COVID Transmissions for 10-11-2021

It's looking like ivermectin for COVID-19 is based on fraud

Greetings from an undisclosed location in my apartment. Welcome to COVID Transmissions.

It has been 694 days since the first documented human case of COVID-19. In 694, the Visigothic King Ergica, who was under pressure of having his kingdom in Iberia invaded by Muslims, accused the Jews of being conspirators with the Muslims. He sentenced all Jews to slavery. Later descendants of the Visigothic Kingdom would continue the tradition of antisemitism through events like the Spanish Inquisition.

Speaking of actions taken without evidence, today I’d like to talk about how the evidence base for ivermectin in COVID-19 is crumbling. Also, a reader comment about the Johnson and Johnson vaccine in the context of vaccine effectiveness waning.

Have a great week!

Bolded terms are linked to the running newsletter glossary.

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Now, let’s talk COVID.

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Ivermectin for COVID-19 appears to be thoroughly based on fraud

The indomitable Gideon Meyerowitz-Katz, who has made quite a name for himself as an epidemiologist during the pandemic, has been turning to Medium to investigate claims that many of the apparently successful studies with ivermectin, the anti-parasitic drug, in COVID-19 were in fact based on fraud.

I’ve covered one of these stories here before, with the infamous Elgazzar paper, but Meyerowitz-Katz has rounded up the details on why several other prominent ivermectin studies also appear to be fabrications, in a 5-part series:

• Part 1

• Part 2

• Part 3

• Part 4

• Part 5

The reason I’m sharing this here is not because I believe my readership is at serious risk of using ivermectin for COVID-19, but because I think it’s important that you be armed with tools to respond to claims that this drug works for the disease. We simply do not have any clear evidence of that, and the clinical trials that would need to be conducted to show it have not been done. I think it’s important not to outright say that it is impossible for ivermectin to have a benefit until it is very clear there is no such benefit, but what I can say so far is that the evidence that is much-touted by ivermectin promoters is not real. That doesn’t look good for the drug’s future prospects.

Thankfully, we don’t need ivermectin. There is a treatment algorithm for COVID-19. It starts by preventing it, or at the very least its most severe manifestations, by getting vaccinated. If one gets sick anyway, there are early options for treatment—monoclonal antibodies. These can prevent a mildly bad situation from getting much, much worse. If things progress beyond the stage when monoclonal antibodies are most effective, there are anti-inflammatory options like steroids and tocilizumab. This will not work perfectly in 100% of cases, but it represents a meaningful defense-in-depth against serious negative outcomes of COVID-19, and is allowing us to fight back against the disease. We have more options on the way, too, like molnupiravir that I wrote about last week. We don’t need to be turning to fabricated data about ivermectin in order to attach the problem of COVID-19. The solutions are in reach already, starting with vaccination.

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What am I doing to cope with the pandemic? This:

Naming our baby

Over the weekend, he held a naming ceremony over Zoom for our baby. In Judaism, as in quite a few other religions, for a long time, only male children had major rituals associated with their birth and life milestones. This has, thankfully, changed, but in some cases it has changed more recently than one might realize.

The ceremony that we held over the weekend was one that was written this century, based off of the liturgical moments from a male child’s circumcision ritual, but written for the noninvasive procedure of naming a girl. We happen to know the people who created it, in fact, which means, I hope, that we are doing our part to create new traditions of gender equality.

Also, it’s just lovely to share the name of our child with family and friends. I won’t be sharing it publicly here, however, out of respect for her future privacy. Being known on the Internet is a decision she should get to make, in her own time.

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Carl Fink had the following comment on the last issue:

A couple of weeks ago, didn't Johnson and Johnson release data indicating that their vaccine shows no waning at all after six months? (That was the one-dose original regimen. Presumably the two-dose version would last even longer.)

This was about the roundup of Pfizer vaccine waning that I had shared and walked through. Carl is right that the J&J single-shot vaccine has shown minimal waning, but I think the comparison is somewhat unfair, and here’s why:¹

Since we don’t have data on the waning of the same endpoint [efficacy vs symptomatic disease] for Pfizer, it’s pretty hard to make any comparison here, but the J&J effectiveness was always lower to begin with after a single dose. Since we’re comparing very different populations, vaccines, and endpoints here it’s very hard to say whether there’s a meaningful difference between vaccines in this regard. Maybe it’s just that every vaccine settles out at the ~68% effectiveness against disease that a single dose of J&J started with. That wouldn’t be so bad, really.

The reality here is that I think we are going to learn a lot about how different vaccine schedules work to prevent COVID-19 over the next few months. While it was necessary to use rapid schedules to get the vaccines deployed effectively at the beginning of this year, I don’t think that anyone has ever believed that these schedules were the absolute best option. Many—including myself—have called for further clinical studies to optimize the immune response that these various vaccines generate. While I didn’t support the idea of varying the vaccine dosing regimens and schedules without clinical studies, I did and do support the idea of studying them further to figure out the approach that yields the most durable and effective immunity against COVID-19. The rest of 2021 and into 2022 is going to bring us scientific advancement on this topic, I think. Stay tuned here for more information.

You might have some questions or comments! Send them in. As several folks have figured out, you can also email me if you have a comment that you don’t want to share with the whole group.

Join the conversation, and what you say will impact what I talk about in the next issue.

Also, let me know any other thoughts you might have about the newsletter. I’d like to make sure you’re getting what you want out of this.

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Part of science is identifying and correcting errors. If you find a mistake, please tell me about it.

Though I can’t correct the emailed version after it has been sent, I do update the online post of the newsletter every time a mistake is brought to my attention.

No corrections since last issue.

See you all next time. And don’t forget to share the newsletter if you liked it.

Always,

JS

1. Please note I’ve actually edited this version of the comment somewhat, because I wrote it wrong when I originally posted it. The full version, with later clarification, can be found on the discussion thread for the previous issue.