2019-2020 coronavirus pandemic (Vaccination 2021 Edition)

Phoenixmgs

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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?)
Because the Recovery trial said it worked. Here's some of the stuff that pops up if you google search "steroids covid" (between March 1 and June 1) on the 1st page.

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.
You mean like the same experts that misread the SARS and MERS studies and concluded that steroids are bad when they weren't? The same experts that recommended remdesivir? He definitely seems more on point than all these experts you keep referencing.

From Kory's interview, there isn't even very concrete data on treating organized pneumonia to begin with, he said info is mainly from case studies and not large scale trials. The reason Kory said he knew what it was 4 patients in was because of all the patients with organized pneumonia he treated pre-covid and it was the same thing.

I have nothing against doing really thorough trials and everything. But you don't have that luxury when there's a new virus. We don't even have really thorough trials on stuff we've seen before like aforementioned organized pneumonia. We have plenty of holes or incomplete info with many known things still let alone a new virus. And why are you gonna slap doctors' hands over drugs that are already proven extremely safe when you don't know if they don't work? And you're gonna approve something that doesn't have the results (safety and effectiveness) or even a theory in past science for why it could even work (remdesivir)? How does that make any sense?

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.
Ivermectin is far from reckless and dangerous (decades of data). I forget which South American country(s) that was trying to do trials for ivermectin and they couldn't because too many people in the population were taking it already. It's known to be very very safe and you have millions that have probably already taken it just for covid already. How much more data do you need for safety purposes? It's like all the variant fear mongering, we already have real-world data that the vaccines work on them, it's not guesswork anymore.
 

Phoenixmgs

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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.
Kory's paper is peer reviewed. Tess Lawrie is a respected doctor that consults with WHO and NHS. She's helped on many papers that these organizations use to form guidelines and recommendations. She's part of that group of experts that you tout as rigorously going over things. I'm guessing her meta-analysis with Bryant is in the process of getting peer-reviewed.

And yet HCQ hasn't been proven ineffective and tons of places use it as standard care. You act like we have all these "final words" on everything when we just don't. There are reasons explaining why ivermectin has the mechanisms of antiviral properties and inflamation. Where's that for remdesivir? There's a double standard there. If ivermectin or HCQ were rated on the same standards as remdesivir, they'd be recommended drugs for covid. Heck sugar pills would be recommended treatment for covid using remdesivir standards.
 

Agema

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Because the Recovery trial said it worked. Here's some of the stuff that pops up if you google search "steroids covid" (between March 1 and June 1) on the 1st page.

You mean like the same experts that misread the SARS and MERS studies and concluded that steroids are bad when they weren't? The same experts that recommended remdesivir? He definitely seems more on point than all these experts you keep referencing.
None of those say what you think they do.

The first suggests restricting corticosteroid use to "septic shock, or in critical cases". The second states that "Various studies in humans noted that corticosteroids appeared effective in reducing immunopathological damage": like, for instance, covid-19 induced ARDS. The third points out that a study showed "found that in more severe forms, the administration of methylprednisolone significantly reduced the risk of death by 62%."

What they are saying is that you don't just give anyone who is infected corticosteroids, because the efficacy is dubious and there are substantial risks of adverse side effects. Corticosteroids are frequently used and well known drugs with many potential complicating side effects. There are a lot of prudent cautions about their use, with good reason. But in fact all three state evidence suggests corticosteroids are likely to be effective for severe cases. And indeed, they were right: that's what the RECOVERY trial demonstrated to be true.

From Kory's interview, there isn't even very concrete data on treating organized pneumonia to begin with, he said info is mainly from case studies and not large scale trials. The reason Kory said he knew what it was 4 patients in was because of all the patients with organized pneumonia he treated pre-covid and it was the same thing.
It's very nice for Kory to have a eureka moment over organising pneumonia, but really, so what? Covid-19 had similarities to a wide range of conditions that justified the use of corticosteroids without any mention of organising pneumonia; there's any number of routes a physician could reasonably come to that conclusion.

Seriously, for every Pierre Kory there are literally thousands, if not tens of thousands, of other physicians worldwide who had covid-19 patients turn up in their hospital, and when they considered the symptoms compared to their experience of prior similar conditions, came to the conclusion corticosteroids were a likely option. The difference between them and Pierre Kory is merely that they are just getting on with their jobs, and not running a vigorous self-publicity campaign.

We have plenty of holes or incomplete info with many known things still let alone a new virus. And why are you gonna slap doctors' hands over drugs that are already proven extremely safe when you don't know if they don't work?
I have no objection to physicians trying out drugs when there is no established treatment. I have objections to physicians side-stepping appropriate medical and scientific routes and promoting quackery direct to the public and their political representatives. The history of this is filled with more woe than benefit.

Ivermectin is far from reckless and dangerous (decades of data).
Pretty much all drugs are potentially dangerous without proper medical advice. Of particular issue is that whilst safety data may exist for drugs in isolation, there is vastly less information on drug-drug interactions, so you can have a seriously misleading idea of how problematic a drug might be just from the basic safety information. It is estimated a tenth of all unplanned hospital visits are due to complications from medication: and the more medications someone takes, the risks of requiring hospital increase a lot. There is also the unfortunate fact that many people operate under a delusion that because something might be good for them, the more of it they take, the more beneficial it should be. They even more likely to do so if they believe casual claims it is "safe".

Therefore encouraging people to acquire and consume drugs outside medical oversight is dangerous.

Kory's paper is peer reviewed. Tess Lawrie is a respected doctor that consults with WHO and NHS. She's helped on many papers that these organizations use to form guidelines and recommendations. She's part of that group of experts that you tout as rigorously going over things.
I repeat: I am totally unclear why Kory and Lawrie are more important than all the other medical and professionals out there who are also respected doctors who also have valuable contributions to their fields. Let me be blunt: you are giving Kory and Lawrie completely undue credence because they are saying what you want to believe, not because they have a particularly good scientific argument. You know about them through their relentless, aggressive advocacy and self-promotion, not because of their brilliant, underlying professional bona fides. You are being encouraged to empathise with them because they pitch up on YouTube and provide a "human face" and personal story, as opposed to all the unknown, faceless professionals who are just getting on with their day jobs producing data and reports. It's a marketing trick.
 
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Phoenixmgs

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None of those say what you think they do.

The first suggests restricting corticosteroid use to "septic shock, or in critical cases". The second states that "Various studies in humans noted that corticosteroids appeared effective in reducing immunopathological damage": like, for instance, covid-19 induced ARDS. The third points out that a study showed "found that in more severe forms, the administration of methylprednisolone significantly reduced the risk of death by 62%."

What they are saying is that you don't just give anyone who is infected corticosteroids, because the efficacy is dubious and there are substantial risks of adverse side effects. Corticosteroids are frequently used and well known drugs with many potential complicating side effects. There are a lot of prudent cautions about their use, with good reason. But in fact all three state evidence suggests corticosteroids are likely to be effective for severe cases. And indeed, they were right: that's what the RECOVERY trial demonstrated to be true.
Restricting corticosteroid to something as critical as septic shock doesn't make much sense. Why would you wait so long? They definitely did not recommend corticosteroids for when you should indeed employ them. Nobody recommended giving every infected person corticosteroids on day 1 of infection.

It's very nice for Kory to have a eureka moment over organising pneumonia, but really, so what? Covid-19 had similarities to a wide range of conditions that justified the use of corticosteroids without any mention of organising pneumonia; there's any number of routes a physician could reasonably come to that conclusion.

Seriously, for every Pierre Kory there are literally thousands, if not tens of thousands, of other physicians worldwide who had covid-19 patients turn up in their hospital, and when they considered the symptoms compared to their experience of prior similar conditions, came to the conclusion corticosteroids were a likely option. The difference between them and Pierre Kory is merely that they are just getting on with their jobs, and not running a vigorous self-publicity campaign.
Most physicians aren't that good with the "working it out" part as there just isn't too much of that doctors do nowadays, which is both good and bad. They diagnose and consult the recommend treatment guidelines because we have treatments for most things now. Kory said all these doctors in New York he knew were looking for answers or having issues treating with things that weren't recommended. Quite often doctors weren't allowed to doctor. This NY Times article talks about all the infighting that was going on. It is paywalled but I did a CTRL+A & CTRL+C before the wall came up so I can copy paste the whole thing if you want. It also has literally the whole story of Kory and steriods in there as well. Here's a few excerpts.

In addition to fighting resistance from their administrators, the doctors were sometimes also at odds with their colleagues, especially infectious-disease doctors, many of whom believed that anti-inflammatories like tocilizumab and steroids could do more harm than good. “You’re killing these patients,” one infectious-disease doctor told Hahn at Long Island Jewish.

In April, supportive care alone was considered the best option for patients with Covid-19, given that there was no evidence yet to back other treatments.


I have no objection to physicians trying out drugs when there is no established treatment. I have objections to physicians side-stepping appropriate medical and scientific routes and promoting quackery direct to the public and their political representatives. The history of this is filled with more woe than benefit.
I have a problem with doctors not allowed to do what they think is best for their patients. That's what happened in many places.

Pretty much all drugs are potentially dangerous without proper medical advice. Of particular issue is that whilst safety data may exist for drugs in isolation, there is vastly less information on drug-drug interactions, so you can have a seriously misleading idea of how problematic a drug might be just from the basic safety information. It is estimated a tenth of all unplanned hospital visits are due to complications from medication: and the more medications someone takes, the risks of requiring hospital increase a lot. There is also the unfortunate fact that many people operate under a delusion that because something might be good for them, the more of it they take, the more beneficial it should be. They even more likely to do so if they believe casual claims it is "safe".

Therefore encouraging people to acquire and consume drugs outside medical oversight is dangerous.
Stuff like HCQ was and is handled out like candy, even given to pregnant women. It's extremely safe. Same thing with ivermectin, we have millions that have taken it in the past year. If there were some severe adverse effects, we'd know about them.

I've never encouraged people to acquire drugs without a doctor's recommendation/prescription. A doctor prescribing either of them (and almost certainly knowing the select few interactions, if any, to avoid) is extremely safe.

I repeat: I am totally unclear why Kory and Lawrie are more important than all the other medical and professionals out there who are also respected doctors who also have valuable contributions to their fields. Let me be blunt: you are giving Kory and Lawrie completely undue credence because they are saying what you want to believe, not because they have a particularly good scientific argument. You know about them through their relentless, aggressive advocacy and self-promotion, not because of their brilliant, underlying professional bona fides. You are being encouraged to empathise with them because they pitch up on YouTube and provide a "human face" and personal story, as opposed to all the unknown, faceless professionals who are just getting on with their day jobs producing data and reports. It's a marketing trick.
Again, I don't really care if ivermectin works or doesn't work. I have no horse in the race, I don't want to hear that it works (or doesn't work). Kory was right about how the WHO looked at the steroid studies for SARS and MERS wrong. He's 1 for 1 so far. He's not some quack that doesn't know what he's doing. Neither is Lawrie. She was part of plenty of recommendations before covid that you'd most likely agree with. Kory's meta-anaylsis was peer-reviewed, what's wrong with his science then?

You've completely glossed over all my questions about remdesivir? If you apply those same standards that got remdesivir recommended, you'd have a ton more recommended covid treatments right now. Do you agree that the experts got remdesivir wrong? What actual scientific argument did they even have that it might work? These panels of experts aren't as infallible as you claim them to be.
 

Phoenixmgs

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Someone hacked CNBC's Twitter account and put porn on it.

I wonder if it's just really a ploy for public approval, being seen doing the right thing when you know the right thing has like no chance of happening anyway. What's the chances of the US actually being able to alter patents on a worldwide level? I believe none of the companies with the vaccine patents are US companies anyway. Biden was all for Medicare for All during the election and that like immediately fizzled out after taking office.
 

Agema

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Restricting corticosteroid to something as critical as septic shock doesn't make much sense. Why would you wait so long? They definitely did not recommend corticosteroids for when you should indeed employ them. Nobody recommended giving every infected person corticosteroids on day 1 of infection.
You're just moving the goalposts to complain for the sake of it. You've tried to argue corticosteroids were argued against using sources that in fact defended their use situationally, and which were broadly accurate in their suggestion of the situations where they would be most useful. They have to be forgiven some imprecision, because there was limited data.

In short, you're just wrong.

Most physicians aren't that good with the "working it out" part as there just isn't too much of that doctors do nowadays, which is both good and bad. They diagnose and consult the recommend treatment guidelines because we have treatments for most things now. Kory said all these doctors in New York he knew were looking for answers or having issues treating with things that weren't recommended. Quite often doctors weren't allowed to doctor.

In addition to fighting resistance from their administrators, the doctors were sometimes also at odds with their colleagues, especially infectious-disease doctors, many of whom believed that anti-inflammatories like tocilizumab and steroids could do more harm than good. “You’re killing these patients,” one infectious-disease doctor told Hahn at Long Island Jewish.

In April, supportive care alone was considered the best option for patients with Covid-19, given that there was no evidence yet to back other treatments.

...
I have a problem with doctors not allowed to do what they think is best for their patients. That's what happened in many places.
Okay, just stop to think about what you're arguing here.

You are claiming that most physicians aren't good at working things out. Then you are arguing that doctors "should be allowed to doctor". What happens when you put these two together is that a load of doctors who don't know what to do who are masters of their own domain and can go unchallenged in their underperformance. Does this sound like a good idea?

Regulations and guidelines exist as things drawn up by experts to help summarise evidence bases on immensely complex topics to help doctors treat patients where they might not otherwise be as well informed. The other way they help treat patients is that doctors talk amongst themselves and work in teams, because otherwise lone doctors are more likely to miss information and perspectives. Several of my friends are doctors. One of them related a story where a surgeon had a problem mid-operation, declined to bother checking with colleagues who could have identified the problem because he thought he knew, and the end result was a dead baby. What a great victory for "doctors being allowed to doctor". Vast quantities of malpractice and accidents occur because doctors make mistakes (whether understandable oversights or outright incompetence) that would have been caught had they had oversight or better communication with colleagues. We literally train doctors to seek advice and second opinions.

Yes, there's a new disease and doctors argued about what might or might not be the best treatment. This is as it should be. It is better than the model of doctors as dictators of their own regime who do as they please. Inane fantasies about hero physicians held back from saving patients by the system should be left to the movies. But of course, that's exactly the sort of image Kory is trying to put forward and play on.

Stuff like HCQ was and is handled out like candy, even given to pregnant women. It's extremely safe. Same thing with ivermectin, we have millions that have taken it in the past year. If there were some severe adverse effects, we'd know about them.
Actually, you might not, because the countries being most afflicted by drug insanity have weak healthcare systems. They could be dying out there right now, and we'll never know the toll because there's no way of finding out. I prefer not to take the standpoint of who gives a fuck if its mostly poor Africans having seizures and dying from useless medicine.

I've never encouraged people to acquire drugs without a doctor's recommendation/prescription.
And yet you refuse to criticise a doctor who effectively did. He went onto a national stage and hyped a drug with no proven effectiveness when he should absolutely have known that this would encourage people to seek out the drug through improper channels. Not only because it had already happened several times in the current pandemic, but has happened every time there's a health panic in history.

Again, I don't really care if ivermectin works or doesn't work.
This seems untrue given how much you are arguing about it.

Kory's meta-anaylsis was peer-reviewed, what's wrong with his science then?
He does not adequately address flaws in the studies he looks at. It is thus to a significant degree superficial and low quality. Kory, of course, is not obviously a particularly proficient meta-analyst. At least that is within Tess Lawrie's specialism.

You've completely glossed over all my questions about remdesivir?
It's basically whataboutery and I could not give a shit.

Never mind the the sheer stupidity of the argument boils down to "Remdesivir doesn't work, therefore, why not take other drugs that don't work." Or, in a related form more familiar, "That guy committed a crime, so I should be allowed to commit a crime, too". Two wrongs here do not make a right.
 
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Gethsemani

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Yes, there's a new disease and doctors argued about what might or might not be the best treatment. This is as it should be. It is better than the model of doctors as dictators of their own regime who do as they please. Inane fantasies about hero physicians held back from saving patients by the system should be left to the movies. But of course, that's exactly the sort of image Kory is trying to put forward and play on.
When I was still a nursing student in the late-00's I remember one of the Senior Residents at the lung medicine ward I was interning at lament that House was causing his medical interns and junior residents to develop "House Complex" in which they modelled their professional behavior on Dr. House. This not only caused them to be terrible to patients by being arrogant, but more dangerously made them unwilling to seek out advice and counsel from more senior doctors and nurses. The latter because they thought nurses were beneath them and unable to provide important observations or knowledge about medical conditions and the former because it would be to show weakness to admit that you weren't a walking, talking Grey's Anatomy. He made a point of curbing those tendencies whenever he saw them due to how dangerous he felt it was that House taught new doctors that they should be Ace Lone Wolves in a line of work that's all about inter-disciplinary teamwork.
 
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He made a point of curbing those tendencies whenever he saw them due to how dangerous he felt it was that House taught new doctors that they should be Ace Lone Wolves in a line of work that's all about inter-disciplinary teamwork.
If people who have graduated from medical school need to be told not to emulate a television show, then I weep for the future of the species.
 

Agema

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If people who have graduated from medical school need to be told not to emulate a television show, then I weep for the future of the species.
You should experience them as first-second year medical students. Many of them will have developed a substantial way just to get that point after graduation.

Fun fact: Medicine is a course with one of the highest rates of cheating in university assessment, along with law students. Yes, that's right: Medicine and Law. In fact, we already have had emails from conscientious students warning us that less conscientious students have been discussing strategies for how to cheat in this year's exams.
 

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If people who have graduated from medical school need to be told not to emulate a television show, then I weep for the future of the species.
Many of them are also in their early to mid 20's in a high pressure job where good mentoring is a must but often lacking and where you are expected to be both insanely competent and knowledgeable but also haven't had a chance to develop any of the experience necessary to turn your book knowledge into practical know-how. On top of that you're expected to put at least 40 hours, preferably 50+, every week into your job and when you're on call you'll be lucky if the Resident that's supposed to be your guidance gives a good answer, let alone if they actually show up during an emergency. As if all of that isn't enough, you've got a bunch of nurses that have their own college degree in an adjacent field that you barely understand, with decades of experience in a hospital setting and who are laser focused on their cluster of 4-8 patients demanding that you make decisions and perform examinations NOW, no matter if you've got an emergency in the other ward or not (and just because a nurse said it was an emergency that's not necessarily true, so you better know what's an actual medical emergency and what's a nurse posturing so that you tend to her patients faster for her convenience). If you show weakness everyone will come down on you, because your job is to maintain a stiff upper lip and a calm mind no matter how many patients you need to tend to, no matter if you haven't slept in 24 hours and no matter if you actually have the experience to tend to the patients that are now under your care.

I am not surprised that many interns and junior residents develop weird personality quirks, I am surprised that there aren't more of them that does. Their working conditions can be terrible, especially if they end up in hospitals and clinics where senior residents treat them as peons and not as colleagues in training, and they've got a bad ratio of responsibility to actual executive power.
 

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I wonder if it's just really a ploy for public approval, being seen doing the right thing when you know the right thing has like no chance of happening anyway. What's the chances of the US actually being able to alter patents on a worldwide level? I believe none of the companies with the vaccine patents are US companies anyway.
Moderna, Pfizer, and Johnson & Johnson are all American companies.

Biden was all for Medicare for All during the election and that like immediately fizzled out after taking office.
?

No he wasn't. Biden didn't support M4A during the campaign.
 
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Phoenixmgs

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You're just moving the goalposts to complain for the sake of it. You've tried to argue corticosteroids were argued against using sources that in fact defended their use situationally, and which were broadly accurate in their suggestion of the situations where they would be most useful. They have to be forgiven some imprecision, because there was limited data.

In short, you're just wrong.
The goalposts were never moved. I posted a NY Times article stating that "In April, supportive care alone was considered the best option for patients with Covid-19". Recommending something when it's probably too late is not a good recommendation.

Okay, just stop to think about what you're arguing here.

You are claiming that most physicians aren't good at working things out. Then you are arguing that doctors "should be allowed to doctor". What happens when you put these two together is that a load of doctors who don't know what to do who are masters of their own domain and can go unchallenged in their underperformance. Does this sound like a good idea?

Regulations and guidelines exist as things drawn up by experts to help summarise evidence bases on immensely complex topics to help doctors treat patients where they might not otherwise be as well informed. The other way they help treat patients is that doctors talk amongst themselves and work in teams, because otherwise lone doctors are more likely to miss information and perspectives. Several of my friends are doctors. One of them related a story where a surgeon had a problem mid-operation, declined to bother checking with colleagues who could have identified the problem because he thought he knew, and the end result was a dead baby. What a great victory for "doctors being allowed to doctor". Vast quantities of malpractice and accidents occur because doctors make mistakes (whether understandable oversights or outright incompetence) that would have been caught had they had oversight or better communication with colleagues. We literally train doctors to seek advice and second opinions.

Yes, there's a new disease and doctors argued about what might or might not be the best treatment. This is as it should be. It is better than the model of doctors as dictators of their own regime who do as they please. Inane fantasies about hero physicians held back from saving patients by the system should be left to the movies. But of course, that's exactly the sort of image Kory is trying to put forward and play on.
Doctors should be able to do what they think is best, whether it's standing pat being cautious and waiting for treatments to be put through trials or treating based on their past experiences with similar diseases. They shouldn't be forced to do anything they are not comfortable with. Doctors that wanted to treat a certain way weren't allowed to treat that way, that's a problem. That's what literally happened, a doctor was denied getting presciptions from the pharmacists (in the NY Times article). A NY doctor also had to resign from a major medical center because of not being able to treat how they wanted (again, in the NY Times article).

Actually, you might not, because the countries being most afflicted by drug insanity have weak healthcare systems. They could be dying out there right now, and we'll never know the toll because there's no way of finding out. I prefer not to take the standpoint of who gives a fuck if its mostly poor Africans having seizures and dying from useless medicine.
We definitely know about HCQ, it's handed out like candy before the pandemic. Ivermectin has decades of safety info as well.

And yet you refuse to criticise a doctor who effectively did. He went onto a national stage and hyped a drug with no proven effectiveness when he should absolutely have known that this would encourage people to seek out the drug through improper channels. Not only because it had already happened several times in the current pandemic, but has happened every time there's a health panic in history.
If a doctor is recommending something, then it has a doctor's recommendation obviously. If a politician said a drug works, then yeah, that's not a doctor's recommendation.

This seems untrue given how much you are arguing about it.
I really don't, I just want to know the truth about things. I don't think I'd have anyone close to me getting sick from covid at this time as everyone I know either had it already or got vaccinated.

He does not adequately address flaws in the studies he looks at. It is thus to a significant degree superficial and low quality. Kory, of course, is not obviously a particularly proficient meta-analyst. At least that is within Tess Lawrie's specialism.
Tess Lawrie's meta-analysis is saying the same thing. Kory read the SARS and MERS studies correctly vs the panel of experts that you keep praising that read them wrong.

It's basically whataboutery and I could not give a shit.

Never mind the the sheer stupidity of the argument boils down to "Remdesivir doesn't work, therefore, why not take other drugs that don't work." Or, in a related form more familiar, "That guy committed a crime, so I should be allowed to commit a crime, too". Two wrongs here do not make a right.
That's not my argument. My argument is that if your "panel of experts" thought it was a good idea to even give people that didn't have the virus anymore an anti-viral that had no chance of working in the 1st place (no science supporting why it could work), why should anyone trust their expertise then? How is that even ethical to give patients something you have no reason to believe would even work based on known science? Then, to double-down on it with results that showed it did nothing, they recommended it as a treatment. Why should I trust these people? Lastly, shouldn't all treatments be held to the same standards of efficacy? That's obviously not what's going on.
 
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Phoenixmgs

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Moderna, Pfizer, and Johnson & Johnson are all American companies.



?

No he wasn't. Biden didn't support M4A during the campaign.
My bad, I thought at least both mRNA vaccines were foreign made. Pfizer I'm almost certain does not own the patent for the vaccine, it's Biontech, a German company. But yeah, Moderna and J&J are American.

Biden is/was for a public option at least.
 

Phoenixmgs

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Video queued up to the part about how the virus can't really mutate so much to escape the vaccines. Any organism can only mutate so much like we can't turn into giraffes or covid can't turn into ebola obviously. You form CD8 cells across 52 different pieces of the spike protein so if you have a couple mutations, you're plenty good still. It's basically an impossibility that all those 52 different pieces are gonna mutate.
 

Phoenixmgs

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Remember that time the CDC director said there was "IMPENDING DOOM!!!"?

And just about a month later, no impending doom at all!!!

That was a pretty damn easy call (and raise all-in) on that bullshit from the CDC director though.
 
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Agema

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The goalposts were never moved. I posted a NY Times article stating that "In April, supportive care alone was considered the best option for patients with Covid-19". Recommending something when it's probably too late is not a good recommendation.
Yes, that would be the article that points out that physicians randomly chucking drugs at patients with risk of anecdotal bias meant people had HCQ shoved down their throats for no reason for months, and slowed down the ability of many to properly find out what worked. As it so neatly contained:

Should Kory and his colleagues have been administering steroids when they did? Were they right? Kory thinks so. But Eric Rubin, the editor of The New England Journal of Medicine, thinks it’s not so clear-cut. “You could also say he was lucky,” Rubin said.

But it's funny how you took precisely zero of that away from it, eh?

Doctors should be able to do what they think is best, whether it's standing pat being cautious and waiting for treatments to be put through trials or treating based on their past experiences with similar diseases. They shouldn't be forced to do anything they are not comfortable with. Doctors that wanted to treat a certain way weren't allowed to treat that way, that's a problem.
Okay, so why bother with clinical trials, if doctors should just be able to decide at whim? If a pharmacist checks a prescription and notices it is the wrong dose or wrong drug for the patient, should the pharmacist be compelled to just hand it over anyway? Why even train pharmacists - let's just replace them with vending machines, because they're obviously useless. Why should we bother to oversee junior doctors with consultants, and consultants with heads of medicine? What's the point in a multidisciplinary meeting or clinic, if the doctor should have absolute power to do as they please?

We definitely know about HCQ, it's handed out like candy before the pandemic. Ivermectin has decades of safety info as well.
Right, and later meta-analyses after trials demonstrate that HCQ increased all-cause mortality from covid-19. You are literally advocating killing more people with improper drugs, and calling them "safe". Because you really are that clueless about what you are talking about.

If a doctor is recommending something, then it has a doctor's recommendation obviously.
And if 20 other doctors recommend against that doctor...?

I really don't, I just want to know the truth about things.
No, you obviously don't. Because you not only dispute everyone who points out your errors, you also advocate policy based on your (inaccurate) perception of truth. Someone who just wanted to know the truth would go into a thread and ask whether ivermectin worked. They wouldn't insist it worked on bad evidence, and therefore that everyone with covid should be be given ivermectin.

Tess Lawrie's meta-analysis is saying the same thing.
What about everyone else's ivermectin meta-analyses? It's very interesting you can only name the people who wrote supportive ones. Is this what you call "just want to know about the truth", that you don't bother properly researching evidence?

Kory read the SARS and MERS studies correctly vs the panel of experts that you keep praising that read them wrong.
'“You could also say he was lucky,” Rubin said.'
Given he looks likely to be wrong on plenty else like vitamin C and ivermectin, Rubin may well have a point.

My argument is that if your "panel of experts" thought it was a good idea to even give people that didn't have the virus anymore an anti-viral that had no chance of working in the 1st place (no science supporting why it could work), why should anyone trust their expertise then? How is that even ethical to give patients something you have no reason to believe would even work based on known science? Then, to double-down on it with results that showed it did nothing, they recommended it as a treatment. Why should I trust these people? Lastly, shouldn't all treatments be held to the same standards of efficacy? That's obviously not what's going on.
Actually, all of the expert "panels" I think are important to listen to say remdesivir has minimal or no efficacy, and is not worth using.

This is your hypocrisy, even if you do not understand the fact: you want doctors to be able to doctor with the drugs according to their best wisdom, and then you complain when the FDA attempts to enable them to do so.[
 
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Buyetyen

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Remember that time the CDC director said there was "IMPENDING DOOM!!!"?

And just about a month later, no impending doom at all!!!

That was a pretty damn easy call (and raise all-in) on that bullshit from the CDC director though.
Your attempts at tearing down the experts only make you look more and more desperate in your bullshit. It's not enough to wear the mantle of Galileo, you have to be right.
 

Gethsemani

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If a doctor is recommending something, then it has a doctor's recommendation obviously.
Some things that doctors have recommended throughout the ages:
* Regular imbibing of radioactive water to improve overall health.
* Induced Insulin coma for several days or weeks to calm the nerves.
* Smoking to improve respiratory function.
* Regular use of heroin to calm the nerves.
* Regular use of cocaine to maintain mental acuity.
* Regular use of (meth)amphetamine for women to lose weight and keep slim.
* Bloodletting to reduce bad humors and become healthier overall.
* Plombage (blocking a lung to induce a lung collapse, creating a cavity underneath the ribs and filling it with gauze to prevent the lung from recovering) to speed up recovery from tuberculosis.
* Lobotomy.

We should be careful with accepting something just because a doctor recommends it, particularly if said doctor is controversial and doesn't have the support of the rest of the medical community.