820 Comments

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.

Expand full comment

The relationship between the major pharmaceutical and corporate interests and the military and economic powers should make the bigger picture quite clear.

They don’t want to allow Ivermectin or discussion of any therapeutics because then the whole justification for their longer term overhauls of the system falls apart….

Whitney Webb’s latest expose should wake anyone up who hasn’t already caught on.

https://unlimitedhangout.com/2021/06/investigative-reports/a-leap-toward-humanitys-destruction/

Expand full comment

I'm loathe to go down that rabbit hole of imagining that this is a money/power grab situation because that would be truly evil to me. But the behaviors are there and are stacking up. If the end game is truly virus mitigation and treatment, why wouldn't all avenues be explored? Especially ones that have been proven to be safe over decades and billions of doses? Why wouldn't they want to combat vaccine hesitancy with alternatives, thereby leading to less virus transmission than with vaccines alone? Like I said, I have my suspicions. But I hope they're wrong.

Expand full comment

I appreciated your comments above, and this one as well. It does me no pleasure to encourage you to accept the bad news of the corruption you suspect. To me the evidence is conclusive that our gov't intentionally suppressed ivermectin and similar drugs for the purpose of directing billions to pharma via enforcing vaccines as the sole remedy. Secondary benefit to their strategy is demonstrating state power by sowing fear. The episode is also a searing indictment of the MSM, demonstrating yet again the corrosion caused by TDS. Truth and objectivity are foreign concepts now. Matt here is a Shining Star in that dark universe.

As the 2020 elections unfolded and the evidence of a stolen election mounted, it hurt. I was raised to love this country, and in my 3 score so far I found it mostly deserving of praise, lumps and all. The most essential point of pride was the will of the people expressed via a gov't elected by the people. And now that is torn from us, by the same people who manipulated COVID for money, power, and ideology. It hurts to have your faith broken by bad actors. 2020 sure hurt for me. But you must be true to yourself and accept your own conclusions.

The good news is there will be a tomorrow, almost everyone you meet is a good person, and the idea and promise of America still beats in millions of hearts. Long term, I believe we'll be fine. :)

Expand full comment

As long as this nation is filled with mostly people who think the 2016 election was turned by the Russians or the 2020 election was stolen, then, long term, I'm positive things will continue down the shit hole we've been on for decades.

Expand full comment

Michael, Unless unless circumstantial and hard evidence, to you, are useless biproducts of critical analysis, then the logical conclusion of 2016 was that the Russia most likely had very little influence. (MT is largely on Substack because he was willing to say that, and that Orange Man was not a Putin conspirator.)

Conversely, 2020 generated a mountain of circumstantial evidence that may not have provided a smoking gun (yet) but is substantially significant enough to warrant grave concern about the legitimacy of the process, if not the outcome. Read the Time article about the "shadow" campaign and tell us that was an altruistic effort. https://time.com/5936036/secret-2020-election-campaign/

I realize that MT's readers tend to be the kind who call bullshit, regardless of what party shovels it. However, even when running the objective middle of the road, there are times when one finds that they are still on the wrong side of it.

Red or blue, there is plenty of foolishness to go around. Yet the shithole being dug currently is on a scale so grand and agresive that to not call it out and pin it squarely on the left is enough to get the best career umpires banished.

Expand full comment

If you think this nation's obvious decline in all matters is due to the "left", which has 0.0% power in this country, then by all means indulge in that fantasy.

This nation is a full blown oligarchy, controlled by one party posing as two, whose primary concern is the maintenance of an empire that is failing on all fronts even as the nation itself is disintegrating, and uses cultural issues to keep both bone spur righties and snowflake libs at each others' throats, as meanwhile the rape continues full speed ahead.

Trump won in 2016 because the elites of both parties were totally removed from the concerns of the people and con man Trump saw that and played the card perfectly. Biden won in 2020 because Trump, true to his inheritance boy nature, couldn't see the pandemic in any terms other than how it might affect his own fortunes, and lacked the emotional maturity to simply say he was wrong in his initial depiction of the pandemic as not a real threat and simply admitted his error, an act that would have required both a level of maturity and concern for others he's never had, and never will.

Trump's great failing is not his narcissism; his is no worse than any other politician you might care to name, but his complete inability to recognize that fact and hide it, as even dumb ass Bush could do, and is surely Obama's greatest strength, which he did let slip with his shameful Flint Michigan performance, where he downplayed lead poisoning and feigned an unquenchable thirst, which one wetting of the upper lip vanquished.

Expand full comment

I think everything was suppressed to green light the vaccine acceleration. Remember how Fauci said no way can we get a vaccine by end of 2020? Amazingly, all hurdles were removed, all potential alternatives talked down. Had there been "promising" medicine, the vaccines might have been delayed, more thoroughly tested. I think everyone went all in on the vaccines (incl. Trump) and the vaccine proponents HAD TO BE SQUASHED. Latest research I've seen shows those under 30 are more likely to be hospitalized due to a vaccine reaction than covid. But what do I know. I just read the data. I don't have MD or DO or PhD in my title.

Expand full comment

It is interesting that the 'vaccines are the answer' mantra seems to have begun around early April of last year. Although I don't have the references at hand I remember reading that Fauci said something like 'what we need is a vaccine' sometime around that timeframe. And in France Macron took a call from either Gates himself or someone at The Bill and Melinda Gates Foundation in early April, following which Macron publicly announced that the answer to the crisis is a vaccine. Up until that point he was a bit more ambiguous on the right medical approach to the crisis.

Although I don't remember when I saw the clip, I do specifically remember Gates himself being interviewed last year about Covid and saying (here I may be paraphrasing but not by much) 'the only thing that is going to fix this problem is a vaccine'.

When Bill speaks people listen.

Expand full comment
founding

I'm not sure the evidence is conclusive... it's more like a retrospective cohort study, warranting further experimentation ;)

Expand full comment

I'd caution about ruling out evil. It exists all around us and is hidden when possible, but it is there.

Expand full comment
founding

I think we think alike here. I was resisting this hypothesis, too. With HCQ there was so much going on (need for combination versus monotherapy, etc) and the anti-Trump thing was huge. But with the clearer Ivermectin story, we have Occam's razor coming down to pharma.

One way I have thought about it is this: it's not necessarily super-active, but rather it's a network effect. The other day I saw a Twitter thread from someone that they started to shout down the lab leak hypothesis (this was a few weeks back actually) again, but then scientific friends reached out and said to them "hey, this actually might be real". So they stopped shouting it down and got on board. So it's not necessarily pharma actively pushing, but rather the pharma people who went to college with the media voices less actively chilling stories with "advice" and cooling ivermectin.

One thing that baffles me is how pharma could not want this drug to be widely used in the developing world, where no one will pay for their vaccines and now they are being threatened with loss of patent protection and massive IP problems.

Expand full comment

Last year, an executive for Goldman Sachs reminded the attendees at a conference for the pharmaceutical industry that there's no profit in curing people. This is on record, although had it not been disclosed by independent media we'd never have heard about it.

Expand full comment

Politicians are almost all sociopaths. There's way more "evil" than you may believe. The word "evil" has such religious connotations that I am reluctant to use it, but the common meaning of the word describes the situation and TPTB. 911, whether you want to believe it or not, had the direct involvement of our government and that was evil. There have been many false flags and there will more. Beware.

Expand full comment

I wonder if the upcoming military “exercise” Sea Breeze led by the US, the UK and 30 other countries in The Black Sea near Ukraine might be the CFR’s latest military wet dream to get in Russia’s face by literally threatening to invade Crimea?:

https://seemorerocks.is/hal-turner-it-starts-next-week-june-28/

While we are discussing Covid, Kamala’s non-border visit etc., Biden and Co. are up to no good thousands of miles from our shores wasting more billions on provocative military exercises when the money could be used instead to better the lives of the American people.

We are being so punked.

Expand full comment

Things are definitely in an end-game situation. These acts of encirclement and massive exercises are not signs of strength, they are signs of weakness and desperation. All their regime change and economic warfare tactics have failed. This is all they have left, but the reality is that Russia unveiled their new generations of weapons. The US and NATO are generations behind, there is no tactical or strategic way in which they could win.

But these guys really believe in the whole idea of just managing perception, trying to trip people up and getting them to psych themselves out.

It just shows how completely incompetent and rotted out with decadence the Western oligarchy has become.

On the other hand, the sooner we recognize the West has completely lost and is completely bankrupt, we can actually start talking about dealing with the realities and actually engaging other nations and cultures in a manner informed by an actual understanding of the history and culture of nations outside the West, and our common interests in mutual economic development, especially in the domain of science and infrastructure.

https://www.strategic-culture.org/news/2021/06/25/russia-wants-to-be-relevant-feels-squeezed-by-china-and-other-popular-delusions-of-a-dying-technocracy/

Expand full comment

If I were Putin, i'd have a couple regiments of Backfires ready for that event.

A US Navy without Phoenix missiles would be hard-pressed to deal with an attack such as that.

Expand full comment

I agree, Jennifer. The anecdotes provided by Matt are also somewhat misleading in that ivermectin is probably not a miracle cure for patients near death. I recently watched an excellent discussion by Dr. Darrell DeMello (based in Mumbai) with Dr. Mobeen Syed (based in the U.S. or Canada, I believe) -- https://www.youtube.com/watch?v=EdKgxv5e2kk. Dr. DeMello claims outstanding success with his treatment plan which includes anti-clotting and anti-inflammatory drugs along with ivermectin (antiviral) when first presented with symptoms, rather than waiting for a test to confirm. He says that patients die from the immune response rather than from the virus directly. So it's important to prevent the problems the virus causes, and before irreparable damage is done.

His comments jibe with what I've heard from Weinstein and Kory -- the clinicians who have a lot of experience treating COVID patients directly and observing the results should be taken more seriously in relation to the scientists looking for definitive proof. Something is lost when we demand perfectly pure studies that try to remove all potentially complicating factors. Something is gained when we admit to the complexity of the interactions as observed on a first hand basis.

Expand full comment

Mobeen is amazing. Love him. Hi from Ypsi 👋🏻

Expand full comment

I agree with you Jennifer. I have been following this situation with growing alarm. There are many people discussing it and some going so far as to suggest that a crime against humanity has taken place. One of the less obvious conclusions that I have drawn is the fact that algorithms don't work. I am pretty sure that an honest investigation by unbiased staff at Facebook would not have prohibited discussion of Ivermectin. So it may be evidence that management solutions proposed by big tech don't work. You will notice that there is trolling going on here on Matt's substack. Someone is motivated to follow this and get us to argue about silly stuff and finally get exhausted from fighting trolls. I don't know what Matt can do about this. My question is who pays these people? I am pretty sure that corporations are paying trolls. Foreign governments may or may not be doing it but I am willing to bet that most trolls that absolutely ruin online discussion are paid well by our very own US corporations. Maybe Matt can look at what is going on right now on his new site and discover something?

Expand full comment
founding

The problem is that you think there are unbiased staff at Facebook.

Expand full comment

Trolls, shills, whatever... they're here to make sure Matt doesn't deviate to much from 'the narrative'. It's okay to be an investigative journalist and all but deviating too far from the accepted version can have dire effects on your income and your standing in the 'progressive' community.

Expand full comment

I think he's choosing not to take a position in the scientific and medical aspects of the conversation. And I'll come to his defense for that. Do you remember his story about the overreach of journalists fact-checking into adjudicating scientific controversies?

And reading through the comments here I don't have the impression that Matt not positively boosting ivermectin is doing it any harm at all. On the contrary, he's letting us come to our own conclusions and those are overwhelmingly skewing one way. So the cause is being served even while Matt sticks to a journalistic principle, about which he just recently made a song-and-dance. I don't see a big problem.

https://taibbi.substack.com/p/fact-checking-takes-another-beating

Expand full comment

A meta-analysis is simply a summary of a bunch of smaller studies. It absolutely doesn't rise to the level of evidence on which to base medical decisionmaking. Sorry, but you have been misinformed.

Expand full comment

What exactly am I misinformed about? I never said a meta analysis was on par with large scale studies. I said given the volume of global data (smaller studies arguably being a better indicator as their aggregate signals aren't easily corrupted by a singular misstep) and the limited time we have for virus mitigation, a large scale study would be unnecessary and impractical.

Expand full comment

I'm not sure I fully understand what you mean by " smaller studies arguably being a better indicator as their aggregate signals aren't easily corrupted by a singular misstep," but if I did, then you are incorrect.

Large, multi-center prospective clinical trials are the gold standard because they establish an apples to apples comparison as best as possible in the real world.

A meta-analysis - which is basically a big book report in which someone gives you their opinion about someone else's work - is the exact opposite. You compare apples from one study to pears from another study to oranges from a 3rd. This is intuitively less useful in every single way than a multi center clinical trial.

Expand full comment

So am I to understand that you are advocating for waiting for your gold standard testing rather than trying a treatment with multiple efficacy studies and decades worth of safety data? And the promising prophylaxis statistics should be brushed aside and squashed for the vaccines that are proving to be questionable in the face of variants (not to mention the adverse reactions and safety issues cropping up). My issue is with the denial of discussion about possible alternative treatments. Clinging to your "gold standard" makes me relieved you're not my doctor.

Expand full comment

Jennifer, it's not clear to me what you understand, if anything at all. You misuse terms and exhibit a generally poor understanding of the topic at hand.

It certainly is curious to me that you have such strong opinions on this topic. Do you have strong opinions on foreign currency exchange markets? How about nuclear physics?

None of those? So why experimental therapeutics for severe COVID-19?

You should know that interactions like this are why I chose a job in medicine where your opinions about me are very unlikely to matter should you be in need of my services, which generally are reserved for people who would die without them.

Should you require them every in the future by some stroke of chance, know that I would care for you with the same dedication and vigilance that I would give my family. Whether or not you would be thankful for them is utterly irrelevant.

Expand full comment

Please let me know exactly which terms I have misused and what makes you think I am uninformed about the topic at hand. Because I assure you, I am not.

Expand full comment

Also, you haven’t answered my question. Are you advocating for squashing a drug with efficacy and safety data in the middle of a pandemic because it hasn’t reached your gold standard of study?

Expand full comment

You are not a doctor. That much is clear.

That you dispense so much condescension in light of that fact is truly disturbing.

Expand full comment

Horatio, great reply from your lofty perch. Bravo, I say. But next time yell a little louder to us little people- we'll all feel better about it knowing our places.

Expand full comment

Hey why are you so rude and arrogant?

Expand full comment

You seem very lovely!

Expand full comment

"Large, multi-center prospective clinical trials are the gold standard because they establish an apples to apples comparison as best as possible in the real world. "

Hmmmm. Too bad this gold standard doesn't apply to the vaccines. Because if it did then it would have been approved by the FDA.

Expand full comment

How large, with multi-center prospective clinical trials were the current vaxes subjected to?

Expand full comment

You don’t know basic terms. You’re embarrassing yourself. It’s like you’re addicted.

Expand full comment
founding

If one multi center clinical trial was the standard, the FDA wouldn't require two successful clinical trials for drug approval. They are applying exactly the logic Jennifer asserts - that one trial may suffer from some unknown bias.

Expand full comment

you are being deliberately obtuse and come across as arrogant. RCT's have many serious limitations.

Expand full comment

You said a large scale study was unnecessary because of “data coming in from across the globe”, which is completely untrue. A bunch of small studies showing efficacy is not the same as a large multi-center clinical trial. We already lived this story before with hydroxychloroquine. It’s not true we don’t need that data, and it’s not true that omitting a bunch of tiny studies as evidence from an article is “downplaying the ample data”. To be honest, it seems like you have a pretty poor grasp on statistics and how data around medical studies work.

Expand full comment

I said a large scale study was unnecessary and impractical in the context of a mass-casualty inducing pandemic, in light of the data coming in from across the world. As to your reference to "a bunch of tiny studies", I'll just refer you to the detailed posts found throughout this comments section. You may want to read up.

Expand full comment

The only way to know for sure is by a large scale study as meta data analysis does not account for variables nor differing methodologies of the studies analyzed.

Expand full comment

That is precisely what meta-analysis does.

Expand full comment

You sir are misinformed - if I may kindly say so -

You clearly have not been trained in medical epidemiology or statistics.

Please do not say things or spread things online that are simply untrue.

RCT almost always have some kind of bias - ie when the drugs are begun in the illness time course - the dosing of the drugs may be too high in one and too low in another RCT, the patient population may be totally different.

Very sophisticated statistics have been developed that are able to put multiple RCT together into a large study called a meta-analysis. The biases of the individual studies is then minimized and researchers can glean signals that are not present in a single one.

Meta-analysis of RCT have been the gold standard of drug efficacy and safety for as long as I have been a physician - just look at the pages of any Annals of Internal Medicine or NEJM. The same can be said about studies evaluating diagnostic testing.

That all of a sudden all kinds of shade is being thrown on meta-analysis is very telling in my opinion. People like you are not approaching this in good faith. The readers of your comment need to know this. You have not a clue what you are talking about.

Expand full comment

Also, a meta analysis is not just a "summary of a bunch of smaller studies". That's an absolute minimization. It's a detailed analysis of said studies in order to come to a broader conclusion.

Expand full comment

"Detailed analysis" is very generous. At best you're aggregating patient cohorts with optimistically comparable demographics. They are retrospective, they have issues with finding appropriate control cohorts, and they suffer from the fundamental sin of multiple statistical testing as well (re-analysis results in multiple testing by definition, increasing the likelihood of Type II error

Expand full comment

A so-called doctor who missed the lesson on hierarchy of evidence.

Expand full comment

Reading through his comments, I’m genuinely baffled. He dismisses ivermectin as a “silly” drug and the testing of it a waste of time, despite mounting evidence to the contrary, during a pandemic when masses are dying and we don’t have the luxury of meeting the highest goals of study. And rather than provide a solid, robust debate from his alleged position in the medical profession, he links to one study claiming that ivermectin is of no benefit in severe cases. That’s it. That’s the evidence he gives for his opinion that the discussion and study of a safe drug that has shown across the world to be highly effective in early to moderate treatment as well as a prophylactic against a devastating new virus is a “waste of time”.

Expand full comment

I’m not baffled anymore. At first I thought he was an intern playing grownup. Upon sober reflection it’s obvious he is a paid pharma shill. Just a touch of scientific training as these shills typically have, just enough to sound slightly credible.

Expand full comment

Shown in very small studies with certain cohorts. Why is it to difficult to acknowledge the ĺimitations of the available evidence? You ask for a robust debate yet we have no robust evidence.

Try one of the vaccines, those actually work.

Expand full comment

You should watch how Dr Kory handles your concern regarding meta-data on the Rogan show.

Expand full comment

This guy will not watch that or educate him on the subject because he is being purposefully obtuse and trying to keep out anything that will pop his bias bubble.

Expand full comment

well said

Expand full comment

WL, I've read your many posts and assuming you are who you say you are (an MD and PhD), I have a few questions for you: Is Ivermectin proven safe ? If not, why not? If yes, do you believe adults should have the right to request this drug as a prophylactic or treatment? If not? why?

Expand full comment

I'm not a doctor nor a veterinarian, but the anthelmintic, ivermectin, has a proven safety record and requires a very substantial overdose to begin to cause adverse side effects. All one has to do to know this is to read the package inserts which describe clinical trials. I've used it for decades on horses and dogs.

Expand full comment

...who often have reactions to medications that humans tolerate.

Expand full comment

What do you mean "proven safe?" Lots of things are safe when they are taken at certain doses for the treatment of certain diseases, and not safe when taken at other doses in different context. Ivermectin is a great way to de-worm your cattle AND your mother, too! No arguments here.

I think adults have the right to request whatever drugs they want for whatever reasons they want. Happens all the time! Physicians are also allowed to say no. Sorry, you do not have a constitutional right to prescription drugs.

Patients are also allowed to find other physicians who will write them silly drugs for silly reasons. totally fine by me. Not my patient, not my problem. People choose to drink and smoke and shoot heroin every day too - I'm not stressed about that either.

Expand full comment

What surprises me about the response of some physicians to ivermectin is the total absence of curiosity, much less excitement, around the effectiveness of ivermectin as a treatment for Covid.

I would hope that my response as a physician to hearing someone like Kory describe his results with the drug and seeing what it seems to have done in India would be something along the lines of 'Holy Cow, this stuff may be the answer to the problem. Let's get it on it. Now!'.

Instead we seem to hear a lot of patronizing pooh poohing over trial sizes and structure. I find this cool response inconsistent with wanting to fix the problem, and save lives, being the overriding priority.

Expand full comment

I am in a town with a supposed world class medical establishment. The physicians I see are incurious and basically uninterested in the medical conditions they see. Most act like they are shopkeepers ( I have great respect for working shopkeepers) in that they open shop and close shop and spend their time thinking about their real estate deals and investments rather than reading the literature, thinking about anomalies in patient's presentation, etc. This is a generalization, since I have been treated my some thoughtful people; but they are rare.

When I was a post-doc in NY Medical Centers this was definitely not the case, and I had long conversations about medicine with my physicians. Whether this is the fault of the control of corporate medicine today, I do not know, but physicians may simply not have the time or motivation to engage in medicine given the control of their practices by the MBAs.

Expand full comment

Yes, and how much rigorous testing did the "rushed through" vaxes go through?

Expand full comment
Comment deleted
Expand full comment

The physician sunshine act and subsequent policies have limited this a lot. Some physicians do bank off of drug companies but it is a minority. Most are probably too busy seeing patients and getting through their endless amount of Charting to garner more interest than looking at the cdc website, uptodate, and a few news stories here and there. Your average physician is not the enemy. It is the power brokers.

Expand full comment

Word games. Yes, at prescribed levels. (as the saying goes: water can be fatal if too much is ingested). And if you were my physician and provided that response, I'd find another doctor. Let me just say that I seriously doubt you are an MD by your comment : "Ivermectin is a great way to de-worm your cattle AND your mother, too! " Surely as a physician, you would know that it has been used to great success to cure River Blindness and Elephantiasis, among other human conditions (and, btw, I AM a mother and you are an asshole ). That comment is a give-away: You are not an MD.

Expand full comment

As a physician I believe he probably is a doctor. Physicians are a cynical and snarky bunch. Largely (I contend) as a defense against an ever imposing health care system and demanding patients— as Matt proposed, capitalist medicine is a very mixed bag. Hospital systems must squeeze more “production” out of their docs and this created great moral distress and cynicism from those who didn’t go into the job expecting to be treated as cattle… so we make cattle jokes. It’s not good but it’s there.

Expand full comment

I am curious on one point. Many people suspect that physicians are somehow captured by Big Pharma. Although there may be other vectors out there, I can think of three ways this might happen:

1) a doc works for a large practice or hospital which has some arrangement with the pharma companies (discounted medications, for example) and so is actively encouraged to promote the Big Pharma 'take'.

2) an individual doc might be given soft perks by Big Pharma - all expense paid trips for him or her (and the spouse) to attend this or that medical conference, which just so happens to be at a resort location, for example.

3) some sort of direct payment (or, in plain language, kickback) arrangement whereby an individual doctor is actually somehow directly compensated by a drug company for prescribing a certain medication.

Can you comment on (or refute) these or other arrangements? Thanks.

Expand full comment

Thanks for your perspective.

Expand full comment

But ivermectin is used to deworm humans.

Expand full comment

A good deworming is good for everyone.

Expand full comment

I’d be curious if you’ve applied the same level of scrutiny to the covid vaccines. Are you at all concerned that they simply don’t have a safety record beyond a few months?

Expand full comment

Exactly!

Expand full comment

Apparently you are only "stressed" by the fact that an off-patent drug widely used around the planet with virtually zero adverse effects is far more effective than the expensive drugs pushed by big Pharma. Your linguistic dissembling is par for the course for Lefty hacks.

Expand full comment

I'm an MD and your bias is clear and against the scientific published papers out there.

Expand full comment

I think you might understand meta-analysis better if you watch the segment where this is discussed on the JRE podcast. (sorry don't have time stamp) Nonetheless, I think your understanding is incorrect on a fundamental level.

Expand full comment
founding

Wow Horatio, your condescension and Gish gallops sure scream Industry Professional.

Expand full comment

People need realize pig pharma knew 1+yr ago that HCQ+zn & IVM worked to zap C19! To get EUAs for experi vaxes, they censored/prevented world from learning about HCQ & IVM efficacy, willfully condemning millions to suffering and DEATH. Why is that not premeditated mass murder? And all the pretend MDs blathering here are complicit. Shills are compensated in blood money. Not worth it for a decent human being.

Expand full comment

You are correct on HCQ (see Didier Raoult for chapter and verse) and your question is apt.

The war on generics has certainly not been confined to the US - it has been a worldwide assault but most effective in the western world. Poorer countries have - to their credit - had less patience with Big Pharma's agenda.

Expand full comment

Conspiracy alert. Ignore.

Expand full comment

Straw man alert.

Expand full comment

WL: good luck to you on this site, armed with your viable reading of the best research, you expertise in the field, comprehension of the available data, no left/right blinders, no apparent iron in the political fires. Commenters here know what they like, and like what they know

Expand full comment

You underestimate this audience. And how could you know this poster is reading the 'best' research? How could you verify their expertise in the field? Even if they are a PhD MD, they very well may not have any specialized knowledge relevant to the topic. Here you must rely on the merit of your comments - we've been doing the forum thing for decades and anonymous appeals to authority are worthless in the absence of substantial contributions to the conversation.

Expand full comment

It’s a paid poster praising another paid poster.

Expand full comment

To put it charitably; MT's Ivermectin articles seem to have summoned several never-before-seen commenters out of the woodwork, a few of whom specialize in tedious ad hominem attacks and/or invective.

Perhaps they are, in fact, longtime subscribers who have become suddenly enthused and energized by this topic.

Expand full comment

If you look at the areas of industry knowledge and contrast them to the gaps (an “ER” doc? Is this 1988? Lol), the pattern fits a pharma rep quite well. Which is more evidence that the entire narrative is paid for.

Expand full comment

On the other hand, if there really is someone out there willing to pay me for this shit, then I ain't gonna get in the way of THAT payday....

Expand full comment

It's "commenter," not "poster." And the only remuneration I seek is the lord's blessing for my humble truth seeking, and his unwavering faith in my blessed pursuit of certain eternal truths, truths that will make me free, and deliver me to the gates of heaven, where eternal life awaits.

Expand full comment

Me underestimate this audience? I doubt that. I'm continually wowed by this audience. This audience, for me---or so I like to think---continually surpasses expectations every day, almost on every thread.

I don't know anything about this guy, WL, who I'm told is now commenting under the nom de plume "Horatio." This development certainly ought to be scrutinized and carefully monitored. And I'd like updates whenever available. What's the consensus here with this WL/Horatio fellow anyway? A no-goodnik, a mountebank? Maybe a russian outfit guy on the run, here on TK cosplaying an ersatz suburban PCP (that's "primary care physician," not "phenylcyclohexyl piperidine") presenting himself as fully up-to-snuff on this Ivermectin thing? I hereby retract any sort of "supporting" comment or comments that I may have leant this eery fellow previously. It's gotten our man Sevender, here, thinking I'm on the take. If only it were so! Working one of the substack back alleys for Big Vaccine! Convince'em that a tin of Skoal is more effective than that ivymarxin concoction in treat'n "The Virus." Why, it's mostly sulphur, magnesium and a touch of molasses. Everyone knows that! Winners dance with the spike protein! What's a matter, kid---you 'fraid of needles? But in my defense, once you've heard one IVM salesman, you have heard them all.

Question. Why would anyone who is not a medical professional, with absolutely no formal training in medicine, think that parroting reams of second-hand information on a topic such as the drug ivermectin is a valuable use of their time? Or if you were a medical professional, but with no special knowledge or expertise of ivermectin or complex viruses in general, why would you proselytize for or against Ivermectin? Especially in a forum such as this one? Why do I think WL/Horatio knows what he's talking about? That he's a reliable guide to the efficacy of IVM in treating covid-19? I don't. Nor could I possibly know whether he's spot-on or a falling-down fraud. Nor, knowing myself, could I possibly ever care about such a thing. Why would anyone who is not trained and educated in such matters, even attempt to speak authoritatively on a subject like ivermectin---the nuances and complexities of which are quite clearly beyond their grasp? Answer me, kids---what's this debate really about?

Expand full comment

It's too bad because it's very much against the entire ethos of why I read Taibbi to begin with. I'm just jousting at windmills, but thanks for the kind words :)

Expand full comment

I think WL is now Horatio... and I agree with your assessment.

Expand full comment

What kind of lowlife sociopath earns a living spewing deadly lies for venal vax cartel predators? Paid by the word or the corpse?

Expand full comment

The usual garden variety run of the mill deadly lie spewing lowlife sociopath...(?)

Expand full comment

And if meta analysis doesn't rise to that high level then what does mr. expert opinion? Balderdash!! That is exactly the best evidence because individual trials can have errors baked in. You should really read more!

Expand full comment

Brilliant summary! The officials at Metck who so subtly nudged the suppression of Ivermectin should be charged with manslaughter.

Expand full comment

Agree... lives are at stake, and that should be front and center of EVERYONE'S thinking!

Expand full comment

Meta data analysis lacks control of multiple variables although algorithms an be use to minimize biases associated with those variables. There are positive signs that it works albeit the studies are small in number. Further studies are warranted.

Expand full comment

Further studies are always warranted. That doesn’t mean that they’re required. In this case the combination of existing evidence and the overall pros and cons appear to be easily in favour of it.

Expand full comment

Oh I absolutely think it’s worth trying ivermectin; I just don’t think we have conclusive evidence.

Expand full comment

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).

Expand full comment

Patients can be treated for one dollar with hydroxycloroquin or ivermectin while Remdesivir costs $3,000 per treatment. Does capitalism have a play in this?

Expand full comment

Capitalism per se isn't to blame. Regulatory capture isn't a feature of capitalism, it is a corruption of the functions of government, i.e. it's a failure of democracy. Capitalism provides the structural incentives for the concentration monopolistic corporate power but allowing that power to own what should be our government is a political failure.

And the intransigence of academics, professionals, bureaucrats etc. once they have staked out a position isn't a feature of capitalism, it's human nature.

Expand full comment

Who corrupts the functions of government? Who has the means and desire to do so? When the only goal is profit, all means are acceptable for achieving that goal.

I think that left to its own devices, capitalism will indeed degenerate into a few monopolists controlling everything. In fact, we see it around us every day.

The fact YouTube can do what it does is the direct result of the monopoly power.

Expand full comment

"Who corrupts the functions of government?" Good question. It's been well know for thousands of years that unfettered creditor power always defeats democracy one way or another. So our first job as a democracy with a market economy is to fetter creditors and the concentration of capital and the power that comes with it.

Americans bought into the Reagan/Clinton ideology so completely that even now, after four years of Trump and the year of our plague, they still want it (Biden). That ideology was explicit: remove government.

Now to your question... who did this? We did it. All the boomers and most of the genxers who cling to this bankrupt theology need to die before the rest of us get another crack at it.

Expand full comment

Nice, if morbid reply <g>

Expand full comment

The very best evidence-based treatment for hospitalized COVID-19 patients is IV dexamethasone which is a fairly old, inexpensive, readily available steroid

Expand full comment

You mean the exact corticosteroid that Dr Kory was instrumental in getting accepted as a treatment for COVID-19 despite receiving huge pushback and criticism at the time? Yes, it’s almost like people should be paying attention to him again this time, right?

Expand full comment

Bingo. Organizing pneumonia.

Expand full comment

** specific pharmacotherapy to be clear, most "care" has nothing to do with a specific drug but rather supportive measures like fluid and blood pressure support, airway support etc

Expand full comment

Thanx for that. It's not just about the drug.

Expand full comment

Well, for most diseases, there is no "single drug." In COVID-19, it will depend on how sick they are.

If they have a cough and headache they can take tylenol and stay at home or whatever.

If they have florid ARDS and are brought in by ambulance in distributive shock with ground-glass opacities on CXR and sats in the toilet, they are going to get RSI dose roc and etomidate and I am going to put a tube in their throat to help them breathe.

Then they will get a million other drugs to manage their other problems like norepinephrine for hypotension, bicarb to correct their acidosis, some kind of sedative drip like ketamine to keep them comfortable while they are intubated and proned, Lasix to clear their extra fluid when they inevitably develop kidney failure if they're here long enough, and so on and so forth.

Thats why IDGAF about ivermectin or remdesivir or any of those drugs that, at the very least, I can say for certain are not a silver bullet. If they don't get the patient to walk out of the ICU - if we're measuring success in meaningless terms - who cares?

Expand full comment

I believe that most people that are advocating ivermectin are seeing it being used well before people land in the ICU. It is best used either for prophylaxis or treatment in the viral stage.

You say "If they have a cough and headache they can take tylenol and stay at home or whatever."

The 'whatever' is ivermectin and if they took that you would have a lot less to deal with in the ICU.

Expand full comment

That's exactly what I was going to say...if I knew what it all meant...😳

I think these issues get lost in the stupidities of everyone imagining they know something about the topic because they saw it on the internet, when, in fact, they don't have a clue. IADGAF when mopes that have no apparent connection to ongoing issues suddenly turn up on Joe Rogan and Youtube and suddenly gain validity via pop exposure and watch YT stuff all the time, but I do NOT get my medical advice on either one. Generally, I like Joe, but the credibility some seem to think is imparted by Joe is idiotic. It's Joe. It's pop culture, not medical proficiency.

Expand full comment

$3000 a dose vs. $2 a dose, and ivermectin probably more effective.

Money honey. Screw healing.

Expand full comment

'Appear to" is the understatement of the century. There's money to be made and everyone is whoring.

Expand full comment

Except that the COVID-19 Plandemic was just that: planned and released.

So.. it follows logic.

Expand full comment

Hmm, plandemiic? Can I patent the word? 😅 No, full disclosure - I didn't invent the word.

Expand full comment

The evidence for all of these drugs is fairly poor. I do agree that it is ridiculous that remdesivir got an EUA, though to be fair there are even worse offenders. ie. bamlanivimab (probably didn't spell correctly, but it's eli lilly's product).

Expand full comment
founding

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.

Expand full comment

There is a large amount of very conclusive, high quality evidence that effective pharmacotherapeutic control of high blood pressure can lower your all-cause mortality risk largely by preventing or slowing the progression of cardiovascular disease. same for

There is a small amount of low quality evidence of mixed conclusions to suggest that ivermectin might be helpful in the setting of COVID-19. I linked one of those studies above, but I will repost it here: https://pubmed.ncbi.nlm.nih.gov/33175880/

I am not sure who you are referring to when you refer to "the medical establishment" as there are lots of different organizations I could imagine falling under that umbrella, but there is generally no interest in it because there haven't been any specifically effective therapies for COVID-19 (excepting vaccination).

The strongest evidence for any drug in the treatment of COVID-19 is the use of the steroid dexamethasone for hospitalized COVID-19 patients. You can read that study here. https://www.nejm.org/doi/full/10.1056/NEJMoa2021436

Expand full comment

The evidence is not low quality. Catch up.

Expand full comment

I have an MD and a PhD. How about you?

Expand full comment

Why would Oxford bother with yet another study if there were no "there" there? There are more studies regarding the efficacy of Ivermectin than Remdesivir, yet Remdesivir is FDA approved for Covid 19 treatment. Since Ivermectin has been proven to be safe, and there is at least evidence that it might be helpful, there is no down side to using it that I can see. Better to bless doctors to prescribe the human kind than to have people eating horse-paste, right? By the way, I don't have an MD or a PhD and I've been drinking.

Expand full comment

To be fair you're right there is enough interest that someone is looking into it. Good. I don't have a problem with that. I just think it will be a waste of time, but I am of a fairly cynical nature because I have seen both sides of the benchtop to bedside research pipeline.

There is always a downside to using drugs, even if it is subtle. If you had a headache and I told you to take Miralax because it might help, would you? Why not?

If you can't answer that question, then I'm curious about the interest in ivermectin - an anti-worm drug - to treat a viral infection with superimposed multisystem critical illness (ARDS) with autoimmune features.

The argument that has been advanced by Dr Kory and others is extremely thready, heavily based in benchtop science hypotheses (mice and cells in a dish) that did not produce an effect in the best trial on the topic that I've read to date. You can read that one here: https://pubmed.ncbi.nlm.nih.gov/33175880/

Expand full comment

You seem to be missing quite a lot of research (it has moved well beyond "mice and cells in a dish"). I doubt if you have even read the most of the studies (another good one just came out of Israel). Many years before the pandemic, researchers were already investigating Ivermectin's antiviral capabilities for other viral illnesses - that is how the critical care doctors discovered it during the pandemic. There are doctors and researchers from major universities in the US and all over the world who began using it and recognized a signal. Why would these practicing doctors and researchers risk their credibility? The fact is, people are wired not to put their livelihoods in jeopardy, so that just bolsters their credibility. There is no ROI in trying to change your mind (your bias is showing, in any event). I have learned during the pandemic that the layers of bias that envelop people are pretty much intractable. The fact is, it really doesn't matter if I convince you or not (and you're probably a troll and I'm probably wasting my time right now). I'll tell you what is really telling, and that is when Facebook and Youtube take down any post mentioning the word "Ivermectin" and all of the "articles" start coming out leading with the words "horse paste" or "anti-worm drug" when describing Ivermectin.

Expand full comment

I realized that I didn't answer your question about Mirilax: your analogy is a logical fallacy. However, assuming, arguendo, that Mirilax had notside effects and was generally considered safe, and I trusted your judgment because you convinced me on some level of your authority and trustworthiness, I might just try it (in other words, there is no downside so why not?).

Expand full comment

That’s an interesting question.

“There is always a downside to using drugs, even if it is subtle. If you had a headache and I told you to take Miralax because it might help, would you? Why not?”

If a patient was dying, does it matter that they are given a placebo? If all other options have been tried, and they are still dying, would it harm them to swallow a placebo? This drug isn’t harming the patient, unless they have some sort of allergic reaction to it. It has been given to humans billions of times. So it’s effects on Covid are, at worse neutral and at best life-saving. I’d say a doctor would be fulfilling his oath to do no harm if he prescribed the drug for patients that had not improved with any other treatment.

Expand full comment

IVM warrior.

Expand full comment

You are still full of it. You know better than Kory, Barody, McCullough, Risch, Marek, Varon, Syed, Lawrie, Zelenko and thousands frontline MDs risking their reps to save lives? Yuch to your puny degrees, only make you credentialed blowhard.

Expand full comment

You have a bruised ego because you're mad about something you truly don't understand. So sorry!!! Consider taking a walk :)

Expand full comment

Hey WL and others, thanks for acting out that whole populist/anti populist drama Matt describes in the article. Very illustrative!

Expand full comment

IVM warrior.

Expand full comment

Mengele too had an MD and a PhD.

Expand full comment

Ouch!!

Expand full comment

I have laughter for your pathetic attempts to argue from authority.

Expand full comment

So you think it's better to argue from a place of total ignorance? That is clearly your strategy so, bold move.

Expand full comment

Looks like we found the proverbial doctor at the bottom of the class.

Expand full comment

Do you understand what a false dichotomy is?

Expand full comment

A really obtuse IVM warrior.

Expand full comment

I think it was those with MDs and PhDs who were behind the hormone replacement debacle for menopausal women. My experience in that era eroded my trust in the recommendations of medical professionals and it has not recovered.

Expand full comment

Oh - so you're one of the experts.

Expand full comment

Almost certain he's not what he says he is. Prove me wrong WL.

Expand full comment

No you don’t. The fact that you can’t recognise that your response is a complete non sequitur shows that you probably don’t have what it takes to achieve either of those qualifications.

Expand full comment
Comment deleted
Expand full comment

Gibsons Law...For every PhD, there is an equal and opposite Phd...

Expand full comment

Would you want him as your surgeon?

Expand full comment

Compared to you? 😆 😆 😆

Expand full comment

IVM warrior.

Expand full comment

So is it your position that any mention of the drug should be censored off the internet until there are higher quality studies, Dr? Or that hospitals should refuse to administer it when prescribed? Do you have any conflicting interests to disclose?

Expand full comment

I don't think anything should be censored off the internet. That's silly.

I don't think that it should be given to treat COVID-19 because there isn't any evidence that it works.

I'm not opposed to somebody else studying it further to see if it does, but seems likely to be a waste of time, based on my knowledge of the literature that is out there.

Lol, and no, I have no conflicting interests to disclose, but that's funny. Does the free breakfast burritos at grand rounds count?

Expand full comment

“based on my knowledge of the literature”

So, nothing.

Expand full comment

If you had said “sufficient evidence” you might have at least sounded like you were trying. But saying “any evidence” shows that you either know nothing about this topic or you are a deliberate liar.

Expand full comment
founding

What is the downside of ivermectin? Is there a serious risk of harm to the patient?

Expand full comment

Thanks for being a voice of reason here. It’s clear that people want ivermectin to be everything it’s claimed to be because it will back up their prior view that this is a global conspiracy. This is not about ivermectin at all, it’s just a means to an end to confirm a world view. Bret has clearly jumped the shark, just look at his last few posts.. he is devolving in front our eyes… sad.

Expand full comment

Agreed.

Expand full comment

There you go! We have a winner! In the category: "Why are all the nut jobs so enthralled with ivermectin"? They're IVM warriors!

Expand full comment

Do you have anything to offer except for an ad hominem? Your lack of substantive argument speaks volumes.

Expand full comment

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.

Expand full comment

Have your people changed over the last few years? A lot of folks on your side of the aisle are asking that question.

On ivermectin, good points. MedCram is a very solid site which I have dipped into a time or two but did not know they were looking into ivermectin.

Expand full comment

Same same same. We got our hands on IVM after hearing that some people are using it for long haulers issues. It’s awesome! Big improvements in our house. 👏🏻

Expand full comment

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.

Expand full comment

Your comment resonates deeply with me. I've had fatigue and depression most of my life and spent literally decades trying to figure it out. Almost every doctor I saw put me on anti-depressants, which made me feel weird. I wondered how many doctors actually knew what anti-depressants make you feel like (I suspect not many). Anyway, I finally found an endocrinologist in private practice who was not hamstrung by "the system." She diagnosed a genetic disorder (confirmed via DNA) that would have eventually and slowly killed me if I had not figured it out. I think the medical system is designed to keep you miserable and tethered to it in perpetuity.

Expand full comment

What I've seen over and over is doctor's don't really listen to patients. It's as if they've already made up their mind what's wrong and ignore any information that doesn't fit with their preconceived diagnosis. I think in some ways, this has impacted their willingness to listen to individual accounts of effectiveness of ivermectin (not to mention its been politicized).

Expand full comment

That is why you have to own your own health and what is being done. Just like you did.

Expand full comment

Amen. I was in the field from the late 70s to early 90s and I too have witnessed how the field has deteriorated . Well meaning physicians suffer under requirements to see as many patients as possible and you’re lucky to get 10 minutes with a doctor. I’ve seen firsthand the monetization and the turning of the medical profession into an industry.

Expand full comment

Last month I had a visit with my primary care Dr. This appointment had to be set up a few months in advance. As it was explained, these types of visits require more time with the physician than an normal office visit.

I would estimate we were in the office together for about 20 minutes. I would estimate 80% of that time the physicians eyes and actions were focused on completing all of the tasks required by the computer system. I grew up accustom to having 70% of the time focused on the patient. I'm fortunate to be mostly healthy.

"The Machine" consumes so many resources just to survive, never gets smaller and offers less and less choices as time goes on.

Sounds like a recipe for failure, unless somebody else is paying for it.

Expand full comment

I have also noticed a decline in the quality of nursing care. A friend of mine is also a Registered Nurse in ICU and she and I compared horror stories about newer grads sitting on their phones texting while their patients need nursing care, not just an IV hung or vitals checked. Turning, oral care, skin care, communication etc. The compassion is lacking with doctors and nurses.

Expand full comment

Before I retired a year ago I worked with several new grads and was appalled at their lack of knowledge and lack of interest in gaining any real experience. One -- any I'm not making this up -- worked the night shift and a man who kept telling her he had terrible chest pain, sweats, etc. (classic signs of a heart attack) told him those were signs of detox and he'd be fine. He died. This nurse is planning on furthering her career as a nurse practitioner.

Expand full comment

Every person I've known who has had a family member in the hospital, I've encouraged to stay with them as much as possible. And anytime I've gone to a doctor's office it's been the same scenario -- he (or she) rushes in, smiles, sits down in front of the computer and types as you tell them your symptoms. It's no wonder so much is missed. My sister-in-law went to 5 different doctors before she was diagnosed with multiple myeloma even though she had bones breaking for no reason.

Expand full comment

Matt,

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.

Expand full comment

This guy sounds like a REAL doctor (unlike some of the people on this thread who are claiming to be doctors). Thank you for your open mind and genuine compassion for your patients.

Expand full comment

And a doc that actually treats patients, as opposed to, for example, a bureaucrat or academic.

Expand full comment

Thanks for the great comment, however there’s no difference between “veterinary” Ivermectin and “human” Ivermectin. Same molecule, different dosages. e.g People still think Ketamine is a “horse tranquilizer”, when in fact it was patented in 1962 as a safer battlefield anaesthetic.

Expand full comment

I'm presuming 'safer than opioids'? Serious question.

Expand full comment

Yes, precisely.

Expand full comment

Hi IM Doc. Nice to have you here. I have very much valued your contributions at NC.

Expand full comment

Thanks for your honesty and professionalism

Expand full comment

Bingo.

Expand full comment

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.

Expand full comment

Great input, thanks! And glad your health regimen is working for you. Well done.

Agreed with your analysis of bad incentives in the US health system. I'll go further and posit the cause is profit comes from a small cadre making decisions above, rather than diffuse consumers making choices from below. If the real customer is regulators, insurance corps and giant pharma, serving the needs of the patient is circumstantial to the conversation.

Aside from patients the next biggest losers are doctors. Their autonomy to help the patient is constantly chipped away by directives from above. Like everything else in life, free people making their own choices, in aggregate, will result in best outcomes.

Expand full comment

My daughter has Crohn's and RA. I've been trying to interest her in diet changes for many years now - diagnosed at 13, she's 26 now. She's had a hip replacement already and had several feet of bowel removed. One of these days... smart kid too but she is just convinced that the apex of Western medicine is the apex of how she needs to be treated.

She's on the biologic of the week - they stop working randomly - and methotrexate. I'd almost rather her be diabetic like me. At least insulin just makes you gain weight and acts like a steroid.

Expand full comment

I used specific carbohydrate diet to cure my son’s IBD. 👏🏻

Expand full comment

I wish your daughter the best. Unfortunately, the medical profession is pretty clueless when it comes to treating Crohn's.

Expand full comment

I too have a distrust of medical expertise, even though I was once in the medical field. I trust science but not necessarily all clinicians. I had some issues and went to multiple doctors, all who wanted to start me on pain killers as they could find no underlying condition for my pain. I just stopped going and didn’t take all the drugs. I’ve found reducing stress and meditation have been best for me. Having said that, I absolutely made sure I didn’t have a neurological condition such as ALS or MS . I’m probably a socialist if categorizing my political views.

Expand full comment

Stress reduction and meditation have also been a big part of my treatment regime. So much so that I quit my job as a litigator and moved to Buddhist country where I go on regular meditation retreats. The ambient stress in the U.S. is toxic.

Expand full comment

So true. I moved out to WV and got myself 7 acres of land with lots of trees ~2 years ago. Stopped watching TV entirely. It's been like a great new world for me.

Expand full comment

Not watching TV is a quick quality of life enhancer.

Expand full comment

So glad for you.

Expand full comment

Excellent.

Expand full comment

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.

Expand full comment

Excellent comment.

"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"

A lot of the technocrats aren't even "placed" in positions of responsibility by the people. Who the fuck ever voted for John Brennan or James Clapper for anything? Yet there they are, first running intelligence agencies and then stinking up the mass media.

I'd argue -- from gut feeling and no empirical (although prolific anecdotal) evidence -- that we're at a tipping point between "technocracy/meritocracy" and "neofeudalism/nepotism." We may have already tipped.

Who among us has done time amidst the expert/technocrat class? Who among us thought that they were generally the smartest and most capable people in the room? Who among us knew people who achieved senior positions through dedication, knowledge, and personal integrity; or, conversely, achieved senior positions because they were somebody's relative or "knew somebody?"

Expand full comment
founding

I am not part of anything anymore. I write that not out of false modesty or disinterest; I am of a certain age and mindset. I have lived; I have seen.

What is causing these great upheavals of American society? I am shocked at what Americans allowed to be DICTATED to them during the last 15 months. If anyone with half a brain thinks about it, they should ask questions, they should object; but they don't. Lalala.

The vax passport is basically here. I can't believe it.

Several years ago, I think I was a public defender then, but anyway it was awhile back. There was a huge case in Illinois about whether the State Police could set up "Safety Checks" to stop drivers and question them (looking for DUIs). Of course, it passed constitutional muster. I thought about that the other day, thinking about what else our government will be allowed to do to make us "safe."

Expand full comment
founding

Someone got neocon in our neoliberal! The Noble Lie is alive and well and suppressing treatments to make vaccination more compelling, suppressing aerosol transmission theories to prevent costly requirements, and save masks for docs. People aren't trusted by experts, who are no longer trustworthy anyway. Credentials and connections suffice for 'expertship', and both are for sale. And why shouldn't they be? Markets are always best, let the truth be decided by PR budgets, controlled by the omniscient beneficence of the invisible hand!

Expand full comment

So what you're saying here, effectively, is that all the pros have gone rogue and now we should start relying on the amateurs? Say, maybe, our next door neighbor, who just happens to teach chemistry at the local community college? Other than the usual TK fife-and-drum shit one encounters all too often (all too often) on these threads, that's pretty much the message here, even if the commenter can't recognize it.

I'd also be careful conflating your tin-foil politics with the humanities and especially the sciences. Yes, the political class in this country require some serious straightening out, but this ain't the route to do the straightening. Neither is it imbuing trust to opportunistic charlatans such as D. Trump. Grassy-knoll talk is fun, but if this were really the case in the sciences, and if you framed it as you have above in a public forum such as this one, either you'd be happily oblivious to it, or if you were genuinely aware of it and bitching about it in this manner would get you hauled out of your basement and clamped into leg irons. Those days are not here, but who knows, perhaps they are near at hand.

Here's Taibbi: "A secondary consequence: while there are plenty of doctors of all political persuasions showing interest in researching the drug, the public voices on the subject are almost exclusively either conservatives or denizens of alternative media. It’s no accident that Lorigo, in addition to being ivermectin’s de facto litigator in America, is also the Chairman of the Erie County Conservative Party. “Outside of Fox News, no one is covering it,” Lorigo sighs...."

Mostly, ivermectin is only controversial to a small minority of right-wing no-nothings who primarily traffic in ignorance, misinformation, and outright propaganda, in service of their beloved retrograde beliefs. Ivermectin is the latest right-o-rage. IVM warriors. And anyway, if really you do believe all this shit---any plans to get active and do something about it? Or is this as far as it goes? Slick high-school newspaper editorials posted on a substack that make you feel like a somebody? But expose you in all probability as a nobody? Get to work.

But, hey, why end this comment on such an unpleasant note? Here's a link below that describes who the real enemies are in the U.S., and yes, around the world. Mazel tov, baby!

https://www.propublica.org/article/lord-of-the-roths-how-tech-mogul-peter-thiel-turned-a-retirement-account-for-the-middle-class-into-a-5-billion-dollar-tax-free-piggy-bank

Expand full comment

Teaching chemistry at a local community college means they’re not an intellectual like you?

Expand full comment

"So what you're saying here, effectively, is that all the pros have gone rogue and now we should start relying on the amateurs?"

The Stupid/Ignorant* Person's Dilemma:

1. This person's "betters", i.e. experts and/or authorities, tell him A is true.

2. Later, this person discovers A is contrary to what their experience tells them, and thus apparently false.

3. This person's "betters", i.e. experts and/or authorities, tell him B is true.

4. Later, this person discovers B is contrary to what their experience tells them, and thus apparently false.

...

[This goes on many, many times, with serious life consequences, for years, maybe decades]

...

n. This person's "betters", i.e. experts and/or authorities, tell him X is true.

n'. Will this person believe X? *Should* this person believe X, either rationally, or morally? What should this person do? Remember, this person does *not* likely have a trust network of experts to rely on -- this person is *on their own*.

n+1. [The future, not yet known.]

------------------

* It would be better to neutralize this, as I do not intend it to be perjorative, as stupidity, and yes, ignorance, are *primarily* un-bootstrappable. Maybe "The limited capacity, uninformed person's dilemma" is better, but it is awkward ... and in any case, I'd rather not give into the Woke Word Games' whack-a-mole.

Expand full comment

Just to be clear, I am one who occupies this role. You are not the author of your own brain, you cannot rewind the decades to a different worldview, and and there are only so many hours in a day. Live in the here and now, and don't let them shame you for demanding explanations before changing your mind.

Expand full comment

All of this makes Colbert's "Colbert Report" seem even more prescient than ever.

Expand full comment

Too bad that show isn't on any longer. As the Late Show host, colbert kind of sux.

Expand full comment

Yeah, it’s another late show. There are momentary flashes of brilliance, but nothing like Colbert Report.

Expand full comment

I'd say he blows. He blows the people who let him on the show. The recent episode with John Stewart was very telling.

Expand full comment

Well put, Thomas.... Frank? ;)

Expand full comment

The collapsing confidence in the expert class.....well said.

Expand full comment

Perhaps they read the latest IPCC report predicting that billions will die?

Expand full comment

To the best of my knowledge, the IPCC has never stated what the Davos- sponsored Swedish Doom Goblin and her ilk shriek about. The summary for policymakers gets twisted and distorted by the “media” and the rest of the sociopathic technos.

Expand full comment