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The Official MacNN COVID-19 Thread (Page 25)
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I don’t personally think most Ivermectin-seekers are going to be bright (or crafty) enough to concoct a reasonable story for their doctors. In fact, I think many of them don’t “have” a doctor in the first place. They may say “Rand Paul says this stuff works and he’s a doctor…” but if they’ve bought into not being vaccinated, they may not have the ability to cognitively deal with the fact that Ivermectin is an anti-parasite drug. And they are probably ignoring the huge spike in poison control calls for Ivermectin poisoning.
Ivermectin is a neurotoxin. A little too much of it and you start having central nervous system symptoms like drooling, seizures, convulsions and so on. I HOPE that such symptoms, once a “true believer” sees Aunt Molly wetting herself, barfing and lapsing into a coma, will be horrifying enough to at least stop some people from poisoning themselves because the Marmot and his cronies said to.
But if that’s the way they want to go, I probably won’t be as upset about them as I am about the kids who will die because their governors don’t want their teachers vaccinated and won’t allow the schools to mandate masks.
And I formally apologize to any and all actual marmots for the comparison I made above. It ain’t their fault.
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The neurotoxicity isn’t going to be an issue if it’s in the proper form and dosage. In other words, the problem isn’t IVM, it’s IVM abuse.
The advisory has a graph of prescriptions by doctors. How is that relevant to the crisis of IVM abuse?
Rhetorical question. It’s not.
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Originally Posted by ghporter
But if that’s the way they want to go, I probably won’t be as upset about them as I am about the kids who will die because their governors don’t want their teachers vaccinated and won’t allow the schools to mandate masks.
There was a small piece of paper taped to the wall letting us know that there was a positive Covid case in my kid's before/after school care at some point. No contact tracing, no mention of when/who/how long. No email or purposeful notification this year like there was last year. Masks are optional aka rare. Because we have no clue what our kid's exposure level was, we can't in good conscience have him around anyone else, vaccinated or not. For now we're getting some in-home tests, and long term we're considering switching him to the bus, where masks are required and he wouldn't be around as many kids from all over the city for extended periods of time.
Originally Posted by subego
The neurotoxicity isn’t going to be an issue if it’s in the proper form and dosage. In other words, the problem isn’t IVM, it’s IVM abuse.
Since when do people who eschew medical science care to follow recommended dosages?
The advisory has a graph of prescriptions by doctors. How is that relevant to the crisis of IVM abuse?
Rhetorical question. It’s not.
Apologies in advance for answering your rhetorical question. If there was a gigantic spike in IVM prescriptions coinciding with morons promoting it as an anti-Covid drug, there are only a couple of possible scenarios:
1. There was a totally coincidental but corresponding spike in parasitic infections. Doctors are prescribing IVM legitimately for actual parasitic infections.
2. Doctors are purposely prescribing IVM to treat Covid even though there is no research to support its efficacy and the FDA has not approved it for that use.
3. People are lying about symptoms in order to get a script for IVM.
It seems like your argument is assuming that every prescription is a good prescription, but I don't think we can assume that.
"The opioid crisis isn't really a big deal, most of these addicts are just taking the drugs that they've been prescribed."
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I have a feed store about 5 miles from my house. It’s a local business, and we’ve gotten our dogs’ vaccination meds from them a few times. They have horse tack, and of course horse drugs. Dog drugs, horse drugs, they don’t need one of those “know it all” doctors to write a prescription for them. And it’s usually a lot cheaper too.
So a LOT of people using IVM are using veterinary meds if they’re smart enough to figure out that feed stores have them. Or they “know somebody” who gets it for them - which I think is pretty common. If you’re gullible enough to think an anti-parasite medicine for horses will protect you from a virus that targets humans, getting your “life saving medicine” from “Jake, who has it in the trunk of his car” or similar supremely reliable sources probably isn’t a problem.
Me? If I visit that store it’s to get leather strapping to make a new leash for one of my dogs - or the hardware for it, etc. But I may stop by just to see how they’re handling the situation.
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Originally Posted by Laminar
2. Doctors are purposely prescribing IVM to treat Covid even though there is no research to support its efficacy and the FDA has not approved it for that use.
It seems like your argument is assuming that every prescription is a good prescription, but I don't think we can assume that.
"The opioid crisis isn't really a big deal, most of these addicts are just taking the drugs that they've been prescribed."
What’s wrong with number 2? As per the NIH link at the bottom of the CDC advisory, “[t]here is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19” [emphasis added]. In other words, it may actually help. Is that not a good enough reason to prescribe it?
My argument is prescriptions from doctors for IVM isn’t a health crisis.
IVM isn’t addictive, and is considered safe in the proper dosage. Where’s the science saying I should consider IVM analogous to opioids?
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Originally Posted by subego
What’s wrong with number 2? […]
My argument is prescriptions from doctors for IVM isn’t a health crisis.
IVM isn’t addictive, and is considered safe in the proper dosage. Where’s the science saying I should consider IVM analogous to opioids?
I think you are looking at it too narrowly: Ivermectin has become most popular amongst people who reject vaccines and masks but are eager to believe in alternative remedies du jour such as hydroxychloroquine (spelling?) and now Ivermectin. The damage is two-fold: many of these people will continue to eschew vaccines and instead put their faith in drugs that haven’t proven effective. Secondly, even the people who get Ivermectin/wonder-drug-of-the-day through their doctor, they will contribute to making them more popular. And then other people will get Ivermectin in other ways, e. g. in the form of medicine for livestock or horses. I remember someone dying from ingesting fish tank cleaner that contained hydroxychloroquine.
It’s the same story as with homeopathic remedies: they are harmless as “medication”, but they still can cause damage because e. g. people either reject or postpone ordinary medical treatment.
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If my patient is infected with COVID, I give any and all treatments which may increase their survivability. I do not deprive my patient of a possible treatment because someone else may get the wrong idea.
Should I be a government health agency, I do not interfere in this process until it is proven the treatment is ineffective or harmful to the patients it has been given. Discussion of vaccination is irrelevant, because the patient is already infected (IVM is a treatment, not a prophylactic).
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Originally Posted by andi*pandi
He’s surprisingly positive.
He cites the same NIH page I did, which seems to have changed from “not recommended” to “we don’t know”.
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Originally Posted by subego
If my patient is infected with COVID, I give any and all treatments which may increase their survivability. I do not deprive my patient of a possible treatment because someone else may get the wrong idea.
If that patient only got infected because he figured there was a great treatment, but that supposed treatment doesn’t actually work, then he’s still a fucking dumbass for not having got vaccinated, and whoever convinced him of it actually killed him.
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I’m taking a qualitative approach to this.
The NIH can neither recommend for or against IVM.
Therefore, the CDC should neither encourage or discourage it’s administration by doctors, or patients seeking it from doctors.
The CDC should discourage repurposing veterinary medicine.
Well, they should encourage using Vetrap, which is the veterinary brand of disposable flexible bandage. Just as good as the human stuff, but cheaper, and comes in rainbow colors. It is approved for human use… by me.
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Originally Posted by subego
If my patient is infected with COVID, I give any and all treatments which may increase their survivability. I do not deprive my patient of a possible treatment because someone else may get the wrong idea.
Is this your own personal morality or is it best medical practice? Doctors can prescribe drugs for off-label use but to me it seems like this idea that "I'll give my patient any drug they ask for until enough people get sick or die from the treatment, then I wait for the government to step in and stop it" isn't a good route to go.
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So if I ask the doc for OxyContin, and the CDC hasn't ruled it out for Covid ... the doc should give me the prescription? Um, you know, to prevent catching Covid.
And since proper dosage hasn't been established for treating covid, that means I can specify the quantity too? Great. 5 kilos, please.
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How did “I give treatments which improve survivability” translate into “I give patients whatever they ask for”?
If it helps explain anything, the practice I’m suggesting is to take this clinical trial data:
https://www.covid19treatmentguidelin...clinical-data/
And using it to make a determination of whether IVM will help my patient. If I think it will, I prescribe it. If I think it won’t (or may more likely cause harm), I don’t.
These trials give little indication it’s harmful, and a number of them suggest it will at least reduce the viral load.
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Last edited by subego; Sep 3, 2021 at 05:23 PM.
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Originally Posted by subego
How did “I give treatments which improve survivability” translate into “I give patients whatever they ask for”?
The FDA does not recommend Ivermectin for COVID treatment at this time. If you ignore regulatory authorities, going with anything that hasn't been ruled out -- then you have a free-for-all. And since recommended amounts have not been established for drugs not recommended for COVID, then the quantities are open as well. Essentially, whatever drug the patient asks for, so long as the FDA hasn't ruled it out.
The linked studies are inconclusive, suffering from small numbers. It's worth pursuing further trials, which are being done. If it were conclusive today, Ivermectin would get an EUA and be recommended for use.
Originally Posted by turtle777
And in regards to effectiveness against COVID, don't believe everything government bureaucrats tell you.
...
Many countries are using IVM successfully to manage Covid. Just look at India. They squashed they Delta outbreak with IVM. And they had single digits vaccination status back then. I'm sure it's unlikely that ALL of these countries are stupid enough to continue doing something that doesn't work.
India isn't that stupid - they revoked Ivermectin use against covid.
I'm quite skeptical about what government bureaucrats tell me. But I pay attention to doctors in the FDA and CDC. Experts, as opposed to people elected in popularity contests.
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Originally Posted by reader50
The FDA does not recommend Ivermectin for COVID treatment at this time.
We’ll take this one at a time.
Why is the FDA recommendation superior to the NIH recommendation?
On matters of health, why should I follow a regulatory agency instead of a health agency?
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Originally Posted by subego
Why is the FDA recommendation superior to the NIH recommendation?
... because the FDA decides what drugs can be used in the USA, and for what purpose, while the NIH handles research? ie - FDA decisions carry the force of law, while NIH recommendations (along with other agencies, like CDC and WHO) inform FDA decisions.
The NIH has not reached a conclusion on Ivermectin - it's still being evaluated.
Recommendation
• There is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19.
Originally Posted by subego
On matters of health, why should I follow a regulatory agency instead of a health agency?
I didn't intend to create a distinction - the FDA is both. "regulatory" got written because I didn't think of "health" first. But to answer vs the NIH (which I think you meant):
NIH offers recommendations, and has none on ivermectin today. I don't think you can be arrested (or have your medical license revoked) for going against NIH recommendations.
FDA offers decisions with legal force, and does not recommend ivermectin for covid treatment today. Pending further studies.
Seems straightforward to me. The FDA has a recommendation on ivermectin today, and the NIH doesn't.
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Originally Posted by reader50
and for what purpose
My understanding is doctors are given discretion when it comes to off-label use of pharmaceuticals. Are doctors not meant to use the discretion they’ve been given? By definition, off-label use requires contravention of FDA recommendations.
Edit: and hence looking to other authorities for information.
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Last edited by subego; Sep 4, 2021 at 01:37 AM.
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That is my understanding as well (doctors can prescribe for off-label use). I don't feel knowledgeable enough about the ins and outs. Perhaps the problem is that no drugs have been approved (yet) for fighting covid. Only for prevention (vaccines), and to support patients until (or if) they recover on their own (oxygen, certain steroids, anti-inflamatories, etc).
Prescribing drugs to fight covid, when none have been officially found yet, amounts to blind research. A human trial, without registering for one. A doctor might make an informed guess that an alternate drug can do the job of a primary drug, which is unsuitable for whatever reason. But no primary drug exists yet for comparison.
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Originally Posted by subego
Are doctors not meant to use the discretion they’ve been given? By definition, off-label use requires contravention of FDA recommendations.
In individual cases that would not cause a problem, and especially with a disease like Covid trial and error might lead to an accidental discovery of a treatment that is effective against Covid. But I remember that e. g. there was a hydroxychloroquine shortage for a while for people who really needed it, because some people thought it was effective against Covid. Prescribing medicine that does not seem effective can be very problematic, even if there are no severe side effects for the individuals taking them.
I think you focus too much on the individual dimension, but not larger scale ramifications.
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Originally Posted by turtle777
LOL, you gotta stop sourcing your knowledge from Wiki. It's a shithole these days.
Originally Posted by turtle777
And in regards to effectiveness against COVID, don't believe everything government bureaucrats tell you.
And you should take a step back and think why anyone would suppress this kind of information? Cui bono — to whose benefit?
If ivermectin were effective, wouldn’t every government on planet earth lined up to sign contracts making sure they get their share? A cheap drug that has already gone through trials and whose side effects have been thoroughly tested? That’d be a dream. And potentially a (second) Nobel Prize.* The effectiveness is not decided upon by “bureaucrats”, but by experts. And nobody has an interest in suppressing the economy, limiting their own freedoms — unless there is a really good reason for it.
* I would put money on the couple that owns BioNTech and perhaps 1–2 other people who did the foundational research on mRNA vaccines will be awarded the Nobel Prize next year.
Originally Posted by turtle777
Here are some pre-Covid research papers attesting anti-viral properties of IVM.
There are many anti-virals on the market today, none of them have been proven to have a significant effect on Covid. Just because ivermectin is an antiviral does not mean it is effective against Sars CoV-2.
Originally Posted by turtle777
Many countries are using IVM successfully to manage Covid. Just look at India. They squashed they Delta outbreak with IVM. And they had single digits vaccination status back then. I'm sure it's unlikely that ALL of these countries are stupid enough to continue doing something that doesn't work.
Correlation is not causation. Nor is cherrypicking studies a good idea as a lay person. Even as an expert, it is not easy to immediately spot problems. Lay persons also don’t understand the difference between pre prints and peer reviewed studies.
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Originally Posted by OreoCookie
But I remember that e. g. there was a hydroxychloroquine shortage for a while for people who really needed it, because some people thought it was effective against Covid.
My horse told me they were willing to make the sacrifice. ![Wink](http://forums.macnn.com/images/smilies/oldschool/wink.gif)
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Originally Posted by subego
My horse told me they were willing to make the sacrifice.
I just saw this headline on Twitter: “Gunshot Victims Left Waiting as Horse Dewormer Overdoses Overwhelm Oklahoma Hospitals, Doctor Says” ![Frown](http://forums.macnn.com/images/smilies/oldschool/frown.gif)
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As a heads up, that story got walked back. The link has an update.
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Originally Posted by subego
As a heads up, that story got walked back. The link has an update.
Thanks for spotting that, good to know. The headline had something Onion-esque about it, too.
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Last edited by OreoCookie; Sep 6, 2021 at 06:13 AM.
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On the other hand, the report could be that doctor’s personal impression of the extent of the local issue. It’s easy to exaggerate problems like this when you’re frustrated with why they arise in the first place.
I cannot sufficiently stress that humans using veterinary medications is a Very Bad Thing. In vitro, HUMAN ivermectin has been seen to inhibit replication of SARS-2 virus. Which is good.
But as a treatment, it seems to only be useful to the individual being treated. Prevention of an infection in the first place ALSO helps protect everyone around the vaccinated person. And since Delta can cause a symptomatic infections in vaccinated people, proper masking can also be protective of others.
To me, even if the Ivermectin crowd is right about it, it seems to be a very selfish approach.
Wearing a mask is unpleasant (go tell a GI who has had to wear chem gear in a Texas summer how unpleasant it is…), so people don’t want to be bothered by it. And completely disbelieving the overwhelming majority of the medical community - who disagree with an entrenched idea that it’s all a conspiracy to do something or other - means that getting two little shots that are a little inconvenient just can’t be tolerated.
But using an off-label and truly experimental (for this application) medicine without an extensive record of what side effects might occur and how severe they may be, well that’s fine because it might protect that person. The selfishness of this approach feels abominable to me.
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Originally Posted by ghporter
Ivermectin is a neurotoxin. A little too much of it and you start having central nervous system symptoms like drooling, seizures, convulsions and so on. I HOPE that such symptoms, once a “true believer” sees Aunt Molly wetting herself, barfing and lapsing into a coma, will be horrifying enough to at least stop some people from poisoning themselves because the Marmot and his cronies said to.
Which is exactly why I'm upvoting everything I see on reddit about someone taking it. We should poison as many of these people as possible.
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Originally Posted by ghporter
I was tempted to write more about this in my reply to turtle’s post. AFAIK the ivermectin craze started with the two publications mentioned in this thread, the study on humans I referred to and this in vitro study. The first study was fraudulent (see linked article). Understanding the relevance of the in vitro study is more nuanced. As a general rule, in vitro (as opposed to in vivo) studies can only give hints, because by definition you are only looking at a subsystem of the human body. So the positive effects in one type of tissue could more than be cancelled out by negative side effects in others. At best, in vitro studies can suggest new mechanisms and hypotheses to be studied more seriously later on — which it was.
With this in vitro study in particular, there is an additional problem: the concentration of ivermectin was significantly higher than what you would use in approved treatments. (I seem to remember a factor of 1,000, but I am not sure about this.) So even to replicate the level of concentration of ivermectin in the relevant tissue of the human body via oral ingestion, you’d have to go significantly beyond the currently approved limit — with obvious potential for severe and dangerous side effects.
I’m not saying that ivermectin cannot work, but from all the available evidence we have, there is no good scientific evidence that current treatment regimes with ivermectin are not effective.
You know what has proven to be highly effective, though? Vaccinations and masks.
PPS Of course, the evidence could change as new trials are performed. Getting another arrow in the quiver of doctors would be highly desirable, but even in the best case scenario, we would look at a sequence carefully controlled studies of increasing scope.
Originally Posted by ghporter
To me, even if the Ivermectin crowd is right about it, it seems to be a very selfish approach.
Bingo.
Originally Posted by ghporter
Wearing a mask is unpleasant (go tell a GI who has had to wear chem gear in a Texas summer how unpleasant it is…), so people don’t want to be bothered by it. And completely disbelieving the overwhelming majority of the medical community - who disagree with an entrenched idea that it’s all a conspiracy to do something or other - means that getting two little shots that are a little inconvenient just can’t be tolerated.
You know what was also unpleasant for me? Not being able to attend my mom’s funeral this year. And my cousin’s last year. And not being able to witness the birth of my second child in November or December. The pandemic sucks. We all know. But whining about a piece of cloth is so hard for me to sympathize or empathize with. I don’t even want to call it a sacrifice, because it really isn’t one.
PS Just to be clear, I don’t think I am special in this regard. I am sure most of us had to make sacrifices similar to or perhaps worse than mine.
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Last edited by OreoCookie; Sep 7, 2021 at 04:30 AM.
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Originally Posted by turtle777
LOL, you gotta stop sourcing your knowledge from Wiki. It's a shithole these days.
lololol how'd I know you were going to latch onto that one?
To reiterate - the only info I pulled from Wikipedia were the dates that IVM was approved for animal and human use. A point you were wrong about and haven't provided any evidence to the contrary.
Key argument winning tactic: Don't like the info? Attack the source!!
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Curious about what’s up with that, I decided to do some comparisons between Idaho and Montana.
Montana’s population is 1.069 million, Idaho’s is 1.787 million.
Montana has 2,259 hospital beds. Idaho has 2,529.
Edit: Montana obviously has a lot more area, which I imagine means they require more redundancy, but that’s still a pretty stark contrast in infrastructure.
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Last edited by subego; Sep 7, 2021 at 10:58 PM.
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Originally Posted by turtle777
LOL, you gotta stop sourcing your knowledge from Wiki. It's a shithole these days.
MWGA
Okay, so you're pretty picky about choosing reputable sources, right?
Registry Expiration: 2021-11-24 03:24:55 UTC
Created: 2020-11-24 03:24:55 UTC
Registry Expiration: 2022-02-03 23:26:41 UTC
Created: 2021-02-03 23:26:41 UTC
But yeah, let's shit on Wikipedia.
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Went to my very first super-spreader event Friday night. My son got us tickets to a concert for father's day last year, but, of course, it got cancelled and re-scheduled for this year. It was at an outdoor arena, at least. Still, 20,000 people crammed together, even outdoors. I masked-up, ate a gummy ![Big Grin](http://forums.macnn.com/images/smilies/oldschool/biggrin.gif) , and had a fantastic time. I think that was the first bona-fide actual concert I've attended in, maybe, fifteen years?
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Yep. Alanis, Garbage, and Cat Power. My son got the tix last year, when Liz Phair was part of the show. I’m a big fan of Liz, and a show with her, Alanis, and Garbage was something I really wanted to see. But, after the year delay, Liz dropped out of the tour right before it started this year, and Power took her place. So, no Liz, but it was great show neverthelesss.
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Cat Power … are they a downer when you watch them live? Their version of the Stones’s Satisfaction is disturbing(ly good).
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Originally Posted by OreoCookie
Cat Power … are they a downer when you watch them live? Their version of the Stones’s Satisfaction is disturbing(ly good).
It was just her and her guitar. No backing band. She was definitely somber-ish, but it really let you hear her words and get into her vibe. I wasn't at all familiar with her music, and I'm glad I got to see her.
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Originally Posted by Thorzdad
It was just her and her guitar. No backing band. She was definitely somber-ish, but it really let you hear her words and get into her vibe. I wasn't at all familiar with her music, and I'm glad I got to see her.
Do yourself a favor and listen to Satisfaction by the Stones and then by Cat Power. Amazing. Although I need to be in the mood to want to appreciate her.
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I’m pretty sure she did it at the show. It kind of sucked in a way. She went on at 7, and there were still a ton of people coming in, getting seated, etc., so it was a little hard to hear just her and a minimally-amped guitar over the noise of the crowd.
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Let’s stay a little more on-topic and drop the personal attacking stuff, huh?
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Glenn -----OTR/L, MOT, Tx
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Fine. People going to large events like concerts right now are fucking idiots.
Vaccinated. Still. Spreads. Covid.
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Originally Posted by MacNNFamous
Fine. People going to large events like concerts right now are fucking idiots.
Vaccinated. Still. Spreads. Covid.
From what I gather at this point, it unfortunately looks like herd immunity against Delta simply isn't possible, even with 100% vaccinated.
So the only option is to completely ban all mass events until a generation of people has grown where all were routinely vaccinated as kids, or had the infection and are largely immune.
Someone correct me if I'm wrong.
I still think that it's a bit callous to refer to a concert off-handedly as a "superspreader event" when talking about having attended it — because there's still a long way to go.
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Originally Posted by MacNNFamous
Fine. People going to large events like concerts right now are fucking idiots.
Vaccinated. Still. Spreads. Covid.
Suggest a little more detail on complaints. I read your statement as:
Rob doesn't like Cat Power, and thinks her fans are F. idiots.
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Originally Posted by reader50
Suggest a little more detail on complaints. I read your statement as:
Rob doesn't like Cat Power, and thinks her fans are F. idiots.
I read it as:
Rob is understandably terrified of losing his immunocompromised partner to Covid, and (again understandably) goes ballistic when he sees people acting in ways that promote the spread of the virus.
FWIW, I don't think going to a concert masked and vaccinated makes you an asshole, but I can relate to where he's coming from.
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Originally Posted by Spheric Harlot
From what I gather at this point, it unfortunately looks like herd immunity against Delta simply isn't possible, even with 100% vaccinated.
So the only option is to completely ban all mass events until a generation of people has grown where all were routinely vaccinated as kids, or had the infection and are largely immune.
Wrong. Ban all large events and lock the fuck down everywhere. Close all restaurants indoors, delivery only. Force all businesses to do curbside pickup. Masks required, even in buttfuck tiny-dicked patriotland freedomville, fine anyone who argues, or throw them in jail, or just shoot them in the fucking head for all I care. We could be done with this in a couple months, and covid would be GONE, forever.
But nah, we gotta half ass it. When America actually is aligned and wants to fuck shit up, they win (WW2). When they have one foot out the door and half ass things, we get dragged out events like Vietnam/Afganistan/Covid. It fucking sucks.
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Rob, you are not wrong... that's what I was saying a year ago... It wasn't fair at the beginning when we in WA/MA/NY were struck hard and locked down and not leaving the house, to see other areas ignoring it, belittling it, and living their lives, and thumbing their noses at us. And now the shoe is on the other foot with delta, in some regards.
I think what we're seeing is how long people can hold out in isolation, and the toll it takes. Getting vaccinated was like a breath of fresh air, mental relief. I willingly wear a mask if it's the small price to pay to leave the house.
What is the new normal?
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