, which dramatically improved the survival chances going forward. There would have been a far higher death rate without this discovery.

Much of the media hostility revolved around the fact that the likely death rate for an un-checked pandemic at that time, without proper medical treatments, was going to be more than half a million people.

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Lockdowns are a terrible idea with catastrophic consequences. They were never rooted in facts or science. And even the way the lockdowns were applied were unjust and illogical. 'Essential v. non-essential' is dumb. The local small grocery guy had to close but Wal-Mart could stay open? Please. Foolish and the fact it's still being considered is madness. All part of the moral panic I guess. America is definitely wise to not be discussing this.

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> 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"?

Don't try to stop people from taking ivermectin if it's not dangerous. Do encourage them to take vaccines because they're safe and effective.

But if the government says "it's safe and effective" and 93% don't believe it, a coup is probably imminent.

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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".

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"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.

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YES. The culture war needs more replication studies, or AARs, or etc. Scott - you're doing yeoman's work. Thanks.

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Right off the bat I learned pored is spelled differently from poured, so strong start to this post.

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"I'm not going to watch it, because it is a video..."

You don't watch videos?

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Sorry Paula, we only consume text-based content here.

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Come on Paula, send us an ascii picture of your nudity.

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You can always tell the guys who grew up with 300 bps modems.....

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(.)(.)

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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.

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Some browser addons that let you watch videos at any speed. Speeding up by x3 or x4 makes most videos of people talking tolerable.

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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).

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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.

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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.

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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.

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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.

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"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.

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Me too. I really want to hear about that.

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You can have it for free from me: honesty, transparency, humility, good faith.

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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.

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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.)

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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.

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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.

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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.

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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.)

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Community masking (assuming non-N95) against respiratory virus is incontrovertibly demonstrated to be effective? Am I understanding your comment correctly?

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I mean, yes - https://www.poverty-action.org/sites/default/files/publications/Mask_RCT____Symptomatic_Seropositivity_083121.pdf - but that wasn't the claim. I claimed that if we did good enough larger scale RCTs rapidly, we would have found that there was an effect much more quickly.

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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.

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Speaking as someone who has worked in manufacturing - the religious belief in RAPID supply and demand is completely wrong. Generally speaking, factories operate near or at capacity, and ramping up is a slow, laggy process. That's why we STILL have chip shortages, even though we produce enormous, enormous amounts of them.

It's not possible to ramp up without building another factory oftentimes.

Ivermectin has a large supply because we use a lot of it on livestock. That's not true of a lot of other drugs.

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I've read something from a person with scabies who needed ivermectin, and it became barely available because of a sudden increase of demand-- they were sharing their ivermectin with a friend who was having trouble getting it.

It takes time for manufacturers to ramp up production, and they'd be gambling on what people will want.

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Have you looked at the in vitro studies? Because the ones I've looked at showed that they reduced virus numbers... Scott completely ignores all the evidence on mechanisms of action

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I have. It would take more than 35x the standard dose of ivermectin to achieve 50% inhibition according to the in vitro studies.

More than 10x the standard dose is toxic in humans.

The probable mechanism of action is disruption of cellular processes, which is why it is unsurprising that ivermectin is not useful for treating COVID in humans.

Bleach kills COVID in vitro, too. The problem is, it will kill YOU, too.

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How do you know if the things that you're trying are working? How do you know if they're making things worse?

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Oh. So if you give someone a medicine, and they get better, that means that it works? And if you give it and they get worse, that means that it doesn't work?

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"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.

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Yeah, I think if there is one single thing we should take away from this whole shit show it is that trying to manipulate people, however mild the manipulation is, and however in-good-faith the manipulation is, *massively* sabotages your credibility.

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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.

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"No, no, you misunderstand, we're lying to you because you're stupid, and will do wrong things otherwise."

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"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. "

Does not equal "lying to people"

A lot of experts are very very wary of saying untrue things. "Here! Take these 10 pills, they'll help!" may be an untrue thing when you have no idea if any of those 10 actually work. And if you turn around 6 months later and say they don't work then people will declare you a liar.

unfortunately there are a lot of deeply deeply dishonest people, the sort of people who there's no point even trying to get through to who will intentionally distort that and still call you a liar because they read a crappy news article or tweet summarising the refusal to endorse those 10 drugs as a claim in the opposite direction.

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> same people who will cheerfully drink fish tank cleaner.

"Then some human scientists suggest vaccinating against the plague. The aliens say this is idiotic, vaccines originally come from cowpox, even the word “vaccine” comes from Latin vaccus meaning “cow”, are you saying you want cow medicine instead of actual brain implants which alien Science has proven will work? They make lots of cartoons displaying humans who want vaccines as having cow heads, or rolling around in cow poop. Meanwhile, the first few dozen studies show vaccines work great. Many top human leaders, including war heroes from the struggle against the aliens, get vaccines and are seen going out in public, looking healthy and happy."

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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.

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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.

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Vinay Prasad proposed a "randomization by default" approach to important clinical questions in "Ending Medical Reversal". It's a great idea.

We wouldn't need meta-analysis aggregating a bunch of questionable small studies if we had a few big well-done simple RCts

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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.

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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

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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

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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.

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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.

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Obviously not, given how many people guzzle down such misinformation. It leads to all sorts of trouble.

If people made decisions based on statistical analysis, they'd make better decisions.

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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.

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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."

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Quarantines work.

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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.

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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.

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Doesn't the same logic apply to the 'vaccine'?

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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.

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We don't have the 100% confidence though that vaccines are enough to stop the spread of the virus. My belief is that from the scientific evidence, since the vaccines don't stop spread, even if 100% of the world population by some scant luck had taken the vaccine, it can still spread and mutate and would eventually develop into a more infectious strain such as how we have Delta today.

Vaccines that don't prevent vaccines, i.e. leaky vaccines are that by their inherent nature, not able to completely eliminate a virus. Eventually, since the virus still exists in a COVID-19 vaccinated environment, it would have mutated and spread into a more infectious strain.

The only difference is today we blame the unvaccinated as speeding up that spread and responsible for the Delta variant.

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It's worse than that. Even if 100% of the world population had taken the vaccine, and 100% of humans were vaccine free, due to animal reservoirs of the virus it would escape into the wild again. COVID is here to stay.

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Vaccines greatly reduce spread.

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Yes, There is a lot of talk about how the Virus will very likely become endemic. All the more reason to get vaccinated if you have access. This pandemic is new to humanity, there are other vaccines being developed that may turn out to work better than the ones we have now. We may be able to eradicate it in 10 years instead of the 80 that it has taken for Polio.

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Vaccines do prevent infections. But they don't prevent *all* infections.

The problem with COVID-19 is that it is ridiculously infectious. For most viruses, reducing the R0 by a factor of 6 will put it well below 1. COVID-19 has an R0 of something like 8-12, so even a vaccine that cuts infection by 6x will only reduce it to 1.2-2, which is still not low enough.

The reality is that you have to have full measures going on - masks, vaccines, no indoor dining, social distancing, no in-person school, work from home where possible, etc.

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Just because vaccines work doesn't mean the 'vaccine' works! The logical definition of working would be, the risk of the virus is greater than the risk of the vaccine, and that depends on many things. The most important under an EUA is tracking and analyzing adverse events. And the most important for convincing skeptics is open discussion about those events. The lack of candor about risks and benefits, and the outright suppression of reports of adverse events has exposed, yet again, the evil of authoritarianism.

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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

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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".

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"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.

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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.

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Just to clarify, because it does affect how I contextualize your other comments, are you arguing for homeopathy NOT being pseudoscience?

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You can easily establish that homeopathy is false, but you might have a tougher time establishing that it's dangerous.

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It is dangerous if you are advertising as protection against a dangerous condition to children(or Republicans). \s

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Sorry I wasn't clear and wasn't reasonable in my timeframe to respond to you.

My argument was that we use the label pseudoscience and misinformation synonymously, and then set the bar for what qualifies as science as very high and to standards where basically only elite stakeholders can do the "sciencing".

We disregard the science done by small people, small studies, we look for science done by highly prestigious research bodies and published in highly prestigious journals. We use a lot of Ad Hominem to disqualify science over the arguments behind the science.

If someone like Scott Alexander had simply shown up on News media to share this analysis to talk about ivermectin versus all the current "elitist" style reporting of "All these quacks are taking horse dewormer and look at how one guy who thinks he's smarter than the CDC tried to treat COVID by himself"

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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.

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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.

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Shutting stuff down is easier than doing stuff.

I'm not sure why this is a hard concept.

And we ran a bunch of trials on all sorts of stuff.

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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

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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."

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"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?

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Isn't there usually some low-confidence hypothesis though?

For the murder, let's look at all the "usual suspects" - criminals that commit crimes at a higher rate than the population as a whole.

For ivermectin, it might be something like, "this is medicine known to work with other diseases." The casual nature of chemistry and biology doesn't enter into the reasoning. And on that level, given the "worm impact," it appears even to have been right for those cases!

Of course, in the latter case, you need to ask why this medicine and not others. But I think the response is something like, "docters all over the world have been trying everything they can think of, and this one stuck." Also it wasn't the only one, there are others that have some (maybe low) evidence that are now being followed up.

The problem for me, isn't that, it is going from low confidence priors, to high confidence. I don't understand that, even in the faces of Scott's Australia conquering aliens. Wouldn't you just distrust everything? Why does low-confidence evidence from alternatives sources get trusted?

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Ivermectin was shown to have anti viral properties in vitro. Theory states it enables zinc to enter the cell and stop replication of viruses and it prevents inflamation. So a doctor tried it and had good results. Soon other doctors were using it and found it to be effective keeping people out of the hospital. Good RTCs are very expensive and there is zero profit in doing one for a generic drug, but a very big incentive to do a fake study to prove the generic doesn't work, If the author didn't point this out in his evaluation, it undermines his credability to the point his opinion is useless. We don't need more blind people to follow.

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My wife has some insight into medicine, and her judgment on Ivermectin was something like: "The prior probability of this type of thing being a cure for this type of disease is extremely low. There is some evidence in favor of Ivermectin, but it is too weak to overcome the priors." I guess she passed this rationality test with flying colors.

But the quality of one's priors depends on their knowledge. As an extreme example, if you have no idea what "ivermectin" or "covid" mean, you could go with: "well, you asked me a yes/no question, so the prior probability of yes is 50%".

A better model would be that ivermectin is a "cure" and covid is a "virus", and it is generally known that you can use a "cure" against a "virus", although not every "cure" against every "virus", but still the chances of ivermectin are way better than... the chances of a random object you would pick up in a shop...

A yet better model is that killing a virus is not the hard part (an atomic bomb surely destroys covid, too), the problem is to find a cure that succeeds to kill the virus without hurting the human too much, which is quite difficult.

And then, people like my wife can have even better model of how ivermectin works, how covid works, so their priors can be even more precise.

Problem is, better priors are often built from more background knowledge, which makes them more difficult to communicate to other people. For that reason, I did not try to argue with my wife, I just asked how certain she feels about what she said, and I trusted her judgment.

This again required me to have priors about the quality of her judgment, which are quite high. And that again is because I have a lot of data about her. So I wouldn't expect her reasoning to be equally convincing to other people. Therefore, I didn't try to convince other people by saying "because my wife said so, and I trust her"; that obviously wouldn't work.

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In particle physics, a similar issue is called the "look-elsewhere effect".

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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.

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Well put!

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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.

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"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.

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>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?

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The more drugs you throw at the wall, the more likely some will appear to work by chance.

It's the M&M problem, writ large.

It's better to focus your efforts on things that you have good reason to believe will work.

Worse, some of these probably killed people. Dexamethasone probably harmed non-respiratory COVID patients who took it. And several killed people for no benefit at all.

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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?

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Except it's all lies.

These areas of the world had worse *COVID TESTING*. They didn't have lower mortality rates. In fact, their excess mortality rates were *higher* - probably by 2-4x.

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You could argue that people were incorrect in their interpretation of the data, leading them to test HCQ and IVM for no reason. But that is not the same as "its all lies". The reason people tested in the first place absolutely is the epidemiological evidence. This is not something any of those people are hiding from you, it is only something google et al are hiding from you.

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Do you have a list of the countries?

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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.

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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.

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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.

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Young people not considering Covid a big deal is an illegitimate and deeply selfish perspective, since they can still be carriers, even if their personal outcomes are likely to be good.

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Those who are vaccinated can still catch covid and infect others too even if their personal outcomes are likely to be good, so what's your argument here?

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What those who exhibit blind trust in what the heads of institutions say need to consider is: What if they're corrupted. What if their ability to think rationally is compromised, like Biden, and the vaccine mandates turn out worse than his surrender to the Taliban.

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Love how you disappeared after receiving responses to your false argument. Still believe the same thing as before?

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