From the masthead of the forum…
This is a place for gracious dialogue about faith and science.
Yes, there can be overlap, but the primary mission should not be derailed or hijacked. All in all, I do not think the moderation is overbearing.
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If you read their bios, calling them fringe epidemiologists was completely accurate, as they certainly did not hold to the mainstream concensus and as it was a personal email not a public statement, no apology was necessary, although Collins has been gracious in his admission that things could have been done better.
Regarding moderation, indeed these things have been bantered back and forth ad nauseum, and has remained open for those still feeling they need to waste their time with it. Maybe that is something a dose of ivermectin can cure.
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This remimds me of something I read awhile back to the effect that we don’t have a cure for the flu but we still prescribe therapeutics for it… I might have botched that, but it was something along those lines… I also understand there was this as a factor
The EUA authority, granted under Section 564 of the Federal Food, Drug, and Cosmetic Act, allows the FDA to authorize unapproved medical products or unapproved uses of approved products during a public health emergency when certain criteria are met—namely, that the benefits outweigh the risks and there are no adequate, approved, and available alternatives.
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Can you clarify? Tamiflu shortens the duration. Most flu variants don’t respond to the other options well.
Ivermectin has no benefit with Covid, at least as borne out by studies so far. To my understanding, they felt while studies were pending, they didn’t recommend against them. However, prescribing placebo for something is dangerous. Once proven unhelpful, it is actually detrimental: it avoids treating appropriately, sometimes causing morbidity and mortality; and is not truthful to the patient, giving a false sense of security. Also, ivermectin is not entirely safe, especially in the wrong doses.
I had hopes for hydroxychloroquine when it first was being tested, but it was quite clearly not helpful in good studies. Hydroxychloroquine is not very toxic to most people, but it can be–I have used it for arthritis, and we have to watch for fatal QT prolongation (that is why it is no longer prescribed for leg cramps at night–the risk outweighs the benefit, though it did work for that indication).
Does that help? Maybe I’m not understanding. Thank you.
I can’t find the original article which goes back a number of years now, but I did find this,
Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally.
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What a clever fellow you are JPM. Your principle must be if you can find nothing relevant to advance a topic, simply change the topic. Dr. Bhattacharya never mentioned that drug, only the need for focusing attention on those at highest risk, and that natural immunity should be acknowledged. And of course you would agree that Collins owes no apologies for his ad hominem attacks. That is shameful.
I was of course referring to its efficacy in treating brainworms, tongue in cheek.
The meta-analysis study you cited of course cherry picked early small poorly controlled studies with sample groups as low as 24 and have been superseded by international larger well controlled studies that show no or minimal benefit. Here are a few a quick Google picked up:
https://www.jiac-j.com/article/S1341-321X(23)00316-1/fulltext
https://www.nejm.org/doi/full/10.1056/NEJMoa2115869
https://jamanetwork.com/journals/jama/fullarticle/2801828
https://www.journalofinfection.com/article/S0163-4453(24)00064-1/fulltext
Judge for yourself where the deception lies.
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Great question, @heymike3. I hope you are keeping warm, by the way. It’s a warm break here in Michigan at about 60 degrees, but it will be 36 as a high tomorrow. Oh, well! The maple sap is running, and becoming syrup!
Some wise person once said (and my dad, a surgeon, often quoted), “Medicines are poisons wiht a desired side effect.” (Of course, I could have countered, “Dad, your scalpel is a weapon with a desired side effect!”). He was right, though. We have to be very careful what we give to peoople–not only whether something works, but whether it is safe.
We know that ivermectin works in a test tube against Covid and a lot of other things. However, was it safe and effective in the low levels seen in the human body? High levels can cause seizures and imbalance, for example.
The experts made a hypothesis that it would work, and observed how folks did in non randomized trials. Here is an overview of the level of evidence that we can rely on:
After they started with initial case series, in small experiences as @jpm notes, there was some hope. However, Covid is quite variable in effect. So, we need good samples of people who are randomized to ivermectin and placebo, who match each other in risks as much as possible.
The next step would be non blinded trials, either retrospective or prospectve. They do have some error. For example, in the Women’s Health Initiative with regard to hormone supplementation, a well done, randomized, prospective trial evaluated whether women actually did better with hormones than without. Previous non randomized, retrospective studies implied that they did. However, by constructing a better trial that compared apples to apples in terms of risk, they found that the net benefit was really because women that took hormones were often more health conscious, going to their doc, exercising, eating well, etc. Taking the hormone actually does not help with overall mortality (there is a big breakdown of whether estrogen or progesterone was more concerning, but that’s for another time).
A meta-analysis compares studies that are of good quality, (the best are prospective, randomized, blinded (to avoid confirmation bias), placebo controlled. The meta analysis is only as good as the studies it uses. Good job in selecting a meta analysis–but as JPM wrote, they did not use good studies.
As an example of the power of placebo, researchers studied the effect of magnets on healing. Many people who wore magnets in a bracelet felt that better. So, the researcher randomized people to wear some bracelets that had magnets, and some that did not, but did not tell them which ones had magnets. Interestingly, everyone that had a bracelet felt better–even though there was no magnet. There was no difference whether there was a magnet or not.
More time, with better accumulation of good studies, reinforces the quality of a decision. So, usually, meta-analytical studies that compare data later are better. The referenced one from 2021 was very lmited. A better one is at Cochrane.org.
In the long run, later evaluations found no benefit at all for ivermectin. Here are others in regard to mild to moderate disease, with placebo control, and selecting for early onset in the hopes the low, nontoxic level of ivermectin would help with the low initial viral level
I am reading a book in Audible currently about the development of cancer treatment, “The Emperor of All Maladies.” I appreciate Siddhartha Mukherjee’s recounting of how treatment with radical mastectomy and bone marrow transplanting (for breast cancer; the latter does work for some blood diseases), while very well intended, appeared initially to be helpful, but wound up ineffective and harmful. It is truly amazing how the evidence works.
I am not a researcher @T_aquaticus and @glipsnort are), and I have to rely on how researchers accumulate good data.
There are even meds that we used to use (theophylline, Vioxx, and Darvocet) that I used to prescribe, which are no longer recommended because accumulated evidence has shown either that they are not effective enough, or have too many side effects.
It’s really quite scary; and I appreciate folks that can catch me.
I am sure you know a lot I don’t in your area of training, and can teach me a ton.
Even in primary care, as they say, we “know less and less about more and more, till we know nothing about everything”!
Thanks and blessings. Have a good afternoon.
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Tomorrow is the 5th anniversary of the announcement by Governor Larry Hogan that the gyms in Maryland would be closed for 2 week, stretching to 50 weeks. What was missing at the time and in many analyses since has been HUMILITY. Doctors, scientists, politicians, the media, as well as religious folks got a lot wrong. Medical people would not listen to scientists who had studied aerosol development and movement. Politicains who could not bring themselves to believe that their opponents might be right about some things. At some point, Dr. Collins got it right when he observed that the medical community was far too narrow minded in not considering the wider social consequences of their recommendations. If CDC were in charge of the New Jersey Turnpike, then the speed limit would be 15 mph, for example.
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Greetings, @wbwane . It is really hard. However, would you please clarify this source, and what your reasoning is for coming to this conclusion?
The aerosol communicability varies tremendously among viruses. For example, it can be extremely dangerous to be anywhere near someone, as in measles; and in some harder to communicate bugs, like Ebola. Recommendations also really differ a lot depending on the degree of illness we can get–RSV and flu kill, and shots and even quarantine in close quarters, like nursing homes, can be life saving, though the degree of mortality does not require that we all shut down in an outbreak of most of the current variations. It feels to me that the New Jersey turnpike would be more like RSV or flu–standard speed limits and laws apply, with the occasional branch shut down in case of bad weather or needing a slower transport to engage.
As you know, COVID does spread quickly, and was quite lethal in the first years. I have helped in assisted care facilities where it has killed despite attempts at isolation, and no one was exercising or blowing out high quantities there. Even yesterday, my kids and I were careful and tested one of us prior to going to the gym, as there are a lot of covid and flu cases here (Michigan has a high rate right now), and many elderly go to our gym…
Covid’s spreadability and lethality were relatively unknown. at the time. I think it was, in retrospect, wise to close our gyms, especially with the lack of herd immunity. I fully agree–Collins does a great job of talking about Braver Angels and how to communicate. This link is where he recommends a pledge he signed to help listen better. He now says his first question is, “Please tell me how you came to that conclusion,” or something similar.
Currently, both measles (due to lack of immunization) and avian flu (with new transmissibility among species) are potential threats that may require that we all do the best we can to protect others. I hope not, but there are books and stories of quarantine, like LM Montgomery (a humorous short story by the author of “Anne of Green Gables,” “The Quarantine at Alexander Abraham’s”), and someone I talked to last week who lost most of his family to the Spanish flu, which remind us of nature to human jumps and adaptation that occur all the time.
Thanks.
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Here is a note I sent to our pastor at the National Presbyterian Church in the summer of 2021.
Attached is an article from a recent Economist concerning Covid transmission that is a CATASTROPHIC indictment of the World Health Organization. Not only did they get it wrong, but they stated that any disagreement with THEIR statement was dangerous mis-information. The purpose of this note is to assist NPC and the Session on planning and proceeding with reopening. And, perhaps some rethinking about improved ventilation. Also attached is the PNAS article by Bazant and Bush, and their supporting information.
NPC requires Session members to have financial experience, but not necessarily scientific knowledge. So, copies are going to several members who might appreciate what is said and how these results play into NPC Plans. These findings are not necessarily good for ‘singing”, other than for vaccinated crowds. And, it may be a little late in the NPC renovations to improve ventilation.
We participated in an American Physical Society sponsored discussion last winter lead by Jose-Luis Jimenez. He expressed considerable frustration at the degree to which the medical community was uninterested in the research of people who had invested their careers in aerosols and their movement. His Ph. D. thesis at MIT concerned “automotive emissions”. Then, he was a post doc with John Seinfeld at Cal Tech, the editor at PNAS who accepted the Bazant paper……and who had interactions with our Maryland group back in the 90s.
I will have to dig a bit to find the video, however. If you want the articles, send me a direct note at wwalters@umd.edu. I also have a nice article about the vaccine for the 1957 flu which both my wife and I had in very different locations…but, we were young at that time. And, both my grandmother and aunt Mary dies in the 2017-8 time frame.
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Here are data and items from a Jimenez presentation at an APS regional meeting. At the end are links to some of his slides.
2021 Annual Meeting of the APS Four Corners Section
Volume 66, Number 11
Friday–Saturday, October 8–9, 2021; Virtual; Mountain Daylight Time
[
Session A01: Plenary I
](APS -2021 Annual Meeting of the APS Four Corners Section - Session Index 4CS21)
9:00 AM–10:15 AM, Friday, October 8, 2021
Chair: Astrid Morreale, Los Alamos National Laboratory
Abstract: A01.00002 : The modes of transmission of SARS-CoV-2 and other respiratory viruses: What we know now, and how to protect ourselves
9:15 AM–9:45 AM
Preview Abstract 
Abstract 
Author:
Jose Jimenez
(University of Colorado, Boulder)
The modes of transmission of COVID 19 have been the subject of intense controversy. Overwhelming evidence supports that COVID 19 transmission is mostly airborne: some infected people (those with high viral load) exhale little balls of respiratory fluid and saliva that contain the virus (respiratory aerosols''), that float in the air like an invisible smoke, following air currents. Aerosols infect when we inhale them, and easily explain substantial transmission in close proximity, superspreading events, and why transmission indoors is far larger than outdoors. Surface transmission is difficult, and not a single case of surface transmission has been demonstrated. A small fraction may go through ballistic WHO’’ droplets, mostly important when an infected person coughs or sneezes on someone’s else face. The causes of the WHO’s extreme resistance to aerosol transmission are rooted in a century of denial of airborne transmission, since the work of American public health luminary Charles V. Chapin in 1910. I will present some ideas about how to protect ourselves better from COVID 19 in the coming months and also from other respiratory diseases, focusing on the ones that appear to be underappreciated: (1) the use of visible CO2 monitors in all public spaces where we share air with others; (2) the critical importance of mask fit; and (3) the types of air cleaners, of which some are very useful (filters and UV) and others are likely or certainly dangerous (those based on chemistry such as ions, plasmas, and hydroxyls, or those based on spraying chemicals in the air). Resources include: Lancet: \underline {Redirecting}; Science 1: \underline {https://science.sciencemag.org/content/372/6543/689}; Science 2: \underline {https://www.science.org/doi/10.1126/science.abd9149}; Scientist’s frequently asked questions: \underline {http://tinyurl.com/faqs-aerosol}; Presentation slides: \underline {http://Bit.ly/COVID-Aerosols3}; Estimator of COVID-19 transmission: \underline {COVID-19_Aerosol_Transmission_Estimator - Google Sheets}; Twitter: http://twitter.com/jljcolorado
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Emotions are a powerful thing, especially when they get tied up in fear and tribalism. People were scared, not only for their health but about their jobs, income, paying rent/mortgage, basic freedoms, and so forth. I would hope there are psychologists and sociologists studying the pandemic to see what we could do better in the future. When it comes to human emotions, facts aren’t always the best cure. We have at least one doc who is a regular in these forums, and I am sure they can speak at length about treating the whole patient, including their worries and fears.
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There were certainly many people who were conned by misinformation spread on social media, and this caused them to not get the vaccine. This means there were people who died who would have otherwise not died if not for that misinformation. Once the vaccine became available more than 90% of hospitalizations and deaths were amongst the unvaccinated even as vaccination rates neared 50%. How do we tackle this moral and ethical problem?
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I think the demographic study estimated that number to be about 230,000 who died unnecessarily once the vaccine was widely available due to vaccine hesitancy.
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The fact only a single person liked this tripe (your post) is testament to the reality…Dr Collins was right and the overwhelming influx of sick patients into hospitals was always a key factor in lockdowns…it was an accurate and proven decision. Countries that did jack, their health care systems were completely swamped amd a lot of unrelated sick individuals suffered and died because of COVID overloading the system thus starving them of necessary surgeries and or care.
Lets face it, why should my 90 yearold grandma see out her final days in a nursing home, where we thought she would be safe, being ground into the grave from the effects of a covid infection given to her by ass asswipe who enterred the place whilst sick sending a devastating illness around that nursing home killing old people?
Then my wifes current boss…refused vaccination, took extended leave on pay (because she had enough to do so) posting photos of herself sunning at the beach, whilst other teachers who refused to be vaccinated were sacked, then this naive twit managed fo worm her way into a school principalship immediately after COVID and now my wife, who followed the rules and got vaccinated did her duty despite the lack of staff…and now my wife has to putup with working under an individual she has absolutely zero respect for…
Ill stop there before i swear, however ill just finish with…
Whilst i dissagree with Dr Collins on many theological issues, he was 100% right on this and i am glad someone was out in front who has common sense.
Blow it…ill add in another…
Protest march in Melbourne cbd …i was working on a shopfront that day as the march went right past. I was bailed up by a dimwitted dole bludger who claimed that face masks dont work…then he used as evidence in support of his claim a research result where apparently in testing the one that did work was glued to a test subjects face.
I dont know if anyone else sees the irony there, however im hoping we are all able to agree this guy and his supporting evidence are nonsensical in that if a mask works when glued to ones face then clearly the mask fabric works as intended!
I told him to “go and get a job” (as one would expect)
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Absolutely. Importantly, the flow of misinformation went both directions.
When mistakes of commission or omission are made, most honest people demand an admission, if not an apology. At the very least we expect some form of acknowledgement, and most good/honest brokers do exactly that. But even as the egregious and absurd lies were told to us during the Covid debacle, some are still burying their little heads in the sand. Such is the vulnerability of those sycophants who choose to ignore the truth. So the stories/evidence continues to mount:
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First it was the adhominems directed toward the scientists who correctly saw the need to individualize the vaccine. That outrageous slur upon Bhattacharya remains…
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But now comes even the NYTs telling us, and admitting to us that Dr. Francis Collins and Dr. Fauci actually intentionally misled them about the viral origins. The title of the NYTs piece is We Were Badly Misled About the Event That Changed Our Lives:
“Around the time Donald Trump was calling Covid-19 the “China virus” in 2020, U.S. government disease doctors Anthony Fauci and Francis Collins, whose institution had supported EcoHealth Alliance coronavirus research in Wuhan, were pushing a narrative minimizing the possibility that Covid-19 might have been created in a laboratory”.
Adding…"
When people started speculating that a laboratory accident might have been the spark that started the Covid-19 pandemic, they were treated like kooks and cranks. Many public health officials and prominent scientists dismissed the idea as a conspiracy theory, insisting that the virus had emerged from animals in a seafood market in Wuhan, China.
To intentionally mislead the public is what is so inexcusable.
We have since learned, however, that to promote the appearance of consensus, some officials and scientists hid or understated crucial facts, misled at least one reporter, orchestrated campaigns of supposedly independent voices and even compared notes about how to hide their communications in order to keep the public from hearing the whole story. And as for that Wuhan laboratory’s research, the details that have since emerged show that safety precautions might have been terrifyingly lax.
As I have said again and again, we are better than that. We should know better than that.
What do you mean by this?
How were people misled? The evidence at the time leaned towards the wet market being the origin, and subsequent evidence has only strengthened that conclusion. There was never any evidence of a lab leak that I saw nor the scientific community.
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The evidence still leans to the wet market from what I have seen, with the news released like the CIA deal being opinion pieces generated by politics. Any newer data that says otherwise that I am ignorant of?
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Not that I have seen. Here is a good article from last September:
https://www.nature.com/articles/d41586-024-03026-9
They were able to identify both SARS-CoV-2 RNA and DNA from multiple known susceptible species in samples taken from the Wuhan wet market. This is in addition to at least two lineages of the virus circulating through the wet market.
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