Ivermectin: Much More Than You Wanted To Know
Read the original on Astral Codex Ten →
Follow-up reading
↳ Highlights From The Comments On Ivermectin — Highlights (companion) · Nov 2021
↳ Response To Alexandros Contra Me On Ivermectin — Scott responds to Alexandros's critique · Feb 2023
Summary
A comprehensive study-by-study analysis of all ~30 ivermectin-for-COVID trials, fairly adjudicating each for fraud (Elgazzar's copy-pasted patients, password '1234'; Carvallo, Niaee, Cadegiani) and methodology, winnowing 29 to 11 credible studies, then running his own meta-analysis (a borderline-significant pro-ivermectin trend that strengthens to clear significance with a Dersimonian-Laird test). The famous synthesis: 'worms!' — the positive trials cluster in Strongyloides-endemic regions (Bangladesh, India, Colombia) and vanish in temperate worm-free ones (Argentina), because COVID corticosteroids trigger fatal worm hyperinfection that a dewormer like ivermectin prevents; ivermectin 'works' by treating undiagnosed parasites, not COVID. Then four takeaways: SCIENTIFIC (the replication-crisis toolkit needs new tools — fraud detection via Carlisle-Stouffer-Fisher and GRIM, and above all mandatory raw-data sharing: 'this year's lesson is read the raw data'); SOCIOLOGICAL (ivermectin believers 'believed Science too much,' trusting dozens of studies over elite say-so; 'Believe Science' backfires, 'believe experts' fails because the experts beclowned themselves and a mere medical student exposed the frauds; maybe 'believe statisticians'); POLITICAL (the 'hostile aliens' parable — why you'd refuse a brain implant from hostile aliens whose arguments you can't check, and how scientists feel like hostile aliens to half the country, vs. Scott as a 'temporarily-embarrassed immunologist'); and a calibrated-confidence SUMMARY.
Why this score
Quality 88 · Excellent. Top-Excellent (88). One of ACX's very best: exhaustive, scrupulously fair primary analysis of a contested literature; a genuinely original and surprising empirical resolution (the worms confound) that dissolves a major public controversy with a correct-feeling mechanism; AND two broadly exported conceptual contributions (the raw-data-sharing/fraud-detection methodological lesson and the 'hostile aliens / temporarily-embarrassed immunologist' model of science skepticism). It is the piece you would send someone to understand both the ivermectin debate and modern science skepticism. Sits with the curated top-Excellent cluster (Categories/Fatima 88), just below Toxoplasma (89) as it is two superb things bolted together rather than one unified frame, and well below the Moloch/Outgroup apex.
Claude’s paradigm shift 62 · Notable shift. Notable-to-major shift (62). The worms-confound synthesis (seeded by Bitterman/Boulware, crystallized and popularized here) and especially the 'hostile aliens / temporarily-embarrassed immunologist' framing of science skepticism were genuinely fresh and influential in 2021; the fraud-detection/raw-data methodology extends the existing replication-crisis discourse rather than originating it, which keeps B below the major-paradigm band.
Real-world impact 4 · Moderate. Dissolved a live pandemic-era public controversy with the 'worms' confound and reached a broad audience during COVID, shaping the ivermectin debate and the wider 'how much should we trust Science' conversation. Genuine topical public significance, but the effect runs through discourse and understanding rather than codified practice or policy — mid RWI.