Yves here. Tom Neuburger explains how “Follow the science” might be more accurately translated as “Follow PMC orthodoxy” or the old standby, “Follow the money”.
I also want to clarify a point that might be missed. Ivermectin is approved by the FDA. It does not need an additional FDA seal of good housekeeping for what is called “off label” use, as in a doctor prescribing it for some other application beyond which it was originally approved. A classic example of off label use is Botox to partly paralyze muscles for vanity cosmetic reasons. If you look at the approved uses of Botox, you’ll see this isn’t on the list.
There is also a fresh and more definitive Ivermectin study than the one Neuburger cites that comes out in favor of its use in the American Journal of Therapeutics, titled Ivermectin for Prevention and Treatment of COVID-19 Infection: A Systematic Review, Meta-analysis, and Trial Sequential Analysis to Inform Clinical Guidelines. As Lambert put it:
First rate authors and methodology, second rank journal, studies themselves pass muster but are not great. However, there are a ton of them. (Studies done or driven by doctors tend to be underpowered because they lack institutional muscle, unlike full-bore RCTs).
By Thomas Neuburger. Originally published at God’s Spies
Ivermectin is cheap and exists. Undeveloped vaccines, with governments desperate to finance and promote them, are money in the bank for years.
One of the challenges of the pandemic period is the degree to which science has become intertwined with politics. Arguments about the efficacy of mask use or ventilators, or the viability of repurposed drugs like hydroxychloroquine or ivermectin, or even the pandemic’s origins, were quashed from the jump in the American commercial press, which committed itself to a regime of simplified insta-takes made opposite to Donald Trump’s comments.”
—Matt Taibbi, Why Has “Ivermectin” Become a Dirty Word?
Matt Taibbi, in a free post at his Substack site, has started to look at a subject dear to my heart, the fact that the admonition to “follow the science” has become its opposite, an admonition instead to not follow the science if the path you tread makes you look insufficiently anti-Trump to your liberal peers and their gatekeepers.
Taibbi’s kick-off point is the controversy (or “controversy”) over the use of the drug ivermectin to prevent Covid-19 infection:
On December 8, 2020, when most of America was consumed with what The Guardian called Donald Trump’s “desperate, mendacious, frenzied and sometimes farcical” attempt to remain president, the Senate’s Homeland Security and Governmental Affairs Committee held a hearing on the “Medical Response to Covid-19.” One of the witnesses, a pulmonologist named Dr. Pierre Kory, insisted he had great news.
“We have a solution to this crisis,” he said unequivocally. “There is a drug that is proving to have a miraculous impact.”
Kory was referring to an FDA-approved medicine called ivermectin. A genuine wonder drug in other realms, ivermectin has all but eliminated parasitic diseases like river blindness and elephantiasis, helping discoverer Satoshi Ōmura win the Nobel Prize in 2015. As far as its uses in the pandemic went, however, research was still scant. Could it really be a magic Covid-19 bullet?
Kory had been trying to make such a case, but complained to the Senate that public efforts had been stifled, because “every time we mention ivermectin, we get put in Facebook jail.” A Catch-22 seemed to be ensnaring science. With the world desperate for news about an unprecedented disaster, Silicon Valley had essentially decided to disallow discussion of a potential solution — disallow calls for more research and more study — because not enough research and study had been done. Once, people weren’t allowed to take drugs before they got FDA approval. Now, they can’t talk about them. [emphasis added]
These are the liberal gatekeepers I’m referring to, the media who push, shape or ignore certain stories, and the Silicon Valley giants who ban their discussion, all to serve the anti-Trumpian cause.
Where’s the science in that?
What We Could Have Done
There are many ways we could have approached the Covid-19 crisis. One would would have been mitigation through eradication, just as we did with the SARS crisis. Recall that “we” (the world’s collective leaders) decided to handle that crisis without a vaccine but with a program of containment and elimination. SARS turned out to be less virulent, and the program worked.
As one scientifically knowledgeable person with “membership of several elite scientific institutions,” put it (quoted here), “The question … is when exactly was it decided to not contain it [Covid-19]. If you remember, some information came out about early and mid-February 2020 closed Senate meetings, after which senators were selling their shares in hotels and airlines, i.e. what was going to happen in late March was known at that time. But it was not in fact too late to contain it in early February, it could have been done with test-trace-isolate. … After all SARS-1 was contained even though it reached hundreds of cases in Canada and the US. … [T]his all becomes even more gruesome when one realizes that the decision of the US to allow it to become endemic meant the same decision was imposed on most of the rest of the world, as the US controls it. … But once it became clear the US will not eliminate and the EU will not eliminate, [other] countries had no choice, although they could have at least held out for vaccines instead of letting it rip.”
Another path would have been mitigation through prevention and treatment — to find medicines that prevented deaths by preventing infection, or treat infection with promising existing medicines and thus eliminate most hospital stays and contagion. The current Covid vaccines haven’t been shown to prevent infection, only symptoms of infection, and that’s by design. All this could have been done while vaccines were in development.
With real and effective non-vaccine options, the need for an immediate vaccine would have been greatly attenuated. If successful, we would have ended up with the same vaccines in the end — or better ones, ones designed to prevent infection — and also seen far fewer deaths and long-term health disabilities.
Covid and the Economy
Not only that, but economic consequences would have also been far milder. We’re in an economic crisis that, grave as it is, we haven’t yet begun to feel. The next big downturn could well be coming. Consider the following discussion on Krystal Ball and Saagar Enjeti’s new show Breaking Points with Washington Post economics reporter Jeff Steiner:
Unemployment is stubbornly high for a variety of reasons — one of which is a game of low wage-chicken fought between a workforce that’s not interested in returning to crappy jobs, and greedy employers not interested in paying more for work they used to get essentially for free.
(I saw this war first-hand in Las Vegas last week. At a resort hotel owned by the MGM Grand corporation, one of the two employment giants on the Strip, wages for their house-cleaning people were kept so low that the corporation couldn’t to hire enough people to guarantee daily room-cleaning service. Many rooms went uncleaned until final checkout. That was a wage-squeeze choice, and simple greed.)
At the same time, according to Stein, there’s zero appetite among DC elites for another round of non-corporate economic support. As a result, most of us will be stuck come September, when previous federal support to humans — as opposed to corporate clients of giant lobbying firms — comes to a permanent end.
What will people do when federal benefits run out? Will they simply submit to the “new normal” and go about their lives? Or will the appetite for rebellion in the country increase again? If it does, Joe Biden’s ramped-up national security state has an answer for that, and it’s not a pretty one.
None of this — none — would have happened if non-vaccine prevention and treatment options had been pursued in addition to then-non-existent vaccines. Yet again, “we” (the world’s collective leaders) chose not to do that.
Claims Supporting Ivermectin Go Unreported
The claims made on behalf of ivermectin as a prevention are considerable(pdf). But are they worth considering? Not in the Age of Trump, it seems, which is with us still. Even today, the follow-the-science crowd isn’t interested, despite the fact that ivermectin is already FDA-approved and thus has a considerable advantage over much more expensive (and, coincidentally perhaps, more profitable) options.
For example, consider this Indian research report, “Prophylactic role of ivermectin in SARS-CoV-2 infection among healthcare workers,” posted for comment in February of this year. It’s apolitical and therefore it attempts to follow the science. From the abstract:
Preventing HCWs [health care workers] from getting infected is a priority to maintain healthcare services. The therapeutic and preventive role of ivermectin in COVID-19 is being investigated. Based on promising results of in vitro studies of oral ivermectin, this study was conducted with the aim to demonstrate the prophylactic role of oral ivermectin in preventing SARS-CoV-2 infection among HCWs at All India Institute of Medical Sciences (AIIMS), Bhubaneswar.
Its conclusion: “Two-doses of oral ivermectin (300 μg/kg given 72 hours apart) as chemoprophylaxis among HCWs reduces the risk of COVID-19 infection by 83% in the following month. Safe, effective, and low-cost chemoprophylaxis have relevance in the containment of pandemic alongside vaccine.”
In plain language, 83% of Covid infection was prevented in the group that took two doses of ivermectin in the previous month. Read the study for the full details. Many similar results have been recorded — but the public has been trained by its media to fear any non-vaccine-only solution.
Why? Perhaps, a cynical person might say, because governments and liberal media are inclined to serve the greed of the pharmaceutical industry. Ivermectin is cheap and exists. Undeveloped vaccines, especially when governments are desperate to finance and promote them, are money in the bank for years.
Or perhaps because liberal opinion-makers are afraid of appearing, to their peers and corporate funders, to be insufficiently anti-Trump. Resistance Fever — the desire to get rid of Trump at any and all cost — drove almost the whole of non-right wing reporting and thinking during the last four years and a half. It’s driving that thinking still.
Or much more simply, perhaps all of our leaders have gone mad and decided, in an act of world-historical hubris, to use the crisis to enhance their power and place regardless of what happens to, well, everyone else on the planet.
It wouldn’t be the first time our rulers have placed their welfare above ours. And given the almost inevitable climate catastrophe, it won’t be the last.
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Neoliberalism’s effort to politicize science (Mirowski writes about this ongoing effort) has paid off handsomely for pharma, the PPE manufactures, and greater concentrations of anti-democratic political power… because Markets. Markets are more important than national health, it seems, when there’s profit involved.
Neuburger’s post describes well some of the fallout from the neoliberal political effort to turn science into “the science”™, aka dogma.
adding: from the abstract of the 2010 Love, Mirowski, and Randalls paper “Introduction: STS and Neoliberal Science.”
“These common outcomes include: the rollback of public funding for universities; the separation of research and teaching missions, leading to rising numbers of temporary faculty; the dissolution of the scientific author; the narrowing of research agendas to focus on the needs of commercial actors; an increasing reliance on market take-up to adjudicate intellectual disputes; and the intense fortification of intellectual property in an attempt to commercialize knowledge, impeding the production and dissemination of science. Taken together, these shifts suggest that the impact of neoliberal science policy and management extends far beyond the patent system into the methods, organization, and content of science.
“We thus urge STS scholars to undertake a detailed exploration of exactly how the external political–economic forces of neoliberalism are transforming technoscience.”
https://www.academia.edu/7999084/Neoliberal_science
Markets are a big part of it, but I also think it’s due to the ideological mythology neoliberalism has built around itself. It is the One True political economy because it is rooted in science, logic, reason. Ergo the “economics is money physics” mindset, they need to present the ideology as being in the same fundamental realm as hard sciences. Problem is, it isn’t, and so instead they are reliant on the institutional aesthetics to convey that imprint of Science onto neoliberalism, such as the Nobel Prize in economics.
So when particular pseudosciences, bunk, woo, gain certain aesthetics and associations that aren’t about the scientific process itself but rather the branding or image, they jump on those aesthetics as the sign of inauthenticity. Typically this isn’t an issue with the way science develops slowly, but with the unusual speed of COVID research and development, what was a reliable association at one point (in this case, non-vaccine treatments being invalid) becomes unreliable within the span of months or even weeks. Science can adjust for that but neoliberalism cannot because if they admit the aesthetics are disconnected from the science, then that disconnects their own “scientific” aesthetic.
This is the goal; it is not an unfortunate outcome. They have to have some method of extracting as much as possible while getting rid of the excess of us. Straight line from Obama’s response to Occupy Wall Street to now.
So large & expensive RCT’s are now the only accepted Gold Standard which would be a good thing in an ideal world, but in the real world that simply gives control to Big Pharma & corrupted governments as to what is designated as good science. There is also flexibility when it happens to suit them as in the case of Remdesivir.
FLCCC are in any case against a large RCT due to the large evidence from data analysis & observation, as in a situation involving a trial it would be a case of potentially sentencing people in the placebo group to death or serious illness.
That of course is a moral judgment not a financial one like BP basically now having total control of what you are prescribed.
I suppose they are too busy with their Trans- and Critical Race Theory indoctrination in the midst of the greatest transfer of wealth up the social pyramid ever, to notice that Fauci and Walensky are maybe worse dissemblers than Trump.
The phrase Follow The Science in current usage includes an element of misdirection. Shutting down alternative inquiries, investigative reporting or other efforts by anyone serves to channel discussion to a narrow and predetermined end. As many observers have pointed out, science is a process and not a product.
Scientists form hypotheses, collect data, discuss methods and welcome or at least acknowledge replications by others for corroboration. When hypotheses become too controversial for discussion, publication or funding, data are hoarded or manipulated, methods are disguised or similar elements of disingenuity are present then science qua science is not served. People collectively suffer from such disservices.
Yep but I suppose that ‘Follow current scientific opinion, that might change as more data comes in and has been properly vetted and analysed‘ is not quite as convincing as ‘Follow the science‘.
The result of shortening it down is that there are people who are now uncertain if what is said to be ‘science’ now is still scientific opinion or if it is scientific fact.
I believe there is a phrase from ‘Through the Looking Glass’ that might apply here:
https://www.goodreads.com/quotes/12608-when-i-use-a-word-humpty-dumpty-said-in-rather
What will people do when federal benefits run out? Will they simply submit to the “new normal” and go about their lives? Or will the appetite for rebellion in the country increase again?
As if resistance to injustice is a bad thing?!
Besides which, despite what “polite company” may think, ALL fiat creation should be for the general welfare ONLY, and while that certainly may include an equal Citizen’s Dividend, it certainly does NOT mean Central Bank loans to and asset purchases from the banks and private interests, typically the rich.
So what is being called “federal benefits” is better described as a partial implementation of an ethical fiat creation system.
The fact that Fauci is still a prop for “science” messaging despite now well-documented lying to congress (isn’t that a crime?) and massive conflicts-of-interest is a symbol to how far down the rabbit hole we’ve fallen.
IMO, now that the military industrial complex and financial industrial complex are in late stage extraction, the bio-med industrial complex is ready for their turn with ever more genetic engineering.
Pandora’s Box?
Reportedly, a wave of expensive antivirals and other drugs are being prepared for deployment under for Emergency Use Authorization when generic Ivermectin is well established as safe and very effective.
But then Fauci can dispatch statistics peppered with obscure terms (manipulative technique) for a mystique of intellectual superiority to suppress/invalidate important re-purposed drugs like Ivermectin and direct a bewildered herd to pharma’s latest expensive block-buster.
The Tyranny of Metrics
https://danielmiessler.com/projects/reading/summary-the-tyranny-of-metrics/
Anything that can be measured and rewarded will be gamed.
An adaption of Goodhart’s Law
Biden just authorized $30,000,000,000 for development and manufacture of anti-virals to combat COVID. I could be wrong, but somehow I think Ivermectin won’t be one of them.
Just read in the WSJ that a new 4.3 Billion casino is supposed to be opened in the strip. I wonder according to this article how they recruit workers….
https://www.wsj.com/articles/resorts-world-to-open-in-las-vegas-as-business-rebounds-after-covid-19-11624354202?mod=searchresults_pos3&page=1
This report from the NIH web site says Ivermectin seems to work at doses about 3 times higher than that approved by the FDA, hence not safe for human use. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7172803/
That is very old news. For one thing, the test was in Mouse tissue, IIRC, and when re tested in human lung tissue, anti viral activity was detected at normal human doses.
And then there is the raft of data showing that it does work. Who you gonna believe, an in vitro study in animals, or real world tests in humans?
Wouldn’t an effective treatment or preventative regime have precluded an Emergency Use Authorization for the vaccines, including mRNA vaccines, which may have taken many years to be widely used in humans without an EUA?
Yes.
My pet theory about the problem with ivermectin is that real wages would have to rise all over the world to cover the added expense of people trying to buy ivermectin all the time; not only whenever they catch a cold but prophylactic use too. How much would the world actually try to spend on ivermectin if it really worked? Too much.
$3.99 for horses!
https://www.jefferspet.com/products/jeffers-ivermectin
https://sciencebasedmedicine.org/ivermectin-is-the-new-hydroxychloroquine-take-2/
Read this site for years, but not sure about this analysis. Starting to wonder about you all when it comes to science. Please read above for a different, science focused take. Warning, very long.
“Where large sums of money are concerned, it is advisable to trust nobody.”
– Agatha Christie
(And yet people still wonder why Agatha Christie is a worldwide, highly regarded, mystery writer. )
On David Gorski – Author of above Science Based Medicine article.
https://www.ageofautism.com/2010/06/david-gorskis-financial-pharma-ties-what-he-didnt-tell-you.html
Age of autism? From 2010? Surely you can do better. Also, the message not the messenger. And most of the takedown was done by others, he just compiled. I could go on.
Please do. / ;)
adding: “There is room for skepticism on the part of the skeptics, but it does not explain the behavior of the skeptics….” – Weinstein in a Rogan interview.. I agree.
https://open.spotify.com/episode/7uVXKgE6eLJKMXkETwcw0D
Can we skip the ad hominem and get to the pharmacokinetics please? Also, the meta analysis isn’t really made of good studies. GIGO. Slapping “Cochrane” on it does not automagically make it high quality. So let’s stick to that. You know, the science. Again, not just Gorski you have to refute here. Btw, did you read it all? Or did you stop at the author…
Sorry, no ad hominem in my comment. In fact, your claiming same sounds a bit straw man, imo. / ;)
Please state exactly the problem with the studies. All of them?
Saying GIGO is not an argument. There is nothing Gorski says that needs refutation. Let’s just admit that we don’t know the pharmacokinetics nor the mechanism. Does this lack of knowledge mean that it doesn’t work?
Wasn’t there an attempt at explaining the mechanism in the J of Antibiotics paper?
https://www.nature.com/articles/s41429-021-00430-5
The best guy IMO on the web in regard to explaining mechanism’s is Drbeen – he’s read 100’s of papers on just about everything that might be of help. Below is his updated Ivermectin video.
https://www.youtube.com/watch?v=GZoBAuR4ajs&t=3s
Rob D
It was hard to choose between the 10 articles from different publications on the 1st page of a duckduckgo that all contain info on Gorski’s conflict of interest, so I just went for the first which basically if nothing else makes clear his whoring himself to Big Pharma & big connection to vaccines.
I hope there is eventually serious karma for his kind of disinformation.
Gorski’s got nothing on Dr. Tess Lawrie
This article is long, goes to too many places, spends too much time on the conspiracy theory aspect, has too many screenshots, and has a tone that is too reminiscent of the lower end of the digestive tract. It really is mostly an attack piece, on various targets. I looked him up minimally (Wikipedia), and I mostly agree with him in many areas (criticism of anti-vaxxers, alternative medicine (some), pseudoscience). I also certainly don’t think Age of Autism is a trustworthy critic.
The scientific bits that I could extract (IVM concentration, weakness of meta-analysis) need to be considered, but this post certainly can’t be seen as dispositive. Too much disorder.
I don’t know where ivermectin is right now. Is India still using it? (I saw a headline that seemed like they were pulling back??) There needs to be one really good randomized controlled trial, even if it kills the control group, because otherwise we’ll never get even CLOSE to an answer. I don’t think it will happen. Why? A big pharma conspiracy seems too organized and complex to be real; timid groupthink is a possibiliy—I don’t have a clue.
My “research” shows that India’s Union Health Ministry withdrew ivermectin from their recommended list on June 7, and that subsequently the state of Goa, which had been pretty much all in, stopped distributing it.
However, yesterday Oxford University was reported as beginning an ivermectin trial. Don’t know where, or on whom, or how big. Maybe we’ll know how effective it is shortly after the pandemic is over.
P.S. To be clear, the article I referred to above is Gorski’s, NOT Neuburger’s.
I have also read this website for many years. However, given the proprietor’s weird decision to get only one dose of mRNA vaccine, and this recent post on a drug that probably doesn’t work, I will unsubscribe from the RSS for it. COVID-19 has made a lot of people lose their minds.
I also tried to post the link to the SBM website in the comments for this post, but it was never put up.
2.5+ million dead, so far. I’ve been fighting on this and other SARS-CoV-2 (Covid-19) issues since last January to no effect. Only now is any of this getting some play. Disgusting.
Seventeen months into the pandemic; many things are highlighted that the corporate media ignores. Nations without functional public health systems were overrun with coronavirus breakouts. The USA is #1 at 618,294 deaths. Australia with a neoliberal federal government still controlled coronavirus outbreaks (910 deaths) since its state public health systems were still in place and working from the first SARS outbreak. New Zealand too (26 dead). The rest of the Western Empire failed. NAFTA, trade pacts, and the European Union superseded and neutered democratic governments. Since the Reagan/Thatcher counter revolt, the meritocracy is in control. Like all human caste systems, the riff-raft, the untouchables are lowlifes of no concern. There is not such thing as society. Only money matters. Identity politics divides and rules. If the gene therapy vaccines fail and with no Plan B; if a variant spike forces another lockdown next winter, the USA falls apart.
In 1924 after WWI and the Spanish flu, the Lost Generation, F. Scott Fitzgerald, described the wealthy the best; “I couldn’t forgive [Tom] or like him, but I saw that what he had done was, to him, entirely justified. It was all very careless and confused. They were careless people, Tom and Daisy—they smashed up things and creatures and then retreated back into their money or their vast carelessness, or whatever it was that kept them together, and let other people clean up the mess they had made.”