Chris Heimerdinger responds to critics

[Doctor Steuss]

On the personal opinion front:

I am all for prescribing treatments, like Ivermecin, that show theoretical promise through in vitro studies. I am all for prescribing treatments, like hydroxychloroquine, that show theoretical promise through retroactive observational studies. I am particularly all for doing this when the drugs have very few potential adverse effects (like Ivermecin). But once resources have been diverted to conduct clinical trials, and those clinical trials are shown to not support the theoretical findings, I feel that it is time to stop wasting limited resources on further trials, pharmaceutical manufacturing, etc., and move those resources to expedite trials for the next potential therapeutic option.

The longer people cling to therapies that have shown no promise in clinical trials, the longer resources aren’t being directed to finding therapies that will work.

On another personal opinion note; based on the gofundme, there’s a decent chance that a significant amount of Chris’ medical bill will go unpaid. So, the cost will then be absorbed and shifted to everyone else. If he had demanded and succeeded in being given treatments with no clinical evidence of efficacy, that would have been additional money that everyone else would have to absorb.

If my coworker goes to the doctor, and the doctor prescribes an off-label medication that is unproven, just because my coworker wants it, the cost is then shared by me in our premiums.

Our healthcare system is consistently stretched thin. Healthcare costs are always rising. I would think that having to share the cost of someone incurring medical expenses, because something is a hot item in the media, should be something we are all adverse to.

[Fence Sitter]

Maybe ivermectin is like tums in the above example or maybe it is like tylenol. Let's see. Let physicians prescribe it after careful consideration and keep politics out of it. Let's not let the idiot that is the subject of this thread poison the well with his idiocy.

It is being given careful consideration by qualified medical researchers and has been found to be ineffective so far.

[Doctor CamNC4Me]

I will try to look at more if anyone is interested, but the chances are admittedly slim as I’m hitting my laziness threshold, and the evidence is seeming pretty solid that there is no statistically significant difference, when it comes to treating COVID, between being given Ivermecin, or being given a placebo.

[ETA: One of the studies above was done in Columbia, one in India, and one in Argentina.]

I’m definitely interested in seeing if an anti-parasite drug can kill or disable a coronavirus. If you’re out of energy that’s fine, too.

- Doc

[PseudoPaul]

[ETA: One of the studies above was done in Columbia, one in India, and one in Argentina.]

Intestinal parasites tax the immune system. Getting rid of them leaves your immune system better equipped to fight off a virus. Unless you have worms, horse paste isn't going to help you with COVID.

[Doctor Steuss]

One thing I’ve found in looking at some more studies is that there are quite a few in vitro studies that have shown promise for using ivermectin to treat a myriad of viral infections (including HIV). It makes absolute sense that doctors/researches would have been looking to have it used as a treatment. Especially after the ROSs. But, it still looks like every DBP shows no significant difference between ivermectin and placebo for treating COVID. This is one of the quirky things about our bodies. Theoretically, something works on paper. In a lab setting with human tissues, etc., it works. Even in live animals, it works. Put it in a living human body, with all of its metabolic pathways, enzymes, tissue concentrations, and endless amazing complexity… and it doesn’t work.

A few more personal comments on a couple more studies:

This one is an analysis of the clinical studies available as of publication (July 2021). This was done in Germany.

They do a pretty good deep dive of the various studies, their limitations, strengths, etc. They also go through almost all of the metrics used to determine efficacy (ranging from reported symptoms in an out patient setting, measured viral load, mechanical ventilation intervention, etc.). The end conclusion was that “reliable evidence available does not support the use of ivermectin for treatment or prevention of COVID-19.” They did, however, note that there could be benefit in continued research in randomized trials.
https://pubmed.ncbi.nlm.nih.gov/34318930/

This one was conducted in 2020 in Spain (80 patients). It was patients admitted into the ER, and were given only a single (heafty) dose of ivermectin – 400mg/kg. I would’ve had to down over 50 grams of the stuff.

The ivermectin group did see a statistically significant improvement over the placebo with sleep issues (hyposomnia). Resolution of that particular symptom was almost twice as much as that with placebo. As far as the other metrics go, there was no difference except there was a tendency towards lower viral loads at 21 days. At 4 days and 7 days there was no difference, so not enough evidence/difference to draw conclusions, but they suggested it might warrant assessment in larger trials.
https://www.thelancet.com/journals/ecli ... 8/fulltext

This is a rather small (60 ivermectin, and 60 placebo) study. It was completed, but I don’t see where it’s been peer-reviewed or published yet, so grain of salt and all that jazz.

One of the advantages of these types of pre-published studies is that almost all of the data is available without the need to pay for the article. Despite the small test group, there are some interesting things. One is that people on ivermectin vs. placebo had a higher instance of self-reported symptoms from the symptom list provided by the trial. Not just with many symptoms, or most, but in every one of the 12 defined symptoms, as well as “other.”

The ivermectin group also had the only serious adverse effect during the trial (CNS and spinal cord infections). It was only one person, so obviously statistically insignificant. There were a few urinary tract infections in the ivermectin group (none in the placebo). Probably not related, but given the other infection, and the various symptoms, I can’t help but wonder if ivermectin might increase susceptibility to some types of bacterial infections(?). I went on a short excursion to explore it a bit more, and ivermectin has shown result in vitro for reducing one type of staph, but not others. Maybe this highly selective targeting alters the microbiome enough for other bacteria to gain a foothold that otherwise wouldn’t. Just spit-balling.

The study was funded by a research outfit in Mexico.
https://clinicaltrials.gov/ct2/show/results/NCT04407507

[¥akaSteelhead]

If the hospital isn't doing anything and the treatments don't harm, then why not allow them? Making a stink over using off label drugs seems to be falling into the conspiracy theory that Pfizer et al are behind the denials because they don't want the competition. I thought the standard response to cancer patients was to allow any non-harming treatment as long as the other regimens were followed. There are many quack cancer treatments out there and giving a patient hope when the treatment doesn't do anything but doesn't do harm might help. The placebo effect works at times.

The further you deviate from an established medical protocol the more you open yourself up to malpractice lawsuits. Prescribing a drug for a purpose not recognized by the FDA is a pretty substantial deviation.

[¥akaSteelhead]

Here is another study back in 2003. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128816/

Thank you. I had forgotten that prior to the ROS studies, there were In vitro studies that lead to the hypothesis for use against SARS-CoV-1 (which inevitably lead to the ROS studies for SARS-CoV-2).

Unfortunately, in vivo placebo-based double-blind studies didn't support the hypothesis. Our bodies, nasties, and drugs are weird when all of the moving parts and variables come together.

The most oft quote ivermectin meta study has been retracted for problems with methodology. Neither ivermectin or hcq have been shown to have meaningful results in the double blind well conducted clinical studies I am aware of to date.

Re "in vitro studies" - a drug that has in vitro impact at levels that are toxic to living humans is pretty moot. If my memory serves both the in virto studies for ivermectin and hcq were such.

[Dwight]

Another thing is to consider that there is an additional cost, not just in money, to administer these medicines. It might be negligible in certain cases, it may increase the time the nurses/doctors have to get the medicine to the patient, monitor the patient, and logistics of storage and having the medicine in the right place. I hear from friends that some of the no beds available is not that there isn't rooms, equipment, or beds, but there isn't the staff to make that stuff useful in treating someone. So if the nurse has to spend even 5 minutes more per patient so they can get their placebo what does that do to the rest of the care they can provide?

I suppose if it was so irksome he could have taken care to get it beforehand, and/or go to a hospital that would meet his needs/desires in the free market.

[Bought Yahoo]

Another thing is to consider that there is an additional cost, not just in money, to administer these medicines. It might be negligible in certain cases, it may increase the time the nurses/doctors have to get the medicine to the patient, monitor the patient, and logistics of storage and having the medicine in the right place. I hear from friends that some of the no beds available is not that there isn't rooms, equipment, or beds, but there isn't the staff to make that stuff useful in treating someone. So if the nurse has to spend even 5 minutes more per patient so they can get their placebo what does that do to the rest of the care they can provide?

I suppose if it was so irksome he could have taken care to get it beforehand, and/or go to a hospital that would meet his needs/desires in the free market.

Once again, hospitals are free all around the US today to use these avant garde treatments. You could get horse medicine today. But, a physician must write the prescription. And physicians do not work for hospitals. There is a rare exception for hospitalists. But even ER docs don't work for hospitals.

You people seem to think that the hospitals are to blame.

[Res Ipsa]

Another thing is to consider that there is an additional cost, not just in money, to administer these medicines. It might be negligible in certain cases, it may increase the time the nurses/doctors have to get the medicine to the patient, monitor the patient, and logistics of storage and having the medicine in the right place. I hear from friends that some of the no beds available is not that there isn't rooms, equipment, or beds, but there isn't the staff to make that stuff useful in treating someone. So if the nurse has to spend even 5 minutes more per patient so they can get their placebo what does that do to the rest of the care they can provide?

I suppose if it was so irksome he could have taken care to get it beforehand, and/or go to a hospital that would meet his needs/desires in the free market.

Once again, hospitals are free all around the US today to use these avant garde treatments. You could get horse medicine today. But, a physician must write the prescription. And physicians do not work for hospitals. There is a rare exception for hospitalists. But even ER docs don't work for hospitals.

You people seem to think that the hospitals are to blame.

It's a common misconception. The first firm I worked for did lots of med mal defense. Most firms who did that work specialized in defending either nurses, who are employed by hospitals, and doctors, who aren't. I had no idea before that about how it worked.