What happened in Iquitos (Peru)? (2020-07-23)

[-] Z3rul | 1 points | Aug 14 2020 02:11:38

what an amazing read. i hope i really hope ivermectin gets recognition soon. this drug needs to be in the spotlight and get alot of atention

[-] TrumpLyftAlles | 1 points | Aug 16 2020 04:31:55

Would you please give me a TL;DR on the Medium article? It's longer than my brain capacity. I wish I was joking.

[-] Flipping_chair | 2 points | Aug 28 2020 22:15:08

Actually Juan points out that most of the deaths in Loreto happened before mid-May, when ivermectin wasn’t so widespread. That totally makes sense!

[-] Flipping_chair | 1 points | Aug 28 2020 20:57:55

Author is saying that ivermectin works and point to Loreto Peru where there is a very widespread use.

I got excited seeing Egypt trial’s results, but that faded quickly after looking into Peru. Loreto has 919 deaths and 14,486 infections for a population of 900k. This death per 1M is higher than than Peru’s national average, which already leads the world at 850/1M.

Is there another explanation for Peru? Really bad heath system? Older population? Can’t just believe those anecdotes where doctors claim 100% recovery rate with ivermectin because 99% survive anyways.

[-] TrumpLyftAlles | 1 points | Aug 28 2020 21:15:05

Do you do use twitter? Maybe @jjchamie could answer your question.

It's hard to draw any conclusions from Loreto since we don't know how widely ivermectin is used there, and we of course cannot guess what the infections/deaths would be without it. Epidemiology (as I understand it) needs lot of data points, like data about thousands of people in Loreto, or data about people in lots of states like Loreto. Looking at just Loreto overall, we can't infer anything.

Can’t just believe those anecdotes where doctors claim 100% recovery rate with ivermectin because 99% survive anyways.

I understand your argument, and it's a good one. That's what makes control arms so crucial. The most recent Bangladesh trial, for example, showed the virus clearing for 83.6% (IIRC) of patients by day 6 when they were treated with ivermectin + doxycycline. What % would have cleared by day 6 with placebo? We'll never know.

The Egypt prophylaxis study has a real control arm, with random assignment to experimental and control arms so we may assume they're essentially the same. So that's a credible result. IMO.

Maybe it would help you (and me and us) if you look into patterns of covid-19 disease. For covid-19 patients with mild or moderate disease, how many days does it normally take to clear the virus? What percent of covid-19+ patients die? Those are tough questions, because the answers depend on so many factors. Maybe you can develop ranges?! Or find an article that does, that's easier. :)

[-] Flipping_chair | 2 points | Aug 28 2020 22:08:51

Those are all great points! Love your unbiased write-ups. I will keep researching and talking to friends who are medical professionals. Right now, most of them either haven’t heard of it as a COVID treatment or lump it with hydroxychloroquine.

What’s frustrating is that the more “legitimate” double-blind studies won’t be reporting until mid-2021. Hopefully more well designed studies get funded and go live soon. There is no reason newer drugs like Remdisivir have already gone through a few rounds of trials while an existing drug like ivermectin need another year (other than $).

[-] TrumpLyftAlles | 2 points | Aug 28 2020 22:25:04

What’s frustrating is that the more “legitimate” double-blind studies won’t be reporting until mid-2021.

Really? I would be surprised if there aren't good trials finishing before that. I keep meaning to create a sortable list of the trials. One of these days.

[-] Flipping_chair | 2 points | Aug 28 2020 22:59:23

I didn’t mean say that the non US and European ones are not legitimate. I think they will just carry less swaying power for american physicians and policy makers. The 3 US ones currently has 2021 or 2022 as their dates. Hopefully things will get pushed up as high quality foreign trials report results in the next few months.