Standard of care is do nothing until you end up in hospital. If you treat with ivermectin by onset of first symptoms (the earlier the better) your chances of survival become between 70% and 90% better than "standard of care". That is already shown to a good degree of certainty by meta analysis of multiple RCTs.

If you take the average CFR of 2% for SOC and conservative mortality RR for Ivermectin as .75 (which would already be a highly effective treatment, reducing the amount of death by 25%) and design a properly powered study to confirm this hypothesis with the standard alpha of 0.05 and beta of 0.2, you will need about 10k participants in each arm.

This will result in approximately the following deaths:

Control: 200 deaths

IVM (late treatment, current best estimate RR=0.5): 100 deaths

IVM (early treatment, current best estimate RR=0.2): 40 deaths

So basically if you do a "large RCT" now of IVM early treatment vs SOC you effectively condemn 160 of placebo to death.

If you do a late treatment IVM vs SOC, you effectively condemn 200+100-40 = 260 people to death.

The ethical thing to do at this stage is to change early stage SOC (ie. DO NOTHNG) to be the FLCCC I-MASK+ protocol. Then do large early stage treatment studies comparing SOC (which is now the I-MASK+ protocol including IVM) to different dosing levels of IVM, combining IVM with HCQ+zinc, Fluvoxamine, IVM (SOC) + Fluvoxamine.

Note that if SOC becomes the FLCCC I-MASK+ protocol or something similar, these studies would have to be even bigger - since with the current full I-MASK treatment started early your CFR would probably be much lower than just IVM at different doses as was the case in the studies quoted above. I've read multiple reports of thousands of people treated with early treatment regiments with 1 or 2 deaths. So the CFR for early I-MASK+ treatment would probably be around 0.1% - that would require studies of around 50k people per arm to detect even large benefits (50%) to the standard degree of certainty (alpha=0.05).

But yeah, since nobody is doing the ethical thing, I guess the only option left is to do a large RCT ASAP, because for the past 3 months the world's medical academia has been condemning thousands of people to death every day due to treatment nihilism.

The figures of the amounts of preventable death is much much larger than the 70% or 75% or whatever percentage you take the RR of using early IVM treatment to be. Because one of the other benefits of IVM is the much much faster resolution of symptoms and viral load reduction. This would lead to much lower R0, which would in turn result in lower spread, which would result in less cases - which has an exponential impact over time.

If 4 months ago, when the data was already extremely compelling, early treatment with Vit.D, Melatonin, Zinc and IVM or something similar (pick your favorite, Fluvoxamine, HCQ+Zinc, Quercetin, hell - even propolis and tumeric has been shown to be effective - just don't use Remdesivir, it has nasty side-effects making it useless as early treatment or prophylaxis and pretty much useless for later phase also) was widely promoted and campaigns were run to get people treatment ASAP and also doing prophylaxis of household contacts was rolled out, the pandemic would have been over in January. Vaccinations could be rolled out to ensure it remains under control and thousands and thousands of lives would have been saved.

My guess is that if such a campaign was rolled out in the US during early November, the total number of deaths would never have crossed 300k. Now it's at 530k and climbing....

Anyway, just ranting a bit, I never would have believed the extent of influence corporations have over policy and how profit margins have driven research and treatment decisions especially in the US and Europe, unless I saw it with my own eyes. It is now clear as daylight how corrupt the world has become. Allowing thousands and thousands to die just for a few extra $$$.

At least, I really hope that's the reason... because I can think of another compelling reason why governments around the world might not want to treat COVID very effectively... and that is the fact that healthy people rarely die of COVID. And sick people place a heavy financial burden on governments. The classic problem where longer life expectancy results in a population with a large percentage of older people. People relying on government healthcare, pension funds etc. I really really hope the reason early treatment SOC = do nothing and late treatment SOC = Remdesivir is purely just corporate greed.

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At the time Dexamethasone didn't have the level of evidence IVM has now. Also, many would argue that Dexamethasone should have been approved much much earlier (one of them would be Pierre Kory, who's first senate testimony was to promote Dexamethasone).

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