Tuesday 9 November 2021

Ivermectin: I'm not taking medical advice from Joe Rogan.

Update 2022-02-07 below

Desperate times call for desperate measures. Desperate people do desperate things.

From the outset of the pandemic, the supposed antiviral properties of the antiparasitic drug ivermectin has been bandied about left, right, and center. Even if expert sources of information like the CDC and the FDA said not to use it, people, especially those on the right led by Fox News, kept pushing ivermectin “propaganda”. Has anybody read the science, and if they did, did they understand what they were looking at? The slightest hint of anything positive has turned into possibility and if it doesn’t kill you, what the heck, what harm could it do? Who knows? It may very well do something!

For some reason, mainstream media, CNN as but one example, has taken to referring to ivermectin as a drug for deworming animals. I always knew the drug as a treatment for parasites in humans and had no idea it was used in veterinary medicine. No matter. It was obvious to me that referring to deworming animals was an attempt to make fun of anybody using ivermectin as a legitimate treatment for the coronavirus. Since the drug is only available by prescription, and I’m guessing going to a doctor represented a stumbling block for self-experimentation, the only way of getting it was to buy it from veterinary supplies where it’s available over the counter. Bingo, the origin of ivermectin is for deworming animals!

I didn’t want to get involved in this fight. I, for one, follow the experts, the CDC, the FDA, etc., and had no intention of self-medicating myself with the next fad proposed by an ill-informed, desperate fringe group. I wear a mask; I social distance, and I got vaccinated when told to do so.

But here we are. It is what it is, and I feel I have to speak up because others want to voice their opinion without doing their homework. I’m sick of listening to people tell me what they believe when I want to hear what they know. And if you don’t know, please sit down so we can all hear from somebody who does.

Never have so many said so much while knowing so little.

Correlation vs Causation
On Monday, I feel sick. On Tuesday, I eat a peanut butter and jelly sandwich for lunch. On Wednesday, I feel better. On Thursday, I detail how the protein in peanut butter combined with the natural flavoring of fruit provides the body with an antiviral boost to the immune system, contributing to the cure of colds, flu, acid reflux, irritable bowel syndrome, and hangnails.

Independent scientists doing independent research can independently arrive at the same results.

That’s science. That’s not an opinion; that’s a fact. Just because two events happen at the same time, it does not mean one event caused the other. Things in life can merely be a coincidence.

What is the origin of Ivermectin as a treatment for Covid?
Preamble: Malaria is a mosquito-borne infectious disease caused by a parasite. (Wikipedia) Ivermectin, an antiparasetic, is used against this parasite. Malaria is not a virus.

During the Zika outbreak of 2015, researchers were frantically looking a treatment for the virus and thought to look at ivermectin, an antiparasitic drug used to combat malaria, because it was widely available. They discovered that the drug had an effect on the Zika virus, a mosquito-borne flavivirus. However, it is important to note that the amount of ivermectin was greater than that necessary to fight malaria and questions were immediately raised as to the danger to human beings. Subsequent investigations failed to prove ivermectin was effective as an antiviral in human beings in the fight against the Zika virus. (The British Medical Journal, Feb 2, 2016)

Based on this idea, back in April 2020, researchers at the Monash Biomedicine Discovery Institute in Melbourne, Australia published a paper saying that the drug ivermectin killed the Covid virus in vitro, that is, in a petri dish in a laboratory, emphasizing that trials would have to be conducted to determine if this worked in humans. Since then, other trials have questioned these results, not necessarily finding an antiviral causation, and pointing out that the amount of ivermectin necessary to kill the virus is toxic to humans. Various organisations have attempted to warn the public as there have been examples of people poisoning themselves by self-administering the drug. (Monash Biomedicine Discovery Institute, Apr 3, 2020) (APF Fact Check, June 29, 2021) (The New Daily, Sep 24, 2021)

Dosage of Ivermectin
The alarm about using this drug is about purchasing it from veterinary supplies, the drug being destined for animals, especially horses. In the United States, the average human being is around 180 lbs. (81 kg). The average horse weighs 880 lbs (400 kg).

The recommended dosage of ivermectin for a human being is 3 milligrams. For a horse, it can be as high as 1,200 milligrams.

The Washington Poison Center, Seattle, Washington, reports a five-fold increase in calls regarding ivermectin.

A second important point is that for humans, ivermectin is prescribed as a one-dose treatment. Alternative anti-covid treatments have people taking the drug on a daily basis, and since ivermectin takes several days to flush out of the system, a daily dose means the drug builds up in the body to toxic levels, so the individual inadvertently poisons themselves.

The Danger
Is there any evidence ivermectin can treat COVID-19? We analyzed the prominent scientific studies -Salon, Aug 18, 2021
Despite promising words in some studies, experts say ivermectin is a false hope for treating COVID-19. Here's why

Dr. Benhur Lee, a Professor of Microbiology at Icahn School of Medicine at Mount Sinai

Ivermectin has been shown to inhibit a broad spectrum of DNA and RNA viruses with no underlying unifying logic (HIV, influenza, Dengue, Zika, pseudorabies virus, polyoma virus, adenovirus). These results were all based on in vitro test-tube/cell culture work; to a virologist, that raises eyebrows.

In vitro" refers to studies that take place in test tubes, petri dishes, or otherwise outside of human patients. Lee used an example to explain how what happens in vitro might not necessarily translate to the human body.

“I can increase the concentration of sodium chloride (table salt) by 50% to my tissue culture cells and show inhibition of most viruses," Lee said. "But I don't go asking people to eat as much salty food as possible to combat virus infections, much less SARS-CoV-2.

Hoping ivermectin works based on "in vitro efficacy studies" is "magical thinking."


Dr. Benhur states that the amount of ivermectin needed to stop the virus is toxic to humans.

In other words, if you put enough of just about any substance in a petri dish containing the coronavirus, at some point, you’re going to kill the virus. That doesn’t, however, make the substance an antiviral.

I reminded of the famous White House briefing in 2020 when t**** suggested to Dr. Birx she look into disinfectants. (NBC News, Apr 24, 2020) By the way, Dr. Birx looks so uncomfortable, listening to t****’s lunacy, it appears as if she’s hoping the Earth would open up and swallow her.

Shortly thereafter, I saw a funny meme going around social media:

To be fair, if you inject disinfectant into your body, you will not likely die of Covid-19.

I still chuckle at that one, but I do have to shake my head. People are scared. People want answers. And people are desperate. But on the other hand — and this is truly insane — a significant portion of the population, hypnotized by Fox News and other media personalities of The Right, completely distrust the government and any associated expertise. Dr. Fauci? The CDC? The FDA? Masks are not necessary. Vaccines are bad. The Washington Post details how this tactic is an integral part of the Republican playbook, making it all that much more difficult to get the nation to pull together to defeat Covid, or do anything constructive at all! (Conservatives have long stoked distrust in government — and now we’re paying for it, Oct 12, 2021)

I’m writing because of Joe Rogan and Russel Brand
Background: Joe Rogan is a podcaster (Wikipedia). Russell Brand is an English comedian, actor, a radio host. (Wikipedia)

Joe Rogan has been reported as to be antivax and to promote the use of ivermectin.

On Oct 13, 2021, Joe Rogan had a three-hour conversation with Dr. Sanjay Gupta. The important point of this convo was Rogan going after Gupta about CNN's repetition of ivermectin being a dewormer for horses without recognizing its use as an antiparsetic for humans.

4 key moments from Dr. Sanjay Gupta's appearance on Joe Rogan's podcast, CNN, Oct 15, 2021

On Oct 20, 2021, Brand posted one of his podcasts where he talks about Joe Rogan and takes CNN to task for stating ivermectin is for deworming horse when the drug is, in fact, an antiparasitic for both animals and humans.

“They Outright LIED!!!” Joe Rogan EXPOSES CNN & Don Lemon's Rebuttal
Russell Brand, YouTube 14:09, Oct 20, 2021
As Americans' trust in media dips to the second lowest on record, could CNN's coverage of Joe Rogan's Covid medication serve as an example as to how this has come to be?

“You Dumb Mother F*****” Joe Rogan UNMASKS CNN’s True Agenda
Russell Brand, YouTube 15:37, Oct 28, 2021
As CNN releases a fiery statement regarding its feud with Joe Rogan, we look at the network's corporate relationships.

One point for Brand.

But...

I’ve watched several of Brand’s videos where he starts by saying he’s not a medical expert, and he’s not giving out medical advice; it is up to us to determine what best for our own medical treatment.

An observation: CNN, questionable, Rogan bad
Whether it’s Russel Brand, Fox News, or other media personalities on the Right, everybody piles on CNN for this odd emphasis on ivermectin as a horse dewormer, but nobody is taking Joe Rogan to task for promoting ivermectin. CNN has committed a peccadillo while Rogan is spreading Covid misinformation. Statistically, nobody will get sick or die because of CNN but people could become sick or die because of Joe Rogan.

Joe Rogan tests positive for Covid
On Sep 2, 2021, Rogan released the following video, announcing a positive test.

Joe Rogan says he has COVID-19, ABC7, Sep 2, 2021, YouTube 2:35, 2:35
0:15 We immediately threw the kitchen sink at it. All kinds of meds, monoclonal antibodies, ivermectin, Z-Pak, prednisone, everything.

Joe Rogan says he has COVID-19, has taken controversial drug ivermectin - CNN, Sep 2, 2021
Rogan's revealing his positive diagnosis comes after he dismissed to some extent the usefulness of the vaccine on his podcast, "The Joe Rogan Experience," which is exclusively available on Spotify.

In April, Rogan told listeners that if a 21-year-old asked him if they should get vaccinated, he would suggest they don't.

"If you're a healthy person, and you're exercising all the time, and you're young, and you're eating well, like, I don't think you need to worry about this," Rogan said.

He later clarified his comments, saying he is "not an anti-vaxx person" and that he is "not a respected source of information, even for me."


I watched Rogan’s video announcement and his kitchen sink approach to dealing with the situation. I saw a man who was scared and had no idea of what he was doing, desperate to try anything. In looking back on Rogan and his talk of Covid, I very much see a macho bravado attitude, typifying the tough guy American of the Right. I find it odd. In reading the Wikipedia article on Rogan, I discovered he had voted for Bernie Sanders which right there tells me we would see eye to eye on politics, and yet, he demonstrates repeatedly the same distrust as The Right for authority and expertise. His promotion of ivermectin tells me that he heard the rumor of positive results of the drug killing the virus in vitro (in a petri dish), but read nothing of the subsequent studies, showing no causal link as an antiviral in vivo (in human beings).

I’m disappointed. One could argue that media personalities like Joe Rogan and Russell Brand are just ordinary folk, spouting their opinion — all of us must listen with caution. I note that Fox News sells Sean Hannity and Tucker Carlson not as journalism but as “opinion” shows.

However, I feel these people have a greater responsibility than us ordinary folk in researching what they say because of the influential power they have on their audiences. I remember hearing Rush Limbaugh at the beginning of the pandemic say on air, “Covid is just the common flu. Nothing to worry about.”

Oops!

Influenza, the flu, kills on average thirty thousand people a year in the United States. Covid killed a half a million people in the first year. (Measuring Mortality In The Pandemics Of 1918–19 And 2020–21, HealthAffairs, Apr 1, 2021)

Final Word
While Joe Rogan and Russel Brand are public figures and podcasters of some renown, they are both just people, and I would put forward that the average person does not do their research and so develops opinions and a worldview based on what they hear from around them: family, friends, peer group, news, social media, politicians, etc. I admit that the average person is not going to take the time I’ve taken to look things up, read various sources including medical journals, and try to get to “the truth”. Even then, I’m sure there are those who will still not believe my article.

Would I take ivermectin? No. It’s an antiparasitic; it’s not an antiviral. Taking the drug is a misinformed act of desperation. I trust Dr. Fauci, the CDC and the FDA, and I have every intention of following their recommendations. I’m not going to self-diagnose or self-medicate.

But let me qualify that. I do not believe medical science has all the answers. However, I believe medical science has far more answers than I do. Dr. Fauci is only human, and I’m sure he will make a mistake from time to time. However, I’m sure that Dr. Fauci as a career epidemiologist is going to make far fewer mistakes than I will as a person with no medical training whatsoever. In other words, I trust but I also know I’m not going to get 100% perfection. I’m certainly not going to get my medical advice from Fox News, t****, or Joe Rogan; that would be asking for trouble. Incompetent people tend to have incompetent opinions. Anybody offended? Let me cite the Dunning-Kruger Effect: Never have so many said so much while knowing so little.

“I am not a doctor. I am a fucking moron. I am a cage-fighting commentator … I am not a respected source of information even for me. But I at least try to be honest about what I am saying.” -Joe Rogan, as reported by The Hollywood Reporter, Apr 29, 2021

Several years ago, a reporter asked a Republican senator about climate change, and he replied, “I don’t believe in global warming. But I’m not a scientist.” Think about that. A man with the power to vote on policy just admitted he doesn’t know what he’s talking about.

Everybody wants to give their opinion. But then they want a Get Out of Jail Free card by qualifying their lack of expertise in case they’re wrong.

They have two choices:
  1. Educate themselves.
     
  2. Shut the f**k up.

Joe Rogan has millions of listeners for his podcast. He has influence. He has a responsibility to do his homework before he opens his mouth. In reference to ivermectin, he’s wrong. If I can research this topic as I’ve done in this article, so can Rogan.

I will continue to get medical advice from Dr. Fauci, not from Joe Rogan.

I like Russell Brand but his laser-like focus on this one particular aspect of CNN’s reporting, misses the bigger picture that CNN is correctly following the recommendations of the experts like Dr. Fauci: wear a mask, get vaccinated, and don’t take ivermectin. I’ve seen several of Brand’s videos, and he starts off by saying he’s not a medical expert and does not pretend to give a medical opinion. In this case, he’s done just that. By siding with Rogan about CNN’s peccadillo but not taking Rogan to task about ivermectin, Brand contributes to Covid misinformation and gives ammunition to those who distrust mainstream media. Now, how am I supposed to trust Brand?

Have my words made a difference? Is anybody going to listen? Probably not, but it’s been interesting putting this article together. I now know why the authorities don't recommend ivermectin, and I agree with them. I feel I better know what’s gong on. I think I’ll reward myself with a peanut butter and jelly sandwich.

Cartoon by Jon Adams, The New Yorker
(I apologise. I do not have permission to repost this, but it is too good to pass up.)

Update 2022-02-07
The following article goes into detail about the origins of the misinformation about ivermectin, compromised studies, and plagarized reports distorting the conclusions of the original scientific papers.

‘You will not believe what I’ve just found.’ Inside the ivermectin saga: a hacked password, mysterious websites and faulty data.
Marketwatch, Feb 7/2022
How a drug used to treat parasites for decades became the hot and controversial drug of the pandemic.

Several prominent medical figures have found themselves in hot water during this pandemic for making what turned out to be unsubstantiated claims. Were they themselves duped or were they caught up in the dazzle of their 15 minutes of fame?


References

Wikipedia: Correlation does not imply causation
The phrase "correlation does not imply causation" refers to the inability to legitimately deduce a cause-and-effect relationship between two events or variables solely on the basis of an observed association or correlation between them. The idea that "correlation implies causation" is an example of a questionable-cause logical fallacy, in which two events occurring together are taken to have established a cause-and-effect relationship. This fallacy is also known by the Latin phrase cum hoc ergo propter hoc ('with this, therefore because of this'). This differs from the fallacy known as post hoc ergo propter hoc ("after this, therefore because of this"), in which an event following another is seen as a necessary consequence of the former event, and from conflation, the errant merging of two events, ideas, databases, etc., into one.

Wikipedia: Ivermectin
Ivermectin is a medication used to treat parasite infestations. In humans, these include head lice, scabies, river blindness (onchocerciasis), strongyloidiasis, trichuriasis, ascariasis, and lymphatic filariasis. In veterinary medicine, the medication is used to prevent and treat heartworm and acariasis, among other indications. Ivermectin works through many mechanisms of action that result in the death of the targeted parasites; it can be taken by mouth or applied to the skin for external infestations.

Wikipedia: COVID-19 misinformation
COVID-19 misinformation refers to any kind of subject about the COVID-19 pandemic that has resulted in misinformation and conspiracy theories about the scale of the pandemic and the origin, prevention, diagnosis, and treatment of the disease. False information, including intentional disinformation, has been spread through social media, text messaging, and mass media. False information has been propagated by celebrities, politicians, and other prominent public figures. Multiple countries have passed laws against "fake news", and thousands of people have been arrested for spreading COVID-19 misinformation. The spread of COVID-19 misinformation by governments has also been significant.

WebMD: Is Ivermectin Approved to Treat COVID-19?
The FDA hasn’t approved ivermectin to treat or prevent the illness caused by the coronavirus.

Scientists have been studying the drug to find out if it can treat COVID-19, but they need more information before they can say whether it’s safe or effective. That’s why major groups like the FDA, the Infectious Diseases Society of America, and the World Health Organization say you shouldn’t take ivermectin for COVID-19 unless you’re enrolled in a professional medical study called a clinical trial.

The best way to protect yourself and your loved ones from the coronavirus is to get vaccinated. The COVID-19 vaccines are approved for everyone 12 years old and up. They’re generally safe and effective, with the benefits outweighing any risks.

The same can’t be said about taking ivermectin for COVID-19. If you’re not under a doctor’s care, it’s possible to take too much and overdose, which can lead to seizures, coma, and death.

This is how easy it is to get ivermectin, the dewormer drug that conspiracists say cures COVID-19
Salon, Sep 1, 2021
Telehealth platforms make it easy to get off-label prescriptions of the anti-parasitic drug with bad side effects

Is there any evidence ivermectin can treat COVID-19? We analyzed the prominent scientific studies
Salon, Aug 18, 2021
Despite promising words in some studies, experts say ivermectin is a false hope for treating COVID-19. Here's why

Fringe Doctors’ Groups Promote Ivermectin for COVID despite a Lack of Evidence
Scientific American – Sep 29, 2021
Much of the public interest in ivermectin as a treatment and prophylactic for COVID can be traced to a study led by Australian scientist Leon Caly that was in the spring of 2020. In that work, scientists added very high concentrations of the drug to cells grown in petri dishes and reported that it prevented the virus that causes COVID from making copies of itself. Similar studies in the past have indicated that ivermectin has antiviral properties when added to lab-grown cells: it blocked replication of viruses that cause dengue, Zika, West Nile, AIDS and other diseases. Prior to the pandemic, however, only one clinical trial had evaluated ivermectin specifically for a viral illness (dengue fever), and it showed no clinical benefit. (National Library of Medicine, May 18, 2021)


References: Origin of Ivermectin as a treatment for Covid

Ivermectin and Covid-19: how a cheap antiparasitic became political
Pharmaceutial Technology, Apr 19, 2021

Study finds anti-parasitic drug could kill coronavirus in 48 hours
Pharmaceutial Technology, Apr 6, 2020

Lab experiments show anti-parasitic drug, Ivermectin, eliminates SARS-CoV-2 in cells in 48 hours
Monash Biomedicine Discovery Institute, Apr 3/2020

The amount of ivermectin needed to kill Covid-19 is toxic to humans, says Prof Salim Abdool Karim
Time Live, Jan 28, 2021

Why You Shouldn’t Take Ivermectin for COVID-19: Doing so can send you to the emergency room.
Clevland Clinic, Aug 30, 2021

Is ivermectin going to kill you? Probably not unless you take the dosage meant for horses
Spokesman-Review, Spokane, Washington, Sep 18, 2021
"In horses, ivermectin doses run up to 1,200 milligrams. For humans, the recommended dose is about 3 milligrams." -Dr. Scott Phillips, medical director, Washington Poison Center

During a Zika virus outbreak in 2015, Phillips said researchers found that high concentrations of ivermectin could prevent the virus from replicating and reproducing.

Ivermectin to prevent ZIKV transmission: a word of caution
BMJ, London, England, Feb 2, 2016
The achieved plasma levels [dosage of ivermectin] are sufficient to have an impact on malaria transmission. However, plasma levels fall short of concentrations that are likely to affect the survival of Aedes mosquitoes, even if the highest currently used dose of 800 μg/kg is administered (see figure). If ivermectin is to be used for control of the transmission of ZIKV, even higher doses of ivermectin are necessary for which the safety profile needs to be determined in long-term pharmacokinetic and safety studies.


2021-11-09

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