Bari Weiss: anti-vaxer?

January 22, 2022 • 11:30 am

In this segment of Bill Maher’s show last night, Democratic Congressman Ritchie Torres from New York, Bari Weiss, and Maher discuss Covid-19, with the topic being “whether it’s time to move past Covid restrictions and get back to normal.” Weiss and Maher seem to say “yes,” while Torres urges caution. 

Bari Weiss declares that she’s “had it” with Covid, that masks don’t work, that you can be vaccinated and still get infected with omicron, that lockdowns cause suicide, that few children have died from Covid and that “it’s time to end it”, apparently meaning we no longer need to take precautions against Covid, including getting rid of masks, lockdowns, and vaccinations. She’s arguing, as Torres characterizes her view, that “the response to the disease has been worse than the disease itself.” But have 800,000 Americans committed suicide from Covid-induced depression? No: look at the data from StatNews:

Those of us who posited that suicide rates may actually decline during the pandemic were either dismissed or criticized. But we were right: Provisional data released by the U.S. Centers for Disease Control and Prevention suggests that for the entire year of 2020 — when most lockdown procedures were put in place, many communities saw their highest rates of Covid-related deaths, and economic uncertainty was at its peak — suicide rates dropped by 3%.

For verification of this, see here and here (the latter is the Suicide Prevention Resource Center, which says that more data should be analyzed when it comes in later).

As for the efficacy of masks, the data summarizing their value can be seen at the CDC website, which actually gives data and doesn’t just say “wear masks”.

The gist of what she says here is that we shouldn’t have done anything about the pandemic. Maybe we would have had 2 millions deaths, but that’s just collateral damage.

Torres makes the point that nearly 100% the people in the hospital with Covid now are unvaccinated. They’re still dying, so how can you claim that vaccines don’t work? (The original clinical trials, of course, confirmed the efficacy of the vaccine.). As reader Paul wrote,

At least on COVID, Bari Weiss seems to have joined the other side. She and Bill seem to believe that the vaccine only protects the recipient against hospitalization and death and doesn’t help them avoid catching and passing on the disease. In general, Weiss seems to be positioning herself as a “media personality” rather than a writer, at least that’s my take.

Not only that, but she’s not even hewing to the data.  She’s come perilously close to being an anti-vaxer, if she isn’t one already.

In Weiss’s case, she hasn’t stayed in her ideological position while the left moved further left. No, she appears to be shifting to the right. I wouldn’t be surprised if eventually she become a never-Trumper Republican. I hope not, but what she had to say in this short segment greatly disheartened me.  And so did Maher’s response.

Weiss, at least, owes America a clarification of what she means when she says, “it’s time to end it.” End WHAT?

 

You can order your free Covid test kits now

January 18, 2022 • 11:30 am

Although American households were supposed to order their 4 free Covid test kits beginning tomorrow, reader Paul, quick to the mark, found out that you can order them NOW.

Just go to this site (or click on the screenshot below), and enter your name and address after pressing the blue button. Check out (no charge), and you’ll immediately get a confirmation email from the USPS.

The details (remember, rapid antigen tests aren’t usually accepted for international travel):

  • Limit of one order per residential address
  • One order includes 4 individual rapid antigen COVID-19 tests
  • Orders will ship free starting in late January

DO IT NOW!  Thanks, Paul.

The Epstein-Barr virus appears to be an important cause of multiple sclerosis

January 14, 2022 • 9:15 am

The Epstein-Barr virus has been associated with a variety of diseases; as Wikipedia notes (my emphasis, and I’ve left in the footnotes so you can consult 11-13, which I’ve put in bold):

The Epstein–Barr virus (EBV), formally called Human gammaherpesvirus 4, is one of the nine known human herpesvirus types in the herpes family, and is one of the most common viruses in humans. EBV is a double-stranded DNA virus.[2]

It is best known as the cause of infectious mononucleosis (“mono” or “glandular fever”). It is also associated with various non-malignant, premalignant, and malignant Epstein–Barr virus-associated lymphoproliferative diseases such as Burkitt lymphoma, hemophagocytic lymphohistiocytosis,[3] and Hodgkin’s lymphoma; non-lymphoid malignancies such as gastric cancer and nasopharyngeal carcinoma; and conditions associated with human immunodeficiency virus such as hairy leukoplakia and central nervous system lymphomas.[4][5] The virus is also associated with the childhood disorders of Alice in Wonderland syndrome[6] and acute cerebellar ataxia[7] and, based on some evidence, higher risks of developing certain autoimmune diseases,[8] especially dermatomyositis, systemic lupus erythematosus, rheumatoid arthritis, Sjögren’s syndrome,[9][10] and multiple sclerosis.[11][12][13][14] About 200,000 cancer cases globally per year are thought to be attributable to EBV.[15][16]

Infection with EBV occurs by the oral transfer of saliva[17] and genital secretions. Most people become infected with EBV and gain adaptive immunity. In the United States, about half of all five-year-old children and about 90% of adults have evidence of previous infection.[18] Infants become susceptible to EBV as soon as maternal antibody protection disappears. Many children become infected with EBV, and these infections usually cause no symptoms or are indistinguishable from the other mild, brief illnesses of childhood. In the United States and other developed countries, many people are not infected with EBV in their childhood years.[19] When infection with EBV occurs during adolescence, it causes infectious mononucleosis 35 to 50% of the time.[20] In 2022, it has been shown that EBV infection increase the risk of developing multiple sclerosis by 32-fold.[21]

EBV infects B cells of the immune system and epithelial cells. Once EBV’s initial lytic infection is brought under control, EBV latency persists in the individual’s B cells for the rest of their life.[17][22]

Here are two EBV virl particles with some proteinaceous spheres (not nuclei!) containing the viruses’ genetic material.  I had mono about twenty years ago, so I’m probably carrying the virus, too.

It has spikes, like Covid-19:

Source

At any rate, note that the association with the virus (henceforth “EBV”) with multiple sclerosis (“MS”) has been suggested before (references 11-13, ref. 14 is this paper). I haven’t read the first three papers, but #14 is just out in Science, and I’ll mention it briefly today. It surely is, given the discussions, the strongest evidence to date for an EBV cause of MS.

The paper was called to my attention by the tweet below from Matthew. And, apparently, this is the strongest suggestion yet that EBV actually causes multiple sclerosis.  If this proves to be the case, and the evidence is pretty strong, then this opens the way to preventing MS, most likely via I suspect shots in the young, because once the diease develops, a shot wouldn’t work. In fact, Moderna is at this moment making an mRNA vaccine against the virus. (Although, coronaviruses like Covid-19 have RNA instead of DNA as their genetic material—EBV has DNA—it doesn’t matter what genetic material the virus uses to replicate, for the mRNA in a vaccine is used by the body to make viral protein that then activates the host’s immune system.)

One note: MS is a disease that appears when your immune system attacks the myelin sheath surrounding the nerves, which disrupts nerve impulses. That in turn can lead to multiple effects, including difficulty in breathing, walking, and seeing. All of us have known people with MS, and you’re probably aware that the disease varies widely in its severity, with of the afflicted dying very quickly and others living a life of nearly normal span. On average, MS takes away five to ten years from your life, and a lot of that life is unpleasant.

Here’s the tweet that alerted Matthew, and then me, to the new results:

The paper below with the nearly dispositive data is free; click screenshot for access or get the pdf here. The reference is at the bottom.

(There’s also a News and Views piece on this article, which you can get for free by clicking the screenshot):

Now the best way to see if the virus causes the disease is to inject virus-free humans with EBV, and see if the injected group gets MS more often than does a control (noninjected) group. But since 90% of adults are infected anyway, and this experiment is highly unethical, one has to find other ways.

These researchers did the next best thing: a retrospective analysis of blood serum left over from AIDS tests on more than 10 million U.S. military personnel.  The criterion for “causality” here is the philosophical one: A causes B if you never get B unless you have A beforehand. (This doesn’t mean, of course that A is the sole cause of B.) As the authors say, “causality implies that some individuals who developed MS after EBV infection would not have developed MS if they had not been affected by EBV.” Note that they say “some individuals”, as there may be other causes of MS. But this is more than an association study, as EBV negative individuals could be tested for infection status during their period of activity duty, and then screened for MS to see whether the disease is associated with earlier infection.

The ten million soldiers were screened over a period of 20 years, and the leftover serum, fortunately, had been stored.  All samples were analyzed for EBV infection and then the MS status of the individuals determined during the period of active duty.

5.3% of individuals whose blood were tested were EBV-negative (as I said, most of us are infected) and in a sample of ten million that’s about half a million people.

Among the personnel examined, 955 MS cases were identified, of which 801 cases had several blood samples available taken at differen times. For each one they looked at three serum samples taken BEFORE onset of the symptoms. Each case was matched with at least one non-MS-afflicted control individual of same age, sex, ethnicity, branch of service, and date of blood collection.

The results were pretty compelling. Under the causation scenario, you’d expect MS to develop almost entirely in the group that were initially EBV negative but then got infected, and only then did they develop MS.

And that’s what they found. To quote the paper:

Only one of the 801 MS cases occurred in an individual who was EBV-negative in the last sample, which was collected at a median of 1 year before MS onset [hazard ratio (HR) for MS comparing EBV-positive versus EBV-negative = 26.5; 95% confidence interval (CI): 3.7 to 191.6; P = 0.001, conditional logistic regression]. At baseline, 35 MS cases and 107 controls were EBV-negative. All but one of these 35 EBV-negative MS cases became infected with EBV during the follow-up, and all seroconverted before the onset of MS (fig. S3). The median time from the first EBV-positive sample to MS onset was 5 years (range: 0 to 10 years), and the median time from estimated EBV seroconversion, defined as the midpoint between the last seronegative sample and the first seropositive sample, to MS onset was 7.5 years (range: 2 to 15 years).

Remember, all of the 801 cases were EBV negative at the first sampling. Then all but one of the individuals who developed MS had gone from EBV negative to EBV positive. (The authors discuss the one outlier case, but you can read that for yourself.) To see if it was really EBV that was associated with the onset of MS, they looked at other viruses as well, and also looked at other disease markers that could show whether MS had already begun (but without physical symptoms) when the patients were still EBV-negative. (They didn’t find that.)

They did other tests as well trying (like good scientists) to try to rule out a causal role of EBV in MS. They ruled out “confounding by unknown factors” because of the strong association between EBV infection and later development of MS. No risk factor could account for the huge increase in MS propensity among those who went from EBV negative to EBV positive.

The other factor was “reverse causation”: perhaps EBV doesn’t cause MS, but the early development of MS, not detected clinically, could make a patient more susceptible to EBV infection. This is ruled out because only the EBV virus was associated with the pathology, while one would expect the “reverse causation” syndrome to make MS patients more susceptible to other viruses.  That wasn’t seen.

I won’t go on except to show this graph, which displays significant differences in the level of antibodies against various human viruses between controls and those who got MS (remember, these are all EBV negative people at the start of the trial.) The blue bars represented antibodies against viral proteins that showed higher levels in controls than in those who got MS, while the orange bars represent the level of antibodies  significantly higher in the blood samples of those those who got MS than the controls. As you see, the level of antibodies against EBV is much, much higher in the pre- and post-MS-onset blood samples than in the control (no MS) samples. In other words, no other virus beside EBV was associated with MS either before or after the symptoms appeared.

The last paragraph of the Science paper suggests MS therapy with monoclonal antibodies against the viral proteins might be better than current therapies, and in fact we’re using monoclonal antibodies now to help patients already infected with Covid-19.

But a better tactic would be not to get the disease in the first place, and the tweet below suggests a vaccine that might do this is in development. And if EBV is associated with all those diseases mentioned above, like cancer and inflammatory bowell disease then a jab when young might stave those off, too!

________________________

Reference:

Bjornevek, K. et al. 2022. Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Science,10.1126/science.abj8222(2022).

The New York Times might have used Bayes’ Theorem

January 4, 2022 • 10:00 am

by Greg Mayer

The New York Times has a data analysis division which they call The Upshot; I think they created it to compensate for the loss of Nate Silver’s 538, which was once hosted by the Times. The Upshot reporters and analysts tend to be policy wonks with some statistical savvy, so I took note of a big story they had on page 1 of Sunday’s (2 January) paper on why many prenatal tests “are usually wrong.

The upshot, if you will, of the story is that many prenatal tests for rare chromosomal disorders unnecessarily alarm prospective parents because, even if the test result is positive, it is unlikely that the fetus actually has the disease. This is because when a disease is rare most positives are false positives, even when the test is quite accurate. For the five syndromes analyzed by the Times, the proportion of false positives (i.e. “wrong” results) ranged from 80% to 93%!

The Times does not go into detail of how they got those figures, but from links in their footnotes, I think they are empirical estimates, based on studies which did more conclusive followup testing of individuals who tested positive. My first thought, when looking at Sunday’s paper itself (which of course doesn’t have links!), was that they had used Bayes’ Theorem, the manufacturers’ stated sensitivity and specificity for their tests (the two components of a test’s accuracy), and the known prevalence of the condition to calculate the false positive rate.

Bayes’ Theorem is an important result in probability theory, first derived by the Rev. Thomas Bayes, and published posthumously in 1763. There is controversy over the school of statistical inference known as Bayesian statistics; the controversy concerns how one can form a “prior probability distribution”, but in this case we have an empirically derived prior probability distribution, the prevalence, which can be thought of as the probability of an individual drawn at random from the population in which the prevalence is known (or well-estimated) having the condition. There is thus no controversy over the application of Bayes’ Theorem to cases of disease diagnosis when there is a known prevalence of the condition, such as in the cases at hand.

Here’s how it works. (Remember, though, that I think the Times used empirical estimates of the rate, not this type of calculation.)

Using Bayes’ Theorem, we can say that the probability of having a disease (D) given a positive test result (+) depends on the sensitivity of the test (= the probability of a positive result given an individual has the disease, P(+∣D)), the specificity of the test (= the probability of a negative result given an individual does not have the disease, P(-∣ not D)), and the prevalence of the disease (= the probability that a random individual has the disease, P(D)). Formally,

P(D∣+) = P(+∣D)⋅P(D)/P(+)

where the terms are as defined above, and P(+) is the probability of a random individual testing positive. This is given by the sensitivity times the prevalence plus the specificity times (1- the prevalence), or

P(+) = P(+∣D)⋅P(D) + P(+∣ not D)⋅(1-P(D))

The whole thing in words can be put as

probability you are ill given a positive test =

sensitivity⋅prevalence/[sensitivity⋅prevalence + (1-specificity)⋅(1-prevalence)]

Let’s suppose we have a sensitive test, say P(+∣D)=.95, which is also quite specific, say P(-∣ not D)=.95 (sensitivity and specificity need not be equal; this is only a hypothetical), and a low prevalence, say P(D)=.01. Then

probability you are ill given a positive test =

= (.95)(.01)/[(.95)(.01)+(.05)(.99)]

= .16.

Thus, if you had a positive test, 84% of the time it would be “wrong”! This is right in the neighborhood of the rates found by the Times for the five conditions they examined. Notice that in this example, both sensitivity and specificity are high (which is good– you want both of these to be near the maximum of 1.0 if possible), but because prevalence is low (.01), the test is still usually “wrong”.

In an earlier discussion of Bayes’ Theorem, Jerry noted:

This [tests for rare conditions being usually wrong] is a common and counterintuitive result that could be of practical use to those of you who get a positive test. Such tests almost always mandate re-testing!

He’s absolutely right. A test with these properties is useful for screening, but not for diagnosis– you’d usually want to get a more definitive test before making any irreversible medical decisions. (For COVID 19, for example, PCR tests are more definitive than the quicker antigen tests.) The Times also discusses some of the unsavory aspects of the marketing of these tests, and the tragedy of the truly life and death decisions that can ensue, all of which flow from the results of the tests being misunderstood.

(Note: an alert reader spotted a mistake in the verbal equation, and in checking on it I spotted another in one of the symbolic equations. Both corrections have now been made, which are in bold above. The numerical result was not affected, as I’d used the correct numbers for the calculation, even though my verbal expression of them was wrong!)


For a nice but brief discussion, with some mathematical details, of the application of Bayes’ theorem to diagnosis, see sections 1.1-1.3 of Richard M. Royall’s Statistical Evidence: A Likelihood Paradigm (Chapman &Hall, London, 1996). Royall is not a Bayesian, which demonstrates the uncontroversial nature of the application of Bayes’ Theorem to diagnosis.

Two bits of Irish woo

December 23, 2021 • 11:15 am

There’s a time when “blarney” becomes crazy and harmful, and we have two cases that appeared at the same time.  The first represents the New York Times‘s recent presentation of woo in extenso, with almost no critical remarks. The editors are soft on astrology, they’re soft on dowsing, they’re soft on religion, and now they’re soft on a mixture of religion and spiritual healing. Click the screenshot to read:

As the article reports, there are a number of faith healers in Ireland who have what they call “the cure”. It’s nothing new; it’s the old “laying on of hands” by believers, often accompanied by prayer, holy water, etc., to effect cures. The guy in the photo above, Joe Gallagher in Pullough, is the seventh son of a seventh son (not that rare in Catholic Ireland, but increasingly rarer), and this is supposed to give him special healing abilities. Here’s how the author, Megan Specia, describes “The Cure”:

Mr. Gallagher is just one of hundreds of men and women across Ireland who are healers, or have “the cure,” an approach to health care that interweaves home remedies with mysticism, superstition, religion and a sprinkle of magic.

It’s part of a belief in folk medicine, curing charms and faith healers that is still a way of life for many in Ireland, if a fading one.

Some who are believed to have the cure are seventh sons, like Mr. Gallagher, a birth order long thought to bestow special powers.

Others are keepers of family customs that range from rituals, prayers and charms to herbal tinctures, offered up as treatments for everything from burns and sprains to rashes and coughs.

Since his childhood, people have sought out Mr. Gallagher. “I think you must have the belief,” he said, acknowledging that the process doesn’t always work. “I wouldn’t say that I can do miracles.”

Indeed!

People come from miles around to see healers like Gallagher, who are reputed to cure things like:

  • burns
  • sprains
  • coughs
  • rashes
  • warts
  • shingles
  • ringworm (in dogs, too!)

An example:

Bart Gibbons, 57, who owns a grocery store in the village of Drumshanbo in County Leitrim, has a cure for warts that was passed down from his father and his father’s father before him.

It involves taking a bundle of rushes and saying a combination of prayers as they are held over the affected area. Then, he buries the reed-like plants. The belief is that when they decay, the warts are gone.

They don’t get paid, so at least that’s good, but have they done controlled trials with these shamans? I don’t think so. At least they’re cheaper than doctors, but isn’t there a form of national healthcare in Ireland? And, as you know, warts sometimes go away by themselves.

The only comments that are negative in this longish piece are these:

Attributing positive outcomes of the cure to something like a placebo effect makes sense to Ronald Moore, an associate professor of public health at University College Dublin who has spent years researching folk cures and who emphasized there is little scientific evidence for the efficacy of these practices.

Well, then, why not just give the people sugar pills? And the statement above is quickly followed by this:

But that doesn’t mean the medical community completely dismisses potential benefits, with some doctors known to send their patients for the cure, often for skin issues or other minor troubles.

“Modern practices on the one hand pooh pooh this, as scandalous and outrageous and quackery,” Dr. Moore said. “But in fact, and in reality, they utilize it.”

Those doctors are shameful. At least they don’t send patients to the Irish shamans for maladies like cancer and heart disease. (Shamans may, however, try to cure people of more serious stuff.)

Although the practice is “deeply religious”, it works on dogs, too!  Can dogs lose their ailments by “The Cure”? I thought Edward Feser maintained that dogs don’t have souls. But here’s the last picture of healing in the piece; I’ve included the paper’s caption. The picture makes me laugh out loud: a real LOL:

Mr. Keane performing the cure for ringworm on one of the dogs from a neighboring house in Cloghans.Credit…Paulo Nunes dos Santos for The New York Times

Once again the New York Times is touting quackery by publicizing it and only bringing in one lone dissenter, who is immediately countered by a physician enthusiast. What is going on with this newspaper?

****************

This article with its hilarious title is a serious piece in another Times—the Irish Times. Being a Catholic coutry and all, I suppose papers there have more article like this one. If you read the piece, you’ll see that “lay theologian” (indeed!) Brendan Butler is deeply besotted with God and baby Jesus, the “eternal Cosmic Christ.” And Jesus is said to be the “culmination of 13.8 billion years of evolution.” This implies that evolution in humans has stopped, but yet we’re still evolving and so is every other species.  Read and weep to find out why Jesus is the End of Evolution:

Okay, here’s the whole scientific explanation of why Jesus is the culmination of evolution (it’s part of a longer piece that sounds like a sermon):

How to reconcile a human and a divine nature in one person became the subject of controversy until it was resolved in 431 at the council of Ephesus by declaring Mary as ‘Theotokos’ – the mother of God.

But this led to another question: why did the eternal creator God become a mortal and fragile human creature? Various explanations were put forward, with the most common being that it was necessary for God the Son to become human and die on a cross for the sins of the human race.

However, another explanation associated with the Franciscan theologian John Dun Scotus, fits in with our post-Darwin, post-Einstein and post-Hubble world. In this view the baby Jesus, born in Bethlehem, was the culmination of 13.8 billion years of the evolutionary process.

He was born with the substance of the stars and molecules of prehistoric life present and active in his body. In this Christology the baby is not just a child of the universe but the eternal Cosmic Christ who released that primal energy which burst forth and created the universe.

Evolutionary process

This Christ remained an integral part of the evolutionary process, sustaining it and driving it forward towards greater and greater complexity until the apex of that movement emerged as homo sapiens.

It was always God’s plan that the creator Christ, already present in the universe as an invisible presence, would become fully human and be born as a human being.

I think Mr. Butler should take a course in evolution, where he’d learn that there is no evidence that evolution is teleological, and that it was going on for 3.5 billion years before Baby Jesus was born. Who sustained evolution until then?  But I’m pleased to learn that Jesus, like the rest of us, was made of billion-year-old carbon. Still, he’s got to get himself back to the garden (of Eden).

It’s just tripe, of course, but why would the Irish times give a millimeter of space to stuff like this?

Below: the author with the paper’s caption; Butler is apparently Jesus’s ghostwriter:

Brendan Butler is a lay theologian and author of My Story by Jesus of Nazareth

h/t: Kieran, Alexandra

A funny title but a serious point about ivermectin and Covid-19

December 16, 2021 • 9:30 am

Reader Martim sent me a link to this article in The Economist, which is pretty much paywalled but includes a paragraph and two graphs you can see. Click on the screenshot below to see what’s viewable:

And the figures, which buttress the title’s assertion:

Just using Fisher’s Exact Test* on the directionality above (dots to left or right of line), the difference is not statistically significant, but it is in a suggestive direction. We need more data to see if this disparity is statistically significant and thus “real” (i.e. not produced by chance under an equal frequency null hypothesis).

Now this is basically all of the article I’m allowed to read, but it hints at why some studies may show a positive effect of Ivermectin on patients infected with Covid-19. To put it simply, worms are a “comorbidity”, that might be eliminated with ivermectin. If having worms makes raises your chances of dying or hospitalization from having the virus, then taking ivermectin could help save your life not by affecting the virus, but by ramping up your immune system after the worms have gone.  Ivermectin would not, then, be of any use in treating patients unless they’re known to be affected with roundworms. (Ivermectin helps get rid of roundworms that cause intestinal strongyloidiasis and onchocerciasis, conditions that weaken your immune system.)

The graphs above suggest what one might predict: ivermectin would be more efficacious against Covid-19 in countries with a higher prevalence of worms, specifically the kind of worms killed by ivermectin. And that’s what the graphs show.

Of course, some of the studies above, both positive and negative, may already have been discredited by subsequent inspection (I haven’t checked), but I’m surprised that nobody has suggested this explanation before. (If they have, I haven’t seen it.)

In a month or two we should know the results of the properly conducted Oxford study on the effects of ivermectin on Covid-19 mortality. I’m almost positive that if the drug does have a positive effect on the disease, it will be minor—certainly much less than that of vaccination or the new Pfizer antiviral pill. But we will wait patiently. I tried to bet my doctor on 3:1 odds (if I won, I’d get $10, while if he won, and Ivermectin had a big positive effect, he’d get $30) that ivermectin wouldn’t show a greater preventive or curative effect than jabs and the new treatments, but he rejected that as a “sucker bet”!

UPDATE: I’ve just managed to subscribe for free and so have seen the rest of the article; it appears that some have considered worms as a comorbidity. A quote (emphasis is mine):

Yet ivermectin’s advocates insist that there is solid science demonstrating the drug’s efficacy. One well-documented website lists and links to 65 different papers on the subject, many of which, on the surface, seem to support this claim. Could this many studies all be wrong? Recent analysis by Avi Bitterman, a dermatologist in New York, and Scott Alexander, a prominent blogger, suggests that the answer is nuanced. Ivermectin probably does help one subset of covid-19 patients: those who are also infected by the worms it was designed to fight.

Wading through the papers whose methodologies appeared sound, Dr Bitterman noticed that the studies that looked best for ivermectin tended to cluster in regions with high rates of infections by strongyloides, a parasitic worm. Common in much of Africa, Asia and Latin America, strongyloides can cause, among other things, diarrhoea, fatigue and weight loss. However, they only pose a graver threat if their numbers grow out of control. Such “hyper-infection”, which is often fatal, becomes far more likely if a patient is receiving corticosteroids, which both suppress the immune system and appear to make female worms more fertile. And dexamethasone, a corticosteroid, is now a standard treatment for severe covid-19, because it prevents the immune system from going into overdrive and attacking the body’s own cells.

Building on observations by David Boulware, a professor of medicine at the University of Minnesota, Dr Bitterman concluded that strongyloides may account for the conflicting results of studies about the effectiveness of ivermectin as a treatment for covid-19. In trials conducted in countries where the parasites are common, many people could have both covid-19 and strongyloides infections. Covid-19 might already have weakened their bodies’ defences against the worms; treating the coronavirus with corticosteroids would let the parasites run wild.

In the groups who received ivermectin during trials, the drug would keep strongyloides in check. But patients in control groups would be left at the worms’ mercy. This would make it look as if ivermectin were preventing deaths caused solely by covid-19, when in fact it was preventing those caused by the parasites or by a combination of the two infections. This mechanism would explain why most studies conducted in places where strongyloides are rare showed no benefit from taking ivermectin. “Ivermectin doesn’t treat covid,” Dr Bitterman wrote. “It treats parasites (shocker) that kill people when they get steroids that treat covid.” He concluded that “taking strongyloides endemic populations, putting them into a control group with corticosteroids is a death sentence”.

In July 2020 a group of doctors argued in the Journal of the American Medical Association that it was “reasonable to consider presumptive treatment with ivermectin for moderate- to high-risk patients not previously tested or treated for strongyloides”, and said that the risk of infection by the worms in covid-19 patients should be “based on factors such as country of origin and long-term residence”. The World Health Organisation also recommends ivermectin in this context. However, most people in rich Western countries like America—where demand for ivermectin, driven by advocates on social media, is so high that some people have resorted to taking the equine version of the drug—do not fit this description. At least when treating patients who have never been to countries with widespread strongyloides, the evidence suggests that mainstream doctors in such places are right to avoid prescribing ivermectin.

None of this, of course, suggests that vaccinations are less efficacious than ivermectin in preventing death from the virus alone, much less, as Bret Weinstein and Heather Heying suggest, you’re better off not getting vaccinated than getting vaccinated. Just get tested for worms if you get covid and live in a roundworm-infested part of the world!

 

*Note that Fisher has been canceled.

More about ivermectin!

December 14, 2021 • 11:00 am

I feel bad for this man and his wife, but there’s a strong dose of irony in this story from USA Today (click on title below to read):

An excerpt:

Keith Smith, whose wife had gone to court to have his COVID-19 infection treated with ivermectin, died Sunday evening, a week after he received his first dose of the controversial drug.

He was 52.

Smith was in a hospital in Pennsylvania for nearly three weeks and had been in the hospital’s intensive care unit in a medically induced coma on a ventilator since Nov. 21. He had been diagnosed with the virus on Nov. 10.

His wife of 24 years, Darla, had gone to court to compel the hospital, UPMC Memorial, to treat her husband with ivermectin, an anti-parasitic drug that has not been approved for treatment of COVID-19.

York County Court Judge Clyde Vedder’s Dec. 3 decision did not compel the hospital to treat Keith with the drug, but it did allow Darla to have an independent physician administer it. He received two doses before Keith’s condition grew worse, and the doctor halted the treatment. . .

. . .Darla sued UPMC to treat her husband with ivermectin after reading about similar cases throughout the country, all filed by an attorney in Buffalo, N.Y. She was assisted by a group called Front Line COVID-19 Critical Care Alliance, which promotes the use of ivermectin in the treatment of the virus.

He received his first dose on Dec. 5, two days after Vedder’s decision in the court case. After Keith received a second dose, the doctor overseeing the drug’s administration – a physician not affiliated with UPMC – ended the treatment as Keith’s condition deteriorated.

Here’s a photo of Keith and Darla; note the caption (click photo to enlarge):

Now there may have been nothing that would save this man once he was infected, and, after all, this is only one anecdote, not a disproof of the claim (made, among others, by Bret Weinstein and Heather Heying) that ivermectin is an efficacious preventive and cure for Covid-19. But I point out that we still have no good evidence that ivermectin can do either of these things, while we have strong evidence not only for the efficacy of vaccination (particularly with a booster), and now also for the new Prizer antiviral pill, which, if given within three days of the onset of symptoms, reduces the risk of hospitalization and death by 89%.  Even if ivermectin proves to have a marginal effect (and, given the studies, that’s the most it could have), it’s no match for existing treatments.

To see a summary of the “evidence”, read this short piece in Stat, a site for health and health-and-business related news (click on screenshot):

As I’ve already pointed out, many past studies purporting to show an effect of ivermectin were fatally flawed in different ways, including cases of apparent data-faking as well as post facto analysis without proper controls. Here’s a summary of the article above:

Where to look for higher quality data? A group called the Cochrane Collaboration spends its time conducting meta-analyses of the best-conducted clinical trials. After excluding dozens of ivermectin studies with “high risk of bias,” the collaboration left little room for optimism: “Based on the current very low- to low-certainty evidence, we are uncertain about the efficacy and safety of ivermectin used to treat or prevent Covid-19.” The group recommended that ivermectin use be restricted to clinical trials that might actually generate high quality data.

The World Health Organization and the Infectious Diseases Society of America concur. Even Merck, an ivermectin manufacturer, avers that there is “no meaningful evidence for clinical activity or efficacy in patients with Covid-19.” And just last weekend the FDA warned people not to use the drug as a treatment for Covid-19.

An FDA tweet. (Note: yes, people, I know that ivermectin has valid uses in humans for eliminating lice and parasites, so don’t bother to correct me. We’re talking about viruses here.)

Note that Stat reports that a properly designed study is in progress (my emphasis below).

Yet ivermectin boosters and merchants have convinced many to use this therapy for Covid-19, particularly in Latin America where its use is so widespread that researchers have had difficulty recruiting patients for trials of other potentially effective products. In June, YouTube suspended the account of Sen. Ron Johnson (R-Wis.), a member of the Senate Homeland Security and Governmental Affairs Committee, for a week for spreading misinformation about ivermectin and hydroxychloroquine.

I’ve also criticized Weinstein and Heying, who work in my own field, for not only denigrating vaccines, but pushing ivermectin. Those who heeded their advice have been put in danger.

The increased demand for the drug, combined with enhanced scrutiny from pharmacists, has caused shortages of veterinary formulations of the drug. Inevitably, a spike in calls to Poison Control Centers connected to the use of veterinary ivermectin has followed.

And the money paragraph:

The University of Oxford’s rigorously designed PRINCIPLE trial is now trying to determine if ivermectin actually benefits people with Covid-19. But until those results come in, I urge people to heed the lessons of hydroxychloroquine, bleach, and all the other purported Covid-19 cures: effective treatments will be identified through systematic scientific study, not by wishful thinking, fabrication, or miracles.

Remember the Hippocratic Oath’s dictum: “First, do no harm.”

If the Oxford study shows ivermectin has appreciable value in preventing or curing Covid-19, I will admit that I was wrong, though I reserve the right to judge whether such an effect is sufficiently strong to make the drug more valuable than current treatments.

Likewise, if the Oxford study shows very low or no value of ivermectin in preventing or curing Covid-19, I expect that Weinstein and Heying will issue a statement saying, “We were wrong. We may have put people in danger.”

But I can already say with assurance that anybody following their advice, dosing themselves with ivermectin and avoiding vaccination, is doing precisely the wrong thing.

Talking sense about the Omicron variant

December 1, 2021 • 12:00 pm

Reader Tom sent me this 19½-minute video about Omicron from health science expert and nurse John Campbell, who’s apparently been dispensing sound information on the coronavirus for a long time. Tom said this:

Dr. John Campbell has been my go-to-guy for the past 14 months on a nearly daily basis.  He’s lucid, authoritative, clear, concise and engaging, just a superb source of reasonable advice.

When I asked for more information because Campbell’s Wikipedia bio was scanty, Tom added this:

He’s had a YouTube channel since 2008 and is an evidence-based medicine proponent to the bone.  His videos are daily, usually about 20 minutes long and shot in a spare room of his home.  Just him wielding a sharpie, an overhead camera, printed sheets of the day’s topic and a calm, no nonsense discussion delivered in a clipped English accent.  No histrionics.  Like visiting a well-loved teacher during office hours.

Now remember, we know very little about this virus—neither about its infectivity or its virulence (which really encompasses severity and spreadability).  So take this with a grain of salt. However, Campbell readily admits our ignorance while claiming, with support, that this variant will be the dominant strain throughout the world.

He does sound a note of hope, i.e., the vaccinated, when infected with Omicron, seem to get generally mild cases, and hypothesis that its spreadability is negatively correlated with how sick it makes peope.

John also gives us a pessimistic timeline for a vaccination (early to mid-2022). He summarizes where all the cases are (everywhere), and the mortality rate (thankfully, zero).  Remember, it’s early days.

It must be the full moon

November 5, 2021 • 8:25 am

Yep, the wackos are out: here’s a comment I got (but didn’t post) on my piece “Bret Weinstein and Heather Heying go unvaccinated for Covid, take and promote Ivermectin instead“. It’s from one Stephanie, who won’t be posting here again:

I have ivermectin and didn’t get it at an animal feed shop. It’s for human beings, prescribed by a human internist that treats Covid patients (a real living MD). He also prescribes it to ease vaccine side-effects. It helped mine, I had my period for months after the Moderna shot, along with neuropathy in my right arm which prevented me from working for 2 weeks. I did not follow up with a second dose and will not until at least third generation vaccines are available.You are a dangerous person and I challenge your view, your vaccine indoctrination. There are safe, healthy options for All and instead of promoting health, an MD’s ability to practice and prescribe, you support a billionaire class who wants you hooked into a booster program. You’re the laughable one, the one that should be shamed but you’re so insecure, you point at Bret and Heather

No control in her assertion of “it helped mine”, of course, and if she listened to Bret Weinstein and Heather Heying she wouldn’t have gotten the shot in the first place. If ivermectin is a “safe and healthy option,” why did she get a jab?

I stand by what I said: there is no convincing evidence that Ivermectin is either a palliative, a cure, or a preventive for Covid 19, much less a reliever of symptoms from the vaccination. There are mixed results from some studies of the drug, but those are almost all retrospective analyses, have pathetically small sample sizes, and many lack real controls.

We will have more definitive data in a couple of months. But regardless of that, we know that the shots are powerfully effective in preventing Covid, and, if you get it anyway, you get a milder case. Faced with the assurance of that result contrasted with our ignorance about Ivermectin, which simply cannot have as powerful a result as the vaccines, you’d simply be dumb to forego up the shots (which Weinstein and Heying have been urging; neither is vaccinated) and take a medicine designed for roundworms and head lice.

It’s not me who’s the dangerous person.

The hypocrisy of the AMA (and other elite organizations like the NYT)

November 2, 2021 • 9:15 am

I call your attention to my post yesterday on the apparent metastasizng wokeness of the American Medical Association (AMA) in its new Medspeak guide, “Advancing Health Equity: A Guide To Language, Narrative and Concepts.” That guidebook, full of new medical euphemisms, was an almost unbelievable display of wokeness, so outré that it was funny—except of course that instantiated what’s happening in every college, every venue of mainstream media, and every professional and scientific organization in America. In fact, one of my friends who reads this site wrote me this assessment of the AMA pamphlet:

 I honestly think that the woke are minting new Republicans by the hour. We’ll be back to Trump, and then we can really kiss our collective ass goodbye.

Indeed. You don’t have to be a rocket scientist to see that!

But lest you think the whole AMA has gone woke, have a look at this article from The Hill (click on screenshot):

It’s pretty much what it says it is: the AMA President doesn’t want a “Medicare for all” system. Maybe for poor people (though they already have one), but President Dr. Patrice Harris says this:

The president of the American Medical Association (AMA) criticized “Medicare for All” as a “one-size-fits-all solution” on Wednesday, but acknowledged that some doctors, particularly younger ones, support the idea.

“We just don’t think a one-size-fits-all solution works,” Dr. Patrice Harris told The Hill when asked about a Medicare for All, single-payer system.

“And so, we believe that there should be choice for patient, choice for physician, and there should be a plurality of available options, but absolutely having a strong safety net,” she added in the interview at the group’s national advocacy conference in Washington.

Of course a “plurality of options” means different forms of medical insurance and that in turn means that doctors get to keep their high salaries and prestige. (I’m not of course implying that all doctors have this notion.)

Dr. Harris adds:

But attitudes among doctors could be changing. Asked if younger doctors are more open to single-payer, Harris said, “I’ve seen that, I’ve witnessed that.”

“I think there are folks of all, you know, age ranges and specialties that might support that,” she added. “But again, that’s the beauty of the AMA and our democratic process and our value of diverse thoughts and opinions.”

In other words, Harris’s sense of “diversity” is not the one we’re used to: she means, “Let a thousand insurance companies blossom,” which of course is good for the well-being of doctors, but not perhaps of patients who are well off or who have job-provided medical care. In fact, the article admits that:

The American College of Physicians, the second-largest doctors group after the AMA, made waves in January when it endorsed single-payer health insurance, as well as a public option, as ways to achieve universal coverage.

The rest of the health care industry, including hospitals, drug companies and insurance companies, remains strongly opposed to single-payer, though.

Many doctors worry that the payment rates under Medicare for All would be insufficient, given that Medicare currently pays lower rates than private insurance does.

This is about salary and prestige that some doctors are insistent on keeping. “But,” you might be asking yourself, “how can the AMA be against single-payer insurance and yet issue a document that is ultra-woke in prescribing the language to use?”

Well, how doctors use language to conform to current ideology doesn’t affect their wages, does it? Instead of coining euphemisms, if they really cared about the well being of poor people and minorities, they’d be lobbying Congress for “Medicare for All.”

The point, as Batya Ungar-Sargon suggests in her piece below on Bari Weiss’s site, is that Wokeness is not mainly a race issue but a class issue, one largely promulgated by privileged and well-off white people who use it to buttress their self-esteem while simultaneously propping up a meritocracy from which they benefit. That, after all, is what the AMA seems to be doing.

Click below to read Batya’s article. She’s an opinion editor at Newsweek and has a new book out, Bad News: How Woke Media Is Undermining DemocracyRead also Bari Weiss’s introduction to her article.

Now Ungar-Sargon is concerned with journalism and not medicine, but there are parallels. Journalism was once a middle-class profession, but has risen to an elite profession whose practitioners are not only uber-woke (at least in the Left media), but also pretty well off (she gives some salaries).  Not all of them are white, but you already know that wokeness is promulgated primarily by the white folk that own and manage the MSM. As Ungar-Sargon says, “Once working-class warriors, the little guys taking on America’s powerful elites, journalists today are an American elite, a caste that has abandoned its working class roots as part of its meritocratic climb. And a moral panic around race has allowed them to mask this abandonment under the guise of ‘social justice.’”

And here’s her argument. The more I think about it, the more I think it does explain how elite organizations such as the AMA and NYT can at the same time promulgate big-time wokeness and yet try hard to keep their position as members of the “elite.”

. . .Wokeness perpetuates the economic interests of affluent white liberals. I believe that many of them truly do wish to live in a more equitable society, but today’s liberal elites are also governed by a competing commitment: their belief in meritocracy, or the fiction that their status was earned by their intelligence and talents. Today’s meritocratic elites subscribe to the view that not only wealth but also political power should be the province of the highly educated. Still, liberals see themselves as compassionate and progressive. And perhaps unconsciously, they sought a way to reconcile the inequality that their meritocratic status produces with the compassionate emotions they feel toward the less fortunate. They needed a way to be perpetually on what they saw as the right side of history without having to disrupt what was right for them and their children.

A moral panic around race was the perfect solution: It took the guilt that they should have felt around their economic good fortune and political power— which they could have shared with the less fortunate had they cared to—and displaced it onto their whiteness, an immutable characteristic that they could do absolutely nothing to change.

This is how white liberals arrived at a situation where instead of agitating for a more equal society, they agitated for more diverse elites. Instead of asking why our elites have risen so far above the average American, they asked why the elites are so white. Instead of asking why working-class people of all races are so underrepresented in the halls of power, white liberals called the working class racist for voting for Trump. Instead of asking why New York City’s public school system is more segregated than Alabama’s, white liberals demanded diversity, equity, and inclusion training in their children’s exorbitantly priced prep schools.

In other words, wokeness provided the perfect ideology for affluent, liberal whites who didn’t truly want systemic change if it meant their children would have to sacrifice their own status, but who still wanted to feel like the heroes of a story about social justice, who still wanted to feel vastly superior to their conservative and even slightly less radical friends.

This clarifies a lot of things, including the fact that wokeness is highest at the most prestigious universities: places like Harvard, Princeton, and Yale. It explains why many of the white Woke are obsessed with trivialities like policing languages, art installations, and other behavior, and don’t really get out there in society and actually help poor people.  It’s why they can get away with dismissing the poor and working class as racists because so many of them vote for Trump.

I don’t think (nor does Batya) that this is the sole explanation for fulminating Wokeness. But I think she’s got a handle on one reason, and an important one.