This Substack was started to host my response to Scott Alexander’s article on ivermectin. This is an update on that conversation. Without Further Ado Scott’s update is small and utilitarian, added to the mistakes page and the original article, about two-thirds of the way through:
Take it from me. No matter what you call yourselves--what philosophical school you wish to adhere to--human nature is human nature. We believe what we believe with a passion that surpasseth all passion until we stop believing it and believe something else, and then we can't believe we ever believed the former, having now become wise.
He prides himself on his intellect; he's had some battering done to him in the past and all his wounds are still raw; he wants to be loved again by the arbiters of popular acceptance. If he joins the side of the lepers his life's work is lost.
You pride yourself on your reasonableness; you've followed this ivermectin trail openly, inviting collaborators globally to join in the quest for truth; it's really painful to be treated contemptuously under Scott's guise of rationality and superior intellectual capacity.
Don't ache over it. You've done good and honest work and those of honest temperament see it, are glad of it, and hold for you the only sort of regard that matters.
Scott is, perhaps, not as towering a philosopher as popular rumor would have you think.
Thanks for the reasoned and passionate essay, Mr Marinos. Too bad Semmelweis didn’t have benefit of peers with your dedication to rational methods and discourse. Perhaps he could have avoided the asylum. Thanks also for the recent article on Dr. Malone, re inventor claims.
(Btw, I’m disappointed that you don’t seem to have a larger audience. The small number of likes for your articles is a little depressing. You deserve more visibility.)
Jun 3, 2022·edited Jun 3, 2022Liked by Alexandros Marinos, Eva Tallaksen
I didn't come into this Covid / early treatment discussion with a particular bias in any direction. I was genuinely open to both sides and wanted to hear the best arguments and see a discussion as I've seen with rationalist / skeptic communities do in other domains.
This started out okay with the discussion rebel wisdom hosted and the podcasts Bret Weinstein and Sam Harris were releasing, but quickly derailed as both Sam and David Fuller refused to entertain further discussion and never went back and reviewed evidence, updated their viewpoints, or said what they got right and wrong. In the meantime you, Bret, Heather and others have continued to update their views frequently, trying to make sense of a constantly evolving landscape. You admit errors where you make them and are rigorous even if it would be a knock against your overall argument. I am overall more convinced of the arguments coming from the pro IVM / early treatment camp, but more importantly I am happy how you are genuinely open to discussion and debate. As you say this discussion with Scott could have been an exemplar of how to have a public rational conversation about a controversial topic, but we seem to run up against exceptions in normal standards of rationality for anything Covid related.
In addition many of the discussions you have had with those who disagree are with people who are very quick to sling insults and generally not extend a hand in trying to advance the conversation, and that says a lot.
Thanks for the quality posts and looking forward to whatever comes next.
Jun 3, 2022Liked by Alexandros Marinos, Eva Tallaksen
I stopped reading Scott Alexander a few months back. His pieces are always an engaging read, with interesting topics, and often thoughtful, but (imho) they are permeated with a tribalistic worldview broadly aligned with Western elites (a very rough picture would be "progressive-leaning Democrat types"). It is precisely his trust in "the system" that caused his interpretations to lose their meaning and usefulness for me: governments' responses to COVID can't have been that bad, publicised experts' claims can't have been that bad, institutions' support for the overarching narrative can't have been that bad, media reporting about facts and context can't have been that bad... And that is where I lost faith in his ability of honest appraisal. Because the governments' responses to COVID were horrifically bad, publicised experts' claims were often terribly misleading, institutions' support for the overall narrative and approach was often completely antithetical to their previous functioning or purpose, mainstream media reporting was fantastically propagandistic. But because they are all holding together, even now, all these elite groups of society are carrying on as if their words and actions in the past two years were reasonable, rational, if perhaps a teeny bit imperfect, but certainly life-saving, humane and compassionate. Most of them probably actually believe it, reassured by the common response of their fellow elites.
Evolution of the discussion to this point leaves me sad. It mirrors the arc of real-life and professional interactions over the last dozen years or so, accelerating over the last 2+. My day job aka professional career is empirical analysis, and the universe within which that is meaningful shrinks daily.
The irony of a trial intended to bring people (drugs?) TOGETHER actually pulling people apart.
A strange turn of events on Fluvoxamine. I wrote about it previously and it seemed to have a multitude of MoA's, and to see the FDA now pulling a "whoopsie" actually should call the entirety of those trials into question, but if we do so then should we disregard those studies? The questioning of Fluvoxamine should at least indicate that we should not refer to those TOGETHER trials altogether.
Strange what's happening to this so-called Rationalist community. It seems like it's going the same way as that of the Skeptic community from a few years back during the Gamergate era. During the Skeptic community era it felt like many people knew what was going wrong culturally, but they weren't necessarily educated or informed in a manner to properly articulate the problems.
I wonder if many people who have taken an "unbiased" position are doing so because they aren't informed and would rather feign ignorance through ambiguities. I think Coleman Hughes is very smart, but that post at least suggests he's not sure what the science says and instead took a very broad position on the matter.
I don’t have much to add other than in anticipation of a possible lice exposure for my kids I went to the CDC to look up current recommended medications and found it hilarious to Ivermectin listed.
Im sure this is very old and they forgot to scrub it clean of the reference (they also refer to pregnant “women” instead of people so you know this article must have been last updated a very, very long time ago like 2018).
“Given as a tablet in mass drug administrations, oral ivermectin has been used extensively and safely for over two decades in many countries to treat filarial worm infections. Although not FDA-approved for the treatment of lice, ivermectin tablets given in a single oral dose of 200 micrograms/kg or 400 micrograms/kg repeated in 9-10 days has been shown effective against head lice. It should not be used in children weighing less than 15 kg or in pregnant women.”
"In the original article, Scott spent the first two-thirds of the text going through individual early treatment studies he found on ivmmeta.com one by one, keeping only the ones he found credible. He then removed a further six studies on the say-so of Gideon Meyerowitz-Katz, leaving him with a final set of 11 studies. Of these, he attempted a rudimentary meta-analysis, from which he got a p-value of 0.15. After tweaking the endpoints in an attempt to be more fair, he got a p-value of 0.04."
Why go to all this trouble? He could just throw a dice and keep a favorable to invemectin review only if it comes on 6.
Alexander's truculent refusal to attempt replication of his findings with more useful strategies is unsurprising, given how radioactive the subject has become.
Such reluctance is the logical outcome of casting a foundation in shifting sands. One must abide at the apex of an edifice so constructed, the toppling of which would unquestionably be injurious to the engineer that certified the soil analysis prior to setting the forms.
This rather disturbing aspect of human nature often relegates many of our best and brightest to the ranks of those whose best accomplishments are examples of spurious correlation defended by motivated reasoning.
Observing this is a timely reminder to "trust if you must, but verify to clarify."
Jun 3, 2022Liked by Alexandros Marinos, Eva Tallaksen
Dr. Lawrie pressed Hill, "Could you please give me a name of someone in UNITAID I could speak to, so that I can share my evidence and hope to try and persuade them to understand it?
Dr. Hill evaded, "Oh, I'll have to think about who to, to offer you with a name...But I mean this is very difficult because I'm, you know, I've got this role where I'm supposed to produce this paper and we're in a very difficult, delicate balance...Yeah, it’s a very strong lobby..."
Its scary to me how easily we can get so cynical that we project nefarious motivations onto activity that would be natural, that would be baseline, that would be common sense. The part I'm talking about is:
'But what truly bothers me is that Scott denigrates something we’d expect every sane civilization that is hit with a novel disease to do: keep a public, live, meta-analysis tracking every single study on 42 different proposed treatments, and an even broader list of 837 proposed treatments for the disease, constantly updating with every scrap of evidence it can find anywhere, in favor or against any of these. Instead of providing feedback for how to do the job better, the message Scott seems to give is “give up, leave this up to the journals and the fraud detectives.”;
I'm going to try to remember it so if ever find myself doing it I'll know I've gotten too biased about something. Haters always get to a point where they hate someone for simply being. 'That band just plays some basic chord progressions and then adds some vocals...they suck' 'That player only makes the shots he makes' 'Oh that reciever, he only catches TDs' and the like
Jun 3, 2022·edited Jun 3, 2022Liked by Alexandros Marinos
Per usual, you are being very generous here.
Cognitive bias affects all of us, but the facts have been clear, coupled with a not subtle media campaign against IVM efficacy and suggestive of IVM harm (how about those Emergency Departments overflowing with IVM overdoses?)
Add in the fact that virologist Andrew Hill is *on video* saying he changed his meta-analysis conclusions on IVM in response to pressure from his funder UNITAID…talk about a smoking gun.
In the face of all that and more, why would the obviously intelligent Scott Alexander continue to say that he still believes that the earth is the center of the solar system?
For Scott Alexander or Nick Mark etc it’s not a matter of adjusting their opinion based on new or re-analysed evidence, it’s more about saving face. They were so forthright with their opinions pre the Hill-Lawrie video that they now have painted themselves into a corner and can’t get out.
Ditto the FDA and similar regulatory bodies, who are also in fear of having to retrospectively compensate those who suffered or relatives of those who have died.
It seems to me at the very least IVM has some degree of benefit in treating Covid, irrespective of whatever studies or analysis is used.
The question is what’s next? What will it take for the opinion on IVM to be reversed?
Unfortunately, I feel the answer is nothing will ever happen. It’s somewhat of a tragedy and very unfair and those at the center of it will not get their comeuppance.
But at least you’ve tried and are continuing to try, we’re all grateful for that
There’s something highly suspect about a rationalist “community,” as it implies an inherent groupthink. Any such confederation ought to be routinely disrupted by angrily tossed papers and overturned ink pots to have any merit, I think.
Rationalism is merely an expression of rebellion against God. The problem is that no initial premises (beyond I think therefore I am which doesn't lead very far) can be derived by a purely rational process. And therefore, as successive generations of philosophers realize this, one inevitably moves from the rationalism of the early enlightenment, to Popper's critical rationalism to nihilism. And there you stay - believing in nothing at all. This is the root of Moloch if you like, and this is the exact process which Milton recognized and described in his immortal work. Without God there is no truth, no morality, and no knowledge at all.
And a man is nothing but his reputation, his pride, his works, hsi will and his power. And this he behaves in exactly the way you see here.
On the other hand, if one accepts the existence of God, then one can also have truth, morality, humility, and life eternal.
Ah, you kids.
Take it from me. No matter what you call yourselves--what philosophical school you wish to adhere to--human nature is human nature. We believe what we believe with a passion that surpasseth all passion until we stop believing it and believe something else, and then we can't believe we ever believed the former, having now become wise.
He prides himself on his intellect; he's had some battering done to him in the past and all his wounds are still raw; he wants to be loved again by the arbiters of popular acceptance. If he joins the side of the lepers his life's work is lost.
You pride yourself on your reasonableness; you've followed this ivermectin trail openly, inviting collaborators globally to join in the quest for truth; it's really painful to be treated contemptuously under Scott's guise of rationality and superior intellectual capacity.
Don't ache over it. You've done good and honest work and those of honest temperament see it, are glad of it, and hold for you the only sort of regard that matters.
Scott is, perhaps, not as towering a philosopher as popular rumor would have you think.
Thanks for the reasoned and passionate essay, Mr Marinos. Too bad Semmelweis didn’t have benefit of peers with your dedication to rational methods and discourse. Perhaps he could have avoided the asylum. Thanks also for the recent article on Dr. Malone, re inventor claims.
(Btw, I’m disappointed that you don’t seem to have a larger audience. The small number of likes for your articles is a little depressing. You deserve more visibility.)
I didn't come into this Covid / early treatment discussion with a particular bias in any direction. I was genuinely open to both sides and wanted to hear the best arguments and see a discussion as I've seen with rationalist / skeptic communities do in other domains.
This started out okay with the discussion rebel wisdom hosted and the podcasts Bret Weinstein and Sam Harris were releasing, but quickly derailed as both Sam and David Fuller refused to entertain further discussion and never went back and reviewed evidence, updated their viewpoints, or said what they got right and wrong. In the meantime you, Bret, Heather and others have continued to update their views frequently, trying to make sense of a constantly evolving landscape. You admit errors where you make them and are rigorous even if it would be a knock against your overall argument. I am overall more convinced of the arguments coming from the pro IVM / early treatment camp, but more importantly I am happy how you are genuinely open to discussion and debate. As you say this discussion with Scott could have been an exemplar of how to have a public rational conversation about a controversial topic, but we seem to run up against exceptions in normal standards of rationality for anything Covid related.
In addition many of the discussions you have had with those who disagree are with people who are very quick to sling insults and generally not extend a hand in trying to advance the conversation, and that says a lot.
Thanks for the quality posts and looking forward to whatever comes next.
I stopped reading Scott Alexander a few months back. His pieces are always an engaging read, with interesting topics, and often thoughtful, but (imho) they are permeated with a tribalistic worldview broadly aligned with Western elites (a very rough picture would be "progressive-leaning Democrat types"). It is precisely his trust in "the system" that caused his interpretations to lose their meaning and usefulness for me: governments' responses to COVID can't have been that bad, publicised experts' claims can't have been that bad, institutions' support for the overarching narrative can't have been that bad, media reporting about facts and context can't have been that bad... And that is where I lost faith in his ability of honest appraisal. Because the governments' responses to COVID were horrifically bad, publicised experts' claims were often terribly misleading, institutions' support for the overall narrative and approach was often completely antithetical to their previous functioning or purpose, mainstream media reporting was fantastically propagandistic. But because they are all holding together, even now, all these elite groups of society are carrying on as if their words and actions in the past two years were reasonable, rational, if perhaps a teeny bit imperfect, but certainly life-saving, humane and compassionate. Most of them probably actually believe it, reassured by the common response of their fellow elites.
Anyway, thanks for your articles, Alexandros!
Evolution of the discussion to this point leaves me sad. It mirrors the arc of real-life and professional interactions over the last dozen years or so, accelerating over the last 2+. My day job aka professional career is empirical analysis, and the universe within which that is meaningful shrinks daily.
The irony of a trial intended to bring people (drugs?) TOGETHER actually pulling people apart.
A strange turn of events on Fluvoxamine. I wrote about it previously and it seemed to have a multitude of MoA's, and to see the FDA now pulling a "whoopsie" actually should call the entirety of those trials into question, but if we do so then should we disregard those studies? The questioning of Fluvoxamine should at least indicate that we should not refer to those TOGETHER trials altogether.
Strange what's happening to this so-called Rationalist community. It seems like it's going the same way as that of the Skeptic community from a few years back during the Gamergate era. During the Skeptic community era it felt like many people knew what was going wrong culturally, but they weren't necessarily educated or informed in a manner to properly articulate the problems.
I wonder if many people who have taken an "unbiased" position are doing so because they aren't informed and would rather feign ignorance through ambiguities. I think Coleman Hughes is very smart, but that post at least suggests he's not sure what the science says and instead took a very broad position on the matter.
I don’t have much to add other than in anticipation of a possible lice exposure for my kids I went to the CDC to look up current recommended medications and found it hilarious to Ivermectin listed.
Im sure this is very old and they forgot to scrub it clean of the reference (they also refer to pregnant “women” instead of people so you know this article must have been last updated a very, very long time ago like 2018).
https://www.cdc.gov/parasites/lice/head/treatment.html
“Given as a tablet in mass drug administrations, oral ivermectin has been used extensively and safely for over two decades in many countries to treat filarial worm infections. Although not FDA-approved for the treatment of lice, ivermectin tablets given in a single oral dose of 200 micrograms/kg or 400 micrograms/kg repeated in 9-10 days has been shown effective against head lice. It should not be used in children weighing less than 15 kg or in pregnant women.”
"In the original article, Scott spent the first two-thirds of the text going through individual early treatment studies he found on ivmmeta.com one by one, keeping only the ones he found credible. He then removed a further six studies on the say-so of Gideon Meyerowitz-Katz, leaving him with a final set of 11 studies. Of these, he attempted a rudimentary meta-analysis, from which he got a p-value of 0.15. After tweaking the endpoints in an attempt to be more fair, he got a p-value of 0.04."
Why go to all this trouble? He could just throw a dice and keep a favorable to invemectin review only if it comes on 6.
Alexander's truculent refusal to attempt replication of his findings with more useful strategies is unsurprising, given how radioactive the subject has become.
Such reluctance is the logical outcome of casting a foundation in shifting sands. One must abide at the apex of an edifice so constructed, the toppling of which would unquestionably be injurious to the engineer that certified the soil analysis prior to setting the forms.
This rather disturbing aspect of human nature often relegates many of our best and brightest to the ranks of those whose best accomplishments are examples of spurious correlation defended by motivated reasoning.
Observing this is a timely reminder to "trust if you must, but verify to clarify."
Dr. Lawrie pressed Hill, "Could you please give me a name of someone in UNITAID I could speak to, so that I can share my evidence and hope to try and persuade them to understand it?
Dr. Hill evaded, "Oh, I'll have to think about who to, to offer you with a name...But I mean this is very difficult because I'm, you know, I've got this role where I'm supposed to produce this paper and we're in a very difficult, delicate balance...Yeah, it’s a very strong lobby..."
https://drtesslawrie.substack.com/p/a-letter-to-dr-andrew-hill?s=r
Its scary to me how easily we can get so cynical that we project nefarious motivations onto activity that would be natural, that would be baseline, that would be common sense. The part I'm talking about is:
'But what truly bothers me is that Scott denigrates something we’d expect every sane civilization that is hit with a novel disease to do: keep a public, live, meta-analysis tracking every single study on 42 different proposed treatments, and an even broader list of 837 proposed treatments for the disease, constantly updating with every scrap of evidence it can find anywhere, in favor or against any of these. Instead of providing feedback for how to do the job better, the message Scott seems to give is “give up, leave this up to the journals and the fraud detectives.”;
I'm going to try to remember it so if ever find myself doing it I'll know I've gotten too biased about something. Haters always get to a point where they hate someone for simply being. 'That band just plays some basic chord progressions and then adds some vocals...they suck' 'That player only makes the shots he makes' 'Oh that reciever, he only catches TDs' and the like
Per usual, you are being very generous here.
Cognitive bias affects all of us, but the facts have been clear, coupled with a not subtle media campaign against IVM efficacy and suggestive of IVM harm (how about those Emergency Departments overflowing with IVM overdoses?)
Add in the fact that virologist Andrew Hill is *on video* saying he changed his meta-analysis conclusions on IVM in response to pressure from his funder UNITAID…talk about a smoking gun.
In the face of all that and more, why would the obviously intelligent Scott Alexander continue to say that he still believes that the earth is the center of the solar system?
Cmon y’all. Your not a horse.
For Scott Alexander or Nick Mark etc it’s not a matter of adjusting their opinion based on new or re-analysed evidence, it’s more about saving face. They were so forthright with their opinions pre the Hill-Lawrie video that they now have painted themselves into a corner and can’t get out.
Ditto the FDA and similar regulatory bodies, who are also in fear of having to retrospectively compensate those who suffered or relatives of those who have died.
It seems to me at the very least IVM has some degree of benefit in treating Covid, irrespective of whatever studies or analysis is used.
The question is what’s next? What will it take for the opinion on IVM to be reversed?
Unfortunately, I feel the answer is nothing will ever happen. It’s somewhat of a tragedy and very unfair and those at the center of it will not get their comeuppance.
But at least you’ve tried and are continuing to try, we’re all grateful for that
Great article!
There’s something highly suspect about a rationalist “community,” as it implies an inherent groupthink. Any such confederation ought to be routinely disrupted by angrily tossed papers and overturned ink pots to have any merit, I think.
Rationality is a dead end.
Rationalism is merely an expression of rebellion against God. The problem is that no initial premises (beyond I think therefore I am which doesn't lead very far) can be derived by a purely rational process. And therefore, as successive generations of philosophers realize this, one inevitably moves from the rationalism of the early enlightenment, to Popper's critical rationalism to nihilism. And there you stay - believing in nothing at all. This is the root of Moloch if you like, and this is the exact process which Milton recognized and described in his immortal work. Without God there is no truth, no morality, and no knowledge at all.
And a man is nothing but his reputation, his pride, his works, hsi will and his power. And this he behaves in exactly the way you see here.
On the other hand, if one accepts the existence of God, then one can also have truth, morality, humility, and life eternal.