The problem with ivermectin is that it's a potentially viable treatment and most rational scientists dearly wish it would work but the evidence currently just isn't that great for Covid-19 🤷‍♂️ #WorldIvermectinDay
The real issue is that there's a certain segment of conspiracist weirdos who won't accept anything other than outspoken advocacy for the drug no matter how weak the evidence might be
We will know quite soon whether ivermectin works for COVID-19, and I sincerely hope it does, but pretending the evidence is high-quality when it isn't just makes you seem obsessed not scientific

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More from @GidMK

27 Jul
Another day, another two ivermectin studies that have impossible values in their tables of results. Both included in meta-analyses (rated as high risk of bias this time)

This is getting truly insane
The entire ivermectin for COVID-19 literature is just...awash with this absolute trash. Studies that are pre-registered after publication. Tables of results that contradict the text. Percentages that are impossible
Endless examples of RCTs where the analysis plan is a single sentence long (we did chi-squared and some t-tests, p<0.05 was significant)
Read 5 tweets
26 Jul
People have claimed that ivermectin is 100% effective as a prophylactic for COVID-19 based on an observational trial of the drug

I'm extremely concerned about this trial. It definitely should not be used as evidence for anything 1/n Image
2/n The paper is here, and it's actually two studies - a pilot and a larger interventional trial where the authors gave ivermectin+carrageenan to one group of healthcare workers, and compared to a "matched" control media.marinomed.com/8b/7a/c7/nota-… Image
3/n The authors report that 0% of the people treated with ivermectin+carrageenan got COVID-19, while in the pilot 11% and in the full trial more than 50% of the control group got sick
Read 23 tweets
23 Jul
A fairly well-demonstrated fact about COVID-19 and lockdowns is that the more severe restrictions tend to have smaller marginal benefits once enacted
In practice, this means that the reduction in transmission for, say, limiting travel to 5km radius is probably quite small once you've already implemented other interventions such as stay-at-home orders
In other words, when we talk about 'hard' vs other lockdowns, the language often doesn't match the evidence. There's no strong reason to believe that adding small extra limits on behavior will have a large impact on the spread of COVID-19
Read 4 tweets
22 Jul
A large, well-done observational trial just found a big mortality benefit for ondansetron in the treatment of COVID-19

I think this is a fascinating case study in how we use observational research
academic.oup.com/ofid/article/8…
The authors used a huge database of people who'd been treated for COVID-19, and looked at the associations between mortality and 84 drugs or drug classes
They found that metformin, nicotine, fluticasone, SNRI, expectorants and ondasetron reduced the risk of death from COVID-19, but given the potential for residual confounding only focused on ondasetron
Read 10 tweets
22 Jul
This is a fascinating paper by @EpiEllie and team. The available high-quality evidence shows "no evidence to support the conclusion of the existence of a biological relationship" between blood type and COVID-19 risk medrxiv.org/content/10.110…
For those who remember, the headlines claiming that there was a relationship were numerous and, it appears, incredibly misleading
Just goes to show how easily bad science can cause serious, long-term beliefs and research investment, and it takes months of effort to even make a dent in terms of correction
Read 5 tweets
20 Jul
BIG NEWS

New paper out in BMJ Global Health with a brilliant team of researchers on the health impacts of lockdowns

Long story short - lockdowns aren't ideal, but COVID-19 outbreaks are probably much worse 1/n

gh.bmj.com/content/6/8/e0…
2/n What did we do in this paper?

It's a narrative review, so basically represents our knowledge and opinions about the topic, using all of the data that we could find ourselves
3/n That means that this isn't the definitive word on lockdowns, or interventions like them

Having said that, we do think that there are a few points that are extremely clear from the evidence to date
Read 15 tweets

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