# A no win situation for doctors **URL:** \ **Category:** The Quarantine Zone\ **Tags:** covid-quarantine\ **Created:** [August 30, 2021, 6:11pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790 "2021-08-30T18:11:57Z")\ **Posts on this page:** 20\ **Page:** 6
**Author:** ![gdave](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gdave/32/3683_2.png) [@gdave](https://boards.straightdope.com/u/gdave)\ **Post date:** [September 4, 2021, 2:59pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/101 "2021-09-04T14:59:15Z")
I mean, sure, that’s technically possible? But by that logic, we should give someone who’s sick literally every possible medicine for every condition that _could_ be weakening the immune system, on the off chance that they have _one_ of those conditions and it just hasn’t been diagnosed. The fact is that there’s just no good evidence that ivermectin has _any_ therapeutically useful effects in treating COVID. And, again, it’s _technically_ possible that a _few_ people were actually helped because they had undiagnosed parasitic worms, and there just weren’t enough of them to be statistically significant, but…again, at that point, just give everyone with COVID everything, because they _could_ have _something_ besides the SARS-COV-2 virus. Before trying to come up with reasons _why_ ivermectin could be useful, it would be nice to have evidence it actually _is_ useful. ---
**Author:** ![k9bfriender](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/k9bfriender/32/3283_2.png) [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)\ **Post date:** [September 4, 2021, 3:07pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/102 "2021-09-04T15:07:24Z")
I’m certainly not recommending it. I’m just wondering if that may be behind some of anecdotal stories of people getting better after taking it. ---
**Author:** ![gdave](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gdave/32/3683_2.png) [@gdave](https://boards.straightdope.com/u/gdave)\ **Post date:** [September 4, 2021, 3:56pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/103 "2021-09-04T15:56:15Z")
Sure, it’s technically possible. But since there’s no good evidence that ivermectin actually has a statistically significant therapeutic effect, there’s really no particular reason to look for reasons why it “worked” in specific cases. It’s possible that _some_ people treated with ivermectin _could_ have _also_ had parasitic worms just by sheer coincidence, and it’s _possible_ that the ivermectin was effective in deworming them, and that in turn deworming them _could_ have helped them fight off the SARS-COV-2 virus. But it’s overwhelmingly more likely that anyone “helped” by ivermectin simply benefitted from the placebo effect, particularly regression to the mean and natural recovery. A _lot_ of people have recovered from COVID _without_ ivermectin. The fact that _some_ people have recovered from COVID after taking ivermectin doesn’t actually tell us anything useful. Anecdotes aren’t really use_less_, but in a situation like this, they’re not particularly use_ful_. _If_ there’s statistically significant evidence that treatment with ivermectin actually makes a difference in meaningful clinical outcomes, _then_ it makes sense to figure out exactly why. I’d personally bet that anecdotal stories of people getting better after taking ivermectin are _entirely_ due to the fact that people sometimes get better. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [September 4, 2021, 4:03pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/104 "2021-09-04T16:03:19Z")
New drugs, and new uses for drugs, are routinely found by observation and anecdote. Of course such uses should be studied before they become recommended standard treatment. And i think it’s dumb to take ivermectin for mild covid outside of a clinical study. But in the case of a guy who is going to die on the best standard treatment, i don’t think it’s crazy to try unproven treatments that are only supported by anecdotal evidence. ---
**Author:** ![k9bfriender](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/k9bfriender/32/3283_2.png) [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)\ **Post date:** [September 4, 2021, 4:39pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/105 "2021-09-04T16:39:19Z")
> [@gdave](#): > > I’d personally bet that anecdotal stories of people getting better after taking ivermectin are _entirely_ due to the fact that people sometimes get better. And really, the problem is that it’s not _sometimes_, it’s most of the time. It makes it hard to tell if something that really does have a benefit actually did anything, or if you would have recovered on your own. Anyway, my point was not to say it should be used _in case_ the patient has parasites, just more or less idly speculating if some doctors have fooled _themselves_ when they have seen improvement after administering it, when the improvement came from a completely unrelated issue. > [@puzzlegal](#): > > But in the case of a guy who is going to die on the best standard treatment, i don’t think it’s crazy to try unproven treatments that are only supported by anecdotal evidence. Sure, using people who are probably terminal as medical guinea pigs is practical, but I don’t know that it’s really all that ethical. The chances that he recovers under our best standard treatment seem small. But administering drugs with no reason to help, and potential side effects could make his recovery even less likely. As I was saying to gdave, what anecdotal evidence there is could be coming from treating an entirely unrelated problem, and as gdave rightly points out, the anecdotal evidence could be entirely bunk anyway. I tried reading through some medical studies, and they are all over the place, but kinda consolidating them, I _think_ he would still have around a 5-10% chance of recovery, maybe more, after being on a ventilator for over a month. So, this also has the PR problem, in that if he does recover, then suddenly Ivermectin becomes a miracle drug, and people will count on it rather than on actual medically and scientifically backed treatment. ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [September 4, 2021, 5:10pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/106 "2021-09-04T17:10:40Z")
> [@puzzlegal](#): > > But in the case of a guy who is going to die on the best standard treatment, i don’t think it’s crazy to try unproven treatments that are only supported by anecdotal evidence. It’s a nice hypothetical, but that’s the thing - we don’t know they’ll die with the best standard treatment. The probability never gets to 100%. It’s the ticking time bomb hypothetical all over again. We developed our current system for a reason - anecdotal evidence based on random guessing really doesn’t work. People were saying the same thing about taking a chance on HCQ, which at best did not help and at worst actually hurt patients. So, yeah, I’m ok with the idea of off label use and trying different things but the “well, might as well try it if there’s no other option” kind of ignores lots of options. Sherlock Holmes’ adage about eliminating the impossible is well and good but there’s a nearly infinite number of possibilities. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [September 4, 2021, 5:24pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/107 "2021-09-04T17:24:50Z")
> [@k9bfriender](#): > > Sure, using people who are probably terminal as medical guinea pigs is practical, but I don’t know that it’s really all that ethical. It’s not about “using people as guinea pigs”, it’s about attempting to help that person. I really don’t think there are ethical problems so long as the patient (or their advocate, if they aren’t capable of consent) understand the issues and consents. ---
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [September 4, 2021, 5:33pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/108 "2021-09-04T17:33:09Z")
> [@puzzlegal](#): > > New drugs, and new uses for drugs, are routinely found by observation and anecdote. Of course such uses should be studied before they become recommended standard treatment. And i think it’s dumb to take ivermectin for mild covid outside of a clinical study. But in the case of a guy who is going to die on the best standard treatment, i don’t think it’s crazy to try unproven treatments that are only supported by anecdotal evidence. This is very similar to the Hydroxychloroquine debacle, and the drug actually is very similar. There is reason to think these anti-parasitics might be effective anti-virals, they interfere with some chemical pathways that viruses use to replicate. There is a lot of _theory_ as to why these drugs might be effective anti-virals. Theories that have **consistently** failed to translate as effective clinical treatments, against HIV, against flu, against other SARS viruses. Covid is unique, but it’s not that damn unique. The fact that these anti-parasitical drugs have consistently failed as anti-viral drugs is decidedly not promising. ---
**Author:** ![puzzlegal](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puzzlegal/32/3827_2.png) [@puzzlegal](https://boards.straightdope.com/u/puzzlegal)\ **Post date:** [September 4, 2021, 5:38pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/109 "2021-09-04T17:38:28Z")
Yeah, to digress slightly, it drives me nuts that the FDA is making vaccine recommendations as if we’ve never studied any other vaccine, and they can’t possibly recommend anything but exactly a protocol that has been studied in exactly this circumstance. So they aren’t going to approve any boosters other than another dose of the same thing (because those will be the funded studies) and they didn’t consider the UK/Canadian “get first doses out quickly” protocol when vaccines were in very short supply. (End rant) ---
**Author:** ![ParallelLines](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/parallellines/32/3575_2.png) [@ParallelLines](https://boards.straightdope.com/u/ParallelLines)\ **Post date:** [September 4, 2021, 5:46pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/110 "2021-09-04T17:46:24Z")
I understand, and sympathize with those people who are willing to try anything (Ivermectin, etc) when the patient’s circumstances are desparate, I do not _agree_ with them. Which, again, seems to be similar to pretty much everyone else in the thread. But as to why they’re doing it … [https://comb.io/IEFT3B](https://comb.io/IEFT3B) [Futurama0 - Look, you want false hope or not? Only if you don’t have any real hope. All joking aside, I disagree (immensely) with the overriding the Doctor’s advice for that of a quack without admitting privileges. My biggest issue though is that actions like this lead credence to those who aren’t in desperate circumstances and/or disregard proven techniques such as vaccines and masking. Again, false hope is only acceptable if you have no ‘real’ hope. Don’t throw out the real hope for the false. ---
**Author:** ![Ziberian](https://avatars.discourse-cdn.com/v4/letter/z/919ad9/32.png) [@Ziberian](https://boards.straightdope.com/u/Ziberian)\ **Post date:** [September 4, 2021, 6:55pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/111 "2021-09-04T18:55:35Z")
> [@Chronos](#): > > Sure, it’s conceivable that maybe Ivermectin really does something, and conceivable that it might help this schlub. But the thing is, you can say that about lots of things: There’s just as much evidence that aloe vera, or kale, or rattlesnake venom is effective against covid. And any court that ordered doctors to administer rattlesnake venom would absolutely, 100% be wrong. Or maybe not 100%. Brazilian viper venom is showing some promise in the treatment of Covid. Since some snake venoms affect clotting, it’s not all that farfetched that they might be useful against a disease where clotting is a serious component. Will the next big trend among anti-vaxxers be getting a bite from a venomous snake? [https://thehill.com/policy/healthcare/public-global-health/570466-brazilian-viper-venom-shows-promise-as-drug-to-combat](https://thehill.com/policy/healthcare/public-global-health/570466-brazilian-viper-venom-shows-promise-as-drug-to-combat) ---
**Author:** ![susan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/susan/32/17537_2.png) [@susan](https://boards.straightdope.com/u/susan)\ **Post date:** [September 4, 2021, 7:07pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/112 "2021-09-04T19:07:06Z")
> Will the next big trend among anti-vaxxers be getting a bite from a venomous snake? “Signs following.” ---
**Author:** ![Kimera757](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kimera757/32/3765_2.png) [@Kimera757](https://boards.straightdope.com/u/Kimera757)\ **Post date:** [September 4, 2021, 7:30pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/113 "2021-09-04T19:30:39Z")
It gets worse. > **[A doctor's claims about ivermectin-overdose cases in Oklahoma ERs are being...](https://www.businessinsider.com/oklahomas-emergency-rooms-are-clogged-with-people-overdosing-on-ivermectin-2021-9)** > > An emergency-room doctor told a local news channel that people who overdosed on ivermectin were adding to overwhelmed hospital emergency rooms. There’s an ad wall so I’ll quote the most relevant text here: > [@](#): > > A doctor in rural Oklahoma said the number of people overdosing on the deworming medication ivermectin was so high that emergency rooms were filled to the brim. > > The situation is so dire that people with gunshot wounds have to wait their turn to get treatment, Dr. Jason McElyea, an ER physician affiliated with hospitals in Sallisaw, told KFOR, an NBC affiliate in Oklahoma City. > > McElyea spoke to the channel this week about the dangers of overdosing on the version of ivermectin meant for use in livestock. He said the hospitals he worked at became overwhelmed after people started taking ivermectin, believing unverified claims that it’s an effective COVID-19 treatment. > > “The ERs are so backed up that gunshot victims were having hard times getting to facilities where they can get definitive care and be treated,” McElyea said. > > He added: “All of their ambulances are stuck at the hospital waiting for a bed to open so they can take the patient in and they don’t have any, that’s it. If there’s no ambulance to take the call, there’s no ambulance to come to the call.” It’s not just a “hail mary” strategy, it’s actively causing harm to other patients. ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [September 4, 2021, 11:56pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/114 "2021-09-04T23:56:01Z")
> [@k9bfriender](#): > > I do wonder if there are some people with an undiagnosed case of parasites, which could be suppressing the immune system, Although that would be a theory for preventing COVID infection, does it work as a theory for curing COVID hospitalization? Are people who are in ICU people who have continuing low immune response? ---
**Author:** ![Tfletch1](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tfletch1/32/5340_2.png) [@Tfletch1](https://boards.straightdope.com/u/Tfletch1)\ **Post date:** [September 5, 2021, 12:06am UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/115 "2021-09-05T00:06:03Z")
> [@Chronos](#): > > …What’s Jane Goodall doing here? Oh jeez. I was testing the suggestion by @puzzlegal. Hey, Jane Goodall would not approve of veterinary strength ivermectin. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [September 5, 2021, 4:23pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/116 "2021-09-05T16:23:36Z")
That same article includes a statement from a hospital McElyea practiced at in Sallisaw (but supposedly hasn’t seen patients there in the past two months), noting that they haven’t treated ivermectin overdose patients, and no trauma or other emergency patients have been turned away because of overcrowding. ---
**Author:** ![Bootb](https://avatars.discourse-cdn.com/v4/letter/b/e19b73/32.png) [@Bootb](https://boards.straightdope.com/u/Bootb)\ **Post date:** [September 6, 2021, 2:09pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/117 "2021-09-06T14:09:45Z")
> [@DMC](#): > > For the record, [ivermectin is currently being studied properly](https://www.principletrial.org/news/ivermectin-to-be-investigated-as-a-possible-treatment-for-covid-19-in-oxford2019s-principle-trial) and I’m perfectly fine with doctors utilizing it if the study ends up showing positive results. The problem is that a lot of the current pro-ivermectin research is just regurgitating the original utter shit of a study that really started this thing, as eviscerated below: The general anti-vaxxers (i.e. “Vaccines cause autism”) still quote Andrew Wakefield’s study that was published in the Lancet, even though he’s long been discredited. ---
**Author:** ![k9bfriender](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/k9bfriender/32/3283_2.png) [@k9bfriender](https://boards.straightdope.com/u/k9bfriender)\ **Post date:** [September 6, 2021, 2:14pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/118 "2021-09-06T14:14:45Z")
Which, assuming it is true, does not invalidate the claims, as the doctor, as far as I can see, never said anything about that hospital. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [September 6, 2021, 2:28pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/119 "2021-09-06T14:28:08Z")
It should be easy to back up the doctor’s claims with reports from other physicians, and patients who were supposedly turned away - unless one postulates a massive area-wide coverup. ---
**Author:** ![gnoitall](https://avatars.discourse-cdn.com/v4/letter/g/bb73d2/32.png) [@gnoitall](https://boards.straightdope.com/u/gnoitall)\ **Post date:** [September 6, 2021, 3:25pm UTC](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790/120 "2021-09-06T15:25:22Z")
> [@gdave](#): > > But by that logic, we should give someone who’s sick literally every possible medicine for every condition that _could_ be weakening the immune system, on the off chance that they have _one_ of those conditions and it just hasn’t been diagnosed In other words, [![](https://i.imgflip.com/4fi8w2.png) ](https://i.imgflip.com/4fi8w2.png) [Previous page](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790.md?page=5) [Next page](https://boards.straightdope.com/t/a-no-win-situation-for-doctors/949790.md?page=7)