The Jimmy Kimmel show seemed to be an odd battleground to wage a successful First Amendment war. Apparently the free speech rights of celebrities are more important than those of Israel genocide protestors.1 But another, longer-term, less visible battle has begun between medical organizations and state public health officials who are not on board with the Administration and in particular, its efforts to raise doubts about certain vaccines and medications and even restrict access to some by no longer recommending them. As we saw with Covid shots, the CDC ending its recommendation for an annual jab didn’t just lead to insurers not covering them but major pharmacy chains not stocking them. Now that the CDC has adopted the half-pregnant “personal choice” stance, states are trying to figure out what that means. But the shots do seem to be available again at major pharmacies.2
Soon below, we will discuss in some detail a Wall Street Journal article, The Doctors Building a Public-Health Universe Outside the Government. It describes how key medical associations and some states are bucking the new Federal recommendations, particularly with respect to vaccines. Perhaps even more important, they are seeking to fill a data void that historically had been filled by the CDC.
The latter focus, on being a data warehouse and potentially a clearinghouse/distributor of treatment recommendations, if done well, could give this initiative the chops to indeed constitute a parallel public health system. We had severely criticized Biden CDC head Rochelle Wallensky for clearly not having the experience to run a 32,000 employee organization, whose major duty had been to be an information shop for clinicians. The CDC massively dropped the ball on Covid via its failure to give front-line physicians guidance, particularly treatment guidelines, as it had done very effectively during AIDS.
A second issue is, if states split on vaccination guidelines, which is already underway, how insurers respond. There are already far too many case of insurers refusing to pay when state law says otherwise;3 they seem to make a point of not implementing state-specific requirements well.
But third is that we are also in a period when medical care is being split ever more on class and ideological lines. The big driver of MAHA is very affluent health conscious patients (and more important, the doctors and product providers who cater to them) who are often keen about alternative medicine and fetishistic about food purity, someone most dull normal consumers cannot readily access4 or afford if they could. Many of them reject all or part of conventional medicine. Recall Steve Jobs refusing to get a conventional treatment for his highly treatable pancreatic cancer based on his undue faith that he could beat it with “natural” methods.
Now it is also true that the skepticism among this elite cohort has some foundation, even before the abysmal failure to get adequate data on Covid vaccine injuries and craft vaccination policies that allowed for informed consent.5 Overtreatment and overtesting are widespread in American medicine.
Sadly on the vaccine front, this polarization of views has led to black/white position where neither is optimal. For instance, with the CDC considering changes to the pediatric vaccine schedule, one candidate for removal was the immediately-after-birth Hep B vaccine. Bill Cassidy, the Republican chair of the Senate Committee on Health, Education, Labor and Pensions had forcefully defended this vaccination in recent hearings, with the result that an advisory committee that was expected to vote against it instead postponed its vote.
This story is not as straightforward as one might think. As The Conversation pointed out:
Before the United States began vaccinating all infants at birth with the hepatitis B vaccine in 1991, around 18,000 children every year contracted the virus before their 10th birthday – about half of them at birth. About 90% of that subset developed a chronic infection.
In the U.S., 1 in 4 children chronically infected with hepatitis B will die prematurely from cirrhosis or liver cancer
However, the counter-argument is that ob/gyns test pregnant women regularly, and that it would be comparatively easy to check them for Hep B, and vaccinate only those babies who were at risk.
But that presupposes adequate care. The US already has the highest maternal death rate among affluent countries. 7% of live births are to mothers who received late or no prenatal care. The US had over 3.6 million live births in 2024. 7% of that is 252,000. It’s not hard to imagine, given the gaping holes in US pre-natal care, that a lot of these mothers would not be well tested, if at all.
In other words, I would take the anti-vaxxers a lot more seriously if they pumped aggressively for more extensive prenatal treatment and also educated doctors as well as the women seeing their ob/gyns to get tested for Hep B and administer the vaccine to newborns only if indicated. But I have yet to see any Hep B vax-after-birth objector making this sort of proposal in a public venue.
Nevertheless, what seems to be baked in is even more ideologically-driven practice of medicine. This will only increase patient distrust and confusion, as well as the potential for additional doctor and patient stress due to more fights with insurers over conflicting Federal v. some state guidelines.
Now to key sections of the Wall Street Journal account:
A growing contingent of doctors and policymakers say they have grown wary of federal health guidance since longtime vaccine skeptic Kennedy became Health and Human Services Secretary—and they are forming a parallel public-health universe outside the U.S. government.
Professional medical societies are releasing guidelines that depart from the government’s stance. Governors and state health officials are changing rules to ensure access to vaccines within their borders.
At the nucleus of the effort is an initiative that [Dr. Daniel] Crawford [past president of the National Association of Pediatric Nurse Practitioners ] mentioned as a new trusted expert: the Vaccine Integrity Project, a group of public-health veterans and researchers who have banded together to sift through and analyze the latest studies on vaccines.
The article describes the focus on vaccines and now allegedly acetaminophen (Tylenol) as causes of autism as the bloody flag for RFK, Jr. and his fellow travelers. We’ve described repeatedly that autism is not a post-natal condition. The most likely cause for the rise in autism is changes in criteria, with the result that far more children are classified as autistic than before, and mothers giving birth at older ages.
We then get to the battle in progress:
The resistance has been building since Trump tapped Kennedy and said he told him to “go wild on health.” In May, Kennedy posted a video on X announcing the removal of a Covid-19 vaccine recommendation for pregnant women and healthy children….
In June, Kennedy removed all 17 members of the Advisory Committee on Immunization Practices, or ACIP—the panel that met last week—and replaced them with a team that includes vaccine skeptics. Distrust reached a boiling point at the end of August, when the Trump administration ousted the CDC’s newly sworn-in director, Susan Monarez, following clashes over vaccine policy with Kennedy.
Last week the new ACIP team—including several members appointed just a few days earlier—dialed back the government’s strong recommendation of the Covid vaccine, advising instead “individual decision-making” with a physician, nurse or pharmacist. The advisers also removed the government’s recommendation of a combined vaccine for measles, mumps, rubella and varicella, or chickenpox, for children.
The varicella vaccine is a live virus vaccine which can lead to stronger reactions, including more susceptibility to near-term infection (live virus vaccines, however, also confer a longer-term general immune system boost). And in general, the US is way too gung ho on administering multiple vaccines at once for the convenience of medical practitioners. So spacing them out is not a crazy idea, but no foundation was laid for this proposal.
And to the consequences, of inconsistent responses across insurers, and resistance:
Private insurance plans normally use ACIP recommendations to guide their coverage. Some insurers have signaled they would continue to cover vaccines that were recommended before the changes last week.
Doctors and other healthcare professionals protested the vote outcomes and the new ACIP’s departure from traditional procedures for weighing evidence based on a labor-intensive evaluation of the latest research.
The Infectious Diseases Society of America reacted in real-time. “Scientific evidence continues to strongly support broad COVID-19 vaccination,” the group posted on X. It also posted: “.@SecKennedy presents a clear and present danger to the American people and their families.”….
Early this month, several states broke with the CDC on vaccine policy. Some formed coalitions to come up with their own public-health guidance.
“We have to step up as governors to do this because the federal government is not a trusted partner right now,” said Gov. Tina Kotek of Oregon, one of four states in a newly formed group they call the West Coast Health Alliance. The alliance issued guidelines for the Covid, RSV and flu vaccines for the fall season a day before the ACIP met.
However, the leaders of the Vaccine Integrity Project include Michael Osterhelm of the University of Minnesota’s CIDRAP, which has been a very reliable source of information on Covid….and Rochelle Wallensky. The latter one assumes is meant to bolster confidence among the true-blue. It will backfire with a lot of fence-sitters, particularly if she’s used as a spokescritter. However, the Journal focuses on Osterhelm, highlighting his role as the moving force and suggesting he will be the face of this initiative.
Christy Walton has provided $246,000 in seed funding. The mission so far:
Osterholm and his team canvassed health organizations, medical societies, hospital systems and others, asking: If the CDC and ACIP were to be seriously compromised, what could Osterholm’s group do to help them with vaccine recommendations?
They reviewed the responses with a steering committee made up of public-health leaders, former Republican Gov. Asa Hutchinson of Arkansas and a former Republican congressman. Ultimately, they decided that the best thing they could do was research—the kind the CDC normally provides to these groups.
The story describes at length the credentials and efforts made by other senior member of this effort. And they are already swinging into gear:
In August, a virtual audience logged into a webinar to hear the results of the project’s research on fall shots. Doctors and researchers presented their findings.
“What you’re about to hear is an analysis typically done by CDC,” said Osterholm. The webinar now has more than 9,000 views.
It is way too early to tell how effective this initiative to fill in the chasms that have emerged in CDC information will fare. I don’t like invoking libertarian phrasemaking. But to the right wingers who object to pushback against MAHA, pray tell, how can you oppose competition in the market for ideas?
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1 The lawyers in the house can no doubt make the point more precisely, but it was not Kimmel’s free speech rights that were restricted. Kimmel operating in his capacity as an Disney/ABC employee is subject to whatever his contract allows regarding his content, and one can be confident it does place limits on what he can say. It was ABC that was the recipient of pressure and ABC that initially folded.
2 I don’t like having to weigh in but failing to do so will lead to undue squawking in comments. Yours truly is not a fan of the mRNA vaccines. Among other things, the immunity boost they confer is short lived at best and often not operative due to the continued mutation of the virus. Unfortunately, the fight over this technology has had the effect of strengthening the de facto campaign against the use of Novavax, which is based on a different technology that is older and safer than mRNA and also confers more durable immunity.
Two additional elephants in the room: the fixation on vaxxing has been a big contributor to continued high baseline Covid rates in the US due to failure to implement other preventive measures, above all better ventilation and masking. And the demonization of mRNA as a vaccine is leading to prejudice against its use as a cancer therapy, which is a completely different application.
3 For instance, in the Covid era, New York State required that Covid tests be reimbursed. Recall there was a period when airlines required a recent negative Covid test in order to fly. Cigna refused to pay out on these claims and I repeatedly had to get the state insurance regulator on them.
4For instance, one can meet the cow that will be your later source of beef and even specify what type of grass it will eat before slaughter.
5 I know personally of 2 cases of vaccine injuries that were not reported to VAERS. IM Doc also described, repeatedly and contemporaneously, of how his reports of injuries, which included ones that were severe, in particular a death, were more often than not rejected. My impression that only about 1/3 were accepted. So the VAERS database is not even remotely reliable as a guide to the level of Covid vaccine injuries.
Ostensibly, this is a fight about vaccine treatments. But from a wider angle, the tectonic forces here revolve around authority, bureaucracy, and of course money flows inside an unsustainably expensive medical system. We have states, the federal government, doctors, insurers, and all kinds of advocacy groups battling it out for who controls the health sector and its policies. Compare and contrast to the ostensible battles over ‘anti-semitism’ at universities, a fight for control in another unsustainably expensive sector.
Like a lot of politics today, I think the immediate issues are incidental. The true reason for the battle is that the money has run out and factions are fighting over the shrinking spigots. This is how the process of decline is manifesting in our society, not as a rational, managed husbanding of dwindling resources, but as a heated, irrational, undignified scramble for control and resources. Where the soviets had kalashnikov gunfights on factory floors, americans have ideological melodramas played out with lawyers and pr-men. The end result will be the same, public institutions privatized for pennies by oligarchs.
But but but … the invisible hand is *always* rational in the aggregate. Right? Riiiiiight???
Thanks for this excellent summary. One element still not acknowledged by the public health establishment (which I guess I am part of, or was) is its enthusiastic suppression of speech during the Covid era as Taibbi, among others, is quick to point out. All those rushing to the defense of Kimmel, Colbert, and other Dem cheerleaders conveniently forget that defenders of The Science [TM] thought nothing of de-platforming (or worse) dissidents who often were merely stating truths, e.g., that the vaccines do not prevent infection or transmission. All is forgotten now that the shoe is on the other foot. A direct parallel: horror at Trump’s massacring Venezuelan fishermen, a pass to Obama’s Tuesday kill list.
There was a deliberate agenda – to suppress any information on COVID treatments, and to suppress any negative information on the MRNA vaccines. It was a sell job using the power of the CDC to eliminate competition for the (very profitable) vaccines. Utterly corrupt.
Never attribute to malice what can be explained by stupidity. Our elites have become incompetent across the board. Contact tracing (which would have a made a big difference if done early enough) was hard. Masking, which is accepted in Asia both culturally and due to its success in SARS-1, was treated as unacceptable, due in part to America’s wild paranoia about crime. A second reason was businesses, particularly restaurants, travel-related, entertainment, did not want masking as a reminder that the virus was still out an about. Ventilation was never seriously considered because it was perceived that that would require infrastructure rebuilds, as opposed to Corsi boxes.
I don’t see the big corruption as mainly pharma-driven, save for the downgrading of Novavax and the thin justification for yanking J&J. I see it as operating at a much higher level. Businesses wanted an end to Covid-careful practices, particularly masking and distancing. The vaccines were their magic bullet.
Yes I have to agree after following the whole thing closely in 2020 and 2021. I saw that any video or article or post by doctors no less, that said these might be alternative treatments or do this, was taken taken within the day. And the post originator was slandered and mocked and hounded and in some cases lost their jobs.
I remember HCQ was mocked and derided and no notice was taken of pre-Covid scientific papers saying it was a very safe medicine. And when doctors started wondering if IVM could treat or prevent, I said at the time that this would become the new HCQ, and it did within weeks.
What part of the CDC ‘horse paste’ propaganda was just a mistake? And it was mightily effective as a meme.
It really was a deliberate attempt to mock and muzzle anybody who wondered about it, by the CDC. They were all in on whatever Wall Street wanted, whether people died or not. Paraphrasing a British general in WWI, “whats a few more people (dying)”..
The lines between public and personal health policies are hopelessly blurred in the US. The criteria for success in each of these differ wildly but in the US are assumed to be the same. Just another manifestation of extreme selfishness. They want it all and they want it now, no there is none left for anyone else.
This is a problem in so many multiple ways it is hard to list them all. I will focus on the one that seems most immediate. Not the least problem, is we are apparently going to have in medicine what Franklin called “incubators of freedom.” When each state or group of states now begins to do different things, it may become very quickly obvious that some sacred cows are not so sacred. I am not sure how either side will handle that. I know my profession in its current form will not handle it well at all. You can clearly see this by the smug and arrogant asides that are documented in the post above.
The biggest and most immediate problem I see coming right now is liability.
First of all, there is the credibility problem of the national agencies and health services. I can assure you that it is now officially gone. This is not just a MAGA issue, far from it. Groups like ABIM, AAP, etc, have deplatformed, lied, etc. to the point there is no credibility at all. Only to the PMC do their proclamations matter – even large cohorts in the physician membership are balking at their behavior. Staffing these other new groups and think tanks discussed above with scientists and doctors in the same orbit is basically a non-starter. I mean Rachelle Walensky and Deborah Birx? Come on, man. I would like to have what you are smoking. The leaders of the professions of public health and medicine are failing to realize even today that we are in a whole new world. They have destroyed their credibility and the entire issue in this post is but one part of the consequence.
To me, however, the most important problem with the dual path by selected states is the fact that our implementation and legal systems regarding liability are overlayed with huge layers of federal, state, and even in some cases local law. Something that should be said straight up in this regard – there is no current evidence that current boosters add anything to the picture as far as efficacy. Normally, when new vaccines/boosters come out, my email is loaded with pre-prints, discussions, etc. Now, this autumn, about COVID vaccines – NADA. This has nothing to do with RFK – there have been a few new vaccines this year – and my email had all kinds of data and prints from the manufacturers and the agencies. August would have been the historic month for COVID vaccine info – absolutely nothing. I assume it is because there is nothing. I certainly can’t find anything. So again, there is no evidence that any new boosters will do a thing. As if to torch their credibility further, the IDSA as quoted above says there is – and as far as I can tell we are still in the “the truth is whatever I say it is” mode. Again, no evidence.
The emergency use authorization is now officially over. As it should be. These vaccines play no role whatsoever in cutting down on transmission; ergo, there is no longer any use for them in any kind of “emergent” way. And they have now been taken off the kids’ schedule – as they should be. Things that are given to kids among all groups, should have the strongest evidence of efficacy. These vaccines do not. They are now no longer emergency use and they are not on the kids’ schedule – therefore the liability issues are much much different. In reality, that is a large part of what this entire imbroglio is all about.
So, as a practicing physician, it is already clear to me based on what is happening this fall, how completely different is the landscape with these COVID vaccines. Please note, I am talking here about COVID vaccines, not every vaccine.
My office and my hospital never provided these for the public from day 1 – I thank God every day this is so.
But the patients were very able to get them from local pharmacies. Prior to this year, they were largely covered by insurance. That is no longer the case. They are on average about 300 dollars a dose. Patients on most commercial insurance end up paying it all through their deductibles. The CDC has now made new recommendations that these boosters are not needed in healthy people under 65. This is correct. It is all risk and no benefit for this gigantic cohort. We have this year basically joined the rest of the world in this assessment. The pharmacists will without orders give them to anyone that is over 65, or under 65 with any on a list of conditions. They will not give them to anyone else. I am certain this is orders from headquarters. The unacknowledged secret here is that EVERYONE knows there are safety problems with these things at a low level. Now that there is any question about liability, they are just not interested in deviating from those guidelines. If the patient they vaccinate out of the guidelines has a PE 2 hours later, it may be all on them. So, now there is a push on to have the primary care doctor write an Rx for people outside the guidelines. I will not do so. The guidelines are largely medically accurate – and until IDSA and others produce basic studies showing otherwise, their “because we say so” is just not going to hold up in a lawsuit. And the patients truly do not need it. And we have been given a discussion from malpractice carriers and our employer – we may not be covered should something happen. And guess what – this all applies in Alabama and it applies in Massachusetts – so I assume these states pulling off from the CDC are going to start self-funding liability shields?
This is insane for these states to be behaving this way. It is all going to be interesting to see how this all turns out. Individual providers are simply not going to be too interested in taking on the liability for the entire system. It may become difficult to get malpractice insurance in those states if they continue to buck the system. My guess is that going forward, where I work and many other places across the fruited plain are going to continue to be bombed by MD applicants for positions from these big blue states like CA. In the past 2 years, this has become an increasing pattern.
While I agree with you on the credibility point, I have reservations about your take on the liability issues. Even though I have not looked at it much in the medical context, I have a ton in the securities law, trust law, and corporate liability contexts. I hope lawyers with relevant expertise will pipe up.
Medicine is regulated by state law, hence for instance state licensing of doctors. Insurance is state law regulated, ex of course Federal insurance programs, as in Medicare. Medicaid is operated by states but subject to a lot of Federal provisions.
Private insurance is regulated by states.
So the majority of malpractice suits are tried in state courts. Even the ones taken to Federal court will rely on state law, not Federal law, ex what search tells me are fairly narrow exceptions.
So if Oregon wants to set treatment standards (and it codifies them in law or regulation), doctors, insurers, hospitals and HMOs in that state will need to operate in accordance to that or risk liability.
One area where I do see potential problems is where expert bodies that have traditionally set standards for specialities make recommendations that are counter to what the CDC or HHS recommends. I think this has the potential to weaken as opposed to increase practitioner liability. The reason is that there is a 1994 Supreme Court decision on what is called secondary liability. When corporate officers have hired an expert and he gives advice to them and they follow it, they are not liable. You would think a bad or crooked expert would be liable but the only party that can sue him is his client, not those who suffered as a result of flawed or corrupt recommendations.
Now in the corporate cases, they contracted for advice. I do not know if this principle could/will be extended to dues-paying members of medical bodies that set professional standards. States that were mindful of the issue (doctors and medical organizations being caught between potentially conflicting standards) could also clear this up by specifying which bodies have primacy in their state.
I think this is like any other drug not just vaccines. If you give anything off-label to a patient, and the “label” in medicine has ALWAYS been in our current era the FDA or other agencies, than it is all on you as the individual provider if something goes wrong. Now that can be mitigated if you are crystal clear with the patient and you document in the chart that you have discussed the risks with them. I have done all kinds of medical malpractice cases as an expert witness and this is how it is every single time. There have been a few issues where the state did indeed do something in law ( this has been with devices not so much meds) and it meant nothing because the federal authorities supercede their input. The individual physicians and their insurance companies have lost in multiple of these cases I have been involved in. All of these states now going their own way are going to have to make very specific laws in this regard. They are going to have to have all the data to support their decisions and that is going to be a big problem. Oregon is going to have a very large constitution or statute book if it has to codify each treatment in law. Their legislature is going to be very busy.
I would also point out that we have just been through a 5 year period where the ONLY thing that mattered regarding COVID was what the CDC said that week – no matter how lunatic it may be. On multiple occasions our local and state health officials knew the lunacy – but were completely hamstrung by the kow-towing to the CDC.
And FYI there are states on the other side who also are going their own way. I do not know for sure how many now – but multiple states have made ivermectin OTC. There are all kinds of other issues going on right now. Multiple states have realized that their public schools are going to be toast unless they do something about the vaccine mandates – because the parents are just leaving them, going to private schools, charter schools or homeschooling. And I mean lots of parents in some areas – enough to torpedo the whole system.
I think it really may be an issue. If it were not, I would not be comparing notes with my colleagues around the country on what their malpractice carriers are telling them. This is a very confusing mess right now.
Wikipedia has a long list of meds routinely prescribed off label which amusingly does not include Botox. One entry:
https://en.wikipedia.org/wiki/List_of_drugs_known_for_off-label_use
The “first line” claim is striking.
I’ve had non-FDA approved treatments, namely stem cells. One group had a novel method which I found quite effective but they stopped operating. By contrast, I later used a more “regular” provider, an orthopedist, who harvested adipose and bone marrow cells and injected them into joints. My trainer had sent 2 pro soccer players and a middle aged woman he said was similar to me (fitness enthusiast with shot hips) and he said the results were miraculous.
Mine were disastrous. 2 days of absolutely excruciating pain. Unable to reach down to my feet for four days. Unable to walk without a walker for a week.
He had had me sign quite the waiver BUT he had statements on his site that depicted stem cells as FDA approved, which they were not.
I barked hard and got my money back and did not sign any release of liability (I threatened reporting him to his credit card service as a fraudulent operator, which would have gotten his merchant account cancelled). I did not have time to document my condition with an MD. I’m told had I persisted with an MD letter, his med mal insurer would have coughed up $20,000 w/o any argument.
Point is it seems that a lot of operators who operate outside the FDA regime get full waivers, and don’t rely just on records in their notes of having briefed a patient.
“The CDC massively dropped the ball on Covid via its failure to give front-line physicians guidance, particularly treatment guidelines,”
This is an extremely mild characterisation of the CDC’s behavior – not only failing to issue treatment guidelines, but also actively suppressing information on treatments that had been found effective by practitioners who were treating actual patients. It seems to me rather suspicious, considering that the emergency use approval for the MRNA vaccines is contingent on there being no known treatments. This is Commissar-level behavior by Fauci and Collins, supported in lockstep by a complicit media (of whom Kimmel a key player in their cruel demonization of people resisting the corporate MRNA vaccine agenda).
This COVID operation has revealed the utter corruption of the federal public health apparatus. It is a good thing that their monopoly is being broken up on several fronts, as the article notes. Perhaps we will just arrive at a distributed corrupt system, rather than a centralized one. We shall see.
*Sigh*
The problem with ivermectin is it is cheap and off patent.
No one was ever going to spend the money to do proper studies. The only studies on it being effective were small and underpowered.
And even then it has to be administered in close time proximity to being sick….and a fair # of people didn’t get positive test results soon enough. And as much as ivermectin administered early does speed recovery, I do not know either way if it helps prevent Long Covid or other long-term damage (keep in mind we now have evidence that even asymptomatic cases are harmful).
Having said that, it has such a good safety profile (better than aspirin) that I do not know why it is not available OTC. My NYC MD did Rx it before it became controversial. In Thailand, pharmacists dispense it without even asking why you want it.
c19early cataloged 106 studies in regards to IVM, but I can’t make heads or tails of study design, nor whether c19early is capable of properly evaluating these.
IVM reduces COVID-19 risk: real-time meta analysis of 106 studies (c19ivm ivmmeta)
Today, the only way I’ve found to get IVM is from compatible providers and pharmacies listed on the (formerly) FLCCC web site. I’ve only found it available as a compounded capsule. Early on, in 2021 or 2022, it was possible to get tablets. Oh well. It’s also extremely expensive relative to pre-Pandemic costs.
If I read the table correctly (big if) many if not most of the studies had study or controls or both of <100. Not reliable. Should have been tossed. That is what I mean by "underpowered".
On further checking, this article is not trustworthy. It omits that most of the countries that adopted IVM use for Covid reversed it later when Paxlovid became available.
Second, many of the studies are too small to be included.
Third, we don’t know if they were double-blinded, Any not double blinded need to be tossed.
So this meta-study is crap. IVM may be helpful but this meta study is not credible. The inclusion of so many itty bitty studies is a tell.
The same was true of the much hyped Cochrane meta study on masks. It claimed masks did not work by including many poor quality and irrelevant studies.
For-what-it-is-worth:
Early in the pandemic I came across a paper detailing the antiviral effects on Covid of a bunch of medicines, including ivermectin. Long story short, you can’t safely get a high enough blood level to be effective against Covid virus, but 1% ivermectin cream [Rosasol cream etc, which we prescribe all the time for rosacea] vastly exceeds the concentration needed to kill Covid virus.
On that basis, and knowing that the Covid infection generally starts in the nose then after a few days moves on to other targets like the lungs and cardiovascular system, [in addition to masking] my wife and I started to swab out our noses with ivermectin cream twice a day every day. 5 years later, still no Covid. [We’ve each had about a dozen Covid immunizations].
Oh, I have to see if I can get that here! Thanks a ton.
The name brand in the USA is Soolantra – it is hideously expensive here. This is for rosacea – like WC Fields. It works wonders. It is an antidote to the lie – that this is just a “worm” med. Actually the mechanism of action in this preparation seems to be a very vigorous anti-inflammatory action in the specific areas where the bacteria that cause rosacea run wild. I am told by derm colleagues that they often use this on some severe acne issues as well. I am trying right now to find if it is generic.
Not so sure, at least the US brand, that I would be putting it up your nose. The carrier is for normal skin and not nasal, oral or any other mucosal surface.
The doctor who recommends this is a derm, FWIW, so he presumably can assess the skin issues, and in Canada, so probably way less pricey.
I looked these up.
“Rosasol is a little known combination sunscreen and metronidzaole formulation.”
Metronidzaole is an antifungal. There is no ivermectin in Rosasol. Furthermore:
“Rosasol is no longer being manufactured for sale in Canada”
Soolantra in the U.S. does contain ivermectin. According to the FDA:
“SOOLANTRA cream {1% ivermectin} contains the following inactive ingredients: carbomer copolymer type B, cetyl alcohol, citric acid
monohydrate, dimethicone, edetate disodium, glycerin, isopropyl palmitate, methylparaben, oleyl alcohol, phenoxyethanol, polyoxyl 20 cetostearyl ether, propylene glycol, propylparaben, purified water, sodium hydroxide, sorbitan monostearate, and stearyl alcohol.”
“The absorption of ivermectin from SOOLANTRA cream was evaluated in a clinical trial in 15 adult male and female subjects with severe papulopustular rosacea applying 1 g SOOLANTRA cream, 1% once daily. At steady state (after 2 weeks of treatment), the highest mean ± standard deviation) plasma concentrations of ivermectin peaked (Tmax ) at 10 ± 8 hours post-dose, the maximum concentration (Cmax) was 2.10 ± 1.04 ng/mL (range: 0.69 – 4.02 ng/mL) and the area under the concentration curve (AUC0-24hr ) was 36.14 ± 15.56 ng.hr/mL (range: 13.69-75.16 ng.hr/mL). In addition, systemic exposure assessment in longer treatment duration (Phase 3 studies) showed that there was no plasma accumulation of ivermectin over the 52-week treatment period.”
“Soolantra is made in Quebec, Canada, for GALDERMA LABORATORIES, L.P. Fort Worth, Texas 76177 USA”
https://www.accessdata.fda.gov/drugsatfda_docs/label/2014/206255lbl.pdf
I wonder if one could prepare a solution containing ivermectin for nasal/throat irrigation? I use a netty pot with saline when cold symptoms increase despite zinc, quercetin, and Vit C taken at very first signs. Saline effective against COVID and other upper respiratory infections, but I find it unpleasant to do the netty pot and the saline tends to dry my mucous membranes – so it’s my last resort. So why not an ivermectin solution, delivered by netty pot?
Speaking of noses and Covid, I unfortunately or fortunately have a chronic nasal drip and carry around hankies, looking like a lady from another century – but! I am wondering if this is why I’ve never had Covid (been tested a few times and no symptoms or illness and only one J&J vaccine). My nose runs, not much but it is chronic. I do not usually use any type of spray, don’t even think about it really for the past 3+ decades but that stuff flowing out and getting wiped away may have protected me. Also, I went out A LOT during Covid, to restaurants and whatever was open, keeping my mask on. Anecdotal and gross, I’m sure so pardon me, but anyway why do we not have a nasal vaccine in the US? If we do, it’s not advertised. Would think it makes a lot more sense for obvious reasons and also for kids and others who understandably hate the needle.
Yes – there are simply no sponsors for studies of off-patent drugs. However, I’d like to say a word in favor of practitioners – they also wear white coats and as part of their healing practice they experiment with patients consent to find out what drug and what dosage works for their particular ailment. This is also professional research of the most basic kind, the kind practiced by Jenner, for example, Galen, and Maimonides (ben Maimon). Were these not advancing knowledge and the science of healing? All the trappings of our scientific establishment and yet they came up with “there is no treatment” in the midst of a pandemic when practitioners found several drugs (ivermectin, as you mentioned) which actually saved lives. (Dr. Zelenko claims that of the 3,000 COVID patients he treated he only had three deaths, IIRC). But these doctors and their results were utterly ignored, gainsayed, and even demonised by the public health, scientific, and media establishment. To me, it’s very revealing of the nature of the establishment – it serves itself, while claiming to serve us.
Hopefully decentralisation and competition will actually improve the situation from that produced by the cartels and monopolists who rule us now. It is an uneven and somewhat chaotic process. Hard to plan for outcomes. But, never underestimate the forces of order!
This is a critical point when people but but but about how things are done in whatever other country.
In other news, the giant Corp that owns my primary care is now advising “your local retail pharmacy” for vaccines.
I still have the re-definition of Vaccine during the big covid wave, to make way for mRNA treatmemt, sticking between my teeth and in my craw. Words matter.
Flu shot. Implies the short term efficacy, has its asterisks.
Vaccine: use to be defined as a long-term (permanent) solution against pernicious disease.
Vax and shot used to mean very different things. And yes, some accines are administered as shots.
But, some were in oral gels, or sugar cubes.
Even a Tetanus shot was a shot, not a vaccine. Limited but pretty good 10 year effect.
And tetanus, like many things we know, is NOT something one wants to play with or contract!
I have to say, between this article, and the one on AI, and IM Docs experience with the Big Name School Resident stating that she would trust the “turn the brain off’ AI answer, I am more loathe than ever to get anywhere near new modern monopoly Big Med.
My mileage, this far, is not bad, Y M M V My take is longevity has some very real potential downsides.
Maybe medicine, society, government and the Courts can sort through and get behind the choice and means to a dignified off-ramp.
This seems an indiction that the Voice option -as discussed by A.O. Hirschman- could be abandoned in favor of the Exit option. As always, the need for resources to initiate, build and sustain a viable alternative institutional entity is critical. The lack of resources is an impediment that has historically made public health utterly dependent upon the state -and therefore unable to exercise the Exit option. Here, to complicate things, we may have states exiting their relations with the federal government. Trump’ depravity -once again- is an accelerant.
Interestingly, this might be an opportunity to try to lobby these new organization(s) in regards to improving indoor ventilation and respirator usage. Probably a heavy lift, but perhaps there’d be more receptivity than Biden’s or Trump’s CDC. Sadly Public Health seems more or less degraded into vaccination-only la la land for all public health challenges. Taking determinants of health seriously might perturb the capitalists.
That IS a good idea.
If nothing else, getting healthy ventilation standards updated for Covid safety for new builds would be a win. Expensive retrofits aside, let’s make sure that when we build new stuff we aren’t repeating the same mistakes.
Dr. Roger Seheult on autism and Tylenol (16 minutes)
https://www.youtube.com/watch?v=SGaQw5HyX38
Some readers might be interested to know that the current U.K government policy for the vaccines this fall and winter are that the vaccine will be offered to adults 75+, residents in care homes for older adults, and those over 6 months old who are classified as immunosuppressed (eight categories). There is no blanket recommendation for everyone to get a a covid vaccine.