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Adam W Gaffney Profile picture
@awgaffney
Aug 24, 2021 • 7 tweets • 3 min read • Read on X
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It first seemed like ivermectin was one more low-evidence-based drug, albeit with a curious degree of politicized enthusiasm. It is far worse. Its evangelists appeared to have convinced some, perhaps many, that it is a substitute for vaccination.

washingtonpost.com/nation/2021/08… Image
Pierre Kory, the most prominent physician backer and head of the ivermectin enthusiast group FLCCC, has been cagey about this at times, but here he is posting a slide "Pfizer v. Ivermectin" suggesting superiority of ivermectin vs. vaccine in Covid prevention. Image
However, even worse is that the FLCCC Alliances' COVID-19 "prevention" protocol includes ivermectin (as well as vitamins, mouthwash, etc.) but ... no mention of vaccination. Maybe it was just an innocent oversight? Hmmm...

covid19criticalcare.com/wp-content/upl… Image
It is also notable that the FLCCC Alliances' Long Covid treatment protocol contends that Long Covid can be caused both by Covid-19 and ... Covid-19 vaccination. ("likely due to monocyte activation by the spike protein from the vaccine", they assert.)

covid19criticalcare.com/covid-19-proto… Image
Their Long Covid treatment protocol in turn calls for yet more ivermectin, "mast cell stabilizers", steroids, "monocyte repolarization therapy", and more.

They claim this protocol also works for the type of Long Covid they allege is caused by vaccination
covid19criticalcare.com/covid-19-proto… Image
(None of this is evidence-based).

Pierre Kory also made a claim about ivermectin being effective for what he called "post vaccine inflammatory syndromes" when he appeared on Joe Rogan's podcast with Bret Weinstein.
Ivermectin evangelists are delivering an effectively anti-vaccination message whatever they claim.

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More from @awgaffney

Adam W Gaffney Profile picture
Nov 16
Here is the thing about RFK Jr.

Even if you ignore his crank beliefs about WiFi & vaccines & ivermectin etc etc (not that you should), he’s also not going to do anything useful about “chronic diseases”.

Take the environment, which RFK Jr. purports to care about …
… and which can drive morbidity from chronic disease (e.g. air pollution > asthma).

Well, last time around Trump shredded a 100 environmental regulations, and worsened air quality. He’s going to do the same thing again.
Take nutrition among kids. Yes, we should have more nutritious (and free) school lunches. Do you really think Trump is going to bolster federal spending to improve access to high quality school lunches? Then I have a bridge to sell you.
Read 6 tweets
Adam W Gaffney Profile picture
Jul 1
We have an article just up in @thenation on Medicare "Dis-Advantage": on the waste and inequities that Medicare Advantage imposes on our healthcare system.

With @swoolhandler & David Himmelstein.

A Brief 🧵. Image
There is not too much controversy at this point that Medicare Advantage bilks taxpayers.

MedPAC, Congress' nonpartisan Medicare advisory board, in March estimated some $83 billion in overpayments.

A New York Times 2022 expose shed some light on insurers' dodgy maneuvers. Image
But here's the thing: if it were simply a matter of overpayments, we could give insurers a haircut in payments and just move on.

As we argue , however, the problems with Medicare Advantage are far more fundamental — they undermine Medicare's very foundations.
Read 15 tweets
Adam W Gaffney Profile picture
Jun 29
Maybe we need more trials, but this must not be waved away & deserves attention: intensive blood pressure lowering reduces major vascular events per new RCT in the @TheLancet, & also all-cause mortality (as a secondary outcome).

Brief thread.

1/6
thelancet.com/journals/lance…
I understand caution or even skepticism about such findings, but we need to take a step back & look at the big picture: for decades, RCTs again & again show major benefits of medical blood pressure reduction. SPRINT & now ESPRIT show benefits of more intense lowering.

2/6
I understand methodological critiques - but at the very least burden of proof has now shifted to those who favor less intensive lowering, not the other way around.

I also want to make a point also about our orientation towards blood pressure treatment culturally/socially.

3/6
Read 6 tweets
Adam W Gaffney Profile picture
Apr 3
Pfizer's EPIC-SR study is (finally) published (what took this so long?).

1: Primary finding: No benefit from Paxlovid on symptom alleviation among vaccinated or unvaccinated people.
Image
Image
2: Not a significant difference, but 0.8% of those who got paxlovid and 1.6% of those who got placebo had a COVID-19 hospitalization or death from any cause. Underpowered for this outcome & not really high-risk group (e.g. a single death from any cause among 1,288 participants). Image
Given this, should not extrapolate to truly high-risk patients, e.g. an octogenarian with severe emphysema.

UK-based PANORAMIC study, which enrolled almost 30,000 people may have something more to say about effects for truly high-risk people. But no idea when. Image
Read 5 tweets
Adam W Gaffney Profile picture
Feb 13
Great reporting by @rmc031 on how some states are using Medicaid funds to help cover housing costs for some, i.e. "a prescription for housing."

I have some thoughts on the issue —  concerns, from a Left perspective.

1/X
vox.com/2024/2/13/2406…
First, to be clear, there is zero question that social goods like housing are critically important for health, usually more than medical care — it is an urgent social and political prerogative to realize them.

That's not what's up for question to my mind.

2/X
What's up for question is instead three-fold: (1) the role of medical institutions in providing access to these goods; (2) whether Medicaid should be the funding source; (3) the likelihood that there will be "returns on investment" in form of reduced medical spending.

3/X
Read 11 tweets
Adam W Gaffney Profile picture
Aug 31, 2023
As a general principle, if the reproductive number largely determines the share of a population that will be infected before a respiratory viral wave ends, then only those behavioral/interventional changes that permanently change the reproductive number will reduce ...
the share of the population infected in a wave.

So the term "wave" can be misleading in this context because it suggests that waves eventually "pass through" a population with time: instead, they (typically) end because of the rise in population immunity.
In this context, reducing social contacts / reproductive number would be expected to only reduce the number of infections if such changes are permanent. For those seriously interested in altering respiratory viral epidemiology this reality needs to be honestly acknowledged,
Read 7 tweets

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