TripleWood posted this OP on AUG 21. My reply is the only one since.
I posted today, and Stump posted about an hour later- now tell me again how Stump ignores my posts.
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explain this, Stump
LOL She didn’t say 100% and wasn’t even suggesting prophylactic use.
74% is pretty strong
It can be effective for those who can’t get do monoclonal. It’s proven.
Read the tweets. Both studies ivermectin people cite were bs.
Is this recommendation for COVID or for parasites that are common to those origin countries?explain this, Stump
Still think Ivermectin is only for de-worming horses?
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Ivermectin is used to treat River Blindness caused by parasitic worms, etc.Is this recommendation for COVID or for parasites that are common to those origin countries?
Is this recommendation for COVID or for parasites that are common to those origin countries?
ARTICLE FROM 1989:This recommendation is for parasites, but the purpose of the document is to dispel the massive amounts of misinformation leading folks to ignorantly believe that this drug that won it's discovers the Nobel Prize, is primarily a veterinary medicine used to treat horses and cows.
I'm not pushing Ivermectin per se, but I do want to see ANY and ALL viable COVID treatments be given appropriate consideration.
Lastly, have we ever repurposed a drug before? Have we had an effective drug, that we later found would help with other diseases and pathogens that it wasn't developed for???
Are there studies out there that have impressed you and aren't dubious in nature / pre-print / etc.?The answer is that it improves the condition of some symptomatic patients ~75% of the time when used within the first 5 days.
It’s also not the #1 go to treatment but is an option for a certain subset of patients. Just like the vax, there’s not just one right answer. But to say “I don’t know” is ignoring a good amount of accurate information and growing amount of overwhelming evidence.
Are there studies out there that have impressed you and aren't dubious in nature / pre-print / etc.?
Whenever I get in tangles with Ivermectin proponents, it's never real data ... it's anecdotal ("I know a guy that got better") or #joerogan.
I'm lost on how any Ivermectin "data" could be "overwhelming" in the face of current ground-truth vaccine data.
Not a vaccine replacement. It’s an effective form of treatment for some symptomatic patients. Particularly those who for whatever reason aren’t candidates for monoclonal antibody treatments.
AGAIN…. Not a vaccine replacement or prophylactic medicine. But not a viable treatment option to be dismissed either.
From a local ID doc who has done a lot of reading and studying about all things covid
“The thing all writers do best is find ways to avoid writing.”
Ivermectin
Well, I’ve stalled long enough. I’ve been asked a million times lately to render an opinion on ivermectin, and I’ve kept putting it off because a) there’s a lot to cover, and b) people hang on to their beliefs about ivermectin like they cling to their favorite college football team! But I’m going to dip my toe in, and I expect to stir some people up with this one!
What is ivermectin? Before earlier this year, my profession was probably the only field in medicine that ever used the drug with any regularity, although (as we have all heard) the veterinary community uses a ton of the stuff. It’s an antiparasitic drug, and in the US, we use it almost exclusively for a human parasitic worm called strongyloides, and we use it for scabies. It’s a GREAT drug for both. For animals, it’s a worming medicine, including heartworms in your dog. But for people in the US, there just aren’t that many indications for usage.
As with many drugs, there are data showing “in vitro” antiviral activity for ivermectin. This means that in a laboratory setup, the drug stops some viruses. Extrapolating in vitro data into real-world effectiveness, though, is fraught with danger. Dumping a drug into a culture system does not take into account anything about human metabolism, drug degradation, interactions between the pathogen and the host, drug absorption, or any of the thousand other processes that determine a drug’s actual effectiveness. It also doesn’t take into account any potential side effects of the drug. For instance, if you put a little bleach in a viral culture system, it’s going to kill the virus. But a bleach injection would be nutty.
So anyway, when we started looking around for treatments for COVID, we started pulling out drugs that have had some in vitro antiviral activity. This is how we got on the HCQ highway early in the pandemic, and we also briefly tried nelfinavir (a drug used for HIV) before determining that neither drug offered anything for COVID. Then came the ivermectin craze, and it just won’t let up!
Let me say that I think a psychologist could make their career off of studying people and their though processes over the past 18 months, but this really isn’t a COVID-specific problem. With all of medicine, there is always a subset of patients who think that they have found some secret to treating a disease that is better than established medical care, or that “mainstream medicine” is somehow suppressing the truth about treatments. We see this in cancer therapy all the time, and we especially see it in diseases for which treatment doesn’t exist or is not very effective. Unscrupulous hucksters have forever been preying on people who are medically desperate. I’ll never forget one poor man I took care of who had well-defined Lou Gehrig’s disease, and yet some quack had soaked him to the tune of about $200,000 over a year treating him for “chronic Lyme disease.” My point is not to say that those pushing ivermectin are doing so for personal profit, but rather to say that, in times of medical uncertainty, we’re all receptive to someone offering a treatment. And in this case, it’s a drug we already use safely, and it’s cheap! So it seems like an attractive alternative when we don’t have a whole lot else to offer, and people want to cling to that hope.
Back to the ivermectin question: does it work? The answer is that I don’t know. There are some small, flawed studies showing some level of benefit, but the higher-quality the study (that is, how well was the study designed, was it appropriately randomized, were there enough patients, was it done in multiple locations, was the blinding solid, were the outcomes robust and measurable, and all of the other details that separate good studies from bad ones), the less benefit is seen from ivermectin. One of my colleagues noted that the more studies you have to do to prove something works, the less likely it is that it actually DOES work.
I’ll just mention one tragically funny episode in the ivermectin legacy. Back in November, a study from Egypt appeared on a preprint server showing enormous benefit from ivermectin, with over a 90% reduction in death. For those of you not familiar with the nuance of the medical literature (excuse me for a minute while I put on a tweed jacket and get my pipe and speak in hushed, reverent tones), here’s what this means. When a study is completed, it is written up in a standard format (think about those lab reports you had to write in high school science class) and submitted to a journal for publication. The journal’s editors look at the report, and if they like it, they’ll accept it and then send it out for “peer review.” This means that the editors identify other experts in the field, not connected with the authors or the study, and ask them to review the article and provide feedback. This would include looking at the data and seeing if it makes sense, if the conclusions drawn by the authors were supported by the data, and sometimes asking the authors to beef up their supporting data. There can be a number of re-writes of the article, based on this constructive criticism, before it is published. The peer review process is key, because often the final article that gets published is very different from what was originally submitted, but it is also a whole lot cleaner and hopefully less biased.
Back in the dark ages before social media, articles never had an opportunity to get in circulation before they were peer-reviewed and published, and there really wasn’t much market for raw studies. The peer-review process was recognized as a key ingredient to the validity of status of a study. But with COVID especially, releasing data on Twitter and preprint servers have become de rigueur, and as a result, a lot of crap has made it into circulation. Specifically this study from Egypt with its large numbers and dramatic results. They put it up on a server without any peer review, and the ivermectin world ate it up. It was cited in numerous other articles and included in several meta-analyses showing benefit of ivermectin (for those wondering what a meta-analysis is, it is where the data from a bunch of different studies are analyzed collectively in hopes that the larger data set will be more valid. It’s the Rumpelstiltskin alchemy: take a bunch of straw and spin it into gold, and it usually produces results of…questionable validity). Then in July, an English grad student really dove into the paper, and he found that most, if not all, of the data were fabricated, and the language in the study had largely been plagiarized from other articles and run through a thesaurus program. To invoke a different fairy tale, it was the Emperor’s New Clothes all over!
Again, I’m not accusing the ivermectin truthers of fabricating all of the studies, but I AM saying that the literature supporting ivermectin use is very shaky. I’m also concerned because none of the normal trial processes have been undertaken for ivermectin, so we don’t even know what an appropriate dose would be. Ivermectin docs are giving much higher doses than are given for worm infections, with some reports coming out about patients suffering significant side effects. And then there’s the issue of people using Secretariat’s worming medicine instead of human preparations. Even the FLCCC docs (big proponents of ivermectin) say not to use animal preparations!
So should you take ivermectin? I wouldn’t ever prescribe it for COVID, though some of my colleagues whom I respect do. I just don’t think there is enough evidence for it. If you’re dying to take it, try to find an actual clinical trial and volunteer to be a part of trying to answer the question of whether or not it works. In the meantime, get your vaccine, and keep masking and distancing. We know those work, and you won’t end up trying to bite the postman!
From a local ID doc who has done a lot of reading and studying about all things covid
“The thing all writers do best is find ways to avoid writing.”
Ivermectin
Well, I’ve stalled long enough. I’ve been asked a million times lately to render an opinion on ivermectin, and I’ve kept putting it off because a) there’s a lot to cover, and b) people hang on to their beliefs about ivermectin like they cling to their favorite college football team! But I’m going to dip my toe in, and I expect to stir some people up with this one!
What is ivermectin? Before earlier this year, my profession was probably the only field in medicine that ever used the drug with any regularity, although (as we have all heard) the veterinary community uses a ton of the stuff. It’s an antiparasitic drug, and in the US, we use it almost exclusively for a human parasitic worm called strongyloides, and we use it for scabies. It’s a GREAT drug for both. For animals, it’s a worming medicine, including heartworms in your dog. But for people in the US, there just aren’t that many indications for usage.
As with many drugs, there are data showing “in vitro” antiviral activity for ivermectin. This means that in a laboratory setup, the drug stops some viruses. Extrapolating in vitro data into real-world effectiveness, though, is fraught with danger. Dumping a drug into a culture system does not take into account anything about human metabolism, drug degradation, interactions between the pathogen and the host, drug absorption, or any of the thousand other processes that determine a drug’s actual effectiveness. It also doesn’t take into account any potential side effects of the drug. For instance, if you put a little bleach in a viral culture system, it’s going to kill the virus. But a bleach injection would be nutty.
So anyway, when we started looking around for treatments for COVID, we started pulling out drugs that have had some in vitro antiviral activity. This is how we got on the HCQ highway early in the pandemic, and we also briefly tried nelfinavir (a drug used for HIV) before determining that neither drug offered anything for COVID. Then came the ivermectin craze, and it just won’t let up!..................
Back to the ivermectin question: does it work? The answer is that I don’t know.
So should you take ivermectin? I wouldn’t ever prescribe it for COVID, though some of my colleagues whom I respect do.
I’m also concerned because none of the normal trial processes have been undertaken for ivermectin, so we don’t even know what an appropriate dose would be. (normal processes for the vaccine weren't undertaken either)
In the meantime, get your vaccine, and keep masking and distancing. We know those work (No, we don't)
You caught some of the stuff I was talking about, that so many others typically miss.
In the meantime, get your vaccine, and keep masking and distancing. We know those work (No, we don't)
LOL. Seriously.
agree, it was a dumb thing for the writer to say.
1. The vaccine works. Any belief that it doesn't, at this point, is devoid of reality.
2. To suggest *any* comparison between the efforts and brain power behind the mRNA / COVID vaccines and Ivermectin is laughable.
The mRNA / COVID vaccine did move fast, but it was because it was an "all hands on deck" effort. The fact that the United States put men on the moon is not diminished because other countries haven't been able to do it. We were simply the only people group with the resources and fortitude to make it happen.
Same with this vaccine. You can argue that it hasn't been proven yet if I'll grow a third arm out of my head, but the evidence that the vaccine keeps people from being hospitalized and dying is irrefutable.
Damn you're stupid.1) The vaccine does not protect against Covid. Vaccinated people still contract Covid. The vaccine allegedly alleviates severe symptoms. (I say allegedly because no one can say with certainty symptoms would be worse, or would have been worse, since no one can have AND not have the vaccine.
2) Ivermectin has been tested and available for use in humans for 35 years. The fact that the Coronavirus hasn't yet been isolated can attest to the enormous amount of "research" that has gone into Covid- a novel coronavirus that couldn't possibly have been fully tested, since "novel" indicates it's never existed before, and no long-term effects are possible to know. We do not even know the animal species the virus supposedly jumped from- we can only speculate it was a bat, but that foregoes the conclusion of many that it did not jump from an animal to a human.
In short, we don't know for a fact where it originated, how it originated, and if it were naturally occurring or lab created. We have not identified the species, and we have not isolated the virus. We do know that masks do not stop transmissions nor infections, we know outside contact is nearly non-existence, and we know double-vaccinated people can still contract Covid.
No, it has not been "proven". Proven would be 100% certainty, and you cannot predict with certainty the effect Covid will have on an individual, since all individuals react differently.
1. The vaccine works. Any belief that it doesn't, at this point, is devoid of reality.
2. To suggest *any* comparison between the efforts and brain power behind the mRNA / COVID vaccines and Ivermectin is laughable.
The mRNA / COVID vaccine did move fast, but it was because it was an "all hands on deck" effort. The fact that the United States put men on the moon is not diminished because other countries haven't been able to do it. We were simply the only people group with the resources and fortitude to make it happen.
Same with this vaccine. You can argue that it hasn't been proven yet if I'll grow a third arm out of my head, but the evidence that the vaccine keeps people from being hospitalized and dying is irrefutable.