Cont: Corona Virus Conspiracy Theories Part IV

[michaelsuede]

You do not know ivermectin is safe in Covid-19 until you do the studies. You may guess that because ivermectin is safe pre-Covid-19 when used to treat parasitic infections that it is safe to treat covid-19, but you do not know until the RCT has been done.

if you speculate that covid-19 affects virus-host interactions based on in vitro studies the actual real world impact can only be confirmed by properly planned studies.

There is not a vast body of high quality evidence of the efficacy of ivermectin for covid-19. It disappears as soon as you look at it.

If a properly powered RCT fails to show that there is not a significant effect you can be reasonably sure there is not a significant effect. In clinical medicine, one cannot just count up unpublished papers pro and con, you have to assess the quality power and relevance of studies. High quality, well performed, large studies fail to show an effect. Small, fraudulent, poor quality studies, show unbelievable results. You cannot say 6 terrible non-peer reviewed unpublished papers beat 4 good studies. Anyone who starts an argument in clinical science with the number of studies on one side versus the other has lost.

Anyone who uses an argument based on a fantasy about big pharma influencing the FDA has lost. The NHS easily deals with big pharma. Just look at the number of pharma companies who come to 'confidential' arrangements with the NHS when the NHS refuses to pay the price asked.

If a drug works, it works in a RCT. I do not disagree prospective cohort studies are good trials; but they are as good as RCT not better.

FWI you do the study appropriate to the intervention. For the 'parachute' study you would use a 'play the winner' study not a RCT. There is actually a lot of finesse in clinical research.

Given that billions of doses of ivermectin have been given out during this pandemic with no clear safety signals emerging, I'm pretty sure it's safe for COVID. You got 240 million in Uttar Pradesh getting boxes of this stuff:

While you continue to harp on RCTs, of which we have several dozen all showing benefit, we also have an entire Indian state wiping out COVID deaths after handing out those COVID kits to everyone.

Epidemiological data should not be dismissed. RCTs are not the end-all-be-all of medical research. I'm positive I could rig an ivermectin RCT to show no benefit by giving out low doses, selective recruitment, only giving it to late stage hospitalized patients, including patients on remdesivir in the ivermectin group but not in the control group, etc.. etc.. RCTs are good, don't get me wrong, but let's not ignore what epidemiology brings to the table.

 

[carlitos]

Neil Young had something to say to Spotify about that... "You can have Rogan, or Young... not both."
An ultimatum or pull his catalog. All of it.

Good on ya, Neil. [emoji2955]

I see that "only" half of his publishing was sold to investors, so maybe he can demand it be pulled from Spotify. Other artists won't have the luxury of doing something like this, since their publishing will have been long sold for big money.

• Bob Dylan (100% of his publishing catalogue to Universal Music Publishing) est. US$300-400 million. UPDATE: On January 24, 2022, Sony acquired his master recordings. That’s worth another ~US$200 million.
• Neil Young (50% of his career catalogue to Hipgnosis), est. US$150 million
• Stevie Nicks (a majority stake in her songs to Primary Wave), US$100 million
• Imagine Dragons (everything they’ve done up until now), US$100 million
• Whitney Houston (her entire catalogue to Primary Wave), price undisclosed.
• David Crosby (everything he’s done to Hipgnosis), price undisclosed.
• Disturbed (entire catalogue to Primary Wave), price undisclosed
• The Killers (all releases up until 2020 to Eldridge Industries), price undisclosed
• Lindsey Buckingham (his Fleetwood Mac songs along with his solo material), price undisclosed
• Barry Manilow (entire catalogue to Hipgnosis), price undisclosed

 

[carlitos]

Interesting stats from NYC - vaccinated were MUCH less likely to test positive for Omicron:

[IMGw=500]https://pbs.twimg.com/media/FJ90cRfWYAQeP5f?format=jpg&name=large[/IMGw]

 

[Skeptic Ginger]

Before heading down the Ivermectin rabbit hole, it may be worth listening to this podcast.

This goes very into the weeds, but the TL;DL is that the meta-analyses rely on a few large studies to generate large outcomes for ivermectin, and these have very serious question marks over their reliability. In fact, some are probably outright fraudulent research and have been retracted.

Once you remove studies with a high level of bias there seems to be little left.

Link

One of the people on the pod is an epidemiologist who has his own Medium articles here.

I'm not down the rabbit hole. Don't think I wasn't on the 'ivermectin is quack medicine' train until today.

Much as you'd like to think I am, I'm not stupid. And I know how to read the medical literature without a podcast to interpret it for me.

Also, there are multiple meta-analyses, not just one. And I posted my concerns about the research along with a couple of boxes of popcorn waiting for more evidence to be posted.

Unlike some people, I'm capable of actually changing my position when the evidence supports a change. And you can't say it doesn't just because you listened to a podcast. I don't see anything refuting all the evidence that is out there and cited in this thread.

Re the sources cited in your podcast: Link one: preprint, the kind you are always handwaving off.

Link two: close to a year old.

Link three: looks at a single dose.

Link four: that's one of the meta-analyses but it isn't the only one cited in this thread.

 

[Skeptic Ginger]

The reference was to 'any western government' I did not think the reference meant the governments of California, Oregon and Washington.

You cited an NHS guideline, did you not? it's not applicable in the US in any state.

Re meta-analyses.
Considered them mostly crap. They include fraudulent studies. Stick to the cochrane collaboration, they at least have expertise in meta-analysis.

I suppose you read every study in them?

Keep in mind the WHO has not determined ivermectin to be useless, they merely state it only be used in RCTs (or some other legit trials).

If there is a Cochrane review on ivermectin, by all means cite it.

 

[Skeptic Ginger]

Given that billions of doses of ivermectin have been given out during this pandemic with no clear safety signals emerging, I'm pretty sure it's safe for COVID. ...

That's not true. People taking ivermectin on their own have had serious medical consequences.

 

[michaelsuede]

That's not true. People taking ivermectin on their own have had serious medical consequences.

That's actually not true. That was all spin by the media.

TRUTH: poison control center calls for ivermectin went through the roof

ALSO TRUTH: virtually none of the calls were for overdosing, they were for information on proper dosage instructions.

Ivermectin is orders of magnitude safer than any NSAID.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133431/

Ivermectin has a wide therapeutic index and previous studies have shown doses up to 2000 mcg/kg (ie, 10 times the US Food and Drug Administration approved dose) are well tolerated and safe; the highest dose used for onchocerciasis is a single dose of 800 mcg/kg.

Typical COVID dose is 200 mcg/kg up to 600 mcg/kg for the hard cases.

Typically pills come between 3mg to 12mg, so overdosing requires a lot of pills to be consumed.

Here's another one https://pubmed.ncbi.nlm.nih.gov/17234315/

Similarly the LD(50) of around 50mg/kg indicated a wide margin of safety (250x) considering therapeutic dose of ivermectin as 200microg/kg.

 

[angrysoba]

Has anyone mentioned Uttar Pradesh yet? Or Japan?

Given that billions of doses of ivermectin have been given out during this pandemic with no clear safety signals emerging, I'm pretty sure it's safe for COVID. You got 240 million in Uttar Pradesh getting boxes of this stuff:

[qimg]https://cdn.substack.com/image/fetch/w_1100,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2F322f2c7c-2831-43be-bd47-5a7e47ffcb1c_480x640.jpeg[/qimg]

While you continue to harp on RCTs, of which we have several dozen all showing benefit, we also have an entire Indian state wiping out COVID deaths after handing out those COVID kits to everyone.

Epidemiological data should not be dismissed. RCTs are not the end-all-be-all of medical research. I'm positive I could rig an ivermectin RCT to show no benefit by giving out low doses, selective recruitment, only giving it to late stage hospitalized patients, including patients on remdesivir in the ivermectin group but not in the control group, etc.. etc.. RCTs are good, don't get me wrong, but let's not ignore what epidemiology brings to the table.

Link

Ivermectin Didn’t Save Uttar Pradesh From Covid-19

The issues with claims about ivermectin is that a) there are 250 million people in Uttar Pradesh, but there were probably only, at best, 5 million medical kits, b) Utttar Pradesh used various interventions including lockdowns, quarantining etc... c) ivermectin had been in use for a long time, so there is no reason to assume that the spike in cases, followed by the sudden decline, was attributable to an ivermectin intervention and d) data from Uttar Pradesh is probably not very reliable anyway.

Plus, why would it be massively successful in only one state in India? In fact, it seems the rest of India went through a similar spike and fall. But because no reports came out about ivermectin being used outside of Utttar Pradesh, it is ignored by cherry-pickers among the FLCCC.

 

[angrysoba]

I'm not down the rabbit hole. Don't think I wasn't on the 'ivermectin is quack medicine' train until today.

Much as you'd like to think I am, I'm not stupid. And I know how to read the medical literature without a podcast to interpret it for me.

Also, there are multiple meta-analyses, not just one. And I posted my concerns about the research along with a couple of boxes of popcorn waiting for more evidence to be posted.

Unlike some people, I'm capable of actually changing my position when the evidence supports a change. And you can't say it doesn't just because you listened to a podcast. I don't see anything refuting all the evidence that is out there and cited in this thread.

Re the sources cited in your podcast: Link one: preprint, the kind you are always handwaving off.

Link two: close to a year old.

Link three: looks at a single dose.

Link four: that's one of the meta-analyses but it isn't the only one cited in this thread.

Sorry, could you tell me the best evidence for ivermectin?

Please cite the best study that you can find.

 

[Jim_MDP]

I see that "only" half of his publishing was sold to investors, so maybe he can demand it be pulled from Spotify. Other artists won't have the luxury of doing something like this, since their publishing will have been long sold for big money.

Good catch, hope he has some pull left and ain't shootin' blanks. Prop lawyers are truly sharks.

Damned odd coincidence between a love of mine, a Stevie look-alike, and my coffee table book of Roger Dean album artwork produced by Hipgnosis, that she "melded" with a spilt candle.
[emoji57]

 

[marting]

Most current review I've found. Jan 19 2022, online ahead of print.

Ivermectin in COVID-19 Management: What is the current evidence?

https://pubmed.ncbi.nlm.nih.gov/35043770/

Abstract:
Ivermectin (IVM), an approved anthelminthic drug, has been reported to have antiviral, antibacterial, and anticancer activities. Antiviral activity is due to the inhibition of nuclear cargo importin (IMP) protein. The anti-SARS CoV-2 activity through in vitro study was first reported by an Australian team. Later, many studies were conducted, and most of the study results were available as non-peer reviewed preprints. In this narrative review, literature on the clinical studies conducted with ivermectin from published articles, preprints, and unpublished evidence are collected till 13th June 2021 and they are discussed based on the severity of COVID-19 disease. Out of the 23 peer-reviewed published articles, 13 studies were randomized controlled trials and the remaining were either prospective interventional, prospective observational, retrospective cohort, cross-sectional, or case series type of studies; additionally, there were 10 randomized controlled trials available as preprints. In most of the studies, ivermectin was used in combination with doxycycline, azithromycin or other drugs. Some of the studies suggested either higher dose and/ or increased duration of ivermectin use to achieve favorable effects. In this review, articles on the prophylactic role of ivermectin in COVID-19 are also discussed - wherein the results are more promising. Despite accumulating evidence suggest the possible use of ivermectin, the final call to incorporate ivermectin in the management of COVID-19 is still inconclusive.

The TOGETHER trial, which was a high quality DBRCT, discontinued IVM testing for lack of efficacy. However, Fluvoxamine looks promising and they are investigating refinements with additional treatments.

Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial

https://www.sciencedirect.com/science/article/pii/S2214109X21004484

Findings
The study team screened 9803 potential participants for this trial. The trial was initiated on June 2, 2020, with the current protocol reporting randomisation to fluvoxamine from Jan 20 to Aug 5, 2021, when the trial arms were stopped for superiority. 741 patients were allocated to fluvoxamine and 756 to placebo. The average age of participants was 50 years (range 18–102 years); 58% were female. The proportion of patients observed in a COVID-19 emergency setting for more than 6 h or transferred to a teritary hospital due to COVID-19 was lower for the fluvoxamine group compared with placebo (79 [11%] of 741 vs 119 [16%] of 756); relative risk [RR] 0·68; 95% Bayesian credible interval [95% BCI]: 0·52–0·88), with a probability of superiority of 99·8% surpassing the prespecified superiority threshold of 97·6% (risk difference 5·0%).

 

[angrysoba]

Most current review I've found. Jan 19 2022, online ahead of print.

Ivermectin in COVID-19 Management: What is the current evidence?

https://pubmed.ncbi.nlm.nih.gov/35043770/

Interesting, but it seems the abstract is the only thing available and we cannot know which papers are being discussed.

However, there is a red flag for me:

Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.

Remember that this is the same company that published Steve Jones's 9/11 Truther paper.

Bentham Open journals employ peer review;[8] however, a fake paper that was generated using SCIgen in 2009 was accepted for publication, though it was never officially published in any of Bentham's journals - and the publisher contends that the acceptance was an attempt to catch the author who submitted the paper.[9] Another SCIgen generated fake paper submitted to the Open Software Engineering Journal in 2009 as part of the same operation was rejected by the publisher after peer review.[10][11][12]

Bentham Open was accused of spamming scientists with invitations to become members of the editorial boards of its journals in 2008,[13] prompting the fake submission.[11] The emails sent by Bentham included invitations to the editorial board of subjects where the recipient had no expertise.[11] In consequence, some editors quit the collaboration with Bentham.[10][12]

In 2009, the Bentham Open Science journal The Open Chemical Physics Journal published a study contending dust from the World Trade Center attacks contained "active nanothermite",[14] a well known 9/11 conspiracy theory. Following publication, the journal's editor-in-chief Marie-Paule Pileni resigned stating, "They have printed the article without my authorization… I have written to Bentham, that I withdraw myself from all activities with them".[15]

In a July 2009 review of Bentham Open for The Charleston Advisor, Jeffrey Beall noted that "in many cases, Bentham Open journals publish articles that no legitimate peer-review journal would accept, and unconventional and nonconformist ideas are being presented in some of them as legitimate science." He concluded by stating that "the site has exploited the Open Access model for its own financial motives and flooded scholarly communication with a flurry of low quality and questionable research."[16] Beall has since added Bentham Open to his list of "Potential, possible, or probable predatory scholarly open-access publishers".[17]

In 2013, the now-discontinued The Open Bioactive Compounds Journal was one of the journals that accepted an obviously bogus paper submitted as part of the Who's Afraid of Peer Review? sting.[18]

In a 2017 study of invitation spam by publishers, Bentham Open was one of the most frequent invitation spammers.

I think I will wait to see what papers they looked at.

 

[marting]

Interesting, but it seems the abstract is the only thing available and we cannot know which papers are being discussed.

Remember that this is the same company that published Steve Jones's 9/11 Truther paper.
I think I will wait to see what papers they looked at.

The TOGETHER trial had a presentation last year where they discussed IVM and Fluvoxamine. IIRC, they saw a very small indication that IVM had some effect (10% or so) that didn't reach statistical significance or their own criteria for continuing. OTOH, Fluvoxamine does look promising. Roughly similar to Merck's drug at 30% improvement. Couple orders of magnitude cheaper though. Pfizer's new drug is great but has contraindications that will limit it in addition to low availability.

TOGETHER does a really good double blinded RCT and report results based on "Intention to treat" rather than just the results of adherence to protocol. The former is considered the gold standard of RCTs.

There are other quality RCTs currently going on for many generics including combos and some with IVM. Haven't seen any compelling results at this point.

 

[angrysoba]

The TOGETHER trial had a presentation last year where they discussed IVM and Fluvoxamine. IIRC, they saw a very small indication that IVM had some effect (10% or so) that didn't reach statistical significance or their own criteria for continuing. OTOH, Fluvoxamine does look promising. Roughly similar to Merck's drug at 30% improvement. Couple orders of magnitude cheaper though. Pfizer's new drug is great but has contraindications that will limit it in addition to low availability.

TOGETHER does a really good double blinded RCT and report results based on "Intention to treat" rather than just the results of adherence to protocol. The former is considered the gold standard of RCTs.

There are other quality RCTs currently going on for many generics including combos and some with IVM. Haven't seen any compelling results at this point.

Yes, I certainly think that the TOGETHER trial is good evidence.

I certainly hope that fluvoxamine starts to be used more than it is.

 

[Skeptic Ginger]

Sorry, could you tell me the best evidence for ivermectin?

Please cite the best study that you can find.

Why should I?

 

[angrysoba]

Why should I?

Sorry, but what are you trying to do in this thread?

You don't want to talk about Paul Marik, despite the fact that this is a thread about him.

Sorry, I don't give a **** about Marik. It sounds like he can take care of himself. He's not the only doctor who has suffered for using non-evidence supported COVID treatments.
What I do care about is the evidence ivermectin treatments work or don't work. I appreciate your citations on that. I am leaning toward: we need to reevaluate that in the medical community. That's going to be a seriously uphill battle given ivermectin is already in the quack medicine category.

By the way, except for probable denial of insurance coverage, healthcare providers with prescriptive authority in the US can prescribe FDA approved drugs for off-label purposes. We don't need special FDA approval.

So, you only want to talk about ivermectin. When I ask you about it, you don't want to post the evidence that supports its use.

It is very confusing understanding what you want to discuss, and how people are supposed to discuss it.

If you don't present the best evidence for ivermectin, and you don't want to talk about Marik, what are you doing in this thread?

 

[The Great Zaganza]

[qimg]https://i.imgur.com/4voB7tN.png[/qimg]

[qimg]https://i.imgur.com/e0oYYNk.png[/qimg]

ETA - An "abbreviated list" of podcast appearances by Dr. Robert Malone

And they still complain about being silenced....
Cognitive dissonance is a survival trait of theirs.

 

[Skeptic Ginger]

Sorry, but what are you trying to do in this thread?

You don't want to talk about Paul Marik, despite the fact that this is a thread about him.

I plan to start a new thread tomorrow when I have more time and energy because it's not my intent to hijack this thread. My apologies to michaelsuede.

As for what am I trying to do, I want to have an evidence based discussion on the evidence for or not for ivermectin. There appears to be an awful lot of evidence in the last year that warrants a fresh evaluation, hopefully from a more neutral position.

So, you only want to talk about ivermectin. When I ask you about it, you don't want to post the evidence that supports its use.

It is very confusing understanding what you want to discuss, and how people are supposed to discuss it.

If you don't present the best evidence for ivermectin, and you don't want to talk about Marik, what are you doing in this thread?

What I don't want is a discussion one on one with you. Why do you think my goal would be to convince angrysoba that there is evidence supporting the use of ivermectin?

I'm more than willing to address the MULTIPLE meta-analyses on the use of ivermectin. I mentioned my biggest concerns:

In post #21 I said: "It would be very convenient and relieving to find said meta-analyses all have flaws."

In post #19 I said, "I'm concerned all the research is from countries outside of the 'Western medicine' realm. But beyond that, it looks like it might be time to revisit ivermectin use in COVID."

In none of my posts in this thread have I said or implied: "Hey guys, this stuff works."​

I'm not here to present the best evidence for ivermectin use. I'm here to discuss the evidence both pro and con. And I don't find the blanket claims convincing that the all positive evidence is fraudulent or otherwise flawed.

 

[Bubba]

You think vaccines are killing people based on deaths that are unreported,*

No. Not dot deaths that are unreported (that would defeat the claim ie its a lame misrepresentation of what I said).


I said Deaths that are wrongly reported as caused by something other than the injection, when it was the actual cause of death.


And you, or anyone cannot know how many times that has happened.


*Wouldnt it be you that attempts to revise something I said, again.

 

[Cosmic Yak]

No. Not dot deaths that are unreported (that would defeat the claim ie its a lame misrepresentation of what I said).


I said Deaths that are wrongly reported as caused by something other than the injection, when it was the actual cause of death.


And you, or anyone cannot know how many times that has happened.


*Wouldnt it be you that attempts to revise something I said, again.

Then you don't know how many times that has happened, so what's your point?

There are, of course, plenty of ways this could be discovered, and these have been pointed out to Bubba, but it's water off a duck's back to such entrenched ignorance, really.