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Health Nerd Profile picture
@GidMK
Sep 21, 2021 • 13 tweets • 4 min read • Read on X
People promoting ivermectin keep saying "But what about Uttar Pradesh!!" as if this analysis wasn't truly woeful and totally incorrect

A short thread 1/10
2/10 The claim is pretty simple - Uttar Pradesh uses ivermectin a lot, therefore it's doing well on COVID as opposed to places that don't use ivermectin. Just look at the graphics! Image
3/10 This is quite transparent nonsense and it's easy to see why. Firstly, Uttar Pradesh officially incorporated ivermectin into treatment protocols and started using it in hospitals in Aug/Sept 2020 Image
4/10 Private use of the drug - people buying it for themselves and taking ivermectin - was probably quite high even before that. So really, our graph should look like this... Image
5/10 Moreover, Uttar Pradesh's Covid deaths line up very well with the rest of the country, so it's unlikely that the ivermectin protocol of this one state did all that much ImageImage
6/10 On top of all of this, we know that deaths are undercounted in India, particularly in the poorer states. If we take a plausible undercount ratio of 90% in UP from this paper, the true number of covid cases might be 50-60% of the population medrxiv.org/content/10.110…
7/10 India has also done a pretty excellent job vaccinating people, with UP leading the pack. The vaccination rate is nearly 50% for the state! Image
8/10 So explaining the dramatic drop in COVID cases/deaths is, it turns out, quite easy:

1. Massive outbreak leading to high rates of previously infected individuals
2. High vaccination rates
9/10 It is also worth noting that the data coming out of UP is very low quality (read the linked paper above for more info), so even the case figures are quite challenging to assess
10/10 To sum up - the current low case rate in Uttar Pradesh:

- cannot possibly be explained by ivermectin use
- may be due to a very large outbreak+vaccines
- there are many unknowns that make it hard to assess
11/10 One minor addition - even using the dates that UP started mass-distributing ivermectin aren't really measures of exposure. We simply do not know how many people in the state took ivermectin at any point in time, which is FUNDAMENTAL for this analysis
12/10 I've noted this elsewhere, but worth adding to the thread that UP also has had a very large public health response including restrictions that are still in place in October. This likely contributed to the dramatic fall in cases economictimes.indiatimes.com/news/india/utt…
13/10 And, to clarify, because people do love taking things out of context, this tweet should probably read "the dramatic and continued drop" rather than just "the dramatic drop"

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More from @GidMK

Health Nerd Profile picture
Mar 4
The final large published trial on ivermectin for COVID-19, PRINCIPLE, is now out. Main findings:

1. Clinically unimportant (~1-2day reduction) in time to resolution of symptoms.
2. No benefit for hospitalization/death. Image
Now, you may be asking "why does anyone care at all any more about ivermectin for COVID?" to which I would respond "yes"

We already knew pretty much everything this study shows. That being said, always good to have more data!
The study is here:

For me, the main finding is pretty simple - ivermectin didn't impact the likelihood of people going to hospital or dying from COVID-19. This has now been shown in every high-quality study out there.pubmed.ncbi.nlm.nih.gov/38431155/
Read 8 tweets
Health Nerd Profile picture
Feb 20
Fascinating study.

What's particularly interesting is a finding that the authors don't really discuss in their conclusion. These results appear to show that gender affirming care is associated with a reduction in suicide risk 1/n
2/n The paper is a retrospective cohort study that compares young adults and some teens who were referred for gender related services in Finland with a cohort that was matched using age and sex. The median age in the study was 19, so the majority of the population are adults. Image
3/n The study is very limited. The authors had access to the Finnish registries which include a wide range of data, but chose to only correct their cohorts for age, sex, and number of psychiatric appointments prior to their inclusion in the cohort.
Read 11 tweets
Health Nerd Profile picture
Oct 26, 2023
These headlines have to be some of the most ridiculous I've seen in a while

The study tested 18 different PFAS in a tiny sample of 176 people. Of those, one had a barely significant association with thyroid cancer

This is genuinely just not news at all Image
Here's the study. I'm somewhat surprised it even got published if I'm honest. A tiny case-control study, they looked at 88 people with thyroid cancer and 88 controls thelancet.com/journals/ebiom…
Here are the main results. There was a single measured PFAS which had a 'significant' association with the cancer, the others just look a bit like noise to me Image
Read 7 tweets
Health Nerd Profile picture
Oct 11, 2023
A new study has gone viral for purportedly showing that running therapy had similar efficacy to medication for depression

Which is weird, because a) it's not a very good study and b) seems not to show that at all 1/n
Image
Image
2/n The study is here. The authors describe it as a "partially randomized patient preference design", which is a wildly misleading term. In practice, this is simply a cohort study, where ~90% of the patients self-selected into their preferred treatment sciencedirect.com/science/articl…
3/n This is a big problem, because it means that there are likely confounding factors between the two groups (i.e. who is likely to choose running therapy over meds?). Instead of a useful, randomized trial, this is a very small (n=141) non-randomized paper
Read 15 tweets
Health Nerd Profile picture
Oct 6, 2023
This is SO MISLEADING

The study showed that COVID-19 had, if anything, very few long-term issues for children! As a new father, I find this data very reassuring regarding #LongCovid in kids 1/n Image
2/n The study is here, it's a retrospective cohort comparing children aged 0-14 who had COVID-19 to a matched control using a database of primary care visits in Italy
onlinelibrary.wiley.com/doi/10.1111/ap…
3/ The authors found that there was an increased risk of a range of diagnoses for the kids with COVID-19 after their acute disease, including things like runny noses, anxiety/depression, diarrhoea, etc Image
Read 13 tweets
Health Nerd Profile picture
Sep 20, 2023
This study has recently gone viral, with people saying that it shows that nearly 20% of highly vaccinated people get Long COVID

I don't think it's reasonable to draw these conclusions based on this research. Let's talk about bias 1/n Image
2/n The study is here. It is a survey of people who tested positive to COVID-19 in Western Australia from July-Aug 2022 medrxiv.org/content/10.110…
3/n This immediately gives us our first source of bias

We KNOW that most cases of COVID-19 were missed at this point in the pandemic, so we're only getting the sample of those people who were sick enough to go and get tested
Read 12 tweets

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