200,000

Peter Fairbrother peter at tsto.co.uk
Fri Sep 18 05:53:49 PDT 2020


On 18/09/2020 01:22, Zenaan Harkness wrote:
> On Thu, Sep 17, 2020 at 12:45:36PM +0100, Peter Fairbrother wrote:
>> On 16/09/2020 21:59, jim bell wrote:
>>> Also, search 'covid ivermectin'
>>
>> Doesn't seem to work, or at least not very well. Promoted by many of the same
>> people who promoted chloroquine, incidentally.
> 
> 
> Why do you say that "[ivermectin] doesn't seem to work, or at least not very well" ??

It is far easier to investigate drugs in cell cultures than in whole 
humans, so researchers try many drugs in cell cultures to see if they work.

That doesn't mean they will work in humans (or not work in humans, you 
can miss potential treatments too), but it is fairly easy to do and 
gives some hints about what may work.

You can also try a lot more different drugs in cultures than you could 
try in humans.


Ivermectin has been shown to inhibit COVID replication in cell culture. 
It is very effective at doing this. But only at levels which are too 
high for use in humans.

So, the theory goes, give it a try in humans at the highest sustainable 
doses and see if it works. A bit of a hail-mary, but it costs very 
little and the drug is already medically and legally characterised as 
safe, so you don't have to do safety testing and the trials are even 
cheaper and easier and quicker.


Unfortunately politics has gotten involved, and politicians have 
invested political capital in the effectiveness of ivermectin. This 
complicates matters.

Scientists have methods to find out whether a drug is safe and effective 
but they take time (and cost lives). When politics (or finance, or 
reputation) become involved that process is disrupted, and answers 
become nebulous, at least temporarily.



Clinical trials of ivermectin have begun. Afaik no real big trials have 
completed, but early reports are not encouraging - I don't mean they are 
discouraging, but if it worked spectacularly we would have heard the 
trials people going yeah yeah yeah by now.

If you do search for 'covid ivermectin' in google, on the first page you 
won't find any positive reports from the trials people of its use in 
humans. [1]


It might still work a little: though I doubt it personally, that is 
still possible. I hope it does. But it isn't a spectacular success, 
unlike dexamethasone and conjecturally [2] vitamin D, because if it was 
by now the trials people would be doing handstands and cartwheels - and 
they aren't.


BTW this is almost the same story of chloroquine in COVID. Works well at 
too-high-for-humans doses in cell culture, is perhaps 
over-enthusiastically reported by the cell-culture guys, gets picked up 
by politicians, but, as expected, doesn't work well, or possibly at all, 
in humans.



I say "as expected" because both were hail-mary's, we pretty much knew 
from the start they were unlikely to work in humans at tolerable doses. 
If you read the papers carefully you will see that, but perhaps you have 
to read them carefully and know how such papers are written.

As to the cell-culture-guy / political-pickup issue, the cell culture 
guys were excited not only by a vague hope of a treatment but also 
because they were learning things about how the virus works. In a 
hit-it-and-see-if-it-breaks kind of way, but sometimes that can be 
illuminating.

As to the politicians, I guess they either don't have real science 
advisors or they ignored them.



Peter Fairbrother

[1] There was a positive report by Prof Mehra etc, but it was widely 
disbelieved and has been withdrawn. As has his chloroquine paper. It 
looks like he, or the statistics company, just made stuff up - 
scientists can be mistaken and even lie too, though that is (supposed to 
be) the cardinal sin.

There have been other positive reports, especially from Australia, 
Florida and Utah, but these have been mostly anecdotal. Hey if people 
can say COVID doesn't exist, other people can also say that x or y cures 
it. Doesn't make them right.

If you look carefully you may find that quite a few the people who once 
said ivermectin cures 100% are now saying, well, maybe it helps.

There are reasons why we do double-blind trials, even though they may 
cost lives. Anecdotal reports are unreliable.




[2] We know that people who lack vitamin D are more likely to die from 
COVID, but we don't actually know that giving people who lack it vitamin 
D will make them have a higher survival rate. It seems likely, and I 
assume so, but correlation does not imply causation, and we just don't 
know for sure. It is just an assumption.


OT: Have you noticed, the "we expect that politicians lie" meme has 
grown to the extent that politicians now use the expectation to get away 
with outrageous lies and similar behaviours?

"Hey, I'm a politician, you expect me to lie".


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