Jeff Duntemann's Contrapositive Diary Rotating Header Image

Odd Lots

  • Research shows that ivermectin works. Here’s a paper published this past July in The American Journal of Therapeutics. I’ve read in a number of places that ivermectin is one of the safest drugs known. No, the FDA hasn’t approved its use against COVID-19. The Pfizer vaccine wasn’t FDA approved either until a few days ago. I can’t help but think that people are dying needlessly because of all the government screaming and yelling about people taking horse medicine, when taking horse medicine is a vanishingly small phenom. If ivermectin has no serious side effects, why not let doctors try it? What’s the downside?
  • Here’s a 30-page review of evidence demonstrating the effectiveness of ivermectin in treating COVID-19. Again, if it’s a safe drug that’s been on the market and widely studied for 30+ years, why not let people try it?
  • It’s become harder and harder to find evidence of the effectiveness of hydroxychloroquine (HCQ) in combination with zinc. I’ve looked. The early clinical experience emphasized that the two work together or not at all. I find it weird that nearly all the studies I’ve seen test HCQ either alone or with azithromycin–but not zinc. Clinical evidence shows that the combo doesn’t work well on late and severe cases, but rather when symptoms first appear. Still, if ivermectin works as well as recent studies show, HCQ’s moment may have come and gone.
  • I may have backed the wrong horse. Recent research seems to show that the Moderna vaccine generates twice the antibodies as the Pfizer vaccine does. Now let’s see some research on the rates of breakthrough infections versus vaccine type.
  • Here are some recent stats on the prevalence of breakthrough infections. The real eye-opener would be to know which vaccine is best at preventing breakthrough infections. That said, the chances of breakthrough infections occurring is very low. If you don’t read the paper, at least skim down to find the odds chart. Cancer risk is 1 in 7. Breakthrough infection risk is 1 in 137,698. I like those odds.
  • Ugggh. Enough virus crap. Let’s talk about something else. My pre-2000 pandemic penny jar (a thick glass bottle that once held cream from Straus Family Creamery) continues to fill. Last week I got a 1950-D wheat penny. A few days ago I got something a little odd: A 2 Euro cent coin from Ireland, dated 2002. It’s almost precisely the same size as a US penny, and if I didn’t look closely at coins I might have missed the fact that it was 19 years and an ocean away from home. Getting pennies from the 1980s is an almost everyday thing now. The penny jars are clearly still out there and still emptying into the McDonald’s till.
  • We lived near Santa Cruz for three and a half years and never visited its famous Mystery Spot. It turns out that mystery spots, roads, hills, and holes are all over the place. Here’s another interesting compendium. Yes, it’s bullshit. Yet I get the impression that it’s often very clever bullshit, and I wouldn’t mind getting a look at one or two.

28 Comments

  1. ace says:

    The U.S. still has pennies and $1 bills. Remarkable.

    1. And the aged pennies continue to circulate: This morning, McD gave me three pennies: 1986, 1980, and…1970.

    2. And today (September 7) I got a brilliant uncirculated 1998 penny. Almost 25 years old. Looks like no one’s ever touched it.

  2. We do. Pennies are basically accounting tokens, and most people don’t use them to buy things. I think that’s one reason why so many old pennies are turning up. People are getting rid of them by the jarful.

    As for dollar bills, well, they’re still useful. The US has had indifferent luck with dollar coins. If the current monetary inflation gets bad enough, pennies may go away. I still can’t decide how likely it is that we’ll move from dollar bills to dollar coins.

    1. TRX says:

      I don’t know how much pressure there will be for coinage changes in the near future. Usage seems to be decreasing as people move to plastic or phone payments.

      I’ve been seeing mention of “credit/debit only” stores and restaurants over the last few years. They won’t take cash, just plastic.

      I was chatting with the owner of a local restaurant a while back, and he said that maybe 90% of his customers pay by plastic. Most purchases would be in the $10 range.

      McDonalds is “trialing” a new system in some franchises up in Yankeeland. You have to download their app onto a compatible Android or Apple smartphone, create a McDonalds accound, and link it to a credit or debit card. *Then* you can use it to order and pay for your food. They don’t take orders at the counter or window, and they don’t take cash. If you’re not set up with their app, no burgers for you. I haven’t seen anything about that lately, maybe it didn’t work out like they expected.

      1. Keith says:

        I don’t know how much effect this has on the phenomenon, but it is, or at least at one time was, the law that the U. S. currency had to be accepted by anyone for any payment. A business could refuse to accept credit cards or traveler’s checks, but they had to accept the paper money that the government printed.

        I don’t know whether that legal obligation is still in effect. If it is, I imagine that would be a big obstacle to these schemes to go cashless.

        1. I went to take a look at this question online, and the Federal Reserve (who probably knows, heh) says very clearly that private businesses can accept or refuse cash payments at their option unless a state law says otherwise. Massachusetts and New Jersey have such law. I’m not aware of any others.

          Here’s the link: https://www.federalreserve.gov/faqs/currency_12772.htm

  3. RickH says:

    Just noticed that the AMA (American Medical Assn) is saying to not use invermectin: https://thehill.com/policy/healthcare/570519-american-medical-association-calls-for-immediate-end-to-use-of-ivermectin :

    “We are alarmed by reports that outpatient prescribing for and dispensing of ivermectin have increased 24-fold since before the pandemic and increased exponentially over the past few months,” the AMA said in a statement, joined by the American Pharmacists Association and American Society of Health-System Pharmacists. “As such, we are calling for an immediate end to the prescribing, dispensing, and use of ivermectin for the prevention and treatment of COVID-19 outside of a clinical trial.”

    Another article here https://www.cnet.com/news/ivermectin-and-covid-19-why-people-are-taking-this-unproven-controversial-drug/ .

    “The NIH said in February there was insufficient data to “recommend either for or against the use of ivermectin for the treatment of COVID-19.” It did say lab tests found the drug stopped the reproduction of the SARS-CoV-2 virus that cause the disease. However, to be effective, the dosages would need to be “100-fold higher than those approved for use in humans.”

    While some clinical studies showed ivermectin to have no benefit, the NIH said others saw a lower mortality rate among patients. However, those studies were incomplete or had methodological limitations such as small sample sizes or patients receiving additional medicine along with ivermectin, according to the NIH. ”

    The paper by Dr. Kory: “The paper was also included in the Frontiers of Pharmacology journal in January but was then removed in March. Dr. Frederick Fenter, chief executive editor of the journal, said the paper was removed due to “strong, unsupported claims based on studies with insufficient statistical significance, and at times, without the use of control groups.” Fender also said the authors promoted their own specific ivermectin-based treatment, which goes against editorial policies. ”

    IANAD (I am not a doctor), although I have stayed at a Holiday Inn, but I am inclined to disagree with those that would tout invermectin as a treatment.

    I think it is much more important to get the vaccine. The vaccine appears to significantly reduce the symptoms of the ‘evil cootie’, even if you get the infection after getting the vaccine. So, I have gotten the vaccine. And I also take a vitamin D-3 supplement daily.

    1. TRX says:

      Less than 20% of American doctors are members of the AMA. The other 80% mostly loathe the organization. Besides its political bias and championioning questionable social issues, they consistently back medical theories with no supporting data and practices that have long been shown to be counterproductive or harmful to patients.

      “Endorsed by the AMA” is the medical version of “HUGO Winner!” on the jacket of a science fiction novel.

  4. We got the shots as soon as our demographic could get them. (March.) I am not a vaccine skeptic. To the contrary, I’m an enthusiastic supporter and get the flu shot every year. Sometimes the shot fails, and I understand why. This doesn’t prevent me from thinking statistically. Most succeed. It’s an inherently messy business.

    I AM skeptical about government health organizations. The NIH quote in your post includes this: “However, to be effective, the [ivermectin] dosages would need to be “100-fold higher than those approved for use in humans.” I call BS on that. Physicians are using the drug at approved doses. It works. And there are plenty of peer-reviewed studies showing its effectiveness.

    The real issue is breakthrough infections. We don’t have enough history to know how long the vaccine’s protective effect lasts. Some are saying four months, and one (can’t find the link now) says 90 days. This means our shots have already timed out. The ghastly thing is that government authorities seem reluctant to accept any sort of treatment of the disease, even when both clinical and study evidence points toward effectiveness. I’m willing to try ivermectin if one of us comes down with this damned thing. The hitch is that my own doc won’t prescribe it, and I may have to go the telemed route.

    I’m not a doctor either. I am, however, an informed layman who knows how to read medical research. Most of the advice government has given us is useless or misleading. Dates of mask mandates or lockdowns don’t seem to align in any way with the case curves. This tells me that mask mandates and lockdowns have done little or nothing to prevent the spread of SARS2.

    Something doesn’t add up. I won’t discuss it further, as it would then edge into politics, and for the most part I don’t discuss politics here.

  5. Bob says:

    “The hitch is that my own doc won’t prescribe it, and I may have to go the telemed route.” Even if you get a prescription you may not be able to get it filled. A conservative radio talk program played a voicemail ( with identifying information beeped out) from a pharmacist saying that she refused to dispense ivermectin for him despite the fact that he had a prescription. He said that he had to get his doctor to call another pharmacy directly to insist that they dispense the medicine.

    1. Telemed (as I’ve seen it online) typically handles both the medical exam and the provision of prescribed medicines. Ivermectin is not a controlled substance, and can be shipped from a remote pharmacy. Sad that it has to go that way, and sadder that a prescription for a benign, not-controlled medicine can be refused on the whim of a pharmacist.

  6. My bride (of 51 years) and I recently returned from a 15 day visit to Ireland. We stayed in hotels, dined in pubs and had a great time. Among super-events was a visit to my old family castle, now known as Portlick Castle as a World Heritage site., but under renovation
    We found COVID measures manageable although sometimes tedious. The worst was a requirement for a negative COVID test from a specific lab: Randox Laboratories Ltd. No other lab results were acceptable for boarding a flight back to the USA. The cost was 60 pounds sterling per person. Quite a racket.

    1. TRX says:

      Yes indeed. Stateside, you can get a full blood workup for that.

      After Obamacare (Hillarycare++) went into effect, the medical insurance we had moved from “whatever” to “more than we actually made.” So we have what we can get through one of the “exchanges.”

      Coverage of our “Affordable” plan is sharply limited compared to our old plan. During some medical problems last year my doctor mentioned he would really like to monitor some stuff in my blood, but my insurance would only pay for three tests per calendar year, and he was trying to figure out how he could best use them.

      When I got home I had an idea and started searching the web. Diagnostic labs in my area used to be parts of hospitals or dealt only with medical practices. That has changed; you can get anything from a CAT scan to a blood sugar test on your own dime, no MD or insurance carrier needed.

      Prices turned out to be surprisingly reasonable, at least compared to what has appeared on various medical bills. Markup and “special” pricing there, of course. I’m guessing the labs realized there was no regulatory reason (yet) they couldn’t sell their services directly, and, hey, money is money.

      But if you need something your insurance won’t cover, hit the web and start looking.

  7. Rich Rostrom says:

    Did you see the “story” about ERs in Oklahoma being swamped with ivermectin overdose cases? It was a front-page headline in Rolling Stone. And it was a complete and utter hoax.

    When one side in a controversy repeatedly includes blatant lies in their discourse…

    1. Yes. It was indeed a hoax, apparently intended as a dig at Joe Rogan. Monumentally stupid, completely transparent and easily debunked. My hope is that the supposed physician responsible will never again work in a clinical setting. The last thing on earth we need are MDs throwing away their integrity on political slander.

  8. Bob says:

    Jeff, A couple of seemingly unpoliticized articles about ivermectin. This article, by a practicing physician, has a lot of references and it also discusses the FLCCC.

    https://www.realclearscience.com/articles/2021/09/08/lessons_from_the_ivermectin_debacle_793483.html

    this one is from A journalist but discusses a lot of the issues.
    https://nondoc.com/2021/08/26/ivermectin-a-medical-can-of-worms/

    I am interested in your opinion of them if you get to read them.

    1. Excellent articles, though they studiously avoid my primary question: As a well-understood and benign drug, why not let doctors prescribe it to the infected? If it doesn’t work, the patient is no worse off. If it does work, it could be a life saved. No, the research isn’t entirely there. Why does that matter? Again, good god, why do I have to repeat this so much: If a drug without serious side effects at human doses might turn around a fatal infection, why are we still arguing about it?

      A pharmacist who refuses to fill a legitimate prescription for the drug from an MD should have their license revoked for life and do a year in prison. That is practicing medicine without a license, and should be a felony and a career-ending offense. I have little to no patience for that sort of thing.

      My suspicion (and I will not discuss it further here) is that this is a wholly political phenomenon. And as my long time readers know, I consider politics filth.

      1. TRX says:

        > As a well-understood and benign drug, why not let doctors prescribe it to the infected?

        “What qualifications have these people, who have decided they can interfere with a doctor’s lawful treatment of a patient?”

        A few years ago my wife got a notice from her medical insurer; they had “evaluated” her records (which they would have obtained from her doctor, though they refused to acknowlege that) and told her she needed to be on a particular blood pressure drug, and if she didn’t see her doctor and get a prescription for it, they would cancel her medical insurance.

        That is, some bureaucratic flunky half a country away had made himself her doctor, trying to force a prescription on someone he’d never even seen, behind the back of her own doctor. AETNA, if anyone cares.

        She wound up getting the prescription rather than go through the hassle of being dumped and possibly blackballed by the insurers, but her doctor pointed out she didn’t have to take the pills when she got them.

        Most states have medical associations which have very strict definitions about what they consider “practicing medicine without a license,” which usually has official sanction as a matter of civil or criminal law. But somehow bureaucrats and corporate drones get a free pass… funny, that.

  9. Bob says:

    Jeff, I agree with you that people should be allowed to take medicine as prescribed by their doctor. and it is unconscionable that pharmacists refuse to sell legally prescribed medicines. One caveat, though, in the first article the author questions the recent recommendation from the FLCCC to double the dose from that ordnarily prescribed. The FLCCC doctors could not support this change with anything scientific. as always, it’s best to avoid getting infected. Here’s a good lecture by a doctor on ways to build up your immune system:

    https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de_default/index.html?videoId=6160148583001

    1. I haven’t seen a great deal of research on ivermectin’s effects at higher doses than those recommended. I think a lot depends on how long the dosage continues, but that’s just a guess. Downing the equine formulation with a tablespoon might well be damaging. I’d love to know what sort of damage would occur, and what the limiting dose is to trigger that damage.

      I have a hunch that no progress will be made on the ivermectin front. I might not have pursued it as much as I did absent the emergence of significant numbers of breakthrough cases among the vaccinated. The CDC has recently redefined vaccines as providing “protection” rather than the longstanding “immunity.” Anybody with half a brain would understand that this is the CDC admitting that the vaccine does not deliver what was promised. Carol and I got the vaccine five months ago. How much “protection” does that give us today? Nobody can tell me. I suspect that in this case, at least, nobody knows. The vaccine we got five months ago was only approved by the FDA on August 23rd.

      I will watch the video as time permits. (Thursdays are always nutso days for me.) We keep our D levels at the top of the recommended range. We take zinc supplements. We get at least 8 hours of sleep per night. (People get angry with me when I suggest that 5 or 6 hours aren’t enough. It is a puzzlement.) We exercise. We love each other deeply. I’m not sure what else might be done.

    2. I forgot to add to my previous reply: I’m now researching monoclonal antibodies as a COVID-19 treatment. I’ll post what I learn here as I learn it.

  10. Mapleton Reader says:

    The more I read about Covid, the more I realize that most of what we know is still tentative or misunderstood.

    In the misunderstood category: Apparently most people thought the vaccine was a 100% preventative, now we are reminded that the vaccine was tested for reduction of hospitalizations and deaths and breakthrough cases were expected and approved for use under those conditions. The preventative capability is there (as found in later studies) but at quite a bit lower rate. See the quote below:

    “There was so much initial euphoria about how well these vaccines work,” says Jeff Duchin, an infectious disease physician and the public health officer for Seattle and King County. “I think we — in the public health community, in the medical community — facilitated the impression that these vaccines are bulletproof.” https://www.npr.org/sections/health-shots/2021/09/12/1036356773/i-got-a-mild-breakthrough-case-heres-what-i-wish-id-known?utm_source=pocket-newtab.

    On the tentative side I put the euphoria for Ivermectin. In the article you referenced, the authors graded the quality of the research that had been published that they used in their meta study. All but one category were in the low to very low rating for the quality of their data. It was only when all data was combined that the quality rating went up to a moderate quality (see page e9). Many of the individual studies results could not be distinguished from chance events (e.g. the 95% confidence interval included zero). It was only in the combining of the studies that an effect stood out, but again statistical significance may not represent the importance of the effect.

    People have used NNT (Number Needed to Treat) calculation to determine if an intervention is worthwhile. My rough NNT calculation (I may have done it wrong) for this aggregate study is ~20-40 (eg you would have to treat twenty to forty people to on average save one from death. You can compare this with other common interventions at https://www.thennt.com/. Of particular interest, since you have mentioned this before, may be that of use of Zinc to reduce the downtime in common colds with an NNT of 5 and an NNH of 12 (H stands for harm which was basically bad breath, nausea), a much more promising intervention but a single person has only a 20% chance of it helping.

    I understand that two more Ivermectin studies are in the works and it would be nice to see how they turn out, especially if they calculate an NNT.

    1. Thanks for the note on NNT and NNH, which I’ve heard about but have never researched.

      Yes, the vaccine has been way oversold as complete immunity. Now that we have some solid experience with breakthrough infections, the medical community is going to have to admit that it was oversold. Carol and I got it as soon as we could. We’ve begun to wonder if the protective effect is still present, going on six months later.

      Masks were oversold from the beginning. I’ve written quite a bit about that and won’t recap here, except to say that mask mandate dates plotted on case and death graphs for the various states don’t indicate that the masks changed much, if anything.

      As this becomes common knowledge, government health agencies like the CDC will have little if any credibility with the general public. Fauci is a laughingstock. I don’t know how you fix something like that. It may not be fixable.

      What makes me furious is things like CVS pharmacists who have taken it upon themselves to refuse to fill legitimate prescriptions for ivermectin and probably HCQ. (I will never set foot in a CVS store again.)

      What is happening to ivermectin will probably happen to probenecid, which shows promise as an antiviral, with studies underway. (There’s another that I noticed in a news report yesterday, but I was heavily involved in something else and didn’t bookmark it.) I’ll bet other such drugs will turn up. If a well-tolerated drug with no serious side effects at traditional doses shows some evidence of antiviral properties and we refuse to try it with patients who might likely die, what does that make us? I’ll leave that question hanging in the air.

  11. Richard Wagner says:

    There is a site called archive.org, and it has tons of old books, movies, and music, radio tv programs and everything else imaginable. Lately they are cutting back on what’s available due to copyright. But there is still an incredible amount of stuff to be had. Talking about music TONS of it there some 30 second samples, but many full albums of every genre. You may be interested in the Billboard downloads which I believe are still available. I was able to download 1960 thru 1970 songs , each year having over 600 songs that were popular that year. No I do not see it anymore, as I said they have really cut back on what they once offered. It’s sad it was a tremendous source. I’ve even seen more and more lately downloads that were posted by Deadheads in the past being taken down and now being sold. THIS is not what THEY had in mind years ago. It was all free and encouraged to record and swap by the band. They even set up special recording areas for that purpose at concerts. That being said there are still some LIVE recordings on this site (Archive.org) It’s a great sight. You just have to dig.

    Dagwood

    1. I’ve known about archive.org for a long time, and have gotten things from them here and there down the years. Mostly it’s been newspaper stuff and old magazines, some of them very old. At one time (I haven’t checked in awhile) they had every issue of Wayne Green’s 73 Magazine and quite a few (perhaps all) of PC Tech Journal, where I worked from 1985-1986. All that said, I’ve never looked for music there. I’ll budget an hour or to for a scan to see how things stand today. Many thanks for the tip!

  12. Rich Rostrom says:

    “Research shows that ivermectin works…”

    OTOH, Derek Lowe (In the Pipeline https://blogs.sciencemag.org/pipeline/) doesn’t think so. He’s reviewed many of the supporting studies, and his opinion is that these studies are nearly all small, weak, or flawed. I’m not qualified to pass on his credentials. But I’ve read his blog for many years, and I’m pretty sure of several things.

    First, that he is what he says he is: a PhD chemist working in drug development for thrty years.

    Second, that he has a lot of experience in reading and evaluating scientific papers and reports about pharmaceuticals.

    Third, that he has no axe to grind.

    Fourth, that his readers include lots of other veteran chemists who would call him out any time he tried blowing smoke.

    The amount of bullshit flung against ivermectin is a very strong indicator in its favor. But then, what about Lowe?

    1. What if someone higher up at his employer started spreading the word that ivermectin is not to be endorsed for COVID-19? He may not have an axe to grind, but other people at his firm might, especially if they develop drugs that might be antivirals.

      I’ve seen mention of those studies. Yes, they are weak. More studies are currently underway, and I’ll hold off any further opinion until then. Physicians are using ivermectin, and it appears to be especially effective when given as soon as symptoms appear. Other drugs have promise as well, including a few I hadn’t heard of before this morning. I was just sent the following link by one of my readers (Thanks, Bill!) and am currently digesting it:

      https://www.treatearly.org/promising-drugs

      Once again, my question for the medical community is this: If a drug is well-understood and safe dosage is known, why not try it? I find a peculiar reluctance to treat the disease abroad in the medicopolitical world. Physicians prescribe drugs off-label all the time. This sudden sound and fury about using a well-understood drug not FDA approved for COVID puzzles and (in truth) infuriates me.

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