When leftists shun ivermectin, they show how scientifically illiterate they are

By James V. DeLong, AM THINKER

Saturday, July 24 is World Ivermectin Day, as “people of the world will come together to celebrate ivermectin for a day focused on unity, love, and gratitude for this precious gift from Mother Earth.”

I will be with them.  Being of venerable age, I am at risk for COVID, so I follow the debates over the vaccines and treatments, such as ivermectin and hydroxychloroquine, with intense interest.

My conclusion, on which I am willing to bet my life, is that taking ivermectin is a superior alternative to vaccination, both for prevention and, should it come to it, treatment.  I am convinced by the careful scientific work of the FLCCC, the BIRD group, and independent researcher Andrew Hill and reinforced by the refusal of the government health agencies to respond in any coherent fashion.

A priori, one would not expect issues of drug safety and efficacy to be a political hot potato, but one would be wrong.  The Progressive wokesters, and especially their Deep State and Big Tech minions, are all in on the propositions that the vaccines are wonder drugs and ivermectin is worthless.  These positions are maintained by a refusal on the part of the health agencies to examine the evidence and by intense censorship by Big Tech.

The latest stroke in this conflict came from the lefty Guardian, which reported “Huge study supporting Ivermectin as Covid treatment withdrawn over ethical concerns.”  The article identified a number of data problems with a particular study from Egypt, which, if true, would be serious, and the pre-print service that had published the paper withdrew it.  The author protested that he had been blindsided without a chance to defend his work, and the matter is now being explored.

Many media outlets echoed the Guardian, characterizing the problems of the Egyptian study as eliminating the most important randomized control trial (RCT) and thus knocking out a crucial pillar of support for ivermectin.  No other kind of evidence is regarded as relevant.

Supporters of ivermectin downplay the concerns, because re-running the crucial meta-analyses (linked above) supporting ivermectin without the Egyptian data does not change the favorable result.  Multiple RCTs remain, along with significant observational and epidemiological studies, so the loss of the Egyptian data (even if the criticisms ultimately stand) means little.

Behind this specific dispute is a larger, important, and subtle conflict over the nature of evidence in medical research.

Everyone agrees that RCTs represent a high standard.  In an RCT, patients are divided into two groups.  One gets the drug under investigation; the other gets a placebo.  The study is double-blind in that neither patient nor doctor knows who is getting which, so expectations cannot influence the outcome.  If the results for the groups are significantly different, one can be confident that the drug is beneficial.  And if side-effects in the treated group are rare, one can also be confident of safety.

But total reliance on RCTs runs into immediate problems.  They are expensive, so their number is inherently limited.  In particular, no private company will fund one for any off-patent drug, which is why Big Pharma is opposed to research on ivermectin.  No one owns it.  Performing research on off-patent drugs should be a major task of government health agencies, but these appear to be under the thumb of Big Pharma and not interested.

Recruiting for an RCT can be a big problem.  Identifying relevant population sub-groups is difficult, and the more possible sub-groups that exist, the more expensive the trial and the more difficult its design and interpretation.  Dosages must be determined, as must timing and possible interaction with other drugs. That RCTs adequately identify side-effects, especially for sensitive groups such as the elderly, is disputed.

An RCT that shows no benefit under one set of circumstances may be wildly wrong about the overall situation.  To show this, in 2018, a group of doctors once published a learned article showing that the parachute showed no benefit for people jumping out of planes.  The fine print noted that the further research would be advisable, because their experiment was conducted at zero altitude and zero speed.

In this tradition, if a researcher wants to show that a drug has no benefit, he can give it to patients already at death’s door.

In the real world, RCTs are one component of a complex system for collecting knowledge.  A lot of preliminary works is necessary before one gets to the point of doing an RCT, and that work in itself produces evidence of varying strength.

Lab workers have looked at mechanisms of action and formulated and tested various hypotheses. As clinical research and experience accumulates, lab and clinical work cross-fertilize.

Clinicians have also observed diseases, formed ideas about what might work, consulted colleagues, and tried things out.  To a high degree, medical progress depends on crowd-sourcing by doctors. Once the FDA approves a drug for any purpose (which provides good information about safety), any M.D. can prescribe it for any other purpose.  Then they go to medical meetings, play golf, and compare notes.  Repeated clinical experience, especially from multiple doctors, and subjected to devil’s advocate review, can be as good as an RCT.

A patient also serves as his own control group.  If a doctor gives a drug to patient who has a longstanding condition and it immediately clears up, the doctor thinks, “Hmm.”  This an anecdote.  If it happens with a second patient, the doctor thinks, “Wow.”  A third time, and we are getting into the realm of “studies.”

Yet another source of knowledge is epidemiology.  If a disease is prevalent in a population, a drug is distributed, and the disease recedes, this is evidence, especially if the disease remains in comparable populations that did not receive it.  Some of the best evidence of the efficacy of ivermectin comes from India and Mexico, which pass it out freely.

To reduce this complex system of producing knowledge down to a reliance on “nothing but RCTs” is not just stupid; it can be fatal. Anthony Fauci is a leading advocate of this view.  His position unnecessarily killed thousands during the 1980s AIDs crisis.

The major mystery remains: why would the health authorities take such a position?  And why does Big Tech, and so much of the media, support it as well?  Anyone who deals with facts in the real world — doctor, lawyer, scientist, engineer, spy — is familiar with the reality of different kinds of evidence and the subtleties of assessing them.  None of the ideas set forth here are novel.

So why are the health authorities and the media embracing a stance of deliberate stupidification?  One keeps trying to think of non-malevolent reasons, but the task keeps getting more difficult.

James V DeLong lives in the Shenandoah Valley.

July 24, 2021 | 3 Comments »

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3 Comments / 3 Comments

  2. Some of them are not illiterate. They want people to DIE!
    Fauci wants to rewrite the laws of immunity.

  3. It is obvious to me that these medical dudes are just winging it when it comes to the vaccines that they are jabbing everyone with. It is becoming clear that their effectiveness wanes after about 5 months, and that the “experts” have no idea what they are doing. Definitely not reassuring.

    Ivervection and hydroxichloriquine have been proven to work when the disease is treated early. Also, they have some effectiveness and prophylactics. By way of contrast, no one knows how effective the vaccines are in the long run.

    Jerusalem Post ? Health & Science
    Is Israel or the UK right when it comes to COVID-19 vaccine effectiveness?
    According to one Israeli researcher, both sets of data could be correct. Here is why:
    By MAAYAN JAFFE-HOFFMAN   JULY 24, 2021 21:01
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    A MAN takes a picture of himself receiving a coronavirus vaccine at a Meuhedet Health Fund center in Jerusalem this week.
    (photo credit: MARC ISRAEL SELLEM/THE JERUSALEM POST)
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    05:21

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    Is the Pfizer coronavirus vaccine 88% or only 40% effective against preventing symptomatic infection?

    Two separate studies, one published by Israel’s Health Ministry and the other published in the New England Journal of Medicine late Thursday showed striking differences.

    “This discrepancy is kind of unsettling and needs to be further investigated,” said Prof. Cyrille Cohen, a member of the advisory committee for clinical trials on SARS-COV2 vaccines at the Health Ministry.

    Specifically, the ministry’s study found that the Pfizer coronavirus vaccine was only 40% effective against symptomatic cases of COVID-19 and 39% effective at stopping infection at all against the Delta variant.

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    It did, however, show that the vaccine remains 91% effective against developing serious cases of the disease and 88% effective against hospitalization.

    The British study, in contrast, found that two doses of the Pfizer vaccine were 88% effective against stopping symptomatic infection against the Delta variant.

    The study was authored by researchers from Public Health England, the National Institute of Health Research, Guy’s and St. Thomas’ Hospital NHS Trust and the University of Oxford.

    The Delta variant is currently responsible for more than 90% of cases in the country and has been found to be significantly more contagious.

    According to Cohen, there are several possible answers to the data gap.

    First and critical is the difference in time between exposure to the Delta variant and vaccination.

    England vaccinated at a much slower pace than Israel, meaning that the majority of its population was only fully vaccinated by mid-April 2021. This is in contrast to Israel, where around 90% of the country’s most vulnerable population were jabbed by the end of January.

    It is beginning to become clear that vaccine immunity begins to wane after about six months. The Israeli study showed that for people vaccinated more than six months ago, the effectiveness of the vaccine at stopping coronavirus dropped to as low as 16%.

    Among more than 1.8 million people who received two shots by January 31, some 5,770 contracted the virus – and 1,181 of them, or 20% of all new infections, were contracted during the week of July 11 to 17, the Health Ministry reported.

    “If you take into account that they [the UK population] vaccinated later and were exposed to the Delta variant a month before us,” Cohen said, “it could make sense that at the point they checked, they had around 80% effectiveness. The question is what is going to happen in three months? Will they see the same efficacy that we are seeing?”

    THE NEXT issue is age.

    Both Israel and the UK were careful to first vaccinate healthcare workers and the elderly. In England, however, the older population was largely administered the AstraZeneca vaccine, whereas people under 40 were offered Pfizer or Moderna as an alternative, due to evidence linking AstraZeneca to rare blood clots. The same study showed that the AstraZeneca vaccine was only 67% effective against symptomatic disease after two doses.

    In Israel, everyone received Pfizer. Breakthrough infections were most prominent among people aged 60 and older, a cohort that already has a greater tendency to be immunocompromised and prone to developing symptomatic if not severe cases of COVID-19.

    A third explanation relates to the level of PCR testing carried out in the two countries. Israel uses a more sensitive or stringent PCR testing regime than the UK.

    Genetic matter from the virus is amplified in cycles by PCR tests. The more cycles that are run, the more likely the lab is to detect the virus. Israel uses 37 amplifying cycles, which means that you are positive for the coronavirus even if the test process required up to 37 cycles to detect the virus.

    “If the PCR testing is less sensitive, England may miss some cases – or Israel may catch more cases – and that could play a role in the numbers,” Cohen said.

     

    FINALLY, a separate Oxford University study that was published over the weekend found that an eight-week gap between the first and second doses of the Pfizer vaccine is a “sweet spot” when it comes to generating neutralizing antibodies.

    When England launched its vaccination campaign, it did not have enough doses to vaccinate the population according to Pfizer’s recommended regime of two doses three weeks apart. As such, it spread doses out to between four and 12 weeks to allow more people to get at least one jab.

    Specifically, the new research showed that neutralizing antibody levels, the level of those antibodies responsible for defending cells from pathogens, were higher after the extended dosing interval (six to 14 weeks) compared to the conventional three-to-four-week regime.

    In contrast, the T cell response was of a marginally lower magnitude after the longer dosing interval. T cells provide longer-term immunity and scientists believe that they could provide some immunity to COVID-19, even when antibodies become less effective at fighting the disease.

    “The question is: Would you wait eight weeks when there is a pandemic?” Cohen asked, noting that separate studies have shown that one dose of the Pfizer vaccine is only around 30% effective against the Delta variant, which would leave the population vulnerable for two months. “It’s a tough question.”

    Cohen’s solution is to provide a third shot to the most vulnerable people, which new research is starting to show does a good job in boosting antibody levels. [???]

    “We are still learning the best way to immunize people with these vaccines,” he said. “But we are still in the middle of the pandemic.”

    Tags Coronavirus COVID-19 Coronavirus Vaccine Pfizer vaccine efficacy
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