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Steven Phillips, MD

@StevePhillipsMD

12 Sep

This is enraging, scandalous, & pathetic.

And it's close to happening here in the US--Pharmacists have been cracking down on ivermectin prescriptions over the past month in an orchestrated fashion. 🧵👇

theguardian.com/australia-news…

Before Covid politics:
Ivermectin excites scientists: "help improve global public health by treating a diverse range of diseases, with its unexpected potential as an antibacterial, antiviral and anti-cancer agent being particularly extraordinary.🧵👇
pubmed.ncbi.nlm.nih.gov/28196978/

Before Covid politics:
"Ivermectin has continually proved to be astonishingly safe for human use"

Now most media refer to it as an "unapproved animal de-wormer" & have flooded the public with hundreds of false & exaggerated overdose stories. 🧵👇

pubmed.ncbi.nlm.nih.gov/21321478/

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Steven Phillips, MD

@StevePhillipsMD

29 Nov 20

I'm disappointed that there are no RCT's of the old, cheap, safe, supplements rutin & procyanidin for #COVID.

They're active in so many in-silico models, including a prescient study from the start of the pandemic which found activity for ivermectin. Little 5 tweet thread.👇

This article from March accurately predicted antiviral activity of such notables as ivermectin, which hit 2 of the 3 #SARSCoV2 targets evaluated.

Both rutin and procyanidin each hit 2 targets as well.

who.int/bulletin/onlin…

Rutin:

"the binding affinity of Rutin was much higher than Chloroquine and Hydroxychloroquine, and the reference drug Remdesivir"

pubmed.ncbi.nlm.nih.gov/33200697/

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Steven Phillips, MD

@StevePhillipsMD

20 Jul 20

Designing valid retrospective reviews is like putting lipstick on a pig. But RCT's have no porcine roots. They start out with racehorse potential, which made it even more sad when the major design flaws in this study rendered this horse lame. Analysis:👇 acpjournals.org/doi/10.7326/M2…

To test whether #HCQ works for #COVID19, subjects must have had proof that they actually had it, not just clinical suspicion. Without this evidence, we can't draw reliable conclusions. But only 1/3 had positive COVID tests. And maybe that's why the following didn't add up:👇

Case fatality rate (CFR) for the placebo group was about 0.5%, but the observed US COVID19 CFR at the time of study enrollment was 5.58%. Could this discrepancy have been in part due to many in the study never having had COVID19 in the first place?👇cebm.net/covid-19/globa…

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Steven Phillips, MD

@StevePhillipsMD

7 Jun 20

My Dad's recent #COVID19. Not an academic document-just sharing a human experience of outrage & triumph.

My Dad is almost 90, frail as can be, in a nursing home. I went to visit him 3 months ago & wore a mask before it was fashionable to protect him just in case I had it.

I sent an email to 5 people at the nursing home the next day saying that I was shocked that none of the staff or visitors were wearing PPE. I warned them that the now infamous Seattle nursing home which had massive deaths early on in the #COVID pandemic was a sentinel event.

I warned them that they needed to "act now" to prevent a "major tragedy," but not a single one of the recipients responded to my email, silence. I reached out to my Dad's doctor to discuss the situation. She felt that he was a sitting duck and that prophylaxis was appropriate.

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Steven Phillips, MD

@StevePhillipsMD

4 Jun 20

I think the authors put forth a good effort, but there are significant issues with this study, which was intended to evaluate #COVIDー19 post-exposure prophylaxis with #HCQ. My two cents:👇nejm.org/doi/full/10.10…

Planned enrollment threshold was within 3 days of exposure due to the average incubation period of 5.5 days. But then the threshold was changed to 4 days. Cutting it close. One can argue that the study nearly misses its basic premise of being a PEP trial. And then this: 👇

Authors wrote that the "vast majority of the participants" couldn't get diagnostic testing for #Covid. Instead, they looked at symptoms and labeled some cases as "probable," about which they admit, "predictive power of this case definition is unknown." Is this OK?👇

Read 10 tweets

Steven Phillips, MD

@StevePhillipsMD

30 May 20

Subconscious biases are ubiquitous and powerful. We all have them, so what are going to do about it? "Confirmation bias—probably the most pervasive and damaging bias of them all—leads us to look for evidence that confirms what we already think." theatlantic.com/magazine/archi…

Physicians are vulnerable to bias just like other humans and it can lead to diagnostic errors. "The culture of medicine has never been one that encourages discussion of physician vulnerability."
beckershospitalreview.com/hospital-physi…

This article details how researchers are blind to their own bias but can easily point it out in others, including when it comes to how receiving gifts from pharmaceutical companies affects decision making. cmu.edu/news/stories/a…

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