2019-2020 coronavirus pandemic (Vaccination 2021 Edition)

Eacaraxe

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It means your meta-commentary is trying to sound wise, but is really just lacking experience.
Well you're certainly free to continue doing the same thing over and over and expecting different results next time when you just conceded what you're arguing isn't the actual case, then.
 

Silvanus

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Well you're certainly free to continue doing the same thing over and over and expecting different results next time when you just conceded what you're arguing isn't the actual case, then.
What would you prefer? Entertain those promoting non-functioning remedies by refusing to challenge them? Or fund endless studies debunking whatever some quack pulls out?

There's a reason researchers and doctors spend time and energy correcting misapprehensions about medicine. It's the only option, and misinformation flourishes unchallenged.
 

Agema

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Last year I was diagnosed with a condition in my hands called Trigger Finger. When I was talking to my doctor about possible treatments, he mentioned having steriod injections into my hands. He wasn't keen on doing that because not only was it insanely painful, but steroids weaken the immune system and it was not a good idea in the middle of a pandemic. So that is probably why doctors aren't using steroids to treat Covid 19.
Covid-19 is generally fatal due to acute respiratory distress syndrome (ARDS). This is where the immune system becomes hyperactive in the lungs and causes a massive inflammatory response.

This is problematic because the inflammation allows more fluid to permeate tissues, as well as immune cells (white blood cells) to access tissue to combat the damage or infection. This is bad for the lungs in excess, because if lots of fluid, cellular matter and mucus builds up in the lungs, it impairs gas exchange of O2 and CO2: essentially, you drown in your own lung fluid. Inflammation is also bad news if overactive or chronic because immune cells kill not just invading pathogens, but a lot of the body's own cells too. Rheumatoid arthritis, for instance, is a disorder of chronic inflammation in joints; chronic inflammation is also a major contributing factor in neurodegenerative diseases.

Anyway, corticosteroids suppress the immune system. They are not advisable early in infection whilst the body is initially fighting the virus, but do become useful if hospitalisation is required because they help suppress the extreme immune reaction that causes to ARDS. Steroids are currently the best option for people who require hospitalisation for covid-19.

They are also not advisable unless clearly needed generally because whilst great at what they do in suppressing the immune system, they have a whole battery of shitty side effects (especially with chronic use), and if taken long enough are also unpleasant, difficult and sometimes downright dangerous to come off. You can usually buy topical corticosteroid creams for skin conditions without a prescription, but that's mostly because it's a low dose and not so much gets absorbed into the wider body to wreak havoc - even then, however, you would usually be recommended not to use it for more than a week or two.
 

Agema

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Well you're certainly free to continue doing the same thing over and over and expecting different results next time
My desired results are no greater than not letting misinformed people with delusions of competence spout bullshit go without challenge, because hopefully the fewer other people will propagate that bullshit even further.

when you just conceded what you're arguing isn't the actual case, then.
I think this could kindly be described as a conclusion that cannot be supported by the available evidence.
 

Phoenixmgs

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On the one hand, Kory is supporting a treatment (steroids) that has adequately proven efficacy. On the other hand he is aggressively advocating a treatment that doesn't. A treatment that by his own words he has called a "wonder drug", despite having plainly inadequate evidence. He has, on one of the grandest stages imaginable, manifestly made claims he cannot defend. That is tackling his argument. Just to be clear here, one of his primary co-authors has written an article where he reviews ivermectin and cites debunked papers, which is not a sign of quality. His attack on the RECOVERY trial is basically bullshit. He's essentially complaining it is not an optimised treatment plan, but it never was an attempt to generate an optimised treatment plan. It was about measuring the basics of drug efficacy.

Kory quit his job because his institution did not like him claiming ineffective treatments were effective. His institution has a point, because doing so damages his and the institution's reputation, thus their patients' trust in their medical care and staff, and even worse endangers the public because they can then do stupid stuff like poisoning themselves with veterinary drugs. When he says "they" wouldn't let him do administer what he liked, he's not talking about faceless bureaucracy, he means the senior medical personnel at the hospital. Because doctors are actually not supposed to do whatever they please, they are supposed to work collaboratively and seek agreement and advice, otherwise loose cannons kill people. And the institution that hosts them is also going to be at least part liable.



Well, here's the thing: Kory's colleagues at his institution didn't agree with him - at least on ivermectin. Therefore he fails even by the standards you claim.
He was right about steroids before just about anyone else. Looks like he can defend his claims. From Kory, it sounds like you shouldn't give that little of the steroid to anyone. If you don't give enough of something, it obviously might not work.

I gotta laugh at poisoning people with veterinary drugs because remdesivir has more serious adverse effects than ivermectin and remdesivir literally has no logic or theory behind why it would even possibly work in a hospital setting after the virus was cleared (giving an anti-viral to someone with no virus, why?). If you had to label either ivermectin or remdesivir as a poison, remdesivir would be it by a long shot right now. Calling ivermectin poison over remdesivir is really only explained by confirmation bias (which I keep getting accused of). Trying something that is extremely safe falls in the "better safe than sorry" approach. Why recommend not using it until you actually have proof that it doesn't work?

Also, currently on NIH's official website:
There are insufficient data for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19.

Thus, there's no proof either way and you're jumping the gun saying Kory is wrong.


Last year I was diagnosed with a condition in my hands called Trigger Finger. When I was talking to my doctor about possible treatments, he mentioned having steriod injections into my hands. He wasn't keen on doing that because not only was it insanely painful, but steroids weaken the immune system and it was not a good idea in the middle of a pandemic. So that is probably why doctors aren't using steroids to treat Covid 19.
When people start getting really sick with covid, the immune system already cleared the virus so there's really no risk in weakening it at that point.


What would you prefer? Entertain those promoting non-functioning remedies by refusing to challenge them? Or fund endless studies debunking whatever some quack pulls out?

There's a reason researchers and doctors spend time and energy correcting misapprehensions about medicine. It's the only option, and misinformation flourishes unchallenged.
Remdesivir is OFFICIALLY promoted and it's a non-functioning remedy.
 

Eacaraxe

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My desired results are no greater than not letting misinformed people with delusions of competence spout bullshit go without challenge, because hopefully the fewer other people will propagate that bullshit even further.
Okay you're clearly not getting what I'm pointing out, so I'll spell it out for you. You may know the pharmacology but you don't understand the rhetoric at play.

You're making a broad, categorical, universal statement about a topic. When you do this, you set the burden of proof for countering your statement trivially low as all the person endorsing the counter-position must do, is prove your statement is false by showing the mere existence of counter-evidence. That puts you immediately on the defense, and the person then shouldering the burden of proof, as that leaves you one of two possible rhetorical moves from that point forward: abandoning your initial position by clarifying and disclaiming it, or attacking the validity of the counter-claim. Here, you have chosen the latter, which is the position with the higher burden of proof which you must meet, and the worse risk-reward because if you fail to meet that burden of proof your credibility has been completely lost.

Meanwhile, your own credibility has already been degraded for making a bold first move that was quickly and easily countered. That provides an opening for those arguing the counter-position to go on the attack, and you have no counter for that as the failure of your first position speaks for itself to third parties, and to then choose the former of the two moves (abandoning your position) is a concession of ground you never should have made to begin with.

In other words, you put yourself in a lose-lose position by merely arguing the way you do. And by extension, you make the position you endorse appear weaker. Especially when you roll back into a thread dropping this take in response to a post from me, when I was criticizing the way this topic is discussed in the first place and how inadequacies in it provide opportunities for misinformation to spread. You proved my point merely anteing into the conversation that way.

The ideal response to my post, if you're absolutely hellbent for leather on just completely ignoring the point I was trying to make and dropping for all intents and purposes a massive, easily-countered, non sequitur, would have been "there are pharmaceuticals that are more effective at halting cytokine storms and hyperinflammation with fewer potentially life-threatening consequences for the patient which make for a preferable drug regime to countering COVID-inflicted ARDS, like dexamethasone".

There's a reason researchers and doctors spend time and energy correcting misapprehensions about medicine. It's the only option, and misinformation flourishes unchallenged.
And one could say the same of every policy issue in which "science" is at the forefront: renewable energy, climate change, nuclear energy, the future of space exploration, over-population, sustainable development. COVID isn't even a blip on the radar compared to some of the major policy debate shitshows of the 20th or 21st Century. Not even limited to ongoing debate, the same shit happened with the ozone layer, DDT, and leaded gasoline, too.

None of "the science!" in the world matters, if it doesn't come with a persuasive argument. This is why scientists, engineers, doctors, and researchers across the globe constantly get clowned on by the media and major corporations who have a vested financial stake in preserving the status quo by any means necessary. One side brings eggheads to the table who have convinced themselves only the data matters and its mere presentation is sufficient to win hearts and minds, and thereby extract policy concessions, the other brings propagandists who know damn well none of the data actually matters as long as they sufficiently baffle the masses with bullshit.
 
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Agema

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Okay you're clearly not getting what I'm pointing out, so I'll spell it out for you. You may know the pharmacology but you don't understand the rhetoric at play.
I know what you're pointing out. It's just that you're wrong because the problem here is that you're late to the show, and thus in the position of complaining about the conclusion only because you haven't seen the preceding discussion. As far as I'm concerned that problem is yours.
 

Gergar12

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I just got my second vaccine shot, and there were a lot fewer people there than in April. I barely had to wait in line, I got parking where the handicap is for sporting events, It took me less than a minute to get a shot. And this was in a college area.

I don't think we are getting covid-19 vaccine immunity until kids as young as 6 months are getting it, and even then I am feeling very nervous.
 

Eacaraxe

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I know what you're pointing out...As far as I'm concerned that problem is yours.
And if this is indeed the case and you've been meaningfully successful in your professed goals, the thread is 69 pages long and "...half...me explaining the science of HCQ and covid-19..." how, precisely? Because all I see is a polarized, circular clusterfuck of the same people (you included) repeating the same arguments, with the same shitty argumentative forms, ad nauseam with nary a point taken nor given in its thirteen-month pedigree.

You're not persuading the people you're arguing with, and third parties to it will have made up their minds who to listen to and whom to not listen to, months ago.
 

Agema

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He was right about steroids before just about anyone else.
Yes, that's just what he wants you to think. But is it true?

For a start, he was a long way behind a load of Chinese physicians who were using them months before a single case appeared in his hospital. There's a letter in The Lancet in early February 2020 from the Chinese Thoracic Society stating it is their consensus expert opinion corticosteroids are recommended for severe cases of Covid and suggesting a full clinical trial.

Likewise were many other physicians all over the rest of the world using them, early... because it's just not that clever or difficult a hypothesis. Corticosteroids were one of the first things the RECOVERY trial looked at, starting in March, and sure as hell they didn't come to that idea because Kory called up and told them.

From Kory, it sounds like you shouldn't give that little of the steroid to anyone. If you don't give enough of something, it obviously might not work.
And yet it did work. Perhaps it's just Kory's arrogance that makes him think he knows better. I can access the BNF (the UK's principal pharmacopoeia) and it states the normal dose for dexamethasone (outside specific emergency conditions) is 0.5-10mg daily. 6mg is therefore clearly a substantial dose.

I gotta laugh at poisoning people with veterinary drugs
No, I mean people read stories that things will save them from covid, and they acquire drugs and take them without medical advice. It's estimated over 5000 people in Iran were hospitalised (over 500 died) from methanol poisoning because people spread bullshit alcohol could save them from covid.

Thus, there's no proof either way and you're jumping the gun saying Kory is wrong.
Kory was wrong. He went in front of a body no less significant than the US Senate and announced ivermectin was a wonder drug with no adequate evidence to defend his point. It's funny that you don't seem to think he warrants any criticism for that.

The fact he can write himself a one-sided appraisal of ivermectin studies that misrepresents or clearly fails to address serious shortcomings in their study designs merely means he is ignorant or intellectually dishonest.
 

Agema

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You're not persuading the people you're arguing with, and third parties to it will have made up their minds who to listen to and whom to not listen to, months ago.
Likewise are you totally free to whine at me ineffectually about some meta-complaint regarding "rhetoric" because you don't have an argument of substance that matters a damn.
 

tstorm823

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You're not persuading the people you're arguing with, and third parties to it will have made up their minds who to listen to and whom to not listen to, months ago.
Excuse me, don't you know that if someone posts a youtube video, that entitles people to thoughtlessly condescend for literally a year? Those are the formal debate rules around these parts.
 

Phoenixmgs

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I just got my second vaccine shot, and there were a lot fewer people there than in April. I barely had to wait in line, I got parking where the handicap is for sporting events, It took me less than a minute to get a shot. And this was in a college area.

I don't think we are getting covid-19 vaccine immunity until kids as young as 6 months are getting it, and even then I am feeling very nervous.
Congrats

Kids don't need to get the vaccines for herd immunity, they really don't spread it much to begin with. Also, kids that are like under 5 or 6 (somewhere in there) don't even have the ACE2 receptors that covid attacks. That's why you start seeing the spread more in high school as kids mature vs grade school. The pure fact that it barely effects kids means they are getting rid of it really fast, which lowers any transmission window quite a bit on that aspect alone. Lastly, in the US, kids can't be forced to be vaccinated to go to school because the CDC can only mandate vaccines for kids in diseases that disproportionately affect them and covid affects them less than the flu, thus they aren't forced to get flu vaccines.

Anyway, you can just look at UK and Israel infection curves to show herd immunity has kicked in there. I believe the US's current downturn is also the result of immunity kicking in and it will continue on and mirror UK and Israel. The US will probably lag behind a bit because of how big it is and how many regions there are and some regions will have vaccinated quite a bit more than another region and whatnot. So in some regions, immunity will be pretty kicked in while somewhere else it might just be starting to.


Apparently a large number of people are missing or skipping their second shot. Which, y'know, doesn't help efficacy.
I don't have the data to say otherwise but those efficacy numbers are based on not getting infected at all. IIRC, one shot was like 80% and 2nd shot moved it up to like 95%. The main question is does one shot stop hospitalizations and deaths, that's the main factor. And if people do get mild infections, chances are lower that they are spreaders so maybe you're at like 5% of one dose people can get infected and spread it and say only 1% of 2nd shot people can, that's not that big of a difference. And, when infection numbers go down, it's harder and harder to get infected obviously. Thus, a one shot strat could lead to less infections faster as it will lower infections faster resulting in less getting infected even though they are a bit more vulnerable to getting infected. The UK used the strat of getting as many people one-shot vaccinated first and delaying 2nd shots and that strat has obviously worked there. Though I'm not saying "fuck taking your 2nd shot" by any means as people seem to always interpret stuff like that from what I say.
 

Phoenixmgs

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Yes, that's just what he wants you to think. But is it true?

For a start, he was a long way behind a load of Chinese physicians who were using them months before a single case appeared in his hospital. There's a letter in The Lancet in early February 2020 from the Chinese Thoracic Society stating it is their consensus expert opinion corticosteroids are recommended for severe cases of Covid and suggesting a full clinical trial.

Likewise were many other physicians all over the rest of the world using them, early... because it's just not that clever or difficult a hypothesis. Corticosteroids were one of the first things the RECOVERY trial looked at, starting in March, and sure as hell they didn't come to that idea because Kory called up and told them.
I meant more in the US/Western perspective. I know he wasn't the first at all as he said so in the video he thinks it's organized pneumonia and he asks radiologists and they're like "we knew that months ago". I'm not trying to say he's some genius and the only one that knew. When he was saying to use steroids, people were saying that you shouldn't, that's what the consensus was at the time.

And yet it did work. Perhaps it's just Kory's arrogance that makes him think he knows better. I can access the BNF (the UK's principal pharmacopoeia) and it states the normal dose for dexamethasone (outside specific emergency conditions) is 0.5-10mg daily. 6mg is therefore clearly a substantial dose.
He's been doing higher doses and pulse doses from the beginning. He said in the video he gives a higher dose of steroids to 80 year olds with a COPD exacerbation more than 6mg. I'd trust the doctor that has treated the thing for years over a single trial's dosage.

No, I mean people read stories that things will save them from covid, and they acquire drugs and take them without medical advice. It's estimated over 5000 people in Iran were hospitalised (over 500 died) from methanol poisoning because people spread bullshit alcohol could save them from covid.
I thought you were taking a cheap shot at ivermectin. You can't stop everyone from being stupid. Whether it's taking fish tank additive that has the same thing in it as HCQ (which happened) or stupid shit like Tide Pods. I'm not spreading anything like taking alcohol cures covid either. Also, lots of citizens in India think remdesivir is the cure, which isn't a good thing either.

Kory was wrong. He went in front of a body no less significant than the US Senate and announced ivermectin was a wonder drug with no adequate evidence to defend his point. It's funny that you don't seem to think he warrants any criticism for that.

The fact he can write himself a one-sided appraisal of ivermectin studies that misrepresents or clearly fails to address serious shortcomings in their study designs merely means he is ignorant or intellectually dishonest.
There's also Dr. Tess Lawrie's meta-analysis. It's kinda hard to trust lots of official recommendations because you have stuff like remdesivir being recommended for no reason (that's probably all money) and the fact that these top people interpreted the steroid studies on the SARS and MERS wrong leading them to think steroids were bad for those diseases and also bad for covid. People died because the people that should be able to read and interpret studies properly didn't. Even if Kory is wrong with Ivermectin, he's batting .500 then, I don't think the CDC is doing any better than that.
 

Agema

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I meant more in the US/Western perspective. I know he wasn't the first at all as he said so in the video he thinks it's organized pneumonia and he asks radiologists and they're like "we knew that months ago". I'm not trying to say he's some genius and the only one that knew. When he was saying to use steroids, people were saying that you shouldn't, that's what the consensus was at the time.
If there was a consensus not to use steroids, how come so many doctors worldwide quckly turned to them? He might argue there was a consensus in his hospital against, or that it was risky. I'm sure there were a lot of physicians not as on the ball as him who were clueless. But he does clearly seem to me to be posturing in that video to inflate his own competence.

(And if Western doctors didn't take note of Chinese experience treating the disease and instead make it up themselves... why?)

He's been doing higher doses and pulse doses from the beginning. He said in the video he gives a higher dose of steroids to 80 year olds with a COPD exacerbation more than 6mg. I'd trust the doctor that has treated the thing for years over a single trial's dosage.
What makes you think the people who designed the RECOVERY trial didn't have or seek opinion from top pulmonary medicine experts who likewise had been treating this sort of thing for years?

This is the sort of thing I don't get. How do you get to the point that a random clinician pitches up on YouTube blowing his own trumpet and claiming he has The Answer is assumed to be a top expert, and yet not stop to consider that the physicians, scientists people who design massive, major national trials are almost certainly top experts in their field?

Also, this is literally what science is about: collecting empirical evidence to demonstrate a point. Anecdotally pointing out you did it a different way means what, exactly? What's better? Are either better? I can tell you my experience of science is that when my experiments are in progress, I sometimes think they show things and other times not, and then go away and analyse them in proper detail and find what I thought I was seeing at the time doesn't exist. We impose our cognitive biases, hopes and wishes on our work, even scientists and doctors. That's why analysis and scrutiny matters so much. You have no idea whether a doctor thinks he's achieving great things off four patients really has achieved, or whether he's fooled himself because he wants things to work. Not least in a pandemic where they so badly want something to work, because they feel so frustratingly impotent due to the lack of treatments.

I thought you were taking a cheap shot at ivermectin. You can't stop everyone from being stupid.
No, but as a responsible professional, you should be expected to recognise that they do and control for it. Going in front of the top political body in your country and making wild, unsubstantiated claims, especially in a major health panic, as he did was reckless and potentially dangerous.

There's also Dr. Tess Lawrie's meta-analysis.
That meta-analysis is not peer-reviewed, nor even very detailed - I do not believe it is of publishable quality. I can also read analysis that she lumped together some studies that absolutely should not be combined, because they do not have adequate comparisons of methodology to justify doing so. In general, the scientific opinion is that the standard of individual studies supporting ivermectin tends to be very poor: major methodological limitations and high risk of bias, and the evidence is insufficient to justify any recommendation of use.

Also, contextually, Tess Lawrie is head of a company that is in reality pretty much three people in a shed with a glossy internet profile. They have no obvious reputation or record to be particularly trustworthy. Given that assessments on ivermectin exist from a large range of sources and they overwhelmingly state that there is no worthwhile conclusion to be drawn except that more high quality studies are needed, I cannot really justify taking Tess Lawrie and Pierre Kory over them.

FInally, and when I think of a few slightly suspicious statements I've read from Tess Lawrie herself, this ties into a wider public attitude of distrust of institutions and authorities. The mindset that over-rates the hero maverick against the sclerotic, faceless, bureaucracy. There is a reason a lot of this is going through some very dubious and anti-medical establishment channels, with undercurrents of accusations against Big Pharma, etc. There's thus an attraction to it from this sort of angle, and an inclination to grant these people a lot more credibility than they deserve under the harsh light of reality.

And finally we've been through all this with HCQ - excessive optimism over small and low quality studies that turns out to be a total wash when subjected to more rigour.
And the similarities don't just end there: likewise that ivermectin is variously touted as prophylactic and treatment for early covid and treatment for serious covid and as HCQ was (and also a treatment for long covid, because EVERYTHING). This again should cause skepticim, because multiple biological mechanisms would need to be triggered to support this, and the chances that ivermectin hits all of them are surely low to nothing. We've been through it with vitamin D, another great hope that turned out to be a great deal less impressive when better studies rolled along. I get that people want to believe in a wonder drug. However, once reality keeps dousing their hopes, they should be learning skepticism, not just transferring their desperation to the next overhyped miracle and its dodgy, aggressively self-publicising proponents.
 

Eacaraxe

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You're saying this?
You certainly seem to have no problem with my rhetorical style -- so long as I'm going after anyone on these forums but approximately three to four individuals of choice. Definitively never seems to be an issue when I'm rolling on the conservative-leaning posters.
 

Silvanus

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You certainly seem to have no problem with my rhetorical style -- so long as I'm going after anyone on these forums but approximately three to four individuals of choice. Definitively never seems to be an issue when I'm rolling on the conservative-leaning posters.
I don't care much about your rhetorical style either way; it was more about the stunning lack of self-awareness in saying someone else's debate style was counter-productive to being persuasive.