Yesterday's @Rspodcast with @juliagalef & @KelseyTuoc on COVID-19 covered ivermectin, and included a pretty shocking final twist. Thread:
@Rspodcast @juliagalef @KelseyTuoc I trust @KelseyTuoc. I consider her a friend. She was one of the first journalists to suggest the concern about the pandemic was reasonable, and early on she wrote a thread admonishing herself for expressing more concern amongst friends than she was willing to publish publicly.
Reviewing the literature, Kelsey didn't find the evidence for ivermectin for critical condition COVID patients convincing at all, but found that it may have a small effect on early mitigation of disease severity, and said it looked most promising as prophylaxis (with caveats).
Kelsey still didn't personally think the cost-benefit analysis panned out positively for most people, but she could easily understand — for example — a doctor without vaccine access taking ivermectin prophylactically.
Kelsey and Julia discussed the surprisingly strong media immune response to ivermectin, agreeing that it seemed disproportionate to the risk-benefit status of ivermectin. Messing with your gut biome might not be ideal, but if you're taking human doses, you're going to be fine.
After taping the episode, Kelsey wrote Julia with a pretty stunning update. Screenshots from the episode transcript.
If this is true, it casts serious doubt on ivermectin's strongest use case: as prophylaxis. Depending on the extent of the fraud that can be proven or reasonably argued, it could also be very bad news for people hoping to use ivermectin for early treatment.
It'll be interesting to see what happens when these accusations and supporting evidence are published. I don't know how that will pan out, but for the time being, I agree with Kelsey: the somewhat tenuous evidence for ivermectin should probably now be considered *too* tenuous.
-On the object level, this isn't something to celebrate. In an ideal world, there would be lots of ways to prevent and treat COVID. Regardless, we can and should celebrate the people working to figure out what's going on — always. Always, always.
Because the discourse is dominated by pro-vaccine or anti-vaccine zealotry, treatment has taken a backseat, and we're really not talking much about what can help people after exposure or symptom onset. And for highly vulnerable people, vaccinated or not, that's crucial.
As Kelsey noted in the podcast, fluvoxamine — another repurposed drug — has recent shown arguably greater promise in methodologically-sound clinical trials than ivermectin.
Indeed, early results from the Together Trial, a massive-scale rigorous study on early treatment protocols, show lackluster efficacy for ivermectin but considerable improvement in patients given fluvoxamine. Hope lives on for an effective early treatment for COVID!
As a general rule: wish each other well. Be epistemically humble. Hope, but verify. Better treatments, and even better vaccines, are likely coming. Do what you can to protect yourself today, including getting vaccinated if medically appropriate.
Here's a link to the podcast. I definitely recommend listening!…
In the interest of transparency: I have ivermectin on hand, and barring an alternative I will probably take it if I start to get sick. As it stands, the standard protocol for early stage COVID is "go home, come back if you can't breathe."
Re: vaccine — personally, my main concern has been fertility. New studies have been launched to study widely-reported disturbances in menstruation, but are unlikely to produce results soon. Preliminary pregnancy data looks pretty good. Broader fertility data unlikely to come soon
Women in my position have to make the vaccination decision based on what we know and what we're likely to know over a reasonable time horizon. I don't judge anyone for the decision they make.

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More from @webdevMason

8 Sep
You shouldn't have political opinions about medication, if "they did it first" is your defense you need to go ahead and try that out loud in the presence of an actual adult
Resist the politicization of everything by getting a fucking life
If you're trying to figure out if you should be happy for a public figure who recovered quickly from a serious illness or whether his not dying represents some kind of larger injustice, how about this, fuck off, turn off your devices, eat something you cooked for yourself
Read 6 tweets
8 Sep
*cocks shotgun at the dinner party table* it's 8 months
If she's watched you pee because she entered an unlocked bathroom and you said "what's up?" instead of having an apparent conniption fit you need to either wife that lady up or get out and let someone else be her man
None of this is trad, this is the pumpkin spice latte of dating takes. 8 months? You know after 8 months. You could slice that in half and the false positive/false negative rate is still well within tolerances. Stop being pussies
Read 5 tweets
28 Aug
It is almost impossible to square the media narrative on child COVID hospitalizations with the CDC data. This wave hasn't been hospitalizing any more children than the winter wave; it's just that fewer adults are joining them
A plausible theory is that some hospitals and public health officials are quietly conflating "hospitalized (for anything), tested positive for COVID-19" with "hospitalized for COVID-19"…
Honestly, I find the whole thing truly puzzling
Read 7 tweets
28 Aug
Thinking about relationship stuff & browsing a debate on the merits or harms of “calling your partner out on their bullshit,” it strikes me that there’s a ton of stuff like this; healthy in a *real* relationship but annoying af when, deep down, you know you’re just playing house
The only way “calling a partner out on their bullshit” ever works is when you care enough about the relationship to have exercised patience and restraint many times prior, and they care enough about the relationship to notice that & appreciate it such that they are softened
If those terms aren’t met or your relationship exists on a fully at-will basis, “calling your partner out” just becomes a power play — a way to determine things like which partner is least secure or more willing to leave, or to solidify roles like “selfless giver” or “alpha dude”
Read 8 tweets
21 Aug
Very little writing, including public messaging, is meaningfully intended to persuade anyone anymore. “You look like an idiot” is the one trick the pony knows, and if you simply don’t respond to that you almost immediately and invariably induce blind rage
A lot of people are extremely insecure about their own intelligence, and the best way to earn their loyalty is to convince them that they’re surrounded by mouth-breathers who don’t even deserve to be persuaded — which of course absolves them of having to actually make arguments.
If you’re insecure about your intelligence, the last thing you want is to be confronted by the idea that oversimplified and misleading public messaging undermines public trust. That comes dangerously close to suggesting that *your* trust might not be a sign of superior smarts.
Read 5 tweets
19 Aug
My extremely hot take is that it is actually not great for children to be yelled at when they try to get some relief from physical discomfort at school ImageImageImage
I'm trying to understand how it isn't immediately obvious to everyone that strapping something to your face that you constantly want to rip off is extremely counterproductive to attentively listening to lectures, something children already famously struggle to do
On a slightly tangential note, Conor and I both have attention deficit issues and found school borderline torturous, and to this day it makes my blood boil when adults moralize these challenges in children
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