Truth and doubt in a time of pandemic

In the pandemic, I find it hard to decide who I can trust about questions such as vaccine effectiveness, lockdown effectiveness, ivermectin effectiveness and so on.

Authorities such as the Centers for Disease Control and World Health Organization haven’t always told the truth, or at least not the whole truth.  But this doesn’t mean the critics of the CDC and WHO are necessarily reliable.   When doctors disagree, how can I, a layman, decide?

That’s why I’m impressed with this interview of Eric Osgood, a physician, by David Fuller, a co-founder of a podcast called Rebel Wisdom, even though I don’t usually spend time watching long videos on computer screens.

Fuller is more interested in getting the facts right, and Ogood more interested in what is best for his patients, than about defending one side or another.

Osgood recommends vaccination to most of his patients, but also prescribes ivermectin.  He gets flak from the right-wing anti-vax fanatics, who tell him he is a tool of the establishment, and the left-wing anti-ivermectin zealots, who say he is helping the anti-vaxxers.  

 He used to be a member of the Frontline Covid-19 Critical Care Alliance, which is the chief promoter of ivermectin, but now has reservations about Dr. Pierre Kory’s recommendation to double the dose against the Delta variant, which he doesn’t think has any empirical basis.

I think Dr. Kory has followed a common path by those who question an ideological orthodoxy. A dissenter is cast out by those he had been accustomed to thinking of as his friends.  His dissent is welcomed by those of the opposing ideological orthodoxy.  Gradually, the opposing orthodoxy comes to seem more and more reasonable.

One interesting fact that I hadn’t known is that Dr. Kory himself and his daughter caught Covid-19.  Dr. Kory is not explicitly anti-vaccination, but he didn’t get vaccinated himself. 

His infection was a mild case, so maybe ivermectin did some good.  Dr. Osgood’s view is that ivermectin is harmless, cheap and of some benefit, and just possibly the wonder drug that Dr. Kory thinks it might be, so there is no reason not to use.

For what it’s worth, that’s what I now think, too.  I was much more of an ivermectin enthusiast when I first heard about it than I am now.  I still oppose the campaign to prevent it being prescribed or discussed.

One of the things I resolved early in life was never to feel humiliated when I was proved wrong about a topic.  Rather I should feel pleased that I understand things better today than I did yesterday.

I haven’t found it easy to keep this resolution.  When I feel attacked, I defend my views, and only the day after, or the month after, or 10 years after think things over and change my mind.

There is a technique recommended by the blogger Scott Alexander Suskind.  Instead of saying he believes something, he expresses his degree of certainty about a topic.  

Thus I might say that I used to be 80 percent certain that Unidentified Flying Objects had some mundane explanation, even though the explanation might never come to light.  In view of recent reporting on UFOs, my certainty level is down to 60 percent.  This makes it easier for me to gradually change my mind over a period of time without thinking I’m admitting defeat.

When I first heard of ivermectin, I was 98 percent certain there was no reason to prevent physicians from prescribing the drug, and 80 percent hopeful that it might be a wonder drug, comparable to penicillin.

The idea that it was a wonder drug was based on reported results in the field, in India, Peru and other countries.  But recently I have read Fuller’s material questioning these reports.  So my hopefulness about ivermectin having a big impact is down to 40 percent or less.  I am still sure it has some usefulness, but I have questions about its degree of usefulness.

LINKS

Unapproved by FDA, Ivermectin useful as Covid-19 treatment, local doctors say by Dan Herbeck for the Buffalo News.

Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19 by Drs. Pierre Kory, Gianfranco Umberto Meduri, Joseph Veron, Jose Iglesias and Paul Marik for the American Journal of Therapeutics.

The Political Pill for COVID by Dr. Pierre Kory for Inside Sources.

Ivermectin—For and Against: Briefing Document by David Fuller and Ed Prideaux for Rebel Wisdom.

Bret Weinstein, Alternative Media and Vaccine-Related Controversy by David Fuller for Aero.

Vaccine Safety, Ivermectin and the Dark Horse Podcast: An Investigation by David Fuller for Medium.

Has the Case for Ivermectin Been Hijacked by Anti-Vaccine Activists? by David Fuller and Ed Prideaux for Medium.

Ivermectin: Much More Than You Wanted to Know by Scott Alexander Suskind for Astral Codex Ten.  [Added 11/17/2021]

Other Issues

I’ve been thinking about healthcare, health outcomes and American exceptionalism by Elizabeth Bear. 

IM Doc on Medication / Medical Supply Shortages and Political Backlash by Yves Smith for Naked Capitalism.  The comment thread is also worth reading.

What Is America’s COVID Goal Now? by Sarah Zhang for The Atlantic.

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