As a Twitter follower of just about everyone mentioned in this post and someone who is just trying to make sense of the data on promising early treatment options for Covid, I applaud you for this write-up. The combination of intellectual rigor, unemotional review of the data, and most of all the tone of respect in communication is admirable. We need more of this everywhere. Thank you for your efforts.
If the side effects are non-existent and/or manageable, and the only effect is placebo, it would be worth it for that effect alone, IMO.
But yes, the lack of large-scale IVM or HCQ trial by the many governments willing to spend $Bs on unproven vaccines flies in the face of ... well, sanity, to be honest.
There would be more than enough volunteers, that much is obvious.
You are brilliant! Thanks for putting in the time. The biggest red flag in all of this— why is there such a concerted effort by so many people and organizations to demolish any virtue in ivermectin. It’s obvious that people won’t give ivermectin a chance, which is a signal that it can’t work for some conspiratorial purpose that I can’t name. One day we will understand why the Fauci cult of Covid 19 became such blind zealots.
Side point, but you omitted from the litany of past self-owns GidMK's enthused gleeful promulgation of the transparently ridiculous Rolling Stone horse dewormer ICU hoax. We're dealing with bad faith gatekeepers for Project Vax, one who has published a couple of biased articles on Medium, one who's a demented Tim Pool stalker, and one who apparently aspires to debunk Vitamin D.
Like Alex, I don't consider myself on "Team Ivermectin". I obviously hope that Pfizer and Merck's new covid drugs are highly effective against covid.
I also agree with Alex that fundamental sensemaking is the most important issue here, and that Ivermectin is merely one of the more useful examples we have that illustrates the profound derangement of our current sensemaking, largely due to the information pollution committed by corpogov (the modern fusion of corporations and governments).
Here is my epistemic baseline with regard to Ivermectin. It is an old drug that has a well established strong safety record. If it even shows minor efficacy in treating covid, it's use is a no brainer. Full stop.
Further, it is a generic drug, and therefore there is *more* reason to trust data that shows its efficacy. This is an obvious heuristic, or at least it should be. When billions of dollars are at stake, we should expect grotesque derangement of public sensemaking. We should expect troll farms, sock puppets, and ghost written articles by "scientists" supporting billion dollar product X. That is where the incentives lie, unfortunately.
The coordinated campaign against Ivermectin was, and continues to be, amazing. We witnessed the FDA tweet propaganda that equated IVM with horse dewormer. We saw Rolling Stone publish a curious article that claimed that gunshot victims were being left to die because Emergency Departments were being overwhelmed by ivermectin overdoses. The article read as if it was penned by the current iteration of Operation Mockingbird, and was widely disseminated throughout the media landscape. We saw a Regime "comedian" "joke" that people taking "horse goo" should be refused medical care.
As for Ivermectin, we have a January 2021 study that examined 47 different drugs to assess their efficacy for inhibiting 3CLpro enzyme--a key protease used by SARS CoV-2 for viral replication.
What did this study find? Ivermectin had the highest efficacy out of all the drugs tested for inhibition of 3CLpro.
What is the mechanism of action for Pfizer's new covid drug? Inhibition of 3CLpro.
Did Pfizer sensibly design their soon to be patented and released drug based on publicly and/or privately known data derived from research on Ivermectin?
I don't know, but it would have been a very logical thing to do.
I get the sense that the overall disagreement boils down to: Scott has the intuition that buying into IVM given the evidence he's seen would be proving too much, whereas Alexandros has the intuition that rejecting it would be an isolated demand for rigor.
And that might very well be fixed with backs and forths like this article; where Scott may learn that some of the evidence he didn't look at is important (the studies by GidMK or the other parallel lines of evidence other than formal studies that Scott probably didn't look into much); or where Scott gives Alexandros some better examples of similar levels of evidence in favour of obviously false things.
Also, wecome to here! And yes, this is a nicer place for rounded-up thoughts than a network of twitter threads (that I cannot even read properly on tweetdeck because of your shadowbanning or sth)
great analysis. it is hard for me to understand why we throw everything at this virus, except safe alternative treatments. whatever we are seeing here coming out of the mic.. it is not competence and health nerd is a symptom of that.
You're a breath of fresh air in the ether of madness we inquisitive lay people are feeling today. Please keep engaging so honestly. Your thoughts and conclusions are supporting so many of our desparate personal wars within the fog we are all trying so hard to navigate through.
Re: trust in experts or doctors - I want to mention here Peter Attia (PA) and his podcast. I don't know if you listened to his podcasts or not, but they are very interesting in general. He's pushing the idea that we need to learn from the medical advances to live a life free of disease for as long as possible. His idea is that the goal is not to live longer (though it might be a side effect of life style changes), but to live a high quality life as long as possible. Now, fast forward, he invited Paul Offit (PO) this year in one of his podcasts to talk about vaccines in general, and the CV19 vaccines in particular. You probably know already that PO is an adept of CV19 vaccines, for kids as well (I do not want to go there). In the podcast PA mentioned his wife got the vaccine, then she went for an X-Ray, and they observed she had swollen lymph nodes. The radiologist mentioned that it is common for vaccinated women to have this issue. What struck me is that for an intelligent guy so preoccupied to be healthy in old age he and his wife chose to get vaccinated, and he kind of brushed off his wife's side effects. At that point I did not know whether I can trust him anymore. Well, I don't trust him... The damage is done. Does he genuinely believe the CV19 vaccines are good for one's health, or for his health or his wife's health? Is it possible that he lied in the podcast, and he and his wife didn't get the CV19 vaccine? Was he paid to promote the CV19 vaccines to his listeners base, and organize the interview with PO, who's a proponent of CV19 vaccines?
I have another example - Sam Harris. I recall vividly, when Wikileaks was about to dump HRC's & DNC's emails, Sam Harris tweeted something in the line "what can be interesting in these emails". Sorry, I cannot find his tweet (I tried to search for it but I could not find it), but it was an unusual comment coming from him. I always have seen him as a promoter of atheistic topics. Did he genuinely believe there was not going to be anything interesting in those emails? Can he be that dumb? Was he paid to follow an agenda? Either way, it cemented my idea that the guy cannot be trusted. I haven't listened to him recently. I know he got into meditation.
Same with these guys mentioned in the article (minus Scott, but the jury is still out), are they sincere? I doubt it. The fact that GidMK and his buddies didn't provide the data to support their point of views indicate to me that they are propagandists.
Ultimately, like you said in the article, a sane health authority would have explored all the other treatments, and it would have used them by now if there were indications that they work. Instead they took a different path, and here we are.
I would like to add one point that may have relevance to the apparent mystery behind the coordinated campaign against ivermectin. The point is unoriginal, but it doesn’t seem to be raised much nowadays.
Pfizer is pushing for an Emergency Use Authorization for their new Covid drug, which has the same mechanism of action as has been demonstrated in studies by Ivermectin (3CL Protease inhibition).
From my reading of the EUA guidelines, it appears that an EUA would not be granted if there is a drug in the same class which shows efficacy.
You can obviously go into huge complexity analysing all the studies, but if you stand back and look at the population data where ivm has been widely used (Japan, India, Mexico etc) those with an open mind should at least say “that looks interesting”. Add to that the number of front line doctors, the ones who are inclined to move away from fda etc dogma, who swear by early treatment using repurposed drugs in various combinations and claim they have virtually no deaths — do we think they are all liars? Give the problem with replication issues in the science world these real world anecdotes seem as powerful as anything.
"In fact, in a sane world, we’d have done the same for many of the substances on this list and probably a few more. This is real evidence that the public health establishment is indeed not acting sanely, and it does weigh on my ability to take them at their word on everything else they say on early treatment and beyond." No truer words than these !
"I think of it as like the Large Hadron Collider. If the people who run the LHC ever become biased, we’re doomed, because there’s no way ordinary citizens can pool all of our small hadron colliders and get equally robust results."
I have in my background some Physics training and I know Scott doesn't because he wouldn't have assumed that Physicist just collude to announce results. In real empirical science, the hallmark is perpetual self-doubt. This is the reason why when the Higgs Boson signal was trying to be observed in 2012, the LHC had two teams looking the experiments independently without knowing the results of the other (CMS and ATLAS collaborations). They could still be wrong about their conclusions but they at least tried to not trick themselves. They might still have but the public is not required to believe anything about the Standard Model of Physics because findings made no impact on what we knew and didn't know. We still don't have a calculation that explains why the masses of whatever masses particles have, have that mass. It's just an empirical observation.
Most importantly, the whole world is not being asked to unquestionably obey orders based on experiments conducted by two adversarial teams!
Now, what if people in Infectious diseases and Medicine had the kind of skepticism and demand for empiricism that Physicists demand from each other?
Can any medical researcher confidently say that if we had teams in a blinded study where you do not know the status of the person you are collaborating with (vaccination status, support for specific infection prevention measures) and do no know what group is the treated group or untreated, that all teams will come-up with the exact same computational result as LHC scientists with Higgs Boson?
I really doubt that if experimentalists and data analysts were not suffering from grave conflicts of interest with respect to their own health/immunization status, and the policy positions of the funding agencies they write grants to, we would see such synonymous conclusions every single time.
As a Twitter follower of just about everyone mentioned in this post and someone who is just trying to make sense of the data on promising early treatment options for Covid, I applaud you for this write-up. The combination of intellectual rigor, unemotional review of the data, and most of all the tone of respect in communication is admirable. We need more of this everywhere. Thank you for your efforts.
If the side effects are non-existent and/or manageable, and the only effect is placebo, it would be worth it for that effect alone, IMO.
But yes, the lack of large-scale IVM or HCQ trial by the many governments willing to spend $Bs on unproven vaccines flies in the face of ... well, sanity, to be honest.
There would be more than enough volunteers, that much is obvious.
You are brilliant! Thanks for putting in the time. The biggest red flag in all of this— why is there such a concerted effort by so many people and organizations to demolish any virtue in ivermectin. It’s obvious that people won’t give ivermectin a chance, which is a signal that it can’t work for some conspiratorial purpose that I can’t name. One day we will understand why the Fauci cult of Covid 19 became such blind zealots.
Side point, but you omitted from the litany of past self-owns GidMK's enthused gleeful promulgation of the transparently ridiculous Rolling Stone horse dewormer ICU hoax. We're dealing with bad faith gatekeepers for Project Vax, one who has published a couple of biased articles on Medium, one who's a demented Tim Pool stalker, and one who apparently aspires to debunk Vitamin D.
This "war of the Alex's" is a lesson in debate, scientific and constructive thinking. And English. Thank you for the hard work you have put into this.
Damn, this is such a good article! Perfect dissections of some of the same issues that I had with SlateStarCodex's article. A++
Great work Alex.
Like Alex, I don't consider myself on "Team Ivermectin". I obviously hope that Pfizer and Merck's new covid drugs are highly effective against covid.
I also agree with Alex that fundamental sensemaking is the most important issue here, and that Ivermectin is merely one of the more useful examples we have that illustrates the profound derangement of our current sensemaking, largely due to the information pollution committed by corpogov (the modern fusion of corporations and governments).
Here is my epistemic baseline with regard to Ivermectin. It is an old drug that has a well established strong safety record. If it even shows minor efficacy in treating covid, it's use is a no brainer. Full stop.
Further, it is a generic drug, and therefore there is *more* reason to trust data that shows its efficacy. This is an obvious heuristic, or at least it should be. When billions of dollars are at stake, we should expect grotesque derangement of public sensemaking. We should expect troll farms, sock puppets, and ghost written articles by "scientists" supporting billion dollar product X. That is where the incentives lie, unfortunately.
The coordinated campaign against Ivermectin was, and continues to be, amazing. We witnessed the FDA tweet propaganda that equated IVM with horse dewormer. We saw Rolling Stone publish a curious article that claimed that gunshot victims were being left to die because Emergency Departments were being overwhelmed by ivermectin overdoses. The article read as if it was penned by the current iteration of Operation Mockingbird, and was widely disseminated throughout the media landscape. We saw a Regime "comedian" "joke" that people taking "horse goo" should be refused medical care.
As for Ivermectin, we have a January 2021 study that examined 47 different drugs to assess their efficacy for inhibiting 3CLpro enzyme--a key protease used by SARS CoV-2 for viral replication.
https://www.nature.com/articles/s42003-020-01577-x
What did this study find? Ivermectin had the highest efficacy out of all the drugs tested for inhibition of 3CLpro.
What is the mechanism of action for Pfizer's new covid drug? Inhibition of 3CLpro.
Did Pfizer sensibly design their soon to be patented and released drug based on publicly and/or privately known data derived from research on Ivermectin?
I don't know, but it would have been a very logical thing to do.
Nice post!
I get the sense that the overall disagreement boils down to: Scott has the intuition that buying into IVM given the evidence he's seen would be proving too much, whereas Alexandros has the intuition that rejecting it would be an isolated demand for rigor.
And that might very well be fixed with backs and forths like this article; where Scott may learn that some of the evidence he didn't look at is important (the studies by GidMK or the other parallel lines of evidence other than formal studies that Scott probably didn't look into much); or where Scott gives Alexandros some better examples of similar levels of evidence in favour of obviously false things.
Also, wecome to here! And yes, this is a nicer place for rounded-up thoughts than a network of twitter threads (that I cannot even read properly on tweetdeck because of your shadowbanning or sth)
great analysis. it is hard for me to understand why we throw everything at this virus, except safe alternative treatments. whatever we are seeing here coming out of the mic.. it is not competence and health nerd is a symptom of that.
You're a breath of fresh air in the ether of madness we inquisitive lay people are feeling today. Please keep engaging so honestly. Your thoughts and conclusions are supporting so many of our desparate personal wars within the fog we are all trying so hard to navigate through.
Re: trust in experts or doctors - I want to mention here Peter Attia (PA) and his podcast. I don't know if you listened to his podcasts or not, but they are very interesting in general. He's pushing the idea that we need to learn from the medical advances to live a life free of disease for as long as possible. His idea is that the goal is not to live longer (though it might be a side effect of life style changes), but to live a high quality life as long as possible. Now, fast forward, he invited Paul Offit (PO) this year in one of his podcasts to talk about vaccines in general, and the CV19 vaccines in particular. You probably know already that PO is an adept of CV19 vaccines, for kids as well (I do not want to go there). In the podcast PA mentioned his wife got the vaccine, then she went for an X-Ray, and they observed she had swollen lymph nodes. The radiologist mentioned that it is common for vaccinated women to have this issue. What struck me is that for an intelligent guy so preoccupied to be healthy in old age he and his wife chose to get vaccinated, and he kind of brushed off his wife's side effects. At that point I did not know whether I can trust him anymore. Well, I don't trust him... The damage is done. Does he genuinely believe the CV19 vaccines are good for one's health, or for his health or his wife's health? Is it possible that he lied in the podcast, and he and his wife didn't get the CV19 vaccine? Was he paid to promote the CV19 vaccines to his listeners base, and organize the interview with PO, who's a proponent of CV19 vaccines?
I have another example - Sam Harris. I recall vividly, when Wikileaks was about to dump HRC's & DNC's emails, Sam Harris tweeted something in the line "what can be interesting in these emails". Sorry, I cannot find his tweet (I tried to search for it but I could not find it), but it was an unusual comment coming from him. I always have seen him as a promoter of atheistic topics. Did he genuinely believe there was not going to be anything interesting in those emails? Can he be that dumb? Was he paid to follow an agenda? Either way, it cemented my idea that the guy cannot be trusted. I haven't listened to him recently. I know he got into meditation.
Same with these guys mentioned in the article (minus Scott, but the jury is still out), are they sincere? I doubt it. The fact that GidMK and his buddies didn't provide the data to support their point of views indicate to me that they are propagandists.
Ultimately, like you said in the article, a sane health authority would have explored all the other treatments, and it would have used them by now if there were indications that they work. Instead they took a different path, and here we are.
I would like to add one point that may have relevance to the apparent mystery behind the coordinated campaign against ivermectin. The point is unoriginal, but it doesn’t seem to be raised much nowadays.
Pfizer is pushing for an Emergency Use Authorization for their new Covid drug, which has the same mechanism of action as has been demonstrated in studies by Ivermectin (3CL Protease inhibition).
From my reading of the EUA guidelines, it appears that an EUA would not be granted if there is a drug in the same class which shows efficacy.
You can obviously go into huge complexity analysing all the studies, but if you stand back and look at the population data where ivm has been widely used (Japan, India, Mexico etc) those with an open mind should at least say “that looks interesting”. Add to that the number of front line doctors, the ones who are inclined to move away from fda etc dogma, who swear by early treatment using repurposed drugs in various combinations and claim they have virtually no deaths — do we think they are all liars? Give the problem with replication issues in the science world these real world anecdotes seem as powerful as anything.
Jesus, that's the first time I saw Nick Brown's tweet equating vitamin d with crimes against humanity.
"In fact, in a sane world, we’d have done the same for many of the substances on this list and probably a few more. This is real evidence that the public health establishment is indeed not acting sanely, and it does weigh on my ability to take them at their word on everything else they say on early treatment and beyond." No truer words than these !
"I think of it as like the Large Hadron Collider. If the people who run the LHC ever become biased, we’re doomed, because there’s no way ordinary citizens can pool all of our small hadron colliders and get equally robust results."
I have in my background some Physics training and I know Scott doesn't because he wouldn't have assumed that Physicist just collude to announce results. In real empirical science, the hallmark is perpetual self-doubt. This is the reason why when the Higgs Boson signal was trying to be observed in 2012, the LHC had two teams looking the experiments independently without knowing the results of the other (CMS and ATLAS collaborations). They could still be wrong about their conclusions but they at least tried to not trick themselves. They might still have but the public is not required to believe anything about the Standard Model of Physics because findings made no impact on what we knew and didn't know. We still don't have a calculation that explains why the masses of whatever masses particles have, have that mass. It's just an empirical observation.
Most importantly, the whole world is not being asked to unquestionably obey orders based on experiments conducted by two adversarial teams!
Now, what if people in Infectious diseases and Medicine had the kind of skepticism and demand for empiricism that Physicists demand from each other?
Can any medical researcher confidently say that if we had teams in a blinded study where you do not know the status of the person you are collaborating with (vaccination status, support for specific infection prevention measures) and do no know what group is the treated group or untreated, that all teams will come-up with the exact same computational result as LHC scientists with Higgs Boson?
I really doubt that if experimentalists and data analysts were not suffering from grave conflicts of interest with respect to their own health/immunization status, and the policy positions of the funding agencies they write grants to, we would see such synonymous conclusions every single time.