> This is the first anti-Ivermectin argument that you want to believe...
I discounted a highly biased echo chamber in social media and more traditional media and went with 30-odd studies that appear to have been assembled in good faith even now. I changed my mind immediately on seeing "Parasitic worms are a significant confounder in some ivermectin studies, such that they made them get a positive result even when honest and methodologically sound: 50% confidence".
You are describing how you want me to be thinking, not how I am thinking.
I have a pretty good memory for comment histories and you've been pushing this for far more than it is worth.
That this single article would change your mind is fortunate, but I do not suspect that to hold true for the bulk of the conspiracy peddlers that remain.
Isn't this an example of some rigid and ineffective thinking patterns?
Article publishes sound arguments, doesn't talk down to the audience, admits problems with appeals to authority... and converts a conspiracy believer!
...No way, there is no way that can possibly work, the others are way too dumb, and the convert is a bad person... basically anything to just go back to pretending appeals to authority work. Despite clear evidence to the contrary. Or lamenting that they don't. I'm drawing some parallels with miracle cures here ;)
I've been following with some amazement the number of conspiracy peddlers on HN for the last 18 months or so and one case of conversion isn't going to make me overly happy. It is a bit like the story about the lie getting halfway around the world before the truth puts their shoes on, in the extreme long term the truth will come out, meanwhile, the damage is done. This guy until yesterday wanted his mother to take some ivermectin, 'just in case'. I want my mother to take her doctors advice, not mine.
As an engineer, sometimes I say "ship it!" to code that doesn't make me happy but works and solves a real problem.
Edit: I meant this to go with debating techniques, not cures. There are people for whom no amount of saying "why can't you just listen to Dr. Fauci" is going to work. We can say they are bad people, but that doesn't work very well for getting them to agree either.
You are right to call out above that there were other anti-Ivermectin arguments before and roenxi might not have had the background to understand them. That's exactly the point: here we have an argument that he can understand, and it's effective. This is good science journalism. The kind that doesn't work (too much moralizing or too confusing for the general audience) is bad journalism.
I hope that that only goes for things that you can oversee the risks of and that you would refrain from giving medical advice to your relatives assuming that you are not a doctor.
"move fast and break stuff" is the wrong attitude for medicine and aerospace.
But a solution is better than no solution, and of all the countermeasures that we had available in March 2020 we only used a fraction.
As to your edit: no, here we have an argument that he thinks he understands, that's not the same thing. The argument as presented is at best a hypothesis, it isn't proof of anything, just one more theory that may or may not end up being the right one explaining the sometimes observed effect, assuming it really was observed in the first place.
This is precisely what makes this discussion so tiring: people will be swayed one way or the other based on arguments that they have no way of understanding unless they were trained in that particular field.
Unfortunately, there are plenty of politicians that fall into the same trap, leading to terrible examples of wishful thinking, outright quackery and conspiracy amplification. The harm that this is causing is substantial.
So even if this article swayed one person I'm pretty sure you'll be able to find people who get the opposite out of it, because hey 'x' has now joined the establishment, must have sold out.
"Sold out" is a real problem. More people than we want to admit see corruption coupled with big media as a enemy, not a thing to be trusted. Many ordinary people flat out do not know when to trust, so they don't.
They then seek others and continue to have conversations, and they find others lacking trust resonates and that opens the door for a lot of BS normally and easily seen.
Just an example of the difficulty we now face:
Hiding YouTube dislikes will, among other effects, serve to help big corporate media compete against new media.
Hiding the dislikes also breeds more mistrust. This is unavoidable no matter how reasoned the move is.
Public trust in corporate media is really low, and the younger a potential user of that media is the worse those metrics are.
Had that same media held more closely to journalism, rather than access journalism, which is essentially a sales job, the trust problems we struggle with today would not have grown into the chronic problem it all is today.
You identified politicians committing similar abuse of the public trust.
Look at Russiagate. Basically, it flat out did not happen the way many believed it did. Back when that started, many and myself included went to the original documents, saw speculation and in some cases saw it helpfully color coded, and turned on the news only to see all that elevated to fact.
That scared me frankly.
What can one conclude?
I do not see how judging others helps right now. Not saying anyone did here, but I am saying that is happening a lot and when it happens the door for good info to find it's way home gets closed. Advocates render their efforts far less potent.
Secondly, the lack of trust really can't be assigned to people. We have a lot of "they are stupid" type discussion, judgement and rationalization going on and very little of that is helpful.
ie: 70 million people voted for...
The people who had a far better position of authority and trust denigrated that themselves, and for dollars and ratings.
All that is a real mess!
How can authorities, who have abused public trust be counted on to fact check and improve on misinformation without amplifying the already chronic trust problems they created?
In a more basic sense, how can we improve on public trust at all?
I am not sure how that is done quickly.
Longer term, we need media that makes informing people a priority. And doing that likely means a move away from the current AD and access based media we have now.
Given how things are right now, the more important thing is to avoid judgement of others and encourage more and better information exchange. We will not know what reaches people, until it does.
Once it does, we need those people to continue seeking better information so we see more people making better choices more of the time.
I have slowly come to the conclusion that maybe we grew up a bit too fast with respect to media and social media in particular. In the past change to society came slow and we could internalize and stabilize it before the next round of changes appeared.
Now the changes are coming so fast and are so drastic that we as society - including our legal system - have no way of keeping up with it. Technology routinely moves from one phase to the next before the legal framework has caught up with it. This translates into effectively operating without a legal framework for a very important chunk of society.
That's dangerous territory. I don't have any solutions and I'm sure that there are plenty of people that disagree with me but I've gone from a technophile to being very skeptical about the degree to which I allow tech into my life. Familiarity breeds contempt, or something to that effect.
That will be true for very large numbers of people. Not their fault at all. It simply does not happen that a population all ends up able to sort these kinds of things out.
Implying they should is fine in the sense of self improvement, but as policy? Nope.
Perhaps it is time we, as concerned people, begin to take much harder look at our national priorities and demand the public interest be far better served than it is today.
Having done that, and sadly we are no where close to the basic consensus needed, we will find painful discussions like this one are a lot less frequent.
Know what I did not see in this exchange?
"Yes! You got there. How can we reach more people and help get past this?"
Feels a lot more like, "better late than never, and you need to do much better."
However, and as a thought exercise, say we did not go down the Citizens United path after Reagan repealed the Fairness Doctrine, and Clinton Telecommunications Act of 1996.
Social media viewed through that lens, one where both the public interest is a thing we recognize must at least compete with profit, and the public trust is recognized and maintained as the high value part of our Democracy it is.
I do not disagree with you about tech and the law being behind. And right now we remain in a particularly difficult time due to so many legislators not understanding tech well enough to perform their role as well as it needs to be performed.
That said, our difficulty right now is greatly exacerbated by basic policy priority shifts that happened well in advance of tech.
Owning that is particularly difficult too. Money and markets are a higher priority than the public interest is, and that is true for government as well as big media.
The vacuum was there and significant, leaving tech, social media to rapidly expand into it.
Had that time been one of more robust public trust, social media would have to compete much harder, and regulation may well have both been more effective as well as earlier, more robust in its positive impact.
You could try spreading the truth instead of bullying people? I do care about my mothers health you know. And if a doctor isn't convinced by a large number of studies I want them to explain why not rather than call me a conspiracy peddler.
The way someone gets ivermectin is to walk a doctor through the evidence they've seen and then ask them to prescribe it.
I am a doc. I am also a medical researcher, but you (and most other people here) _have_ to realize that the vast majority of practicing MDs are _not_ scientists, and understand almost nothing when reading medical studies. And that's fine, because it's not their job. The profession is bound by guidelines and expert opinion. Experts do research, formulate guidelines, and guidelines get applied by practitioners. And no, that absolutely does not mean you know better than the average doc because you've read 10 studies. That's telling a highly specialized labourer that you know the job better because you've read 0.0001% of the theory.
As someone who is actually an expert in a subfield of medicine, not only do doctors not understand it at all, but the experts making guidelines often recommend the exact opposite of what is the best treatment for the patient, usually for liability reasons, but occasionally for true lack of understanding. The quality of research is so poor that often times there are more flawed studies showing X than proper studies which would show ~X. Other times there is no research on the matter at all, and the conventional wisdom (even among experts!) is incorrect. For fields where practice and theory diverge, like an experimental surgery with sparse research, the surgeons know that the guidelines are useless.
What you yourself _have_ to realize is that the expert researchers who are in a position to create and inform guidelines are themselves not some kind of 'super-experts' who know everything better than normal experts. They're just researchers in a political position in a bureaucracy.
I don't exaggerate when I say that an average HN reader could write better guidelines for patient outcomes in my subfield, with no prior training, simply by reading a few studies and observing a practice.
Now, does any of this apply to internal medicine, specifically covid? Probably not. But when the data is anything other than crystal clear, you should not assume the expert guidelines are anything more than some guesses by guys in a room. The consequence of knowing this is that all guidelines and consensus is suspect until you see the data yourself, like TFA outlines. In this case it seems true that Ivermectin doesn't cure covid. But with my experience, the exact opposite result could have been shown and I would not be surprised whatsoever; experts saying it doesn't work does not constitute in my eyes anything other than noise until the data is clear.
I'm not saying that experts are doing a stellar job or that they're special in any way, far from it. I have slaved enough under 'true experts' to know the extent of the catastrophe. We even had a truly spectacular example of failure at the start of the pandemic with the 'intubate early and withhold steroids' expert opinion. This particular one, I won't ever forget.
What I'm saying is only that:
- on average, experts do spectacularly better than Joe Schmoe. Including science degree holders thinking they understand medical studies while missing the whole political and social context of the field.
- it's not the job of field practitioners to prescribe experimental therapies, and those people cannot do better than follow expert opinion and guidelines.
But I actually agree with you on all points, especially regarding flawed research and understanding. Which makes people basing opinions solely on papers without any practical knowledge of the field wrong all the more often. Does it make it a good idea for people to go and try on their own the thing they read about in the last issue of 'covid today'? I don't think so.
>on average, experts do spectacularly better than Joe Schmoe. Including science degree holders thinking they understand medical studies while missing the whole political and social context of the field.
I'm saying that, when the data is unclear and Joe is thorough, I don't even think that's true. Or at least it's not spectacularly better. My point is that for something like Ivermectin where the data was initially null and even now isn't super clear, the word of experts was basically meaningless. Trust them if you don't care enough to look into it, but if you're Joe I'd say just go ahead and believe whatever you understand to be correct until there's a better consensus.
The medical profession gets it wrong with some regularity, but this Ivermectin thing fell out of the sky without any support, and was touted as the miracle cure that big pharma was withholding in order to protect their profits.
So even if the data is unclear we can safely conclude that it isn't a miracle cure and never was. And Joe Schmoe here isn't talking about some condition that he's been walking around with for a while and has studied extensively, Joe Schmoe here is a guy who believes doing your own research is watching youtube videos by people who have done their own research reading a bunch of papers without understanding any of it.
The problem is that that gets in the way of achieving the goal: beating this pandemic, and that isn't going to happen with ivermectin. (Or HCQ for that matter).
Your Joe is the average HN reader. My Joe is my average patient. I completely agree that the word of experts is meaningless on matters where dust had no time to settle. I however maintain that practitioners have to follow guidelines and experts regardless because I believe in the principle (if not the current application) of evidence-based medicine, and that Joe should not be allowed free access to any drug he wants to prevent frequent self harm.
I don't know about that. I'd rather see all of this stuff disappear from youtube and to deny the conspiracy sphere its oxygen than to let this run its course. The damage is very real. Experts tend to communicate via scientific papers and symposia, not via youtube, that's aimed squarely at the masses only a very small fraction of which has the capacity to interpret what they are hearing, but almost all of them have the capacity to filter that to select the bits that they like or that they feel support their pet desired outcomes.
The damage caused by mis- and dis-information is real, but suppressing dissenting voices (even comically mistaken ones and bad actors) destroys institutional credibility, which is far worse in the long run.
The dissonance here is intense. On the one hand, "practicing MDs ... understand almost nothing when reading medical studies", but also I don't "know better than the average doc [just] because [I've] read 10 studies."
Is the idea that doctors deserve deference because they are conditioned to submit to guidelines formulated by experts?
There is a lack of consensus on many long-standing, common medical questions, much less novel diseases. When I ask my GP about prostate screening, for example, he lays out the current state of research as best he can, but delegates the decision to me. Why is the COVID situation different, given that experts are still fighting through a figurative fog of war?
Great point. Perhaps the idea is that neither you nor the avg doc can conclude much from reading 10 studies. Therefore, defer to the experts?
As to why the COVID situation is different, presumably because prostate cancer screening affects only you (and perhaps your family in the case of a true/false positive/negative diagnosis), and COVID represents a threat to everyone around you, and everyone around them, etc.
Your GP may try to lay out the state of research before you, but that does not change the fact that he/she will do one of those things:
1. Treat you according to guidelines/expert opinion, should you choose to.
2. Give you the opportunity to participate in a relevant study.
But _never ever_ will your GP formulate an experimental treatment plan based on his own research. Not GP's job, and big risk of liability. Your GP has at best a cursory view of the research happening in a certain field. COVID is different due to several good and bad reasons: hugely politicized, confusing messages from experts, and most of all novelty. 'Lack of medical consensus' usually means 'several treatments backed by experts are available', not 'do what you like'. COVID is too new for the dust around expert debates to have settled. That's what makes it different.
But why do you even assume that it works? The doctor might not be able to disprove it because disproving is fundamentally hard and may not even be possible. But the direction that makes sense is that we prove if something does work/has an effect.
The zero hypothesis is the long standing default, that a random thing will not cure this illness. The alternative hypothesis is that it does cure it and then we can analyze the results based on the results of a fair trial.
This is a blogger who took time out of their day to do this. Why do you have to be catered to to be convinced? The blogger didn't produce any new data, it was already there, you chose to ignore it, or rather, picked something else to be convinced by.
It's not bullying or "talking down to" to simply ignore bullshit, it's effective use of your time.
I was never an ivermectin proponent — although I thought the "horse dewormer" rhetoric was self-defeating, because it's obviously and well-known to be also a human dewormer (amongst other parasites), and the "horse" part just seemed to be played up to make ivermectin supporters look stupid — but this article is indeed the first one I've seen to make the parasite-COVID-comorbidity argument. It's not, in fact, the first time that argument has been made... But it seems like the first time that link was made was within the last month, as the blog post links to the following Twitter thread from a medical researcher: https://twitter.com/AviBittMD/status/1456376484180922368
It's not ridiculous to me that this blog post would be someone's first encounter with that argument, considering how recent the link is.
I have a little bit of experience with reading lots of research papers about COVID safety measures, and coming to the opposite conclusion of medical experts: in early 2020 I read lots of papers on masks, and tried to convince most of my family to mask up even when the CDC said that masks didn't work. I happened to be right, and to my parents, I now look like a smart and forward-thinking, science-driven person. But that's only because I was right! I could see someone doing the same with the ivermectin studies, and while it appears that they were wrong, I don't think it deserves dismissal or derision — especially when it comes from someone willing to change their mind and admit they were wrong when presented with compelling evidence to the contrary.
Please provide sources that "many people" are using horse doses. I only hear of well known people such as Joe Rogan and Aaron Rodgers using human-prescribed pill form ivermectin.
On the contrary, the majority of people who called poison control were "worried well" who had no symptoms. And I think "not a lot in absolute numbers" is really underselling it: the total number of "reported exposure cases" was 459 in a country of 330 million people, up from 133 cases the previous month (before people started thinking ivermectin was a suppressed miracle cure). That's one out of every million people. Of those, zero died.
By way of comparison, every year, two out of every million people in the US die by falling out of bed.
There were many news articles stating this that were corrected for grossly exaggerating the situation. I would suggest going back and re-reading the source material to see if it has been updated or has disappeared.
What’s a better practice is to explain the rationale per situation, what is known and what is not known. The right turned science into a culture war flashpoint, which meant the left blindly preaches “believe in science” as if it’s about faith. This is all very disingenuous and not at all what science is actually about.
It’s very unfortunate that Covid started under trump because being anti-science was part of his marketing message to his base, many because of the risk to certain jobs with caring about climate change (aka the great “hoax”) and the association of science/medicine and abortion.
Unfortunately explaining the rationale in a way that people can comprehend and not tune out is very very difficult, and far more time consuming than whatever 2 syllables Trump could come up with as a retort.
> The right turned science into a culture war flashpoint, which meant the left blindly preaches “believe in science” as if it’s about faith.
These two perspectives are not equivalent opposites though.
"Believe in science" is not a religious statement.
It is a shorthand for "trust in the scientific institutions that have proven their track record via decades of public health progress, and not in anti-scientific rhetoric with a culture war agenda".
That concept wasn't even controversial on most of the political right until their recent nationalist turn.
Knowledge and understanding of the world is constantly growing. There are endless examples of how scientists and other intellectuals have a current paradigm of how something must work, only to be disproven in the future (usually by someone who gets castigated until held up years later). So to say 'believe in science' is actually dogma. It makes me cringe when I see it as a political banner, or along side signs like 'in this house we believe in....' It would be more accurate to say 'the scientific method works', but it really only works in the long run. At any point in time our understanding is incomplete and erroneous.
The facts are out there, whether you believe it or not, and eventually the scientific method will catch up.
Of course if you're not a trained scientist, then it's hard to appreciate how the scientific method works, and that even when we're very sure of something, true scientists will always hedge their statements. This will be misinterpreted by those who are outside this world as there being more gray than actually exists, and those with an agenda will drive a truck right through it.
No, people who will amplify bullshit because they want to believe in miracles rather than to face the music. As long as it is just about yourself go wild, do whatever you want. But keep your mental viruses to yourself, lest they destroy the lives of others.
May I ask, completely sincerely, what approach you would settle on for trying to discriminate truth from fiction if you believed you couldn't get reliable information from reading 30-odd studies?
In short: papers lie, and grad school teaches you to read around the lies. Papers lie because people are competitive (you lose your job if you aren't publishing), want their narrative to be true (don't we all), and the people reading the papers professionally know how to interpret them.
Pretty sad, but that's what we've ended up with. It was incentivized for.
Reading 30 studies certainly seems to be a bad way to learn anything unless you're conducting a meta-analysis of them. For one thing, you'd get tired. But just shoving 30 pieces of information into your head and forgetting some of them doesn't help you find out which of them were correct.
Especially in a field in which you are not trained, do not have the background knowledge required to understand the various qualifications and established best practices in. That gap can be absolutely enormous, even for fields that are peripherally related. Specialization is there for a reason, the body of knowledge that we now command is way too large for any single individual to absorb to a substantial depth.
Suggesting that there's no way someone could have the mental stamina to read 30 papers, over the course of two years, is completely ridiculous, insulting, and invalidates your viewpoint, in my opinion.
Why are you assuming they tried to read it in one sitting? Nothing remotely suggests that in the comment thread. All we know is that they read 30 papers sometime within the last two years or so. You chose a perspective, and just reinforced it, that they were incapable of extracting anything useful from reading those papers, which is insulting. It could be that they read a paper every couple of days, or perhaps when they became available. For some reason, it seems you've already decided that they're incompetent.
Isn't the correct answer to wait for more reliable studies? Which is what most "anti-ivermectin" folks were saying to begin with? If your primary goal is to have a miracle cure in hand that would allow you to push back against vaccine mandates, then this approach probably won't sit well. But if you are interesting in actually finding truth, than waiting for larger, more robust studies was the answer.
Why wait? Why not take ivermectin as a precautionary therapeutic given it is well tolerated with low risk of side effects?
There's a chasm between the epistemic question of "does this drug really work?" and the pragmatic question of "does a risk-reward analysis under uncertainty say that I should take this mostly safe drug that might slightly reduce my covid severity?"
FWIW, I wouldn't take ivermectin either as a prophylactic or therapeutic, the evidence just isn't strong enough, but I don't really fault anyone that would add it into the stack of treatments upon a diagnosis in the hopes of a small net benefit.
What other prophylactic treatments do you take in your life before or after COVID? Because in my lifetime I can think of only a small number of classes of general prophylactic treatments I've ever seen a small number of groups of people take.
- Silicon valley rationalist types taking stacks of vitamins despite having no evidence on bioavailability because they are generally without side effects and who knows, you might live forever. I think the consensus on this now is that more or less this is not a useful practice, though I am unaware of any evidence for it being unsafe.
- Prophylactic hormone replacement therapy in middle aged women, which was eventually generally recognized as unsafe because of unexpected cancer risks not initially understood.
- Prophylactic breast self-examination, mammograms, and prostate exams based solely on age, the former of which have been significantly dialed back over the last decade because the risk of false positives or catching slow-growing low risk cancers causes a net negative from the treatment. I don't know what the state of prostate exam research is.
- Prophylactic aspirin for heart stuff: we seem to go back and forth on this, but the last I read was that actually there's mounting concern about chronic low-dose aspiring. At the very least, it's not obvious this is doing anything.
- Statin treatment in response to mild elevated blood pressure with no symptom of disease; not exactly prophylactic, but close in the sense that it's about advance management of expected disease. And last I read, researchers were increasingly recommending dialing back statin treatment for minorly elevated blood pressure because of, again, unforseen side effects.
So I just mention this to say that what I take from your post is "the precautionary principle suggests giving more weight to prophylaxis with no known side effects" and what I take from major medical stories in my lifetime is "no known side effects almost always turns out to involve side effects in the end, and that has to be part of the precautionary principle as well".
And I should note all of the above prophylaxis is based on clearly defined treatment regimens and physician supervision, not the kind of wild west ordering various formulations of ivermectin at unknown doses with or without medical supervision on an ad hoc basis.
It occurs to me that I didn't mention PReP for HIV, which is obviously effective in what it does. I do tend to think of the direct risk in a PReP context as more severe, and also PReP requires active management of a physician's care, so it is a bit different than the thing being discussed, but it's also a counterexample to my point and so in charity I decided to add it in this reply.
I took chloroquine as a prophylactic treatment. Not against covid, obviously; against malaria. Also, I took prophylactic treatments for measles, mumps, rubella, tetanus, polio, and another dozen or so diseases. I'm currently taking vitamin D; my original justification for this was as a prophylactic against covid, but now it's just a prophylactic against hypovitaminosis D.
I had alarming symptoms after the chloroquine treatments, and regret having done it. But nobody would ever put chloroquine in the "no known side effects" bucket.
I said I don't fault people for using it as a precautionary therapeutic upon diagnosis.
I didn't say that I don't fault people for taking it as a prophylactic. I do fault people for doing that because the side effects of long term use are less known, as you say.
> FWIW, I wouldn't take ivermectin either as a prophylactic or therapeutic, the evidence just isn't strong enough, but I don't really fault anyone that would add it into the stack of treatments upon a diagnosis in the hopes of a small net benefit.
If you're familiar with software development, this is akin to "there's a bug in my codebase and I'm just going to add a bunch of code that probably won't affect anything in the hope that it will fix the bug".
Meds shouldn't be administered in this way. It just ads noise to the system and will complicate things down the road.
You make a good point even though I take supplements such as vitamin d, etc. I would argue that the human body is already so complex that troubleshooting it similar to how we troubleshoot software is not a fair comparison because software is easier in a relative sense!
Why not pray for satan with a goat sacrifice? That also doesn’t harm you and has similar quality of evidence for working. But my point is that there are literally infinite things that could cure covid, but in the end only empirical evidence is meaningful. But we have to choose our “fights” and methods with not even a probably way of effect are more than likely useless.
And that touches on another problem: all of this Ivermectin (and HCQ before it) bullshit takes funding away from studies that might turn up something useful. The only reason these drugs are even studied at this point is because they are so well publicized, even if there is approximately zero proof that they actually work.
If they were miracle drugs as described the effect would be so large that those studies would be unnecessary. But here we are, and study it we will.
Again, stop saying "proof". You're misusing this word. It really seems like you have an ideological axe to grind. There is not "zero proof". Did you read the article? What you are saying and your level of confidence seem detached from the article's contents.
There is tentative evidence of a small to medium effect, but the quality of that evidence is low and that quality is insufficient to recommend use. This then deserves more attention and resources to figure out if it's real and why there's an effect. That's how science works.
Contrary to your claims here, scientists aren't studying it because some cranks on the internet propped it up. They're studying it because some field doctors had positive anecdotal experiences and some early studies showed promise.
As you've said, the medical establishment really wants to end the pandemic. Which is why they're looking into this drug, among many others.
> given it is well tolerated with low risk of side effects
That's not a given, that depends on the patient, the dose and a host of other factors. You may well end up harming someone significantly. You are in no position to proscribe any kind of medication to someone else unless you happen to be a licensed practitioner.
While it's true that virtually any substance has a toxic dose, avoiding that dose is straightforward for drugs as well-known and widely-used as ivermectin. There is no risk of harming someone significantly. (There's also, I think, no chance of being effective against covid at safe doses.)
It is true, but unfortunate, that in many societies only licensed practitioners are in a position to prescribe (or proscribe) most drugs. That's a policy that does some good but also an enormous amount of harm.
The issue is that folks who are taking ivermectin are doing it in lieu of getting vaccinated. If you get vaccinated and want to take ivermectin for the heck of it, no one is going to stop you. But if you claim that ivermectin is a miracle cure for covid and as such vaccines are no longer necessary, then that is a problem.
Why not using a de-wormer against a virus? Well, because that's what vaccines are there for. And we do have rather effective ones by now. All of which have a low risk of side effects as well.
Using ivermectin as a therapeutic and getting the vaccine are not mutually exclusive.
Also, I don't like your first sentence, it's a rhetorical gotcha that is actually not in line with the medical establishment's thinking on ivermectin's hypothesized mechanism of action:
If the 30-odd studies are chosen adversarially to persuade you to believe something that isn't true, probably asking someone more trustworthy for relevant studies would be a good idea.
If you're not familiar with the field the studies are in, it might be a good idea to rely on the opinion of someone who is; unfortunately, this means you have to judge whose opinion to rely on, which puts you in the position of trying to guess who's really familiar with the field. It's going to be hard for you to do better at this than just believing whatever is most popular.
It is obvious that ivmmeta.com is picking up something that is a real signal. The only question is a signal of what. Fraud? Bias by the site authors? One of many complex statistical effects? A working drug?
There were loud, even unreasonable, voices in the debate but nobody was raising an actual problem with the results. Ivermectin has a respectable safety profile. "Maybe it works, no obvious downside" was a reasonable position.
It was always a long shot, the evidence was weak. But loudest voices in the anti-ivermectin crowd are people like, eg, jacquesm in this thread. A lot of bluster, a smidge of bullying and a weak-sauce appeal to authority for why statistical evidence should be ignored. And YouTube et al. believe it to be convincing evidence or they wouldn't bother to censor discussion of it. If that is the opposition then they don't seem to have uncovered a methodological problem yet or they'd raise it.
But Scott raises an interesting theory that would be enough to explain ivmmeta.com. Since it was only ever weak evidence that is enough for me to change my mind.
I discounted a highly biased echo chamber in social media and more traditional media and went with 30-odd studies that appear to have been assembled in good faith even now. I changed my mind immediately on seeing "Parasitic worms are a significant confounder in some ivermectin studies, such that they made them get a positive result even when honest and methodologically sound: 50% confidence".
You are describing how you want me to be thinking, not how I am thinking.