R&I – FS
When podcast king and comedian Joe Rogan reported that he was ill with Covid-19, a media firestorm commenced. This was no surprise, given the interest the public has in celebrities diagnosed with Covid-19, especially celebrities with a history of expressing ambivalence towards the highly-effective vaccines. However, the headline was not typical at all: Joe Rogan Says He Has Covid, Taking Bogus Ivermectin ‘Cure.’
How did we get here, to a place where Forbes Magazine leads off a celebrity news bit with a slap at a long-used medication, currently being seriously studied for possible benefit against the disease in question? Ivermectin’s is a fascinating story, in a rubbernecking-past-the-highway-accident kind of way; and depressing, too, given the mess that we’re left to clean up. Truly, the story of ivermectin in this pandemic is a cautionary tale of the perils of hubris in science, medicine, and public health. We would do well to learn its lessons.
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Talking About Science Instead of Shouting
Everyone involved in the ivermectin debacle can take responsibilty for their own part, and resolve to do better with the pandemic’s next turn. I wish those with large public platforms, who saw only the promise of ivermectin and not the pitfalls, had been more balanced in their descriptions of the medication, and had sought out counsel from those with expertise that perhaps they lacked. For those of us, myself included, who rose to maximum skepticism at the first message of a “miraculous” drug, I wish we’d behaved better, with fewer eye rolls and haughty put-downs of the studies. Our public health institutions would have done better to be curious and open to novel treatments, and message support over chagrin. The public, both believers and doubters in ivermectin, could have tried harder to seek different viewpoints and interact more civilly with those who disagreed. Social media platforms did not need to stoke the fires of conspiracy theories by censoring those who wanted to tout ivermectin. We all could have done better.
We might get another chance with another potential repurposed, generic medication, the SSRI fluvoxamine. That same TOGETHER trial reported unpublished data showing about a 30% decrease in hospitalization and death among the nearly 750 Covid-19 patients randomized to fluvoxamine, echoing the promise of an earlier, smaller trial. If the data holds up to scrutiny, how will we respond? Already I have seen a snarky social media comment about unvaccinated people showing up with the (exceptionally rare) SSRI side-effect of serotonin syndrome. I sincerely hope we do better this time, and avoid the extremes of hype, dismissal, and censorship – even if some people who have denounced vaccines or touted ivermectin decide to push fluvoxamine.
Yet again, this pandemic has reminded us that science’s attempts to describe reality are fraught with uncertainty. Our greatest gift, when confronted with uncertainty, is to recall that none of us really know the truth. Real intellectual humility in science – not the “I’m humbled to be named coach of this great football program” variety of humility, but truly questioning whether we know what we think we know, and choosing to update our pre-conceived notions regularly — is the smoothest path to advancing medical science. It’s dearly needed now.
As to Joe Rogan: I’m glad the apparently fit, martial arts enthusiastic is doing better. I don’t think he should have promoted the mind-bending array of therapeutics he pumped into his body once diagnosed with Covid-19; to say that combining monoclonal antibodies, prednisone, azithromycin, IV vitamin B3, and ivermectin in a “kitchen sink” approach, was not evidence-based is a great understatement. He also burned through the better part of $20,000 worth of therapeutics, two of them involving IV infusions, and ended up with a case of Covid-19 that sounded more severe than the average breakthrough infection someone might have after a free vaccine. I hope he does not claim to his myriad followers that he got better because of this protocol. But taking some ivermectin? I won’t fault him for it. And I definitely wouldn’t fight him over it.
Gellieman
Article URL : https://www.realclearscience.com/articles/2021/09/08/lessons_from_the_ivermectin_debacle_793483.html