Talk:Ivermectin

COVID-19

It is truly shocking the lengths taken to suppress information about this potentially life saving treatment for covid. The WHO and CDC have sat on this cheap safe potential treatment since August, meanwhile promoting an unproven expensive vaccine. Why? This is another tool in the toolbox, yet only negative articles are allowed on Wikipedia. When did Wikipedia become so politicized? Is this source good enough for mention? https://clinicaltrials.gov/ct2/show/NCT04668469 .2mg / kg is a low dosage proven to be safe, not the nonsense stated in this wiki

— Preceding unsigned comment added by 2601:603:4A80:5870:3910:DA7:2204:1AE2 (talk) 23:34, 25 December 2020 (UTC) 

Incoming edits due to https://www.news.com.au/lifestyle/health/health-problems/coronavirus-australia-ivermectin-antiparasitic-drug-kills-covid19-in-lab/news-story/615c435e56aefc4b704f4fd890bd4c2c for sure.... — Preceding unsigned comment added by 193.116.241.225 (talk) 14:15, 3 April 2020 (UTC)

Right now [48] and [78] are duplicate refs to the same COVID-19/invermectin article. Boud (talk) 23:38, 5 April 2020 (UTC)

Article incorrectly refers to SARS-COV-2 as a negative sense RNA virus. It is a positive sense RNA virus.

On December 8th 2020 Dr Pierre Kory, speaking as a representative of a group of doctors who together have published nearly 2,000 peer-reviewed publications appeared at a meeting of the Senate Homeland Security and Governmental Affairs Committee to plead that the NIH be forced to review the most recent evidence on the use of Ivermectin as a treatment and prophylactic for Sars-Cov-2 and Covid 19. He claimed that the use of Ivermectin on Covid 19 patients had a "miraculous impact", and this description was based on "mountains of evidence that has appeared in the last three months". He pointed out that the NIH's recommendation that Ivermectin not be used outside of controlled trials was made in August 2020, before the "mountains of data" that emerged subsequently. Dr. Kory presented a summary of this data, and the committee chairman Senator Ron Johnson promised to pass this on to the NIH for review.... <https://osf.io/wx3zn/> <https://www.youtube.com/watch?v=Tq8SXOBy-4w> AussiePete56 (talk) 02:46, 15 December 2020 (UTC)

It is okay to publish the truth about this drug now, and the results it has proven for Covid Treatment. Now that the marxists that control Wikipedia and all the internet have defeated Trump, the truth can come out. https://buffalonews.com/news/local/2nd-wny-hospital-ordered-to-treat-covid-19-patient-with-experimental-drug/article_f32339f0-5d01-11eb-b752-4f8966804581.html — Preceding unsigned comment added by 24.116.87.50 (talk) 11:39, 30 January 2021 (UTC)

I would delete this comment per WP:TPG, but perhaps it's instructive to leave it as an illustration of where the pro-Ivermectin boosterism is coming from. Alexbrn (talk) 11:48, 30 January 2021 (UTC)

Unreliable. Would need WP:MEDRS. Alexbrn (talk) 06:17, 15 December 2020 (UTC)

Here is some more reliable evidence on the effectiveness of Ivermectin in preventing and treating Covid-19 . https://covid19criticalcare.com/wp-content/uploads/2020/11/FLCCC-Ivermectin-in-the-prophylaxis-and-treatment-of-COVID-19.pdf .

https://c19ivermectin.com/ . AussiePete56 (talk) 05:40, 21 December 2020 (UTC)

Unreliable. Would need WP:MEDRS. Alexbrn (talk) 05:43, 21 December 2020 (UTC)

I dispute the claim of "unreliable" by Alexbrn since the two articles are secondary reviews of others' research and therefore qualify as reliable as per the WP:MEDRS guidelines. I notice that the "unreliable" tag was applied to this page three minutes after the links to the two review articles were published - three minutes isn't enough time to read even half of one of the reviews, let alone properly evaluate both. The charge of "unreliable" is therefore itself seemingly unreliable AussiePete56 (talk) 14:47, 21 December 2020 (UTC)

We need secondary sources in reputable medical journals (or medical textbooks, etc). These are obviously not that, and appear to be self-published web sites. Alexbrn (talk) 14:59, 21 December 2020 (UTC)

Using medical journals , textbooks etc is ideal, but as the guidelines state, "It is a generally accepted standard that editors should attempt to follow, though it is best treated with common sense, and occasional exceptions may apply." We are currently in a "war" with a virus which is currently killing nearly 14,000 people a day worldwide - a number which is increasing every day. Information which can save lives is desperately needed. As per guidelines, "Wikipedia's articles are not meant to provide medical advice. Nevertheless, they are widely used among those seeking health information." I maintain that this is clearly a time where an exception to the normal stringent editorial standards should apply. Ivermectin has been taken 3.7 billion times over 40 years and its safety is not in dispute - the only unknown is its efficacy. There is after all, no alternative medicine for Covid 19, and even ventilation in hospital will allow about 23% of patients to die. Surely the "mountains of evidence that Ivermectin works miraculously on Covid 19" that Dr Kory and his team refers to should be mentioned on these pages to allow access to as many medical professionals as possible the information they need to make their own assessments on how to best treat their patients. AussiePete56 (talk) 15:53, 21 December 2020 (UTC)

The current situation is all the more reason why we used the best quality sources, which is why general sanctions apply for this topic requiring WP:MEDRS, of which you have been notified. What you're proposed to add is dodgy (as the word "miraculous" should clue you in to at once). We already cite high quality WP:MEDRS: PMID 33227231. I shall not respond further unless new sources are proposed as this is a clear-cut case. Alexbrn (talk) 16:03, 21 December 2020 (UTC)

My point is that the information being presented in these reviews IS the "best quality source" available - ie, the very latest real-world studies demonstrating life-saving treatments. Alexbrn didn't even read these studies. 6% hospital deaths versus 23% are the results achieved. Some of these studies lack peer-review which typically takes months - time that these 14,000 people who are dying daily no not have. To give priority to ideological purity over thousands of daily deaths is insane and inhumane. To repeat a point that Alexbrm ignores - 3.7 billion doses of Ivermectin has been taken over 40 years. It is safe. There is only potential benefits to using it and strong and growing evidence supports such use. Allowing this information to be available, together with suitable disclaimers, is the appropriate and responsible decision. AussiePete56 (talk) 23:26, 21 December 2020 (UTC)

"In November 2020 a meta-analysis found only weak evidence of benefit.[89]"

I propose changing this vague and ambiguous sentence to, "In November 2020 a meta-analysis found a 47% reduction in mortality (statistically significant) for Ivermectin-treated Covid-19 patients, however, due to a relatively small sample size (629 patients) the evidence is considered weak. [1] AussiePete56 (talk) 05:40, 25 December 2020 (UTC)

Alexbrn The actual meta-analysis linked as reference is much more positive as to the effectiveness of Ivermectin that what is stated in this wiki: There is only very weak evidence of ivermectin's benefit when used as an add-on therapy for people with non-severe COVID-19; there is no evidence for people with severe disease.[85]

Why not just quote the conclusion of the actual meta-analysis? Ivermectin is an established drug with a long history of clinical use and with minimal safety concern. Recent observational studies have reported the effectiveness of this drug as add-on therapy in patients with COVID-19. Our meta-analysis also supports this finding and suggests the modest utility of ivermectin in reducing all-cause mortality and improving clinical outcomes. Currently, many clinical trials are on-going, and definitive evidencefor repurposing this drug for COVID-19 patients will emerge only in the future. — Preceding unsigned comment added by Adriaandh (talk • contribs) 17:48, 31 December 2020 (UTC)

}}

"The National Institutes of Health recommend against the use of ivermectin for COVID-19". In the interests of full disclosure, I propose amending this to, "The National Institutes of Health recommended against the use ivermectin for COVID-19 in August 2020". Since then, dozens of research reports on Ivermectin and Covis 19 have been released. Putting a date on the recommendation flags for the reader that it does not necessarily encompass the most recent research. AussiePete56 (talk) 17:36, 1 January 2021 (UTC)

This would be possible is it was also added "... and is still current as of 2021", because of course such guidelines are under constant review. And we wouldn't want to give the false impression that the NIH is somehow outdated, now would we? Alexbrn (talk) 17:41, 1 January 2021 (UTC)

I would accept your suggestion on a "better than nothing" basis. Do you really think that the NIH's position is not outdated Alexbrn? You always exude the attitude that conformity to authority equals virtue. Do you have any theories on why the NIH, CDC and FDA allocated zero public funds to the investigation of re-purposing existing drugs against Covid 19, and instead went "all-in" on developing novel vaccines? I'm not cynical, but cynics would say, "Because that's where the money is." Many billions of dollars. And the vaccines don't work on patients who already have the virus. And it will take about a year for 80% of first-world countries to get vaccinated, and many more years for third-world countries.

So we're up to 15,000 people per day dying from Covid 19 at the moment, most of whom could be saved on the evidence of dozens of studies that the NIH ignores.... AussiePete56 (talk) 14:37, 2 January 2021 (UTC)

Please do not use Talk pages to push conspiracy theories. As multiple editors have now advised you, WP:FOC. Alexbrn (talk) 14:46, 2 January 2021 (UTC)

We should try to avoid turning this into a discussion board, and try to focus on reporting what our sources say. Since regulatory bodies routinely change their positions, their prior positions by their own admission were outdated. Teishin (talk) 14:51, 2 January 2021 (UTC)

Alexbrn, you have repeatedly referred to the 28 studies which each independently found that Ivermectin works to alleviate Covid 19 illness as "fake" - that sounds like a conspiracy theory to me. AussiePete56 (talk) 14:50, 3 January 2021 (UTC)

Something trying to pass itself off as a journal article, when it's just a self-published web site, is a "fake" journal article. As noted, people sharing it on Facebook get banned. Maybe Wikipedia should do the same. Alexbrn (talk) 14:55, 3 January 2021 (UTC)

I have no skin in this game. I just saw this chart stating far lower cumulative deaths from COVID-19 in the Mexican state of Chiapas compared to all the others and how that correlates with it being alone amongst them in using Ivermectin: https://twitter.com/Covid19Critical/status/1347721731272830976 (That mention of Ivermectin brought me here.) The correlation may be something which can be readily verified or disproved as it claims to be from public official data and the outcome mentioned on the main page. ― Ralph Corderoy (talk) 12:08, 10 January 2021 (UTC)

I'm late for this discussion. c19early, c19study, c19legacy, c19ivermectin, ivmmeta, c19hcq, hcqmeta, and others, use grossly incorrect methodology, producing biased results with bizarre p-values. They are still being used as "evidence" by political groups in Brazil to spread medical disinformation. (talk) 01:23, 26 April 2021 (UTC)

Does the recommendation from the ministry of health of India count as a reliable source ? https://www.icmr.gov.in/pdf/covid/techdoc/COVID19_Management_Algorithm_22042021_v1.pdf I hear also IVM is used in Mexico city now https://mexicobusiness.news/health/news/ivermectin-controversial-covid-19-drug-used-mexico-city Isn't it enough to say at least that there is no consensus on efficacy? We don't live in Disneyland, health agencie's recommendations in rich countries account for billions in drug purchasing.How could there be no influence when there are choices like $1000 remdesivir vs $5 hcq or ivermectin ? In countries with lower financial resources there are also bright people, but less pressure not to reuse existing drugs.— Preceding unsigned comment added by Pweltz (talk • contribs) 15:34, 28 April 2021 (UTC)

Reliable for their view, but since the Indian govt. is a busy hive of quackery and pseudoscience not reliable for any rational assertion about reality. Alexbrn (talk) 15:50, 28 April 2021 (UTC)

Could we just remove the "misinformation" claim? "A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness" https://pubmed.ncbi.nlm.nih.gov/33278625/ HaraldTheBlue (talk) 23:32, 6 June 2021 (UTC)

Hospitalized patients only, says the study. Not for mild disease, at home. And it concludes with Larger trials will be needed to confirm these preliminary findings. 72 participants is quite a small sample indeed. --Fernando Trebien (talk) 03:47, 7 June 2021 (UTC)

The link shows that it isn't misinformation and the source for the 'misinformation' claim comes from a patient group on social media. The reference to 'misinformation' needs to be removed if this page is to conform to the neutrality rule.

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Note the imprecise wording of the Invermectin COVID-19 Wikipedia entry: "As of January 2021, the U.S. National Institutes of Health COVID-19 Treatment Guidelines state that the evidence for ivermectin is too limited to allow for a recommendation for or against its use." This wording does not make clear that ivermection is now a treatment option for COVID-19. In fact, the “neither for nor against” NIH classification is the "recommendation given to monoclonal antibodies and convalescent plasma, both widely used across the nation." [2] Unfortunately, this clarification can not be made because the COVID-19 section is locked down for edits even from autoconfirmed users--which is contrary to the edit notification for that section. I hope this is just a mistake and not a tragic example of "cancel culture" impacting Wikipedia. — Preceding unsigned comment added by Swisswiss (talk • contribs) 18:48, 20 January 2021 (UTC)

Concerns about reporting of study results:

This statement is false: A randomized controlled trial (RCT) of 24 patients with non-severe COVID-19 and no risk factors found no difference in PCR-positive nasal swabs nor in viral load between patients who received ivermectin and those given placebo. I quote directly from the study: the median viral load for both genes was lower at days 4 and 7 post treatment in the ivermectin group with differences increasing from 3-fold lower at day 4 (p = 0·24 for gene E; p = 0·18 for gene N) to around 18-fold lower at day 7 (p = 0·16 for gene E; p = 0·18 for gene N)

The study DID find a difference - it was just not statistically significant based on the threshold chosen. Even the PCR found a difference - RR 0·92. If you want to write something negative based on the results of this extremely small study, then write that it was underpowered to find statistically significant difference. Because every single endpoint found a difference showing benefit of Ivermectin use.Adriaandh (talk) 09:53, 10 February 2021 (UTC)

• I found the same error. It is interesting that the one paper cited in support of ivermectin's ineffectiveness actually does a pretty good job selling its beneficial effects - note that, on top of the difference in viral load that did not meet the significance threshold, it did find a significant reduction of symptoms. Whether or not the experimental design designated this as a "primary finding" would seem to me to have no bearing on the scientific merit of the finding, or its relevance to the text of this article. 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:08, 18 May 2021 (UTC)

• • Not to worry, the editors simply deleted all mention of this study rather than reckon with their error.2600:1700:7CC0:4770:C47C:4E3C:EC7D:831 (talk) 20:34, 18 May 2021 (UTC)

The section on Covid seems to be highly subjective

The section on Covid seems to be highly subjective and possibly inaccurate. I believe it should be changed to more neutral and objective as Wikipedia standards dictate - removing the word "misinformation" and to change "no reliable evidence exists" to "no large scale studies have been done."

All research that has been performed to my knowledge has shown that ivermectin is effective at treating Covid. A meta-analysis of four papers, accessible through the NIH, shows a .02 p value that adding ivermectin to a treatment regimen leads to improved clinical outcomes.

While they do stipulate that the quality of the individual papers included in the meta-analysis is "very low," they go on to say "currently, many clinical trials are on-going, and definitive evidence for repurposing this drug for COVID-19 patients will emerge only in the future."

As far as I am aware, all subsequent papers have all found that ivermectin was effective in treating Covid. This website that performs a real time meta-analysis of all papers (as of comment, 55 studies) shows a p value of disproving the clinical results as p = 0.000000000000043.

While there are no large scale studies of ivermectin as of yet, there is nothing but positive research (again, as far as I know) that show that it is effective. Therefore, "misinformation" does not objectively apply to this situation. It should only be applied when we have reliable information that the claim is false. On the contrary, the only reliable information we do have is that the claim is true, though I grant that it is far from settled science due to lack of large scale studies.

Further, while any of the smaller studies on their own might not be considered "reliable," surely a meta-analysis of 55 studies demonstrating a remarkably small p-value, could arguably considered reliable. Notwithstanding the lack of a large scale study, the meta-analysis data should disqualify the descriptor "not reliable" from being used by an objective source such as Wikipedia. 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 08:45, 16 May 2021 (UTC)

ivnmeta.com is not a reliable source. This article cites several reliable sources. Alexbrn (talk) 08:57, 16 May 2021 (UTC)

I believe my overall point stands even with only the first source. The authors find a statistically significant beneficial effect in their meta-analysis of 4 papers (though they stipulate the individual papers to be of very low quality) and say only time will tell when there is more of a body of evidence shown.

As others have pointed out, since the publication of that paper, many other papers have shown significant results in favor of ivermectin, even if not all 55 papers included in the website you mention are legitimate (I wonder, which aren't? I genuinely don't know).

My argument against the use of the word disinformation therefore stands, as this is an active ongoing area of research (and I might add, the overwhelming body of evidence, however inconclusive, points to its efficacy).2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:09, 16 May 2021 (UTC)

Things have moved on since November, but in fact we already cite that review (actually, at COVID-19 drug repurposing research#Ivermectin which is transcluded here). The line from ivermectin proponents was for a long time that high-quality evidence of benefit was just around the corner. It hasn't appeared, and ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing.[3] There's not much more Wikipedia can do than report the caution from our best (WHO, FDA, NHS, etc.) sources and the shame of the misinformation that's been spread. Alexbrn (talk) 09:15, 16 May 2021 (UTC)

Why is science based medicine deemed reliable here and not the other websites of individual physicians? Again, I am relatively new to this issue and am trying to understand the terrain here. As for "ivermectin advocacy has passed into the realm of quackery, antivax, COVID denial and conspiracy theorizing," this again reads as highly subjective.2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:24, 16 May 2021 (UTC)

We don't cite that SBM article (there's no need when we have top-level WP:MEDRS), but SBM is regarded as a reliable source for fringe medical claims (see WP:RSP). I'm not sure what you mean by subjective. If you want to read about the sociological aspects of ivermectin/COVID advocacy - which Wikipedia does not really cover - there's plenty of reading to be done, starting here maybe? As far as (lack of) evidence of efficacy goes, we have unimpeachable sources already cited. Alexbrn (talk) 09:32, 16 May 2021 (UTC)

Your linked source (New Statesman) does not address any of the points I am making RE subjective use of "disinformation." It reiterates that the papers have been included in meta-analyses are low quality, and that a large scale trial at Oxford is underway. Where is the sufficient objective basis to label this issue "misinformation?" 2600:1700:7CC0:4770:3CB4:489B:79C1:24A7 (talk) 09:46, 16 May 2021 (UTC)

The subjective/objective distinction, if meaningful anywhere, is not meaningful for the purposes of reflecting what reliable sources say. By any measure the claim that ivermectin is a "miracle cure" or indeed effective at all, is misinformation. Reliable sources contain that knowledge, Wikipedia reflects it. That is the function of an encyclopedia. There is more detail on the misinformation at the COVID-19 misinformation article. Alexbrn (talk) 10:10, 16 May 2021 (UTC)

"By any measure the claim that ivermectin is a "miracle cure" or indeed effective at all, is misinformation." According to the WHO, no conclusion has been reached on this question. Certainly an investigator who finds an effect, in an ongoing worldwide clinical effort, in not spreading misinformation by reporting their finding. Certainly the WHO's own analysis that no conclusive finding has been reached, should outrank a non-SME deeming ivermectin benefits to be "misinformation." I also question why the European Medicines Agency recommending against its use, is being cited over the WHO, which does not recommend either for or against.2600:1700:7CC0:4770:D89C:66EE:D017:775B (talk) 21:06, 16 May 2021 (UTC)

From the New Statesman article linked above by Alexbrn as a reputable source - "at the moment the only scientific response is to withhold judgement." This language far more accurately describes the current state of the science as far as I can tell. I remain confused as to why "misinformation" is an accurate characterization of the potential benefits of ivermectin, and further why it should be included in a single-sentence synopsis on the topic - seems to me that something more akin to the official WHO language would serve to inform readers better, rather than arbitrarily shepherd them towards adopting a subjective opinion RE misinformation. 2600:1700:7CC0:4770:D89C:66EE:D017:775B (talk) 00:04, 17 May 2021 (UTC)

The WHO is already cited. Claims that ivermectin is an effective COVID treatment are misinformation. A statement that we should "withhold judgement" would not be; but that's not what the advocates are saying. That's the reality according to the sources. Alexbrn (talk) 05:48, 17 May 2021 (UTC)

Surely, under your definition, misinformation is spread about every drug known to humanity. The question is, what is the most informative way to present the relevant information in a one-sentence synopsis? Is it to debunk a notion that the reader may or may not have prior to reading the article, in a manner that easily could lead others to a false understanding of the scientific record - ex. "Wiki says Ivermectin being effective against Covid is misinformation, so this must mean it is not effective!" Or is it to provide a simple summary of the science - "research to ascertain effectiveness is underway"? In my opinion, the current language creates a false impression in the reader and endeavors to "correct" rather than inform. If use of "misinformation" is strictly necessary, then more specificity as to what is misinformation and what is not would seem to me to be of the utmost importance.2600:1700:7CC0:4770:8C96:D3CD:38B2:2270 (talk) 18:51, 17 May 2021 (UTC)

"There is no evidence it is effective" obviously means just that. We are not responsible for any misunderstandings by people who cannot read. There are people out there who tell you it works against COVID, and Wikipedia needs to tell you that those people pulled that information out of their own ass. I don't know what is so difficult about that. --Hob Gadling (talk) 05:39, 18 May 2021 (UTC)

That is not an accurate characterization of my argument. Allow me to point out what exactly I find misleading: "During the 2020 COVID-19 pandemic misinformation was widely spread claiming that ivermectin was beneficial for treating and preventing COVID-19. No reliable evidence exists to back up such claims." Notwithstanding the fact that a paper cited in the body of the article (deemed reliable) does offer evidence that ivermectin is beneficial in the treatment of Covid, labeling the claim "misinformation," which indicates that the information is false, could indeed lead a careful reader to conclude that the information is not simply unsubstantiated (again, I would argue against that claim as an aside) but indeed that it has been falsified (incontrovertibly not the case). The word "misinformation" in the context of this sentence simply is not merited in my view. 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 05:56, 18 May 2021 (UTC)

We assume our readers are reasonably intelligent. Any reader who was provoked into imagining something nonsensical about the falsifiability of a drug's efficacy would not be a "careful reader", they'd be daft. You seem to be pursuing some kind of Truth™ but Wikipedia's purpose is to reflect reliable sources. Alexbrn (talk) 06:05, 18 May 2021 (UTC)

Nonsense. Equivalence with a placebo could be easily determined by an experiment designed towards that end. 2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:14, 18 May 2021 (UTC)

I will also repeat an argument earlier for which I have heard no response. Why should a researcher, accurately reporting their findings, deemed to be spreading "misinformation?"2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:20, 18 May 2021 (UTC)

The is good evidence, or there is not. We're in the latter circumstance. It's likely that the True Believers will always find something in any experiment that they say supports their Truth™, no matter how unencouraging it is. Anyway, without new sourcing I think we are done here. Your question has no relevance to our article text. Alexbrn (talk) 06:22, 18 May 2021 (UTC)

The article text improperly uses the word misinformation. That is the relevance of my question. As for whether there is good evidence or not, do you now believe the paper that is currently cited by the article is no longer "good evidence," now that you have been informed that it contains significant evidence of benefits of the use of ivermectin in treating Covid?2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:25, 18 May 2021 (UTC)

Per WP:GEVAL we need to make sure misinformation (e.g. "wonder drug") is properly identified. This is policy. There is no good evidence per the WP:MEDRS sources we cite; this is a the sourcing standard for biomedical information on Wikipedia. If you have a specific proposal, make it, but this is just looking like a prolonged waste of time so I shall not respond further if no concrete policy-based proposal is made. Alexbrn (talk) 06:33, 18 May 2021 (UTC)

I feel I have (more than) adequately detailed my concerns over the term "misinformation" as it is deployed currently in the summary of ivermectin vis a vis Covid. Certainly specifying what is misinformation (ex. "miracle cure" has clearly been established by the research not to be accurate) and what is not (the open prospect that it might be deployed as a beneficial treatment and/or preventative measure) would be a good way to begin addressing these concerns.2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 06:46, 18 May 2021 (UTC)

No, because your "open prospect" narrative is a WP:PROFRINGE one out of alignment with the way in which decent sources refer to the matter. Alexbrn (talk) 06:52, 18 May 2021 (UTC)

It aligns perfectly with the language within the paper currently cited in the article (I was not the one who deemed this paper reliable). Regardless, if the term "misinformation" must be used (I wonder why this is the case), it certainly should be directed at a specific target. What exactly is misinformation?2600:1700:7CC0:4770:200A:7D27:DC73:41AB (talk) 07:01, 18 May 2021 (UTC)

You have no idea how ironic what you're spouting is. 2402:B801:2867:E200:C5E8:96E4:1417:F9CC (talk) 09:36, 23 May 2021 (UTC)

Miracle Cure or Cruel Hoax (May 6th 2021).Moxy- 21:52, 18 May 2021 (UTC)

If the term "miracule cure" indeed is what is referred to by "misinformation" in the introductory sentence, then that should be specified. As it stands, the vague application of misinformation appears to be directed towards the idea that ivermectin is beneficial in treating covid - a conclusion which by no means is reflective of the current state of the science. Further, I would question why fact checking the "miracle cure" claim would warrant "lede" status, but I am not willing to die on that hill ;) 2600:1700:7CC0:4770:C47C:4E3C:EC7D:831 (talk) 22:14, 18 May 2021 (UTC)

MEDRS Dhama et al (2020) on Ivermectin and Covid

From p. 29 of this MEDRS in one of the best journals (Clinical Microbiology Reviews):

Recently, another FDA-approved drug, ivermectin, was reported to inhibit the in vitro replication of SARS-CoV-2. The findings from this study indicate that a single treatment of this drug was able to induce an 5,000-fold reduction in the viral RNA at 48 h in cell culture. One of the main disadvantages that limit the clinical utility of

ivermectin is its potential to cause cytotoxicity. However, altering the vehicles used in the formulations, the pharmacokinetic properties can be modified, thereby having significant control over the systemic concentration of ivermectin (338). Based on the pharmacokinetic simulation, it was also found that ivermectin may have limited therapeutic utility in managing COVID-19, since the inhibitory concentration that has to be achieved for effective anti-SARS-CoV-2 activity is far higher than the maximum plasma concentration achieved by administering the approved dose (340). However, ivermectin, being a host-directed agent, exhibits antiviral activity by targeting a critical cellular process of the mammalian cell. Therefore, the administration of ivermectin, even at

lower doses, will reduce the viral load at a minor level. This slight decrease will provide a great advantage to the immune system for mounting a large-scale antiviral response against SARS-CoV-2 (341). Further, a combination of ivermectin and hydroxychloroquine might have a synergistic effect, since ivermectin reduces viral replication, while hydroxychloroquine inhibits the entry of the virus in the host cell (339). Further, in vivo studies and randomized clinical control trials are required to understand the mechanism as well as the clinical utility of this promising drug

I propose we edit the article to acknowledge that this source says "ivermectin, even at lower doses, will reduce the viral load at a minor level.". Forich (talk) 02:40, 24 May 2021 (UTC)

[4].Moxy- 04:35, 24 May 2021 (UTC)

The source is old in comparison to later good ones, and a WP:REDFLAG flies. It does not raise confidence that the text about "immune response" is cited to a single letter, and misrepresents it (by boosting a "can" to a "will"). We already say why pre-clinical work gave rise to the notion that ivermectin might have utility as a treatment. Alexbrn (talk) 10:24, 24 May 2021 (UTC)

ivmmeta and all similar domain names linking to the same site

Tagging in user:Aaronmhamilton to this discussion about sites like ivvmeta.com. These are not MEDRS, and as has been discussed above several times, the findings on that site are not a legitimate reason for any edit on this page. To restate my reasons for this revert:

For 1, you can't change the wording and keep the same citation, that's misleading. Because the citation does not support that claim. For 2, there is actually a great deal to distrust about the website this editor linked. It is not a MEDRS. It is entirely anonymous, no one knows who runs the site or if they actually have any credentials to back up the ad-hoc analysis they're doing.

As a medical researcher and scientist, I can tell you they break a lot of the golden rules of meta-analysis. But you don't have to trust me on that, and you shouldn't, because that's not how wiki works! Trust the RS: There are peer reviewed articles (and several much more informal take-downs that themselves link to MEDRS) detailing exactly what is wrong with that website and how they do their systematic review, and where they go wrong. More than anything, they have cherry picked which outcomes to use from each study, which "informal" studies to include, which patients to include, and they have combined data that is in different settings, different types of patients, all in a way that makes the data look shiny and good for their preferred outcome. You will find that this site differs in conclusion from basically anything published in a reputable MEDRS. There's a reason for that. And it isn't a conspiracy, it's that the scientific community tends to agree on how systematic reviews are meant to be performed. this ain't it, chief. Overall it is a shame that site is so terrible in its methodology, because it has fabulous style. Style points, unfortunately, are not worth much in science. --Shibbolethink ^{(♔ ♕)} 02:15, 25 May 2021 (UTC)

When you bring an inappropriately sarcastic and derisive quip like "this ain't it chief" to the table, it is clear that it's personal to you, and honestly, that you haven't evaluated the specific claims of your citations on the matter. I guess I'll revisit this when there are more cold bodies. Aaron Muir Hamilton <aaron@correspondwith.me> (talk) 03:33, 25 May 2021 (UTC)

Hahaha, no no no, I apologize if it came off that way. I just am tongue-in-cheek about most things. I meant no harm by my comments, you are not the first and you will not be the last to find that site trustworthy, and I spend my time criticising data, not people. Like I said, it is visually very impressive. But I judge badly done science especially poorly, and that site needs some work in its understanding of the levels of evidence re: Greeenhalgh. It's particularly flawed methodology to group RCTs and non-RCTs together in a systematic review, as it degrades the quality of the conclusions you can draw from it. In evidence-based medicine, conclusions are drawn based on what the highest quality available evidence tells us, not the plurality of evidence. One million unblinded case reports do not surpass one RCT. And, as wikians, we are supposed to take what the most reliable highest quality systematic reviews of RCTs say, and restate it for the public. Anyway, when you're ready to come back and talk about it, there's always plenty of people around here to talk about it with! --Shibbolethink ^{(♔ ♕)} 05:10, 25 May 2021 (UTC)

References

Ah, yes. Saying one thing in the style of "this ain't it chief" invalidates all the solid reasoning by the same person. That way of thinking is similar to the fallacy fallacy, but not quite the same. If the way you judge an argument is that superficial, it's no wonder that you cannot tell that site is a bad source. It mimicks the style of science, and Shibbolethink did not, and style trumps content for you. Well, as Shibbolethink said, that is not how Wikipedia works. --Hob Gadling (talk) 09:04, 26 May 2021 (UTC)

National guidelines

Currently the article contains the positions of the WHO, CDC, European Medical Agency (EMA) whose consensus is that ivermectin should not be used for treating covid until clinical trials are done. Also, the usage of ivermectin in a number of countries in Latin America is mentioned, together with the recommendations of the relevant bodies. Recently India's health ministry has published guidelines recommending the use of ivermectin for treating some Covid patients. The questions are

1. Should the positions of national public health agencies on ivermectin be mentioned in this article?
2. If yes, which public health agencies? Only CDC and EMA or also of other major countries?
3. If no, does this information belong to another article? Alaexis_¿question? 19:54, 25 May 2021 (UTC)

To be clear, the question is not about the effectiveness of ivermectin against COVID (as far as I can see the consensus is that there is no proof that it works) but about the notability of the recommendations issues by various national and supra-national bodies. Alaexis_¿question? 19:57, 25 May 2021 (UTC)

Survey

• Nonsensical question. EMA and CDC are not "countries". Does the OP envisage a list of countries and if so how many? 30? 40? 50? Alexbrn (talk) 19:57, 25 May 2021 (UTC)

  CDC is a public health agency of the US, while the EMA is the EU's agency in charge of evaluating medicinal products. This is exactly what I meant by national and supra-national public health agencies. Alaexis_¿question? 20:01, 25 May 2021 (UTC)

  Just saw that I didn't answer the question. If and when all the countries in the world publish their official guidelines, I would summarise it "The position of the CDC and EMA and X other countries, including BigCountry1, BigCountry2, is A; the position of health agencies of Y other countries, including BigCountry3, BigCountry4, is B." If X >> Y and the minority position is not held by major countries, we can ignore it and only write about the mainstream one per WP:FALSEBALANCE. But it's very hypothetical, now we only have a handful of countries and we can easily deal with new information when it comes. Alaexis_¿question? 12:24, 27 May 2021 (UTC)

• Another pointless endeavor. Just give up already, only one view can be reflected on this topic. Adriaandh (talk) 09:17, 27 May 2021 (UTC)

  I understand you are in favour of mentioning the positions of health agencies of major countries even if it's different from the mainstream view? Alaexis_¿question? 12:24, 27 May 2021 (UTC)

I'm in favor of an unbiased reporting on the evidence in favor and against the efficacy of ivermectin and I am in favor of classifying peer reviewed scientific studies as higher quality than APNews fact checks. I am also in favor of reporting all the facts and not just the ones that fit with a specific narrative. I am in favor of free speech and objective media/journalism that does not merely report what a certain government institution mandates. Indeed, I consider the government guidelines of a huge country such as India, which incidentally has a very strong pharmaceutical sector, to be noteworthy if not of equal importance to that of the agencies in the United States, especially considering the country has a population of about 4 times that of the USA, thus their policies affect 4 times the amount of lives. All of this is irrelevant since no amount of voting is going to change this section. Adriaandh (talk) 01:17, 28 May 2021 (UTC)

• Yes. Recommendations from any Public Health Agency or Government could be referred to, not restrained to CDC and EMA. (I was just trying to add a paragraph about the use of Ivermectin as a treatment for Covid-19 based on the decision of the Government of Goa and the Government of Uttar Pradesh.) With respect of WP:GEVAL. It could be presented the way it is in fr.wikipedia. Ceveris (talk) 19:23, 28 May 2021 (UTC)

Discussion

• By convention, CDC, WHO, and EMA set the standards everybody else follows. That's why CDC has investigators in multiple other countries while other countries usually do not. They did it first, and have, so far, done it best (with a few hiccups). What we have so far about other countries' use of Ivermectin makes sense, because listing a few of the countries that are doing it anyway is clearly notable. But anything further would be undue weight, and an excessively long list would be WP:LISTCRUFT. I think having an entire section on India is clearly and evidently excessive. It would be filled with non-MEDRS, as Alexbrn has already stated the India public health agency has a lot of problems with pseudoscience.--Shibbolethink ^{(♔ ♕)} 21:27, 25 May 2021 (UTC)

  So you are saying that we need to have WHO, CDC and EMA as they are most reliable and notable cases of countries straying from these recommendations, is it a fair summary? I'm not proposing a section on India, more like a sentence, or even having one sentence about countries that are doing it anyway contrary to the WHO recommendations which would include both India and the Latin American countries that are already mentioned. Alaexis_¿question? 05:23, 26 May 2021 (UTC)

  As a bit of background here, there was a time when certain ivermectin advocates were pushing to include countries that seemed to endorse Ivermectin (Belize IIRC!) but downplay those that didn't, and it was a rapidly changing scene. Rather than try to have a "dashboard" of national positions it was probably better to skim off the most reputable MEDRS. The wider context here is that in the real world (of medical sources too) ivermectin is a very important drug for its antiparasitic properties, and all this COVID stuff is just a fringe shitshow on the side, which we're in danger of giving too much attention to already. Alexbrn (talk) 05:31, 26 May 2021 (UTC)

  Wrong decisions are also notable, if it's the country the size of India that makes it. The statement that ivermectin cures COVID can be described as a fringe position. But it's not the question that is asked here! Alaexis_¿question? 08:28, 26 May 2021 (UTC)

  The fringe-iness is relevant, because per WP:GEVAL we aren't meant to air fringe ideas (like India's wrt ivermectib) without mainstream context. Hence we would need good secondary commentary. Alexbrn (talk) 08:36, 26 May 2021 (UTC)

  That's a wrong interpretation of policy. Treating dental pain with cocaine is a terrible idea but we mention it in the article about cocaine as it actually happened. Alaexis_¿question? 09:44, 26 May 2021 (UTC)

  It's not an "interpretation" of policy, it is policy itself. We don't bother with obviously historical but if some idea took hold today that cocaine was a great dental pain treatment then yes, it would be governed by WP:FRINGE (assuming it was not mainstream too!) Alexbrn (talk) 09:50, 26 May 2021 (UTC)

  Now you are inventing the distinction between historical and current ideas which is not based on any policy whatsoever. Alaexis_¿question? 10:52, 26 May 2021 (UTC)

Well no, Wikipedia in general doesn't attempt to legislate WP:CLUE. As it happens, in this case, there is some specific supplemental guidance on medical history given at WP:BMI. But if you are concerned the description of an 1879 cocaine experiment represents the undue promotion of a WP:FRINGE theory, then you know how it goes (but maybe expect pushback). Why stop there though? You could progress, say, to Cucking stool and demand that Wikipedia clarifies that witches don't really exist as this is a WP:FRINGE notion! Alexbrn (talk) 12:08, 26 May 2021 (UTC)

Can Wikipedia say that the Indian government is officially using it? Yes, it's a relevant fact. Can Wikipedia suggest that it prevents COVID-19? No, the justification used by Goa was based on a scientific article published in a journal with poor indicators. Can Wikipedia suggest that the Indian health agency must be right and that CDC, WHO and EMA are all wrong? Not as a biomedical claim. Can Wikipedia suggest that the CDC, WHO and EMA are involved in some sort of conspiracy against ivermectin? No, but it could describe the controversy in a neutral way, but this article is not the right place. Here, the tone must be appropriate for the lay reader, writing that India's use of ivermectin goes against international consensus and at a time of despair. In addition, "to keep positivity" (as The Indian Express says) makes the political intention quite obvious. I suggest reading this article in Politico for context. --Fernando Trebien (talk) 00:45, 29 May 2021 (UTC)

Can Wikipedia say that the Indian government is officially using it? Well, maybe. But the important question is, should Wikipedia say this? And the answer to that, per GEVAL and FRINGE, is “no”. Brunton (talk) 09:28, 29 May 2021 (UTC)

I believe that I am as concerned about the bad consequences of this as you are. But the way I understand WP:GEVAL and WP:FRINGE is that they prohibit stating things like "ivermectin works" and then citing the Indian government as a source to support such claims. Saying who did what would not really violate these policies, especially if accompanied by sourced expert criticism. To some extent, this has already been done for other instances in COVID-19 misinformation#Ivermectin and Ivermectin#COVID-19 misinformation. --Fernando Trebien (talk) 12:46, 29 May 2021 (UTC)

In addition to Politico (which presents the political side of the issue), I also recommend reading this BMJ article which provides the scientific side. --Fernando Trebien (talk) 13:00, 29 May 2021 (UTC)

That's right, we are not stating that "ivermectin treats covid" but rather "Indian health ministry recommends it as a covid treatment."I think the relevant policy here is WP:BALASP:

“ An article should not give undue weight to minor aspects of its subject, but should strive to treat each aspect with a weight proportional to its treatment in the body of reliable, published material on the subject. For example, discussion of isolated events, criticisms, or news reports about a subject may be verifiable and impartial, but still disproportionate to their overall significance to the article topic. ”

Applying this to the endorsements by national health agencies, the position of WHO, CDC and EMA should be mentioned first and more prominently that that of Indian health ministry. Alaexis_¿question? 18:34, 29 May 2021 (UTC)

Now inevitably, this.[5] Further evidence of why Wikipedia shouldn't attempt to be some kind of news tracker based on transient information in weak sources. Alexbrn (talk) 14:41, 7 June 2021 (UTC)

Proposal - introductory sentence RE Covid should specify what the word "misinformation" refers to, or the word "misinformation" should be omitted

"Misinformation" should only be used to refer to a claim that has been falsified. As argued above, the use of the word "misinformation" appears to be a subjective conclusion reached by Wikipedia editors and not by a trusted secondary source. Ivermectin's potential for treating Covid is actively being studied by Oxford and others. While it is certainly possible that misinformation about ivermectin's effects have been spread, without specifying what this misinformation is, and how it has been falsified, its use in the introductory paragraph is itself bordering on misinformation.

Since the discussion above RE subjectivity has fizzled out with no action, and the editors have been warned not to "free talk" on this page, I am lodging my previously expressed concerns in the form of a clearly actionable proposal. 2600:1700:7CC0:4770:4C3B:1AF9:643D:6055 (talk) 23:22, 25 May 2021 (UTC)

• Disagree. Header sections are meant to be brief and summarize the content of the article. Not go into in depth definitions of what counts as "misinformation" and what does not. The body of the article should do that. The relevant style guide would be MOS:LEAD.--Shibbolethink ^{(♔ ♕)} 23:38, 25 May 2021 (UTC)

But it looks like the body of the article doesn't say what you say it should. ????--TMCk (talk) 23:47, 25 May 2021 (UTC)

Wikipedia is a work in progress. Let's do everything we can to not make it worse.--Shibbolethink ^{(♔ ♕)} 00:11, 26 May 2021 (UTC)

Well. That was a clear non response.--TMCk (talk) 00:16, 26 May 2021 (UTC)

In other words, I think we should add elaboration to the body, not the lead. That's what MOS:LEAD would tell us to do.--Shibbolethink ^{(♔ ♕)} 00:30, 26 May 2021 (UTC)

I'm not sure the guidelines would prescribe your solution vs. mine. What they certainly do establish is that the current lead is poorly matched to the body of the article.2600:1700:7CC0:4770:4C3B:1AF9:643D:6055 (talk) 00:40, 26 May 2021 (UTC)

Per WP:MOSLEAD as linked by User:Shibbolethink, "...the emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources. Apart from basic facts, significant information should not appear in the lead if it is not covered in the remainder of the article." The use of "misinformation" fails this criteria on multiple fronts. First, it is not elaborated in the body of the article, suggesting it should not appear in the lead. Second, the requisite importance of "misinformation" necessary to establish "lead" status, has to my knowledge not been established by reliable secondary sources (in fact, the term "misinformation" has not been used by reliable sources to my knowledge).2600:1700:7CC0:4770:4C3B:1AF9:643D:6055 (talk) 00:19, 26 May 2021 (UTC)

To further respond to User:Shibbolethink - "Header sections are meant to be brief and summarize the content of the article. Not go into in depth definitions of what counts as 'misinformation.'" At no point did I suggest the lead section should discuss definitions of "misinformation," as I agree that would be wildly inappropriate. Rather, the concern is that "misinformation" is not being directed at a specific target. Please be careful to respond to the actual proposal and not to mischaracterize what is being requested. 2600:1700:7CC0:4770:4C3B:1AF9:643D:6055 (talk) 00:23, 26 May 2021 (UTC)

My overall ask of you would be "Why don't we elaborate on it in the body instead of changing the lead?" Seems a much better and more justifiable approach in my opinion. And per my reading of the article, there actually is some elaboration on it. Could be more. Specifically under "Ivermectin#COVID-19_misinformation." You asked for the introductory sentence to be changed, I think it would be more appropriate to add more content about misinformation in the body.--Shibbolethink ^{(♔ ♕)} 00:30, 26 May 2021 (UTC)

If the article gave me a clear understanding of what justified the term, I would be more willing to adopt your approach. Unfortunately, I am still unclear on what "misinformation" in the lead is intended to refer to. As I described above in this talk page, I believe it to be a wholly inaccurate descriptor RE potential treatment of Covid. As highly reputable secondary sources report, its potential benefits are currently under study by Oxford and others, and by no means a settled question. If instead, "misinformation" refers to specific falsifiable claims such as "miracle cure," its usage would be more justifiable, though I would question its inclusion in the introductory section on a relevance basis. Nevertheless, until the claim is more clearly articulated in the header, and fully substantiated in the body with reliable secondary sources cited, I struggle to understand what merits its current usage.2600:1700:7CC0:4770:4C3B:1AF9:643D:6055 (talk) 00:38, 26 May 2021 (UTC)

Here are several RSes that use the term "misinformation" about ivermectin and COVID. I'll integrate them into the article when I get a chance. As for now they are a reliable source for the fact that the term "misinformation" has been applied to the use of ivermectin to treat COVID-19. We don't need MEDRS for that, by the way, since it's a matter of "are people saying X" not "is X a medical fact." Small distinction, but an important one. MEDRS would be better, but RS will do.--Shibbolethink ^{(♔ ♕)} 00:40, 26 May 2021 (UTC)

• Sorry, why's this hard? The misinformation is that ivermectin is a safe & effective COVID-19 treatment (or even a "miracle cure"!) peddled all over the web. We have a whole section about it at COVID-19 misinformation#Ivermectin which is linked. Alexbrn (talk) 03:47, 26 May 2021 (UTC)

comment - We have to follow WP:LEAD. It's bad idea to ignore misinformation around the drug. We know that it's under investigation currently. AXONOV (talk) ⚑ 18:46, 26 May 2021 (UTC)

References

Yes, the word "misinformation" should be omitted. To use it in this context is ... misinformation. No long term study has been done on Ivermectin's efficacy as a treatment for Covid, but many respected clinicians and scientists have suggested that there is empirical evidence that it could be an effective treatment.

This is a perfect example of a wikipedia article where the "talk" section is far more interesting and informative than the main page. The way in which so many wikipedia pages (like this one) are hijacked by vested interests pushing their agendas is incredibly disappointing. Pages should always be written in encyclopaedic format, with objective fact clearly separated from subjective opinion. Subjective opinion is still subjective opinion even if you can reference it! John2o2o2o (talk) 23:29, 26 May 2021 (UTC)

many respected clinicians and scientists - how many is "many"? how "respected" are they? - uttered a subjective opinion containing words like "suggested" and "could", which is is still subjective opinion, according to you, and suggesting that there is solid evidence for their opinion is misinformation.

Your claims of hijacking and vested interests are not appreciated either. They just show that your thinking runs on conspiracy theories rather than actual evidence. --Hob Gadling (talk) 11:03, 27 May 2021 (UTC)

Setting aside claims of hijacking, etc. Here are some high quality papers that show significant benefits of ivermectin in treatment of Covid. This paper which was previously included in the Wiki article, until it was removed when I pointed out the article was mischaracterizing it in a number of ways. And this paper, which I haven't seen any discussion of here. Caveat that I understand secondary sources take precedent over individual papers. But let's not act as though ivermectin's potential benefits could only possibly be a fringe belief that no "respected" clinician would support. Evidence exists to clearly contradict that, in my view.2600:1700:7CC0:4770:E5BA:10D5:B084:E7DA (talk) 23:01, 28 May 2021 (UTC)

Two broken links. The issue is not whether ivermectin has "potential benefits". The quacks boosting it are saying is has actual benefits which Big Pharma is concealing from you, and that it is a "miracle cure". Alexbrn (talk) 06:58, 29 May 2021 (UTC)

Two repaired links (Was easy, why didn't you do it?):

1) Carlos Chaccour, Aina Casellas, Andrés Blanco-Di Matteo, Iñigo Pineda, Alejandro Fernandez-Montero, Paula Ruiz-Castillo, et al., The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe COVID-19: A pilot, double-blind, placebo-controlled, randomized clinical trial, EClinicalMedecine, Published by The Lancet, Volume 32, 100720, February 01, 2021 https://doi.org/10.1016/j.eclinm.2020.100720

12 patients of 24, were given high doses of Ivermectin (400 μg/kg i.e 28 mg for a 70 kg patient) in summer 2020.

Conclusion: “The positive signal found in this pilot warrants the conduction of larger trials using ivermectin for the early treatment of COVID-19. Such trials should include patients with risk factors for severe disease as well as patients with pneumonia. The potential for a mechanism of action different to direct antiviral effect also opens the door for pre-exposure prophylaxis in high-risk groups.”

2) O E Babalola, C O Bode, A A Ajayi, F M Alakaloko, I E Akase, E Otrofanowei, O B Salu, W L Adeyemo, A O Ademuyiwa, S Omilabu, Ivermectin shows clinical benefits in mild to moderate COVID19: a randomized controlled double-blind, dose-response study in Lagos, QJM: An International Journal of Medicine, 2021;, hcab035, https://doi.org/10.1093/qjmed/hcab035

3 groups totaling 60 patients: (IV: Ivermectin)

“Conclusions: 12mg IV regime given twice a week may have superior efficacy over 6mg IV given twice a week, and certainly over the non IV arm of the study. IV should be considered for use in clinical management of SARS-COV2, and may find applications in prophylaxis in high risk areas.”

From those two article one cannot conclude that saying (as now written in the intro of the article) that “claiming that ivermectin was beneficial for treating and preventing COVID-19” is “misinformation”! Ceveris (talk) 12:09, 29 May 2021 (UTC)

Study (1): The positive signal found in this pilot warrants the conduction of larger trials using ivermectin for the early treatment of COVID-19 This does not mean that it works. This means that more research is needed. The article also says that The ivermectin group had non-statistically significant lower viral loads (one cannot conclude much from that), as well as lower IgG (perhaps a good sign, but these are not neutralizing antibodies), Patients in the ivermectin group recovered earlier from hyposmia/anosmia (looks similar to favipiravir, which shortens disease length but has no effect in reducing mortality; more research is needed). In any case, a sample size of 24 participants is too small.

Study (2): QJM is not a good source, check SCImago.

From those two article one cannot conclude that saying (as now written in the intro of the article) that “claiming that ivermectin was beneficial for treating and preventing COVID-19” is “misinformation” Promoting this treatment to the lay public is misinformation until a benefit is demonstrated through serious research. Ivermectin is mildly hepatotoxic and prolonged use may cause liver damage. On a large scale, this in itself can do a lot of harm, and the illusion of protection will likely lead to risk compensation which will increase transmission rates of the new coronavirus.

Speaking of sample sizes, the EPIC trial had 398 participants. Its conclusion is that ivermectin did not significantly improve the time to resolution of symptoms. and that ivermectin does not significantly affect the course of early COVID-19, consistent with pharmacokinetic models showing that plasma total and unbound ivermectin levels do not reach the concentration resulting in 50% of viral inhibition even for a dose level 10-times higher than the approved dose. --Fernando Trebien (talk) 03:16, 30 May 2021 (UTC)

Yeah, two unreliable sources failing WP:MEDRS. For a source to be admissible it needs to be a secondary source (like if this systematic review ever got reputably published - it's a preprint now so unusable). Until then we know from the WP:BESTSOURCES that there's no good evidence of benefit, some risk of harm, and that despite this a number of quacks and conspiracy theorists are spreading misinformation that "#ivermectinworks". Alexbrn (talk) 04:55, 30 May 2021 (UTC)

I think the sources in the article clearly support the advice against indiscriminate use. But I hope this gets reviewed and published soon. --Fernando Trebien (talk) 21:01, 31 May 2021 (UTC)

"Study (2): QJM is not a good source, check SCImago." *checks SCImago* "QJM is a long-established, leading general medical journal" 2600:1700:7CC0:4770:49D9:257:F3AA:50DD (talk) 23:12, 31 May 2021 (UTC)

Look at the quartiles. Once reputable journals may decline. --Fernando Trebien (talk) 20:02, 4 June 2021 (UTC)

To further defend my post you are replying to, while the sample is small in the first study, they found a symptom reduction result with a < 0.001 p value. I of course would like to see that result replicated, but they themselves report this as a significant benefit. You are correct that they found non-significant viral load reduction on top of that result, which the study was not properly powered to detect, unlike the symptom reduction finding (sample size). Note also that I am not trying to claim that "it works," just that some respected scientists (not fringy nuts) have performed studies showing significant benefits. These claims are somewhat different. In order to be sure that "it works," I would agree that I would like to see replication and larger sample sizes. Note that the study you cite with 398 participants was subject to a number of procedural errors and post-hoc modifications. 2600:1700:7CC0:4770:49D9:257:F3AA:50DD (talk) 23:26, 31 May 2021 (UTC)

Amateurs who think that reliability of sources is a yes-no question are a scourge of Wikipedia.

Something which was published in a "leading general medical journal" is still not necessarily a source we can use on Wikipedia. If it is a primary source about one study, as this one, it definitely is not. Read WP:MEDRS and WP:WHYMEDRS. --Hob Gadling (talk) 07:08, 4 June 2021 (UTC)

If the "evidence" is that thin, then considering the size of the controversy around it, there is an even stronger reason to wait for systematic reviews published in reliable sources. And yes, that study has some known flaws and maybe it is better to remove the reference, as long as we do not replace it by another study that is even more flawed. --Fernando Trebien (talk) 20:02, 4 June 2021 (UTC)

Ivermectin as a medical treatment for Covid-19, Goa, India, May 2021

I added this to the paragraph Medical Use:

=== Covid-19 ===

Vishwajit Rane, Minister of Health of the Government of the State of Goa, India, announced on May 10, 2021, the Government's decision to administer Ivermectin 12 mg, for five days, to all above 18 as a prophylaxis treatment against Covid-19.

but user:Alexbrn reverted 6 minutes later with comment “fringe/pseudoscience without context, failing WP:GEVAL”

I am okay with the usefulness for someone else to add context in order to avoid WP:GEVAL, but not with the plain revert of this information about an official medical use of Ivermectin as a treatment for Covid-19, be it fringe/pseudoscience or not. It is official in one State. Would someone else transform this information in a acceptable way for all?

Ceveris (talk) 09:41, 28 May 2021 (UTC)

Politicians decide what is allowed and what is not allowed within their jurisdiction. They do not tell Wikipedia what is true and what is false. Reliable scientific sources do. --Hob Gadling (talk) 09:47, 28 May 2021 (UTC)

A Medical treatment is a “ the attempted remediation of a health problem”. Is it efficient? True or false, this is the topic that “reliable scientific sources” will clarify. In that Goa case, Ivermectin IS a medical treatment for Covid-19. We could add, in order to comply with WP:GEVAL:

In Uttar Pradesh, the most populous state of India, with a high density of population, “The state Health Department introduced Ivermectin as prophylaxis for close contacts of Covid patients, health workers as well as for the treatment of the patients themselves through a government order on August 6, 2020“

Those individual governments decisions to use Ivermectin as a treatment for Covid-19 don't comply with WHO's March 31, 2021 recommendation “that ivermectin only be used to treat COVID-19 within clinical trials”.

Any objections?

Ceveris (talk) 13:24, 28 May 2021 (UTC)

Yeah that Indian Express source is utter quackery and shouldn't be used. There's some at least sane secondary commentary here - but really this is just part of the terrible story of how quackery has compromised India's COVID response. It may be due to mention in that light at COVID-19 pandemic in India‎, but this page shouldn't become a directory of every region on the planet that's authorized a drug (even if it were a good decision). We just don't do that for drug articles. Alexbrn (talk) 13:36, 28 May 2021 (UTC)

Until we set clear criteria what belongs to the article, I don't see why this information is less relevant than the information about other countries which is already included. I'd be happy to remove or leave it based on the results of the RfC above. "Terrible response" is noteworthy and notable. Alaexis_¿question? 14:23, 28 May 2021 (UTC)

Ceveris, Hob Gadling please note that I've opened a RfC about the notability of various uses of ivermectin. Please leave a comment there, I think the article would benefit from clear criteria. Alaexis_¿question? 14:27, 28 May 2021 (UTC)

Alexbrn the RfC above clearly shows that the use of Ivermectin is notable, irrespective of its effectiveness against Covid. I'm happy to discuss how this information should be presented in the article to avoid making it look like an endorsement by Wikipedia. Refusing to mention it in any way against the position of the majority of other editors is disruptive. Alaexis_¿question? 18:09, 29 May 2021 (UTC)

The RfC is still running. We're not going to do a shopping list of nations/regions/governments with daft policies, as it is of no encyclopedic worth. You are now aware of the sanctions for this topic (which you are in breach of, by restoring disputed content). Alexbrn (talk) 19:08, 29 May 2021 (UTC)

India, population 1.38 Billion, with official (not draft) policy on a “shopping list”. You make my day! The content is most official and undisputed. Ceveris (talk) 19:21, 29 May 2021 (UTC)

@Alaexis: to say that India is endorsing this pseudo-scientific treatment, it is not necessary to inform the dosage and duration of the treatment. This is an incentive to self-medication. Do not use Wikipedia to promote this treatment. --Fernando Trebien (talk) 21:39, 29 May 2021 (UTC)

@Alexbrn: Totally dishonest to ignore the recommendation to the public by the Ministry of Health of the Government of India (version for the public) (pop. 1,380 M) but leave those of US (pop. 332 M) FDA and EU (pop. 513 M) EMA.

You banned it under the pretext it is “irrelevant to "research" - the topic of this article”. This is hypocrisy because such recommendations to the public by health authorities (the Indian one as well as the US and European ones) about a drug are made after consideration of research. — Preceding unsigned comment added by Ceveris (talk • contribs) 21:54, 29 May 2021 (UTC)

— Ceveris (talk • contribs) has made few or no other edits outside this topic.

And the consensus of relevant credentialed qualified health experts does not support that recommendation. That's why it's irrelevant and adding a WP:LAUNDRY.--Shibbolethink ^{(♔ ♕)} 23:14, 29 May 2021 (UTC)

@Ceveris: do not use Wikipedia to promote this treatment. When writing about it, you should also say that the Indian government is using it against international consensus. This last part is very important. --Fernando Trebien (talk) 23:27, 29 May 2021 (UTC)

I agree with that. It's kind of obvious if we mention it right after saying that the WHO, CDC and EMA do not recommend it, but we can say it explicitly too. Alaexis_¿question? 05:32, 30 May 2021 (UTC)

Agree too. No problem!

Alexbrn reverted my last edit ¯\(°_°)/¯

His series of reverts is the cause of this ongoing discussion:

We have to find an acceptable presentation of that Indian decision… (Be it good or bad, what is Wikipedia to judge?) Ceveris (talk) 17:22, 30 May 2021 (UTC)

It seems like India's High Court will block the prophylactic use of ivermectin. I think the best we can do right now is something along these lines:

In May 2021, with hospitals overrun with critically ill COVID-19 patients, the Indian states of Goa and Uttarakhand announced plans to use ivermectin to treat mild cases of COVID-19. The Indian Council of Medical Research issued the recommendation to doctors while warning that the decision was based on low certainty of evidence. WHO chief scientist Soumya Swaminathan reiterated that the WHO does not recommend the use of ivermectin for COVID-19, except in clinical trials, citing the statement by the manufacturer and developer of ivermectin Merck against off-label use.

I'm not sure where this should be placed. Please wait a while for opinions before adding this to the article. --Fernando Trebien (talk) 20:12, 30 May 2021 (UTC)

Maybe add a new first-level section on covid and put everything related to it there (research, actual usage and misinformation)? Alaexis_¿question? 06:58, 31 May 2021 (UTC)

I think we've already got enough (too much) on this fringe aspect of what is otherwise a useful drug. Need to be wary of WP:UNDUE and giving too much attention to a fringe sideshow. Alexbrn (talk) 07:07, 31 May 2021 (UTC)

Alexbrn please next time notify other editors when you solicit feedback at the Fringe_theories dashboard. Alaexis_¿question? 08:50, 31 May 2021 (UTC)

There's no need. Alexbrn (talk) 09:06, 31 May 2021 (UTC)

Alexbrn You misrepresent WP:UNDUE. Fact that ivermectin is, since April 28, 2021, part of the treatment proposed by Indian health authorities for mild/asymptotic covid-19 patients is no “views of tiny minorities”, whose representation is the topic of WP:UNDUE. It is not a “view”. It is a fact. The “view” that ivermectin is efficient as a treatment for Covid-19, although shared by more than “a tiny minority”, is only presented by Wikipedia as “misinformation”. Ceveris (talk) 08:37, 31 May 2021 (UTC)

No, it would be a WP:FALSEBALANCE to give attention to some confused politicians who gave some dumb advice in one part of the world for a few weeks, for a drug which is actually changing the world for the better because of the work of informed policy makers and scientists. We already mention some misguided countries/regions. How does it help convey knowledge to add more? Anyway, you can add your view to the RfC and we'll see where things stand in a month or so. Alexbrn (talk) 08:59, 31 May 2021 (UTC)

Again, (as usual,) you misrepresent the subject. We are not talking about any “confused politician”, but about the “REVISED GUIDELINES FOR HOME ISOLATION OF MILD/ASYMPTOMATIC COVID-19 CASES” published on April 28, 2021 by the Ministry of Health & Family Welfare of the Government of India, directly accessible (one clic) from this page: https://www.mohfw.gov.in/

Presented by the press: Govt issues new guidelines for home isolation of mild, asymptomatic COVID-19 cases, BusinessToday.In, April 29, 2021.

This is notable information for the article about Ivermectin. Ceveris (talk) 09:49, 31 May 2021 (UTC)

PS: thank you Alaexis to let us know about that mean Alexbrn conspiring behind our backs… Ceveris (talk) 09:49, 31 May 2021 (UTC)

I’m not sure that the Indian government is a particularly good authority on medical issues. On the same ministry website, for example, you can find recommendations for using Ayurveda to prevent COVID, and the government has also issued guidance on the use of homeopathy for prevention and treatment of COVID symptoms. They have an entire ministry devoted to this sort of thing. Brunton (talk) 13:46, 31 May 2021 (UTC)

We are not providing medical advice here. Wrong decisions can be notable and should be covered by Wikipedia. Alaexis_¿question? 14:07, 31 May 2021 (UTC)

Better to have sources on the "wrong decisions" then, rather than letting it somehow be implied. We already know, and say, some countries have made wrong decisions - if you must, put this India stuff in that country's COVID article. This is an article focused on an anti-parasitic drug. Look at the weight of serious sourcing on that (800+ scholarly secondary sources). Next to that, piling up a list of tittle tattle about how it doesn't work - which we already cover - is undue. Alexbrn (talk) 14:19, 31 May 2021 (UTC)

Correct. There are loads of references in the article saying ivermectin doesn't work for covid. This balances the Indian choice to have it as a treatment. This choice is a notable information about IVERMECTIN, has its place in Ivermectin.

I put the info as you propose into COVID-19 pandemic in Goa but your accomplice Brunton reverted, instead of WP:FIXTHEPROBLEM! Ceveris (talk) 15:30, 31 May 2021 (UTC)

This piece of random trivia doesn't belong in this article. If we put every crackpot medical idea that the Indian Government has in the individual treatment article, they would be an incredible mess. WP:FRINGE applies here, because that's exactly the Indian Government's approach to medical issues. Black Kite (talk) 16:18, 31 May 2021 (UTC)

WP:FRINGE is Wikipedia:Fringe theories, don't apply:

You confuse the ideas, the “theories”, with the events.

The publication by the Indian Government, 28 April, of a revised guidance for covid with “Treatment for patients with mild/asymptomatic disease in home isolation”, containing Ivermectin, and the decisions taken in such states as Goa (10 May), Karnataka (11 May) and Uttarakhand (12 May), (not talking about Uttar Pradesh) to distribute ivermectin tablets to their population are not ideas or theories (fringe or not)! Ceveris (talk) 16:57, 31 May 2021 (UTC)

The distinction is really simple. Flat Earth is a fringe idea - to put it mildly. Still we mention that it was the dominant theory in the past in the Earth article. Alaexis_¿question? 18:25, 31 May 2021 (UTC)

Ftrebien, thanks for improving the article and incorporating the information about India. Alaexis_¿question? 20:13, 31 May 2021 (UTC)

I hope this settles the controversy a bit. I only disagree about the direct link to the national guidelines, as it can be an incentive to self-medication because it contains usage instructions. It is ok to link to news articles that puts this in the adequate context. I understand that the High Court will block Goa's intention to use it prophylactically, and the national guidelines are only for people with mild symptoms, not prophylactically. --Fernando Trebien (talk) 20:51, 31 May 2021 (UTC)

I don't have a strong opinion on the inclusion of the guidelines themselves, I think it's fine the way it is now. Alaexis_¿question? 06:51, 1 June 2021 (UTC)

So far Ftrebien “improving of the article and incorporating the information about India” as Alaexis thanks him for is sleeping on this talk page.

So, were are we going to put that information that, since April 29, 2021, Ivermectin is included in India’s “revised national COVID-19 treatment protocol for people with mild infection” Times of India, 30 April Ministry of Health? In a new sub chapter Medical uses/Covid-19? In the existing chapter Research/COVID-19? Ceveris (talk) 10:43, 5 June 2021 (UTC)

It's already written that some countries, including India, authorised its use for Covid. What exactly do you propose to add/change? Alaexis_¿question? 12:05, 5 June 2021 (UTC)

It is written that India, among others “allowed its off-label use.” But inclusion in the official protocol is more than allowing off-label use, it is promoting it. This is stronger. So I would suggest to add: “India even included ivermectin in its revised national COVID-19 treatment protocol for people with mild infection, published April 29 2021.” With the 2 references above: The Times of India, 30 April Ministry of Health, Government of India. Ceveris (talk) 12:32, 5 June 2021 (UTC)

I see. In the same paragraph, the text can distinguish between off-label use (prescribed by physicians) and official guidelines for home isolation, which can be understood as some kind of endorsement. I still think we should not link directly to the guidelines, this can lead to self-medication and is unnecessary to support the claim. The USA Today article used as a reference already provides enough support. Times of India is considered to have a pro-government bias. --Fernando Trebien (talk) 13:09, 5 June 2021 (UTC)

Thank you for your answer. You can dump that direct link to the recommendations, but I do like direct link to the original sources the press is only commenting about (like Mercks, WHO, FDA, NIH statements…) I proposed The Times of India (“the largest selling English-language daily in the world“) to please Alexbrn who wrote “that Indian Express source is utter quackery and shouldn't be used.” I am okay with a journal “considered to have a pro-government bias”. At least this would mean that it is not misrepresenting the government initiative. Ceveris (talk) 13:41, 5 June 2021 (UTC)

Oh, I read in your link WP:INDIANEXP that “The Indian Express is considered generally reliable under the news organizations guideline.” So Alexbrn has a strong disagreement with Wikipedia!!! A go for Indian Express source, then? Like this April 30 article. Ceveris (talk) 14:16, 5 June 2021 (UTC)

I think Alexbrn was referring to another article. Anyway, as a news source, the Indian Express is considered reliable. But care must be taken not to express the information as a biomedical claim, only as news, we should follow WP:PSMED#Writing for the right audience and WP:NPOVFAQ#Writing for the opponent. The Indian Express says The guidelines suggest further that the doctor consider ivermectin tablets, which is accurate, and the highlighted parts are important to ensure neutrality. We cannot write that the guidelines recommend it, or that the doctor should prescribe it. --Fernando Trebien (talk) 14:44, 5 June 2021 (UTC)

It would be undue, and take us into laundry-list territory. We can't mention Indian quackery without a source contextualizing that quackery per WP:GEVAL, otherwise it gives the impression it's rational. Alexbrn (talk) 16:01, 5 June 2021 (UTC)

Quackery “often synonymous with health fraud”, “promotion of fraudulent or ignorant medical practices.” is highly disparaging applied to India's Public Health Policy. Especially applied to its policy toward covid-19 (Death/1M Pop: UK/USA/India: 1,874/1,840/249/ - source: https://www.worldometers.info/coronavirus/)

Considering that the whole article is biased against the use of Ivermectin for Covid-19, presenting its advocacy as a “misinformation”, reporting not one study or evaluation in favor of its use, adding the info about the Indian guideline stating: “Consider Tab Ivermectin” as a treatment would not break WP:GEVAL. Ceveris (talk) 16:30, 5 June 2021 (UTC)

I don't think the Indian government is advocating the drug. If that were the case, it would have promoted the drug earlier, as some other governments have done. I think it's succumbing to pressure. As for reporting favorable studies, it would be WP:FALSEBALANCE as they are generally considered poorly executed.--Fernando Trebien (talk) 16:51, 5 June 2021 (UTC)

I agree. We should prefer a reference that provides the appropriate context. So, even if the Indian Express is accurately reporting what the Indian government is doing, it has failed to mention that it goes against international consensus. The USA Today article does both and is therefore a good source. The point that remains is whether to simply write that the Indian government is allowing off-label use or explicitly state that this is now part of a national guideline for caregivers. --Fernando Trebien (talk) 16:51, 5 June 2021 (UTC)

Proposal - added context for Merck's statement on Ivermectin/Covid

As reported by PBS, Merck is developing a novel drug for treating Covid. From the linked article:

"Another existing drug, ivermectin, may also have potential against SARS-CoV-2. A May meta-analysis suggests it could speed recovery and reduce mortality from COVID-19. The idea is controversial; some experts are unconvinced while proponents are eager to put it to use as a cheap, effective treatment. The anti-parasitic, developed by Merck in the 1980s, is no longer under patent. The company has contended there is not sufficient evidence for its use against COVID. Merck declined to respond to PBS NewHour’s request for comment."

Merck's position creates a potential conflict of interest that means proper context needs to be provided when citing their statement on ivermectin. Given that Merck would stand to make far more money through a novel treatment than they would on a generic. The danger with the current text of the article is that it veers from a WP:NPOV and adopts Merck's framing of ivermectin's effectiveness (or lack thereof) without fully disclosing what incentives they may have had to make that statement.

I propose including additional text, using the neutral language provided by WP:RS PBS in the above linked story as a reference. 2600:1700:7CC0:4770:1905:B5EA:593B:F994 (talk) 19:36, 2 June 2021 (UTC)

 Not done Silly news piece, not WP:MEDRS. Merck's position is reported correctly, satisfying WP:NPOV. Alexbrn (talk) 19:38, 2 June 2021 (UTC)

What is "silly" about a report that Merck is developing a novel drug for treatment of Covid? Surely you are not questioning the underlying facts, or their potential for creating a conflict of interest?2600:1700:7CC0:4770:1905:B5EA:593B:F994 (talk) 19:43, 2 June 2021 (UTC)

News about Merck & Co.'s drug development would belong at their article. We're not going to spout moronic conspiracy theories. Alexbrn (talk) 19:51, 2 June 2021 (UTC)

This is not the first time you have been incredibly disrespectful with your comments, and I wonder what the point of it is? Please dial it back.2600:1700:7CC0:4770:1905:B5EA:593B:F994 (talk) 19:55, 2 June 2021 (UTC)

Please WP:FOC. --Hipal (talk) 20:21, 2 June 2021 (UTC)

I agree, let's redirect the conversation to what is or isn't substantively wrong with my proposal, and not use words like "silly" and "moronic" to dismiss it out of hand.2600:1700:7CC0:4770:1905:B5EA:593B:F994 (talk) 20:24, 2 June 2021 (UTC)

Make a new request. You may want to review relevant policy before you do. --Hipal (talk) 21:25, 2 June 2021 (UTC)

I believe I cited good policy. Simply repeating Merck's statement is not NPOV, as Alexbrn suggests. They are not an uninterested third party or authoritative secondary source - they have a source bias as an interested party in this matter. Presumably their statement was included to show that "even the big pharma company who would stand to gain from ivermectin says it doesn't work." This is an educated guess, as the statement does not appear to be relevant on its face, and this argument has been posited by sources previously linked by Alexbrn. Of course, this argument falls down if the full context provided by PBS is taken into consideration. If Merck's statement is to be included in this article then balance is very much needed to fulfill NPOV. 2600:1700:7CC0:4770:1905:B5EA:593B:F994 (talk) 21:27, 2 June 2021 (UTC)

Yeah, we get it. You don't like the facts, so you are digging to disqualify the people who supply the facts. Business as usual, in short.

Merck is selling Ivermectin now, and they could sell more of it now if they said it works against COVID. And you are saying that it does work, but they will not admit it because they do not want that money now, they prefer hypothetical money at some time in the future when they are finished developing something that actually works against COVID (although ivermectin already does that)? That does not make sense in this universe or any parallel ones I know. Even if it did, this is Wikipedia, and you will not convince anyone it makes sense.

So, disqualifying Merck as a source based on that article only works if we follow your contorted ideas.

Go away, you are not here to build an encyclopedia. --Hob Gadling (talk) 07:02, 4 June 2021 (UTC)

Not to mention the idea that a company would tell a blatant lie to conceal its drug's effects, to prolong a global pandemic for its possible future advantage, is one of the more extreme instances of a Big Pharma conspiracy theory one's ever likely to encounter! If it were Merck alone saying this then maybe we'd have an issue, but since their view is aligned with every decent medical source on the planet, we're good, and it's added extra knowledge that even the drug company are saying this. Alexbrn (talk) 07:14, 4 June 2021 (UTC)

In order to erase a link in this article to the neutral NIH recommendation about Ivermectin telling “There are insufficient data 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” for this article, Alexbrn says: “Please don't bring press releases to Wikipedia, they are nearly always useless for the encyclopedia.

And here, he battles to keep as only source about Merck's position about Ivermectin, its own press release, and refuses a respected secondary source contextualizing Merck's position.

This not coherent and not NPOV. Ceveris (talk) 09:56, 4 June 2021 (UTC)

Hob Gadling: “That does not make sense in this universe or any parallel ones I know,” “your contorted ideas”, “Go away, you are not here to build an encyclopedia” :these are blatant personal attacks. Does not respect Wikipedia's policy WP:NOPA. Does not respect also WP:OWN: “No one, no matter how skilled, or how high-standing in the community, has the right to act as though they are the owner of a particular article.” Ceveris (talk) 10:16, 4 June 2021 (UTC)

Except, the Merck source is a "Company Statement", a type of document they distinguish from their "News Releases". There is plenty of secondary coverage of the statement too, if adding it would help. (Update: I added something secodnary from SBM, a premium source for coverage of medical BS. They lend some "context" to the statement too: "The pharmaceutical company that has the most to gain from the sale of ivermectin is actively discouraging its use to treat COVID-19". Probably undue, mind.) Alexbrn (talk) 10:33, 4 June 2021 (UTC); updated 10:50, 4 June 2021 (UTC)

these are blatant personal attacks Bullshit bullshit bullshit. These are very, very blatant attacks on the IP's abysmal reasoning, and just as blatantly not on their person. Go read WP:PA, and while you are at it, Argumentum ad hominem. And neither does it have anything to do with ownership of articles. Bad reasoning can and must be criticized and debunked as bad reasoning. That "ownership" nonsense is just a red herring. --Hob Gadling (talk) 11:40, 4 June 2021 (UTC)

These are very, very blatant attacks on the IP's abysmal reasoning What aspect of my reasoning is abysmal exactly? There is a whole lot of nonsense argument being falsely attributed to me that is not close to accurate (RE: conspiracy theorizing as to whether Merck is intentionally prolonging the pandemic knowing of Ivermectin's effectiveness, etc). If you are going to claim my reasoning is abysmal please specify which part of my argument you are specifically talking about and I can respond appropriately. To once again redirect the discussion to the substance of the proposal, (1) is simply restating the claim of an interested party with no context appropriate RE WP:NPOV, and (2) is the statement even relevant or appropriately included given that WP:MEDRS was given as a reason not to include PBS's report (surely Merck does not fulfill the same criteria).2600:1700:7CC0:4770:9809:7234:5739:83B1 (talk) 22:02, 4 June 2021 (UTC)

falsely attributed to me So you are the same person as some of the other IPs posting here. We cannot really tell, you see, unless you tell us. If you used an account, it would be easier to answer your questions about what is bad about what you said - we quite literally do not know what you said. I am not interested in discussing someone who makes it intentionally difficult. My last contribution was just a response to Ceveris' bullshit and does not concern you. But maybe Ceveris is also you? --Hob Gadling (talk) 05:35, 5 June 2021 (UTC)

Let's WP:FOC and please redirect discussion to my proposal. There have been several comments presumably opposed to my proposal but none are addressing the arguments made in support of it. And yes, this is the same user who has a similar IP address over and over (it changing is not due to any action on my part.)2600:1700:7CC0:4770:E4FE:3D16:8E4A:A766 (talk) 06:02, 5 June 2021 (UTC)

The article cannot include material implying that Merck is suppressing the effectiveness of ivermectin unless you can produce reliable sources supporting this, per (at the very least) WP:OR and WP:BLP. Brunton (talk) 07:35, 5 June 2021 (UTC)

Thanks for your reply. I would just question what merits Merck's statement as it currently stands? As argued above, their statement would seem to fail both NPOV and MEDRS. 2600:1700:7CC0:4770:C1A5:72C2:D47E:72F7 (talk) 22:03, 5 June 2021 (UTC)

The statement is singled-out as significant by secondary sources (one such is cited), so NPOV would point to its inclusion. What Merck's statement says is not, strictly, biomedical information but it could imply it. However, since any implication is aligned with our golden sources (FDA, etc) there is no issue of this being "wrong". Alexbrn (talk) 03:38, 6 June 2021 (UTC)

Are you referring to Science Based Medicine? This appears to be a Patreon-funded blog. Are you claiming this is more of a WP:RS than PBS, whose reliability you previously rejected?2600:1700:7CC0:4770:897E:7CCD:13A6:E14A (talk) 19:43, 6 June 2021 (UTC)

Science-Based Medicine is a good source for fringe topics, per WP:PARITY. Alexbrn (talk) 19:47, 6 June 2021 (UTC)

Epicycles 2600:1700:7CC0:4770:897E:7CCD:13A6:E14A (talk) 00:25, 7 June 2021 (UTC)

Galileo gambit --Hob Gadling (talk) 06:35, 7 June 2021 (UTC)

Again, the PBS article points to a meta-analysis published in a journal that does not score well in SCImago at the time of publication. Simple check to avoid unnecessary headaches. --Fernando Trebien (talk) 20:19, 4 June 2021 (UTC)

---

The existence of a conflict of interest does not constitute medical information and thus doesn't require MEDRS. Alaexis_¿question? 14:59, 5 June 2021 (UTC)

The insinuation of a conspiracy to suppress the use of ivermectin comes under BLP and thus requires RS. Brunton (talk) 16:11, 5 June 2021 (UTC)

How is BLP relevant if I'm talking about a company? We don't have corporate personhood here. Alaexis_¿question? 05:19, 6 June 2021 (UTC)

Companies are controlled by living people. Brunton (talk) 11:12, 6 June 2021 (UTC)

Yes, but BLP as a policy does not normally apply to companies, see WP:BLPGROUP. Alaexis_¿question? 13:11, 6 June 2021 (UTC)

The insinuation of a conspiracy [...] requires RS Beyond the point made by User:Alaexis RE WP:BLPGROUP which I believe is correct, my proposal is to add context based on wording provided by WP:RS PBS. I believe that fulfills the criteria you set forth. 2600:1700:7CC0:4770:897E:7CCD:13A6:E14A (talk) 19:39, 6 June 2021 (UTC)

"Context based on wording" sounds like WP:OR. What exact words are you proposing? Alexbrn (talk) 19:45, 6 June 2021 (UTC)

It sounds like WP:OR? To me it sounds like sourcing from an actually widely known secondary source, PBS (not a Patreon-funded blog you consider reliable because it shares your viewpoint). 2600:1700:7CC0:4770:897E:7CCD:13A6:E14A (talk) 00:27, 7 June 2021 (UTC)

As a news source, PBS can make incorrect biomedical claims if its sources are not good. Good thing someone read the article paying attention. --Fernando Trebien (talk) 03:47, 7 June 2021 (UTC)

Good thing someone read the article paying attention sounds like WP:OR to me 2600:1700:7CC0:4770:897E:7CCD:13A6:E14A (talk) 06:35, 7 June 2021 (UTC)

When you cannot think of a response, use the one your opponent used on you, regardless of whether it works in the context? What is this, kindergarten?

SBM is a far more reliable source on medical subjects than any journalistic source. --Hob Gadling (talk) 06:51, 7 June 2021 (UTC)

PBS do not explicitly say that Merck have a conflict of interest in that article so saying it would be OR. There is one article from generally reliable The Wire that says that it might be the case [6] but I think it's worth waiting until we have more reliable sources explicitly writing about it. Alaexis_¿question? 06:02, 7 June 2021 (UTC)

Yes, and in the The Wire it's (correctly) characterized as a conspiracy theory. Alexbrn (talk) 06:14, 7 June 2021 (UTC)

No, the statement "pharma companies are blocking ivermectin’s entry into the market so that vaccines remain profitable" is described as a conspiracy theory. There is a big difference between a conflict of interest and blocking. Alaexis_¿question? 10:08, 7 June 2021 (UTC)

Not really, because the conspiracy theorists want to state or imply the "conflict of interest" taints Merck's statement. Wikipedia isn't going to play that game. Alexbrn (talk) 14:38, 7 June 2021 (UTC)

So we should eschew WP:NPOV and pretend the conflict of interest doesn't exist?2600:1700:7CC0:4770:FC9A:A677:BAAD:FDFC (talk) 20:47, 7 June 2021 (UTC)

The opposite. We adhere to WP:NPOV by reporting what's in good sources, rather than including conspiracy theories made up by Wikipedia editors. Alexbrn (talk) 09:22, 8 June 2021 (UTC)

New section

Came to this talk page to say that the sections on "misinformation and covid" and "research on covid" are written in a way that violates NPOV. Including the very title of the misinfo section. Can it pls be rewritten in a way that highlights controversy without taking a position, and in fact uses words like "controversy" and "disagreement" instead of "misinformation"? I've long appreciated Wikipedia's entries on biochemistry, drugs, etc. and really don't like seeing them become politicized. Frankly, that begins with avoiding terms like "misinformation" and "conspiracy theory". 104.247.238.179 (talk) 19:01, 5 June 2021 (UTC)

What you're requesting is to violate WP:GEVAL, which is part of NPOV policy. NPOV means we illustrate the mainstream view, especially in science topics, and call out WP:FRINGE theories as such. It's very similar to how climate change denial can be political, but we don't step back from the mainstream position. The beginning of WP:LUNATICS gives some guidance on this. KoA (talk) 19:49, 5 June 2021 (UTC)

Biased not misinformation re Covid 19

Invermectin has been shown to be affective against Covid 19. Doctors in the field have used it and reported success. Watch Kory Pierre interview with Bert Weinstein on You Tube. Kory Pierre is no quack, he is a leading physician in treating Covid 19. Also Australian Doctors back the use of Invermectin in treating Covid 19. — Preceding unsigned comment added by 150.143.179.116 (talk • contribs) 09:50, 5 June 2021 (UTC)

That is your opinion. Reliable sources disagree with you. Reliable sources win.

Also, you should sign your contributions on Talk pages, and new contributions go to the bottom. I rectified both for you. --Hob Gadling (talk) 19:57, 5 June 2021 (UTC)

At this point, the true misinformation on Ivermectin is this Wikipedia article. India is crushing Covid with Ivermectin protocols. Mexico has crushed Covid with Ivermectin, in spite of the misinformation campaign by 'big tech' and the US Medical Establishment, which has not provided a treatement protocol for an eminently treatable illness, and instead tells people to stay home and get sicker and sicker until they go to the hospital to die alone. It's not longer about having data, or the science. It's a suppression campaign.

— Preceding unsigned comment added by 2601:603:4a80:5870:6c38:9241:2cc8:9b8d (talk • contribs) 18:01, 6 June 2021 (UTC)

Correlation does not imply causation and none of those sources can be trusted. No other source confirms there was any legal notice against that scientist. Go away. --Fernando Trebien (talk) 23:31, 6 June 2021 (UTC)

Another source: WHO scientist in dock for opposing Ivermectin’s use for Covid-19 cure. Ceveris (talk) 00:19, 7 June 2021 (UTC)

Can this source be trusted? --Fernando Trebien (talk) 11:01, 7 June 2021 (UTC)

Good question: is the information true or not? Third secondary source, for your information, heraldgoa.in, a “primary” source: Blog Indian Bar Association. Ceveris (talk) 15:18, 7 June 2021 (UTC)

Second “primary” source: Indian Bar Association Press Release, May 26, 2021. Ceveris (talk) 15:25, 7 June 2021 (UTC)

Even if that is true, it only shows that the quackery pushers who are in power in India legally harrass people for disagreeing with them. That says nothing about whether the stuff works. Pure argumentum ad baculum. --Hob Gadling (talk) 15:28, 7 June 2021 (UTC)

Quite, and even if this gets coverage it tells us nothing about ivermectin, but plenty about India - so it may be due in COVID-19 pandemic in India. But not here. Alexbrn (talk) 15:33, 7 June 2021 (UTC)

My Friend’s uncle in India was saved from severe hospitalized Covid by Ivermectin prescription. Anyone who denies Ivermectin as an effective treatment for Covid 19, is either looking at old facts or blind. — Preceding unsigned comment added by 150.143.179.120 (talk) 01:09, 7 June 2021 (UTC)

I suppose he was saved by a combination of complex clinical care and various drugs, carefully administered, while monitoring his vital signs, right? --Fernando Trebien (talk) 03:47, 7 June 2021 (UTC)

That is what it has come to? Anecdotes? What next? Homeopathy helped your aunt? Faith healing helped your uncle?

Please inform yourself on the requirements for Wikipedia sourcing. --Hob Gadling (talk) 06:35, 7 June 2021 (UTC)

Malaysia, Philippines COVID studies

Malaysia recently started studying the use of IVM for COVID treatment. The Philippines did something similar back in April. For your consideration:

https://www.freemalaysiatoday.com/category/bahasa/tempatan/2021/06/06/kkm-mula-uji-ivermectin-ke-atas-pesakit-covid-19-berisiko-tinggi/

https://www.malaymail.com/news/malaysia/2021/06/05/dr-noor-hisham-health-ministry-starts-ivermectin-trial-for-high-risk-covid/1979924

https://www.thestar.com.my/news/nation/2021/06/05/dr-noor-hisham-health-ministry-has-begun-ivermectin-trial-for-high-risk-covid-19-patients

https://www.reuters.com/business/healthcare-pharmaceuticals/philippines-start-clinical-trials-ivermectin-other-drugs-covid-19-2021-04-20/

-SmolBrane (talk) 05:28, 7 June 2021 (UTC)

The lede should mention COVID trials

(I saw the discussion at “crusades”, above, but there appears to be a broken archive tag there, so I'm starting a new section). We currently have a statement on misinformation, and a statement that no evidence exists for treatment or prevention, but we do not mention that many trials have occurred or are still in progress. This misleads the reader into thinking that no application is being investigated. The lede should more accurately reflect the body of the article and include such a statement, such as:

No reliable evidence exists to back up such claims, although many studies are still underway.

-SmolBrane (talk) 23:46, 7 June 2021 (UTC)

Simply being in trials or studies generally isn't something worth mentioning before publication (and WP:MEDRS is pretty clear on more details related to primary literature even after publication). Such information on "studies underway" is typically not encyclopedic, much less something that would be even mentioned in primary sources. Even in the latter, if something isn't published yet, it's like it doesn't exist yet, which is where WP:CRYSTAL comes in. KoA (talk) 00:16, 8 June 2021 (UTC)

The COVID excerpt under Research says “At least 45 such trials were listed as of January 2021.[77]”, which is the source and the basis for my suggested addition. The excerpt also contains the following statements:

After reviewing the evidence on ivermectin, the EMA said that "the available data do not support its use for COVID-19 outside well-designed clinical trials".

The WHO also said that ivermectin should not be used to treat COVID-19 except in a clinical trial.

So I think the ongoing trials are due. Perhaps an addition could be more appropriately phrased. I find it odd that the Research excerpt is 3500 characters and the COVID misinformation section is 800 characters, yet we only mention the misinformation in the lead. -SmolBrane (talk) 03:22, 8 June 2021 (UTC)

Like any drug there are many trials underway or recently completed for ivermectin, for applications as diverse as cancer therapy to underwear treatment. We would need to stick to secondary coverage, and looking at them, about the only thing of note about the COVID research is that is has generally been of very poor quality and/or mis-sold to a gullible fan base as part of a misinformation campaign. This is why the misinformation aspect is more weighty. Alexbrn (talk) 08:32, 8 June 2021 (UTC)

The first paragraph at WP:MEDPOP states “The popular press is generally not a reliable source for scientific and medical information in articles. Most medical news articles fail to discuss important issues such as evidence quality,[28] costs, and risks versus benefits,[29] and news articles too often convey wrong or misleading information about health care.[30]“ I think editors are doing a good job here.

However, the second paragraph states “Conversely, the high-quality popular press can be a good source for social, biographical, current-affairs, financial, and historical information in a medical article.“ I am concerned that the second paragraph is being ignored. Obviously potential treatments or preventions for COVID are important for the social, current-affairs and possibly historical context. The nature of a pandemic makes this all the more relevant—this is not a simple medical article. “Like any drug” is not persuasive to me. If we have a great Reuters source saying that the Philippines is studying ivm for COVID, perhaps it would be worth mentioning on that basis. It can be argued that it is undue, certainly, but it's not unverifiable, it's not a bad source, and it's not misinformation. -SmolBrane (talk) 15:14, 8 June 2021 (UTC)

It's just a factoid, not the kind of knowledge Wikipedia wants to deal in. Are you going to go to each of the articles on methylprednisolone, melatonin, tawa-tawa, and coconut oil and demand that we record the factoid of a COVID clinical trial? If every trial for every substance was worth mentioning on Wikipedia we'd have a almighty WP:LAUNDRY mess. We already say there are some trials. That's enough here. Alexbrn (talk) 15:31, 8 June 2021 (UTC)

Those are good points. I'm not "demanding" anything, I would encourage you to remain civil. I still believe the lead would be better served by acknowledging that ivermectin has, and continues to be investigated as a treatment option for COVID, if we are going to include a statement on COVID misinformation. Perhaps we could say something like:

While at least 45 studies are currently ongoing or completed, No reliable evidence exists to back up such claims.

Additionally, the article fails to acknowledge that India DID use ivermectin as a treatment, not that it was simply being “allowed”, as the wiki article currently states:

Despite the absence of high-quality evidence to suggest any efficacy and advice to the contrary, some governments have allowed its off-label use, including Czech Republic,[89]Slovakia,[89] Peru (later rescinded despite continuing use),[90][91] and India.[92][93]

What the source actually says:

The state of Goa, a major tourist haven, said earlier this week it plans to give ivermectin to all those older than 18, while the Himalayan state of Uttarakhand announced plans on Wednesday to distribute the tablets to any person over the age of two, except for pregnant and lactating women.

The characterization of the sources on Czech Republic and Slovakia seem correct to say “allowed”, although the Peruvian source seems to suggest that usage was closer to a recommendation, from the source(translated):

In the framework of the second wave of COVID-19 , the Ministry of Health (Minsa) and EsSalud once again included ivermectin in the new kit for the outpatient treatment of patients with this disease, despite being withdrawn last year.

-SmolBrane (talk) 16:11, 8 June 2021 (UTC)

The country stuff would be better covered in the misinformation article, where there's already some content about how the misinformation has caused some bad policy decisions. Alexbrn (talk) 16:15, 8 June 2021 (UTC)

I'll address the "country stuff" in the RfC above so we can stop discussing it here. Anyway I still think the lead would more accurately reflect the rest of the page if we mentioned that COVID-related studies are ongoing, or that many occurred. Possible therapies for an ongoing pandemic that has limited therapies has relevance beyond the medical and scientific context; it has affected government policies. Inclusion won't diminish the current statement or mislead anyone, indeed the current lead seems to suggest that only misinformation surrounding ivm and COVID exists. There are many sources that suggest a possible therapy on the basis that ivm has anti-viral uses elsewhere. The investigation of such possibilities should be discerned from the misinformation for the benefit of the reader, if we are going to include such commentary in the lead at all. -SmolBrane (talk) 17:45, 8 June 2021 (UTC)

Compare with Thalidomide, which has an entire section entitled "Society and Culture". SmolBrane (talk) 18:22, 8 June 2021 (UTC)

I'm not sure how that's relevant. As the acknowledged cause of one of the biggest drug scandals in human history, with huge human consequences documented, that would be expected. OTOH, we don't mention current clinical trials for thalidomide in that article's lede, despite the fact there are more of them than for ivermectin. Alexbrn (talk) 18:34, 8 June 2021 (UTC)

Semi-protected edit request on 8 June 2021

The claim that there is no evidence of Ivermectin being effective as prophylaxis and treatment for COVID-19 is false. Ivermectin has shown efficacy in fighting viruses of multiple types in vitro and in vivo. There are multiple peer reviewed observational and RCT studies, as well as review papers discussing this. I suggest you remove this false statement about Ivermectin and COVID-19 entirely. And replace it with a more accurate articulation describing that it is highly disputed amongst scientists and practitioners and there is not a consensus regarding its efficacy in the case of preventing and treating COVID-19. Kwall926 (talk) 02:45, 8 June 2021 (UTC)

 Not done. Wikipedia reflects accepted knowledge as published in reliable sources. Alexbrn (talk) 08:34, 8 June 2021 (UTC)

"No evidence" is shorthand for "no evidence except the sort of useless, weak or crappy evidence you will get when something does not work but there are a lot of people trying to prove it does". --Hob Gadling (talk) 11:40, 8 June 2021 (UTC)

Kwall926, the burden is on you to provide the studies you mentioned. Then we can discuss if they are reliable or not for medical claims. Alaexis_¿question? 11:52, 8 June 2021 (UTC)

There are reliable sources that claim that ivermectine could be used to treat covid, those are already cited and references, hiding the conflict helps no one, treating scientific reaserch as misinformation is clearly a violation of WP:IMPARTIAL. Eloyesp (talk) 22:13, 11 June 2021 (UTC)

Those reliable sources are? --Hipal (talk) 23:50, 11 June 2021 (UTC)

"Laboratory studies found that ivermectin could block replication of SARS-CoV-2 (the virus that causes COVID-19), but at much higher ivermectin concentrations than those achieved with the currently authorised doses. Results from clinical studies were varied, with some studies showing no benefit and others reporting a potential benefit. Most studies EMA reviewed were small and had additional limitations, including different dosing regimens and use of concomitant medications."

"The NIH in February said that some clinical studies showed no benefits or worsening of disease after ivermectin use; other studies suggested using ivermectin had some benefits. "However, most of these studies had incomplete information and significant methodological limitations, which make it difficult to exclude common causes of bias," the NIH said."

A large majority of randomized and observational controlled trials of ivermectin are reporting repeated, large magnitude improvements in clinical outcomes. Numerous prophylaxis trials demonstrate that regular ivermectin use leads to large reductions in transmission. Multiple, large “natural experiments” occurred in regions that initiated “ivermectin distribution” campaigns followed by tight, reproducible, temporally associated decreases in case counts and case fatality rates compared with nearby regions without such campaigns.

Those references seems to make it clear that there exist "reliable sources that claim that ivermectine could be used to treat covid", on the other hand, most of them make it clear that there is still uncertainty about the effectiveness and the security of such a treatment, and that it is not yet recommended, but those already referenced sources do never claim something like "there is no reliable source for that claim". Eloyesp (talk) 02:08, 12 June 2021 (UTC)

"Natural experiments" are especially not WP:MEDRSes, and MEDRSes are the standard of evidence necessary to put a claim into this article. I am sorry but that article you cited from Pierre Korry conflicts with many other sources, and it itself is not a systematic review or meta-analysis. Which are the standard of evidence necessary to make such a claim. It is putting forth the same shoddy evidence standard Dr. Korry has put forth for ivermectin for many months now. And no matter how much lipstick you put on a pig, it will never be prom queen. The evidence is poor quality, it has poor controls, the control groups are not well-matched, it includes many different studies with different standards in the same group of analysis... all of which are fundamentally bad scientific practices. Until we can determine that a consensus of MEDRS publications supports the claims you're making, they should not be included in this article.--Shibbolethink ^{(♔ ♕)} 03:00, 12 June 2021 (UTC)

@Eloyesp: The American Journal of Therapeutics does not look good on SCImago, so WP:RSUW. As for the other two you mentioned, your emphasis is WP:UNDUE. See:

Laboratory studies found that ivermectin could block replication of SARS-CoV-2 (the virus that causes COVID-19), but at much higher ivermectin concentrations than those achieved with the currently authorised doses. Already in the first paragraph of Ivermectin#COVID-19. Results from clinical studies were varied, with some studies showing no benefit and others reporting a potential benefit. Most studies EMA reviewed were small and had additional limitations, including different dosing regimens and use of concomitant medications.

The NIH in February said that some clinical studies showed no benefits or worsening of disease after ivermectin use; other studies suggested using ivermectin had some benefits. "However, most of these studies had incomplete information and significant methodological limitations, which make it difficult to exclude common causes of bias," the NIH said.

EMA and NIH have already done the work of assessing evidence quality (WP:MEDASSESS). --Fernando Trebien (talk) 11:51, 12 June 2021 (UTC)

Clearly both quotes say that most of the studies had "limitations", thus they clearly state that some studies do not match with that criteria, so the article cannot read: "No reliable evidence exists". --Eloyesp (talk) 15:03, 12 June 2021 (UTC)

Maybe out of an abundance of scrupulousness, I have re-worded this to "Such claims are not backed by good evidence". Everybody should be happy now. Alexbrn (talk) 15:45, 12 June 2021 (UTC)

Thanks for the change, it is not the wording I would chose, but it at least makes clear your intentions are not bad.--Eloyesp (talk) 19:11, 12 June 2021 (UTC)

You are right to think that some of them had no such methodological limitations, but wrong to believe that this means they found some benefit. Therefore, there is still no reliable evidence. --Fernando Trebien (talk) 16:44, 12 June 2021 (UTC)

Same mistake again, I do not need to "believe they found some benefit", the burden is on you to provide prove that they found NO study that show a benefit.--Eloyesp (talk) 19:11, 12 June 2021 (UTC)

Absence of evidence ("None of these claims is supported by science") is different from evidence of absence ("Scientific studies have shown that these claims are false"). --Fernando Trebien (talk) 00:51, 13 June 2021 (UTC)

Please read carefully my words, I'm not doing any research myself, I do not claim that there is "absence of evidence", nor that there is "evidence of absence", I DO claim that the referenced sources do not support the claims written on the wikipedia article. What is made evident on your comment, is that you feel that your research on supporting evidence is what actually do support such claims, so you do not need that the actual references say exactly that, so the misrepresentation of the sources is actually just hiding a violation of WP:NOR.--Eloyesp (talk) 14:06, 16 June 2021 (UTC)

This is bizarre, to the extent I wonder if there is a language problem. Eloyesp's statement ("the burden is on you to provide prove that they found NO study that show a benefit") is wrong, to support the claim that "there is no good evidence". That is a fair summary, amply supported by excellent sources throughout the article. Alexbrn (talk) 14:11, 16 June 2021 (UTC)

Sorry Alexbrn, I do not discard a language problem. When I say "the burden is on you to provide prove that they found NO study that show a benefit" I mean that instead of saying some generic statement like "amply supported by excellent sources throughout the article" there might be a quote of one of such excellent sources that make clear that point. On the quotes that were already made from the excellent sources that are referenced in the article the wording used was less strong than the used on the "fair summary" (specially the original one, the new one is much better, thanks for that). But, as already explained, English is not my first language so the difference I observe between the referenced articles and the summary, when one sounds like a humble scientific thinking ("most of the studies where...") and the later as a newspaper headline ("there is no good evidence"), might not be that for an English reader.--Eloyesp (talk) 14:55, 16 June 2021 (UTC)

Many sources. For example the first says "the available data do not support its use for COVID-19 outside well-designed clinical trials"; when we say there is "no good evidence" to support its (assumed clinical) use, that is a fair reflection of that. Evidence needs to be "good" for something to be considered a viable treatment. Alexbrn (talk) 15:01, 16 June 2021 (UTC)

You seems to misunderstand my point, I'm not making a claim like "there is clear evidence that ivermectine do magic", that is not the case. If that were the case, I would be forced to prove that point, but I'm not.

I'm saying that the article makes a claim that is not sourced, adding references that do not prove the point, misrepresenting the referenced sources to make they say what they do not.

The article reads: "No reliable evidence exists to back up such claims." and references three articles that do not say that, forcing the sources to make the claim. If you find a source to support such a claim, please add that as a reference, but those three articles do not do it.

If your conclusion as an expert is that after reviewing multiple papers and a lot of research you have found not "reliable evidence to back up such claims" then write a paper about it and reference that paper on the article, but WP:NOR.

So I do not have to prove that there are reliable evidence (I'm not writing that on the article), but you need to reference the opposite or remove it.

Just to add a little of context: my last edit changed that very phrase for "The EMA and the FDA advises against this use because the available data do not support it" and that phrase is supported by the references given. Eloyesp (talk) 03:37, 12 June 2021 (UTC)

What we say is a good summary of what the EMA says ("the available data do not support it") along with all the other high-quality sources. Per WP:YESPOV this needn't be attributed as it's not in serious dispute. Alexbrn (talk) 06:09, 12 June 2021 (UTC)

Let me disagree with that, the phrase "No reliable evidence exists to back up such claims" is not a good summary for the "the available data do not support it", given that, the second one does not make clear who makes that claims and the context is also different. In the sourced article "it" refers to "an authorized and promoted treatment" while the wikipedia article is talking about ivermectin being beneficial on the treatment and prevention. While that might sound like a subtle difference I think it is not. --Eloyesp (talk) 15:03, 12 June 2021 (UTC)

For that to be a meaningful difference, you'd have to believe it was effective but that multiple health authorities still didn't approve it. That sounds like a conspiracy theory. Wikipedia likes to align itself with reputable sources like health authorities, and by that token Wikipedia's standard for what it "reliable evidence" or not is that same as those bodies have. Alexbrn (talk) 15:38, 12 June 2021 (UTC)

I'm going to remove the dispute tag on this, because now we are quibbling about one specific phrase. I get why it's contentious to some editors, but I believe the consensus is in favor of the current language, not only based on what's been said above, but also based on what has been said several times before on this talk page about this exact question. A dispute about a single phrase that is already arguing between "This is not supported by the evidence" and "there is no evidence to support" is truly not enough for a disputed tag in my humble opinion. If we can get a consensus on this talk page (or elsewhere) that this is actually disputed in credible articles published in journals worth reading (which this one is not), then I will personally add the tag back.--Shibbolethink ^{(♔ ♕)} 15:49, 12 June 2021 (UTC)

I think that is it not good for an encyclopedia to hide disputes and to force confidence. If there is some doubt on the scientific community it is always better to make clear what the positions are. It is clear in those referenced articles that they chosen to be very cautious with the wording they used (for example they used "most of the", instead of "none of the"). That kind of caution or openness to being wrong is very important on the scientific way of think. On the other hand, the language used on the wikipedia article seems to be much stronger and determinant (read less scientific). It is not the type of encyclopedia that I would like to build, I don't know how many of you value the clarity of strong language over the humble language of scientific thinking. At the very end, it seems that it is just another conflict of visions.

I'm over here, I made clear my point and I have no more energy, I'm very sad for this situation. I would like to ask for pardon if I offended someone, it was never my intention, and sorry for my English, it is not my first language.--Eloyesp (talk) 19:11, 12 June 2021 (UTC)

What are you talking about? The article says in the lede, "Such claims are not backed by good evidence." Is something wrong with that? The article say a lot more, but if you wnat to change parts of it, you need to be specific. Unspecific wailing and waving of hands will get you nowhere. --Hob Gadling (talk) 06:12, 15 June 2021 (UTC)

References

Useful studies?

• Carvallo et al 2020. Study of the efficacy and safety of topical ivermectin+ iota-carrageenan in the prophylaxis against COVID-19 in health personnel. J. Biomed. Res. Clin. Investig., 2.

• Cobos-Campos et al 2021.Potential use of ivermectin for the treatment and prophylaxis of SARS-CoV-2 infection: Efficacy of ivermectin for SARS-CoV-2. Clin Res Trials, 7: 1-5.

• Database of all ivermectin COVID-19 studies. 93 studies, 55 peer reviewed, 56 with results comparing treatment and control groups.

• Karale et al 2021. A Meta-analysis of Mortality, Need for ICU admission, Use of Mechanical Ventilation and Adverse Effects with Ivermectin Use in COVID-19 Patients. medRxiv.

• Kory et al 2021. Review of the Emerging Evidence Demonstrating the Efficacy of Ivermectin in the Prophylaxis and Treatment of COVID-19. American Journal of Therapeutics, 28(3): e299.

• Nardelli et al 2021. Crying wolf in time of Corona: the strange case of ivermectin and hydroxychloroquine. Is the fear of failure withholding potential life-saving treatment from clinical use?. Signa Vitae, 1: 2.

• Yagisawa et al 2021. Global trends in clinical studies of ivermectin in COVID-19. The Japanese Journal of Antibiotics, 74: 1.--193.152.127.203 (talk) 10:35, 16 June 2021 (UTC)

See WP:MEDRS for what constitutes a reliable source for biomedical content on Wikipedia. The only one here which gets in sniffing distance is the review in American Journal of Therapeutics, but as has been previously discussed this is a low quality journal harbouring a discredited paper, so not usable. We do, on the other hand, have some excellent high-quality sources from the European Medicines Agency, FDA, the BMJ and so on. Alexbrn (talk) 09:03, 16 June 2021 (UTC)

I assume you have read them. By the way, WP:TALKO.--193.152.127.203 (talk) 10:35, 16 June 2021 (UTC)

Whatever for! Why read crap sources when good ones are available? That's a recipe for a wasted life and a head full of learned lumber. Alexbrn (talk) 10:57, 16 June 2021 (UTC)

I suggest you give the WP:SECTIONHEADINGOWN part of WP:TALKO a more careful read. You do not own this section, we all do, together. It is appropriate for others besides the section creator to edit section headings. See also this relevant quote: "Because threads are shared by multiple editors (regardless of how many have posted so far), no one, including the original poster, "owns" a talk page discussion or its heading. It is generally acceptable to change headings when a better heading is appropriate, e.g., one more accurately describing the content of the discussion or the issue discussed, less one-sided, more appropriate for accessibility reasons, etc."--Shibbolethink ^{(♔ ♕)} 13:21, 16 June 2021 (UTC)

A preprint

I intend to post some relevant articles here:

• Biber, Asaf; et al. (31 May 2021). "Favorable outcome on viral load and culture viability using Ivermectin in early treatment of non-hospitalized patients with mild COVID-19 – A double-blind, randomized placebo-controlled trial" (Preprint). medRxiv. Sheba Medical Center, Israel. doi:10.1101/2021.05.31.21258081. Retrieved 19 June 2021. Seligne (talk) 20:54, 19 June 2021 (UTC)

It's a preprint. Editors trying to use preprints for COVID-19 can expect to get sanctioned, so why propose it? Alexbrn (talk) 04:55, 20 June 2021 (UTC)

Useful study?

• Bryant, Andrew et al. (June 17, 2021) - Ivermectin for Prevention and Treatment of COVID-19 Infection (American Journal of Therapeutics) doi: 10.1097/MJT.0000000000001402

Conclusions: "Moderate-certainty evidence finds that large reductions in COVID-19 deaths are possible using ivermectin. Using ivermectin early in the clinical course may reduce numbers progressing to severe disease. The apparent safety and low cost suggest that ivermectin is likely to have a significant impact on the SARS-CoV-2 pandemic globally."--193.152.127.23 (talk) 21:47, 19 June 2021 (UTC)

@Alexbrn: Is this also a crap source?--193.152.127.23 (talk) 21:47, 19 June 2021 (UTC)

It's a low quality-journal (also the one Kory and Marik eventually got to accept their paper). So not useful, especially considering the WP:REDFLAG for this subject area. Alexbrn (talk) 04:54, 20 June 2021 (UTC)

@Alexbrn: Are you using any quantifiable metric to call the journal low quality? I see H Index of 62 (compared with over 1000 for Nature, Science, JAMA), so clearly it's not a top journal. I believe the relavent guideline you're using (including the WP:REDFLAG allusion) is "exceptional claims require exceptional sources", which states that multiple high quality sources are required for an exceptional claim.

In looking for a definition of or rubric with which to assess source quality, I can find the reliable sources guidelines, which states, "If you are unsure about the quality of a journal, check that the editorial board is based in a respected accredited university, and that it is included in the relevant high-quality citation index—be wary of indexes that merely list almost all publications, and do not vet the journals they list." Do you have a good idea of which citation index is a good reference for "high quality" in this case? As for the editorial board of the American Journal of Therapeutics, I checked the editor in chief and a few others and they appear to be from the Zucker School of Medicine, which is quite small, but is fully accredited as of 2015, and is ranked #66 by US News and World Report in the Best Medical Schools: Research category

Given the above, I think the journal checks at least one of the two boxes for being considered high-quality: editorial board based on well respected and accredited university, and journal being present in a high-quality citation index. I don't see any guidance indicating high quality implies high impact (e.g. as measured by H index). Again, I don't know about whether the journal appears in a citation index which would only include high-quality journals, but if you have evaluated the journal as low-quality, I can only assume you were not able to find it in one such index. Can you please elaborate? — Preceding unsigned comment added by Tcx64 (talk • contribs) 02:08, 21 June 2021 (UTC)

The previous discussion was at #Semi-protected edit request on 8 June 2021. One can use various metrics (an impact factor below 2 is sometimes invoked as a bright line, e.g.) but ultimately WP:CONTEXTMATTERS. For an area with known research fraud, and in which we have multiple unimpeachable medical sources pointing in one direction, an outlier low-quality journal (which has already published one discredited ivermectin paper) isn't going to cut it. As you say, WP:EXCEPTIONAL applies. (Update: the paper is discussed in some detail here and the concerns raised: questionable methodology and undisclosed conflicts of interest, further confirm that this source is not suitable for Wikipedia's purposes). Alexbrn (talk) 06:43, 21 June 2021 (UTC)

Interestingly, the author of that Science Based Medicine piece, David H. Gorsky, is listed as being on the editorial board of the American Journal of Therapeutics. The journal itself doesn't have great impact scores, but Wikipedia guidelines don't require "top-tier", nor should they. I cannot find guidelines supporting calling the Journal low-quality (though I am still unsure about which citation index should be used, I haven't yet found evidence it is predatory, at the very least). In light of the above, WP:CONTEXTMATTERS is in my opinion the more salient guideline here, pertaining to this particular paper. Not the journal as a whole. It seems that Gorski himself might agree. If Gorski is indeed on the editorial board, the fact that he would remain so and yet speak out against the paper is at least worth looking into. Gorski also appears to mock the journal for having published what he deems a hilarious argument made by Kory et. al. i.e. the ecological argument that regions where Ivermectin is used have better Covid outcomes. While I don't think this is nearly as hilarious or fallacious as does Gorski, I think this supports the idea the paper is more controversial than the journal itself. I do find it odd that he fails to mention he is on the board as an associate editor (though for all I know that editorial board list is out-dated).

The reason I'm carrying on about the quality of the journal is that the guidelines require evidence from multiple high-quality sources, which in the case of medical research would most likely be journals. If another paper is published at a journal that meets Wikipedia's standards for high quality, namely being listed on a reputable citation index and having a reputable editorial board, I think it would be quite difficult to argue for not including the claim that there exists evidence that Ivermectin is at least somewhat effective against Covid19. At a certain point defending keeping that claim off the page because WP:CONTEXTMATTERS, based on claims that aren't peer reviewed (albeit from experts like Gorski with high notoriety), starts to feel like a form of original research. — Preceding unsigned comment added by Tcx64 (talk • contribs) 14:25, 21 June 2021 (UTC)

On Wikipedia the position statements of major medical bodies and clinical guidelines are at the top of the tree alongside secondary sources in prestigious medical journals. We have several good sources on Ivermectin/COVID so there's no need to scrape the barrel with something in a minor journal that provokes hilarity in a source which is well-regarded for its coverage of fringe medicine. The "claims on the page" here flow from the WP:BESTSOURCES as they should. Alexbrn (talk) 13:40, 21 June 2021 (UTC)

In order to see how funny the reasoning regions where Ivermectin is used have better Covid outcomes is, you would have to be familiar with the unreliability of that method. Gorski explains further in the other article he links: [7], starting with "But let’s get back to what this trial really is". Also, you did not sign your badly indented contribution. --Hob Gadling (talk) 16:14, 21 June 2021 (UTC)

@Hob Gadling: I understand the argument about ecological analysis, and I'm not going to debate it here, but my disagreement lies in the magnitude of the doubt cast, not that doubt shouldn't be cast at all (in general I mean; perhaps this particular ecological analysis is particularly bad). Instead of merely assigning a judgment to my formatting, why not take a second to explain, or at least link to something useful? Obviously I'm not an experienced Wikipedia editor. Did I indent too many times? Anyway, I like Wikipedia and have used it as data for academic research for years, and have a vested interest in its credibility. I am not attempting to "go rogue" and edit a page where I don't have a strong understanding of the material. Alexbrn My concern is that if a result published in a prestigious journal is contradicted by a result in a not very prestigious journal, it will be thereby disallowed. I think you can see how this could be counter-productive. But if as you say, the American Journal of Therapeutics is well-regarded for its coverage of fringe medicine, and that is the reason for not including its articles as a source for a minority viewpoint, I think that evidence should be provided. When that documentation comes from an associate editor of the journal itself (i.e. Gorski), perhaps that makes the documentation even more credible! But it's not clear to me that Gorski meant to generalize beyond the papers in question to the journal as a whole. Please don't interpret my concern as suggesting foul play, because I'm not. It is pretty clear to me that there is a group of people who very much want to write on this page that Ivermectin is a promising Covid treatment, and there is a group of people that believe this would be highly irresponsible and based on terrible arguments. Not sure if you're doing so, but you would be wrong to interpret my concern as being in the former camp. I am getting the sense, however, that the latter camp is growing increasingly annoyed and as a result dismissive - perhaps for good reason. I appreciate the work people are doing to uphold Wikipedia's standards. Covid and it's treatment is a hugely important issue and more than anything I want to understand the reasoning behind decisions that are being made about how information is disseminated and controlled. I don't think I am alone in that desire.Tcx64 (talk) 17:03, 21 June 2021 (UTC)