CharonY

Another report came out, indicating that vaccinations also cuts down risk for long-haul covid-19 symptoms. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00460-6/fulltext

! Moderator Note Title edited as requested.

I think the issue here is that the method does not properly distinguish between "normal" (i.e. white) and "scary" folks.

Studiot is correct. I will say that depending on application and especially if the total volume does not change much and/or the pipetting might be large relative to the error in the dilution (e.g. if you pipette 1 ul into 1000 ul instead of 1 ul in 999ul) some folks just round up. That, however, is a bit sloppy and if folks do it without proper consideration, it can affect the results (especially for quantitative analyses). Moreover in many student protocols (and annoyingly some papers) I have seen confuse the dilution factor with dilution ratio. I can only recommend that if you write a thesis that you clarify exactly what you mean in your materials and methods section.

I think it is wrong to think of it as lost money. After all it was generated by spending and I think that your main criticism is not debt per se, but what the money was spent on. I think many fiscal conservatives are also confusing that matter a bit. As iNow suggested, lending at low rates can in effect increase your revenue, if you can invest it to get a better return. https://www.stlouisfed.org/publications/regional-economist/fourth-quarter-2020/does-national-debt-matter The actual discussion should be whether 1 billion in the military yields a better net than, say a billion in education, or infrastructure. In many cases that is what fiscal conservatives actually mean rather than issue of debt itself (except when conflating it with personal debt which, as the link above highlights, is mechanistically entirely different). Unfortunately the specter of debt is often invoked in order not to invest into something (often if it runs counter the ideological principles of a given party) and in effect can hinder the economy. There are certain relationships that were thought to be indicative of economic stability (e.g. relationship between GDP and national debt) but empiric evidence have shown that not to be true. I think the discussion should really be in what do invest when cost of borrowing is low, so that we can have a solid foundation for the future, when it might not be.

! Moderator Note Merged topics of treatments into megathread. A couple of other recent treatment news: As mentioned earlier, the TOGETHER trial (which focusses on repurposing of drugs) found evidence for the use of fluvoxamine to reduce the need for emergency room observation (https://www.medrxiv.org/content/10.1101/2021.08.19.21262323v1). Also as mentioned, Ivermectin was showed no effects, which was communicated in a recent presentation https://trialsitenews.com/mcmaster-together-trial-ivermectin-a-no-show-while-fluvoxamine-shows-some-promise/. Another trial involving anti-coagulants indicates improved outcomes in moderate severe cases, but little benefit if patients were already critically ill. https://www.nejm.org/doi/10.1056/NEJMoa2105911 Ronapreve has been approved by UK regulators (it is already authorized for emergency use in many countries). The monoclonal antibody cocktail has shown some prophylactic properties in a few phase 3 trials and might also be useful for individuals with compromised immune systems. As a side note, I think this thread documents how difficult it is to translate initial positive findings into actual clinical usefulness. I could write whole articles (in fact, I have) regarding such issues, but looking back, the first post showed potential benefits of hydroxychloroquine and we all know what the trials eventually said. That is why initial positive results of any medical intervention should lead into trials, and not into a call for self-medication.

Ok so now the argument is that some media outlets have not been fact checking and therefore we should take medication before they go through large trials and getting reviewed? Look, if you move the goalposts further I am going to need a better telescope. Edit, also it seems that the articles now include the comment from the NHS, so basically quoting each of the folks involved, which seems to conform to usual standards. Does it mean I should take half the dose? Or do I need to mix it with another experimental drug until the internet hypes up something else (i really hope it coffee). Edit 2, just to be as sure: don't self medicate with drugs. Ask a MD not the internet. The internet is dumb.

So now you are shifting away from the prophylaxis argument and focusing on treatment? That was not the original argument and obviously folks are constantly trying to repurchase drugs. Which again runs counter to your narrative. Folks are getting treatment, but obviously after they are sick. You on the other seem to promote... something. Potentially Self medication for unknown reasons. Now tell me is ivermectin more efficient for treatment than, say remdesivir? Or steroids? I mean the big medical cabal seem to promote those? Why again are so invested in drugs that are still pending big trials over those that have data? Do you think less evidence is better because somehow pharma is less involved in that? Sorry you reasoning seems to me backwards from what it should be.

Indeed, thanks for pointing that out. I am notoriously bad at proof reading my posts as they are generally more of a stream of thought thing that I do between doing other things, so my general apologies for having to put up with them. I did correct it now but now am unsure whether I should have. Anyway...

Thanks iNow, I have indeed seen the study. I am a bit skeptical that the viral particles would remain intact under the conditions, certain bacteria and certainly spores would have much higher resilience compared to them. But thank for clearing that up.

I always found that that to be bit of a a convenient excuse. See, folks do not have abhorrent believes, but it is because someone made them so. There are a few issues with that statement. The first is the use of political correctness of a pejorative of the right to criticize the left. In reality, there has always been an Overton window that determined what is palatable. The phrase PC has been weaponized by the right to shut down every criticism (justified or not) that stem from progressive ideas. In all honesty neither side is doing well with fostering dialogue, however it seems to me that the right has created a whole ecosystem to systematically shut them off from discourse, which is now exemplified by the presence of an alternative right-wing reality in which things like, say global warming or COVID-19 simply does not exist and antifa has taken over the government. If you want to follow this route and where the origins are, you won't find those in the opposite camp. There is a large body of research now which discusses this in more detail, but in short, it is not a reactionary or even new phenomenon. It follows a long tradition of right-wing patterns which elements of authoritarianism and xenophobia which are rolled into a zero-sum worldview. The only new thing is really the amplification of signals from all sides via the internet which allowed folks in fringe to create and maintain their own alternative universe. It should also be noted that one of the hallmark of these fringes is the duality of a) being heroes of their narratives but b) at the same time being downtrodden and forced to action by the enemy. The narrative that the left forces them to believe in crazy stuff because they have taken over mainstream media and science, is just another element to it.

I am still waiting for someone jumping out of the closet and tell me it was all just a joke. I even cleaned out said closet to make it easier but still no luck. Really? I find that somewhat surprising. The only things I have seen so far was mostly related to increased mortality due to PM2.5 exposure. Do you have a report at hand by any chance?

Yes indeed, controlled studies have shown little to no effect of supplements on overall outcome. However, overall improvement of well-being by life choices (diet, exercise) environmental health and so on, all have positive properties for many diseases as they can improve our ability to combat and survive infections and associated complications. Unfortunately well-being is also often coupled to income. Also unfortunately folks (and I am guilty of that as well, especially with respect to sleep) folks often neglect overall well-being and focus on drugs as primary measure. I.e. fix things when broken, instead of not breaking it in the first place.

A bit off-topic, but considering the background of the founders I am fairly confident that the constitution was set up with slavery in mind, rather than being a compromise of sorts. At best one could consider it ambiguous, but it clearly benefitted slavery operations in its original form. Unless you mean what the ideal should have been, which is a bit more abstract and decoupled from the realities of what it really was.

Excellent, so I suppose you have dispensed with the notion that somehow there is a cabal restricting ivermectin research, considering that there are sufficiently around to actually try to make a meta-analysis? There was another earlier meta-analysis of randomized controlled trials. And as the author noted, many of the studies had sub-optimal quality https://doi.org/10.1002/14651858.CD015017.pub2, which is not terribly surprising for initial (and often limited) trials. If you look at the paper you linked in detail, you will note that especially for prophylaxis they had 3 trials and highlighted that it only has low-certainty evidence of reduction. Even worse, one of the tree trials used for the evaluation was recently withdrawn (at least temporarily). So as a whole there is not a much to shake that particular conclusion. However, even if we ignore these issues for now, as I mentioned earlier, the data (in part due to the quality of data) suggests at best that a bigger controlled trial is needed to figure out effects rather than jumping the fence and ingesting it because of some positive outcomes. As mentioned before, this is not how drug research works. If every initial study was indicative of effectiveness, we would have cured all sorts of cancer a couple of thousand times by now. The good news is that the TOGETHER trial with 1,500 participants could provide some answers. Unfortunately the outcome is not published yet, but in a virtual symposium I attended one of the PIs has mentioned earlier last month that a couple of drugs where dropped out because they did not show benefits over placebos, including metformin and ivermectin. I am not sure whether that talk is public (though I suspect it somewhere) but I do not have a link saved. My notes only say that relative risk was 0.91 (0.69-1.19)and mortality relative risk is 0.82 (0.44-1.52), so no significant effect over placebo (well and that fluvoxamine showed promise, but for some reasons folks are not demanding its use in droves. I wonder why). I think it was a prophetic documentary. When I was younger I thought the future could be a Neuromancer-esque dystopia. Instead, we have this.

What is your point? That vaccines are not 100% protective? We know that and have been discussing it in various threads. In Israel most of the severe breakthrough cases are folks with additional health complications, whereas the hospitalized folks without previous issues or younger persons were mostly vaccinated. So yes, additional treatment options would be great and I have mentioned a few that are actually at least moderately effective and being used. So why promote something with much less evidence? What is the thought process behind it? I mean why not promote Vitamin D instead? At least it is cheaper and has other health benefits especially if the population has deficits in that regard. Or how about getting regular sleep and a good diet. I mean those would also lower risk to quite some degree. And if we talk about overall morbidity the net effect is likely higher than ivermectin. I really wonder who is making money with this drug at this point, this obsession cannot be organic. Something to read about it here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8050401/

Well, I believe judges in Texas are typically elected, so they are in some way a representation of a bat-shit crazy population (though inevitably biased due to gerrymandering). I actually do not know on what basis judges could dismiss lawsuits, even if they wanted to (it being just stupid is probably not enough). As iNow mentioned, the clever bit is that they kind of removed constitutional challenge to the law, which otherwise would probably be the most direct way. And ultimately the idea is probably not even that folks would win these lawsuits. It is more to tangle up healthcare providers with so many lawsuits (of which each has a minimum cost of 10k if lost) that it just does not make sense for them to continue.

This is utter nonsense. If that was the case why did developed countries fund several studies to look into efficacy of ivermectin? The big issue is that the performance was ultimately disappointing. The dewormer comment is also because people are actually buying formulation for deworming cattle for self-medication. In other words, it is not a knee jerk response but a very accurate description of what folks are doing. In your own link you can read why the study is problematic, and it is not because of censorship. It is because we need ideally controlled setups in order to look at efficacy. Yes people are taking it out of desperation but what is the evidence that it actually works? As I mentioned, controlled trials found no effects, some studies were retracted because the data sets were faulty. Employing a new drug should generally be a high bar to pass, at best you are wasting everyone's time, at worst you could make the situation worse. Even taken the small cohort data into account right now the evidence for a beneficial effect of ivermectin is at best moderate and if the ongoing trials see no increase in effectiveness, it is unlikely to see more traction. In other words, the hype around it is not supported by data. Just because many folks are taking it tells us nothing about its effectiveness. Has anyone for example seen that active case numbers in Peru are inversely correlated with use of the drug? If not that is not evidence. Even if it is not dangerous a drug has to perform. Otherwise you can peddle vitamin C, hydroxychloroquine and so on. Especially in the US folks are not taking it because they cannot get the vaccine. They take it because folks peddle it as something instead of vaccine. And that is where the danger is. I can understand desperate folks trying everything, even if it does not work. But in a community where the drug is actually plenty, this is just plain stupid. Moreover, if folks take an ineffective drug and believe that they are protected and therefore engage in risky behaviour, well that is going to drive cases upward. The whole thing is just a stupid endeavour in conspiracies. The ever present desire to be pertaining to some exotic knowledge where only few enlightened folks have access to (but not invest any work in even trying to understand how clinical trials are set up and how to evaluate the evidence). Any lack of evidence is then explained by the evil mainstream (also called science) who is just somehow suppress research groups... somehow (but apparently not before giving them money to research it in the first place). We all know by now that this is just a convenient way to brush away evidence and jus supplant evidence with narratives. It would be funny if it wasn't driving needless deaths and making the life of health care workers a living hell.

Always somewhere "Far Away" and it will never impact us. Obviously all diseases come from "exotic" places where it is not as clean as "here". I occurred to me that I did not comment on the posted study per se, but as it is reported it has some flaws/issues. An overall issue is that it is not a placebo controlled study, it is more set up like a retrospective one. While it is not an issue for a small experimental study, it is important to note that the outcome is not in any way comparable to a controlled trial. A bigger issue that it does not report how they created the study cohort. It seems that folks just decided to take the drug. That has the issue of self selection. I.e. folks taking the drug may also take additional measures to protect themselves. I also cannot see the study group composition (i.e. whether it is built similarly to the control group). So it is not clear to me if both cohorts had equivalent baseline risks. The fact that they found a higher risk for women, indicates some gender bias in the data set- large analyses indicate a similar prevalence for both genders, though severity seemed more common in men. At best that type of data would indicate that the drug might be suitable for a clinical trial. But, as mentioned, it actually has been and the results were disappointing. This study does nothing to change that outlook.

This is what most of the conspiracy bullshitters are stating. The reality is that it is only an issue because for some reasons certain folks run off to dose themselves with horse dewormer rather than using a vaccine that has gone through trials and has been shown to be safe and effective with currently a sample size going in the billion of dosages. Hardly any other medication has that much data available. With regard to treatment, to date even approved medication like remdesivir have only shown moderate effectiveness in actual controlled trials. Likewise, there were some promising results in early (pre-trial) experiments for ivermectin, but the biggest controlled trial (part of the together trial) did not found a positive effect as outlined in an symposium by the PI of the trial (fluvoxamine seemed more promising, though). Trials for treatment options are still ongoing, though so far no magic bullet has been found. The mentioned remdesivir, as well as monoclonal antibodies, high titer convalescent plasma, dexmethasone are currently being used and have generally shown some improvement, though certainly not in all patients. However especially steroids like dexmethasone were likely effective in preventing death in critically ill patients. But obviously that is only useful (as it suppresses inflammation) after things go bad already. Fundamentally, there is nothing even approaching the effectiveness of vaccines in preventing harmful effects, so it is just madness that folks with access to it prefer to use something that does not show benefits in controlled trials. I wonder what could motivate to use these drugs vs another, well researched one. Well, not really wonder, more like despair. In cases where vaccines are not available the solution should not be peddling ineffective measure. Rather we really need to get our act together and get vaccines to everyone on the planet.

Here is a (I think) a good article which echoes many of the frustrations on that matter. https://www.nytimes.com/2021/09/01/opinion/covid-pandemic-global-economy-politics.html As a side point, it has also shown how much many European Health agencies often look toward the US CDC for guidance before getting into gear.

In the US, apparently there is a new tactic in place to restrict or even abolish abortions. In a way it is a clever way to skirt litigation and basically banning abortion by threatening folks performing it, rather than banning the procedure itself. https://www.vox.com/2021/8/31/22650303/supreme-court-abortion-texas-sb8-jackson-roe-wade-greg-abbott

A very good paper regarding long-term COVID symptoms in larger cohort: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext

I think you are conflating mask use in a controlled manner (e.g. hospital, labs) where folks are trained and follow protocol for mas use. Unfortunately that is not the case with the broader population and it has been shown how masks of different materials have different levels of theoretical protection. That being said wearing any mask is better than not wearing. To look at the effectiveness of masks to prevent infected persons to infect others is based on simple maths. In a situation where an unmasked person is present the room can fill up with infectious particles, if even one badly masked or unmasked person comes in (or takes their mask off) there is a high risk of infection. If conversely the infected wears a mask (source control as described in the link you provided) the risk for the badly or unmasked person drops. In a controlled situation you can ensure that everyone wears PPE properly. In a public space situation, you generally cannot control that and it really just takes a few minutes in any space to identify a few who do not wear masks properly (if at all, given lifting of masking mandates).

It depends on which time frame and implementation we look at. Theoretically vaccines also are likely to provide transient protection and only reduce spread but do not prevent it entirely. The point is that added habitual measures (e.g. masking even if you only suspect you might have been exposed) and especially use at onsets of case increases (as models with influenza suggest in the past) help to mitigate spike heights (though with Delta, it is unlikely to curb entirely). For the most part surges can only entirely be prevented by behavioral measures, but those are difficult to keep up for indefinite times. What we are talking about are really just layers of protection that can chip away at the infection rates.