South Dakota Republicans do love to play doctor. Yesterday, seven Republicans who are not medical doctors ignored the advice of South Dakota’s actual doctors and medical experts and approved House Bill 1267, Representative Phil Jensen’s witch-doctoring proposal to allow health care practitioners to hand out ivermectin without a prescription.
Tim Rave, lobbyist for the South Dakota Association of Healthcare Organizations, actually said ivermectin kinda works against covid-19, but only in doses strong enough to kill you:
Tim Rave, executive director for the South Dakota Association of Healthcare Organizations, said ivermectin works but at dangerously high levels.
“The therapeutic dose for ivermectin in COVID-2 according to the NIH study is a hundred times the dose a human should have. At that level it destroys your liver and kidneys. So it will destroy the COVID cell but it will also destroy your liver and kidneys,” he said. He added, “We don’t know that it works in a therapeutic level safe for human beings on COVID-2” [Bob Mercer, “S.D. House to Debate Ivermectin for Covid-19,” KELO-TV, 2022.02.10].
Even there, lobbyist Rave overstates the case for ivermectin. The National Institutes for Health summarize the clinical data available from around the world and find no evidence of clinical benefit from ivermectin. Studies claiming benefits have been found rife with errors. And the last people qualified to analyze scientific data and prescribe medical interventions are Phil Jensen and his fellow yahoo Republicans, who are happy to ban abortion drugs that the FDA says are safe while promoting horse-worm drugs that the FDA says are not safe for people with coronavirus.
Even so, HB 1267 barely passed, as four sensible Republicans—Representatives Carl Perry, Taylor Rehfeldt, Sydney Davis, and Paul Miskimins—joined House Health and Human Services’ two Democrats—Representatives Jennifer Keintz and Erin Healy—in standing for doctors and science and standing against right-wing flailings for any excuse not to take sensible and scientifically proven measures like getting shots, wearing masks, and not going to big social gatherings to beat the pandemic.
Republican leadership is an oxymoron. The faster all the deplorables taser themselves in the testicles until their myocardias infarct the better.
Not sure what the love fest with ivermectin is, but it’s pretty dumb to waste legislative time on this.
Why ivermectin? Is there a shortage of bleach? I thought Kristi stockpiled hydroxy-chloroquine. Shouldn’t we use the snake oil we have before prescribing some alternative? /s
I know Noem stocked up on hydroxychloroquine – maybe they could using up those supplies. Meanwhile, must ALL the cockroaches come out of the woodwork in this session? What a bunch of utter crap.
As long as the dumb-dumbs want to waste time, how about a Democrat introducing a resolution congratulating Vice President Pence for correcting his former boss about his authority to overturn an election on Jan. 6 and that Trump lost the election fairly and squarely? It seems this session is only about validating the abuses of power and lies of #45’s tenure and not about solving any real problems in South Dakota. You’re going to know if the South Dakota Democratic Party has a pulse at all when you see how many seats in the legislature go unchallenged. If there was ever a time when Democrats could regain long lost seats, it’s the 2022 election.
Go for it, South Duhkota. Start with Guv Annie Chokely and give all deplorable magats exactly 100X the recommendead (pun intendead twice) dose for humans and ban any of them from liver or kidney transplants, if they survive the cure.
96, it’s February 11th, and Democrats have filed for 0 out of 35 Senate Seats and maybe 4 out of 70 Representative Seats.
Democratic Party is hungry to lose 2022.
In response to the comment about zero democrats filing for senate seats, let’s be honest here. Democrats lost in 2004 and finally in 2015. There hasn’t been strong representation since then and it would take an extremely strong willed person to put themselves in a democratic race against the republicans in today’s political toxic mess.
There is at least one MD in SD who has made a claim to me that India’s use of ivermectin has been what has kept their infection rates down. I got him to post to me a macro analysis of various “research” on the topic, letting him know that I tutor graduate level research design and statistics, so I would definitely be able to understand what all the jargon meant. After reading it, I reported to him that what it said was that there was that in some studies (about 2/3) the selection and/or exclusion criteria for cases used in the study were likely to make the conclusions invalid (non random – or BIASED selection criteria). In the remainder of the studies (random selection criteria intact) the overall conclusion was that there was NO relationship between Ivermectin use and case outcomes. I also pointed out to him that this was the macro-analysis paper that was used by the healthy department of India to BAN the use of Ivermectin in June of 2021. Guy’s a sports medicine/exercise doc. So, go figure. My guess is he’s probably gonna set up a prescription by mail/internet business if this passes. Ethical problems exist in all professions. Is this any better to the pedophile cop?
BTW, after pointing out to the doc what the analysis actually said – crickets.
Well my wife told me when they used Ivermectin on their horses on the farm you didn’t want to stand behind them for a few days. Republican’s are ignorant but at least they will sheet well.
I’m struggling what this is actually saying, “allow health care practitioners to hand out ivermectin without a prescription”. Does this mean that the animal version of ivermectin?
I do not think that state law can override rules on control and dispensing of federal regulated medication.
An Act to allow certain medical professionals to dispense ivermectin to persons with 2 or without a prescription. 3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA: 4 Section 1. That chapter 34-20B be amended with a NEW SECTION: 5 A practitioner may, in accordance with accepted medical standards, dispense 6 ivermectin to a person with or without a prior prescription. 7 A practitioner is prohibited from seeking personal financial benefit by participating 8 in an incentive-based program that encourages therapeutic or product changes or the 9 ordering of tests or services related to ivermectin. 10 A practitioner, upon dispensing ivermectin to a person, shall provide the person 11 with an information sheet that must include the importance of follow-up care and health 12 care referral information.
34-20B-1
18) “Practitioner,” a doctor of medicine, osteopathy, podiatry, optometry, dentistry, or veterinary medicine licensed to practice their profession, or pharmacists licensed to practice their profession; physician assistants certified to practice their profession; certified nurse practitioners, certified nurse midwives, and certified registered nurse anesthetists to practice their profession; government employees acting within the scope of their employment; and persons permitted by certificates issued by the department to distribute, dispense, conduct research with respect to, or administer a substance controlled by this chapter;
(7) “Dispense,” to deliver a controlled drug or substance to the ultimate user or human research subject by or pursuant to the lawful order of a practitioner, including the prescribing, administering, packaging, labeling, or compounding necessary to prepare the substance for such delivery, and a dispenser is one who dispenses;
No definition for accepted medical standards.
I’m not sure what this bill is trying to do.
I didn’t like when we wanted to legislate marijuana as medicine; I don’t like this now. I do not believe there is any proper role for the legislature in telling doctors what is medicine and what is not. The AMA must step up and police its profession (based on science of course).
As Richard Schriever notes and I’ve been saying for five years, MAGA’s believe anything they agree with. No facts needed, just tell ’em what they want to hear, and they’ll follow you like a l’il lamb.
My friend, a doctor he told me what to do
He said that:
… Ooh-ee, ooh ah-ah, ting tang
Walla walla bing bang
Ooh-ee, ooh ah-ah, ting tang
Walla walla bang bang
Real doctors could say, inept inbred Republicans do love to play know it alls.
Ooh-ee, ooh ah-ah, ting tang
Walla walla bang bang.
Porter, you give the MAGAs too much credit. Your point that they believe what they agree with means that they would have some individual knowledge or stand on these proclamations. I don’t see that as the case. I don’t think before MAGA cult leaders spoke of ivermectin they would have connected this to a COVID treatment. Instead, I would assert that MAGA’s believe whatever their cult leaders tell them. To me, this is the defining characteristic that makes MAGA a cult (a cult of personality at minimum).
Sanford, I think, was the hospital that provided the miracle cure all, hydroxychloroquine. I think that proved just about as effective as Ivermectin, in other words, a placebo for humans involving covid19. Ivermectin does work on horse worm treatment though.
Is my friend Tim Rave a doc now with a medical degree? You diss the legislators for lack of a medical degree and drop in a Rave quote?
There are docs in SD who say early ivermectin is keeping all their patients out of the hospital, and they get better in 1-3 days. Only patients who are further along in their infection are they putting in the hospital. One told me that in a pandemic it’s unethical to withhold a potential treatment. He said he’d throw a kitchen sink at this pandemic if he thought it would help. Too many people have died that would have lived.
Let’s keep this between a patient and their doctor. Pharmacists should stop practicing medicine.
Steve, you’re not dead!
Pharmacists are doctors for all intents and purposes in today’s medical industry so dispensing the drugs to transplant recipients like Professor Hickey is well within their wheelhouses.
Mr. Hickey, what do you call those who graduate medical school at the bottom of their class?
Doctor.
Meta-Analyses Do Not Establish Improved Mortality With Ivermectin Use in COVID-19
Rothrock, Steven G. MD; Weber, Kurt D. MD; Giordano, Philip A. MD; Barneck, Mitchell D. MD
American Journal of Therapeutics
January/February 2022 – Volume 29 – Issue 1 – p e87-e94
Ivermectin has been identified as an inexpensive, readily available drug with the potential to be repurposed as a treatment for COVID-19, especially in countries with limited access to vaccines. Although multiple studies have been published in an attempt to evaluate its usefulness in COVID-19, many are small and not constructed appropriately to detect differences in important clinical outcomes (ie, death). For this reason, researchers have turned to meta-analyses to combine study results and draw summary conclusions regarding ivermectin’s effectiveness. Two such meta-analyses recently published in the American Journal of Therapeutics concluded that ivermectin decreased mortality and improved other surrogate end points in COVID-19. A recently withdrawn article caused both authors to rework their meta-analyses without altering their main conclusions. We feel that shortcomings within both sets of meta-analyses and limitations in the component studies are significant enough to invalidate their main finding that ivermectin reduces mortality. A review of other meta-analyses on the same subject, containing many of the same individual studies, were similarly limited by poor design.
Steve, I don’t cite Tim as a medical authority; he was speaking for the health care providers who are saying those doctors throwing horse pills at their patients are endangering their lives without any evidence that they’ll stop covid.
“There are docs in SD who say”—sounds like hearsay, with no sources and no scientific study. Give us names. Give us verifiable results.
The sponsors of this bill are: Representatives Jensen (Phil), Aylward, Dennert, Howard, and Randolph and Senator Frye-Mueller.
Jensen and Frye-Mueller have often advertised their weirdness. The rest of this group have given us (another) reason to disregard anything they have to say about anything.
Efficacy and safety of ivermectin for the treatment of COVID-19: a systematic review and meta-analysis
J Deng, F Zhou, S Ali, K Heybati, W Hou, E Huang, C Y Wong
QJM: An International Journal of Medicine, Volume 114, Issue 10, October 2021, Pages 721–732
Results
Three OSs [observational studies} and 14 RCTs [random clinical trials] were included in the review. Most RCTs were rated as having some concerns in regard to risk of bias, while OSs were mainly rated as having a moderate risk of bias. Based on meta-analysis of RCTs, the use of ivermectin was not associated with reduction in time to viral clearance, duration of hospitalization, incidence of mortality and incidence of mechanical ventilation. Ivermectin did not significantly increase incidence of adverse events. Meta-analysis of OSs agrees with findings from RCT studies.
Conclusions
Based on very low to moderate quality of evidence, ivermectin was not efficacious at managing COVID-19.
Dave FN – not the same meta/macro analysis I read – but the same conclusion. The underlying studies are poorly designed and unreliable.
And this phrase; “ivermectin was not associated with”, is saying there is not even a correlation between the use of Ivermectin and any positive outcome – let alone a causal relationship. Yep – those RCTs and OSs were all conducted by people using – and advocating the use of Ivermectin. THAT is what is called “experimenter bias”. The term experimenter bias is related to the researcher’s influence on the outcome of his research. When researchers choose their topic of research there is a probable outcome that they have predicted in their minds. In psychology this is termed as ‘observer-expectancy effect’. I.E., they are finding what they set out to find, what the wanted to find, what they designed their “research” to find, not what was actually there. Not examples of disciplined professionalism.
Again, probably nobody posting on these boards are a practicing provider. You can literally manipulate statistics however one wants to. Try looking at the literature as a whole a base your medical decision making off of that.
Dr. Robert Malone and Dr. Peter McCullough are the two who’ve been banned from social media for spreading mis/dis information about the vaccine.
What do you think of these Doctor’s assertions, Allen Jeris?
Larry, nope not dead. Came close before Christmas. Had a double lung transplant in Phoenix on Jan 10. Double pulmonary embolisms size a quarter a few weeks later. That about did me in. Today my daughter took me up to South Mountain to walk a short way and sit. I see the appeal of it here for snow birds. Desert is beautiful. July here might be brutal for me. They won’t let me go home for perhaps a year as there isn’t adequate pulmonary care at this level in Alaska.
I’m not naming my doc friends in SD, they’d get fired by these monopoly and controlling medical systems in the state.
Do we need this bill? Can’t these folks just walk into Runnings or Fleet Farm (or whatever) and purchase their “medicine”?
Richard Schriever
Some much finer distinctions deserve to be made regarding the words “unreliable” and “bias,” as both words have several meanings and are not either/or states, but matters of degree.
With regard to the former, you write: “The underlying studies are poorly designed and unreliable.” On the contrary, the authors of the QJM article, for example, found that the RCTs and OSs taken as a whole were indeed reliable enough for two major recommendations in the sense of the adequacy yet insufficiency of the studies. The studies were concluded as adequate insofar as they led to the recommendation for continued use of ivermectin in clinical trials, and concluded to be insufficient insofar as the use of ivermectin for the general population was not recommended. (These recommendations corroborate those of the World Health Organization, as well the findings of a meta-analysis of some 20 meta-analyses published in the January/February 2022 issue of The American Journal of Therapeutics: https://journals.lww.com/americantherapeutics/Fulltext/2022/02000/Meta_Analyses_Do_Not_Establish_Improved_Mortality.11.aspx ).
In other words, there was indeed a degree of reliability in the studies; there were not unqualifiably “unreliable.”
As far as the usage of the word “bias,” there is the popular usage of the word on one hand and the scientific usage of the word when it comes to RCTs. There are also different kinds of bias including and not limited to “experimental bias.”
“Bias” in its common usage pretty much comes down to nothing but a matter of personal opinion that hasn’t been vetted by use of formal systems in place for its assessment. “Bias” in the sense as used in scientific meta-analyses, however, means something very different as it necessitates the use of formal, conventionally agreed up on instruments to evaluate scientific studies such as RCTs under discussion. Such instruments expose design bias, sampling bias, measurement bias, response bias, interviewer bias, response bias, interpretive bias, to name but a few. They do not nor can they expose subjective, opinion-type bias, whether or not it is present.
In the case of RCTs one such recognized tool is the Cochrane Risk of Bias (RoB2) tool: https://sites.google.com/site/riskofbiastool/welcome/rob-2-0-tool/current-version-of-rob-2 .
When bias is found using this instrument such bias is not to be confused with the popular usage of the word, as though a scientists’ personal opinions were contaminating the research. You seem to imply this in more ways than one, Richard, or at least I am inferring that is what you meant when you wrote “Yep – those RCTs and OSs were all conducted by people using – and advocating the use of Ivermectin.” The RoB2 tool that exposes bias says nothing about whether or not the scientists advocated the use of ivermectin or not. That subjective bias (advocating ivermectin or not) was somehow prior to the findings of the RCTs (which latter were found adequate for some recommendations but insufficient for others) would be an example of the logical fallacy of post hoc ergo propter hoc, whereby bias uncovered by the use of RoB2, for example, would be traceable to preconceived opinions of the researchers.
A finding of bias in the case of RCTs by use of instruments such as RoB2 therefore says nothing about the opinions of the scientists but is a very real sense, the construction of the degree of bias within an RCT after-the-fact, a construction made by application of the instrument itself. In other word, “bias” (in the scientific sense) doesn’t simply “exist” but “exists” solely as a function of the application of an instrument. “Bias” in this sense is literally created by the use of an instrument meant to create it — where it exists.
Of course, this gets into some deeper questions, namely, the criteria used by the RoB2 for ascertaining bias, whether the RoB2 is itself biased and if so, why. Addressing only the second question, one must understand the multiple levels of screening that give rise to an instrument such as the RoB2, namely, multiple levels of peer review for funding to develop such an instrument, multiple levels of referees prior to publication, post-publication scrutiny and response, review prior to adoption of such an instrument, etc. This is a level of scrutiny entirely removed from mere “opinion” as it involves deep layers of formal thought at multiple levels. Science is said to efface the subject, and it does so by its instruments and protocols, privileging the latter over popular opinion which has no such detailed protocols as a lens to view reality. Many are against such privileging, but then, many resent authority of any kind and refuse to privilege it. At their peril, I hasten to add.
Thus, when you write “When researchers choose their topic of research there is a probable outcome that they have predicted in their minds,” the protocols of science when duly applied according to scientifically agreed upon conventions will tend to correct for any such “observer-expectancy effect.” Were your statement true, antivaxxers would similarly say that the scientific efficacy of vaccines is nothing but what the effect of the probable outcome of biased/motivated researchers.
[As an aside, during the mid-1990s, the years of the so-called science wars, saw vigorous debate between “realists,” who maintained that facts were objective and free-standing, and “social constructionists, eg. Bruno Latour, who maintained that facts were entities created by scientific research. Realists were afraid that Latour’s position — that all facts were but socially constructed facts — would give license to validation of everything from antivaxxers and flat-earthers. I would rather indicate that Latour effectively demonstrated the distinction between the naïve realism of non-scientists and the high-level formal constructions of good scientists. We hear things today from the standpoint of the naïve in the form of statements such as “you can make statistics say anything you want,” which is true if one is naïve enough to do so].
As far as Cory’s comment “There are docs in SD who say”—sounds like hearsay, with no sources and no scientific study. Give us names. Give us verifiable results,” or at least have those “docs who say” cite scientific sources for their statements,” yes, indeed. Unless one intends to develop policy and legislation based on nothing but anecdotal evidence, which seems to be the case. [Cory and I likely do disagree on what constitutes valid criteria for so-called “evidence-based” policy on athletic mascots which “harm youth.” Socrates was accused of harming youth (“corruptor of youth”) and iconoclasts throughout history (Isis who destroyed antiquities and others) often did so in the name of perpetuation and transmission of their “true” culture to subsequent generations. The APA has a conflict of interest, as far as I’m concerned, as they benefit by treating the very conditions they themselves diagnose into existence].
As far as Tim Rave and his comments, I can but presume he is attempting to refer to what is properly known as “therapeutic index,” the comparison of the amount of ivermectin that would result in a therapeutic effect versus the amount that causes toxicity. If so, however, “therapeutic index” has a stringent scientific definition as the comparison is a mathematical ratio of the median lethal dose (LD50) to the median effective dose (ED50). Both the LD50 and ED50 are experimentally determined from clinical studies, which would imply human experimentation for calculation of the therapeutic index of ivermectin. That’s not going to happen. We need ask Rave to cite the particular NIH study he is citing. I myself know of no NIH published study that claims to determine the therapeutic index of ivermectin.
Curt, you nailed it! Why can’t they just go buy their own and stop the drama?
LIBERALS FOR LIFE
– Although some post-infection treatments (you’ve tested positive) no longer work against Omicron, others, like remdesivir, seem to. The most effective treatment may be Paxlovid, a Pfizer drug designed to fight Covid.
– Unfortunately, Paxlovid can also be difficult to locate. Rebecca Robbins has written about her maddening search to find it for her mother, who’s 73 and has had cancer. Rebecca had to locate Paxlovid herself, at a Rite Aid 60 miles from her mother’s home and hire an Uber driver to pick it up.
– The supply of Paxlovid, in both the U.S. and other countries, will expand rapidly in coming months, which should help. Yet some of the logistical hurdles will surely remain.
– New York Times (this morning)
Allen Jeris – your statement, “You can literally manipulate statistics however one wants to.” tells me one thing. You are neither a practicing researcher, nor a student or user of statistics. That is a phrase used by the unknowledgeable to discredit expertise. I exemplifies the underlying preference that underachieving MAGATs have for amateurism in all fields of endeavor. Well, that is until they actually need an expert to save their lives.
Dave FN. The “reliability” that you are discussing there has to do with a statistical measure @ sample sizes – not the underlying design of the studies, which the various meta-analysis say were insufficiently randomized, and inappropriately selective in the outcome measures to be applicable to the general population. Just off the top of my memory from reading last week.
Cost of about a buck a day, ol DaveFN and that looney Jeris, should be able to afford it. The problems with these trumpian republicans is that they want it for free on the taxpayer dollar
Richard Schriever
Statistical reliability of which you speak and with which I’m familiar refers to the reproducibility of the measurement when repeated at random in the same subject or specimen. Determination of the coefficient of reliability thus requires replicate measurements.
The Cochrane RoB2 measures risk of bias only. You will nowhere find the statistical term “reliable” nor “reliability” in the RoB2 nor in the cited clinical meta-analysis I.
For any RCT conducted and reported incompletely and inadequately, neither the reliability nor the validity of the trial is able to be determined. Two of the RCTs were retracted (Elgazzar, Egypt and Raad, Lebanon) were found to be unreliable in the sense of the unreliable based on analysis of the raw database. I don’t believe this is the definition of statistical reliability to which you refer?
Actually, one person on the committee does have a medical degree. Erin Tobin is a nurse practitioner. It does seem strange that you can buy ivermectin for your animals without a prescription from a veterinarian as it is safe and effective, but we cannot save human lives without a prescription. Ivermectin has been proven safe for humans for a number of years. I guess the pharmaceutical industry would rather people die of this bioweapon than receive a medication that can cure it. I wonder how many lives were lost because of the policy of the government? BTW I wonder where Fauci is hiding? He should be charged with malpractice as well as promoting the jabs that are disabling, sterilizing and killing many.