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It’s easy to be confidently wrong with statistics.

Ivermectin improves outcomes in a hospital setting… but only in developing nations.

There’s two confounding effects there! One, you have to be sick enough to be treated in hospital and two, living in a place with high levels of endemic parasite infections.

Ivermectin treats parasites. Parasites are helped by the steroids given for severe infections. Treating the parasite infections does -- demonstrably -- help outcomes, but not uniformly. It's not a prophylactic and it won't do much of anything in developed nations where less than 1% of the population has parasites.

I noticed just how bad these studies were when I took Tamiflu for the worst flu I had ever had. I went from crying in pain to "this feels like a mild sniffle" in less than 12 hours, the fastest I had ever experienced flu symptoms subsiding.

My doctor recommended against taking Tamiful because it was expensive (not really) and that studies showed that its effects were marginal, something like reducing the duration of symptoms by a mere 1/2 a day out of 2-3 weeks.

Reducing the duration... reducing the duration. You see, there's no objective method for measuring symptom severity, so during studies of new medications, they don't. They measure duration. But duration is very difficult to reduce, because of the way the learning process of the immune system works. There's a bunch of sequential processes that occur sequentially.

Tamiflu reduces symptom severity but not duration. So apparently it's "worthless", because it improves only outcomes that aren't measured.

Whether you're crying in pain or not is apparently not objective enough...

> Ivermectin improves outcomes in a hospital setting… but only in developing nations.

Precisely. The only studies I could find that were well done and did show correlation were in developing nations. Turns out that having parasites + a severe viral infection can be bad for you.

However, most intestinal parasites are cleared with a much lighter regimen that many ivermectin advocates were suggesting, some with megadoses that are harmful to the liver. There are other dewormers that are much better - some are even single dose.

There are plenty of studies that have participants rate the severity of their symptoms based on some questionnaire inputs. That they didn’t do it on Tamiflu isn’t reflective of an inability to gather that data, it’s just reflective of the fact that it wasn’t gathered.

And, of course the results aren’t totally objective, but absolute objectivity isn’t needed in all circumstances, particularly not when we have no objective way to measure a thing.

> Tamiflu reduces symptom severity but not duration. So apparently it's "worthless", because it improves only outcomes that aren't measured.

To be fair, that's not really "being confidently wrong with statistics" so much as "being confidently wrong by ignoring all of the statistics that are inconvenient to collect".

> But duration is very difficult to reduce, because of the way the learning process of the immune system works. There's a bunch of sequential processes that occur sequentially.

I'm genuinely very curious for more detail about this. Can you describe what some of the processes are (or better, where I can go to learn about it)?

I read about this process in the Immune book by Dettmer.

Your dendritic cells are specialized to ingest pathogens, rip them apart with peroxide, then push their broken parts into cellular windows all over the dendritic cell's surface.

The dendritic cell is also traveling in the lymph system while this is going on, and upon arrival at a lymph node it searches for a t-cell that matches some part that it is presenting. Once a t-cell is found that matches, that cell activates and clones thousands of copies.

Half of the clones go towards the problem sites (where they trigger "ultra killer mode" on macrophages, among other things), and half stay behind to find and activate b-cells, which will then produce antibodies.

This entire process does take a few days.

https://www.washingtonpost.com/books/2022/02/17/dettmer-immu...

Here are some videos that this group made:

Bacterial infection: https://m.youtube.com/watch?v=lXfEK8G8CUI

Compliment system: https://m.youtube.com/watch?v=BSypUV6QUNw

Measles: https://m.youtube.com/watch?v=y0opgc1WoS4

Rabies: https://m.youtube.com/watch?v=4u5I8GYB79Y

Have we seen studies from India, Peru and a few other countries, japan as well I believe, on ivermectin?

> Equally we have many studies showing that vitamin D helps to reduce risk from covid (hint: it doesn't).

But we know the reason for this; in order to get the circulatory and anti-viral benefits of vitamin D, you need to be exposed to a sufficient amount of UVA. But most folks who are getting a sufficient amount of UVA are also getting enough UVB to make enough vitamin D in the first place, which is what always causes the outcomes of the studies to look equivocal. It's really not that complicated, but researchers keep running fake studies to scam money out of the government and make pharma drugs look more effective by comparison.

I'm sure I'm just misunderstanding, but I don't follow the explanation. What do UVA and UVB have to do with this, and why does that lead to weird results?

The reason covid is dangerous is because it binds overly tightly to your ACE2 receptors on the cells in your endothelium and damages them, and when enough of these receptors are damaged the cells die. This can cause all sorts of issues like autoimmune cascades, blood clots, dysregulation of blood pressure and heart rate, etc.

The reason vitamin D is protective is because when you're exposed to UVA, the vitamin D acts as an enzyme that your body uses to produce nitric oxide in your skin and capillaries. Nitric oxide is directly antiviral, but even more importantly it upregulates your ACE2 receptors. With more ACE2 receptors there is less damage caused when some of them are destroyed, which means you are less at risk for blood clots, problems with your heart and blood pressure, deadly autoimmune cascades, etc.

Basically being exposed to UVB causes your body to produce vitamin D, but once you have the vitamin D you need exposure to UVA for your body to produce nitric oxide, which is what causes the health benefits.

The reason smoking is beneficial for covid btw is because nicotine also upregulates the density of your ACE2 receptors. And the reason women are less likely to die is also, you guessed it, because they have more ACE2 receptors.

Aside from vitamin D, you can also obviously upregulate your ACE2 receptors by taking any other food that causes your body to produce more nitric oxide, and/or by taking any ACE inhibitor. OTC things in this category include garlic and hawthorne, and most of the other foods that are commonly used to lower blood pressure.

Do you know if you can get this beneficial UVA from an artificial lamp?

Is it as good as going outside?

Is it good enough to be a near-replacement or is it even worthwhile as a supplement?

> Do you know if you can get this beneficial UVA from an artificial lamp?

I mean artificial tanning uses UVA lamps. But since you can get UVA even in winter, it's probably safer and more effective just to go outside.

We have many studies showing that hypovitaminosis D is correlated with the risk of severe COVID-19 symptoms. What's not clear is whether there is a direct causative relationship, or if higher blood vitamin D levels are just a proxy for other generally healthy lifestyle factors.

Some studies have shown a protective effect from vitamin D supplementation and others have not. The general flaw in most of those studies has been that they gave all of the study patients the same dosage instead of titrating the dosage to hit a target blood level. There are huge variations between individuals based on sunlight exposure, diet, genetics, and other pathologies so the data is really noisy.

Before making any claims in this area I recommend reading through at least the abstracts of all studies indexed on this page. It's a complex area and we have no definitive conclusions yet.

https://vitamin-d-covid.shotwell.ca/

I wonder if people with higher vitamin D levels are more likely to touch grass. It's good for your immune system to go outside.

People who smoke are probably more likely to smoke outside too with the recency of indoor smoking bans

Probably. That's one of the confounding factors which makes this difficult to study in a really rigorous way.

There is very good evidence that vitamin D in general helps your immune response. It may be that there is a second factor here (another commenter suggested that UVA light was also involved in this process), but the evidence in favor of boosting your immune response by getting sunlight every day is pretty conclusive.

I would be surprised if this study was a vindication of vitamin D, though, rather than a false positive. I think smoking has been shown to generally have negative effects on your overall health (and immune system).

> generally have negative effects on your overall health

smoking tobacco for years, every day, definitely changes your body. Most of those effects are not great in the long run, yet many people start and continue to smoke cigarettes for years on end. The change to lung tissue, mucus membranes, tongue, mouth ecosystem.. are real.. and for an otherwise healthy person, yes, they have to get "tougher".

Vitamin D is obviously necessary, mostly for bone health, but any study of supplementing it for other purposes to people without any symptoms of deficiency have been disappointing.

> Vitamin D2 and D3 fills were associated with reductions in COVID-19 infection of 28% and 20%, respectively

- https://www.nature.com/articles/s41598-022-24053-4

- https://news.ycombinator.com/item?id=33648827

> Equally we have many studies showing that vitamin D helps to reduce risk from covid (hint: it doesn't).

How so?

Because people did a bunch of small, poor-quality studies that seeded to show improvement. But when we did larger scale, properly controlled, randomized studies, where we gave people vitamin D, it didn't show much of an effect.

And yet people persist in different theories why it is so. I don't know the mechanism, but randomized, placebo-controlled studies currently are gold standard in medicine. Their results are much more trustable than many observations studies. Sometimes we cannot do randomized studies and observational studies is all we can do but if if we can and research report only observational studies, I take with a big dose of salt.

I dunno.

The only thing convincing that I could find was that a single high doses of Vitamin D had no effect on outcome. No other studies seemed conclusive.