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I feel like the rate of posts on ACX has dramatically increased these last 10 minutes.

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founding

"To mandate vaccines is to state that humans are all born defective, and only become non-defective after jumping through state-approved hoops. It is philosophically corrosive to everything I believe in."

This feels like an isolated demand for rigor. I am constantly choosing to better my existence in many ways because of my 'defects':

* I take ibuprofen (which is government-approved) because my defective body creates headaches

* I upgrade my phone (which is government-approved in various ways) because I need a better camera because my defective eyes don't permanently store images of what they see

* I take the Moderna vaccine because my defective body is incapable of manufacturing the antibodies against a recently-common virulent disease that risks my wellbeing and that of those around me.

All human life is defined by improving our condition, sometimes under the supervision of a government. Regardless of whether those measures are mandated, it is strange to think of some of those actions as perfectly ordinary and some of them as accepting that you're defective.

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"Author briefly looks at 30 of the 66 studies, which we note is much better than most commenters, but still ignores the majority of studies, including the prophylaxis studies."

My reaction to that one is "Oh, person, try me!"

I trawled my way through that Cochrane meta-study of the various studies. A heap of them were "throw everything at the wall and see what sticks" where they dosed people up on ivermectin and whatever they had lying around in the dispensary cupboard; some of them were "you're not testing what you say you're testing when I read your paper" and at least one was "we done screwed up".

One of the positive ones recommended you take your ivermectin with a meal and alcohol, because that made it work better. So at least you get to have a nice steak dinner with a glass of wine, which should make the experience pleasant.

The positive results ranged from "mild" to "really great but it's in Florida". There's no way to say "All the studies or most of them anyway say this works fantastically".

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The longer Americans don't get their damn shots already, the stronger the argument against donating the leftover doses becomes: "we can't donate that vaccine, Dr. Scott in the Bay Area hasn't taken his yet! Would you vaccinate some random Nigerian before Dr. Scott?!"

And that's even assuming those shots *could* be donated. Poorer countries have been discarding doses left and right for months.

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Well, this explains why you were asking "who needs editors?" in the open thread.

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re. "To mandate vaccines is to state...."

This finally clarified to me why I've been getting so god damn HEATED about COVID-19 and global warming denialists in general, compared to other things.

It falls under the list of vague "social contract" things I expect everyone to do because I have to do them too.

Eg, I like being loud in public. I like fighting. I like driving fast on mountain roads. I like shooting guns in my back yard.

But, I don't do any of these things, in exchange for everyone else not doing these things; so when I see a defector (someone not getting a vaccine; someone driving perfectly buffed out brodozer with the fake lift and no liner) it pisses me off because: I wanna do stupid shit!

If I can't fight people in line at the grocery store and shoot squirrels at the park with a 762 and drink in public, YOU have to wear a mask and get your fucking shot.

We live in a civil god damn society where 90% of our individual liberty is sacrificed to protect our ability to live groups; and that's good because if we didn't idiots like me would try to box you for wearing a loud shirt or some equally dumb shit.

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Thank you for the kind mention, I'm happy you read the thread. The analysis has been completed as of this morning, about to start writing up.

I'm in the bay area next week and would love to meet (again) and talk through all this if you're up for it.

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A reasonable critique of Fluvoxamine is that the primary outcome of the trial is a bit weird. The primary outcome was hospitalization/emergency room observation lasting more than 6 hours, and the difference detected was in the observation time, which is a bit subjective and not necessarily relevant to the patient

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Adding up statistically insignificant results to get a statistically significant one is not a horrible idea.

But. Negative results should be weighted higher than positive. We'll need an elaborate weighting system to compare different studies. An Egyptian study done by some no name (as judged by his citation index for example) should have very little weight compared to a study done by known scientists in a first world country. RCTs should be weighted my higher compared to other studies. Etc. And we would never agree on the exact weights of every parameter. So it is unusable in practice.

However, one exception to the rule could be a situation where we have 20 studies on X and all of them are showing positive results and to get statistically significant results on X we would need a trial with like 1 million people.

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"I also think people are overestimating conservative elites’ role here by deliberately conflating opposition to vaccine *mandates* with opposition to *vaccines*. A lot more elites have come out in favor of the first than the second."

Definitely agreed that this distinction is vital and keeps getting lost in the discourse. I am arguably one of the conservative semi-elite (went to an Ivy law school, clerked for a GOP-nominated federal judge, now working for the state government in a red state). I strongly oppose vaccine *mandates* on both legal/constitutional grounds and on the grounds that the scientific calculus of cost versus benefit doesn't point in the same direction for everyone... But I am vaccinated, my wife is vaccinated, and I generally encourage my adult friends to get vaccinated unless there's a clear contraindication. I feel like I am far from alone on this position, but it rarely gets much traction in the broader discourse.

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>I also think people are overestimating conservative elites’ role here by deliberately conflating opposition to vaccine mandates with opposition to vaccines. A lot more elites have come out in favor of the first than the second.

I think you mean "against," not "in favor of," unless I'm misunderstanding?

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The problem with taking "vaccine skeptics" seriously is that they have repeatedly proven themselves willing to promote any lie that serves their agenda. (This was true before COVID, and is true of COVID vaccines as well.) That doesn't mean they can't be right, it just means that you can't *assume* they are right.

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Btw, wasn't one of the pharma companies running trials for a drug that has basically the same mechanism as ivermectin except it can be patented?

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"but it’ll just provide pro-lockdown people with an easy opportunity to tar all their opponents as science deniers." They'd do it anyway. They do it non-stop. Anyone with a disfavored opinion is "anti-science". Sanitizing your actions and thoughts to avoid being smeared as stupid is just another kind of surrender.

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I think a big part of resistance to vaccines is that they are very visibly not working against the metrics that governments use to decide on restrictions. Hence why European police are currently shooting protestors after deciding to place entire populations under house arrest - the vaccination programme is a failure and their case numbers reflect that.

There are several sub-aspects to this that are really important.

1. The vaccination programme has failed, because its goal was to reduce infections. Germany now has HIGHER numbers than at any previous time, and in the UK the data shows vaccinated people are now TWICE as likely to be infected as the unvaccinated. Nobody can explain this.

2. By extension this means trial failure. The trials didn't have hospitalizations or deaths as a primary endpoint, they were approved due solely to their effect on case counts. Yet this has turned out to be woefully misleading.

3. Trial failure on something as critical and dangerous as demanding entire populations take an experimental substance is a big deal. Yet, governments and the fanatically pro-vaxx part of society (journalists, public health etc) aren't acting like it's a big deal. They're ignoring it.

4. This requires us to wonder what else the trials were misleading about. If they were so badly wrong on efficacy, were they also badly wrong on safety?

WRT the last point, there is increasing evidence the answer is yes. The FDA has started slowly releasing documents related to the vaccine approval process. The first batch revealed that Pfizer was taken by surprise by the flood of AE reports and had to hire extra staff to process them. Why were they surprised by this, having just done a trial meant to precisely characterize this exact value?

So let me summarize. Increasingly fanatical governments are now creating as much hate as possible towards a segment of the population whose only "crime" is to observe that huge numbers of scientific studies suck, that pharma/public health is riven with conflicts of interest, that experts have been consistently wrong, that the vaccines are experimental, that they have failed to do what they claimed they would do and that this might explain why people seem to have bad reactions quite frequently (depending on brand/region/etc? some people don't seem to encounter any bad reactions and others do).

This is very bad news regardless of who you are or your stance on vaccines.

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"No anti-vaxxer ever locked me down."

Unless you consider death the ultimate lockdown.

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The matter of treatment delay response was not addressed. Pity.

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Tophattington's perspective must seem very noble and principled from inside their own head, but my GOD is it noxious to have to read. Not a single ounce of consideration is given to the externalities of individual decision-making, nor one moment spent to contemplate the fragility of the structure that provides them the comfort and safety to opine flatulently about the INJUSTICES their government DARED subject them to.

Only a decadent, privileged, and morally depraved society would allow its members to become so detached from reality that they could feel ENTITLED to forget how desperately nature is trying to kill them, and how tenuous our grasp on civilization is.

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Re: the hacker news section, I feel like you are not giving journalists a hard enough time for this. You yourself saw that a lot of stories initially about Ivermectin were genuinely terrible, you even wrote a post about it: https://astralcodexten.substack.com/p/too-good-to-check-a-play-in-three

These stories weren't terrible just because the editor wanted to have something short, rather they were saying things that were directly misleading, or conspicuously lacking context. If the general case was that most people had done the research but they just couldn't write as much about it, the above post would never have happened.

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> reviewing all the studies would have taken too much space

Even in online-only article?

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Scott, did you know you were mentioned on yesterday's episode of the Joe Rogan Experience? It was in reference to your essay last week about ivermectin. Tim Pool was the guest, and he brought your findings up as a retort to Rogan's positive claims about ivermectin. I recommend listening to the interview, starting at the 17:00 mark, and waiting for this key part of the conversation:

Tim Pool: "Now there's an interesting point that just came up today. I can't remember the guy's name, it might be Scott Alexander, I'm not sure, and they found a correlation between worms and parasites and curing COVID. So one of the hypotheses for Uttar Pradesh--people there have a high propensity for parasite infestation, and so if you've got worms and your immune system's being bogged down or strained, you get sick, you're more likely to die, and have a serious reaction. You take ivermectin, you cure those worms, your immune system is more robust. I'm not saying it discredits everything--"

Joe Rogan: "No, no, no, it stops viral replication. It's not as simple as, like, you don't have worms anymore so your immune system is stronger. Because there's plenty of people that don't have worms, that have an immune system that gets wrecked by COVID. What they're showing is, that there's a direct correlation between taking ivermectin and having positive results. The problem is..."

...and I'm sick of transcribing it. Just listen to it yourself, and please share your thoughts on Rogan's interpretation of medical science regarding ivermectin.

You should also weigh in on Joe Rogan's Cure for COVID, which he goes on to mention in the episode (and has in several past episodes). It includes ivermectin, monoclonal antibodies, and some other stuff (probably vitamin megadoses).

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I find the “top down / bottom up” commentary most interesting here.

It looks like a feedback loop in play as well: the more “out there” the bottom up network gets, the more the top down network increases its prior that the bottom up network is mostly cranks and quacks. This makes the top down network more willing to dismiss out-of-consensus opinions. As a result, people with more trust in the bottom up networks increase their priors that the top-down network is overly censorious. So they are more likely to take “out there” ideas seriously, and the cycle repeats.

At least, that’s how I see this. Am I right that there’s a feedback loop in play here? What could be done to stop it?

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" There are dozens of positive double-blind RCTs of homeopathy."

Arguably, this is because endocrine disruptors can have a non-monotonic dose-response curve at very low doses. Google "bisphenol A, non-monotonic dose response curve" to get some sense of what I'm talking about. And 'homeopathy' has a tendency to use a single set of glassware in its dilutions, meaning that most homeopathic dilutions that claim to have zero active substance actually have microgram quantities of substance or less. And we know that microgram quantities of substance can exert biological effects that are qualitatively different than larger doses.

Our sense of smell is the quickest way to demonstrate this. Indole, for example, smells floral at low doses and fecal at high doses, for example. "fecal" is different than "really, really floral." And with scents we're already talking about qualitative differences at sub-microgram levels of exposure.

Homeopathy studies sometimes show real effects because they're banging into a real effect whose mechanism is poorly understood, especially by the homeopaths.

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As for the "physician that has reported zero deaths and 5 hospitalizations with 2,400 COVID-19 patients", I'm just going to leave the public statement by the Brazilian Research Ethics Board:

https://conselho.saude.gov.br/ultimas-noticias-cns/2095-nota-publica-cns-elucida-a-sociedade-brasileira-fatos-sobre-estudo-irregular-com-proxalutamida

Basically, his research had ethical approval for a single hospital in Brasilia, for patients with mild COVID. Somehow, the published data is from many hospitals in Amazonas, with a 50% mortality in the placebo group, with a high proportion of liver and kidney failure in the placebo group. However, since the study was blinded, there was no way to know those deaths were in the placebo group, and the study should have been halted for investigation and possibly unblinding. When requested, the author did not provide information about the chain of distribution of the placebo pill, and it can't be discarded that the control patients were actually receiving a harmful medication instead. The "independent data monitoring committee" was composed led by the study's sponsor. The consent forms presented were different from the ones approved, with suppression of clauses that guaranteed compensation and assistance in case of harms or contraception (androgen blockers have high teratogenic potential)

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The Tophattingdon comment is quite sad to read. I can’t recall if it was Scott but the idea that self sacrifice is a finite resource seems very applicable here.

In any case, the UK did get ahead initially on vaccine procurement and really has been free of restrictions (to the point of even getting rid of very low cost measures like masks in shops) for a few months now. When the initial lockdown measures were brought in back in March 2020, snap opinion polls put them at 98% support! The government were behind the public, many of whom had effectively locked down already.

If you opposed lockdown, fine, these things are difficult to quantify. But it was (particularly initially) a very popular policy that is only not being enacted now because of the amount of vaccines that have been administered reducing the death rate to a level deemed acceptable. Hopefully Paxlovid reduces this further.

But not being vaccinated when you know it’s sensible is just strange. It hasn’t been mandated! You’re free to have a good thing or not have it if you don’t want. If you end up getting badly ill with Covid or pass it to someone you love, what will this bizarre protest have been for?

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Re: mandates - it's worth noting that Trump's getting booed happened in August. Biden announced the mandate two weeks later.

So people were already saying f-you to the vaccine in general. They weren't booing the OSHA mandate.

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While I do think Scott's own chosen numbers and studies don't say what he wants them to, they aren't what I consider to be the most important data on the matter.

Rather than randomized controlled trials, what I'm seeing is an environment where some countries allow and encourage a wide range of treatments, and have near zero case fatality and were almost unaffected by covid, while others have much higher case rates and much higher case fatality rates. Many of these countries seem competent, and I can't really explain them without assuming that they're using some sort of treatment that works.

In addition, whenever a country switches from not treating covid to treating covid, it works.

Not all of the competent countries that have low case fatality and treatments that are not allowed or encouraged in America use ivermectin. Most use a complicated mix of drugs, supplements and catalysts, each with their own special purpose and timing. I want more attention on trying to replicate exactly what they're doing.

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"Unless you are bipolar or in some kind of special bizarre high-risk category"

Do you think fluvoxamine would have a significant interaction with blood thiners for the 10 days that the treatment lasts?

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If you think of finding effective treatments like solving a murder mystery, the last thing you worry about is every bit of information you receive being perfectly credible. You certainly don't won't to disparage or destroy the careers of anyone who ends up giving you bad info. It's 100% expected that you will pursue many dead threads. It should be possible to complete large trials on all these drugs and many more in a couple weeks and let the webcam video trial data be available for everyone to analyse.

The overwhelming point here is that even today is that a very large percentage of people who test positive are recommended to do nothing other than drink fluids.

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> I kind of sympathize with this (and am considering refusing the booster to protest them not sending spare doses to the Third World), but refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases), but it’ll just provide pro-lockdown people with an easy opportunity to tar all their opponents as science deniers.

"Maybe you think the Nazis are evil, but fighting a war against them seems like the most counterproductive way to protest them. Not only will this ensure that your people get more oppressed (due to the ravages of war), but it'll just provide pro-nazi people with an easy opportunity to tar all their opponents as warmongers"

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Re the journalistic standard of concision:

I think this aversion to ultra long form is what turns me off from most articles in the media.

For me, most of the value in a piece is being able to reconstruct the argument/summary from the presented evidence/story, and having enough material to be reasonably confident that my understanding is correct. (The evidence/story also lets me come to my own conclusions that diverge from the author's.) Articles that just say "the data says X" or "he did X because Y" with very little/no follow up infuriate me.

I'm sure journalists try to give good backgrounds, but I think they underestimate how much background is actually preferable. (Or maybe people like me are a different target audience.)

I personally would gladly read one 30 page article about a single subject than 30 one pagers summarizing the daily news.

On a side note, this difference between just having the summary vs having the summary along with a massive amount of data reminds me of one of the last paragraphs of "Varieties of Argumentative Experience":

The high-level generators of disagreement can sound a lot like really bad and stupid arguments from previous levels. “We just have fundamentally different values” can sound a lot like “You’re just an evil person”. “I’ve got a heuristic here based on a lot of other cases I’ve seen” can sound a lot like “I prefer anecdotal evidence to facts”. And “I don’t think we can trust explicit reasoning in an area as fraught as this” can sound a lot like “I hate logic and am going to do whatever my biases say”. If there’s a difference, I think it comes from having gone through all the previous steps – having confirmed that the other person knows as much as you might be intellectual equals who are both equally concerned about doing the moral thing – and realizing that both of you alike are controlled by high-level generators.

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290143/

Maybe look more broadly at effect on other viruses I read somewhere it was used in Africa on influenza reducing annual mortality from 800 to 20

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Yes, give journalists a break. (And you should take some of your own medicine and give the FDA a break, too.) One of the reasons they (or their editors) are as cautious as you observe with (naive I would say) surprise is because they *know* if there's anything to nitpick about what they've said a pack of rabid Internet Experts will instantly savage them. In that world, the only safe option is to print stuff that fits the shibboleths of your major protective tribe, because they you know you *won't* get savaged by your in-group, no matter how many silly mistakes you made, and the critique by your out-group can be dismissed as the usual poo-flinging (even if it isn't) and you'll have your own poo-flingers to back you up.

Furthermore, thoughtful and centrist authors (and editors) get shoved out, because they are unhappy with always just writing partisan sloganeering pap, and unhappy with the viciousness with which they are treated if they try to tackle hard subjects in reasonable ways. So they exit the job and we are increasingly left with shills and hacks who don't shilling and hacking.

It's a God-damned mess, and a reversion to where we were about 40,000 years ago, and I blame the Internet. It's turned us all into instant soi-disant experts, 'cause we read a few Wikipedia articles and googled some stuff ("look! I have a link to a paper where the words I want appear in the abstract! That makes my half-assed screed as credible as a paper in PNAS, pretty much...")

There is absolutely a place for robust criticism, by anybody credentialed or not, of expert judgment, and this is absolutely healthy for expertise -- e.g. science prospers this way. But there's a genuine line between being a useful gadfly and critic and being a pack of fucking chimps hooting and flingiing poo and ruining any possibility of reasoned discussion.

I don't know how we put the genie back in the bottle, or if it's even possible -- this behavior seems wired in to human beings at some unfortunate level, I guess because Nature hasn't had enough time to evolve us to be more adaptive in groups larger than the Dunbar Number. But it's pretty discouraging to watch. Continues to erode my faith in any kind of democratic institution. (And probably not just mine, I think: the amount of contemporary sympathy for a Strong Man that can just shut the gabbling interest groups up and Restore The Republic(TM) is concerning. This is after all the ultimate fate of democracies that gave the Founders pause...too much fratricidal chaos in the Senate and the people turn to an Augustus in disgust.)

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>The entire ivermectin advantage in Ravakirti et al comes from 4/50 people dying in the experimental group compared to 0/50 in the control group.

Typso?

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> refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases)

More lockdowns will also increase lockdown resistance due to lockdown fatigue. People just want to move on now with whatever is the new normal. If his ultimate goal is to force governments to give up on lockdowns as a public health measure, then I imagine a little pain right now to avoid all future lockdowns is worth it.

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Is there any data on the combined prevalence of ivermectin-suceptible parasites so that somebody can redo the analysis without focusing on one species?

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>the spice curcumin

If they're pushing curcumin, they definitely don't know pharmacology. E.g. https://www.science.org/content/blog-post/curcumin-waste-your-time

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"I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns."

I don't understand how anyone thinks this will lead to fewer lockdowns at the moment. Cases were plenty low in the northern cities to justify removal of mask mandates and time/crowd size restrictions. They were mostly not. Cases were much higher in Florida, and they did not have mask mandates.

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Lose 1 French typographic point for diluting the spelling of « écrasez l'infâme ». :-)

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"I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns. I think it’s easy to get discouraged about this given the many “okay, in just a few weeks this will all be over and we can reopen for real” bait-and-switches, but in the long run I do think we’ve gotten less locked down as case numbers have declined. I don’t know how much of that has been epidemiologists agreeing the crisis is less severe vs. anti-lockdown activists forcing governments’ hands."

Speaking for myself and the community I live in (northeastern US, fairly liberal), lockdown type measures have decreased significantly. I think there are 2 factors:

1. People who are vaccinated feel much safer than they did a year ago (which they are!).

2. Between delta and what seems to be the continued refusal of huge numbers of the population to get vaccinated, it's not clear ambient covid risk is going to change any time soon. So at this point it feels like saying "I'm still not comfortable going to a restaurant" means, I "I won't go to a restaurant for the next several years." I think the calculus there was different when folks though the pandemic would be largely over in a few months to a year.

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Scott seems a little too kind to IVMmeta, which seems to be part of a weird large-scale effort to paint all sorts of random stuff as miracle cures for Covid, and whose wordiness is matched only by the one-sidedness of the analysis.

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Good luck renewing your COVID vaccine passport after holding off the booster shot.

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Tangentially, regarding mandated lockdowns vs mandated vaccines, I'd love to see a book review here of "The Premonition: A Pandemic Story" (by Michael Lewis, who also wrote Moneyball and The Big Short) (apparently previously mentioned on ACX [in this comment](https://astralcodexten.substack.com/p/open-thread-171/comment/1933890)), which includes a third option of something like "mandated data reporting". It tells the tale of the people in the US who were trying to make an effective COVID response happen back in January and February of 2020, and the things that got in their way. One notable suggestion was that rather than mandatory lockdowns, the government should have made a temporary exception to medical privacy laws and set up (mandated?) reporting of COVID test results on a localized-to-the-neighborhood basis, and made this data highly-visible so that neighborhoods and states could restrict travel and do voluntary lockdowns. (I may be misremembering the suggestion a bit.) And also that closing schools is way more important than restricting movements of adults.

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> First, the claim that I "[appear] to be against all treatments, labeling them all "unorthodox" and "controversial", even those approved by western health authorities, including casirivimab/imdevimab, bamlanivimab, sotrovimab, and paxlovid." They suggest I am turning my readers away from other treatments including ones that are already standard of care in western health systems.

> This is false and I don't know where they're getting it from.

I assume it comes from that you wrote

> This is from ivmmeta.com, part of a sprawling empire of big professional-looking sites promoting unorthodox coronavirus treatments.

and those treatments are among the ones their empire happens to have pages on. (Go to the very top of the page for the list.)

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I wonder if blood pressure medicine would cure covid. It's an odd disease for which comorbidities seem to matter a lot more than usual. Mild worm cases might be one of them. As I recall, high blood pressure is one of them, with unknown mechanism. Lots of people have high blood pressure and don't know it. If we gave a random sample of people with early covid high blood pressure medication, maybe we'd find they'd do better, on average, than a control group because we'd accidentally be catching some of them with untreated high blood pressure.

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founding

To understand those positions, imagine more concretely. Imagine hostile aliens who say we expect your father to die and have no further treatment options beyond watchful waiting. Also, we urge you to stop waiting. No, we won't permit his doctor prescribe or administer a cheap, known-safe drug that you think might help, and we feel so strongly about this we will fight it in court for as long as it takes for us to win or him to die, whichever comes first.

Or spare the imagination and read this: https://rescue.substack.com/p/a-judge-stands-up-to-a-hospital-step

Anecdote is not data. This proves very little about the efficacy of ivermectin as a treatment. It does demonstrate a lot about how to erode public trust, and why many people might look at the public health care decisions on Covid-19 and see Moloch, mouth open... and assume malice instead. Much easier to understand malice.

"Probably 'Trust Science' is not the right way to reach proponents of pseudoscientific medicine" - or indeed anyone who remembers what science was when it was still science. Nullius in verba. The entire point of science is that trust is unnecessary when you have replication - and we have a replication crisis, generally.

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> I guess it depends whether you trust people that vaccines will at least slightly reduce cases, and that reductions in cases will lead to fewer lockdowns.

For any prediction market of the form "Will lockdowns end/vaccine mandates be repealed/mask mandates be repealed/free travel be restored when metric X is reached?" where X is something like case count, death count, vaccination rate, etc. and not something political like polls, elections, protests, civil war, etc. I would bet that the outcome will *not* occur when metric X is reached.

The reason for this is exactly as you said, over the last two years politicians around the world have made all sorts of promises about how these restrictions are just temporary and every single time not-temporary has turned into permanent or recurring.

I'm curious, Scott, what metric you would pick and would you bet on it?

For someone who looks at the very recent history of politicians making promises and then failing to keep them (see: two weeks to flatten the curve), this idea that "if we just do what they say they'll finally let us be free again" is hollow. It is just someone making another promise in a long serious of promises where they ask us to give up personal freedom today (right to personal medical choice) in exchange for future freedom (freedom of association, freedom of travel), but if history is any predictor of the future those future freedoms will never come.

Looking at a bit longer of a history, one can remember 9/11 where a whole load of rights were trampled on in the name of stopping terrorism, and many of those were intended to be temporary measures to deal with an immediate/imminent threat. Now, 20+ years later, those temporary measures are a permanent fixture in our lives (see: airport/airplane regulations like I can't bring a bottle of water into the airport).

I would like to be convinced that there is a path forward that actually restores our freedoms once they are removed, but at the moment I see no such path and the best strategy seems to be to avoid giving up the freedom in the first place (such as freedom of personal medical choice). Even if you are a strong believer and advocate for vaccines in general, there is value in the social signal that you are unwilling to give up yet another freedom. Often times one must take calculated risks to achieve some larger goal (like slowing the rate of erosion of personal freedoms in this case), and if you are at low-risk of death/disability from COVID-19 then this may be a stand worth making. You can even use it as a bargaining chip: "As soon as my freedoms are restored, I will get vaccinated." in a larger political battle.

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"having all you excellent readers who are masochistic enough to read ten thousand word essays speculating about intestinal parasites."

Our complete and genuine pleasure!

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If the Democrats ever want to win the culture war permanently, all they need to do is pass a law that mandates breathing, and watch as half the other side holds their breath permanently in protest.

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The comment about the LHC makes me think of a question that comes often to my mind: how did the physics academia end up being so good at pooling resources together? It's not just the LHC - the tradition comes from before and outside: Fermilab, Kamiokande, and a lot of other high-energy physics experiments.

In principle the same bad incentives that make medicine/biology/social science professors focus on making their own career about their "own" project and potential discoveries should apply to physics. These incentives (mostly fighting for grants) are what causes this "smallholding" of research.

But for some reason it doesn't apply to physics. I've been (shortly) in that world and there's a general attitude of "yeah, we need to say blah blah for the grants, but what really matters your internal contribution to big project". I'm not sure where that comes from, and whether it could be transplanted to other sciences. This would be much better than putting whatever can be salvaged from 30 random pieces of biased research into one metastudy...

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I'm fully vaccinated, my wife and children are vaccinated. My wife and I got our first shots in March. I am strongly against forced lockdowns and mandated vaccination. I've added my name to a list at my employer that refuses to show proof of vaccinations, because I find demanding it immoral, particularly since the vast majority of the company works from home, and will continue to do so in perpetuity.

I'm also against the rhetoric that the radical left uses on those who are vaccine hesitant. It will get absolutely zero of them to get vaccinated. It makes them dig their heels in more.

Do you want Republicans to win a supermajority in the next set of elections? Then keep this crap up!

(This last comment wasn't directed at Scott; he's been quite reasonable and hasn't branded his ideological opponents in a mean-spirited way. I'm just frustrated with the current political climate.)

What do I want to see instead? Encouragement and incentives. Towards the beginning of general availability of vaccines, I saw plenty of local stores with "for hire" signs offering a $500 signing bonus if you show proof of vaccination. That's fantastic! Restaurants offering indoor seating to the vaccinated, but not turning away any business would also be great.

Using force will turn people against you. If the Biden administration was simply saying stuff like "to the majority of Americans getting vaccinated, we thank you!" Without denigrating those who are hesitant as science deniers or stupid or even terrorists. Assholes on Twitter cheering on as people get fired due to vaccination status will not produce good results.

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Lockdowns and similar measures while the population doesn't have access to vaccines seem warranted to me, but they just don't seem justified once those that want to be have been vaccinated. The disease just seems to be not deadly enough to justify it, no worse than a bad flu year (for the vaccinated). And trying so hard to save those that don't want to be vaccinated seems unproductive, maybe even counterproductive since it concentrates various denier groups.

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I appreciate being highlighted and I think Scott is broadly correct that conservative elites are responding to the incentives created by the base. That said I think it's really important to observe that even when the policy is ideologically neutral, will directly save the lives of their base, and the conservative elites believe it is correct (they got vaccinated), they are not willing to pay any cost in terms of popularity with the base in order to support that policy. Tucker Carlson even went on air to scaremonger about VAERS.

If your answer to the ongoing legitimacy crisis of public health officials, is to increase their epistemic virtue, it's important to note that red tribe perception of epistemic virtue flows through Fox News and Talk Radio. That media has just shown itself totally unwilling to resist pandering to their audiences suspicions even when lives are on the line and they think the policy at issue is correct.

Epistemic virtue is it's own reward and I think it's worth (especially on a blog like this) pushing mainstream institutions to be more inclusive of conservatives and their ideas. What is missed when you ignore conservative elites is that their actions drive down the marginal returns on investment in epistemic virtue in terms of authority generated for institutions and therefore have helped to create the incentive structure where elite institutions maximally pander to educated blue tribers.

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WRT: Tophattington:

Governments didn't randomly decide to do lockdowns for no reason. They did it because they everything was on fire (metaphorically speaking) and they needed to stop the disease from killing millions of people.

The idea that this is some sort of bizarre power grab is completely nonsensical. Lockdowns are unpopular and make people angry; why would politicians randomly decide to lock people down for no reason? It's bad for their tax base (which means less money and power) and it is bad for their own future electability (doing important things, even if they are unpopular, is a good way to not get re-elected).

People are born defective in tons of ways. It's just a fact. You have mutations in you that make you defective, in big ways and small. Heck, the fact that you created a moral system based around this stuff is itself defective, because it isn't congruent or consistent with reality.

We vaccinate people because it stops people from getting sick and dying at nearly the same rate. We do various restrictions because it lowers transmission rates.

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>I actually think this might be more of a crux between us than anything about ivermectin itself. The same people behind ivmmeta have put up websites claiming that 19 different substances, including HCQ, testosterone-blockers, the spice curcumin, vitamins A, C, and D, etc, all cure coronavirus with pretty large effect sizes.

Did you just do a meta-analysis on a bunch of meta-analyses? How much more meta can we go?

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"The same people behind ivmmeta have put up websites claiming that 19 different substances, including HCQ, testosterone-blockers, the spice curcumin, vitamins A, C, and D, etc, all cure coronavirus with pretty large effect sizes. I think this is because they are using a nonconventional form of statistics which is always going to find positive effects. [...] I think ivmmeta is trying to pioneer a new way of thinking about science and statistics without p-values, but I think its new way is actually bad and will get positive results almost all the time."

Why do you think it's a new, nonconventional form of statistics? To me it sounds like the same old p-hacking, garden of forking paths, file drawer problem...

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Now that case rates are higher in vaccinated people, this argument had a short shelf-life, didn't it? "refusing to get vaccines seems like the most counterproductive way to protest lockdowns. Not only will it ensure the lockdowns last longer (because there are more cases)".

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Mar 6, 2022·edited Mar 6, 2022

The technology blog "AT" is very likely Ars Technica, with this post that repeatedly mentions c19ivermectin.com when they probably meant ivmmeta.com: https://arstechnica.com/science/2021/09/the-anonymous-meta-analysis-thats-convincing-people-to-use-ivermectin/ This AT post is dated 2021-09-21. Perhaps someone with more enthusiasm than me can dig through old versions of ivmmeta.com and discover whether the complaints about AT appeared soon after 2021-09-21.

ivmmeta.com says "We also note that the author has never contacted us" at the end of the "AT response" section. The feedback forms at ivmmeta.com don't request the identify of the person filling out the form, so they can't know with confidence that AT didn't contact them.

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Mar 6, 2022·edited Mar 6, 2022

ivmmeta.com isn't "trying to pioneer a new way of thinking about science and statistics without p-values". Their Figure 1 has a graph along the bottom with their "probability results from ineffective treatment" as a function of time, 1 in 100 on January 9 (of an unspecified year!) to 1 in 10 billion on January 6 (of a different unspecified year, but probably 2022). The probability that a result would be observed with ineffective treatment is a p value. If you don't like reading a graph, look at the first table at: https://ivmmeta.com/#results The column title "Probability of an equal or greater percentage of positive results from an ineffective treatment" matches the definition of a p-value.

They might be wrong, but they aren't boldly doing science without p-values.

I wish they were -- frequentist statistics is wrong, and Bayesian statistics is correct. Bayesian statistics doesn't have p-values. I haven't seen medical papers that made a substantial attempt to use them on real problems, but I would like to. But that's not what ivmmeta.com is doing; they are consistently frequentist throughout.

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