Effectiveness or otherwise of Ivermectin for early COVID treatment

2.5 hours?!
What’s the TL;DL version of it?

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We all wish there was a silver bullet.

Well, I’m only about halfway through, but I’ll give you the gist of it.

Kory is a frontline clinician who actually treats (or has treated) COVID patients. He is part of an international team developing best-practice protocols for COVID critical care, although the discussion focuses mainly on prevention of serious symptoms.

They kick off with a conversation about the nature of medicine and medical treatments, how it was practiced in the past, and how it has been increasingly co-opted by ‘suits’, reducing doctors to by-the-numbers functionaries. This situation arose from the idea of “evidence-based medicine”, which was initially a well-intentioned push to discard pointless or dangerous therapies, but which has ended up as an intellectual coup d’etat, taking away clinical judgments from those best placed to make those judgments.

There’s a short segment on the origins and pharmacology of ivermectin, which is very interesting in itself.

They then discuss the clinical experience of various doctors, in various countries, using ivermectin, and review some of the rough-and-ready evidence recommending its use.

It then gets into “why is this not being used?”, interwoven with a discussion of intentions, goals, and endpoints.

This segues into various observations about the vaccine strategy (and other expensive new drugs) and why that strategy might have drawn focus away from anything else that would be of conceivable value. They also discuss the incongruity of new, unknown and somewhat suboptimal technology being approved for emergency use, while a well-characterized drug is dismissed as irrelevant because “there isn’t enough evidence”.

They make the point that vaccine manufacturers may be afraid that ivermectin would (in theory) pull the rug from under Emergency Use Authorizations, but in fact it need not; precisely because it works in a different way, it could act as a very effective adjunct to vaccination programmes.

That’s about as far as I’ve got. Honestly, I recommend it to anybody, whatever side of the aisle you’re on. Both participants are extremely intelligent and accomplished men. They are not twitching-eyelid, tinfoil-hat wearing amateurs. They know their stuff, albeit from different viewpoints, and are exceedingly eloquent. They’re a pleasure to listen to even if you disagree.

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Summary: they make a strong case for the use of ivermectin in treating Covid. :grin:

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Well, I’ve watched the whole thing, and it’s pretty extraordinary.

The upshot of the story is that there is plenty of clinical evidence that ivermectin works, but because there are few (no?) “official” RCTs, ivermectin is being dismissed as useless. The reason there are no RCTs is pretty simple: clinicians in the US at least are forbidden to use it, or even to discuss it.

To be clear: even if a doctor wanted to offer the drug to selected patients on an experimental basis (with, of course, informed consent), he is not allowed to do so.

This amounts to telling doctors that they must let their patients die even if they believe there is a viable way to save them, and that they must under no circumstances attempt to advance the state-of-the-art if that would involve using ivermectin.

It’s hard not to ponder on that and deduce that something stinks.

If you’re going to accuse hundreds of experienced, qualified clinicians of making stuff up you really need a bit more to offer than “this all sounds too good to be true therefore they’re lying”. What you’re saying amounts to suggesting that these people are all involved in some sort of conspiracy. What possible motivation could they have for falsely suggesting that maybe this drug is useful? Do you seriously think that a cabal of evil doctors is determined to cause death and mayhem?

As for demonstrating the mechanism: who bloody cares what the mechanism is? Anesthetics were used for decades before anyone even had the faintest idea how they worked (and we still don’t really know how they work). Clearly, people had a bit more common sense back in those days. I can think of at least half-a-dozen drugs whose mechanism is unknown or only partially characterized. The idea that we shouldn’t use some medical intervention until we know precisely how it does what it does is insane. If it’s safe and it works, that’s all we need to know.

This particular red herring is discussed in the video. It turns out that officials are dismissing ivermectin not precisely because there’s no good evidence (there’s plenty of evidence), but because it’s not a magic bullet; it’s not a 100% sure-fire solution, ergo, it must not be used.

Kory is merely asserting that it’s another tool in the toolbox. TPTB are telling doctors that the only tool they’re allowed to use is vaccines.

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Sad, as it appears to be better than 70%, which is what some of the lower-class vaccines are running at in terms of efficacy.

If it turns out that these guys are right, it’s more than sad. It’s criminal. People are literally being left to die for ideological reasons.

This is barmy to me.

Why don’t they run large scale clinical studies to 'prove 'it’s effectiveness then ?

:man_facepalming:

Because they would be struck off, or worse, if they did. Watch the video. It’s very easy to mock people who are smarter than you if you choose not to even listen to what they have to say, which is basically what’s happening on a large scale here.

When you’ve watched the video (which will probably address most of the trivial objections you have), come back with whatever big guns you’ve got. There is certainly a small possibility that a few hundred frontline ICU doctors are mistaken, deluded, or conspiring to … uh, sell ivermectin to, um, gullible people for their own self-aggrandizement. But if you’ve spotted where the problem is, you need to address the actual argument being made here. Or at least go and read the papers by Kory, Marik, et al and describe the flaws therein.

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Why ?
Why whould they be struck off for running a clinical trial for ivermectin?

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It seems to me that sites promoting Ivermectin tend to be right-wing propaganda sites or health quackery sites.

Reputable sources advise against it.

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Note that this is the expected behavior if the benefit of a medication has not been proven yet.

If the FDA, … warn against using Ivermectine, they don’t say it’s useless or dangerous. They mostly say that this question hasn’t been researched enough yet, so they can only recommend against using it (outside of clinical trials).

If at some time, well-made clinical studies actually prove the usefulness of the medication, the regulatory bodies will probably change their opinion and might recommend usage. However, that also doesn’t mean that they have been wrong all the time and others have been right - it’s just the job of these authorities too be overly skeptical about any new medication, to protect the people!

So far, it seems that some small-scale studies might show some promising results, but we’re simply not at a point where the regulators have enough data to recommend widespread usage. So they can only warn against using it.

Developing medication takes lots of time and getting medication approved to treat a specific disease also takes lots of time. That’s not because “big pharma” or governments are following some evil agenda, but simply because the risks of taking a step like that. So right now, we just need to wait until more data is available.

All perfectly normal.

The problem is when people start to put false hopes in unproven medications in lieu of things that are shown to be effective: “I won’t bother getting vaccinated. If I get sick, I’ll just take Ivermectin.” (Or hydroxychloroquine, or whatever the fad cure-all du jour may be.)

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Let’s not be too quick to dismiss all of these cures.

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You can kill two birds with one stone.

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Exactly.

That is the point of the video. It’s the reason these two guys are discussing (among other things) WTAF is going on.

I really suggest listening to these guys. I know it’s 2hrs, but they’re not conspiracy theory nutjobs. Kory is just a doctor who wants to be left alone to do his job.

Blow out their backs, by all means, but don’t kill the poor birds. :open_mouth:

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Well, no, that’s exactly what it does show. Particularly if they’ve been making it very hard for trials to be conducted, eg., by making it hard for doctors to prescribe the drug or vilifying those who do. I think it’s important to point out that various State governors (in the US and internationally) have banned doctors from using it off-label.

You still haven’t explained precisely what people are being protected against. The drug is well-characterized and has an extremely low risk of adverse effects. So if someone has been hospitalized with a 5-10% chance of death, what level of “protection” [from bad decisions by doctors] do you think is appropriate at that point?

That is not the approach that has been taken towards vaccines, though, is it?

Kory and Weinstein have a little laugh over this point. Something along the lines of “well, I guess a pandemic isn’t serious enough to consider testing out a few different treatments.”

Nothing is being “developed” here. It’s a drug that’s been around for 40 years. There are also no (existing) rules about using drugs off-label if a physician thinks it’s justified and the patient consents. The rules have been enhanced specifically to make it hard for doctors to test novel treatments like ivermectin.

You might be less inclined to take that attitude if it were your relatives in the ICU.

Absolutely.

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So if I actually end up in the hospital, and my doctor actually decides to give me some viagra, because he has read online that it might help - don’t you see any ethical issue about that?

Every medical treatment is a form of bodily harm. However, the medical treatment is still ethical and good if its benefits outweigh the risks and downsides.

Where would be end up if every doctor could just randomly decide to try out some medication because he “feels like” it might help?

Sure, in some cases it might help - but in many cases it might not. That’s why random medical trials are usually illegal when not following very strict ethical boundaries!

So yes, I am totally against doctors running their own trials of “off-label products” without proper supervision!

There are already some treatments out there which are proven to work in increasing chance of survival. Not applying one of those treatments in favor of trying out an unproven one is also unethical!

Besides, as mentioned above, the dose of the medication would probably need to be much higher than the established safe doses.

Yes, it actually is. All the vaccines had to go through large scale studies with 1000s of patients before getting approved. (Unless you’re talking about China and Russia, of course!).

Yes, there are. Doctors are usually not allowed to prescribe random medication when the medication hasn’t been proven to be effective against the illness of the patient. Everything else is just quackery and highly unethical…

Actually, using a already established drug for a new purpose requires new studies. Has always been that way…

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No problem whatsoever as long as he gives me some private time with the nurses.

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