A potential Covid-19 treatment has become hostage to a larger global fight between populists and anti-populists
I think you're down playing the ample data on Ivermectin. You didn't address the recent meta-data analysis showing the efficacy of Ivermectin for both treatment and prophylaxis. As Weinstein, Kory and countless highly reputable doctors and researchers have stated, the call for a big-budget, large scale study seems unnecessary in light of all the data coming in from around the globe, and impractical given the limited time we have with respect to virus spread. The squashing of Ivermectin as a covid prevention is, to me, notably egregious especially as more and more news of variant breakthrough infections comes in. As Weinstein points out in the Rogan interview, the inventor of mRNA tech admitted that if a national Ivermectin protocol were put in place the virus could be eradicated. That may sound hyperbolic (and unfeasible) but should at the very least, promote an open and honest discussion about the efficacy of Ivermectin and other repurposed drugs, rather than the myopic hawking of brand new, relatively untested vaccine technology as the sole solution.
The evidence for ivermectin and fluvoxamine is a hell of a lot better than it ever was for remdesivir, yet somehow the expensive on-patent drug that requires a hospital stay got pushed a lot harder by everyone in charge.
The pharmaceutical companies appear to have fully captured the regulatory process, the media (with massive sums spent on advertising), and the medical journals which are instrumental in the peer review process. I simply cannot come up with another explanation that covers the full breadth of resistance to using it even trying safe and well understood drugs that happen to be off-patent. The Argentinian results on ivermectin alone are sufficient reason to prescribe it given its safety profile.
The mention of Merck downplaying ivermectin is particularly aggravating because even though they developed it, they stand to lose money if it gained acceptance over their on-patent drugs and their co-development of the J&J vaccine.
This fiasco should be a wake-up call to the entire medical industry that the system is broken and ethics are practically non-existent. And I say that as someone who wholly opposes socialized healthcare (Although I think the CDC has completely justified my resistance to it in the past year).
Regardless of whether it has been conclusively shown to help with Covid or there are only indications it might help, ivermectin has been widely prescribed for decades with minimal adverse reactions. I don’t see why doctors shouldn’t prescribe it prophylactically like they do all kinds of things that might help and almost certainly won’t hurt, like taking daily low-dose aspirin as a blood thinner for people with heart disease or hypertension. The fact that the medical establishment is so against it while obfuscating exactly why seems suspicious. I have read speculation that if ivermectin is effective at treating Covid it would interfere with the emergency use authorizations for the (very lucrative) vaccines, so maybe that’s the reason.
Matt: I have virtually attended several conferences featuring the doctors and researchers who either conducted Ivermectin studies or who are utilizing it in practice. I have been following the Ivermectin story since April of last year, when I first heard about it from an educational (not fringe) YouTube channel called MedCram. The doctor who mentioned Ivermectin in those videos is a quadruple board certified M.D. and professor of medicine at Riverside in California. There are many, many highly credentialed doctors from all over the world touting the benefits of Ivermectin. So how do you reconcile the support and advocacy of all of these big medical brains (and all of the published studies) with this being a DIY populist movement? I would have never chosen to take Ivermectin as a prophylaxis (the human kind, prescribed by a doctor and not a veterinarian) if not for the doctors and scientists supporting it. By the way, I am a pretty lefty person who became disillusioned with "my people" during the pandemic. They were on the wrong side of so many things, including this.
I graduated from nursing school 45 years ago and have had a front row seat to observe the deterioration of medical care -- all of it -- from the compromised ethics of doctors (no, not all of them), the gouging of patients for life saving drugs, crippling insurance rates and co-pays and ridiculous hospital charges. The profit motive, belief that in every case they are NEVER to be questioned and, sorry to say, a lack of empathy that is directly related to the time spent face to face with the patient.
I'll give you an example -- an elderly man was admitted to our unit after a suicide attempt. His family doctor sent word by his son that he had been put on a certain antidepressant drug recently and was concerned it had had an adverse effect. I showed the note to his physician and rather than discussing this with the patient and the family, arrogantly doubled the drug. His reason? "They don't know what they're talking about." It doesn't take too many encounters like this for people to lose faith.
I am an internist in fly-over country here in the USA.
Here in my community, we had our big surge of COVID patients and tragedies in the NOV-JAN time frame this past winter.
I will say right up front - I trend toward being a liberal DEM. I had been reading about this drug Ivermectin for months beforehand. I was initially incredulous - this is a worm pill for God's sake. However, after I read the paper from Argentina and about its effects in health care workers ( the paper seemed to demonstrate overwhelmingly positive results as far as prophylaxis), I changed my practice and my mind. At this point, the safety profile of this drug is absolutely overwhelmingly positive - very very safe - and it seemed to me ridiculous to withhold it. Indeed, the medical ethics enshrined in the Helsinki Declarations make it IMPOSSIBLE for physicians to withhold this drug at this time.
So, as our community began to get slammed - I began to hand it out to everyone who was positive - to all their family members and contacts - and to those who wanted prophylaxis. Not one safety issue arose the whole time ( this is something I cannot say about the vaccines which have yielded one death, and 3 hospitalizations and multiple dozens of other minor issues in my practice). And the efficacy results were dramatic. The patients entering the hospital from my practice crashed in just 2 weeks. If you look at other physician's practices in town as control groups - the effect on hospitalization was just amazing. To the point that the hospital admin began to look into my practice to see what I was doing. (They were running out of beds and in a panic).
Was it perfect? ABSOLUTELY NOT - there were still patients who got sick. Did it seem to have an effect - ABSOLUTELY - when compared to other docs around me. And not to mention another fact. In surrounding rural counties, there has been large and widespread use of veterinary ivermectin among large swaths of the population. This has not been true in the county in which I live. Those surrounding counties had huge decreases in patient case numbers, deaths and hospitalizations. At times dramatically so. ( I AM NOT ADVOCATING THE USE OF VETERINARY IVERMECTIN - it is tragic that in the middle of a pandemic like this that people have had to resort to that - I view that as a stain on my profession).
When docs are honest with themselves and their colleagues - these types of outcomes are happening. This drug has an amazing safety profile. At least in my experience and what I am seeing around me as outlined above - it is dramatically more efficacious than anything we have available - the risk benefits are overwhelmingly positive - even more so than the vaccines - and we should be using this without abandon. Screw the RCT - that can come later.
It is a tragedy of the ages - that this kind of stuff has become politicized. I am old enough to have been a young doc in the AIDS epidemic. Back then in the 80's, these kinds of things bubbled up from the troops on the ground all the time - and pissed off the NIH masters ( Bactrim for PCP is but one example) - however we did not have Rachel Maddow and Sean Hannity yelling lies at the American public in that era - and medical treatment remained in the realm of medicine and not litigated by the clowns on cable TV and the NYT every day. Our media and CDC/FDA were not nearly as captured by Big Pharma as they are today.
I will keep right on using Ivermectin for my patients. The COVID positivity is already on the way up in my little area - even among the vaccinated. There are those of us who still need to take care of our patients. The rest of these charlatans I am hoping are going to rot in hell one day for what they have done - that especially applies to the Zuckerbergs of the world who are kneecapping our ability as professionals to discuss these issues with our colleagues.
This has not been a good look for America - we can do so much better.
I'm a life long liberal who has basically always voted Dem, but would put myself squarely in the "untrust" camp when it comes to the medical and pharmaceutical industrial complexes. There is so much corruption and perverse incentives baked into the American system that it is impossible to trust.
When I was diagnosed with Crohn's disease, my mindset was to do everything the doctors told me to do. I simply did not have the time and energy to do my own research, so I placed my trust firmly in their judgment and expertise. I was put on a series of harmful drugs, culminating in a prescription for Humira, a self-injectible drug with a sticker price of around $30,000 per year. None of these drugs did anything to improve my symptoms, and all of them came with considerable side effects, including increased cancer risk. I was then referred to a surgeon to have part of my intestine removed.
Desperate by this point, I turned to the "quacks" on the internet and adopted a new-agey and not-at-all researched protein-powder liquid diet that my doctor specifically told me would not work. Guess what? It worked. I avoided surgery and now do not take any drugs for my condition. I treat myself with alternative non-pharmaceutical approaches based on my own research, and it has turned out to be a far safer and more effective way to go.
All of the incentives of the American for-profit medical and pharmaceutical industries are in favor of expensive drugs and invasive procedures. That is how they make money. There is no financial incentive to invest in research into less invasive and less expensive medical and lifestyle interventions. I am now seeing the same dynamics playing out in the COVID response, with predictably disastrous results. I am pro-science and pro-data, but the corruption behind what data is collected, how it is coded, what experiments are run, where research grant money flows, etc., is so obvious that I cannot trust the existing American system. When people say "listen to the science," they are really saying "listen to the money." There is also now a bizarre layer of authoritarian thinking and tribalism sweeping through these institutions that further undermines their claims to be engaging in anything resembling impartial science. The censorship deepens my mistrust further still.
Despite my distrust, my initial reaction was to get the first approved COVID vaccine I could get my hands on. However, because I now live in a developing country with limited vaccine availability, I still have not had the opportunity to get the vaccine. This time for further reflection and accumulation of further evidence has pushed me towards the socially unacceptable category of "vaccine hesitant." Like with my Crohn's disease experience, I now believe it quite possible that there is a less invasive, less dangerous, less expensive, and possibly more efficacious way to gain resistance to this virus. Ivermectin may be just that. Thankfully countries outside of the U.S., including the vaccine-poor country in which I currently live, are taking that option seriously and conducting RCTs. I will follow the evidence and the science, not the corrupt American institutions.
The collapsing confidence in the professional, aka expert, classes was a long time in the making and long predated Trump. It is actually one reason why Trump was elected. The growing perception that the technocracy who rules Western societies are no longer really serving the people who voted for them or who placed them in positions of responsibility, and instead have become adherents to a different kind of outlook in life, an outlook that tells them it's justified to bend the rules and expectations of a liberal democracy "in the name of the greater good."
Nor is it unique to America. It's the mindset that caused European governments to successively overrule referendum outcomes to sign up to closer EU integration. It's the mindset that went berserk when Britain voted to leave the EU. It's the mindset that completely lost it when Hillary Clinton lost to Donald Trump. It's the mindset that swept through the scientific community surrounding the emergence of COVID-19, who immediately pivoted to the natural outbreak rather than lab escape despite plenty of circumstantial and even scientific evidence it could very well have been a lab escape. It's a mindset that embraces control of information in the name of good. It's a mindset of a technocracy that does not trust, and increasingly dislikes, the people it ostensibly rules.
One of the hallmarks of a liberal democratic society was trust in the people - that the people were trusted to accept the information available and make their own decisions and to be responsible voters, and it did rest upon the acceptance that people were educated and intelligent enough to handle this responsibility. This was what separated liberal democracies from the populist democracies and was one of the great praises of American democracy. It certainly wasn't perfect as no society is, but until a few years ago no one ever questioned the right of the American people to know just about anything to be known.
Suddenly we've been thrusted into an age of censorship and dogmatic political correctness. Why are Americans not trusted to know about ivermectin? Why did the technocracy feel justified in withholding information on a relatively benign drug that could potentially save lives. It's because the technocracy no longer trusts, respects or likes the people it rules and instead sees them very much as obstacles and even an enemy to their own interests. That's why we have a government that wants a commission on January 6 but refuses a commission on the Wuhan lab.
It will be interesting to see how this all plays out.
I live in a Canada, working In one of the Covid epicentres. A friend and doctor has been treated myself and a select group with Ivermectin as a prophylactic to covid. He is brave and also scared shitless of the consequences of getting caught. But it won’t stop him. He is sure and so are we that it has saved us. A surgeon in Saskatchewan has been stripped of his job for cautioning against the vaccination of children. I am devastated at the state of discourse on our continent. I feel our institutions have been captured(Brets term) by forces so beyond my understanding and control that I feel unmoored from my country.
The Ivermectin question is quite simple, so let's not wade too far into the weeds. Ivermectin has a safety profile that far exceeds, let's say, Tylenol, even though you can buy Tylenol over the counter. We have taken prescribed pharmaceuticals with far more significant side effects for uncomplicated diseases than this pandemic that could kill us. Ivermectin won the Nobel Prize for medicine in 2015, improved the lives of 3.4 billion people worldwide, and has an excellent safety record. It's that simple when you or I or grandmother is dying from Covid. I graduated from university in the 80s and have always been a far-left progressive, far-left of how Obama governed, but this is beyond the middle, right, and left; we must discuss the science of Ivermectin, fuck politics. Media, politics, "journalists," not you, Matt, and corporations are not functioning normally, LOL, something else is happening, and we must understand and change this trajectory concerning science.
It has been mind boggling to witness how politicized literally everything about Covid has been. By far the weirdest has been how otherwise intelligent people have allowed Trump to continue to live rent free in their minds. TDS has caused them to lose the ability to reason. The very idea that the potential efficacy of a drug must be demonized because Trump or Ron Johnson thinks it might be beneficial, rather than analyzing the drug on its merits, is amazing. I don't pretend to know what drugs will or won't work, but this kind of shallow "thinking" is dangerous.
I'm a big fan of Matt, but I do think that he's got this one a bit wrong.
"Should the entire world be allowed to practice self-care on a grand scale? That’s a different issue."
It's a different issue--and indeed, it's not the issue here at all. Ivermectin prescriptions are allowed "off-label." Off-label prescribing is a time-honored tradition that allows doctors to prescribe drugs with known safety profiles if they think it might help a condition for which it was not initially approved; think Botox for migraines. 20% of all prescriptions in the USA are off-label, so it's not uncommon. What is uncommon is a regulatory agency stepping into say "doctors cannot prescribe use this product off-label for this specific off-label use."
Additionally, off-label drugs still must be prescribed by a physician. Suggesting that this amounts to "self care on a grand scale" really only makes sense if you define "self care" as "doctors making decisions that are in any way independent of the guidelines set out by regulatory bodies like the CDC." Maybe that kind of top-down approach appeals to some people, but as someone with ME/CFS where the official recommendation was, for years, not only unhelpful but downright dangerous, I have a hard time imagining a worse way to practice medicine. If I'm going to be subject to a potentially harmful procedure, at least give me some choice in the matter!
Finally, as others have mentioned, Ivermectin is probably safer than Tylenol. Heck, unlike with tylenol I don't think you could kill yourself with a bottle of Ivermectin taken all at once (iirc it took 40 mg/kg body weight of ivermectin to kill dogs, and the recommended dose is 0.2-0.4 mg per kg, so you'd need to take 100X the high dose to kill yourself, whereas with Tylenol liver injury becomes possible a little over 4X the recommended dose).
So on the policy front, this is really a fight between those who believe that people should be allowed to make some basic decisions regarding their own lives/bodies/beliefs, and those who believe that any choice which is meaningful is too dangerous to be left up to even trained experts--unless, that is, the trained experts are politically connected and seen on right-thinking news programs.
Which is why I'm sad to see Matt straddling the fence on this one, even a bit.
The gods frown at being asked questions.
For over half a decade at least, there has been massive pushback against the neo-liberal consensus around the world. Brexit in England. Modi in India. Mouvement des gilets jaunes in France. AFD in Germany. Trump. And so on. And all of that is due to the complete and utter failure of the professional class, at every level.
Now, you might ask, what does that have to do with Ivermectin. Well, everything. You see, all answers about how society should be moving must come from Top. Men. Who went to Harvard, or Oxford, or any other "world-class" institutions of neo-liberalism. But, as we have seen, these places are so ideologically one-sided as to not even know what the questions are that need to be asked, let alone what the right answer might be. But, in all of their wisdom, they know what to do, and any other answers, especially crowdsourced ones such as Ivermectin must be stamped out to allow space for their preferred answer, right or wrong as that may be, politically expeditious as that might be.
Matt is understandably tiptoeing ("the Oxford group will complete their studies, and the public will have an answer") around what potentially might be the worst example of a mass deception in history.
No illness, until COVID19, has been treated by one and only holy medicine (the vaccine), excluding anything else. This by itself is the biggest red flag in the whole unholy story. Every single sick patient, no matter if they are suffering from cancer or a serious flue is a unique human being, reacting differently to various approaches and any conscious doctor, remembering The Hippocratic Oath, would do anything to help a patient - he or she would prescribe, adjust, change the medications and / or approach to the patient's reactions.
But not with COVID19!? Follow the old adagio and follow the money and I am afraid, we'd be getting the true, ugly beyond belief, story about this. And if my worst nightmare has even a modicum of truth in it, I fear we'd yet have to see the worst. "They," that monstrous alliance of the pharmaceutical industry and the government would have to double-down on their dogmatic, bureaucratic approach, and keep pushing this health dogma and ominous population control behind it. I can't believe I believe "they" are that evil, but than...
Simple reason why Ivermectin has been so totally censored by the media, the medical establishment and the government is this: If there is an effective drug that can cure and kill the virus, then the drug companies would not be able to get emergency use authorization for their experimental drugs, where they are making a killing financially and actually. And talking about double - blind studies, these m-RNA gene therapies (they are not vaccines) have been barely tested, and their testing was only on healthy people between 18-60.
Looking at myself: a fan of science and tech, a strong believer in western medicine and somebody who received an advanced multi discipline hi tech treatment that worked, familiar with Fauci from the AIDS crises days, I have over the course of Covid Pandemic become truly concerned and than outright antagonistic towards CDC, Fauci, AMA and HCP's and see them politicized and run by woke incompetents that intimidate the professionals around them and who should know better. The Wuhan and Lancet fiascos. CDC leadership signing a manifesto arguing against vaccinating the elderly first because whites would benefit disproportionately? Forget the CRT stuff, focus on the fact that people who run that outfit cannot even figure out that if blacks have generally worse health outcomes, as they claim, they would have actually killed tons of orderly blacks if that stupid idea became a policy. The suppression of regular enquiry in cohort with the ad salesman of Big Tech is the biggest tragedy, medieval dark ages style. Fauci went from hero to an old man sorry figure seeking attention and relevance. And all of this against a background of what one could argue was a triumph of science against this deadly disease. So here you have it, transformed from a fan to doubter to animus. And yes my shots worked.