Joe Rogan, Ivermectin, Sanjay Gupta, CNN, the Culture War | A doctor reflects on the evidence

My substack post:

Ending Medical Reversal

Vinay Prasad, MD MPH
Hematologist/ Oncologist
Associate Professor of Epidemiology & Biostatistics

Host of Plenary Session Podcast

Read our academic papers here:

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Twitter @vprasadmdmph

[georgeboros]

As a treating physician I'm frustrated with the philosophy of waiting until we have completed gold standard studies. The meta-analyses on ivermectin are mostly positive while this is a known medication which is extremely safe at the doses used in these studies as well as extremely cheap. I vote for doing something instead of nothing not on a national level but at least allowing patients to take it and physicians to prescribe it if they decide to do so.

[robyn]

Thank you for talking. Censorship is not the answer.

[edg]

I do disagree and think money for big pharma does have a large play in the whole issue. When attending physicians first started saying that Ivermectin was helpful, the CDC should have raised their head. They should have contracted for a study, not only on this but on any other Rx's that doctors felt might actually work. This is one of their jobs. Just like they dropped the ball when the two cruise ships and the carrier started showing significant outbreaks. This raised a very high possibility that air was the main source of transmission. No, they stuck with wash your hands 200 times a day and waited until about July to bring up airborne. Remember Remdesivir will lose its emergency status if something actually works. I do not find any fault with a doctor prescribing Ivermectin when they think it could help. From what I have seen, it is one of the safer Rx's, and it is better than what was taking place here locally and that is if a person did test positive, sent them home until they got sick enough to be admitted to the hospital.

[LucaAnamaria]

I love robust trials too. But why are we using one set of standards to assess IVM and another set of standards to assess the "pokes"? The pokes are still in phase III clinical trials. So much of the data is not in yet. Why are we comfortable promoting (no, MANDATING) those? Why is one of these treatments getting forced and the other banned? Seems way too polarized.

[timcoolican]

Explain how you can advise people to take any of the experimental Covid vaccines, when they have not yet completed required testing and rigorous peer review? If emergency authorization can be used for vaccines, why are they not being utilized for treatment therapies? Particularly Ivermectin, which has a long history of use and safety data, involving nearly 4 billion people, over the last 40 years.

[theflangdude]

The vaccine trials are not finished, why is it recommended but not ivermectin?

[acugreg]

Given that Ivermectin is cheap and unlikely to cause harm, I fail to see why it is so strongly discouraged. However, I too would really like to see the results of better conducted trials.

[nengnengnengable]

Uttar Pradesh isn't running an RCT, but the Indian State has a population of 230 million and look at the results there with their US$2.65 covid home kits. It's really disappointing that you also seem to think its OK and not at all suspicious that, in your own words, it will take another 6-12 months to run an RCT on ivermectin, when the costs are so low and safety profile (3.7 billion doses administered to humans) is so good.

[helenhenthorn]

I've watched drbeen youtube videos since the beginning of the pandemic and listened to more than a dozen of his guest speakers who treat Covid patients, some have treated 1000s including ICU department heads and other critical care clinicians who have given hour long detailed accounts. All have portrayed with astonishment the effectiveness of the drug and the transformation of their practice from that of a place of death to one where many patients can recover at home.


One take-away I've heard from most is how fast 24-48 hrs. patients with low oxygen saturation's in the low-mid 80s are restored to more normal levels, and can breathe again. The doctors delight at seeing this restorative effect is written across their face as they recount this surprising experience of a drug that doesn’t just help, but transforms.

[Bane]

I’d love to see you have a conversation with Tess Lawrie. She’s an international expert on medical data analysis and has concluded that ivermectin works. Would be interested to see that back and forth.

[pirateslifeme]

"It's so nakedly tribal it sickens me!" This is why we respect you 🙏

[kylepusey]

Like masking. In schools. Where is the RCT for masking kids? My daycare kid does not mask, but my 1st grader must. The delta variant hit both campuses (mildly and on the upswing in rate of cases in September). I just have a hard time believing that a virus that is nanometers big cares about a porous cloth mask in a room that is shared with others for several hours.

[bethjones]

Please talk about rendisivir being pulled from the 2018 Ebola study killing the kidneys. But yet it’s the standard treatment in the hospital for covid

[ANOOPBAL]

We need Vinay Prasad in Joe Rogan's podcast!

[ryanvalicek]

There isn’t any money to be made studying NPI’s either…. ‘Show me the incentives and I will show you the outcome” —Charlie munger

[darkdudironaji]

Can someone tell me why you shouldn't take ivermectin? It might work, and I don't see it doing any harm. So why not take it just in case?

[nancycorbeil]

Of course it's about money! those big double-blind randomised studies cost money and only big companies can afford to invest in them, and will do it only if there's money to be made.
It's quite arrogant to say that all those doctors who use the medicine and get good results don't know what they are talking about.

[thedrunkenchefs]

HCQ did not fail when used with zinc within the first 5 days of symptoms in those with comorbidities.

[SineEyed]

Why would you not have recommended him taking IVM, when despite knowing if it's effective or not, you DO know that prescribing a course of it would at the very least not increase the risk of anything harmful coming about? If there is even a small potential for being helpful vs what is effectively zero risk of causing harm, why would you choose not to help? That makes no sense. At least 62 studies have been conducted already; some of them were of low quality, but not many. Most are done well. Does the existing evidence provided by the studies which have already happened count for nothing? How does a worldwide pandemic not meet your lofty standards for trying alternative medications if it presents even the slightest possibility of saving lives? I can understand sticking to your guns about that under normal conditions, but people are dying -- potentially needlessly. I have no idea how any doctor will reconcile the fact that people under their care have died only because that doctor sat on his hands, refusing to give their patient medication that could very well save the patient's life. The scale of the rationalization they must tell themselves to escape the guilt of ignoring treatment while their patient died, must be enormous. As far as I see it, you doctors are ignoring your oath. Shameful.

I think anyone who says they just don't know yet if IVM is effective against c-19, is being knowingly untruthful to themselves, or willfully ignorant. One only needs to look at the success of Uttar Pradesh to have that question answered. Hundreds of millions of people, in the midst of a potentially catastrophic outbreak, begin a regimen of vitamins and medications supplied by their government; shortly thereafter, not only was that outbreak thwarted, the case rate in that highly populated region is at *0.0* !!

There is a place in the world that quickly defeated this virus - eradicated it - but yeah let's wait another 18 months for some more goddam trials to finish up because 62 of them aren't enough already, but more importantly, because reasons. 🤪

We're all gonna be pretty screwed if all these people don't go looking for the mind they seem to have recently lost.. 😟

[bbruce]

What happened in India? Why have cases gone down so dramatically since the beginning of the year?