The TOGETHER trial on ivermectin is finally published, only 7 months after its completion. 🧵 nejm.org/doi/full/10.10…
Impossible as it may sound, the investigators did not check at all if the patients in the study had taken ivermectin recently. In the paper we see no mention of ivermectin in the exclusion criteria:
However the paper refers us to the previously published trial protocol for more inclusion/exclusion criteria. Is it there? No.
Perhaps ivermectin was not something used commonly in that area at the time? Sounds like a reasonable explanation. Except for 3 facts:

1. Ivermectin is available over the counter in Brazil.
2. The Brazilian government was recommending it as a COVID treatment, as part of its early treatment kit:
3. As a result, sales of ivermectin in the area where the trial was taking place were NINE TIMES higher than normal. (screenshot via Google translate)
otempo.com.br/interessa/vend…
In brief, I have no idea how this trial was even published, lacking the most important exclusion criterion. Without it, we don't know if people in the control group (the one that isn't supposed to be taking the drug) were actually taking the drug. What am I missing?
I've written in a lot more detail about the trial and what the issues with it were, though I'll go through the paper and see if the criticisms hold now that we have a manuscript.
doyourownresearch.substack.com/p/what-went-wr…
Honestly though, I don't think we need to look beyond the exclusion criteria to approach this study with extreme skepticism. Studies have been discarded for much less, and yet the usual suspects are salivating all over the manuscript with no mention of this fundamental error.
It should be noted, however, that this fatally flawed study has been used to drive not one but three separate waves of "ivermectin doesn't work" publicity in the press.

First in August when they published a single slide:
Then again a few weeks ago: archive.ph/QZzU7
And now again finally with the publication of the paper, where inevitably a wave of headlines are already out there. medpagetoday.com/infectiousdise…
It may not be useful as a study of ivm, but it certainly has delivered a masterclass in how certain messages receive top billing in the press over and over again, with no real new information being released whatsoever, while many other studies with opposite results get ignored.
Gathering data anomalies as they get observed here. Something is extremely odd with this trial.

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More from @alexandrosM

Mar 29
The sustainable energy debates are amazing. I've never seen a debate where each side has its own set of ridiculous linear extrapolations that reject the very concept of innovation being possible.

I try not to do "both sides have lost the plot" takes, but when the shoe fits... 🤷‍♂️
On the one hand we have the crowd that thinks that unless we stop burning fossil fuel immediately, the earth is going to be engulfed in hot lava raining from the heavens in about 20 minutes.
On the other hand, we have the people who say things like "Aactually, EVs pollute more than internal combustion cars when you take into account manufacturing!!" - No. They don't. Even if you burn coal to power them. Even if you ignore what it takes to get gas to the pump. Nope.
Read 11 tweets
Mar 28
This was 118 days ago. Anyone heard any news? businessinsider.com/pfizer-vaccine…
This was early in January. Sounds promising. timesofisrael.com/pfizer-ceo-que… Image
This was a week ago. Weird. cbsnews.com/news/covid-vac… Image
Read 6 tweets
Mar 27
Did you ever think to yourself, "I want to know the truth, no matter what it is, I can handle it"? 🧵🧵

The next few threads should call your bluff.
I. Pervasive control system is being erected all around us. A small sampling of parts involved:
II. China, ever the thought leader, is moving ahead to the next step of implementation:
Read 7 tweets
Mar 27
Complication vs. Complexity🧵

Public health approached this pandemic as a "complicated" problem that can be fixed with discipline, whereas it was a *complex* problem, requiring humility in the face of uncertainty.

statnews.com/2022/03/22/cov…
This idea allows us to connect the baffling response to the pandemic with the powerful Cynefin framework: en.m.wikipedia.org/wiki/Cynefin_f…
This is a great illustration. Complicated domains call for experts. Complex domains call for emergent practice. Guess which one we went for? In fact, I'd go so far as to say this is a generalized failure mode of government.
Read 6 tweets
Mar 25
Science has turned into full-scale war. mediterranee-infection.com/communique-de-… Image
"Moreover, Mrs. Bik had written in 22 articles that our research was neo-colonialist..."

This is a smoking gun of a weak argument in my opinion.

mediterranee-infection.com/the-case-again…
Apparently scientists from Lebanese universities performing research in African countries is "neo-colonialist science". Give me a break.

scienceintegritydigest.com/2021/10/28/con… Image
Read 4 tweets

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