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Where Should We Look For Authoritative Answers?
Notice: I have no medical training whatsoever. I am probably not even a good patient. Nothing here should be taken as advice. It is intended to question authority and consider simpler answers to the Covid-19 pandemic.
There are two sides to the answer business. Strategic or theory, and practical. Each side has its own priorities and methods.
The nature of the difference
Theorists want to know why something happens and practitioners don’t care so long as their action doesn’t create new problems and the the outcomes are predictable. Theorists will sometimes settle for large double blind studies that confirm the result without knowing why it is so.
The difference arises because practitioners want answers sooner rather than righter. Practitioners will take the no harm possible benefit as acceptable. Their approach is if it works at least some of the time, harms no one and is inexpensive, let’s go.
Theorists are in the place that says if we can’t prove it works then we can’t approve it. That motivation leads them to test things that theorists might never consider. Sometimes they find things not otherwise available. In situations where not much is known, but when you need a protocol urgently, the practitioners have the advantage.
“In theory, there is no difference between theory and practice. But, in practice, there is” Johannes Lambertus Adriana van de Snepscheut
That quote is not quite accurate. In reality, theorists think there may be small differences, while practitioners think the gap is larger.
Choosing a source
Choosing practical answers relies on two factors:
- What is the cost to wait for a better answer?
- Is there something available that seems to work?
Application to Covid-19
Covid-19 is not something people have experience with from times past. That means there are no specific experts. There are people who have considerable experience and skill with viruses, but not this one. In the beginning everyone is an amateur.
Politicians needed to be seen to be doing something. Every action they could take was at best an educated guess. I find nothing wrong with that, but I have great difficulty accepting that a year and half later they are still guessing.
When there is urgency, you cannot wait for the perfect theory, the perfect study that proves it, and the perfect way to implement. Instead of looking to experts whose bias is to why something will work, they should have been looking to practitioners who have been trying things.
A perfect answer to Covid-19 three years from now is not as good as an 80% answer now. Even 50% now. We undoubtedly know far more at the 80% level now than we did, but the theorists and their media and social platform allies are behaving as if nothing is known.
There are practitioners who would disagree.. Their reasoning begins with a Friedrich Engels thought, “An ounce of action is worth a ton of theory”
We should be taking action now and developing perfection as we can do so. Ignoring what practitioners have learned is not smart. While it may prove to be less than perfect someday, in the interim lives are being lost for want of the “right” answer. Discouraging if there is a plausible alternative.
Alternatives
Suppose there is a familiar drug that seems to work against Covid-19. There are small tests that support the idea. There are no large, rigorous, scientific studies. The drug is Ivermectin.
The elite have decided to prohibit it. apparently because there is no large study. I would be fine with that if they had a reason. I do not accept the not-proven idea. We are in a situation where certainty is a luxury good.
Could prohibition make sense? It would if there were safety concerns, but there are none. The drug has been in common use for decades. Maybe it’s too expensive. A course of treatment would cost less than $50.00. Non-scientific observation shows it can have value as a preventative and possibly as a treatment. Observation is what practitioners rely on, while theorists want statistically significant proof. Observation to date puts it into the likely helps and won’t hurt category.
Are there alternatives? Remdesivir is approved for treatment in some countries and allowable as an emergency use drug in others. There seems to be no study of its use as a preventative and its efficacy in treatment is debatable. A recent study showed no significant advantage. The cost of a course of treatment is high – at least $3,000.
Why is Remdesivir approved and Ivermectin is not? Hopefully the answer is not high priced lobbyists and the profit motive.
Questions
I can appreciate the need for safety in drug application. At the same time if a drug is inexpensive, safe, and seems to work, what is the potential harm even if there is no rigorous scientific proof of efficacy?
Why are there no government studies being done to decide the question? There are some being done with private money. Does the government see political advantage to having the pandemic continue?
How many will die for want of using an imperfect answer? How many have already? Who will be responsible for that outcome?
Why have physicians been told not to use the drug? Are there factors that can reasonably override their professional judgement?
Eventually it comes down to the old detective question, “Who benefits?” There seems to be lots of power and money in the system. Would a cheap, easy to manufacture, safe alternative, hurt some of the players? Who? Vaccine makers, politicians, other drug makers, lobbyists, activists, social media platforms.
The takeaway
I can be of almost no help in deciding, but from what little I have seen and read, the current approach seems to be a loser.
In some countries, Ivermectin is prescribed upon testing positive. That seems to slow down the progress of the disease and often prevents it from becoming acute. What is the risk to do that? $50.
In countries where Ivermectin is in common use, principally in Africa, there seems to be a strong preventive effect. For its price, why would we not all use it as a preventative. Even if it reduced the severe cases and deaths by 5% the cost benefit study would be positive.
The drug requires a prescription yet doctors are not permitted to prescribe it as a preventative. Why not? Is there known evidence that supports the edict?
Maybe Ivermectin will be the next street drug. At the moment I could likely buy Fentanyl easier.
From mathematics
In 1931, Kurt Gödel shocked the mathematics world of the time with his “Incompleteness Theorem.” It establish that there are more things that are true than can be proven. Waiting for proof may take a long time. Time some of the people don’t have. The practical implication is proof would be good, but in the interim, probably helps should not be overlooked.
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