Coronavirus

[Swerd]

Ivermectin in a large clinical trial failed to improve the condition of COVID-19 patients.

The TOGETHER Trial:
A Multicenter, Prospective, Adaptive, Double-blind, Randomized, Placebo-controlled Study to Evaluate the Effect of Fluvoxamine, Ivermectin, Doxasozin and Interferon Lambda 1A in Mild COVID-19 and High Risk of Complications
NCT04727424 https://clinicaltrials.gov/ct2/show/NCT04727424

In this trial the ivermcectin arm failed to meet minimum goals of efficacy at an interim analysis time point. I’m not sure, but I think that treatment arm was stopped early after interim analysis because it failed. Those details might be mentioned in the trial’s full protocol.

A multi-center, adaptive, randomized,... | Gates Open Research

Read the original article in full on Gates Open Research: A multi-center, adaptive, randomized, platform trial to evaluate the effect of repurposed medicines in outpatients with early coronavirus disease 2019 (COVID-19) and high-risk for complications: the TOGETHER master trial protocol

gatesopenresearch.org

A summary of the trial was discussed online by Fact Check (first posted 16 Sept 2021 – updated 29 Oct 2021) https://www.factcheck.org/2021/09/scicheck-ongoing-clinical-trials-will-decide-whether-or-not-ivermectin-is-safe-effective-for-covid-19/

Researchers in the US and across the world have shown great interest in trying to find out if ivermectin, a cheap and widely used antiparasitic drug, could be effectively and safely used to treat COVID-19 patients. As of now, there are 77 studies assessing the use of ivermectin to treat or prevent COVID-19 registered in clinicaltrials.gov, and 139 trials listed in the WHO’s International Clinical Trials Registry Platform.

“Everybody wanted to do what they could when COVID first struck,” said Edward Mills, a Canadian researcher co-leading one of the largest clinical trials on repurposed treatments to be completed yet. “And those of us working in clinical research, we did what we could too.” Mills was speaking on Aug. 6 while presenting the results for the first time during an event sponsored by the National Institutes of Health.

The TOGETHER trial, co-led by Mills, professor of health research methods, evidence and impact at McMaster University in Canada, and Dr. Gilmar Reis, associate professor of medicine at Pontifícia Universidade Católica de Minas Gerais, Brazil, started in June 2020 and was set in 10 cities in the state of Minas Gerais, Brazil. This randomized adaptive platform trial started looking at the effectiveness of ivermectin for the treatment of COVID-19 among high-risk adult nonhospitalized patients on Jan. 15, 2021. The study analyzed whether patients’ health became worse and required hospitalization or more than six hours of observation in an emergency room, within 28 days of randomization.

According to the results presented, (35 slides https://dcricollab.dcri.duke.edu/sites/NIHKR/KR/GR-Slides-08-06-21.pdf ), the study found no indication of benefit on the use of ivermectin – nor any with hydroxychloroquine or lopinavir-ritonavir, or metformin. The ivermectin arm had 1,500 patients: 677 of them received a daily dose of the medication, and 678 others were given a placebo, for three days. 86 patients in the ivermectin group required extended emergency room observation or hospitalization versus 95 in the placebo group. Both the differences in relative risk and mortality relative risk between the two groups were not statistically significant. (At that time, these results had not yet been peer-reviewed.)

“We found that it [ivermectin] had no effect whatsoever on our primary outcomes,” Mills said. “In our specific trial, outpatient, we do not see the treatment benefit that a lot of advocates believe should have been” seen, Mills said.

The modestly positive results for fluvoxamine of the Together Trial were recently published after full peer review, Jan 2022 in The Lancet: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00448-4/fulltext
Note that this paper shows only the clinical results with fluvoxamine. It has no data on ivermectin or any of the other treatments tested in the trial, as they failed to be effective.

 

[Swerd]

Sorry, I don't take Wikipedia to be a reliable source. I will use it occasionally for a quick reference but that's about it.

If you have another source, I am all eyes.

There is no question that Ivermectin has any efficacy against corona virus. (See Together Trial above)

The known pharmaceutical mechanism of action for ivermectin cannot work as an anti-viral agent.

The only suggestion that ivermectin might have anti-viral activity came from a poorly done Australian paper.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129059/
It tested ivermectin in cultured cells infected by SARS-CoV-2. When ivermectin was added to the dishes, it had some activity, but only at concentrations 100 times greater than can be achieved in human blood after oral administration, at the standard oral dose of 12 mg/day for 5 days.

(I have serious doubts about that report of in vitro activity on cultured cells. The authors mentioned that they have detected similar anti-viral activity against a number of other unrelated viruses, including HIV-1, SV-40, dengue fever virus, West Nile virus, Venezuelan equine encephalitis virus, influenza, pseudorabies virus, among others. Yet, no one has clamored for ivermectin to treat infections from any of those viruses.)

Ivermectin has been safely tested at doses as much as 10× higher. https://accp1.onlinelibrary.wiley.com/doi/abs/10.1177/009127002237994 . But that is still nowhere near the concentrations needed for anti-viral activity in the Australian paper.

There is no longer any question about ivermectin – it doesn’t work in people with Covid-19.

And all you can say is that you can’t believe Wikipedia. Instead you prefer unqualified fools on YT.

You claim you don’t have time to fact check Wikipedia, yet you have time to flood this thread with your BS.

 

[Trell]

...
There is no longer any question about ivermectin – it doesn’t work.

And all you can say is that you can’t believe Wikipedia. Instead you prefer unqualified fools on YT.

You claim you don’t have time to fact check Wikipedia, yet you have time to flood this thread with your BS.

 

[SithZedi]

There is no question that Ivermectin has any efficacy against corona virus. (See Together Trial above)

The known pharmaceutical mechanism of action for ivermectin cannot work as an anti-viral agent.

The only suggestion that ivermectin might have anti-viral activity came from a poorly done Australian paper.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129059/
It tested ivermectin in cultured cells infected by SARS-CoV-2. When ivermectin was added to the dishes, it had some activity, but only at concentrations 100 times greater than can be achieved in human blood after oral administration, at the standard oral dose of 12 mg/day for 5 days.

(I have serious doubts about that report of in vitro activity on cultured cells. The authors mentioned that they have detected similar anti-viral activity against a number of other unrelated viruses, including HIV-1, SV-40, dengue fever virus, West Nile virus, Venezuelan equine encephalitis virus, influenza, pseudorabies virus, among others. Yet, no one has clamored for ivermectin to treat infections from any of those viruses.)

Ivermectin has been safely tested at doses as much as 10× higher. https://accp1.onlinelibrary.wiley.com/doi/abs/10.1177/009127002237994 . But that is still nowhere near the concentrations needed for anti-viral activity in the Australian paper.

There is no longer any question about ivermectin – it doesn’t work in people with Covid-19.

And all you can say is that you can’t believe Wikipedia. Instead you prefer unqualified fools on YT.

You claim you don’t have time to fact check Wikipedia, yet you have time to flood this thread with your BS.

There is no longer any question about "fill in the blank" is not a very scientific statement.

I never said I "don't believe Wiki", I said it was unreliable. They say so themselves.
Please alert me to the universities or pharma company labs that use Wiki it for their purposes?

Yes, I still don't have time to fact check or spend too much time on Wiki. Obviously you do. Have at it.

 

[Trell]

ThereYes, I still don't have time to fact check or spend too much time on Wiki. Obviously you do. Have at it.

But you do have more than ample time on your hand to flood threads with your BS.

 

[Mikado463]

SithZedi, I felt compelled to give you a 'thumbs up' since 'ole Treller made his mark !

 

[Trell]

SithZedi, I felt compelled to give you a 'thumbs up' since 'ole Treller made his mark !

You “bros” have to stay together while feeling so “cancelled” and “censured”.

 

[SithZedi]

SithZedi, I felt compelled to give you a 'thumbs up' since 'ole Treller made his mark !

My day would not be complete without a dumb from him or one of his "Bbros".

 

[SithZedi]

You “bros” have to stay together while feeling so “cancelled” and “censured”.

One of the many beautiful things about this site is that don't censure or cancel and everyone seems to feel free to exchange opinions rather openly . I don't feel cancelled or censured, certainly disagreed with. But that's what happens when you express an opinion.
Censorship and cancellation tend to be the biggest tools in a left winger or religious fanatic's box.
Ooops I did it again!

 

[mtrycrafts]

2099?

Thanks. I'll stick around and see the answer.

 

[mtrycrafts]

But didn’t you just ask about references for you to read?

Those are the wrong ones.

 

[Dude#1279435]

Thanks. I'll stick around and see the answer.

Drop the answer off on my plaque please.

 

[mtrycrafts]

Drop the answer off on my plaque please.

I will have it carved to last for a while before nature takes over.

 

[Mr._Clark]

Here's my .02 on Campbell.

I watched a few of his videos earlier in the pandemic. Most of those videos seemed to be quite informative, and he discussed basic factual matters (as I recall). How do viruses invade cells, etc.

I watched a couple more videos more recently. In one he was discussing the use of ivermectin in Japan. As I recall, he pointed to a drop in COVID cases in Japan that apparently occurred after ivermectin started to be used there. The gist of the video seemed to be that ivermectin must have caused the drop in COVID cases. I do not recall him discussing issues with regards to causation (i.e. that there might be other reasons the cases dropped there). The implication that ivermectin must be effective struck me as being speculative (again, this is my recollection, I have not gone back and reviewed the video).

In another video he discussed COVID deaths in the UK. The numbers were apparently in response to a FOIA type request he filed there. The gist of this video seemed to be that almost no one was dying only from COVID. As I recall, I don't think he got into details in terms of what the numbers actually mean. By way of analogy, if someone with diabetes gets shot and they bleed out and die 30 minutes later, the person may have had a preexisting condition (diabetes) and the person may have actually died because the person's brain didn't have enough oxygen, but that doesn't mean that the gunshot wound didn't cause the death. One might say that this person didn't die only from the gunshot wound because it was actually lack of oxygen to the brain that caused the death. Is this what Campbell was doing? I'm not sure. Perhaps he did explain exactly what criteria was being applied, and I may have missed it, but my impression was that he didn't explain it clearly.

Feel free to fact check me. I may have missed something in the videos. My impression is that he has not been very rigorous in some of his more recent videos, and he seems to be drifting away from just presenting facts towards advocating various contrarian positions.

And that's my huge opinion.

 

[davidscott]

Deaths are up but hospitalizations are down in the US. This is to be expected as deaths are the trailing numbers. Maybe we will be out of this Pandemic soon.

 

[SithZedi]

There is no question that Ivermectin has any efficacy against corona virus. (See Together Trial above)

The known pharmaceutical mechanism of action for ivermectin cannot work as an anti-viral agent.

The only suggestion that ivermectin might have anti-viral activity came from a poorly done Australian paper.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7129059/
It tested ivermectin in cultured cells infected by SARS-CoV-2. When ivermectin was added to the dishes, it had some activity, but only at concentrations 100 times greater than can be achieved in human blood after oral administration, at the standard oral dose of 12 mg/day for 5 days.

(I have serious doubts about that report of in vitro activity on cultured cells. The authors mentioned that they have detected similar anti-viral activity against a number of other unrelated viruses, including HIV-1, SV-40, dengue fever virus, West Nile virus, Venezuelan equine encephalitis virus, influenza, pseudorabies virus, among others. Yet, no one has clamored for ivermectin to treat infections from any of those viruses.)

Ivermectin has been safely tested at doses as much as 10× higher. https://accp1.onlinelibrary.wiley.com/doi/abs/10.1177/009127002237994 . But that is still nowhere near the concentrations needed for anti-viral activity in the Australian paper.

There is no longer any question about ivermectin – it doesn’t work in people with Covid-19.

And all you can say is that you can’t believe Wikipedia. Instead you prefer unqualified fools on YT.

You claim you don’t have time to fact check Wikipedia, yet you have time to flood this thread with your BS.

Sorry was on the clock today. Ok, since Dude checked in on this, I felt compelled to get to it asap.
-Aussie report flawed. Agreed.
-ACCP link is from 2013 with the 10x dosage study, I am assuming it still holds.
-Went to Wiki's Campbell page and found this interesting entry:
In August 2020, UNICEF's regional office for Europe and Central Asia cited Campbell's Youtube channel as
an excellent example of how experts might engage with social media to combat misinformation.[11]
For the sake of time, I am willing to assume that Campbell went crackers after August 2020 and cannot be trusted since.

Finally, after further reading, I get to this paragraph taken from the nih.gov, dated Feb 2021. Does not seem to have been updated since but there is a Clinical Data Tab dated Dec 2021. If there is an update, let me know.

Recommendation:
There is insufficient evidence for the COVID-19 Treatment Guidelines Panel (the Panel) to recommend either for or against the use of ivermectin for the treatment of COVID-19. Results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide more specific, evidence-based guidance on the role of ivermectin in the treatment of COVID-19.

Ivermectin | COVID-19 Treatment Guidelines

Review clinical data on the use of ivermectin for the treatment of COVID-19.

www.covid19treatmentguidelines.nih.gov

Before commenting any further, an honest question: Is this paragraph from a reputable source or is it BS?

 

[Dude#1279435]

I will have it carved to last for a while before nature takes over.

Make sure you sign it I came all the way from ____ so visitors will know it's important.

 

[Dude#1279435]

Here's my .02 on Campbell.

I watched a few of his videos earlier in the pandemic. Most of those videos seemed to be quite informative, and he discussed basic factual matters (as I recall). How do viruses invade cells, etc.

I watched a couple more videos more recently. In one he was discussing the use of ivermectin in Japan. As I recall, he pointed to a drop in COVID cases in Japan that apparently occurred after ivermectin started to be used there. The gist of the video seemed to be that ivermectin must have caused the drop in COVID cases. I do not recall him discussing issues with regards to causation (i.e. that there might be other reasons the cases dropped there). The implication that ivermectin must be effective struck me as being speculative (again, this is my recollection, I have not gone back and reviewed the video).

In another video he discussed COVID deaths in the UK. The numbers were apparently in response to a FOIA type request he filed there. The gist of this video seemed to be that almost no one was dying only from COVID. As I recall, I don't think he got into details in terms of what the numbers actually mean. By way of analogy, if someone with diabetes gets shot and they bleed out and die 30 minutes later, the person may have had a preexisting condition (diabetes) and the person may have actually died because the person's brain didn't have enough oxygen, but that doesn't mean that the gunshot wound didn't cause the death. One might say that this person didn't die only from the gunshot wound because it was actually lack of oxygen to the brain that caused the death. Is this what Campbell was doing? I'm not sure. Perhaps he did explain exactly what criteria was being applied, and I may have missed it, but my impression was that he didn't explain it clearly.

Feel free to fact check me. I may have missed something in the videos. My impression is that he has not been very rigorous in some of his more recent videos, and he seems to be drifting away from just presenting facts towards advocating various contrarian positions.

And that's my huge opinion.

One recent episode I watched had four sets of numbers. Campbell picked the 17,000 deaths attributed by covid alone. I thought it was weird he didn't include underlying conditions which would've drove the numbers up much higher.

 

[Mr._Clark]

One recent episode I watched had four sets of numbers. Campbell picked the 17,000 deaths attributed by covid alone. I thought it was weird he didn't include underlying conditions which would've drove the numbers up much higher.

You may have seen the same video I did.

I'm not sure how death certificates are filled out in the UK, but here in the U.S. there has been a tendency to confuse preexisting conditions with causation.

Here's an example of this here in the U.S.:

>>>“Death certificates, on which these data are based, are designed to elicit a causal pathway, or chain of events leading to death. Physicians, medical examiners, and coroners that report and certify the cause of death on death certificates, if they correctly follow the instructions, will typically report more than one condition,” they said.

A CDC document released in April 2020 shows the standard format for such reporting ( here ).

On such reports, it is “not unusual to see something like “acute respiratory failure” due to “viral pneumonia” due to “COVID-19”. On such a record, there would be two conditions reported in addition to COVID-19. But this is clearly a death caused by COVID-19. I.e., COVID-19 was the underlying cause as it initiated the chain of events leading to death. Respiratory failure and pneumonia are clearly reported as complications of COVID-19 and not as competing conditions,” they said.

In a separate section, the certifier is also instructed to report any significant conditions that contributed to death but were not part of the causal sequence.

“So, for COVID-19 deaths, it is not unusual to see conditions such as COPD [Chronic Obstructive Pulmonary Disease], diabetes or dementia, that are known to result in more severe COVID infection, reported in this section. Such contributing factors are also not to be seen as competing underlying causes,” the spokesperson said.

“Currently, based on the death certificate data we have received, for 91% of death certificates with COVID-19 reported, COVID-19 is clearly the underlying cause. In 9% of cases, it was a reported as a significant factor contributing to death,” they added.<<<

Why those with comorbidities are still counted as COVID-19 deaths

by extrapolating from the percentage of people who the NCHS says have died of COVID-19 alone, and not of the virus in conjunction with another illness, condition, or comorbidity.

www.reuters.com

 

[Mr._Clark]

So, here's a link to the directions for filling out death certificates in the UK. Essentially, it appears to be very similar to how it's done in the U.S.

With regards to causation, sections 4 and 4.1 state:

>>>4. How to complete the cause of death section
• COVID-19 is an acceptable direct or underlying cause of death for the purposes
of completing the Medical Certificate of Cause of Death . . .

4.1 Sequence leading to death, underlying cause and
contributory causes
The MCCD is set out in two parts, in accordance with World Health Organisation
(WHO) recommendations in the International Statistical Classification of Diseases and
Related Health Problems (ICD). You are asked to start with the immediate, direct cause
of death on line Ia, then to go back through the sequence of events or conditions that
led to death on subsequent lines, until you reach the one that started the fatal
sequence. If the certificate has been completed properly, the condition on the lowest
completed line of part I will have caused all of the conditions on the lines above it. This
initiating condition, on the lowest line of part I will usually be selected as the underlying
cause of death, following the ICD coding rules. WHO defines the underlying cause of
death as “a) the disease or injury which initiated the train of morbid events
leading directly to death, or b) the circumstances of the accident or violence
which produced the fatal injury”.<<< (emphasis added)

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877302/guidance-for-doctors-completing-medical-certificates-of-cause-of-death-covid-19.pdf

Here's a paper reporting on autopsy results that distinguishes (correctly, as far as I can tell) between preexisting health conditions, comorbidities and cause of death:

>>>We report findings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID-19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to diffuse alveolar damage presented as immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients. Our findings reveal that causes of death were directly related to COVID-19 in the majority of decedents, while they appear not to be an immediate result of preexisting health conditions and comorbidities. We therefore suggest that the majority of patients had died of COVID-19 with only contributory implications of preexisting health conditions to the mechanism of death.<<<

Causes of death and comorbidities in hospitalized patients with COVID-19 - Scientific Reports

Infection by the new corona virus strain SARS-CoV-2 and its related syndrome COVID-19 has been associated with more than two million deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed...

www.nature.com

Edit: Added "preexisting health conditions" to "distinguishes . . . between preexisting health conditions, comorbidities and cause of death" (it appears to me that these three are often conflated, especially preexisting health conditions and comorbidities)(I drifted into this myself)