The Ivermectin discussion

Exactly, penicilan is used in humans and animals.

If penicilan was a cure for covid would they rave on a about your not a dog?

Its just irrelevant.

FDA loses credibility when then they start going on about horses.

I am not sure it is useful - and possibly even harmful - to guess at what a single individuals motivations might be to push a drug. Doctors are no less prone to error or bias or confusion or incentives than the average joe on the street. There is any number of motivations a doctor might have to push a drug. From dark motivations like financial incentives in the background we know nothing about - to very nice motivations such as the doctor themselves becoming convinced, rightly or wrongly, that the drug in fact is beneficial.

So the question should never be what their motivations might be - but whether the doctor(s) in question have solid and good evidence for what they are pushing. And doctors are equally prone to the effect of anecdote as any other human. If they are prescribing this drug and their patients are coming back reporting it helped them - individual doctors can be influenced by that and become convinced they are "on to something".

The problem is that we have this almost messiah view of doctors sometimes and think that their being a doctor increases the value of their opinion. It does not. There is no requirement that a Family Medical Doctor (GP) has any training in epidemiology or the processes by which drugs are evaluated in Clinical Controlled Double Blind trials against placebo (or against other treatments as placebo is often not used in such trials and I have met doctors who do not even know that fact). Doctors can get their qualification without learning how that works or without even reading a paper based on how that works. The public tend to generally overestimate what a doctor must study and be competent in to be a doctor.

So their opinion at the end of the day is just that. Opinion. It should be pushed aside and we should turn to the research. And the research on the effects of Ivermectin is at this moment not promising in relation to Covid. Might that change? Of course! Is there any reason to expect that to change in this current moment? No - not yet.

So what is this research exactly? And why are the public - fuelled by the choices of people like Trump and Rogan - falling over themselves for this drug? Why would anyone think that a drug that paralyses some parasites and is used to treat Scabies in humans might have any effect on a Virus infection at all - let alone specifically this virus?

The reason I think is in part because there does in fact exist research that shows this drug inhibited viral loads on other viruses and of Covid. In petri dishes. About 10 years ago such an "in vitro study" showed an effect on viruses. But the results did not replicate in animals. The authors of that paper did then recently repeat their study on Covid and found similar results. Again in a petri dish. There was then - I hear - a retracted paper based on allegedly fraudulent research that again claimed Ivermectin was very effective against Covid.

But what about trials in humans then? Humans are not petri dishes and effects in a petri dish rarely if ever translate to large complex mammals. Well lets see. A double blind randomized placebo based trial in July showed no difference in hospitalisation using the drug at levels of 190mg - another in march using 300mg showed no change in symptom duration - and another using 400mg also reported no change in levels of hospitalisation - and finally a systematic review of 14 other trials published in July also failed to find any reason to support the use of the drug.

The dose size is interesting enough however as the dose size required to show the observed effect in petri dishes was anything up to 1000s of times higher than anything you could achieve by over the counter medication for humans. I am not aware of any studies yet on what level of the drug is toxic to humans - but that sounds like it would be getting into that area very handily.

I would love to be wrong of course and I would love all that research to be wrong. I want the public to be healthy and well being. So I want us to find effective and useful treatments whatever they may be. And I would love if the treatments are off patent - therefore cheap - and easy to obtain - and sustainable. So I want to live in a world where Covid is treatable by things like Ivermectin and Vitamin D as many people - including public intellectuals like Bret Weinstein - are so convinced they are. But the data at this time simply does not suggest this is the reality we live in. I can hope it is wrong! But hope has never in my experience materially altered reality :(

I have looked at zero studies either way on that one. It's on my to do list. I have heard a lot of people claiming that there is evidence there - anecdotal mostly - that obesity seems to correlate with worse covid outcomes. I think Joe Rogan cites a statistic over and over again that a large majority % of the people who are hospitalised with Covid are obese. Which seems on the face of it to suggest that weight loss will result in less hospitalisations.

And I can imagine that being true for good reasons. But without more research I would hate to comment on it. There is too much to normalise for there. For example did all those obese people Rogan mentioned have an underlying cause of their obesity that unified them? Or were those people a general representation of obesity across the board? If the latter then Rogan is on stronger ground with his claims than if it is the former.

But even then the question is whether obesity itself is the cause here - or factors in and around what causes that obesity - such as being sedentary and hence being indoors where you get a higher and more common viral load (Bret Weinstein still beating that drum about Covid being an "indoors disease") - or such as things being present in and/or missing from their diet. And so on and so on.

But over all yes - I think with or without this pandemic the fact that obesity is a co-factor in diseases in and of it self or in complicating or exacerbating other diseases is rarely in contention? That our populations needs to move more - and stop forcing fisting certain foodstuffs through their wet face holes - is probably not a concept that is going to make the world a worse place and might in fact make it a better place in many ways.

Expensive treatment, but reduced viral load by 95% within 24 hours and 99.9% in 72 hours in phase 2 trial.

Good for you.

Thanks for your personal experience.